Real-Color Volume Models Made from Real-Color Sectioned Images of Visible Korean

Ultrasonographic images and correspondence with real color sectioned images of the upper limb

PURPOSE

For basic training in ultrasonography (US), medical students and residents must learn cross-sectional anatomy. However, the present educational material is not sufficient to learn the sectional anatomy for US. This study aimed to provide a criterion for reading ambiguous structures on US images of upper limb through the sectioned images of Visible Korean.

METHODS

US images of the right arm of a volunteer were scanned (28 planes). For comparison with US images, the sectioned images of the right upper limb (24 bits color, 0.5 mm intervals, 0.06 mm × 0.06 mm sized pixel) were used. After the volume model was constructed from the sectioned images using MRIcroGL, new sectioned images of 28 planes corresponding to the US images of 28 planes were created by adjusting the slope of the volume model. In all images, the anatomical terms of 59 structures from the shoulder to the fingers were annotated.

RESULTS

In the atlas, which consists of 28 sets of US images and sectioned images of various slope planes, 59 structures of the shoulder, arm, elbow, wrist, palm, and fingers were observed in detail.

CONCLUSION

We were able to interpret the ambiguous structures on the US images using the sectioned images with high resolution and actual color. Therefore, to learn the cross-sectional anatomy for US, the sectioned images from the Visible Korean project were deemed to be the suitable data because they contained all human gross anatomical information.

Visible Korean based on true color sectioned images for making realistic digital human, twenty years' record: a review

PURPOSE

Visible Korean (VK) consists of two-dimensional (2D) images and three-dimensional (3D) models. The VK is used in various educational tools and research sources for anatomy. In this paper, we report on the records of the VK over 20 years.

METHODS

Research papers related to Visible Korean were reviewed.

RESULTS

Through this report of VK records, we highlighted the essential points for making true color and ultra-high-resolution sectioned images of human and animal bodies, for making various 2D and 3D applications from the sectioned images, and for good use of the sectioned images and their applications.

CONCLUSION

In this metaverse age that various virtual environments are required in medical education and research, the VK dataset meets the reality of virtual human models as fundamental data owing to the actual color and high resolution of the VK dataset.

Lymph Node Stations of Pancreas Which Are Identified in Real Color Sectioned Images of a Cadaver With Pancreatic Cancer

BACKGROUND

In pancreatic cancer surgery, anatomical understanding of lymph node metastases is required. Distinguishing lymph nodes in computed tomography or magnetic resonance imaging is challenging for novice doctors and medical students because of their small size and similar color to surrounding tissues. This study aimed to enhance our understanding of the clinical anatomy of lymph node stations relevant to pancreatic cancer using newly sectioned images of a cadaver with true color and high resolution and their three-dimensional (3D) models.

METHODS

An 88-year-old female cadaver who died of pancreatic cancer was serially sectioned. Among the sectioned images of the whole body (0.05 mm-sized pixel, 48 bits color), images of the abdomen were selected, and examined to identify lymph nodes and nearby structures. 34 structures (9 in digestive system; 1 in urinary system; 2 in cardiovascular system; 22 in lymphatic system) were segmented on the sectioned images. Based on the sectioned and segmented images, volume and surface models were produced.

RESULTS

Among the known 28 lymph node stations, 21 stations were identified through location, size, and color of normal and abnormal structures in the sectioned images and 3D models. Two near the splenic artery could not be separated from the cancer tissue, and the remaining five were not clearly identified. In the surface models, the shape and location of lymph node stations could be confirmed with nearby structures.

CONCLUSION

The lymph node stations relevant to pancreatic cancer can be anatomically understood by using the sectioned images and 3D models which contain true color and high resolution.

A Novel Human Brainstem Map Based on True-Color Sectioned Images

BACKGROUND

Existing atlases for the human brainstem were generated from magnetic resonance images or traditional histologically stained slides, but both are insufficient for the identification of detailed brainstem structures at uniform intervals.

METHODS

A total of 319 sectioned images of the brainstem were selected from whole-body axial sectioned images, then coronal and sagittal sectioned images were reconstructed from the horizontal images. The fine and detailed structures were annotated in PowerPoint slides, then the volume model was produced and some white matter fibers were traced using MRIcroGL.

RESULTS

In this study, a novel brainstem atlas based on sectioned images was generated that shows the true color and shape, as well as the accurate location of the nuclei and tracts; it reveals the striking contrast between gray and white matter, as well as fine structures. In total, 212 structures, including nuclei and tracts, were annotated in axial, coronal, and sagittal plane views of sectioned images (48-bit true color; 0.2 mm intervals, 0.06 mm × 0.06 mm pixel size). To verify the accuracy of the annotations, a volume model of the brainstem was constructed for independent observations of the three planes.

CONCLUSION

In this paper, we describe several interesting structures included in the atlas. By depicting the fine structures of the human brainstem in detail, this atlas allows comprehensive understanding of the complicated topographies of the brainstem. As such, it will be of value for neuroanatomy education and research, in addition to enriching the literature on the human brain.

Identification of cranial nerve ganglia using sectioned images and three-dimensional models of a cadaver

Background

Cranial nerve ganglia, which are prone to viral infections and tumors, are located deep in the head, so their detailed anatomy is difficult to understand using conventional cadaver dissection. For locating the small ganglia in medical images, their sectional anatomy should be learned by medical students and doctors. The purpose of this study is to elucidate cranial ganglia anatomy using sectioned images and three-dimensional (3D) models of a cadaver.

Methods

One thousand two hundred and forty-six sectioned images of a male cadaver were examined to identify the cranial nerve ganglia. Using the real color sectioned images, real color volume model having a voxel size of 0.4 × 0.4 × 0.4 mm was produced.

Results

The sectioned images and 3D models can be downloaded for free from a webpage, anatomy.dongguk.ac.kr/ganglia. On the images and model, all the cranial nerve ganglia and their whole course were identified. In case of the facial nerve, the geniculate, pterygopalatine, and submandibular ganglia were clearly identified. In case of the glossopharyngeal nerve, the superior, inferior, and otic ganglia were found. Thanks to the high resolution and real color of the sectioned images and volume models, detailed observation of the ganglia was possible. Since the volume models can be cut both in orthogonal planes and oblique planes, advanced sectional anatomy of the ganglia can be explained concretely.

Conclusions

The sectioned images and 3D models will be helpful resources for understanding cranial nerve ganglia anatomy, for performing related surgical procedures.

Gray Matter Volume Abnormality in Chronic Pain Patients With Depressive Symptoms: A Systemic Review and Meta-Analysis of Voxel-Based Morphometry Studies

Background

Gray matter volume (GMV) alteration in specific brain regions has been widely regarded as one of the most important neuroplasticity features in chronic pain patients with depressive symptoms (CP-D). However, the consistent and significant results were still lacking. Thus, further exploration was suggested to be performed.

Objectives

This study aimed to comprehensively collect the voxel-based morphometry (VBM) studies on GMV alteration between CP-D and healthy controls (HCs). And a systemic review and meta-analysis were made to explore the characteristic brain regions in chronic pain and depression comorbidity.

Methods

Search of PubMed, MEDLINE, Web of Science, and Cochrane Library databases updated to July 13, 2021. The altered GMV between CP-D and HCs in VBM studies was included in this meta-analysis. In total, 18 studies (20 datasets) and 1320 participants (520 patients and 800 HCs) were included. The significant coordinate information (x, y, z) reported in standard space and the effect size (t-value or z-score) were extracted and analyzed by anisotropic effect size-signed differential mapping (AES-SDM) 5.15 software.

Results

According to the main analysis results, CP-D showed significant and consistent increased GMV in the left hippocampus (HIP. L) and decreased GMV in the medial part of the left superior frontal gyrus (SFG. L, BA 10) compared to HCs. Subgroup analysis showed significant decreased GMV in the medial orbital part of SFG.R (BA 10) in neuropathic pain, as well as significant increased GMV in the right parahippocampal gyrus (PHG.R, BA 35), left hippocampus (HIP.L, BA 20), and right middle frontal gyrus (MFG.R) in musculoskeletal pain. Furthermore, meta-regression showed a positive relationship between the decreased GMV in the medial part of SFG.L and the percentage of female patients.

Conclusion

GMV abnormality in specific brain areas (e.g., HIP.L and SFG) was robust and reproducible, which could be significantly involved in this comorbidity disease. The findings in this study may be a valuable reference for future research.

Systematic Review Registration

[www.crd.york.ac.uk/prospero/].

Advanced-sectioned images obtained by microsectioning of the entire male body

Realistic two-dimensional (2D) and three-dimensional (3D) applications for anatomical studies are being developed from true-colored sectioned images. We generated advanced-sectioned images of the entire male body and verified that anatomical structures of both normal and abnormal shapes could be visualized in them. The cadaver was serially sectioned at constant intervals using a cryomacrotome. The sectioned surfaces were photographed using a digital camera to generate horizontal advanced-sectioned images in which normal and abnormal structures were classified. Advanced-sectioned images of the entire male body were generated. The image resolution was 3.3 × 3.3 fold better than that of the first sectioned images obtained in 2002. In the advanced-sectioned images, normal and abnormal structures ranging from microscopic (≥0.06 mm × 0.06 mm; pixel size) to macroscopic (≤473.1 mm × 202 mm; body size) could be identified. Furthermore, the real shapes and actual sites of lung cancer and lymph node enlargement were ascertained in them. Such images will be useful because of their true color and high resolution in digital 2D and 3D applications for gross anatomy and clinical anatomy. In future, we plan to generate new advanced-sectioned images of abnormal cadavers with different diseases for clinical anatomy studies.

Real color volume model of cadaver for learning cardiac computed tomographs and echocardiographs

PURPOSE

It is difficult for medical students and novice clinicians to interpret cardiac computed tomographs and echocardiographs. This study was intended to help familiarize them with the clinical images of the heart by providing software to browse the various planes of a heart's volume model with real color and high resolution.

METHODS

On the sectioned images of a male cadaver, the heart and adjacent structures were segmented to obtain color-filled images. Volume models of the sectioned images and color-filled images were reconstructed and sectioned to obtain three orthogonal planes and five standard oblique planes. The planes were inputted into lab-made browsing software, which was then distributed free of charge.

RESULTS

Users of the software would hopefully progress as follows. After experiencing the real color and high resolution, they would become familiar with the grayscale and low resolution. After experiencing the automatic annotation of the basic heart structures, they would become familiar with the detailed structures. After experiencing the designated planes, they would become familiar with the arbitrary planes. After experiencing the still heart, they would become familiar with the moving heart during echocardiography.

CONCLUSION

The software, with a user-friendly interface and realistic features, is expected to properly orient medical novices to cardiac computed tomography and echocardiography images.

Web-based imaging viewer for real-color volumetric reconstruction of human visible project and DICOM datasets

Anatomy remains a cornerstone of medical education. It is vital that students achieve a robust understanding of the spatial relationships between anatomical structures in three dimensions. Volumetric medical imaging studies and true-color cryosectional three-dimensional images of visible human datasets are useful for enhancing anatomy education. However, the software systems available for viewing these datasets have important limitations. A web-based application called Mulrecon Color, which can overcome a number of those limitations, is introduced. Mulrecon Color enables volumetric medical and full color cryosectional datasets to be explored without requiring installation, and can therefore be used on a broad range of desktop, mobile, and even virtual reality devices. The web-based application has an interface that resembles a DICOM viewer used in radiological practice, and can be used both in anatomical labs and off campus for self-study. The Mulrecon Color application is released as an open source tool. It can be retrieved at a project website where sample datasets are also available.

Automatic segmentation of true color sectioned images using FMRIB Software Library: First trial in brain, gray matter, and white matter

Three-dimensional (3D) models of the brain made from magnetic resonance images (MRI) are used in various medical fields. 3D models assembled from grayscale color and low-resolution can be complemented with true color sectioned images of the Visible Korean. The purpose of this study is to apply the MRI automatic segmentation technique to the sectioned images. 3D models of the sectioned images, which have true color and high resolution, can be produced without manual segmentation. The Brain Extraction Tool and the Automated Segmentation Tool of the FMRIB Software Library (FSL) were chosen for automatic segmentation. Using those tools, true color sectioned images were reconstructed from gray 3D models of brain, gray matter, and white matter. Color 3D models of those structures were generated from the gray 3D models using MRIcroGL. The color 3D models made from the sectioned images revealed details of brain anatomy that could not be observed on the 3D models from MRI. This trial suggests that convergence of the MRI segmentation technique with color sectioned images is a time-efficient method for producing color 3D models of various structures. In future, the method of this study will be used for various sectioned images of cadavers. The resulting color sectioned images and 3D models will be made available to other researchers.

Sectioned and segmented images of the male whole body, female whole body, male head, and female pelvis from the Visible Korean

In the Visible Korean, serially sectioned images with real color and high resolution have been prepared from four cadaveric subjects: male whole body, female whole body, male head, and female pelvis. Recently, segmented images of the female whole body were manufactured, permitting the distribution of the complete four data sets. The purpose of this report was to promote the applications of sectioned and segmented images from the Visible Korean by announcing them. Reduced image data were loaded to self-developed browsing software; using the browsing software, the contents could be quickly grasped and evaluated by other investigators. The four data sets were compared to disclose the individual merits and demerits. The sectioned and segmented images showed the possibility to be used to reconstruct the stereoscopic volume and surface models of body structures. The Visible Korean is expected to contribute to the interactive simulation of medical learning and clinical practice.

Peeled images and sectioned images from real-color volume models of foot

PURPOSE

In all educational materials, the foot cannot be peeled from skin to the bone at constant intervals, like as real dissection. The aim of this study was to produce the peeled images which the foot structures can be peeled gradually along a skin-curved surface in real color, like a real dissection. In addition, the sectioned images of typical and atypical planes are presented in real color and high resolution.

METHODS

From the sectioned images of real color, foot volume models were made using Photoshop, Matlab, and MRIcroGL. Peeled images and sectioned images of the typical planes were produced from the volume models. All images were placed into the browsing software. An atypical plane could be shown in a real-time using the volume models of the foot.

RESULTS

Using the peeled images, in which the foot can be rotated at 5-degree intervals and stripped gradually at 0-30 mm depth, the foot anatomy could be learned precisely and efficiently. The sectional anatomy of the foot for radiology and orthopedic surgery could also be learned easily using the sectioned images of typical (horizontal, coronal, and sagittal) and atypical planes.

CONCLUSION

The most significant merit of the volume models is that all outcomes can be displayed with proper colors of the body structures on any plane. By virtue of these merits, the volume models are useful for learning medical education, research, and clinical practice.

Analyzing the advantages of subcutaneous over transcutaneous electrical stimulation for activating brainwaves

Transcranial electrical stimulation (TES) is a widely accepted neuromodulation modality for treating brain disorders. However, its clinical efficacy is fundamentally limited due to the current shunting effect of the scalp and safety issues. A newer electrical stimulation technique called subcutaneous electrical stimulation (SES) promises to overcome the limitations of TES by applying currents directly at the site of the disorder through the skull. While SES seems promising, the electrophysiological effect of SES compared to TES is still unknown, thus limiting its broader application. Here we comprehensively analyze the SES and TES to demonstrate the effectiveness and advantages of SES. Beagles were bilaterally implanted with subdural strips for intracranial electroencephalography and electric field recording. For the intracerebral electric field prediction, we designed a 3D electromagnetic simulation framework and simulated TES and SES. In the beagle model, SES induces three to four-fold larger cerebral electric fields compared to TES, and significant changes in power ratio of brainwaves were observed only in SES. Our prediction framework suggests that the field penetration of SES would be several-fold larger than TES in human brains. These results demonstrate that the SES would significantly enhance the neuromodulatory effects compared to conventional TES and overcome the TES limitations.

Dawn of the Visible Monkey: Segmentation of the Rhesus Monkey for 2D and 3D Applications

BACKGROUND

To properly utilize the sectioned images in a Visible Monkey dataset, it is essential to segment the images into distinct structures. This segmentation allows the sectioned images to be compiled into two-dimensional or three-dimensional software packages to facilitate anatomy and radiology education, and allows them to be used in experiments involving electromagnetic radiation. The purpose of the present study was to demonstrate the potential of the sectioned images using the segmented images.

METHODS

Using sectioned images of a monkey's entire body, 167 structures were segmented using Adobe Photoshop. The segmented images and sectioned images were packaged into the browsing software. Surface models were made from the segmented images using Mimics. Volume models were made from the sectioned images and segmented images using MRIcroGL.

RESULTS

In total, 839 segmented images of 167 structures in the entire body of a monkey were produced at 0.5-mm intervals (pixel size, 0.024 mm; resolution, 8,688 × 5,792; color depth, 24-bit color; BMP format). Using the browsing software, the sectioned images and segmented images were able to be observed continuously and magnified along with the names of the structures. The surface models of PDF file were able to be handled freely using Adobe Reader. In the surface models, the space information of all segmented structures was able to be identified using Sim4Life. On MRIcroGL, the volume model was able to be browsed and sectioned at any angle with real color.

CONCLUSION

Browsing software, surface models, and volume models are able to be produced based on the segmentation of the sectioned images. These will be helpful for students and researchers studying monkey anatomy and radiology, as well as for biophysicists examining the effects of electromagnetic radiation.

Effects of Reading a Free Electronic Book on Regional Anatomy with Schematics and Mnemonics on Student Learning

BACKGROUND

To help medical students learn anatomy effectively in limited hours, a regional anatomy book enhancing students' memorization was developed.

METHODS

Only anatomical terms essential for basic cadaver dissection are included along with schematic figures which enable memorization of complicated anatomical structures. Learning comics and comic strips that depict anatomy mnemonics and jokes were appended and sentences were written to be comfortably readable. The electronic book titled "Visually Memorable Regional Anatomy" has been distributed without payment or registration. With the help of 246 volunteer students from three Korean medical schools, the book's learning effects were evaluated.

RESULTS

These students' book reading led to increase in their anatomy scores, including written examination scores and tag examination scores. It was an encouraging result that almost 20% of students spontaneously read the book no matter who presented their lecture or examination. A webpage version of the book was visited by thousands of users.

CONCLUSION

The book with unique features may suggest a new perspective in the field of anatomy learning. After having acquaintance with essential structures from reading the book, students are able to and willing to study more from other resources.

Advanced Sectioned Images of a Cadaver Head with Voxel Size of 0.04 mm

BACKGROUND

The sectioned images of a cadaver head made from the Visible Korean project have been used for research and educational purposes. However, the image resolution is insufficient to observe detailed structures suitable for experts. In this study, advanced sectioned images with higher resolution were produced for the identification of more detailed structures.

METHODS

The head of a donated female cadaver was scanned for 3 Tesla magnetic resonance images and diffusion tensor images (DTIs). After the head was frozen, the head was sectioned serially at 0.04-mm intervals and photographed repeatedly using a digital camera.

RESULTS

On the resulting 4,000 sectioned images (intervals and pixel size, 0.04 mm³; color depth, 48 bits color; a file size, 288 Mbytes), minute brain structures, which can be observed not on previous sectioned images but on microscopic slides, were observed. The voxel size of this study (0.04 mm³) was very minute compared to our previous study (0.1 mm³; resolution, 4,368 × 2,912) and Visible Human Project of the USA (0.33 mm³; resolution, 2,048 × 2,048). Furthermore, the sectioned images were combined with tractography of the DTIs to elucidate the white matter with high resolution and the actual color of the tissue.

CONCLUSION

The sectioned images will be used for diverse research, including the applications for the cross sectional anatomy and three-dimensional models for virtual experiments.