You know that hologram of a live brain that had Pepper Potts so excited in Iron Man 2? We’re not there yet, but there was some stuff at a recent medical technology meet in the US that caused almost as much of a stir.
There was a robot-supported angiography system, VR 3D models of a foetus, and automated tools that let you 3D print anatomical models — in real time — based on a specific patient’s CT, MR or X-ray images.
These new tools, unveiled at the annual summit of the Radiological Society of North America (RSNA) that began on Sunday, are helping make surgery less invasive, helping treat anomalies and congenital disorders in an unborn baby, and letting physicians simulate hard and soft tissue to better customise joint replacements, plan complex procedures and even teach and explain procedures to patients.
In the VR 3D foetus model, “the virtual reality headset allows you to see the developing foetus instead of the traditional ultrasound. You can study the 3D foetal anatomy by just moving your head,” said study co-author Heron Werner from the Clinica de Diagnostico poor Imagem in Brazil, who presented the findings at RSNA.
“Essentially, the VR tools have transformed imaging from a purely diagnostic tool into an instrument that offers clinicians an immersive experience to help them predict disease progression, plan therapies, lower risk of infection and predict treatment outcomes,” says Dr Vidur Mahajan, associate director at Mahajan Imaging, one of India’s largest medical diagnostics and imaging centres.
One of the biggest challenges for surgeons is the growing number of patients showing up for treatment with one or more chronic diseases, such as diabetes, hypertension (persistent high blood pressure), kidney disease, chronic lung disease, etc. “Such people are at higher risk of complications and death, and take longer to recover from an intervention and surgery, even if it is unrelated to the medical condition for which they are seeking treatment,” says Dr Pradeep Chowbey, chairman of surgery and allied surgical specialities at Max Healthcare, New Delhi.
Given that 200 million Indians have hypertension, 70 million have diabetes, and more than 6 million have chronic kidney disease, the threat from complications is very real.
People with chronic obstructive pulmonary disease who underwent abdominal surgery had longer hospital stays and higher rates of complication and death than otherwise healthy patients, found a study of more than 333,000 patients in the US, published in the journal Surgery, in April.
People with diabetes, a history of heart disease, blood diseases, and chronic kidney disease are also at risk of contrast-induced nephropathy from contrast material given during diagnostic imaging exams such as MRIs, CT scans and angiograms.
Innovations in imaging are making surgery safer even for very high-risk patients. The robot-supported Artis pheno angiography system optimises imaging parameters to minimise radiation, lower risk of infection and treat patients with coexisting chronic diseases such as diabetes, obesity and kidney disease, among others. It’s clinical software application produces 3D images using less contrast materials, to lower the load on kidneys, while its multi-tilt table improves manoeuvrability for improved clarity while scanning extremities and for improved precision while operating on obese patients who weigh up to 280 kg.
The image-guided system is used for interventional radiology, cardiac surgery and minimally invasive procedures. “Artis is particularly useful for minimally invasive valve replacement and complex spine surgeries, including spinal fusion procedures, using lower doses of anaesthesia, smaller incisions and more precision, all of which lower risk of complications and result in faster recovery,” says Elisabeth Staudinger-Leibrecht, president (Asia-Pacific Region) at Siemens Healthineers, makers of the system.
The system can be fitted with optional software applications for complex cases involving multiple health issues that complicate minimally-invasive procedures.
The foetal model, meanwhile, lets parents virtually watch their unborn baby grow inside the womb, through technology that uses MRI and ultrasound data. More importantly, it helps doctors better diagnose and treat a baby inside the womb.
Using a headset, physicians can listen to the baby’s heartbeat and interact with the pictured organ or tissue using devices such as VR viewers and styluses that even let them prod the virtual organs, tissue and bone, plan surgeries and even cut into virtual tissue before making a real incision.
This is just the beginning, and already the possibilities seems magical - as with the automated segmentation tools that let you use CT, MR and X-ray images to 3D print anatomical models for medical use. It may not be a holographic map of the brain, but it’s already helping surgeons plan complex heart, vascular and cancer surgeries.
“3D-printing has caught the medical world’s imagination for the leverage it has in manufacturing patient-matching medical devices, drugs and biologics,” says Dr Mahajan. In the US, a 3D-printed bioresorbable airway splint has been used to save a child’s life, a 3D-printed implant has replaced 75% of a man’s skull, and implants for knees and joints are being manufactured customised to each patient’s anatomy for comfort, optimal range of movement and longer life of the joint.
As Dr Mahajan puts it: “Any tool that improves a clinician’s understanding of diseases and their management fills a real gap, and VR imaging is doing just that.”
Just for fun, check out that scene in Iron Man 2 where Potts was wowed by the hologram of her live brain