EVALUATION OF 3D IMAGING

BY
NAMRATHA DCRUZ
 CONTENTS
Introduction
Evaluation of 3D systems
3D imaging systems
Point digitizers
Surface scanners/digitizers
Volume imaging systems
Measurements
Spatial-Point, Displacement, Area
Mass properties
Target Definition
Anatomic Fidelity
 INTRODUCTION
3D medical imaging and systems are used for non destructive
inspection of the body and its component regions in vivo and in
vitro.
These systems provide 3D data as discrete points, surfaces or
volumes.
3D medical imaging is used for
Diagnosis
Treatment planning
Execution and monitoring of interventions
Extract quantitative measurements
 INTRODUCTION
Determine of any abnormality is present by comparison with
normal controls
Assess change over time.
After acquisition the 3D digital image data is visualized, measured
and compared to perform the above tasks.
The evaluation of 3D imaging system performance depends on
specific application, body region, modality used, observers involved
and subject being studied.
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Evaluation of 3D medical imaging has 2 main purposes:

1. Objectively assess anatomical regions and features using 3D

images

2. Determine the performance of 3D imaging systems in

visualization and measurement of biological structures.
. 3D medical imaging systems are used to inspect and measure
anatomic points, surfaces, slices, or volumes that comprise organs
and body regions.
. Medical imaging modalities that provide 3D data are CT, MRI,
ultrasound, surface scanners, point digitizers etc.
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3D medical imaging systems are used to evaluate biological
structure by acquiring and processing digital data for
static or interactive visualization
measurement comparison.

The evaluation of 3D imaging system performance

therefore depends on specific application, body region,
modality used, observers involved and subject being
studied to estimate
relative diagnostic performance
measurement error
image artifacts
user preference
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Evaluation of imaging systems and procedures is done to assess
their quality using subjective or preferably objective methods.
The principle applications of 3D imaging are visualization and
intervention.
Process or outcome evaluation of 3D medical imaging systems
begins with images and measurements.
3D CT reconstruction facilitate other more complex diagnostic tasks
and is said to be the most useful modality for planning surgical
management in craniofacial imaging.
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3D CT is also useful in certain orthopedic, neurosurgical,
radiotherapy, and otolaryngological applications.
Anthropometry is the study of human body measurement, to
characterize groups rather than individuals and subpopulations
according to gender, age, demographics, or other criteria.
Precise image based measurements obtained in individuals using 3D
anthropometric measurements are used in medical diagnosis and
treatment. Eg. Radiotherapy treatment planning and intra operative
surgical navigation.
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Data collection and format standards are required for transfer and
subsequent processing of raw data obtained from various 3D
imaging systems.
DICOM standards are currently being used and have stimulated the
development of many add-on systems.
Disciplines that use human body surface dimensions require
accurate, repeatable measurement. Eg. Cencit imaging systems.
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The factors that influence validation and testing of an imaging
systems for anthropometric measurements are :

1. The digital images must be as clear and accurate as possible,

allowing visual identification of contrasting intensities or colors
and depths by an observer or by electronic means.

2. Repeated images of the same individual should be nearly identical.

3. The location of the anatomical structures chosen for data

collection must be reliably identified by a trained observer.
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Serial 3D examinations or multimodality examinations are
combined and analyzed as four or higher dimensional data sets.
Real time 3D imaging system(4D) such as mayo dynamic spatial
reconstructor (DSR) is implemented to image the moving heart.
Individual points in 3 dimensions are localized by interactive
digitizers that employ manual, optical, mechanical, electrostatic or
electromagnetic styli.
These instruments locate record individual points on the body
surface or interactively report the location of hand held instruments
relative to organs and body regions.
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Point digitization is the basis of the landmark analysis, such as that
used in craniometry, skull measurement, and orthognathic surgical
planning.

POINT DIGITIZERS
These are the instruments that report 3D coordinate locations of a
stylus tip.
The purpose of these instruments is to report the 3D coordinates of
specific surface points designated by the operator.
A list of points are obtained which is stored in the computer for
subsequent use in object modeling and computation of
measurements.
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Polhemus 3space Digitizer
It is an instrument used in 3D point digitization which is based on
EM measurements of spatial location with a hand held stylus.
The unit consists of a tablet containing the computer, a hand held
stylus, keypad and a footpad.
The stylus connects each landmark, and an electromagnetic field
generated within the unit determines the location of the stylus.
These devices are integrated into interactive surgical navigation
systems.
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Polhemus 3space Digitizer

point digitizers are important in 3D medical imaging as

Several points on the body surface have special anatomic
significance known as landmarks and include nasion,
gonion and many others.
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o Points are tabulated in anatomy and anthropometry literature
and are used for comparison of instruments, studies of skull
growth and development as well as planning and prediction of
outcome of various surgical process.
SURFACE SCANNER/DIGITIZERS
3D surface coordinates is obtained by active optical scanning .
Light source illuminates the surface and image sensors at known
locations are used to triangulate the objects location at every visible
point on the surface.
Eg: Cencit and Cyber ware scanners.
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Cencit and Cyber ware Facial Surface Scanners.
The Cencit imaging system is a non-contact, stationary three-
dimensional active optical imaging system employing structured
light and multiple sensors which are enclosed in a stand-alone unit.
Individual subjects are digitized and the data processed and
displayed on a graphics workstation(Silicon Graphics Indigo 2)
Cyber ware manufactures facial surface digitizer which obtains
millimeter resolution datasets from 360 coverage of the head, neck,
and upper torso.
It is applied to portrait sculpture, orthotics and prosthetics, synthetic
actors, medical diagnosis and communications research.
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Cencit and Cyber ware Facial Surface Scanners.
These devices are essential components of systems for intra-
operative use, to enable 3D ultrasound image acquisition, for 3D
whole body anthropometry, and others.

Facial Scanner Validation Analysis

Principle issues for evaluation include the quantitative accuracy,
precision and repeatability of measurements.
Human volunteers were examined after placing markers on the
facial surface at anatomically significant points.
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Facial Scanner Validation Analysis
Quantitative evaluation of both the systems indicated that the min
and max distance between homologous landmarks at the level of
digitizing, scanning and landmark marking were less than or equal
to the diameter of the black dots.
The precision of Cencit was comparable to that of Polhemus
digitizer.
Error was found in marking landmarks.
Greater precision can be obtained if smaller markers are used to
identify the landmarks.
The precision and repeatability of both the systems are similar.
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Facial Scanner Validation Analysis
The proportion of variance due to digitizing and scanning is low the
large values is due to the error in marking landmarks and can be
overcome by training antropometrist thus increasing repeatability.
Small measurements are less repeatable compared to large
measurements because in large measurements the errors are
distributed across a greater distance.

Evaluation of the Cencit Facial Scanner

The Cencit facial scanner was shown to perform comparably to the
Polhemus 3space digitizer.
It accurately images facial landmarks.
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Evaluation of the Cencit Facial Scanner
Large amount of data can be collected from electronically stored
facial images. It can also be processed according to researchers
convenience.
Such a systems are used in studies of landmarks, surfaces and
volumes and in comparison within or between populations.
Majority error was found in landmarks and is common to all
measurement devices and can be reduced by training and judicious
choice of landmarks.
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VOLUME IMAGING SYSTEMS
Volume imaging is achieved clinically by CT and MRI.
Spiral or helical CT is developed to acquire body region volume
images in less than 1 min.
MRI scanners acquire a volumetric head scan with approximately
256256128 or 256 voxels at 1mm resolution in less than 10 min.

3D CT Images
3D craniofacial imaging was introduced in the early 1980s.
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3D CT Images
Typical CT scans are obtained at 512512 resolution at 1 or 2 mm
intervals throughout the skull in children and adults with congenital
and acquired deformities of the head.
CT scans for 3D visualization and analysis are routinely performed
in patients with craniocytosis, a group of disorders that deform the
skull growth due to abnormalities of the sutures between cranial
bones.
The results of a 3D imaging study helps in distinguishing between
normal and synostosed (closed) sutures.
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3D CT Images
The results were evaluated using 3 kinds of evidence:

1. The incorrect diagnosis of the least experienced reader.

2. The confidence levels of diagnosis in the most experienced reader.

3. Examination of the images in an unblinded fashion.

. Craniosynostosis has historically been treated as an inherently
binary abnormality.
. Sutures have been diagnosed as either normal or abnormal, based on
skull morphology with confirmation by imaging procedures.
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3D CT Images
Comparison of surgical results, histological examination of excised
sutures, and results from 3D CT images suggests that results
obtained histologically and clinically are correct.
For the purpose of evaluation, the results suggest that addition of the
third gold standard. i.e surgeons opinion.

MEASUREMENTS
3D imaging systems are used to quantify and model the geometry of
biological structures.
Measurement of points, surfaces or volumes are obtained by manual
interaction with digital data sets or by automated process.
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SPATIAL-POINT, DISPLACEMENT, AREA
Measurements extracted from 3D medical image data sets include
spatial coordinates of individual points, distance between points
representing displacement or offset between identifiable landmarks
and surface area.

MASS PROPERTIES
Mass properties of scanned or imaged objects include volume,
centroid, and moments of inertia.
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TARGET DEFINITION
It is an essential step in the planning of radiation therapy.
3D conformol radiotherapy is an emerging technology for precision
delivery based on volumetric imaging with target definition on 3D
CT scans of body regions.
The tumor itself, its margins and critical normal structures in the
treatment fields are identified ,segmented and labeled before the
dosimetry and evaluation of the plan can be done.
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ANATOMIC FIDELITY
3D imaging systems have varying degree of temporal, contrast, and
spatial resolution that determine their relative ability to delineate
anatomic structure.
The anatomic fidelity is mostly judged subjectively, where
comparison is made by experts between known or expected levels of
quality in medical images and those synthesized from data sets.
The visualization results is highly dependent on the perceived level
of anatomic fidelity in images.
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