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The use of virtual reality environments for medical training 虚拟现实环境在医学培训中的应用
Pub Date : 2019-07-01 DOI: 10.4103/digm.digm_16_19
J. Parry
GE Healthcare wanted to address these restrictions by creating a VR environment that simulated the hands-on experience of completing CTCA scans. Their aim was to make a training tool that could be accessed 24/7, reducing the need for onsite training and therefore lowering training costs and minimizing health risks to patients. Ultimately, this should mean that more radiographers are CTCA trained, leading to better assessment of patients and better outcomes.
GE医疗希望通过创建一个虚拟现实环境来模拟完成CTCA扫描的实践体验,从而解决这些限制。他们的目标是制造一种可以全天候使用的培训工具,减少对现场培训的需求,从而降低培训成本,最大限度地减少对患者的健康风险。最终,这应该意味着更多的放射技师接受CTCA培训,从而更好地评估患者并获得更好的结果。
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引用次数: 0
The clinical feasibility and effect of online ExacTrac 6 degree-of-freedom system for head-and-neck cancer 在线ExacTrac 6自由度系统治疗头颈癌的临床可行性及效果
Pub Date : 2019-07-01 DOI: 10.4103/digm.digm_18_19
Lirong Zhao, Jin-dong Qian, Xiaojuan Duan, Dingqiang Yang, Yi-bing Zhou, Guang-hui Li, Jian-guo Sun
Purpose: Online adaptive correction in image-guided intensity-modulated radiotherapy appears to be a promising approach for precision radiation treatment in head-and-neck tumors. This research is designed to evaluate the setup uncertainties in the left-right (L-R), superior-inferior (S-I), and anterior-posterior (A-P) directions and rotational variations: pitch, roll, and yaw for head-and-neck cancer (HNC) patients with the ExacTrac 6 degree-of-freedom (6D) image-guided radiotherapy (IGRT) system. Materials and Methods: The setup errors measured by ExacTrac 6D IGRT system at the treatment unit with respect to the planning computed tomography were recorded for 40 patients with head-and-neck tumors. The residual setup errors were computed and quantitatively analyzed. Results: The results indicated that the setup errors measured in the S-I direction were larger than the other two directions. For the three rotational angles, the results were very close. The verifications showed that after the first correction, the overall setup errors were generally < 0.32 mm in the L-R, S-I, and A-P directions and <0.2° in the three rotational variations: pitch, roll, and yaw. According to the results of verifications, we know that ExacTrac 6D IGRT system was accurate and clinical feasibility. Conclusion: The results of our study have shown that daily image guidance with ExacTrac 6D image-guided system for HNC patients is effective. These data suggest it allows a high accurate of setup errors.
目的:图像引导调强放射治疗中的在线自适应校正是头颈部肿瘤精确放射治疗的一种很有前途的方法。本研究旨在评估ExacTrac 6自由度(6D)图像引导放射治疗(IGRT)系统对癌症(HNC)头颈部患者左右(L-R)、上下(S-I)和前下(A-P)方向的设置不确定性和旋转变化:俯仰、滚转和偏航。材料和方法:记录了40例头颈部肿瘤患者在治疗单元通过ExacTrac 6D IGRT系统测量的与计划计算机断层扫描相关的设置误差。对剩余设置误差进行了计算和定量分析。结果:结果表明,在S-I方向上测量的设置误差大于其他两个方向。对于三个旋转角度,结果非常接近。验证表明,在第一次校正后,L-R、S-I和A-P方向的总体设置误差通常小于0.32 mm,三种旋转变化(俯仰、滚转和偏航)的总体设置错误通常小于0.2°。根据验证结果,我们知道ExacTrac 6D IGRT系统是准确的,具有临床可行性。结论:我们的研究结果表明,ExacTrac 6D图像引导系统对HNC患者的日常图像引导是有效的。这些数据表明,它允许高精度的设置错误。
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引用次数: 2
Improving the blood donation practices and role of adoption of technological innovations 改进献血做法和采用技术创新的作用
Pub Date : 2019-07-01 DOI: 10.4103/digm.digm_14_19
S. Shrivastava, P. Shrivastava
126 enable prompt, safe, and timely delivery of blood to all those who are in need.[4] This innovative technological approach has resulted in the significant reduction in the rates of maternal and child deaths by 75% and 66%, respectively, between the start of the current century till 2015. In order to sustain these gains, hundreds of mobile blood collection sites have been established, and the use of drones has enabled the supply of blood in remote regions of the nation. As a part of the quality assurance with regard to the maintenance of the cold chain, an electronic monitoring system has been put in place which promotes real-time monitoring of temperature and transmission of warning text messages, in case the temperature shows any variation from the permitted range.[4]
126 .使血液能够迅速、安全、及时地输送给所有需要的人从本世纪初到2015年,这种创新的技术方法使孕产妇和儿童死亡率分别大幅降低了75%和66%。为了维持这些成果,已经建立了数百个流动采血点,并且使用无人机使该国偏远地区能够供应血液。为保证冷链维修的质素,本署设有电子监察系统,即时监察温度,并在温度偏离准许范围时发出警告短信。[4]
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引用次数: 0
Virtual reality and immersive experience technologies for cognitive health and well-being 虚拟现实和沉浸式体验技术的认知健康和福祉
Pub Date : 2019-07-01 DOI: 10.4103/digm.digm_17_19
David Wortley
93 *Address for correspondence: Mr. David John Wortley, The Old Barn, Pury Road, Alderton, Northants, NN12 7LN, United Kingdom. E‐mail: david@davidwortley.com isolation and unhealthy mental states. They are perceived as encouraging “fantasy” scenarios that do not relate to positive social behaviors. This article, while recognizing that virtual reality (VR) and immersive experiences (such as many other applications for technology) have the potential for negative impacts on mental health, focuses instead on how these technologies can and are being used for positive clinical benefit.
93 *通信地址:David John Wortley先生,The Old Barn, Alderton, Northants, NN12 7LN。电子邮件:david@davidwortley.com孤立和不健康的精神状态。它们被认为是鼓励与积极的社会行为无关的“幻想”场景。本文虽然认识到虚拟现实(VR)和沉浸式体验(如许多其他技术应用)对心理健康有潜在的负面影响,但重点关注如何将这些技术用于积极的临床效益。
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引用次数: 0
Robust point set registration method based on global structure and local constraints 基于全局结构和局部约束的鲁棒点集配准方法
Pub Date : 2019-04-01 DOI: 10.4103/digm.digm_10_19
Kai Yang, Yufei Chen, Haotian Zhang, Xianhui Liu, Weidong Zhao
Background and Objectives: Point set registration is a very fundamental problem in computer vision. The registration problem can be divided into rigid and nonrigid registration. The transformation function modeling of rigid registration is simpler, whereas the nonrigid registration is better to solve the practical problems. Materials and Methods: We proposed a robust point set registration method using both global and local structures. Here, we use a popular probability model, Gaussian mixture model, to preserve the global structure of point set. Then, we designed a local constraint provided by some neighboring points to maintain the local structure of the point set. Finally, expectation–maximization algorithm is used to update model parameters in our method. Results: First of all, we carried out experiments on the synthesized data, which included four degradation cases: deformation, noise, outlier, and rotation. By comparing the mean and standard deviation of registration errors with the several state-of-the-art methods, our method was proved to have stronger robustness. Then, we conducted experiments on real retinal fundus images, aiming to establish reliable feature point correspondence between the two images. The experimental results show that we perform better when the two images have larger shooting angles and more noises. Conclusions: The Gaussian mixture protects the global structure of the point set, and the local constraints make full use of the local structure, which makes our method more robust. Experiments on synthetic data prove that our method obtains superior results to those of the state-of-the-art methods. Experiments on retinal image data show that our method also performs very well in practical applications.
背景与目的:点集配准是计算机视觉中一个非常基础的问题。配准问题可分为刚性配准和非刚性配准。刚性配准的变换函数建模更简单,而非刚性配准更能解决实际问题。材料和方法:我们提出了一种基于全局和局部结构的鲁棒点集配准方法。在这里,我们使用一种流行的概率模型——高斯混合模型来保持点集的全局结构。然后,我们设计了一个由邻近点提供的局部约束来保持点集的局部结构。最后,利用期望最大化算法对模型参数进行更新。结果:首先,我们对合成的数据进行了实验,包括变形、噪声、离群点和旋转四种退化情况。通过比较几种最新方法的配准误差均值和标准差,证明了该方法具有较强的鲁棒性。然后,我们对真实的视网膜眼底图像进行实验,旨在建立两幅图像之间可靠的特征点对应关系。实验结果表明,当两幅图像具有较大的拍摄角度和较多的噪声时,我们的性能更好。结论:高斯混合保护了点集的全局结构,局部约束充分利用了局部结构,增强了方法的鲁棒性。在综合数据上的实验证明,该方法的结果优于现有的方法。在视网膜图像数据上的实验表明,该方法在实际应用中也有很好的效果。
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引用次数: 1
Accuracy of smartphone based photography in screening for potentially malignant lesions among a rural population in Tamil Nadu: A cross-sectional study 在泰米尔纳德邦农村人口中,基于智能手机的摄影筛查潜在恶性病变的准确性:一项横断面研究
Pub Date : 2019-04-01 DOI: 10.4103/digm.digm_29_18
R. Karthikayan, A. Sukumaran, M. Diwakar, V. Raj
Background and Objective: Oral cancer is a major public health problem which carries significant morbidity and mortality. A shift from treatment to prevention by screening is the key to reduce oral cancer lesion among population. Searching for an affordable and viable alternative to face-to-face screening that can expedite diagnosis of oral diseases among rural population with good accuracy is mandatory. One of the most realistic solutions to acknowledge this hurdle and the unavailability of dental professionals, is mobile teledentistry. Materials and Methods: Secondary data analysis was conducted, in which the data were derived from the project of “Oral Cancer Screening Program in Rural population” conducted by Thirumalai Mission Hospital, Ranipet. Ninety-six biopsies were taken for the patients who had visible oral lesions which had been provisionally diagnosed on clinical examination. Oral screening was carried out by unaided face-to-face screening method by a trained and calibrated dentist. In a separate subsequent visit, a trained teledental assistant took photographs of each participant's mouth by using a smartphone camera; the charting of the photographs was conducted independently by two dentists. Results: Intra-examiner reliability of Examiner 1 and Examiner 2 was 0.943 and 0.921, respectively. Inter examiner reliability score of 0.879 was obtained between both the examiners by the photographic method of diagnosis. Intraclass correlation coefficient between two methods of examination was 0.812. Agreement between the photographic examination (Examiner 1, Examiner 2) with the gold standard biopsy report was 0.791 and 0.855, respectively. Conclusion: Smartphone camera use offers a valid and reliable means of remote screening for oral lesions. Photographs of the oral lesions taken from the smart-phone camera with an acceptable diagnostic validity and reliability.
背景与目的:口腔癌症是一个严重的公共卫生问题,其发病率和死亡率较高。从治疗转向筛查预防是减少人群口腔癌症病变的关键。必须寻找一种负担得起且可行的替代面对面筛查的方法,以快速准确地诊断农村人口的口腔疾病。承认这一障碍和牙科专业人员不可用的最现实的解决方案之一是移动远程牙科。材料与方法:二次数据分析,数据来源于Ranipet Thirumalai教会医院开展的“农村人群口腔癌症筛查计划”项目。对在临床检查中暂时诊断为可见口腔病变的患者进行了96次活检。口腔筛查由经过培训和校准的牙医采用无辅助的面对面筛查方法进行。在随后的另一次访问中,一名训练有素的远程牙科助理使用智能手机摄像头为每位参与者的口腔拍照;照片的制图是由两位牙医独立完成的。结果:审查员1和审查员2的内部信度分别为0.943和0.921。通过摄影诊断方法,两名检查者之间的检查者间可靠性得分为0.879。两种检查方法的组内相关系数为0.812。照片检查(检查者1、检查者2)与金标准活检报告的一致性分别为0.791和0.855。结论:智能手机摄像头的使用为口腔病变的远程筛查提供了一种有效可靠的手段。智能手机摄像头拍摄的口腔病变照片具有可接受的诊断有效性和可靠性。
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引用次数: 3
Rehabilitation with robotic glove (Gloreha) in poststroke patients 机器人手套(Gloreha)在脑卒中后患者康复中的应用
Pub Date : 2019-04-01 DOI: 10.4103/digm.digm_3_19
P. Milia, Maria Peccini, F. De Salvo, Alice Sfaldaroli, Chiara Grelli, G. Lucchesi, Nora Sadauskas, C. Rossi, M. Caserio, M. Bigazzi
Background and Objectives: Stroke is a leading cause of long-term disability. Rehabilitation involving repetitive, high-intensity, and task-specific exercise is the pathway to restore motor skills. Robotic assistive devices such as Gloreha are increasingly being used in upper limb rehabilitation. The aim of this study is to explore the efficacy of robotic therapy for upper limb rehabilitation using robotic glove (Gloreha) in patients with stroke. Materials and Methods: The patients affected by stroke who were admitted to our rehabilitation unit were studied. Patients were exposed to Gloreha device rehabilitation (30 min/die), physiotherapy (1,5 hours/die), and occupational therapy (30 min/die). We measured the impairment in motor function and muscle tone using the modified Ashworth scale (MAS), the activities of daily living functional independence measure (FIM), and the finger dexterity Nine-Hole Peg test (NHPT). Results: Twelve patients (mean age = 64.5 years; male/female: 8:4) were admitted at the rehabilitation training. We found statistically significant differences between admission and discharged in terms of functional recovery using the FIM scale (pre/M = 88.33; post/M = 117.25,P = 0.01); hand training showed a better outcome using the NHPT (pre/M = 51.8; post/M = 36.33, P = 0.01). No significant changes were observed in terms of spasticity with the MAS (pre/M = 1.25; post/M = 1.08;P > 0.05). Conclusions: Rehabilitation with robotic glove (Gloreha) can positively promote functional recovery of arm function in a patient with stroke.
背景和目的:中风是导致长期残疾的主要原因。康复包括重复性、高强度和特定任务的锻炼,是恢复运动技能的途径。像Gloreha这样的机器人辅助设备越来越多地用于上肢康复。本研究旨在探讨机器人手套(Gloreha)在脑卒中患者上肢康复中的应用效果。材料与方法:对我院康复科收治的脑卒中患者进行研究。患者接受Gloreha装置康复治疗(30分钟/例死亡)、物理治疗(1.5小时/例死亡)和职业治疗(30分钟/例死亡)。我们采用改良Ashworth量表(MAS)、日常生活功能独立性活动量表(FIM)和手指灵巧性九孔Peg测试(NHPT)来测量运动功能和肌肉张力的损害。结果:12例患者(平均年龄64.5岁;男性/女性:8:4)接受康复训练。采用FIM量表,我们发现入院和出院患者在功能恢复方面存在统计学差异(pre/M = 88.33;post/M = 117.25,P = 0.01);使用NHPT进行手部训练显示出更好的效果(pre/M = 51.8;post/M = 36.33, P = 0.01)。在痉挛性方面,MAS未观察到显著变化(pre/M = 1.25;post/M = 1.08;P > 0.05)。结论:机器人手套(Gloreha)对脑卒中患者手臂功能恢复有积极的促进作用。
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引用次数: 8
Digital continuous care: Future of artificial intelligence-based healthcare 数字持续护理:基于人工智能的医疗保健的未来
Pub Date : 2019-04-01 DOI: 10.4103/digm.digm_15_19
L. Eisen
49 *Address for correspondence: Dr. Leon Eisen, 20, Church Street, Mezzanine, Hartford, CT 06103, USA. E‐mail: leon.eisen@oxitone.com and clouds. The common denominator for all these instruments is that they are generally designed for sporadic measurements rather than continuous monitoring and are usually taken from the shelf when patient already feels bad. Transformation from episodic, manual, and fragmented care toward continuous, automated, and prolonged monitoring can have an impact on the quality of life and well-being of the chronic disease patient by addressing three key health-care objectives: 1. Improved patient quality of life 2. Improved quality of care 3. Reduced cost and risk.
*通讯地址:Dr. Leon Eisen, 20, Church Street, Mezzanine, Hartford, CT 06103, USA。电子邮件:leon.eisen@oxitone.com和云。所有这些仪器的共同点是,它们通常是为零星的测量而不是连续监测而设计的,并且通常在患者已经感到不适时从货架上取下。从偶发的、手工的、碎片化的护理向持续的、自动化的、长时间的监测转变,可以通过解决以下三个关键的卫生保健目标,对慢性疾病患者的生活质量和福祉产生影响:改善患者的生活质量提高护理质量降低成本和风险。
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引用次数: 3
The role of phantoms in magnetic resonance imaging-guided focused ultrasound surgery 幻影在磁共振成像引导聚焦超声手术中的作用
Pub Date : 2019-04-01 DOI: 10.4103/digm.digm_13_19
C. Damianou
This article reviews the role of mimicking materials used in focused ultrasound surgery (FUS) under magnetic resonance imaging. FUS is a noninvasive surgery that has many applications in oncology and neurology. Phantoms (mimicking materials) are mostly based in agar or gelatin phantoms.
本文综述了模拟材料在磁共振成像聚焦超声手术(FUS)中的作用。FUS是一种非侵入性手术,在肿瘤学和神经学中有许多应用。幻影(模拟材料)大多是基于琼脂或明胶的幻影。
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引用次数: 5
Active contour model for medical sequence image segmentation based on spatial similarity 基于空间相似性的医学序列图像分割活动轮廓模型
Pub Date : 2019-01-01 DOI: 10.4103/digm.digm_11_19
Chencheng Huang, Denglan Lei, Zhaofei Li
Background and Objectives: Image segmentation is the basic problem in computer vision and pattern recognition. This study mainly focuses on the segmentation of medical sequence images. Materials and Methods: In this article, we considered the spatial similarity of the medical sequence image in active contour model (ACM) for segmentation. First, by utilizing the similarity of object contour between adjacent slices of medical images, and then using the segment result of the former slice as the initial contour of the next image to segmentation. The proposed model can automatically obtain a better initial contour location and reduce the computing cost for segment processing. Second, to improve the accuracy of image segmentation, we considered the similarity of the object contour between adjacent slices, and introduce a punishment term in localized ACM. Results: We compared our model and other methods for segmenting medical brain magnetic resonance slices, and the experimental results on synthetic medical sequence images validate the effectiveness of the proposed method. Conclusions: By utilizing the similarity of object contour between adjacent slices of medical images, and using the segment result of former slice as the initial contour of the next image to segment, the proposed model can obtain better initial contour location for segmentation sequence images and reduce the computing cost for whole medical sequence image segmentation process.
背景与目的:图像分割是计算机视觉和模式识别中的基本问题。本研究主要针对医学序列图像的分割进行研究。材料与方法:本文在活动轮廓模型(ACM)中考虑医学序列图像的空间相似性进行分割。首先利用医学图像相邻切片之间物体轮廓的相似性,然后将前一切片的分割结果作为下一图像的初始轮廓进行分割。该模型能自动获得较好的初始轮廓位置,降低了分割处理的计算成本。其次,为了提高图像分割的准确性,我们考虑了相邻切片之间目标轮廓的相似性,并在局部化ACM中引入了惩罚项。结果:将该模型与其他医学脑磁共振切片分割方法进行了比较,在合成医学序列图像上的实验结果验证了该方法的有效性。结论:该模型利用医学图像相邻切片之间物体轮廓的相似性,将前切片的分割结果作为下一图像的初始轮廓进行分割,可以获得更好的分割序列图像初始轮廓定位,降低整个医学序列图像分割过程的计算成本。
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引用次数: 2
期刊
Digital medicine
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