System and method for performing a three-dimensional virtual examination

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SYSTEM AND METHOD FOR PERFORMING A THREE-DIMENSIONA VIRTUAL EXAMINATION - 1 -

Description

System And Method For Performing A

Three-Dimensional Virtual Examination WO 98/11524 PCT/US97/16109

Technical Field

The present invention relates to a system and method for performing a volume based three-dimensional virtual examination using planned and guided navigation techniques. One such application is performing a virtual endoscopy.

Background of the Invention

Colon cancer continues to be a major cause of death throughout the world. Early detection of cancerous growths, which in the human colon initially manifest themselves as polyps, can greatly improve a patient's chance of recovery. Presently, there are two conventional ways of detecting polyps or other masses in the colon of a patient. The first method is a colonoscopy procedure, which uses a flexible fiber-optic tube called a colonoscope to visually examine the colon by way of physical rectal entry with the scope. The doctor can manipulate the tube to search for any abnormal growths in the colon. The colonoscopy, although reliable, is both relatively costly in money and time, and is an invasive, uncomfortable painful procedure for the patient.

The second detection technique is the use of a barium enema and two-dimensional X-ray imaging of the colon. The barium enema is used to coat the colon with barium, and a two-dimensional X-ray image is taken to capture an image of the colon. However, barium enemas may not always provide a view of the entire colon, require extensive pretreatment and patient manipulation, is often operator-dependent when performing the operation, exposes the patient to excessive radiation and can be less sensitive than a colonoscopy. Due to deficiencies in the conventional practices described above, a more reliable, less intrusive and less expensive way to check the colon for polyps is desirable. A method to examine other human organs, such as the lungs, for masses in a reliable, cost effective way and with less patient discomfort is also desirable. -2-

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WO 98/11524 PCT/US97/16109 10 15 20 25

Two-dimensional ("2D") visualization of human organs employing currently available medical imaging devices, such as computed tomography and MRI (magnetic resonance imaging), has been widely used for patient diagnosis. Three-dimensional images can be formed by stacking and interpolating between two-dimensional pictures produced from the scanning machines. Imaging an organ and visualizing its volume in three-dimensional space would be beneficial due to its lack of physical intrusion and the ease of data manipulation. However, the exploration of the three-dimensional volume image must be properly performed in order to fully exploit the advantages of virtually viewing an organ from the inside.

When viewing the three dimensional ("3D") volume virtual image of an environment, a functional model must be used to explore the virtual space. One possible model is a virtual camera which can be used as a point of reference for the viewer to explore the virtual space. Camera control in the context of navigation within a general 3D virtual environment has been previously studied. There are two conventional types of camera control offered for navigation of virtual space. The first gives the operator full control of the camera which allows the operator to manipulate the camera in different positions and orientations to achieve the view desired. The operator will in effect pilot the camera. This allows the operator to explore a particular section of interest while ignoring other sections. However, complete control of a camera in a large domain would be tedious and tiring, and an operator might not view all the important features between the start and finishing point of the exploration. The camera could also easily get "lost" in remote areas or be "crashed" into one of the walls by an inattentive operator or by numerous unexpected obstacles.

The second technique of camera control is a planned navigation method, which assigns the camera a predetermined path to take and which cannot be changed by the operator. This is akin to having an engaged "autopilot". This allows the operator to concentrate on the virtual space being viewed, and not have to worry about steering into walls of the environment being examined. However, this second technique does not give the viewer the flexibility to alter the course or investigate an interesting area viewed along the flight path. 30 WO 98/11524 PCT/US97/16109 -3-

It would be desirable to use a combination of the two navigation techniques described above to realize the advantages of both techniques while minimizing their respective drawbacks. It would be desirable to apply a flexible navigation technique to the examination of human or animal organs which are represented in virtual 3D space in order to perform a non-intrusive painless thorough examination. The desired navigation technique would further allow for a complete examination of a virtual organ in 3D space by an operator allowing flexibility while ensuring a smooth path and complete examination through and around the organ. It would be additionally desirable to be able to display the exploration of the organ in a real time setting by using a technique which minimizes the computations necessary for viewing the organ. The desired technique should also be equally applicable to exploring any virtual object.

Summary of the Invention

The invention generates a three-dimensional visualization image of an object such as a human organ using volume visualization techniques and explores the virtual image using a guided navigation system which allows the operator to travel along a predefined flight path and to adjust both the position and viewing angle to a particular portion of interest in the image away from the predefined path in order to identify polyps, cysts or other abnormal features in the organ.

The inventive technique for three-dimensional virtual examination of an object includes producing a discrete representation of the object in volume elements, defining the portion of the object which is to be examined, performing a navigation operation in the virtual object and displaying the virtual object in real time during the navigation.

The inventive technique for a three-dimensional virtual examination as applied to an organ of a patient includes preparing the organ for scanning, if necessary, scanning the organ and converting the data into volume elements, defining the portion of the organ which is to be examined, performing a guided navigation operation in the virtual organ and displaying the virtual organ in real time during the guided navigation.

It is an object of the invention to use a system and method to perform a relatively painless, inexpensive and non-intrusive in vivo examination of an organ where the actual JJCTAJS 97 /16 10 10 15 20 analysis of the scanned organ can be possibly performed without the patient present The organ can be scanned and visualized in real-time or the stored data can be visualized at a later time.

It is another object of the invention to generate 3D volume representations of an object such as an organ, where regions of the object can be peeled back layer by layer in order to provide sub-surface analysis of a region of the imaged object A surface of an object (such as an organ) can be rendered transparent or translucent in order to view further objects within or behind the object wall. The object can also be sliced in order to examine a particular cross-section of the object.

It is another object of the invention to provide a system and method of guided navigation through a 3D volume representation of an object, such as an organ, using potential fields.

It is a further object of the invention to calculate the center-line of an object, such as an organ, for a virtual fly-through using a peel-layer technique as described herein.

It is still a further object of the invention to use a modified Z buffer technique to minimize the number of computations required for generating the viewing screen.

It is another object of the invention to assign opacity coefficients to each volume element in the representation in order to make particular volume elements transparent or translucent to varying degrees in order to customize the visualization of the portion ofthe object being viewed. A section of the object can also be composited using the opacity coefficients.

Brief Description of the Drawings

Further objects, features and advantages of the invention will become apparent from the following detailed description taken in conjunction with the accompanying 25 figures showing a preferred embodiment of the invention, on which:

Figure 1 is a flow chart of the steps for performing a virtual examination of an object, specifically a colon, in accordance with the invention;

Figure 2 is an illustration of a "submarine” camera model which performs guided navigation in the virtual organ; WO 98/11524 PCT/US97/16109 -5-

Figure 3 is an illustration of a pendulum used to model pitch and roll of the "submarine" camera;

Figure 4 is a diagram illustrating a two dimensional cross-section of a volumetric colon which identifies two blocking walls;

Figure 5 is a diagram illustrating a two dimensional cross-section of a volumetric colon upon which start and finish volume elements are selected;

Figure 6 is a diagram illustrating a two dimensional cross-section of a volumetric colon which shows a discrete sub-volume enclosed by the blocking walls and the colon surface;

Figure 7 is a diagram illustrating a two dimensional cross-section of a volumetric colon which has multiple layers peeled away;

Figure 8 is a diagram illustrating a two dimensional cross-section of a volumetric colon which contains the remaining flight path;

Figure 9 is a flow chart of the steps of generating a volume visualization of the scanned organ;

Figure 10 is an illustration of a virtual colon which has been sub-divided into cells;

Figure 11A is a graphical depiction of an organ which is being virtually examined;

Figure 1 IB is a graphical depiction of a stab tree generated when depicting the organ in Fig. 11 A;

Figure 11C is a further graphical depiction of a stab tree generated while depicting the organ in Fig. 11 A;

Figure 12A is a graphical depiction of a scene to be rendered with objects within certain cells of the scene;

Figure 12B is a graphical depiction of a stab tree generated while depicting the scene in Fig. 12A;

Figures 12C-12E are further graphical depictions of stab trees generated while depicting the image in Fig. 12A; WO 98/11524 PCT/US97/16109 -6-

Figure 13 is a two dimensional representation of a virtual colon containing a polyp whose layers can be removed; and

Figure 14 is a diagram of a system used to perform a virtual examination of a human organ in accordance with the invention.

Detailed Description

While the methods and systems described in this application can be applied to any object to be examined, the preferred embodiment which will be described is the examination of an organ in the human body, specifically the colon. The colon is long and twisted which makes it especially suited for a virtual examination saving the patient both money and the discomfort and danger of a physical probe. Other examples of organs which can be examined include the lungs, stomach and portions of the gastro-intestinal system, the heart and blood vessels.

Fig. 1 illustrates the steps necessary to perform a virtual colonoscopy using volume visualization techniques. Step 101 prepares the colon to be scanned in order to be viewed for examination if required by either the doctor or the particular scanning instrument. This preparation could include cleansing the colon with a "cocktail" or liquid which enters the colon after being orally ingested and passed through the stomach. The cocktail forces the patient to expel waste material that is present in the colon. One example of a substance used is Golytely. Additionally, in the case of the colon, air or CO2 can be forced into the colon in order to expand it to make the colon easier to scan and examine. This is accomplished with a small tube placed in the rectum with approximately 1,000 cc of air pumped into the colon to distend the colon. Depending upon the type of scanner used, it may be necessary for the patient to drink a contrast substance such as barium to coat any unexpunged stool in order to distinguish the waste in the colon from the colon walls themselves. Alternatively, the method for virtually examining the colon can remove the virtual waste prior to or during the virtual examination as explained later in this specification. Step 101 does not need to be performed in all examinations as indicated by the dashed line in Fig. 1. WO 98/11524 PCT/US97/16109 -7-

Step 103 scans the organ which is to be examined. The scanner can be an apparatus well known in the art, such as a spiral CT-scanner for scanning a colon or a Zenita MRI machine for scanning a lung labeled for example with xenon gas. The scanner must be able to take multiple images from different positions around the body during suspended respiration, in order to produce the data necessary for the volume visualization. An example of a single CT-image would use an X-ray beam of 5mm width, 1:1 or 2:1 pitch, with a 40cm field-of-view being performed from the top of the splenic flexure of the colon to the rectum.

Discrete data representations of said object can be produced by other methods besides scanning. Voxel data representing an object can be derived from a geometric model by techniques described in U.S. Pat. No. 5,038,302 entitled "Method of Converting Continuous Three-Dimensional Geometrical Representations into Discrete Three-Dimensional Voxel-Based Representations Within a Three-Dimensional Voxel-Based System" by Kaufman, issued Aug. 8,1991, filed July 26, 1988, which is hereby incorporated by reference. Additionally, data can be produced by a computer model of an image which can be converted to three-dimension voxels and explored in accordance with this invention. One example of this type of data is a computer simulation of the turbulence surrounding a space shuttle craft.

Step 104 converts the scanned images into three-dimensional volume elements (Voxels). In the preferred embodiment for examining a colon, the scan data is reformatted into 5mm thick slices at increments of 1mm or 2.5mm, with each slice represented as a matrix of 512 by 512 pixels. Thus a large number of 2D slices are generated depending upon the length of the scan. The set of 2D slices is then reconstructed to 3D voxels. The conversion process of 2D images from the scanner into 3D voxels can either be performed by the scanning machine itself or by a separate machine such as a computer with techniques which are well known in the art (for example, see U.S. Pat. No. 4,985,856 entitled "Method and Apparatus for Storing, Accessing, and Processing Voxel-based Data" by Kaufman et al.; issued Jan. 15,1991, filed Nov. 11.1988; which is hereby incorporated by reference). WO 98/11524 PCT/US97/16109 -8-

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10 15 20 25

Step 105 allows the operator to define the portion of the selected organ to be examined. A physician may be interested in a particular section of the colon likely to develop polyps. The physician can view a two dimensional slice overview map to indicate the section to be examined. A starting point and finishing point of a path to be viewed can be indicated by the physician/operator. A conventional computer and computer interface (e.g., keyboard, mouse or spaceball) can be used to designate the portion of the colon which is to be inspected. A grid system with coordinates can be used for keyboard entry or the physician/operator can "click" on the desired points. The entire image of the colon can also be viewed if desired.

Step 107 performs the planned or guided navigation operation of the virtual organ being examined. Performing a guided navigation operation is defined as navigating through an environment along a predefined or automatically predetermined flight path which can be manually adjusted by an operator at any time. After the scan data has been converted to 3D voxels, the inside of the organ must be traversed from the selected start to the selected finishing point. The virtual examinations is modeled on having a tiny camera traveling through the virtual space with a lens pointing towards the finishing point. The guided navigation technique provides a level of interaction with the camera, so that the camera can navigate through a virtual environment automatically in the case of no operator interaction, and at the same time, allow the operator to manipulate the camera when necessary. The preferred embodiment of achieving guided navigation is to use a physically based camera model which employs potential fields to control the movement of the camera and which are described in detail in Figs. 2 and 3. • Step 109. which can be performed concurrently with step 107, displays the inside of the organ from the viewpoint of the camera model along the selected pathway of the guided navigation operation. Three-dimensional displays can be generated using techniques well known in the art such as the marching cubes technique. However, in order to produce a real time display of the colon, a technique is required which reduces the vast number of computations of data necessary for the display of the virtual organ.

Fig. 9 describe this display step in more detail. 1 WO 98/11524 . PCT/US97/16109 -9-

The method described in Figure 1 can also be applied to scanning multiple organs in a body at the same time. For example, a patient may be examined for cancerous growths in both the colon and lungs. The method of Figure 1 would be modified to scan all the areas of interest in step 103 and to select the current organ to be examined in step 105. For example, the physician/operator may initially select the colon to virtually explore and later explore the lung. Alternatively, two different doctors with different specialties may virtually explore different scanned organs relating to their respective specialties. Following step 109, the next organ to be examined is selected and its portion will be defined and explored. This continues until all organs which need examination have been processed.

The steps described in conjunction with Figure 1 can also be applied to the exploration of any object which can be represented by volume elements. For example, an architectural structure or inanimate object can be represented and explored in the same manner.

Figure 2 depicts a "submarine" camera control model which performs the guided navigation technique in step 107. When there is no operator control during guided navigation, the default navigation is similar to that of planned navigation which automatically directs the camera along a flight path from one selected end of the colon to another. During the planned navigation phase, the camera stays at the center of the colon for obtaining better views of the colonic surface. When an interesting region is encountered, the operator of the virtual camera using guided navigation can interactively bring the camera close to a specific region and direct the motion and angle of the camera to study the interesting area in detail, without unwillingly colliding with the walls of the colon. The operator can control the camera with a standard interface device such as a keyboard, mouse or non-standard device such as a spaceball. In order to fully operate a camera in a virtual environment, six degrees of freedom for the camera is required. The camera must be able to move in the horizontal, vertical, and Z direction (axes 217), as well as being able to rotate in another three degrees of freedom (axes 219) to allow the camera to move and scan all sides and angles of a virtual environment. The camera model for guided navigation includes an inextensible, weightless rod 201 connecting two WO 98/11524 PCT/US97/16109 - 10- particles x, 203 and x2 205, both particles being subjected to a potential field 215. The potential field is defined to be highest at the walls of the organ in order to push the camera away from the walls.

The positions of the particles are given by x, and x2, and they are assumed to have the same mass m. A camera is attached at the head of the submarine x, 203, whose viewing direction coincides with x7xi- The submarine can perform translation and rotation around the center of mass x of the model as the two particles are affected by the forces from the potential field V(x) which is defined below, any friction forces, and any simulated external force. The relations between x„ x2, and x are as follows: x = (x,y,z), r = (rsin6cos(p,rsine5in(p,rcos6), x, = x + r, x2 = x - r, (1) where r, Θ and φ are the polar coordinates of the vector xx,. The kinetic energy of the model. T, is defined as the summation of the kinetic energies of the movements of x, and x2:

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= mxJ + mi2 = m(i2 3 + y2 + z2) + rnr2(02 + ^2sin20). (2)

Then, the equations for the motion of the submarine model are obtained by using LaGrange's equation:

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(3) where the qjS are the generalized coordinates of the model and can be considered as the variables of time t as: WO 98/11524 PCT/US97/16109 -11 - (91,92,93,94,95,9«) = («, 2/,Μ,Φ,^) = q(*)» (4) with ψ denoting the roll angle of our camera system, which will be explained later. The F,s are called the generalized forces. The control of the submarine is performed by applying a simulated external force to xb “(Λ,ί’ν,Λ), and it is assumed that both x, and x2 are affected by the forces from the potential field and 5 the frictions which act in the opposite direction of each particle's velocity. Consequently, the generalized forces are formulated as follows:

Fi = -tnVV(Xi) — + P««t, F2 = -mVV(x2) - fcx2, (5) where k denotes the friction coefficient of the system. The external force F„, is applied by the operator by simply clicking the mouse button in the desired direction 207 in the generated image, as shown in Figure 2. This camera model would then be moved in that 10 direction. This allows the operator to control at least five degrees of freedom of the camera with only a single click of the mouse button. From Equations (2), (3) and (5), it can be derived that the accelerations of the five parameters of our submarine model as: WO 98/11524 PCT/US97/16109 - 12-

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x y s e 1 aV(xx) 3V(xa) fcg F* 2 Ox Ox ' rrt 2m ’

. dv(**f _ *y , A 2k Oy r 8jz ’ m 2m’ l.av(xx) av(xa) _ki 2^ Oz Oz m 2m’ φ* sin 9 cos β -ifco. ,&lt;„.«"£&gt; - + S, fg . 1 --0 + --(Fx cos Θ cos ψ + Fv ws sin — E, sin 0), m 2mr ——-(-20^ cos 0 sin0 av(x»)

Ox ) + cos^(

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Oy k 1 —4sin0 4--(—F. sin &lt;f&gt; + Fv cos ^)1, ·" 2mr gV(x»)n &amp;amp;y " (6) where x and x denote the first and the second derivative of x, respectively, and

eV(x). dV(x). 8V(xk denotes the gradient of the potential at a point x. The terms dx dy dz J (jrsinflcosfl of Θ and _ 26^cos6 of φ are called the centrifugal force and the Coriolis force, respectively, and they are concerned with the exchange of angular 10 velocities of the submarine. Since the model does not have the moment of inertia defined for the rod of the submarine, these terms tend to cause an overflow of the numeric calculation of φ. Fortunately, these terms become significant only when the angular velocities of the submarine model are significant, which essentially means that the camera 15 moves too fast. Since it is meaningless to allow the camera to move so fast because the organ could not be properly viewed, these terms are minimized in our implementation to avoid the overflow problem.

From the first three formulas of Equation (6), it is known that the submarine cannot be propelled by the external force against the potential field if the following condition is satisfied:

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WO 98/11524 PCT/US97/16109 -13- (VF(xx) + VF(x,)| &gt;

Since the velocity of the submarine and the external force Fex, have upper limits in our 5 implementation, by assigning sufficiently high potential values at the boundary of the objects, it can be guaranteed that the submarine never bumps against the objects or walls in the environment.

As mentioned previously, the roll angle ψ of the camera system needs to be considered. One possible option allows the operator full control of the angle ψ. 10 However, although the operator can rotate the camera freely around the rod of the model, he or she can easily become disoriented. The preferred technique assumes that the upper direction of the camera is connected to a pendulum with mass m2 301, which rotates freely around the rod of the submarine, as shown in Figure 3. The direction of the pendulum, r2. is expressed as: r2 = r2(cos 0 cos φάΏ.·φ + sin φ cos ·φ, cos Θ sin φήηψ — cos cos 0, — sin 0 sin-0)· 15 Although it is possible to calculate the accurate movement of this pendulum along with the movement of the submarine, it makes the system equations too complicated. Therefore, it is assumed that all the generalized coordinates except the roll angle ψ are constants, and thus define the independent kinetic energy for the pendulum system as: τ - "‘’ii _ 22

Tp~ 2 ’ ~ 2 ' - 14-

This simplifies the model for the roll angle. Since it is assumed in this model that the gravitational force

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WO 98/11524 PCT/US97/16109

Fj — 777-26 ·—· (τ7ϊ·25β, TT12J?*) acts at the mass point m2, the acceleration of ψ can be derived using LaGrange's equation as:

** X = —{£z(cos0 cos cos — sin^sin^) r2 (c°s 6 sin φ cos φ + cos φ sin φ) k2 . +&lt;?*(— sin Θ cos φ)}--φ. (7) 771-2 5 From Equations (6) and (7), the generalized coordinates q(t) and their derivatives q(t) are calculated asymptotically by using Taylor series as: q(f + A) = q(f) + hq(t) + jq(f) + Ο(Λ3), q(f + A) = q(f) + hq(t) + O(V), to freely move the submarine. To smooth the submarine's motion, the time step h is 10 selected as an equilibrium value between being as small as possible to smooth the motion but as large as necessary to reduce computation cost.

Definition of the Potential Field

The potential field in the submarine model in Figure 2 defines the boundaries (walls or other matter) in the virtual organ by assigning a high potential to the boundary 15 in order to ensure that the submarine camera does not collide with the walls or other boundary. If the camera model is attempted to be moved into a high potential area by the operator, the camera model will be restrained from doing so unless the operator wishes to WO 98/11524 PCT/US97/16109 - 15- examine the organ behind the boundary or inside a polyp, for example. In the case of performing a virtual colonoscopy, a potential field value is assigned to each piece of volumetric colon data (volume element). When a particular region of interest is designated in step 105 of Fig. 1 with a start and finish point, the voxels within the selected area of the scanned colon are identified using conventional blocking operations. Subsequently, a potential value is assigned to every voxel x of the selected volume based on the following three distance values: the distance from the finishing point dt(x), the distance from the colon surface ds(x) and the distance from the center-line of the colon space dc(x). dt(x) is calculated by using a conventional growing strategy. The distance from the colon surface, ds(x), is computed using a conventional technique of growing from the surface voxels inwards. To determine dc(x), the center-line of the colon from the voxel is first extracted, and then dc(x) is computed using the conventional growing strategy from the center-line of the colon.

To calculate the center-line of the selected colon area defined by the user-specified start point and the user-specified finish point, the maximum value of ds(x) is located and denoted dmax. Then for each voxel inside the area of interest, a cost value of dmax - ds(x) is assigned. Thus the voxels which are close to the colon surface have high cost values and the voxels close to the center line have relatively low cost values. Then, based on the cost assignment, the single-source shortest path technique which is well known in the art is applied to efficiently compute a minimum cost path from the source point to the finish point. This low cost line indicates the center-line or skeleton of the colon section which is desired to be explored. This technique for determining the center-line is the preferred technique of the invention.

To compute the potential value V(x) for a voxel x inside the area of interest, the following formula is employed: F(x) = C,a,(x)B + C,( &lt;ie(x) + &lt;2.(xr (8) WO 98/11524 PCT/US97/16109 - 16- where C„ C2, μ and v are constants chosen for the task. In order to avoid any collision between the virtual camera and the virtual colonic surface, a sufficiently large potential value is assigned for all points outside the colon. The gradient of the potential field will therefore become so significant that the submarine model camera will never collide with the colonic wall when being run.

Another technique to determine the center-line of the path in the colon is called the "peel-layer" technique and is shown in Figure 4 through Figure 8.

Figure 4 shows a 2D cross-section of the volumetric colon, with the two side walls 401 and 403 of the colon being shown. Two blocking walls are selected by the operator in order to define the section of the colon which is of interest to examine. Nothing can be viewed beyond the blocking walls. This helps reduce the number of computations when displaying the virtual representation. The blocking walls together with side walls identify a contained volumetric shape of the colon which is to be explored.

Figure 5 shows two end points of the flight path of the virtual examination, the start volume element 501 and the finish volume element 503. The start and finish points are selected by the operator in step 105 of Fig. 1. The voxels between the start and finish points and the colon sides are identified and marked, as indicated by the area designated with "x"s in Fig. 6. The voxels are three-dimensional representations of the picture element.

The peel-layer technique is then applied to the identified and marked voxels in Fig. 6. The outermost layer of all the voxels (closest to the colon walls) is peeled off step-by-step, until there is only one inner layer of voxels remaining. Stated differently, each voxel furthest away from a center point is removed if the removal does not lead to a disconnection of the path between the start voxel and the finish voxel. Figure 7 shows the intermediate result after a number of iterations of peeling the voxels in the virtual colon are complete. The voxels closest to the walls of the colon have been removed. Fig. 8 shows the final flight path for the camera model down the center of the colon after all the peeling iterations are complete. This produces essentially a skeleton at the center of the colon and becomes the desired flight path for the camera model. WO 98/11524 PCT/US97/16109 -17- Z- Buffer Assisted Visibility

Figure 9 describes a real time visibility technique to display of virtual images seen by the camera model in the virtual three-dimensional volume representation of an organ. Figure 9 shows a display technique using a modified Z buffer which corresponds to step 109 in Fig. 1. The number of voxels which could be possibly viewed from the camera model is extremely large. Unless the total number of elements (or polygons) which must be computed and visualized is reduced from an entire set of voxels in the scanned environment, the overall number of computations will make the visualization display process exceedingly slow for a large internal area. However, in the present invention only those images which are visible on the colon surface need to be computed for display. The scanned environment can be subdivided into smaller sections, or cells. The Z buffer technique then renders only a portion of the cells which are visible from the camera. The Z buffer technique is also used for three-dimensional voxel representations. The use of a modified Z buffer reduces the number of visible voxels to be computed and allows for the real time examination of the virtual colon by a physician or medical technician.

The area of interest from which the center-line has been calculated in step 107 is subdivided into cells before the display technique is applied. Cells are collective groups of voxels which become a visibility unit. The voxels in each cell will be displayed as a group. Each cell contains a number of portals through which the other cells can be viewed. The colon is subdivided by beginning at the selected start point and moving along the center-line 1001 towards the finish point. The colon is then partitioned into cells (for example, cells 1003, 1005 and 1007 in Fig. 10) when a predefined threshold distance along the center-path is reached. The threshold distance is based upon the specifications of the platform upon which the visualization technique is performed and its capabilities of storage and processing. The cell size is directly related to the number of voxels which can be stored and processed by the platform. One example of a threshold distance is 5cm, although the distance can greatly vary. Each cell has two cross-sections as portals for viewing outside of the cell as shown in Fig. 10.

Step 901 in Fig. 9 identifies the cell within the selected organ which currently contains the camera. The current cell will be displayed as well as all other cells which are WO 98/11524 PCT/US97/16109 -18- visible given the orientation of the camera. Step 903 builds a stab tree (tree diagram) of hierarchical data of potentially visible cells from the camera (through defined portals), as will be described in further detail hereinbeiow. The stab tree contains a node for every cell which may be visible to the camera. Some of the cells may be transparent without any blocking bodies present so that more than one cell will be visible in a single direction. Step 905 stores a subset of the voxels from a cell which include the intersection of adjoining cell edges and stores them at the outside edge of the stab tree in order to more efficiently determine which cells are visible.

Step 907 checks if any loop nodes are present in the stab tree. A loop node occurs when two or more edges of a single cell both border on the same nearby cell. This may occur when a single cell is surrounded by another cell. If a loop node is identified in the stab tree, the method continues with step 909. If there is no loop node, the process goes to step 911.

Step 909 collapses the two cells making up the loop node into one large node.

The stab tree is then corrected accordingly. This eliminates the problem of viewing the same cell twice because of a loop node. The step is performed on all identified loop nodes. The process then continues with step 911.

Step 911 then initiates the Z-buffer with the largest Z value. The Z value defines the distance away from the camera along the skeleton path. The tree is then traversed to first check the intersection values at each node. If a node intersection is covered, meaning that the current portal sequence is occluded (which is determined by the Z buffer test), then the traversal of the current branch in the tree is stopped. Step 913 traverses each of the branches to check if the nodes are covered and displays them if they are not.

Step 915 then constructs the image to be displayed on the operator's screen from the volume elements within the visible cells identified in step 913 using one of a variety of techniques known in the art, such as volume rendering by compositing. The only cells shown are those which are identified as potentially visible. This technique limits the number of cells which requires calculations in order to achieve a real time display and correspondingly increases the speed of the display for better performance. This technique WO 98/11524 PCT/US97/16109 - 19- is an improvement over prior techniques which calculate all the possible visible data points whether or not they are actually viewed.

Figure 11A is a two dimensional pictorial representation of an organ which is being explored by guided navigation and needs to be displayed to an operator. Organ 1101 shows two side walls 1102 and an object 1105 in the center of the pathway. The organ has been divided into four cells A1151,B1153,C1155 and D 1157. The camera 1103 is facing towards cell D 1157 and has a field of vision defined by vision vectors 1107, 1108 which can identify a cone-shaped field. The cells which can be potentially viewed are cells Β 1153, C 1155 and D 1157. Cell C 1155 is completely surrounded by Cell B and thus constitutes a node loop.

Fig. 11B is a representation of a stab tree built from the cells in Fig. 11 A. Node A 1109 which contains the camera is at the root of the tree. A sight line or sight cone, which is a visible path without being blocked, is drawn to node Β 1110. Node B has direct visible sight lines to both node C 1112 and node D 1114 and which is shown by the connecting arrows. The sight line of node C 1112 in the direction of the viewing camera combines with node B 1110. Node C 1112 and node B 1110 will thus be collapsed into one large node Β’ 1122 as shown in Fig. 11C.

Fig. 11C shows node A 1109 containing the camera adjacent to node Β* 1122 (containing both nodes B and node C) and node D 1114. The nodes A, B' and D will be displayed at least partially to the operator.

Figs 12A - 12E illustrate the use of the modified Z buffer with cells that contain objects which obstruct the views. An object could be some waste material in a portion of the virtual colon. Fig. 12A shows a virtual space with 10 potential cells: A 1251, B 1253, C 1255, D 1257, E 1259, F 1261. G 1263, H 1265,1 1267 and J 1269. Some of the cells contain objects. If the camera 1201 is positioned in cell I 1267 and is facing toward cell F 1261 as indicated by the vision vectors 1203, then a stab tree is generated in accordance with the technique illustrated by the flow diagram in Fig. 9. Fig. 12B shows the stab tree generated with the intersection nodes showing for the virtual representation as shown in Fig. 12A. Fig. 12B shows cell I 1267 as the root node of the tree because it contains the camera 1201. Node I 1211 is pointing to node F 1213 (as indicated with an arrow), WO 98/11524 PCT/US97/16109 -20- because cell F is directly connected to the sight line of the camera. Node F 1213 is pointing to both node B 1215 and node E 1219. Node B 1215 is pointing to node A 1217. Node C 1202 is completely blocked from the line of sight by camera 1201 so is not included in the stab tree.

Fig. 12C shows the stab tree after node 11211 is rendered on the display for the operator. Node I 1211 is then removed from the stab tree because it has already been displayed and node F 1213 becomes the root. Fig. 12D shows that node F 1213 is now rendered to join node I 1211. The next nodes in the tree connected by arrows are then checked to see if they are already covered (already processed). In this example, all of the intersected nodes from the camera positioned in cell I 1267 has been covered so that node B 515 (and therefore dependent node A) do not need to be rendered on the display.

Fig. 12E shows node E 515 being checked to determine if its intersection has been covered. Since it has, the only rendered nodes in this example of Figure 12A-12E are nodes I and F while nodes A, B and E are not visible and do not need to have their cells prepared to be displayed.

The modified Z buffer technique described in Figure 9 allows for fewer computations and can be applied to an object which has been represented by voxels or other data elements, such as polygons.

Figure 13 shows a two dimensional virtual view of a colon with a large polyp present along one of its walls. Figure 13 shows a selected section of a patient's colon which is to be examined further. The view shows two colon walls 1301 and 1303 with the growth indicated as 1305. Layers 1307, 1309, and 1311 show inner layers of the growth. It is desirable for a physician to be able to peel the layers of the polyp or tumor away to look inside of the mass for any cancerous or other harmful material. This process would in effect perform a virtual biopsy of the mass without actually cutting into the mass. Once the colon is represented virtually by voxels, the process of peeling away layers of an object is easily performed in a similar manner as described in conjunction with Figs. 4 through 8. The mass can also be sliced so that a particular cross-section can be examined. In Fig. 13, a planar cut 1313 can be made so that a particular portion of the growth can be examined. Additionally, a user-defined slice 1319 can be made in any WO 98/11524 PCT/US97/16109 -21 - manner in the growth. The voxels 1319 can either be peeled away or modified as explained below. A transfer function can be performed to each voxel in the area of interest which can make the object transparent, semi-transparent or opaque by altering coefficients representing the translucently for each voxel. An opacity coefficient is assigned to each voxel based on its density. A mapping function then transforms the density value to a coefficient representing its translucency. A high density scanned voxel will indicate either a wall or other dense matter besides simply open space. An operator or program routine could then change the opacity coefficient of a voxel or group of voxels to make them appear transparent or semi-transparent to the submarine camera model. For example, an operator may view a tumor within or outside of an entire growth. Or a transparent voxel will be made to appear as if it is not present for the display step of Figure 9. A composite of a section of the object can be created using a weighted average of the opacity coefficients of the voxels in that section.

If a physician desires to view the various layers of a polyp to look for a cancerous areas, this can be performed by removing the outer layer of polyp 1305 yielding a first layer 1307. Additionally, the first inner layer 1307 can be stripped back to view second inner layer 1309. The second inner layer can be stripped back to view third inner layer 1311, etc. The physician could also slice the polyp 1305 and view only those voxels within a desired section. The slicing area can be completely user-defined.

Adding an opacity coefficient can also be used in other ways to aid in the exploration of a virtual system. If waste material is present and has a density as other properties within a certain known range, the waste can be made transparent to the virtual camera by changing its opacity coefficient during the examination. This will allow the patient to avoid ingesting a bowel cleansing agent before the procedure and make the examination faster and easier. Other objects can be similarly made to disappear depending upon the actual application. Additionally, some objects like polyps could be enhanced electronically by a contrast agent followed by a use of an appropriate transfer function. WO 98/11524 PCT/US97/16109 -22-

Figure 14 shows a system for performing the virtual examination of an object such as a human organ using the techniques described in this specification. Patient 1401 lies down on a platform 1402 while scanning device 1405 scans the area that contains the organ or organs which are to be examined. The scanning device 1405 contains a scanning portion 1403 which actually takes images of the patient and an electronics portion 1406. Electronics portion 1406 comprises an interface 1407, a central processing unit 1409, a memory 1411 for temporarily storing the scanning data, and a second interface 1413 for sending data to the virtual navigation platform. Interface 1407 and 1413 could be included in a single interface component or could be the same component. The components in portion 1406 are connected together with conventional connectors.

In system 1400, the data provided from the scanning portion of device 1403 is transferred to portion 1405 for processing and is stored in memory 1411. Central processing unit 1409 converts the scanned 2D data to 3D voxel data and stores the results in another portion of memory 1411. Alternatively, the converted data could be directly sent to interface unit 1413 to be transferred to the virtual navigation terminal 1416. The conversion of the 2D data could also take place at the virtual navigation terminal 1416 after being transmitted from interface 1413. In the preferred embodiment, the converted data is transmitted over carrier 1414 to the virtual navigation terminal 1416 in order for an operator to perform the virtual examination. The data could also be transported in other conventional ways such as storing the data on a storage medium and physically transporting it to terminal 1416 or by using satellite transmissions.

The scanned data may not be converted to its 3D representation until the visualization rendering engine requires it to be in 3D form. This saves computational steps and memory storage space.

Virtual navigation terminal 1416 includes a screen for viewing the virtual organ or other scanned image, an electronics portion 1415 and interface control 1419 such as a keyboard, mouse or spaceball. Electronics portion 1415 comprises a interface port 1421, a central processing unit 1423, other components 1427 necessary to run the terminal and a memory 1425. The components in terminal 1416 are connected together with conventional connectors. The converted voxel data is received in interface port 1421 and WO 98/11524 PCT/US97/16109 -23- stored in memory 1425. The central processor unit 1423 then assembles the 3D voxels into a virtual representation and runs the submarine camera model as described in Figures 2 and 3 to perform the virtual examination. As the submarine camera travels through the virtual organ, the visibility technique as described in Figure 9 is used to compute only those areas which are visible from the virtual camera and displays them on screen 1417. A graphics accelerator can also be used in generating the representations. The operator can use interface device 1419 to indicate which portion of the scanned body is desired to be explored. The interface device 1419 can further be used to control and move the submarine camera as desired as discussed in Figure 2 and its accompanying description. Terminal portion 1415 can be the Cube-4 dedicated system box, generally available from the Department of Computer Science at the State University of New York at Stony Brook.

Scanning device 1405 and terminal 1416, or parts thereof, can be part of the same unit. A single platform would be used to receive the scan image data, connect it to 3D voxels if necessary and perform the guided navigation.

An important feature in system 1400 is that the virtual organ can be examined at a later time without the presence of the patient. Additionally, the virtual examination could take place while the patient is being scanned. The scan data can also be sent to multiple terminals which would allow more than one doctor to view the inside of the organ simultaneously. Thus a doctor in New York could be looking at the same portion of a patient's organ at the same time with a doctor in California while discussing the case. Alternatively, the data can be viewed at different times. Two or more doctors could perform their own examination of the same data in a difficult case. Multiple virtual navigation terminals could be used to view the same scan data. By reproducing the organ as a virtual organ with a discrete set of data, there are a multitude of benefits in areas such as accuracy, cost and possible data manipulations.

The foregoing merely illustrates the principles of the invention. It will thus be appreciated that those skilled in the art will be able to devise numerous systems, apparatus and methods which, although not explicitly shown or described herein, embody

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WO 98/11524 PCT/US97/16109 -24- the principles of the invention and are thus within the spirit and scope of the invention as defined by its claims.

For example, the methods and systems described herein could be applied to virtually examine an animal, fish or inanimate object. Besides the stated uses in the medical field, applications of the technique could be used to detect the contents of sealed objects which cannot be opened. The technique could also be used inside an architectural structure such as a building or cavern and enable the operator to navigate through the structure.