Introduction to Medical Visualization

Outline
1. Visualization in Medicine
2. Computerized Medical Imaging
3. 2D and 3D Visualizations

Visualization in Medicine
Scientific visualization
Deal with the analysis, visualization and
exploration of datasets arising from measurements
or simulation of real world phenomena

Visualization in Medicine
Goals and scenarios of scientific visualization
To explore data
To test a hypothesis based on measurements or
simulations and their visualization
The presentation of results

Visualization in Medicine
Medical visualization
Deals with the analysis, visualization,
exploration of medical image data
A specialty of scientific visualization

and

Visualization in Medicine
Neck dissection planning visualization

Left: Relevant anatomical structures and potentially pathologic lymph nodes are displayed to support
neck dissection planning
Right: The distance between an enlarged and potentially malignant lymph node is color-coded to a
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muscle to support the decision as to whether the muscle should be removed

Visualization in Medicine
Design of medical visualization systems
A process directed to understand the data
Interaction methods
Support users in navigating within the data
Support the interpretation and classification of the data
Support users in the storage of results

Computerized Medical Imaging

Applications of medical visualization
Educational purposes
Visualization techniques are the core of anatomy and
surgery education systems

Computerized Medical Imaging

Applications of medical visualization
Diagnosis
The diagnosis of radiological data benefits from
interactive 2D and 3D visualizations

Computerized Medical Imaging

Applications of medical visualization
Treatment planning
Interactive 3D visualizations of the relevant anatomical
and pathologic structures enhance the planning of
surgical interventions, radiation treatment, and
minimally invasive interventions

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Computerized Medical Imaging

Applications of medical visualization
Intraoperative support
Medical visualization based on 3D data is entering the
operating room (OR)

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Computerized Medical Imaging

Computer support
Not to replace medical doctors
But to support and assist physicians

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2D and 3D Visualizations
2D techniques
Allow an accurate examination and processing
Each pixel can be seen and selected
Support precise exploration and analysis of the
data

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2D and 3D Visualizations
3D techniques
Often a comprehensible overall picture
Physicians who carry out interventions strongly
benefit from interactive 3D visualizations

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2D and 3D Visualizations
A simultaneous employment of 2D and 3D
visualizations

Left: A 3D surface visualization of the relevant anatomical structures for surgery planning

Right: The CT slices from which the data have been extracted
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Medical Image Data &

Visual Perception

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Outline
1.
2.
3.
4.
5.

Medical Image Data

Data Artifacts
Sensitivity and Specificity
Visual Perception
Summary

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Medical Image Data

Volumetric data
Usually represented as a stack of individual images
Each image represents a thin slice of the scanned body
part and is composed of individual pixels

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Medical Image Data

2D grid
All pixels of an image are arranged on the grid
points of the grid

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Medical Image Data

3D grid
All voxels are arranged on a 3D grid

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Medical Image Data

Volume cell

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Medical Image Data

Features of cartesian grid
Constant or regular spacing in each dimension
Regular geometry that can be computed by the grid
index and the spacing
Regular topology
It is only composed of cuboid cells

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Medical Image Data

Interpolation
Nearest-neighbor interpolation
Modest computational costs
Low visual quality

Trilinear interpolation
More sophisticated
High visual quality

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Medical Image Data

Trilinear interpolation

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Medical Image Data

6-neighborhood
(right)

(left)

and

26-neighborhood

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Data Artifacts
Sampling theorem
A signal has to be sampled at least with twice the
frequency

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Data Artifacts
Aliasing
A phenomenon that is directly related to sampling
It is caused by an incorrectly reconstructed signal,
due to insufficient sampling

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Data Artifacts
Moir artifact
The sampling rate is increased from the left to
right and the Moir artifacts are reduced

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Data Artifacts
Undersampling artifact
Different slice and pixel distance in anisotropic
datasets can lead to insufficient sampling

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Data Artifacts
Solutions to overcome undersampling
Increase the sampling rate until we satisfy the
Nyquist rate
Band-limit the original signal by performing a low
pass filtering step

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Data Artifacts
Low pass filters
A box filter
A triangle filter
A Gaussian filter

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Data Artifacts
Side effects of smoothing
If too many frequencies are removed by a low pass
filter, details will disappear

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Data Artifacts
Partial volume effect
Due to limited resolution at volume reconstruction,
large intensity differences cannot properly be
reconstructed

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Data Artifacts
Partial volume effect
The thin membrane Lamina Terminalis at the floor
of the third cerebral ventricle could not be fully
reconstructed

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Data Artifacts
Partial volume effect
False connections are due to the incompletely
reconstructed septum between the upper lateral
cerebral ventricles

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Data Artifacts
Interpolation artifacts
Central differences are typically used to estimate
the gradients of volume datasets
Will generate artifacts if the intensity differences
are large or the grid spacing is anisotropic

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Data Artifacts
Interpolation artifacts
Block artifacts of an isosurface reconstruction of
the label volume of a bronchi dataset

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Data Artifacts
Interpolation issues on anisotropic grids
Different voxel distances in different spatial
orientations are not properly addressed

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Data Artifacts
Interpolation issues on anisotropic grids
Staircasing artifacts (left) and a magnification of
the marked area (right). The flipping normal
direction demonstrates the origin of the artifact
Lighting calculation

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Data Artifacts
Remedies for anisotropic grid spacing
Correct the sample point normals according to the
spacing

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Data Artifacts
Remedies for anisotropic grid spacing
Resample the data volume into an isotropic grid
dataset using an appropriate reconstruction filter

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Data Artifacts
Signal artifacts
Caused by the data acquisition techniques
themselves
The most notorious signal artifacts are metal
artifacts

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Data Artifacts
Signal artifacts
Metallic implants degrade CT image quality in the
maxillary region (left) and beam-hardening artifact
near the base of the skull (right)

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Sensitivity and Specificity

Categories for the evaluation of diagnostic
procedures

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Sensitivity and Specificity

Sensitivity is the probability of correctly
reporting an abnormality

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Sensitivity and Specificity

Specificity is the probability of correctly
reporting that no abnormality exists

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Sensitivity and Specificity

Examples of ROC
Characteristic) curves

(Receiver

Operating

A good curve indicates that a diagnostic procedure

has a high sensitivity and specificity

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Visual Perception
Gray value perception
The human eye is relatively less sensitive in the
brightest areas of an image

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Visual Perception
Aspects of visual perception
Just-Noticeable Differences
The smallest luminance difference of a given reference
intensity that the average human observer can still
perceive

Spatial Resolution
Contrast Perception

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Visual Perception
Color spaces
Device-oriented color spaces
The color is defined in away which corresponds to the
physical realization of color output of that device

Intuitive color spaces

The color is defined in a way that adheres to natural
properties of color, such as brightness

Perceptually uniform color spaces

The color is defined such that the Euclidean distance
between a pair of colors corresponds to the perceived
difference between these colors
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Visual Perception
Color scales for encoding scalar values
Rainbow scale
The full hue range of the HSV color model is mapped to
a selected color range

Isomorphic colormap
Either saturation or luminance is increased in a
monotone manner

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Visual Perception
Discrete color scales
Used to convey whether a value is in a certain
interval

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Visual Perception
Bi- and trivariate color scales
Map two or three scalar values to a single color by
using separate components of a color space

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Summary
The datasets are subject to the sampling
theorem
Gray intensities are not perceived linearly
The same problem arises in color
representations

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