One of the important goals Euromed is striving at is to introduce Virtual Reality within the concept of Virtual Medical Worlds. This integration requires a vast amount of computing which has to be achieved by building up a meta-centre, similar to what is currently being developed in the USA through several initiatives such as the CASA Gigabit network. Euromed's collaborative network, consisting of the Universities of Calabria, Amsterdam, Joensuu and Athens and connected by the Internet, already has realised this Hierarchical Computing Facilities Infrastructure (HCFI) offering a virtual computing centre supplying heterogeneous computing platforms. At present, this meta-centre is creating complex VRML medical models to support activities such as the medical imaging requirements of the Virtual Assisted surgery. In this regard, Euromed is focusing on the ANALYZE project lead by the Mayo Clinic in San Diego to serve as a model.
Defining a Virtual Medical Worlds standard for medical imaging is not enough. The ultimate objective for practitioners is to interact with the medical models by means of surgery planning and assistance, making use of Virtual Reality techniques. This is actually happening at the Mayo Clinic in San Diego where surgeons have developed a Virtual Reality Assisted Surgery Program (VRASP) to provide support for preoperative planning, rehearsal and finally surgery deployment. Initially, the physician plans the surgical procedure, analysing prescanned data from Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) by means of interactive 3-D image rendering and analysis software called ANALYZE. This component already is actively used for craniofacial and orthopedic interventions as well as neurosurgery.
Review and rehearsal form the next step and here the VR equipment and the high-performance computer enter in line to provide the surgeon with a head-mounted display, an interactive data glove and customised interface. Researchers at the Mayo Clinic currently are evaluating this second phase basing themselves on a demonstration version. Specialised surgeons work together with experienced system analysts and programmers to develop the customised software interfaces. The third stage constitutes the actual intervention in the operating-room using the VRASP system. Both preplanned and ad hoc volumetric virtual space images are locked into world-surgeon-patient frames of reference examined by the surgeon who can manipulate the virtual image hands-free or by means of interactive input devices. Plans are being made to implement this final component of the program in two Mayo Clinic hospitals.
Accordingly to this example, Euromed investigates the existing WWW-based telemedical infrastructure of its meta-centre to offer remote computation power in order to support VRASP in a number of European hospitals. To avoid the overall latency of complex simulations, the VR interface has to be designed as a set of asynchronous interacting agents distributing the computation tasks over multiple processors. Euromed has the intention to connect the hospitals and the centralised HPC centres through a direct high speed data link. As a complementary mission, project manager Andrew Marsh envisages the promotion of surgery planning and education at remote sites through the Web. Indeed, the remote accessibility to the VR models for educational purposes is crucial in order to reduce professional isolation.