Real virtuality: Beyond the image

摘要

Biomodelling allows 3D medical imaging data to be translated into an accurate solid facsimile of patient anatomy. 'Real virtuality' is the term coined to describe this visualisation medium. A study of 1000 cases in cranio-maxillofacial surgery, neurosurgery, orthopaedics, vascular surgery and prosthetics was performed. 3D CT, MR, angiography and US data were transferred via DICOM network into a workstation running ANATOMICS BIOBUILD software. The data were edited and converted into build code that directed rapid prototyping systems to manufacture biomodels. Stereolithography, selective laser sintering, thermojet printing, and polyjet printing technologies were investigated. Bureau and hospital based systems were developed and tested. Surgeons have reported that biomodelling is superior to standard imaging in complex cases for diagnosis, surgeon confidence, surgical planning, informed patient consent and surgical outcomes. Surgeons have indicated that biomodelling reduces operation time. A hospital based system has been found to significantly reduce biomodel turn-around time and expand applications into time critical conditions such as trauma. Biomodels have been found to have 5 fundamental applications in medicine. Firstly, as a diagnostic aid, secondly, as a communication tool, thirdly, by allowing surgical simulation, fourthly, by allowing manufacture of customised prostheses, and finally, by enabling stereotaxy. Real virtuality has unique advantages over images which include tactile feedback, user friendliness, implant customisation, realistic surgical simulation, versatility and enhanced patient communication. The main limitations of the technology are reimbursement and the reluctance of RP vendors to meet the needs of the medical market.