In 2006, three clinicians, Sue Wright, Andrew Smith and Bruce Martin from the Cardiology Unit at UCL Hospital, shared their frustration that there was no realistic model of the human heart that could be used to explain cardiac anatomy. study. So they came up with the idea of making a virtual heart, and quickly realized that such a model could be used to generate simulated ultrasound images if based on a 3D dataset of anatomy. This idea has a major impact on training, as this model can also be used to simulate the transesophageal echocardiography (TOE or TEE) experience. Transesophageal echocardiography is difficult to perform because the test requires the insertion of an internal probe to capture images of the patient’s beating heart.
When these clinicians approached Glassworks, a UK-based animation/visual effects company, they approached the company’s team of creative artists to discuss their ideas, and the design ideas began to take shape. The goal is to create an anatomically accurate computer-generated model of the heart that instantly generates lifelike ultrasound images that are animated to show changes in the shape of the heart during the heartbeat cycle in real time. This allows doctors to look at the cardiogram for valuable diagnostic insights.
Glassworks develops virtual heart model
These clinicians and Glassworks named the project HeartWorks. The development and use of this industry-first clinical training tool relies on the high-performance computing and visualization capabilities provided by NVIDIA’s Quadro professional graphics solutions.
NVIDIA declares its commitment to supporting technological innovation in medical imaging and life sciences. Its technology enables medical device providers to develop and sell solutions that meet the demanding requirements of the medical industry in high-performance computing (HPC) and visualization. Through its tireless efforts in recent years, Nvidia has made some amazing progress and, in some unusual partnership programs, has achieved extraordinary technological innovation. HeartWorks is one such outstanding example.
A small team of artists and developers at Glassworks set out to collect massive digital images of the heart, doing everything from participating in open-heart surgery to experiencing the beating of a human heart. As development work unfolded, Wright, Smith and Martin teamed up with leading surgeons, cardiac morphologists, sonographers and other experts to discuss the development of the system with Glassworks.
To create complex, realistic heart models and real-time animations, Glassworks artists and animators turned to animation software running on workstations equipped with NVIDIA Quadro graphics processing units (GPUs). These professional graphics solutions have the processing power to render high-quality images at 30 frames per second, ensuring lifelike, smooth animations.
Hector McLeod, founder of Glassworks, said: “With immersive technology, users can interact with three-dimensional images on the screen. However, in the past, this technology has been limited by the development level and cost budget of graphics technology. NVIDIA Parallel Breakthroughs in GPU technology have changed that. In HeartWorks, what NVIDIA GPUs do is load and Display extremely complex models at 30 frames per second in a sequence of events that are inherently complex. Fast rendering. In any frame, we use the GPU to inspect the model, slice the model, annotate the frame, and display two visualizations—model image and ultrasound image. This process takes less than 1/30 of a second.”
Glassworks software engineer David Llewellen added: “The NVIDIA Quadro can easily handle the large amount of data we hand it. The model contains a large number of polygons – 250,000 of them, two simulation effects to generate, and a full set of anatomical labels. In order to To give the model great graphics, we also used extremely detailed textures, most of them in OpenGL and running the GL Shader language. We needed a lot of processing power to meet all of these requirements on the fly to ensure that HeartWorks provides a real-time experience. “
Glassworks and clinicians in the Cardiology Department of UCL Hospitals marketed HeartWorks through London-based Inventive Medical. Inventive Medical is responsible for the integration, installation and support of the system for hospitals, laboratories and universities. The HeartWorks product delivered to the customer is a turnkey system that includes the HeartWorks software – interactive, virtual heart model and ultrasound image simulation program; high-performance workstation with NVIDIA Quadro professional graphics; monitor/keyboard/mouse; and probe and the torso of the dummy model – giving trainees a hands-on experience when teaching TOE/TEE procedures (Figure 1).
Figure 1 This product allows real-time simulated TTE imaging of a virtual heart using a life-size dummy torso. The torso features soft skin and precise, palpable anatomical landmarks to aid in positioning the handheld ultrasound probe. The image displayed on the screen allows the user to identify the position of the probe on the virtual chest and to determine the orientation of the ultrasound image plane.
HeartWorks put into use at Duke University
Duke University in the United States, to be precise, is an anesthesiology major in the Department of Cardiothoracic Anesthesia and Critical Care Medicine of its medical school, and is one of the early adopters of HeartWorks. The department purchased the simulator in early 2009 for teaching residents and fellows participating in its advanced transesophageal echocardiography course. The product is used primarily by first-, second-, and third-year residents to learn basic transesophageal echocardiographic views and anatomy, while fellows taking this advanced course use it to examine more subtle features.
Dr. Madhav Swaminathan, Department of Cardiothoracic Anesthesiology, Duke University School of Medicine, is an MD, an outstanding faculty member, and a fellow of the American Heart Association. “Simulation has allowed us to make a huge leap forward in our teaching,” he said. “The system basically simulates a beating heart clearly. It’s difficult to interpret the formation of ultrasound images and their correlation to anatomical features. When moving Probe, when you change the image plane, it’s hard to know which part of the heart you’re seeing on the screen, because the heart is three-dimensional and you’re showing a three-dimensional view on a 180-degree plane. The simulator allows people to see side-by-side comparisons of the views , you can not only see how the ultrasound image is generated, but also understand what the slice means. All this is achieved in a relaxed environment in control, you do not have to worry about interfering with the clinical treatment of the patient, or Don’t worry about taking too long. This virtual environment technology allows residents to get started quickly.”
Dr Swaminathan further explained that the main advantage of simulation technology is the real-time interactive experience for residents and fellows. “Being able to see the heart beat and change its image plane, slice and manipulate it at will is a major breakthrough in interactive education compared to having to do what the teacher says.” Animated realistic model of the heartbeat, please visit www.heartworks.me.uk.
Figure 2. 3D image of the heart model. The heart model can also be viewed in tomographic or stereoscopic 3D heartbeat modes.
Following the success of the TOE/TEE application simulator, the University College London Cardiology Department and the Glassworks team began to develop another HeartWorks device. The device, called TTE, is able to simulate the experience of an external ultrasound examination. The device utilizes the same virtual heart model as the original HeartWorks app, however, it interacts with the probe to generate slice planes of the lungs and ribs, which the user can also see.
In developing new TTE applications, Glassworks explored how to further leverage NVIDIA’s Quadro GPU technology by writing shader tools in the NVIDIA Unified Computing Architecture (CUDA) programming language to achieve even greater performance gains. Glassworks’ Llewellyn said: “We want to further optimize to make the product run faster and have better graphics. Whatever Nvidia develops next, we will take full advantage of it.”
Looking to the future
Today’s medical device manufacturers offer systems that capture, compute, render, display, and store more massive amounts of information than ever before. In the future, this trend will intensify. Many innovative technologies have or will change the way clinical examinations are performed.
It is these “new developments” that NVIDIA is committed to designing; by anticipating challenges and providing solutions, empowering clinicians and medical device manufacturers in new ways to address them. The NVIDIA CUDA programming language allows users to dramatically increase computing performance by leveraging the processing power of the GPU. The latest generation of Quadro and Tesla GPUs based on NVIDIA’s Fermi architecture for workstation and server-side applications are designed to deliver outstanding performance that can greatly accelerate the workflow of any medical task and potentially help improve patient outcomes.