Nohwon Park

Augmented reality intravenous injection simulator based 3D medical imaging for veterinary medicine

Augmented reality (AR) is a technology which enables users to see the real world, with virtual objects superimposed upon or composited with it. AR simulators have been developed and used in human medicine, but not in veterinary medicine. The aim of this study was to develop an AR intravenous (IV) injection simulator to train veterinary and pre-veterinary students to perform canine venipuncture. Computed tomographic (CT) images of a beagle dog were scanned using a 64-channel multidetector. The CT images were transformed into volumetric data sets using an image segmentation method and were converted into a stereolithography format for creating 3D models. An AR-based interface was developed for an AR simulator for IV injection. Veterinary and pre-veterinary student volunteers were randomly assigned to an AR-trained group or a control group trained using more traditional methods (n = 20/group; n = 8 pre-veterinary students and n = 12 veterinary students in each group) and their proficiency at IV injection technique in live dogs was assessed after training was completed. Students were also asked to complete a questionnaire which was administered after using the simulator. The group that was trained using an AR simulator were more proficient at IV injection technique using real dogs than the control group (P ≤ 0.01). The students agreed that they learned the IV injection technique through the AR simulator. Although the system used in this study needs to be modified before it can be adopted for veterinary educational use, AR simulation has been shown to be a very effective tool for training medical personnel. Using the technology reported here, veterinary AR simulators could be developed for future use in veterinary education.

Comparison of echocardiography with dual-source computed tomography for assessment of left ventricular volume in healthy Beagles

OBJECTIVE To compare echocardiographic measurements of left ventricular (LV) volume obtained via a modified Simpson or Teichholz method with those obtained via dual-source CT (DSCT). ANIMALS 7 healthy Beagles. PROCEDURES Each dog was anesthetized for DSCT; LV volume was determined from contrast-enhanced images of the LV lumen during all phases of contraction. Echocardiography was performed with dogs awake and anesthetized. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume, and ejection fraction were measured via a modified Simpson method and Teichholz method. Each dog was anesthetized twice with a 1-week interval between anesthetic sessions. RESULTS Results obtained while dogs were anesthetized revealed that the modified Simpson method underestimated LV volume (mean ± SD EDV, 24.82 ± 2.38 mL; ESV, 12.24 ± 1.77 mL), compared with that estimated by the Teichholz method (EDV, 32.57 ± 2.85 mL; ESV, 14.87 ± 2.09 mL) or DSCT (EDV, 34.14 ± 1.57 mL; ESV, 16.71 ± 0.76 mL). Ejection fraction (modified Simpson method, 48.53% ± 4.24%; Teichholz method, 54.33% ± 4.26%; DSCT, 51.00% ± 2.71%) differed significantly among the 3 methods. Echocardiographic results obtained while dogs were awake revealed that EDV, ESV, and stroke volume differed significantly between the modified Simpson and Teichholz methods. CONCLUSIONS AND CLINICAL RELEVANCE LV volume determined via the Teichholz method was more similar to that determined via DSCT than was the LV volume determined via the modified Simpson method. The modified Simpson method underestimated LV volume, compared with that obtained via the Teichholz method, in both anesthetized and awake dogs.

Diffusion tensor imaging of white and grey matter within the spinal cord of normal Beagle dogs: Sub-regional differences of the various diffusion parameters

Diffusion tensor imaging (DTI) is an advanced diffusion weighted imaging technique that can identify early stage lesions and Wallerian degeneration within the spinal cord; these changes are difficult to recognise on conventional magnetic resonance imaging (MRI). The only DTI parameters previously investigated in dogs are fractional anisotropy and mean diffusivity (MD). The aim of this study was to evaluate multiple DTI parameters in sub-regional areas of the spinal cord in normal Beagles. All imaging data were obtained from the lumbar spinal cord (L1-L3) of ten normal dogs using a 3 Tesla MRI scanner. Transverse multi-shot echo planar imaging sequences (b values = 0 and 800 s/mm(2); 12 directions) were used for DTI. Regions of interest were selected from sub-regions of the white and grey matter, and from the whole spinal cord, in the transverse plane in all DTI maps. The DTI parameters in spinal cord sub-regions in the transverse plane were significantly different amongst the white matter, grey matter and whole spinal cord (P < 0.05 for all DTI parameters except MD), as well as between white matter sub-regions (P < 0.05 for most DTI parameters except radial diffusivity, MD and planar index). DTI-based sub-regional analysis of white and grey matter may be useful for regional evaluation of the dog spinal cord.

Contrast echocardiography to assess left ventricular volume and function in Beagle dogs: comparison with 3-Tesla dual source parallel cardiac magnetic resonance imaging.

This study was performed to evaluate the effect and feasibility of contrast echocardiography (CE) compared with unenhanced echocardiography (UE) and cardiac magnetic resonance imaging (CMRI) to assess left ventricular (LV) volume and function, including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) in six healthy Beagles. When the dogs were conscious, LV measurements using CE were significantly higher than those obtained using UE, except for EF, and were similar to the values obtained using CMRI. Additionally, EDV, SV, and EF obtained using UE from anesthetized dogs were significantly lower than those obtained using CE or CMRI. Measurements of EDV, SV and EF using CE were not significantly different from the corresponding measurements obtained using CMRI (31.13±2.18 vs. 32.88±1.17 mL, 18.41±1.25 vs. 17.92±0.96 mL, 59.29±2.29% vs. 53.33±1.69%, respectively). Inter-observer agreements for UE (0.74±0.05) were lower than those for CE (0.80±0.04) and CMRI (0.92±0.03). In conclusion, LV function was assessed reproducibly using CE, and the measurements obtained were consistent with reference standard measurements obtained using CMRI. Measurements made using CE agreed more closely with CMRI than those made using UE.

Doppler ultrasonographic evaluation of renal arterial resistive and pulsatility indices in overhydrated Beagles

OBJECTIVE To determine renal arterial resistive index (RI) and pulsatility index (PI) and clinical signs of overhydration induced by IV administration of saline (0.9% NaCl) solution and to assess RI and PI as variables for monitoring of dogs to detect overhydration. ANIMALS 10 clinically normal Beagles. PROCEDURES Each dog received saline solution at a maintenance rate (2.5 mL/kg/h) and a rate 3 times that of the maintenance rate (overhydration rate; 7. 5 mL/kg/h). Values of RI and PI were determined with pulsed-wave Doppler ultrasonographic examination of renal interlobar or arcuate arteries before saline solution administration, every hour during 5 hours of administration, and 1 hour after administration was stopped. RESULTS No significant changes in RI or PI were detected during administration of saline solution at the maintenance rate. However, RI (starting 1 hour after the beginning of fluid administration [mean ± SD value, 0.589 ± 0.012]) and PI (starting 2 hours after the beginning of fluid administration [value, 0.867 ± 0.052]) were significantly lower during administration at the overhydration rate than they were during administration at the maintenance rate. Clinical signs of overhydration were observed in all dogs starting 4 hours after the beginning of fluid administration at the overhydration rate. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated overhydration of dogs caused significant decreases in RI and PI prior to detection of clinical signs of overhydration. Ultrasonographic determination of renal arterial RI and PI seemed to be a noninvasive and sensitive method for evaluation of overhydration in dogs.

Kilovoltage radiotherapy for companion animals: dosimetric comparison of 300 kV, 450 kV, and 6 MV X-ray beams

Radiotherapy for the treatment of cancer in companion animals is currently administered by using megavoltage X-ray machines. Because these machines are expensive, most animal hospitals do not perform radiotherapy. This study evaluated the ability of relatively inexpensive kilovoltage X-ray machines to treat companion animals. A simulation study based on a commercial treatment-planning system was performed for tumors of the brain (non-infectious meningoencephalitis), nasal cavity (malignant nasal tumors), forefoot (malignant muscular tumors), and abdomen (malignant intestinal tumors). The results of kilovoltage (300 kV and 450 kV) and megavoltage (6 MV) X-ray beams were compared. Whereas the 300 kV and 6 MV X-ray beams provided optimal radiation dose homogeneity and conformity, respectively, for brain tumors, the 6 MV X-rays provided optimal homogeneity and radiation conformity for nasal cavity, forefoot, and abdominal tumors. Although megavoltage X-ray beams provided better radiation dose distribution in most treated animals, the differences between megavoltage and kilovoltage X-ray beams were relatively small. The similar therapeutic effects of the kilovoltage and 6 MV X-ray beams suggest that kilovoltage X-ray beams may be effective alternatives to megavoltage X-ray beams in treating cancers in companion animals.