Professor Richard Robb, director of the Biomedical Imaging Resource (BIR) at Mayo Clinic in Rochester, Minnesota, was a noticeable guest at the first ITIS Conference. Virtual Reality, medical imaging, and their applications constitute no less than a religion to this man, who confesses to have been all his life a die hard "Star Trek" fan, absolutely devoted to the skills of "Bones McCoy", the surgeon of the Star Trek Enterprise. Nevertheless, his medical experiences are fully bathed in the every day practice of fascinating and innovative visualisation techniques. This talented speaker effortlessly enticed his audience into a world where myth and reality self-evidently are shaking hands.
Rochester is a rather small community of 75.000 people. Mayo Clinic employs 20.000 of them and disposes of a staff of 1200 physicians and scientists. The teaching facilities take an important part in the Mayo activities as equally does the scientific research. The hospital counts about 400.000 patient registrations each year and is specialised in multimodality imaging through a wide range of scanning devices. Imaging most simply can be defined as the mapping of objects in order to visualise them by means of registration and segmentation.
Dr. Robb refers to segmentation as the Holy Grail and to visualisation as the pious pillar of medical imaging, since the various methods still remain a largely illusive goal. The results of surface and volume rendering however are little by little being improved. Scientists at Mayo use the Visible Human Dataset (VHD) of the National Library of Medicine (NLM) to perform the complex registration, segmentation and visualisation techniques for virtual image manipulation and endoscopic fly throughs. Additionally, virtual environments are created by means of patient specific anatomic models. All this knowhow has been implemented in an integrated software package, called ANALYZE, which has been made available to the world for about ten years now.
Virtual Reality (VR) as a next step can be understood as the I≥ triangle, the three multiplying exponents being immersion, interaction and imagination. At this point, Dr. Robb is getting philosophical as he supports Karl Popper in his saying: "I hold it to be morally wrong not to believe in reality". He prefers to consider VR as a matter of enhanced reality instead of simulation. His own VR definition refers to "an advanced human-computer interface that allows for highly interactive visualisation and computer generated control over a 3D scene of sufficient detail so as to evoke a sensorial response similar to a real experience".
In and outside the Mayo Clinic, VR already is being applied in various cases of pre-operative planning via the famous Virtual Reality Assisted Surgery Programme, known as VRASP. Soon, VR techniques will be moved into the operating theatre for real time use during surgical intervention. Virtual Medical Worlds Magazine extensively has reported on the techniques of visualisation and endoscopy, the software package ANALYZE, and the surgical programme VRASP as introduced by Dr. Robb and his team at the Mayo Clinic. You really should meet this Parsifal of Virtual Reality in our April issue.