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This week's Health Systems Chat in Social VR take place during two incredibly influential health tech conferences: RSNA18 (Radiological Society of North America Annual Meeting) and the Forbes Healthcare Summit. #RSNA18 is a ginormous conference about medical imaging but includes lots of cool virtual reality and 3D-printing applications. And #ForbesHealth ("The World’s Most Influential Healthcare Event") is all about picking (and investing in) health tech winners that will transform healthcare.

Please join us to talk about virtual reality, 3D-printing, and healthcare breakthroughs and controversial issues, and how to turn our healthcare system’s challenges into opportunities.

What I find most interesting about healthcare technology investment conferences is this. Online, (via @wareFLO) I hang around with a lot of opinionated healthcare futurists... however, I put folks who are looking to invest millions in the next health technology in a special category. They literally put their money where their mouth is!

And what I find fascinating about RSNA (been several times) is that radiologists are early adopters of a wide variety of digital technologies that eventually diffuse into the rest of health IT, including artificial intelligence & machine learning, and virtual and augmented reality.

Here is just a taste of VR/AR related RSNA workshops, presentations, and posters: (See further below for a similar overview of the Forbes Health Summit...)

Applying Virtual and Augmented Reality to Radiology and Medicine

@realizeLAB

By combining a 'hands-on' immersive virtual reality experience and standard slides-based narrative, the learner will be able to: 1. Classify experiences as virtual reality (VR) or augmented reality (AR) and list the components of modern VR/AR technologies; 2. Define medical applications of VR/AR for diverse user groups and describe its role in the patient intervention process based on concrete hands-on case-studies; 3. Describe the methods (hardware and software) of visualizing medical images and models in VR/AR using a comprehensive conceptual framework; 4. Describe key considerations for placing VR/AR visualization tools into a radiology-based workflow.

A. Definitions of virtual reality (VR) and augmented reality (AR) and their respective components. B. Modern VR/AR technologies: 1. mobile vs tethered; 2. development platforms; 3. physical and technical limits. C. Clinical applications of VR and AR classification by degree of patient involvement: 1. Training; 2. Surgical planning and guidance; 4. Interpretation assistance; 5. Patient-based VR/AR therapies D. VR visualization of medical images and 3D models: 1. Visualization of segmented images; 2. Visualization of unsegmented images; 3. Manipulation of data in VR/AR; 4. VR/AR 'virtual presence' collaboration tools.

3D/VR/AR Imaging: Staying on the Cutting Edge of Brain Anatomy/Pathology (Hands-on)

Brain Atlas/VR/AR imaging: Staying on the Cutting Edge of Brain Anatomy/Pathology This hands-on workshop will demonstrate an advanced brain atlas which fuses with a patient's MR brain imaging. Attendees will be able to navigate a patient's brain with 3D googles using Virtual Reality (VR) technology. Augmented Reality (AR) technology will also be presented. The atlas presented has extensive data related to brain anatomy, vasculature, and function. It can map white fiber tracts when conventional DTI cannot be generated as a result of tumor or vasogenic edema. The atlas also takes into account tumor mass effect by deforming adjacent anatomical structures. Given its 3D capability, this tool has been used in neurosurgical pre-operative planning cases. Intraoperatively, the atlas has been successfully fused to neuronavigation systems to aid in real-time surgical guidance. The atlas also has been very useful for radiation treatment planning. It supports individualized medicine, through the generation of videos related to the patient's brain tumor assisting patient education.

Virtual and Augmented Reality Helps in Pre-Operative Planning of Brain Tumors

We found that VR which works with a computer screen and a headset in a closed 'purely virtual' environment is a robust technology. It was helpful in pre-operative planning, which included mapping out the gyral anatomy, arteries, veins, as well as tumor infiltration patterns. However, at this time, this technology can only be used by a single user. AR technology is rapidly evolving. AR uses a clear goggle system which allows the user to see his/her 'real' environment and overlays holographic images onto the patients MR imaging. When used, we found AR was superior to VR in anatomy and tumor display. AR is also capable of being shared by multiple viewers, which is of value in communicating with the surgeon and consultation with other colleagues in real time. However, AR is currently not stable enough for consistent use in clinical cases. AR has the potential to be used intraoperatively, by fusing holographic images to the patient's own brain during surgery. CONCLUSION Both VR and AR are innovative alternatives to analyze complex glioma cases for pre-operative planning. At this time, VR is superior to AR, as it is better established and a stable platform. However, as technology advances, AR will likely overtake VR for pre-operative planning of brain tumors.

3D Printing and Virtual Reality Models Using DICOM Data, Inexpensive, Often Free and More Accessible Than You Think: An Introduction to Key Concepts

To highlight the availability of advanced software online, much of which is free. Demonstrate volume rendering, segmentation and export 3D models based on DICOM data using 3D Slicer and MeshLab. Demonstrate simple and advanced applications such as Sketchfab or Unity game creation software with the Google VR extension to create virtual models that can be viewed with your smartphone or advanced VR headsets Exporting 3D models in printable format and show our own hands-on examples. TABLE OF CONTENTS/OUTLINE Creating your 3D model Introduction to Slicer 3D - Free software (opensource) Importing DICOM data. Volume rendering. Cropping to region of interest. Segmentation Saving 3D object - file formats. MeshLab Edit exported 3D objects. Viewing your 3D model VR the easy way! Sketchfab - Proprietary but free if you share models. Upload and share 3D models online. View on smartphone app. Advanced VR! Brief introduction to Unity game engine. Proprietary but free for students. Creation of google cardboard / Oculus headset apps. Print it Varying cost depending on size, complexity and availability. Potential in surgical planning, research and industrial design. Demonstrate difficult anatomy. Conclusion Radiology residents and consultants often underutilise available technologies because of perceived inaccessibility, cost and complexity.

3D Printed, Virtual Reality, or Augmented Reality Urological Cancer Models: What Works Best, When, and Why?

(1) 3D printed, virtual reality (VR), and augmented reality (AR) models can be generated from medical images and these models allow enhanced understanding of 3D spatial anatomy. (2) Image segmentation is required for these advanced visualization methods and accuracy of 3D models may vary depending on software utilized and experience of user. (3) 3D printed models allow haptic and visual feedback, thereby enhancing understanding of true size and 3D spatial relationships. (4) VR allows simultaneous visualization of a volume rendered dataset and the corresponding 3D meshes, which may contribute to a more comprehensive understanding of cancer. (5) AR permits concurrent visualization of 3D models in the real environment, making it more suitable for use in the operating room. TABLE OF CONTENTS/OUTLINE (1) Overview of use of 3D printed, VR, and AR urological cancer models to depict the cancerous lesion and its relationship to key anatomic structures. (2) Imaging requirements for creating 3D printed, VR and AR urological cancer models. (3) Description of the segmentation workflows used to generate 3D urological cancer models and comparison of results obtained using different software platforms. (4) Pros and cons of each advanced image visualization method (3D printing, VR, and AR) in the context of urological cancer models.

Spatial Medical Imaging Using Virtual Reality, Augmented Reality, and Mixed Reality: How to Use and Evaluate the Effectiveness of Holographic Education

1) To learn the solutions of VR, AR, and MR in medical imaging (special mapping, position scanning, gesture control, 3D stereoscopic imaging...). 2) To learn how to export polygons of targeting organs from DICOM data (CT, MRI…). 3) To learn how to select and use VR/AR/MR devices (HMD, AR tablet, Holographic grasses…) and software applications. 4) To show illustrative examples of VR/AR/MR, such as in medical education, surgical planning, surgical simulation, and intraoperative navigation. TABLE OF CONTENTS/OUTLINE 1. Terminology: The representative forms such as VR/AR/MR are referring to all real-and-virtual combined environments and human-machine interactions generated by computer technology and wearables. 2. The potential role and limitations. 3. Beneficial applications of the VR/AR/MR devices (Oculus, VIVE, WinMR, AR-Kit, Tango, HoloLens…). 4. How to integrate the spatial imaging system by interactive superimposing 3D holograms by tracking the user's eye, head and hand/arm position. 5. Effectiveness: Enhancing scene visualization is a feasible strategy for augmenting spatial awareness in complex anatomy education. For surgery, this reduces the length of the operation and discussion time. This has illustrative benefits in surgical planning, simulation, education, and intraoperative navigation.

The 3D Slicer Open-Source Software Platform for Translational Research in Quantitative Imaging

3D Slicer (https://www.slicer.org) is developed as modular and extensible open-source software for delivering cutting-edge medical image analysis technology to the clinical research community. The platform provides standard radiological display capabilities and advanced post-processing tools. 3D Slicer includes a DICOM interface that enables end-users to pull data directly from a PACS workstation, radiological viewing capabilities for MR, CT, PET, ultrasound and histopathology data with standard reformatting and lightbox viewing of anatomical slices, as well as advanced 3D visualization and virtual reality functionalities. The platform integrates state-of-the-art tools for filtering, segmentation, registration, slice annotation, quantitative imaging, tool tracking and real-time data fusion, and supports the integration of artificial intelligence based tools. 3D Slicer accommodates new research approaches through the Slicer Extension Manager that enables the addition of Slicer extensions plug-ins to the platform. 3D Slicer version 4.9 includes 93 Slicer extensions for a wide range of applications such as radiotherapy, nuclear medicine, shape analysis quantification, informatics and deep learning.

A Preview Of The 2018 Forbes Healthcare Summit

Notes & Themes

How My Health Scare Led To A New Treatment

Ovarian cyst led patient to found a company that developed a device for diagnosing ovarian cancer.

Why Is A Drug Store Buying A Health Insurer? CVS Health buying Aetna

Health Beyond Healthcare

Healthcare is not just about prescribing drugs or performing surgery. Food, transportation, and living environment can matter just as much as medicine. Insurers and healthcare systems are waking up to this reality.

From Zero To Breakthrough

In the biotechnology business change happens fast. Decades of burning cash can be reversed by a single important product. Pharmaceutical research is famously expensive and wasteful. Yet we are in a time when more and more real advances are being developed to help patients.

Healthcare From The Outside In

Lucy Kalanithi is a doctor who understands what it means to be a patient. Her husband, Paul Kalanithi, wrote the bestseller When Breath Becomes Air as he died from lung cancer.

Trying To Change Drug Pricing: Is Drug Pricing Being Disrupted?

Why Patient Data Is Changing Everything

Forget money, drug targets, or even executives. Access to high-quality data about patients has become the most important asset in the healthcare business.

The Patient Data Revolution

Medicine has had to do without the access to big datasets that are so important in other industries.

Spotlight: Watching Discoveries Grow

Grad student studies gene linked to a rare cancer. Now she’s a 33-year-old professor with a $50 million startup.

How Smart Is Artificial Intelligence?

AI is becoming a buzzword. But beyond the hype and headlines, this technology has the potential to change healthcare.

The Synthetic Biology Revolution: genetic engineering

Big Solutions to Big Problems

Plenty of people are ready to criticize Big Pharma. But the industry is winning stirring victories against cancer, hepatitis C, and cardiovascular disease.

Check out highlights from previous Forbes Healthcare Summits including:

5 Fixes For Healthcare That America Needs Now

From High School Dean To Opioid Addict: 'It Can Get Pretty Dark Before Anybody Notices'


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