Sectional depiction of the pelvic floor by CT, MR imaging and sheet plastination: computer-aided correlation and 3D model.

The structures of the pelvic floor are clinically important but difficult to assess. To facilitate the understanding of the complicated pelvic floor anatomy on sectional images obtained by CT and MR imaging, and to make the representation more vivid, a computer-aided 3D model was created from a male and a female torso to develop a teaching tool. A male and a female cadaver torso were investigated by means of CT, MR imaging, and serial-section sheet plastination. A 3D reconstruction of the pelvic floor and adjacent structures was performed by fusion of CT and MR imaging data sets with sheet plastination sections. Corresponding sections from all three methods could be compared and visualized in their 3D context. Sheet plastination allows distinction of connective tissue, muscles, and pelvic organs down to a microscopic level. In combination with CT, MR imaging, and sheet plastination a 3D model of the pelvic floor offers a better understanding of the complex pelvic anatomy. This knowledge may be applied in the diagnostic imaging of urinary incontinence or prolapse and prior to prostate surgery.

A new representation of knowledge concerning human anatomy and function.

By integrating concepts of computer graphics and artificial intelligence, novel ways of representing medical knowledge become possible. They allow unprecedented possibilities ranging from three-dimensional interactive atlases to systems for surgery rehearsal.

Consideration of time-dose-patterns in 3D treatment planning. An approach towards 4D treatment planning.

PURPOSE: The rendering of the 3D dose distribution together with anatomical information and the volumes of interest (VoI) is essential to get a visual impression of the treatment plan and to find modifications for the optimization of the dose distribution. The integration of biological effects into the 3D treatment planning is of interest for the assessment of different time-dose patterns. MATERIALS AND METHODS: One way of taking into account biological data is to relate the physical dose in critical structures to the corresponding tolerance dose. For that purpose the applied time-dose pattern has to be converted into the standard fractionation scheme being the basis of the tolerance dose. Generally any model can be used for these calculations. Here a modified incomplete repair model is used to calculate the relative biological dose distribution (RBD). The visualization of these biologically isoeffective dose distributions can be performed in the same manner as the physical dose so that the physical and biological dose distributions can by displayed side by side. As this is equivalent to introducing the time as a fourth dimension into 3D treatment planning this is called 4D treatment planning. RESULTS: From 3D dose matrices the biologically isoeffective dose distributions are calculated for the organs at risk. The changes introduced by different time-dose patterns are displayed using the same technique as for rendering 3D treatment plans. The visualisation of the three-dimensional biological dose distributions is shown by means of a patient with an oesophagus carcinoma. The RBD related to the tolerance dose of the organs at risk is displayed for different time-dose fractionations. CONCLUSION: The RBD distribution on a 3D treatment plan can be displayed in the same mode as the physical dose distribution. This offers additionally valuable information in a 3D treatment planning process about the dose to critical organs and the influence of different time-dose patterns.

Visualization of 3-D treatment plans with fast neutrons.

The treatment planning for radiotherapy with fast neutrons requires modifications of the planning systems used for photons. The neutron- and photon-component of the treatment fields must be determined and can then be used for separate calculations. The corrections for inhomogeneities are performed by use of attenuation coefficients and the corresponding corrections for changes in the kerma. The treatment planning system MEVAPLAN (Siemens) was modified to follow these requirements. Thus treatment planning for 14 MeV DT-neutrons could be performed. The multiplanar option is used to calculate 3D-dose distributions based on up to 40 serial CT slices. The generated three-dimensional dose matrix and the CT data are transferred via magnetic tape to the visualization system VOXEL-MAN developed at the University Hospital of Hamburg. This system uses a ray casting algorithm based on the generalized Voxel-model to display detailed 3D-images of human anatomy together with the calculated dose distribution. Different treatment plans for neutrons and photons are calculated and visualized. Various manipulations of the data-sets are displayed to improve the critical examination of the simulated dose distribution and to discern the quality of treatment techniques.

[3-D visualization of dose distributions in CT image volumes]. / 3D-Darstellung von Dosisverteilungen im CT-Bildvolumen.

The 3D-visualization of the entire spatial radiation dosage in cooperation with the 3D-radiation volume requires several data volumes. The structure of the interface between the 3D-treatment planning program "ProPlan" and the 3D-imaging system "VOXEL-MAN" is explained. The first results in the radiological application point out the possibilities of the complex registration of dose distributions and the critical examination of the irradiation technique.