Three-dimensional interactive and stereotactic atlas of head muscles and glands correlated with cranial nerves and surface and sectional neuroanatomy

NOWinBRAIN: a Large, Systematic, and Extendable Repository of 3D Reconstructed Images of a Living Human Brain Cum Head and Neck

Despite the tremendous development of various brain-related resources, a large, systematic, comprehensive, extendable, and beautiful repository of 3D reconstructed images of a living human brain expanded to the head and neck is not yet available. I have created such a novel repository and populated it with images derived from a 3D atlas constructed from 3/7 Tesla MRI and high-resolution CT scans. This web-based repository contains 6 galleries hierarchically organized in 444 albums and sub-albums with 5,156 images. Its original features include a systematic design in terms of multiple standard views, modes of presentation, and spatially co-registered image sequences; multi-tissue class galleries constructed from 26 primary tissue classes and 199 sub-classes; and a unique image naming syntax enabling image searching based solely on the image name. Anatomic structures are displayed in 6 standard views (anterior, left, posterior, right, superior, inferior), all views having the same brain size, and optionally with additional arbitrary views. In each view, the images are shown as sequences in three standard modes of presentation, non-parcellated unlabeled, parcellated unlabeled, and parcellated labeled. There are two types of spatially co-registered image sequences (imitating image layers and enabling animation creation), the appearance image sequence (for standard views) and the context image sequence (with a growing number of tissue classes). Color-coded neuroanatomic content makes the brain beautiful and facilitates its learning and understanding. This unique repository is freely available and easily accessible online at www.nowinbrain.org for a wide spectrum of users in medicine and beyond. Its future extensions are in progress.

Mapping the rest of the human connectome: Atlasing the spinal cord and peripheral nervous system

The emergence of diffusion, structural, and functional neuroimaging methods has enabled major multi-site efforts to map the human connectome, which has heretofore been defined as containing all neural connections in the central nervous system (CNS). However, these efforts are not structured to examine the richness and complexity of the peripheral nervous system (PNS), which arguably forms the (neglected) rest of the connectome. Despite increasing interest in an atlas of the spinal cord (SC) and PNS which is simultaneously stereotactic, interactive, electronically dissectible, scalable, population-based and deformable, little attention has thus far been devoted to this task of critical importance. Nevertheless, the atlasing of these complete neural structures is essential for neurosurgical planning, neurological localization, and for mapping those components of the human connectome located outside of the CNS. Here we recommend a modification to the definition of the human connectome to include the SC and PNS, and argue for the creation of an inclusive atlas to complement current efforts to map the brain's human connectome, to enhance clinical education, and to assist progress in neuroscience research. In addition to providing a critical overview of existing neuroimaging techniques, image processing methodologies and algorithmic advances which can be combined for the creation of a full connectome atlas, we outline a blueprint for ultimately mapping the entire human nervous system and, thereby, for filling a critical gap in our scientific knowledge of neural connectivity.

Evolution of Human Brain Atlases in Terms of Content, Applications, Functionality, and Availability

Human brain atlases have been evolving tremendously, propelled recently by brain big projects, and driven by sophisticated imaging techniques, advanced brain mapping methods, vast data, analytical strategies, and powerful computing. We overview here this evolution in four categories: content, applications, functionality, and availability, in contrast to other works limited mostly to content. Four atlas generations are distinguished: early cortical maps, print stereotactic atlases, early digital atlases, and advanced brain atlas platforms, and 5 avenues in electronic atlases spanning the last two generations. Content-wise, new electronic atlases are categorized into eight groups considering their scope, parcellation, modality, plurality, scale, ethnicity, abnormality, and a mixture of them. Atlas content developments in these groups are heading in 23 various directions. Application-wise, we overview atlases in neuroeducation, research, and clinics, including stereotactic and functional neurosurgery, neuroradiology, neurology, and stroke. Functionality-wise, tools and functionalities are addressed for atlas creation, navigation, individualization, enabling operations, and application-specific. Availability is discussed in media and platforms, ranging from mobile solutions to leading-edge supercomputers, with three accessibility levels. The major application-wise shift has been from research to clinical practice, particularly in stereotactic and functional neurosurgery, although clinical applications are still lagging behind the atlas content progress. Atlas functionality also has been relatively neglected until recently, as the management of brain data explosion requires powerful tools. We suggest that the future human brain atlas-related research and development activities shall be founded on and benefit from a standard framework containing the core virtual brain model cum the brain atlas platform general architecture.

Portable Document Format File Containing the Schematics and Operable Surface Models of the Head Structures

BACKGROUND

A book entitled "Visually Memorable Regional Anatomy (VMRA)" consists of extremely schematic figures as well as concise anatomic knowledge. On the other hand, in the Visible Korean (VK) project, three-dimensional surface models of 297 head structures have been reconstructed. The study's objective was to verify how the coexistence of the schematic figures and realistic surface models affected anatomy learning.

METHODS

In the portable document format (PDF) file of VMRA, 19 pages of the surface models of the head from the PDF file of VK were embedded. The resultant PDF file was utilized as a learning tool of the medical students in two universities.

RESULTS

The PDF file could be downloaded free of charge from anatomy.co.kr. The PDF file has been accessed by users from multiple countries including Korea, United States, and Hungary. In the PDF file, the surface models could be selected in any combinations, magnified, freely rotated, and compared to the corresponding schematics. The number of hours that the PDF file was used by medical students and the scores of written examination on the PDF file showed a low positive correlation in a university. The students replied that the combined PDF file was helpful for understanding anatomy and for doing cadaver dissection. They were also satisfied with the convenience of comparing the surface models and schematics.

CONCLUSION

The freely obtainable PDF file would be a beneficial tool to help students learn anatomy easily, interactively, and accurately.

Human brain atlasing: past, present and future

We have recently witnessed an explosion of large-scale initiatives and projects addressing mapping, modeling, simulation and atlasing of the human brain, including the BRAIN Initiative, the Human Brain Project, the Human Connectome Project (HCP), the Big Brain, the Blue Brain Project, the Allen Brain Atlas, the Brainnetome, among others. Besides these large and international initiatives, there are numerous mid-size and small brain atlas-related projects. My contribution to these global efforts has been to create adult human brain atlases in health and disease, and to develop atlas-based applications. For over two decades with my R&D lab I developed 35 brain atlases, licensed to 67 companies and made available in about 100 countries. This paper has two objectives. First, it provides an overview of the state of the art in brain atlasing. Second, as it is already 20 years from the release of our first brain atlas, I summarise my past and present efforts, share my experience in atlas creation, validation and commercialisation, compare with the state of the art, and propose future directions.

Three-dimensional stereotactic atlas of the extracranial vasculature correlated with the intracranial vasculature, cranial nerves, skull and muscles

Our objective was to construct a 3D, interactive, and reference atlas of the extracranial vasculature spatially correlated with the intracranial blood vessels, cranial nerves, skull, glands, and head muscles.The atlas has been constructed from multiple 3T and 7T magnetic resonance angiogram (MRA) brain scans, and 3T phase contrast and inflow MRA neck scans of the same specimen in the following steps: vessel extraction from the scans, building 3D tubular models of the vessels, spatial registration of the extra- and intracranial vessels, vessel editing, vessel naming and color-coding, vessel simplification, and atlas validation.This new atlas contains 48 names of the extracranial vessels (25 arterial and 23 venous) and it has been integrated with the existing brain atlas.The atlas is valuable for medical students and residents to easily get familiarized with the extracranial vasculature with a few clicks; is useful for educators to prepare teaching materials; and potentially can serve as a reference in the diagnosis of vascular disease and treatment, including craniomaxillofacial surgeries and radiologic interventions of the face and neck.

Toward the holistic, reference, and extendable atlas of the human brain, head, and neck

Despite numerous efforts, a fairly complete (holistic) anatomical model of the whole, normal, adult human brain, which is required as the reference in brain studies and clinical applications, has not yet been constructed. Our ultimate objective is to build this kind of atlas from advanced in vivo imaging. This work presents the taxonomy of our currently developed brain atlases and addresses the design, content, functionality, and current results in the holistic atlas development as well as atlas usefulness and future directions. We have developed to date 35 commercial brain atlases (along with numerous research prototypes), licensed to 63 companies and institutions, and made available to medical societies, organizations, medical schools, and individuals. These atlases have been applied in education, research, and clinical applications. Hundreds of thousands of patients have been treated by using our atlases. Based on this experience, the first version of the holistic and reference atlas of the brain, head, and neck has been developed and made available. The atlas has been created from multispectral 3 and 7 Tesla and high-resolution CT in vivo scans. It is fully 3D, scalable, interactive, and highly detailed with about 3,000 labeled components. This atlas forms a foundation for the development of a multi-level molecular, cellular, anatomical, physiological, and behavioral brain atlas platform.

Three-dimensional stereotactic atlas of the adult human skull correlated with the brain, cranial nerves, and intracranial vasculature

BACKGROUND

Although the adult human skull is a complex and multifunctional structure, its 3D, complete, realistic, and stereotactic atlas has not yet been created. This work addresses the construction of a 3D interactive atlas of the adult human skull spatially correlated with the brain, cranial nerves, and intracranial vasculature.

NEW METHOD

The process of atlas construction included computed tomography (CT) high-resolution scan acquisition, skull extraction, skull parcellation, 3D disarticulated bone surface modeling, 3D model simplification, brain-skull registration, 3D surface editing, 3D surface naming and color-coding, integration of the CT-derived 3D bony models with the existing brain atlas, and validation.

RESULTS

The virtual skull model created is complete with all 29 bones, including the auditory ossicles (being among the smallest bones). It contains all typical bony features and landmarks.

COMPARISON WITH EXISTING METHOD(S)

The created skull model is superior to the existing skull models in terms of completeness, realism, and integration with the brain along with blood vessels and cranial nerves.

CONCLUSIONS

This skull atlas is valuable for medical students and residents to easily get familiarized with the skull and surrounding anatomy with a few clicks. The atlas is also useful for educators to prepare teaching materials. It may potentially serve as a reference aid in the reading and operating rooms.

Three-dimensional interactive atlas of cranial nerve-related disorders

Anatomical knowledge of the cranial nerves (CN) is fundamental in education, research and clinical practice. Moreover, understanding CN-related pathology with underlying neuroanatomy and the resulting neurological deficits is of vital importance. To facilitate CN knowledge anatomy and pathology understanding, we created an atlas of CN-related disorders, which is a three-dimensional (3D) interactive tool correlating CN pathology with the underlying surface and sectional neuroanatomy as well as the resulting neurological deficits. A computer platform was developed with: 1) anatomy browser along with the normal brain atlas (built earlier); 2) simulator of CN lesions; 3) tools to label CN-related pathology; and 4) CN pathology database with lesions and disorders, and the resulting signs, symptoms and/or syndromes. The normal neuroanatomy comprises about 2,300 3D components subdivided into modules. Cranial nerves contain more than 600 components: all 12 pairs of cranial nerves (CN I - CN XII) and the brainstem CN nuclei. The CN pathology database was populated with 36 lesions compiled from clinical textbooks. The initial view of each disorder was preset in terms of lesion location and size, surrounding surface and sectional neuroanatomy, and disorder and neuroanatomy labeling. Moreover, path selection from a CN nucleus to a targeted organ further enhances pathology-anatomy relationships. This atlas of CN-related disorders is potentially useful to a wide variety of users ranging from medical students and residents to general practitioners, neuroradiologists and neurologists, as it contains both normal brain anatomy and CN-related pathology correlated with neurological disorders presented in a visual and interactive way.

Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders

Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way.