Expert Talk: Cinematic Anatomy in Lectures

So welcome to our today's expert talk for cinematic anatomy. Cinematic Anatomy is an immersive application which got designed for anatomy education. My name is Andrea Boelke and I'm the product manager of this education solution. Before we go into this talk some housekeeping rules. As already said, I need to ask you to leave your camera and microphone deactivated during the whole talk, since we want to record the session. Your questions you can ask why are the chat this is this little sign here. And I really want to encourage you to use this opportunity also already doing the talks, because this expert talk shall be an exchange and we are looking forward to your questions. And one more thing to announce, we prepared a little questionnaire which we will share also through the chat later on. You just need to invest 2 minutes, but your feedback would be really appreciated. Any questions in regard to these rules so far? Let me look at the chat. So I hope not and then yeah, great. Let me introduce you to our today's guest speakers. In collaboration with Professor Felner and Professor Schultz, we developed cinematic anatomy. They are both not only The Pioneers in working with cinematic anatomy, but also two of the visionary drivers to realize such a vital anatomy concept. Professor fella is head of radiology and Dean of the medical faculty in Linz, Austria, and Professor Schultz teaches anatomy here in our Langen at the university in Germany. This is also where Fabian is studying medicine. Just this month, he switched as a visiting researcher to Stanford. So for him, it's really right early now. Together with me, these are your hosts for today. And now, just one glance at the agenda. After a very short intro, you will see how you could work with the application. Then Professor Schultz will share how cinematic anatomy contributes to his lectures here in Erlangen. Afterwards we will see the very special setup of cinematic anatomy in the mat space in Linz, and then I will summarize from these scenarios how they could scale to your needs. A set. We will answer some questions in between, but also reserved some time at the end. And yeah, now let's get started. What are the challenges you are facing in anatomy education? I listed here just some of the aspects we learned from your from you and in our project discussions, there's a vision and need for digitalization and more efficient learning. Also, you want to prepare your students already for working with radiological images, right? And the dissection classes are not only expensive but also limited in the way how they can, yeah. Complete the Knowledge acquisition besides what you get from anatomy books. So I'm sure this is even uh, I'm sure you see even more challenges, uh. And please tell us also about what you see, uh, in this survey. We think we can help you overcome these challenges with cinematic anatomy and you will see today different scenarios how. I assume that you know already. Cinematic Anatomy provides photorealistic visualizations of DICOM, CT and MRI images based on cinematic rendering. And sorry, this was too fast. But why is photorealism important? Our brain is trained to interpret light, shadow and ambient occlusion. To reconstruct this and shape. Look at the left image here. You have a completely different perception of this just because of the shadow. So for the clinical image, this means the distance of the vessel Jawbone is much easier to detect with cinematic rendering compared to normal volume rendering. The image on the on the right side refers to ambient occlusion, so you will see a much more impressive demonstration of the brain and professor Professor Felner talk later on. Cinematic rendering is a patented algorithm. And it's based on the Monte Carlo method. Monte Carlo Ray tracing renders. A 3D scene by randomly tracing samples of possible light passes, as you see here. And these possible passes of any pixel we simulate with cinematic rendering not only once, but up to 1000 photon paths per pixel. And as a result you see this photorealistic visualization of structures with a real depth and form perception. But enough theory now, time for the demonstration. And uh, with this I would like to hand over to Fabian. And um, yeah, I think if there's no questions so far, we. Right. Switch to Fabians application demonstration. Thank you. Yeah. Thank you for this very nice introduction. And hello also from my side. Yeah, as I've been introduced, my name is Fabian Eckler. I'm a medical student in Erlang and also a researcher at the Institute of Anatomy with Professor Schultz. And now I'm a visiting researcher in Stanford. And in the next few minutes, I would like to share, yeah. How quickly and easily you can already get started with your own cases and get very nice cinematic renderings all by yourself. So this is the main view of our application. We've got a case browser here where you can drop in all of your raw DICOM files that you can just simply import with a big button down here. So for example, if you would like to import something, I've got some Mris here. I could import them easily just by clicking and dragging them here. I've already imported a case that I want to show you today, so if we just double click on it, it's opened up directly in the cinematic rendering view. So there has no preprocessing been done whatsoever. It's really just data that's coming right off the scanner. And as you can see in the middle we have to speak cinematic rendering window and can fully and free dimensionally interact with the image. And it's always live updated to the current vantage point and takes about depending on your machine 2 to 3 seconds to get full image clarity. And yeah to simulate all of those light paths that Mrs Burger has mentioned right now. So for every voxel in here. Yeah, simulate a lot of different combinations of those paths. And this is allowing, like in modern games or in the film industry, just cinematic appearance. So um, as you can see this is the trauma case and in the next few minutes I just wanted to show you some of the tools you can use to really explore the anatomy. So as we are right here, you can directly see this transfer function as we call it is very nice for smooth tissue contrasts or the breasts, the abdominal muscles and also the cervical muscles. We've also got a lot of different other presets, um, that we've grouped into anatomical categories, but there are unlimited to it. So it's really just recommendations. You can also directly start with using one of those heat transfer functions, for example, that are a bit more crazy in a way in this context and can experiment with the different looks these functions provide. So it's probably just stick with this one for now. This is quite similar to the one we've seen. Before. We can also use windowing like in radiology radiological images to, yeah, select which voxels are visible and which are not. And thereby can essentially easily dissect this 3D data set. I can already see some pathological findings on this image right here. Yeah, which might be interesting to discuss with your students in a lecture or in seminars. So if we now further try to explore this data set. You can see it. That windowing, we can get some level of tissue dissection, but obviously cannot get rid of everything. For example, if you want to get, yeah, open for economy or get access to the chest cavity, would probably need to cut in here and that's where the clip plans come into play. Those are essentially. Plans that we can place in any possible. Orientation that can flip into the data set so you can essentially have an open cut plane and look right into the chest cavity. Now this is taking two to three seconds and now you can see the image quality has already improved. But as it's dealing with real light rays, essentially this technique. Lighting is also important and now comes here into play. So as you can see if we want to illuminate the pulmonary arteries and veins, those are a bit dark in here. So maybe we just change the lighting setting to one of those stronger lights that illuminate the entire data set from the front. And as you can see now there really start popping out and yeah, helped us to eliminate those harder to access structures. So for example, now we have a. Nice image of the. Abdominal arterial supply and we think, OK, this, this is a nice image. We like this so far. We would like to save this somehow and show it to our students. And this is where we introduce the concept of a presentation. A presentation is a collection of keyframes. Where keyframes are. Are just essentially metadata that is safe to recreate the current state of the image. So it's a non destructive way of saving those images into groups that you can always come back to and yeah, visualize live in your lectures. So now we've created this presentation from our original data set that now contains 1 keyframe. We can start some more manipulation. Maybe trying some of those presets that already have it in the title? And as you can see, these are very nice for those high contrast scenarios. So maybe we changed the orientation a bit. But now as I encounter here is one of those ECG electrodes still left that I don't want to have in my image. So what can I do about that? We've got the concept of a paint mask, which is essentially. Painting in 3D so I don't want to go too much into the details, but there are different types of masks, lots of different types of masking modes. But essentially I can paint in 3D and now this electrode is gone and not annoying me anymore. But also this happens non destructively so I can always bring it back. Now we've changed our perspective, we can add another keyframe. And now for this very simple and short demonstration. Let's say our presentation is complete here. Now I can always switch between those two keyframes in a live lecture scenario. And as I'm embedded in the data set with these keyframes, I can always realign them or fly around the entire data set at every time. I can for sure also export those datasets as normal images you can select from a different variety of resolutions, so like 4K resolution like on a modern TV or HD resolution can really save all of those. And I can also create a movie by just arranging those keyframes in an order I'd like. And. The software is automatically providing the transitions between those keyframes and generates a very nice animation for me that I can then render and export into a normal video file. Yeah. We've got one last quite handy feature left that I want to show you today in this very quick demonstration, which is the crop box. And the crop box allows you to essentially place clip line and all the standard orientations very easily with these sliders. So you can essentially, yeah. Get your data set to size in a very efficient manner and now you know. Just left with what is interesting to you. Yeah, as you can see, got a lot more features, so there's a lot to explore with this application. And really the possibilities are are just getting started with what I've shown you today. You can also set very detailed different visualizations for the different volume rendering properties and. To conclude this short, limited a little demonstration, I just wanted to show you what, for example, for the anatomists in the audience might be interesting. You could also get from body, body, donor images. So this is an image that I've really quickly prepared yesterday actually. For this presentation right here and just create a different keyframes that I can then swap through, yeah, to tell you a bit about. Yeah, this patient and her condition. And I think also Professor Schultz will go a bit more into detail on how you have to simulating technique with body donors can be used. And with this I would like to conclude my very short little introductory demo. And if you have any questions, please feel free to reach out. Yeah, he really interested in what your opinions are. Thank you. Thanks a lot, Fabian. So. The moment I don't see questions in the chat, I think the people are just flashed. Uh and uh need a little bit to digest, but um. I mean, it said we have the. Questions. Sorry. It is a lot in a few minutes. Yeah, I know and I I know you would have loved to so much more but so today you just can't tease on everything and also really wanna have some time for the use cases and I think so I would now lead over to Professor Schultz and he's actually demonstrating how he's using cinematic rendering videos of cinematic anatomy in and it's like. But first of all. I think, um, yeah, officials wanted. To start with some general statements. Thanks. Thank you Andrea for your kind introduction. I hope the sound is fine. It's a great pleasure for me to give you an insight into the use of cinematic rendering technology and of course the cinematic anatomy application here at our anatomical Institute in Ireland. First of all, I would like to briefly explain what we see as the advantages of this visualization technique as far beyond did already demonstrate. The picture termination of human anatomy with cinematic rendering based on volumetric medical scan data allows us significantly better representation of the anatomical structures than ever before, so the students can understand and literally grasp the three dimensionality of even digitally. But nevertheless, we do not see the use of this technology as a replacement for other teaching tools, but we rather see it as as. Drawing digital support in combination with other former established teaching tools, just As for example the the use of anatomical textbooks. This is and this will still be important of course. Another great advantage is the fact that medical students get in contact with imaging techniques such as CT or MRI's already in the preclinical part of their medical education. This may help them to understand imaging imaging data and learn how to interpret and work with these data at a very early stage of their studies. At this point, I think it's important to make it clear once again it's cinematic rendering is not another digital animation tool to show the human anatomy. There are a lot of things in the web, but this is not cinematic rendering. Cinematic rendering always shows the real and individual human anatomy of a patient, for example, or as in our anatomical context, a body donor. This is important to mention because our body donors are mostly individuals of old. Age. Thus the body dollars that our students dissect physically in their section course show not only the general anatomy, but possibly also pathological changes or age-related degenerative changes or, and this is quite important again an individual anatomical variability. This variability is sudden, sufficiently displayed in textbooks, but in individual. Volumetric scan data. You will always get individual variability. The next slide please. The next slide, please. OK, so taking together the advantages of integrating cinematic images or videos into the medical education of students are huge, but you must always keep one thing in mind. With today's medical imaging capabilities, it is not yet possible to really scan all structures of the human anatomy in a sufficient quality. Take for example the course of peripheral nerves. They are barely or not at all possible to see in a CT or MRI scan. With the cinematic rendering technology, we can only visualize what we can detect with the volumetric scan data. OK, our goal for the next future, he and Alan is to establish a digital well, let's call it pre dissection course that gives students the opportunity to digitally explore the anatomy of the body donor before the end. During the physical dissection, the idea is to give the students the opportunity to deal with the individual anatomy of the body donor before the 1st physical incision is made. And of course also to become aware of special anatomic features or even pathologies of their body donor before they really dissect the body itself. Um, to detect detect degenerative changes and the volumetric reconstruction is a very big point and this is the reason why I will give you whatever I'll show you in the following video sequence. What I mean in a little bit more and then a little bit more clear way, so I will show you. This is the application of cinematic rendering using the CT datasets of two female body donors aged 85 and 92 years old as an example. Andrea, would you be so kind and start the video? So it's going through. Um, OK, now it works now. OK, seems to be it seems to be OK, OK, what you see the first, the first time you see the two-dimensional NPR planes we are scrolling through from rental to dorsal. And when we start the example here, you can clearly see the extremities or the highlighted body cavities such as the as the cranial cavity, the torex, or the abdominal cavity for example with the visualization. Cinematic rendering. It is now possible to create certain anatomical structures in a 3 dimensional way from this MPR plane. So you can see this here with the example of the body skeletal structures. It allows you to recognize the extremities, the skull and especially the Bony towards windowing like Fabian told us before. Also allows us that differently dense tissues can be assigned to different opacities so that not only the bones but also muscles or organs structures can appear. And this possibly looks like it's like a look under the skin which occurs here in a in a high opacity and it's transparent and all. Well, if you look at the torex you can see so-called secular ashes on this at the sternal bone which indicate indicate an earlier surgical intervention. And if you now crop into the torex in a coronary section playing you can see the heart centered in the torix, you see the left. Patrick along the bottom and we can clearly recognize now the course of the early surgical intervention. It's an artificial operating mode indicated by the yellow arrow. If you bury the section plane a little bit, you can see clearly emerging elongated wide structures. These structures represent sclerotic changes in the coronary arteries of this individual. Please look at the yellow arrow again if we now. Yeah, let only the very dense bone structures in the bone become visible again. We can see that not only the coronary results but also the entire course of the aorta is clerically ordered from the torex via its parts abdominalis to the iliac vessels and down to the leg arteries. The blue arrows clearly showed this and give you an impression of that. As I said before, these are not contrasted vessels as used for diagnostic purposes for example, but these are aged degenerative changes. And that can be detected almost in the entire course of the body vessels. Such a volumetric representation is only possible by using cinematic rendering technology. It is not possible, even not in a dissection course, to show it like that. In the second data set we start again with the visualization of the Bony structures, in this case now it's the pelvic ring. Again we can see strongly altered vessels in this area in addition to the easily recognizable bone structures of the hip bone. For example on the on the right side the helium, the sacrum at in the middle of it issue, and of course we see in the front the suffuses pubis. Then, for example, here it's the right female. When you slightly rotate to a lateral few, we can clearly see another great advantage of this visualization technique. We have immediately an impression of the positional relationship of the vessels to the underlying bone structures. We now following the course of the vessels past the knee joint and see the sclerotic deficits within the lower lip vessels leading downwards to the OR in the the the dorsal pedis artery clearly recognizable by these little white nodule like structures that are recognizable onto the Bony dorsum of the foot. Well, when we finally go back to the representation of the whole body and look under the skin again, we can switch back to the representation of the two-dimensional NPR planes and as already shown at the beginning of this video. But for example, the dense bone structures emerge again from display or superimpose both news. So it's possible now to combine the three-dimensional course of such structures with the two-dimensional information from the IPR plane, for example the left kidney. Or the the the liver indicated both by the blue arrows. OK, this brings me at last to the end of this little demonstration. I hope you enjoyed the trip through the human anatomy, and I hope I was able to give you a brief insight into how we use cinematic anatomy here in the anatomy department at the line. And I hope you get an impression or possibilities this application may also offer for your needs and questions. Thank you very much for your attention. Thank you, Professor Schultz. I'm I'm sure this did inspire a lot of your colleagues in the audience. I hope so. Again, people are so fleshed I do not yet see questions. Or maybe later on. Yeah. So maybe then we continue I I stopped my camera because obviously some had some bandwidth problems. Um, so I will share back. To the slides. And um, we would. We would then move on to Professor Fenner from. Yonas, Kepler university. As I said with the met space, they didn't realize in Lynn's a very special setup, but kind of cinematic lecture hall. And we did prerecord some scenes from from these lectures. Because he's really demonstrating this is cinematic and application interactively and um so, but at the beginning he will also explain a little bit how this project started and actually some while ago, and I'm glad that he's also today with us, so he can comment on life on some of the scenes and we would then switch to to this recording now. Thank you. I think it was in 2014 when Klaus angled developed cinematic rendering. At that time in Princeton, when he was working for Siemens Healthineers in the meanwhile, he is in Erlangen. And it was already in 2015 as we installed this cinematic rendering in the deep space of R Electronica Center in Linz. This is the Museum of a future that selectronic a center and there is a deep space. This deep space is very similar to the mid space here 8K high resolution projection room with stereoscopy active shutter glasses. And the we worked. With cinematic rendering, this is the first paper at all about cinematic rendering, introducing this technique originally thought to be used for postprocessing of medical imaging data. And this technique was so spectacular that it has been nominated for the German future price. This German future price is the highest award concerning technique and innovation in Germany. And so we used the cinematic rendering in the deep space of as electronica center from 2015 to 2019 and in this few year years we had more than 20,000 visitors seeing this anatomy presentations for the public. It was really a big success and this was for me. The heart field test for cinematic rendering and 3D projection and I have seen that it works, it is robust and I will use it for virtual anatomy for teaching students, medical students in the 3rd and 4th semester here in Linz. And as I told you last October, we have put into operation this Med space here in Linz. So this idea to do virtual anatomy. With. A large 8K high resolution projection environment. This idea we called the dissecting feature of for future. And we have seen it works very good. This room is a high resolution projection room 8K which is capable of stereoscopy. So with active 3D shutter glasses you get really a very realistic 3 dimensional impression of it. What you see here, this room is brand new. We have put it into operation last year in October and we use this mid space for virtual anatomy, virtual anatomy with computed tomography and magnetic resonance imaging datasets. 3 dimensionally. Reconstructed in real time with cinematic rendering. As you know, cinematic rendering is really an excellent technique for virtual anatomy. So they do here anatomy of living people. So for virtual anatomy I use cinematic rendering, 3D reconstruction, so these reconstructions are done in real time. And furthermore I use anatomy of plane radiograms. In direct comparison with cinematic rendering reconstructions, and our students appreciate that very much. But I use not only plain radiograms, I use only of use also of course sectional source, images of CT, computed tomography and every kind of reconstruction. So, and this is German part of the lecture and. I invite Professor Ferner to comment. Maybe now here. OK. Hello. Can you hear me? Yes, hello. OK, now it works. Wonderful. OK, I have heard here in English comment, but now we are online. So as you have heard, we do here virtual anatomy, the cinematic anatomy for three years in the meanwhile and it works excellently. The spine imaging for example, is an excellent and atomic area for virtual anatomy, and we see some areas are problematic. Of us to your dance, for example, the topographic relations of a small facets joints to the neural foramina and some other things. And this data set that you see here now, her whole body data set polytrauma patient is an all around the data set. We use it. For. Studying the muscles with different muscles and it's very very good how you can visualize the muscles or surface muscles with computed tomography and cinematic anatomy. What is really good? And do all presentations in real time interacting with the students. We are two days here in the mid space, at least two until three hours per day, and there are students have active shutter classes and there are 3D. Impression is really is really good to them and they like it very much. You see the green arrow, this is a free D arrow, you can go upwards, you can go downwards, you can go to the left, you can go to the right and you can go into the depth. It works very, very exactly and the life interaction with the students is is very good and they like it very much. So I use for controlling an Xbox controller. You'll need some hours to learn to work with this Xbox controller, but it's really simple to work life with such an Xbox controller and virtual anatomy. The preparation of a datasets is very very fast now, very very robust and this lessons here in Linz virtual anatomy are well accept. Further use magnetic resonance and free T cinematic rendering in comparison with 2D sectional MRI images and indeed the students appreciate this very much and why they feel well prepared for their clinical studies in the future by learning to read. Radiograms, CT anatomy and magnetic resonance in. It yeah. So this is this is a cinematic rendering of our image and. The data sets uh and uh. You can see what you can reach in terms of. Photorealistic visualization. As soon as the rendering gets to his. It's it's maximum. Now I see. The images this is A7 test like simulation, 3D data set and the brain is also an area that is excellent for cinematic anatomy and virtual anatomy. And this is very very good to switch between the 3D reconstruction surface reconstructions and the multiplanar reconstructions and that can you do in the. Extreme version of a software. Here you'll see the brainstem. Moreover. I use pathological examples. In CT and MRI, in RADIOGRAMS, and I do it interactively with the students in an anonymous matter, I use mentimeter. Mentimeter is very good Internet based. It's robust interaction presentation software and there are students appreciate very very much that it is unanimous, so you cannot blame and it's a permanent interaction. Between free cinematic rendering, Radiograms, 2D sectional imaging of computed tomography and magnetic resonance imaging, and finally quiz of pathological cases, this is the man I do here. Virtual anatomy. So frequently we let our students evaluate the virtual anatomy and anatomy and you see the evaluation of last semester. We had nearly 100%. And you see here the values. How do you rate the overall quality of a lecture? 1.2 it helps me to understand the human anatomy better 1.3. It is a good supplement to conventional anatomy lessons 1.2. It improves anatomical teaching during medical studies. 1.2. It gives me knowledge about human anatomy that goes beyond conventional anatomy classes. At least 1.8. Imparting knowledge of imaging diagnostics is very important to me 1.2. But permanent demonstration of pathological findings and imaging is very important 1.4. And often I invite clinicians and these clinicians show anatomy as you see the anatomy of a human being, living human being during an surgical intervention. The regular integration of clinical guest lectures is very important 1.6 and the regular interaction via mentimeter is very important, although at least 1.7. So. This is indeed, I think, with future of anatomy teaching. V2 classical anatomy with occurs. On cadavers for weeks in crates in a corporation with Professor Hammer from the University of Graz. And then we do 2 semesters, 2 times per week virtual anatomy here in the mid space. And we have seen this combination that is already now state-of-the-art anatomy teaching and it's indeed the future of anatomy. Thank you very much from Linz. Yeah, you know so different use cases and I hope each of you could identify with one or at least saw the potential for for changing the way of anatomy teaching. Thanks a lot Professor Fanner also for commenting. I share back. Yeah. The last thing I want to do is talk a little bit about the scalability of cinematic anatomy, because the good thing is it does not need. To start with, a huge investment like the the meatspace setup, so our offering is scalable. And. What you see here is how you can actually start with cinematic anatomy step-by-step, and with this transform your your anatomy lecture concept. So you could start like Professor Schultz with a lecture in Richmond where you just include rendered videos from the cinematic anatomy application in your lectures. Or you even go for a more immersive experience for the audience with stereo view and sorry. What's the fast and? This means the audience would need to um uh wear 3D glasses. But here also you can start from classroom setup, so smaller groups to a bigger audience with with 3D glasses. And in case you have a virtual reality lab, we actually just release now our VR feature. But this is for a single user experience I have to state here so far. So only the person wearing the VR headset can then also have this immersive experience. Meanwhile, our combat buffer 3D enables to connect to high resolution projectors and with this you can then have the 3D experience for the complete audience in in all scalings. So. As you see here from sitting in front of his 3D monitor, special kind of setup with a so-called smart wall, or going to projections up to, uh, uh, lecture halls in groups of yeah, 250 students. So. What we offer here, I look a little bit at the time, is the software and. What you need to know is our preferred business model is a yearly subscription. Through this you can benefit of the continuous development we we invest in the application. And you can decide on how many devices you want to install the software. So depending on this you offer different packages. What you need is a PC with a good graphics card, so we call it like a gaming PC to have a good rendering experience. And it should be windows space 10 or 11. So this is in a nutshell what we can offer with cinematic anatomy, the photorealistic 3D visualizations, real patient data sets to to share with your students, all this scalable on the display size. And you saw the tools in the in the demonstration of Fabian which easily help you to manipulate or prepare the data for your lecture even from your own body donors. And then you can share this data standard or in stereo. Go pick 3D or um, yeah, with a single user in virtual reality. And so this is what we wanted to introduce you to today. And now I'm happy to answer questions or actually not only me, I hope all my guest speakers as well. We are here for you. You saw some impressive use cases, I see, but what are anatomical structures that are more challenging to visualize? What are the main technical limitations? So. Probably you're referring to things you cannot so well visualized in CTMR like nerves, so. Definitely we. We are better in in high contrast imaging. Bobby and if you wanna. Yeah, so maybe I'll just say if you do this. So the main challenges, um are as uh also Professor Schultz mentioned already in us, so there's currently no really well defined and standardized imaging technique for. From rough visualization, so there are some Mr techniques that get nice images, but cinematic rendering also needs thin slices and both of these combined is kind of difficult. So nerves is what is challenging. And of course if you want to do a vessels that are not contrasted, this is also challenging, so you will have a difficult time. For example visualizing veins on a body donor if there's no perfusion and no contrast but. In general you can say every image that has high contrast and um has like has a lot of contrast. Also for clinical diagnosis will work also relatively well with cinematic rendering. And definitely slice is the better. So that's maybe something we also need to mention. The thinner your slices are and the more slices you have the better. Of course the resolution gets and also the 3D impression and you don't get this aliasing steps phenomenon essentially on the edges. Yeah, so did I would say in general, uh, yeah, central nervous system is probably relatively hard to image. Um yeah, and non contrasted vessels and for example also if you wanna do a bowel imaging without contrast, this would also be difficult. So it's always you need somehow some contrast to differentiate the different tissues because as I've shown you, essentially the main technique for dissecting is either using masks to just get rid of something that is in the way. Or to use the windowing and for windowing you need contrast as a tissue differentiator. I hope. This I. See. Please feel free to or is there a follow up question to that? I think no. I see one more question in regard to, um, which countries in Latin America have already the cinematic anatomy installed and how was this experience? So I have to mention here the cinematic rendering algorithm we have already since quite some years in our portfolio and with different products in our portfolio, but this education education was just released. Last summer. So uh, we have a lot of projects running and uh, I think uh one is with the University of Columbia, but I cannot tell you in detail about where it's already installed. Uh, but I think it's still in progress these projects, because unfortunately it takes some time. For the institutions to get the budgets, since we just launched it to the market. And then there's one more question in regard to what is the main advantage between cinematic and anatomy where the single server with cinematic. So this is actually, as I said, we have cinematic rendering, so this quarter realistic visualization possibility with different products in our portfolio, but usually it's only the radiologists in the clinical institutions which have access to single and with cinematic anatomy. Now we enable actually also the non radiologist, let's say um or even uh yeah um customers who do not have uh other Siemens modalities to get access to cinematic rendering. And this is the the main advantage. Beside that we let's say try to optimize the user interface for the needs of anatomy education and we also offer a lot of additional functionalities which are. This specifically made for, yeah, preparing lectures as you saw the export of rendered videos, but also uh, what you saw for the live demonstrations. And then? There's also one very interesting question in the chat that we didn't mention so far. If there are already, uh, images coming with the app and if you can import a CT and MRI. So the second question first, CT and MRI, both are possible. Honestly, from our experience, CT works better also because it's more uniform. So in MRI, it's really dependent on the different sequences. With cat, you get a lot more consistent imaging and we have a content library, so we have. Got a library of a lot of different cases that we are continually expanding that are already pre prepared and also with annotations. So some of those really have each of the anatomical structures named and marked in 3D. So you can directly use it for for teaching as well. And all of those images come with the application. Let me see in the chat, if I install the application, does it already? Yes, OK you covered this. And there's another one, publishing of the images. So, um, do you mean with publishing really print publishing in journals? So that's what I was trying to say. With this export feature, you can just generate normal, yeah, JPEG images from it in all different resolutions. And those are also definitely high enough so you can fulfill the 300 or 600 DPI requirements in most journals, and that's not a problem. And I see an interesting comment also that, um, cinematic rendering can never replace cross-sectional imaging. It might be complementary. Maybe you've seen in in the demonstration of Professor Schultz. When he switched um within the volume to the MPR view, so this is uh a feature we now implemented also in the application that as uh additional uh clip plane. We can add the MPR image to our volume renderings to have this match between the two D imaging and the volume imaging. Because this is important as you said, what we need to prepare the students for, for or for their future as well. So we commented already, uh, in the chat also that there are trial licenses available. Uh, this also would be one of my last slides. And um. Yeah, I posted also the link to the survey in um in the chat there. In the survey itself you also have my contact for that you always can also further reach out directly to me and also I'm happy to connect you with our pioneer users for dedicated questions afterwards. I know that uh, Professor Farnaz also welcoming you on site if you wanna pass by inlands to see him live in his lectures. And um. Yeah. So I would say um. Thank you so much for your time and and questions today. A special thank you also to our pioneers and guest speakers. They believe together with us, it's cinematic anatomy has the potential to revolutionize anatomy education. So. Please share with your peers what you have learned today about our offering and the and the use cases of cinematic anatomy. This is what is important to us and make everyone aware that we provide also this this free trial license. I, uh, just post this here again. You find it on our web page. And this can give you further insights. And uh yeah, if you don't find the link in the chat for the little survey, you can also just go for this. Bar code here. It's just two minutes of your time, but we would really appreciate your feedback. And still, I mean, there's time I leave this open for further questions. I just didn't want to miss anyone who already needs to step out of this. Assets. Uh, we we recorded the session in order to um, later on also upload it to our web page, we will cut some. Um parts out uh. For guarantying. The anonymization but. So if you have colleagues who wanted to join this expert talk today but missed it, they could then also later on. Have a look at it. This may be one last question in the chat. The. So if all features of cinematic rendering are already included in single VR. I can definitely say no. So it's really intended for a completely different purpose. So. Also, when you've used cinematic in, um single before, it's really much more tailored to the radiological use cases and and cinematic anatomy is much more for this interactive real time interaction with the data. And also, yeah, some more features for doing this three-dimensional dissection, like with the masks with those flexible clip plans. And all of those are not really. There in single there it's just different implementations. But uh, in our case there are several features that aren't present at all in single. And this is just the status, uh, of today, what you saw? Um, I mean for sure, we continuously work on this application. Uh, the next step will be, let's say the possibilities of student involvement. Also you saw already what Professor Fenner does using applications like Mentimeter to add also this interactive exchange in his lectures to. To his cinematic anatomy demonstrations. There's a lot of things we have on our road map, so there's definitely more to come, and we hope we can soon welcome you. S. An additional. Fan in the cinematic anatomy community. I think this we would close. And happy to hear from you. Thanks a lot. Also again to the guest speakers.

1699 1182 791 01 10 0:02/0:10 380 603.3 638 329.8 323.1 500 2016 2017 1.4) 1.5) 1.6) 1.7) 1.8) 1.9) 1.11 1.10 11 12 13 SIEMENS Healthineers Cinematic Anatomy - Expert Talk Welcome! We start at 4pm (CET) May 19, 2022, 4 -5 pm Please let us know in the chat if you are working for a teaching institution, medical institution or industry. Siemens Healthineers colleagues do not need to participate in this query. neer breakthroughs in heal eryone. Everywhere. Welcome to our Expert Talk Cinematic Anatomy Housekeeping Please turn off your camera and micro during whole talk Verlassen Besprechungschat We will record this talk with audio and video. The recording starts now. Please leave this meeting if you do not agree to this. You can ask your questions already during the presentations via the „Chat“- function. We will distribute an online questionnaire via a link in the chat - Thank you for your Feedback! Unrestricted Siemens Healthineers, 2022 Presenters in our talk today Prim. Univ .- Prof. Dr. Prof. Dr. Michael Fabian Necker, Andrea Beulcke, Franz A. Fellner, Scholz, MME, Medical Student Global Product Manager Johannes Kepler Friedrich-Alexander Cinematic Anatomy, University Linz, University Erlangen- Siemens Healthineers, Austria Nürnberg, Germany Nürnberg + Visiting Erlangen, Germany Researcher at Stanford + Working Student for e pioneer breakthroughs in healthca or everyone. Everywhere. Agenda · Challenges in Anatomical Education (Andrea Beulcke, SHS) . Presentation of the application with reference to user questions (Fabian Neckar, FAU) . Use of Cinematic Anatomy at FAU Erlangen (Prof. Michael Scholz, FAU) . Use of Cinematic Anatomy at JKU medSPACE in Linz (Prof. Fellner, JKU) . Scalability of the Cinematic Anatomy solution - requirements of different expansion stages (Andrea Beulcke, SHS) . Concluding Q & A Source: CR of dataset from The Cancer Imaging Archive. The products/features and/or service offerings (here mentioned) are not commercially available in all countries and/or for all modalities. If the services are not marketed in countries due to regulatory or other reasons, the service offering cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Not for clinical use. For training purposes only. Challenges in Anatomical Education Challenges in anatomical teaching What are the opportunities for advancing digitalization in anatomical teaching? How can students be supported in understanding anatomical structures better and faster? How can students optimally be prepared for working with radiological images? What are the didactic possibilities to enhance textbook anatomy with real clinical anatomy? How can the preparation as well as delivery of dissection courses be complemented? Cinematic Rendering Why is Photorealism important? Depth perception Shape perception The products/features and/or service offerings (here mentioned) are not commercially available in all countries and/or for all modalities. If the services are not marketed in countries due to regulatory or other reasons, the service offering cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Not for clinical use. For training purposes only. Cinematic Rendering - Volumetric Monte-Carlo-Ray Tracing for realistic depth and form perception Monitor Data Eye Courtesy: Radiologie im Israelitischen Krankenhaus Hamburg, Germany The products/features and/or service offerings (here mentioned) are not commercially available in all countries and/or for all modalities. If the services are not marketed in countries due to regulatory or other reasons, the service offering cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Not for clinical use. For training purposes only. Cinematic Anatomy Cases Presentations Content Library Groups Case(s) (3) Case Name, Body Part, Import Date Case Name Description Gender Modality Slice Count Body Part Import Date Auftrage Trauma_CASE_Vancouver CT HEAD Oct 25, 1:20 AM body donors Postprocessing Oct 18, 3:57 PM covid ct md ABDOMEN ct chest ct head neck DEMO DUKE breast_mri nmdid forensics Others SHS Forch 2 verse20 train zzz ingo-diep > Factory Cases Import Columns to search ct abd Search Q Search DICOM Folder Upload Case Group Drag and drop a DICOM folder here OR Browse and select a DICOM folder Cancel Browse Name Anderungsdatum Typ Videos OneDrive - Sieme Dieser PC 1 - II NN non-del scoliosis v ... Carotis duenn Presets T. Trauma_CASE_Vanscouver 2 5 Strong Studio MR - Window Lighting CT - Window Abdomen Bones General Head Heart Lungs Vascular Custom Presets Trauma CASE_Vancouver Clip 1 MPR Distance Soft Default Bottom O Front Vessels Left Realign Create Keyframe Create Presentation Arterial Abdomen O Default O Top O Right Front O Back Creating Presentation Right Success Presentation created successfully Creating Keyframe Save Keyframes Paint Mask (E) Applied Masks : (0/4) Paint Masks (1) Mask_1 Create Mask Mode Apply Mask 2 Carve Erase Continuous carving Applied Matks : (1/4) Paint Masks (2) Mask Keyframe created successfully PA Create Snapshot Create Movie - Arterial Abdomen Select Frame(s) & Mask Frames Storyboard Show orientation cube in the movie Choose Parameters Vascu Preview Select Frame(s), Mask and their duration View a preview of the movie Next Generating Preview Previous Lightin Crop Box Left - Right (mm) Anterior - Posterior (mm) Feet - Head (mm) Left - Right (men) Material Parameters Diffuse Anisotropy Sampling Rate Surface Definition Num Light Bounces Presentations (3) What's the diagnosis 11 Keyframes Case Name : WT_DS Case Name : Trauma_CASE_Vancouver Erlangen Anatomy - Body D ... There are unsaved changes. Do you want to proceed without saving? No Yes FA Applying Keyframe Unsaved Changes Loading ... Michael Scholz 1 Friedrich-Alexander University Erlangen Lecture enhancement with Author | Department Cinematic Anatomy - a new tool for lecturers and students INAE Prof. Michael Scholz; Cinematic Anatomy Expert Talk 19th May 2022 FAU Friedrich-Alexander-Universität Institute of Functional and Faculty of Medicine Clinical Anatomy SIG What are benefits using CR in medical education? CR increases and intensifys the understanding of three-dimensional anatomical structures through a photorealistic visualisation With CR, a combination of 2D Anatomy (textbooks, cross sections, etc.) and 3D visualization is possible With CR, medical students come into contact with imaging techniques (CT, MRI) already at the beginning of their studies and learn how to handle and to interpret these data CR is not just another digital animation tool to show the human anatomy, it is always real and individual human anatomy . CR shows not only the actual anatomy of the body, but also certain pathologies, anatomical variabilities and age-degenerative changes Keep in mind: the representation of peripheral nerves in standard CT or MRI is only possible to a very limited extent. This, however, means that those structures can hardly be displayed with CR. heer breakthroughs in heal FAU: Digital (Pre-)Dissection Course Digital representation of the respective body donors anatomy for the students to be „prepared“ for the following dissection course CR based digital reconstructions of CT scans from body donors before the actual dissection course give medical students the opportunity: to deal with the individual anatomy of the body donor before the first incision is made to become aware of special anatomical features / pathologies of the body donor in advance detect degenerative changes in the volumetric reconstruction of imaging data that would possibly not be detectable in the conventional dissection course Live from JKU medSPACE Linz, Austria Cinematic Anatomy lecture set up at Johannes Kepler University heer breakthroughs in hea ryone. Everywhere. medSPACE @ Johannes Kepler University of Linz, Austria 8k resolution on 16x9 m screen regulatory or other reasons, the service offering cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Not for clinical use. For training purposes only. Interactive demonstrations of Cinematic Anatomy at the medSPACE of the Johannes Kepler University of Linz, Austria Cinematic Rendering 2014 Klaus Engel, Princeton 2015 installing Cinematic Rendering in the Deep Space of the Ars Electronica Center XX J. Biomedical Science and Engineering, 2016, 9, 170-175 Scientific Published Online March 2016 in SciRes. http://www.scirp.org/journal/jbise Research Publishing Introducing Cinematic Rendering: A Novel Technique for Post-Processing Medical Imaging Data Franz A. Fellner1,2 'Institute of Radiology, Kepler University Clinic, Medical Faculty of the Johannes Kepler University, Linz, Austria 'Medical Faculty of the Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany Email: franz.fellner@akh.linz.at Received 1 March 2016; accepted 26 March 2016; published 29 March 2016 Copyright C 2016 by author and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). Open Access http://creativecommons.org/licenses/by/4.0/ Rendering DEUTSCHER ZUKUNFTSPREIS Preis des Bundesprasidenten fur Technik und Innovation 2017 nominiert Kreis der Besten 2017 Deep Space AEC 2015- Anatomy presentations more than 20.000 visitors http://www.scirp.org/journal/jbise J. Biomedical Science and Engineering, 2017, Vol. 10, (No. 8), pp: 367-375 Virtual Anatomy: The Dissecting Theatre of the Future-Implementation of Cinematic Rendering in a Large 8 K High-Resolution Projection Environment Franz A. Fellner1,2, Klaus Engel3, Christoph Kremer1 1Central Radiology Institute, Kepler University Hospital, Medical Faculty of the Johannes Kepler University, Linz, Austria; 2Medical Faculty of the Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany; 'Siemens Healthineers, Erlangen, Germany; 'Ars Electronica Center, Linz, Austria Correspondence to: Franz A. Fellner, Franz.fellner@kepleruniklinikum.at Keywords: Virtual Anatomy, Education, Cinematic Rendering (CR), Volume Rendering (VR), High-Resolution, 3D Display, Computed Tomography (CT), Magnetic Resonance (MR) Received: June 19, 2017 Accepted: July 24, 2017 Published: July 27, 2017 Copyright @ 2017 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY 4.0). 8K PACE JOHANNES KEPLER UNIVERSITAT LINZ Extron R A LL Mentimeter: what's wrong? Mentimeter Interaction presentation software www.mentimeter.com Virtual anatomy and patho-anatomy - student evaluation 1. Befragung LVA Virtuelle Anatomie und Pathologie n = 119 1.4) How do you rate the overall quality of the lecture? 1 sehr gut 5 sehr schlecht n=118 mw=1,2 md=1,0 s=0,8 It helps me to understand the human 1 sehr viel anatomy better md=1,0 s=0,6 1.6) It is a good supplement to conventional 1 sehr stark 5 gar nicht anatomy lessons It improves anatomical teaching during medical studies 1.8) It gives me knowledge about human anatomy that goes beyond conventional anatomy classes Imparting knowledge of imaging diagnostics is very important to me 1.10 The permanent demonstration of pathological findings in imaging is very important 1.11 The regular integration of clinical guest lectures is very important 1.12 Regular interaction via mentimeter is very important Excellent/ Very bad/ very much/ not at all very strong Scalability of the Cinematic Anatomy solution Andrea Beulcke 1 Scalability of Cinematic Anatomy - lecture scenarios 1: Lecture enrichment 2: Virtual anatomy classes 3: Cinematic lectures Onsite or virtual lecture Full focus on Cinematic Rendering Lecture hall in MedSpace like complemented with Cinematic patient cases and "virtual dissection". setup with Stereo view and Anatomy images or animations. Optionally with Stereo view through high-end 3D projector enabling QuadBuffer 3D monitor/projector up to 8k The products/features and/or service offerings (here mentioned) are not commercially available in all countries and/or for all modalities. If the services are not marketed in countries due to regulatory or other 3D Display technology* for Cinematic Anatomy 3D Monitor ** 3D-Stereo Smart-Wall ** Projections · for groups up to 250 · any room size Up to 144 Hz · Up to 120 Hz 4K or 8K *All set ups require 3D glasses for audience and Cinematic Anatomy Stereoview ** 3D Monitor PluraView and Smart-Wall picture from https://www.schneider-digital.com Focus on Cinematic Rendering · 3D-Stereo · 4K or 8K "All set ups require 3D glasses for audience and Cinematic Anatomy Stereoview 4K How to get started with Cinematic Anatomy License based on yearly subscription Continuous evolvement of the application License packages for 1- 5 devices Software & hardware requirements Windows 10, Gaming PC* *Details s. Cinematic Anatomy webpage Cinematic Anatomy improves anatomy education with various features Photo-realistic 3D Variety of tools to visualization with true manipulate the data depth and form visualization and to perception through highlight remarkable parts Real patient cases by Stereoscopic 3D using DICOM data files view for audience with from CT and MRI scans 3D glasses Copyright: Hospital do Coracao, Sao Paulo, Brasilien Completely scalable display set ups Virtual Reality from a small laptop over TV screen experience for single user with to QuadBuffer 3D projectors with VR headset large cinema screens Scalable display set ups Questions? Why Cinematic Anatomy has the potential to revolutionize anatomy education Photorealistic visualizations of real patient's anatomy and pathology Enables reversible / "damage free" dissection Emotional engagement of students working on real patient cases Potential to increase efficiency of body donor section classes Courtesy: Melanoma Metastases: The Cancer Imaging Archive. https://doi.org/10.7937/k9/tcia.2018.odu24gze Data generated by the National Cancer Institute Clinical Proteomic Tumor Analysis Consortium (CPTAC) The products/features and/or service offerings (here mentioned) are not commercially available in all countries and/or for all modalities. If the services are not marketed in countries due to regulatory or other reasons, the service offering cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Not for clinical use. For training purposes only. http://siemens-healthineers.com/cinematic-anatomy Overview Features Use cases Customer voices Events > Download your application Try it out and download your Cinematic Anatomy application now. After installing the software enter your product license key when opening the application. Download Cinematic Anatomy application (zip) 4. Check out hardware requirements (pdf) 0.15 MB Get your free trial license More Information reasons, the service offering cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. Not for clinical use. For training purposes only. Your feedback is much appreciated In the chat you find the link to the questionnaire or use this QR code: Thank you for your time! Thank you for your enthusiasm! Siemens Healthineers Andrea Beulcke SHS CS EDU IS IDE andrea.beulcke@siemens-healthineers.com Siemens Healthcare GmbH Hartmannstraße 16 91052 Erlangen, Germany The results by customers of Siemens Healthineers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g. hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.