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Real-Time Visualization and Interaction of Threedimensional Human CT Images

Zhanli Hu*1,2, Jing Zou1,2, Jianbao Gui1,2, Junyan Rong1,2, Yanming Li1,2, Dongxing Xi1,2, Hairong Zheng*1,2
1

Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China. 2 Key Lab for Biomedical Informatics and Health Engineering, Chinese Academy of Sciences. * Email: zl.hu@sub.siat.ac.cn, hr.zheng@siat.ac.cn

AbstractThree-dimensional medical image visualization becomes an essential part for medical field, including computer-aided diagnosis, surgery planning and simulation, artificial limb surgery, radiotherapy planning, and teaching etc. In this paper, marching cubes algorithm is adopted to reconstruct the 3-D images for the CT image sequence in DICOM format under the VC++6.0 and the visual package VTK platform. The relatively simple interactive operations such as rotation and transfer can be realized on the platform. Moreover, the normal vector and interior point are calculated to form the virtual clipping plane, which is then used to incise the 3-D object. Information of the virtual slice can be obtained, in the mean while the virtual slice images are displayed on the screen. The technique can realize the real time interaction extraction of virtual slice on 3-D CT image. The cuboids structured can be zoomed, moved and circumrotated by operating mouse to incise the 3-D reconstruction object. Real time interaction can be realized by clipping the reconstruction object. The coordinates can be acquired by the mouse clicking in the 3D space, to realize the point mouse pick-up as well angle and distance interactive measurement. We can get quantitative information about 3-D images through measurement. Index Terms3D Visualization, interactive, virtual slice, cuboids clipping, mouse pick-up, quantitative measurement, medical imaging, computed tomography (CT)

I. INTRODUCTION Now days, doctors usually diagnose by observing a series of slices of CT, MRI images. It mainly depends on the doctors experiences in reading slices and maybe cannot get intuitionist information. Three-dimensional reconstruction of medical images provides an effective approach for obtaining more intuitionist and accurate information. With the fast development of computer technology, it is now possible to reconstruct and visualize 3-D medical volume data in real-time way [1-4]. Three-dimensional reconstruction of medical images [tissue sections, computerized tomography (CT)] is now an integral part of biomedical research. It has been widely used for demonstrating lesions and/or their localization in
Zhanli Hu, Jing Zou, Jianbao Gui, Junyan Rong, Yanming Li, Dongxing Xi and Hairong Zheng are with the Paul C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China, and also with the Key Lab for Biomedical Informatics and Health Engineering, Chinese Academy of Sciences. (E-mail: hr.zheng@siat.ac.cn)

the musculoskeletal system, vascular system, respiratory and alimentary systems. In biomedicine, 3-D data are acquired by a multitude of imaging devices [magnetic resonance imaging (MRI), CT, 3-D microscopy, etc.]. In most cases, 3-D images are represented as a sequence of two-dimensional (2-D) parallel image slices [5]. Threedimensional visualization is a series of theories, methods and techniques, which applies computer graphics, image processing technique and human-computer interacting technique to transform the resulting data from the process of scientific computing to graphics [6-10]. In this paper, a solution to the three-dimensional reconstruction and interaction of medical images is presented. Firstly, VC++6.0 with VTK was used to reconstruct 3-D images using the CT slice sequence of human head, ankle, knee and pelvis respectively. The simple interactive operations, such as rotation, zoom and transfer can be realized by user interaction with PC. Secondly, cuboids can be zoomed, moved and circumrotated by operating mouse to incise 3-D reconstruction object. Real time interaction can be realized by clipping the reconstruction object. The vector and inner points are calculated to form the virtual clipping plane, which in turn is used to incise the 3-D object. And the information of cross-section images is obtained, at the same time the correspondent images are displayed on the screen. Therefore, extraction of crosssection images on 3-D medicine image can be realized in any direction. The coordinates can be acquired by the mouse clicking in the 3-D space, by which to realize the point mouse pick-up as well interactive quantitative measure the 3-D medicine image. Finally, realization of 3-D medical images interaction are done in fields such as mouse pick-up, angle and distance measure in space, cuboids interaction clipping, extraction of virtual slice on 3-D CT images in any angle etc. II. THREE-DIMENSIONAL RECONSTRUCTION OF CT IMAGES A. Visualization Toolkit Conventional 3-D visualization tools usually have important limitations such as low efficient code execution, poor computing capacity. VTK is an open-source software system for visualization, computer graphics and imaging. It is provided as a C++ library with interfaces to the interpreted languages TCL, Python and Java. Object

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oriented design, high level interface and possibility to write scripted components make it an excellent tool for a wide range of applications, from few lines throw-away scripts, to complex visualization systems. VTK is distributed by Kitware, Inc. (469 Clifton Corporate Parkway, Clifton Park, NY 12065 USA) under an open license that permits free inclusion of VTK components into both commercial and non-commercial applications [11-15]. The object-oriented visualization Toolkit (VTK) has been widely applied in 3-D reconstruction of medical images. VTK is a visualization library that provides a large number of functions for presenting threedimensional data. Interaction with the visualized data is controlled with two-dimensional input devices, such as mouse and keyboard [16-19]. B. Human CT Images The CT images are in the format of DICOM. DICOM is designated medical digital image archiving and transmission standards by the American College of Radiology and the National Electrical Manufacturers Association. DICOM for different manufacturers of medical imaging equipment (such as CT, MRI, ultrasound, etc.) provides a standard interface and interactive agreement; it has gradually developed into an internationally accepted standard in medical imaging [2023]. Many consecutive human head, ankle, knee, pelvis CT images (512 512) sequence in the DICOM data format are acquired with a spatial resolution of 512 512 and scanning interval of 1 mm. Figure 1 shows the reader of the CT images with sequences of head, ankle, knee and pelvis respectively.

(d) Pelvis CT images. Figure1. The original CT images of human organs. (a) Head images. (b) Ankle images. (c) Knee images. (d) Pelvis images.

(a) Head CT images.

(b) Ankle CT images.

C. Implementation of CT Image 3-D Reconstruction Marching Cubes (MC) algorithm is a 3-D reconstruction method developed by W. Lorensen in 1987. Because of its merits of simple, easy to achieve, it has been widely used, is considered as one of the most popular algorithms for display [24-25]. The basic principle of MC algorithm are shown as below: 1) construct iso-surface in the 3-D data, 2) find the cubes passed through iso-surface, 3) obtain the iso-surface in cubes and calculating correlation parameters, 4) use common software tools or graphics hardware to protract iso-surface. In medical applications, the MC algorithm can be used in the reconstruction of the body contour or the internal organs, so that doctors can directly observe space relationship between interest organs and surrounding tissue in 3-D image. MC algorithm takes full advantage of the graphics display hardware acceleration function and produces better reconstruction image quality. The process of MC algorithm can be described as follows: 1) Read two slices and form a layer each time. 2) Use the upper and lower corresponding four points of two slices to form a cube, as shown in Figure 2. 3) Following the order of from left to right, front to back to deal with cube of a layer, and then bottom-up order to deal with cube of n-1 layer until algorithm end, called Marching Cubes. For each cube, its eight vertexes of the gray values can be directly got from the input data. It is necessary to appointment the extractive iso-surface threshold for user. The threshold is the material density values we extracted [26-28]. For example, the threshold will be relatively larger in extracted bone, and then extracted iso-surface triangular mesh expression based on volume data information. If a vertex of the gray value greater than the threshold, it will be marked as black (marked vertex), otherwise, it will not be marked (unmarked vertex), as shown in Figure 3.

(c) Knee CT images. Figure 2. Cubes sketch. Figure 3. Marked vertex and unmarked vertex.

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In the paper, based on MC arithmetic, VC++6.0 with VTK was used to reconstruct the 3-D images using the CT slice sequence in DICOM format. The result of threedimensional reconstruction is given in Figure 4.

(g) Pelvis bone reconstruction images.

(a) Head skin reconstruction.

(b) Head bone reconstruction.

(h) Pelvis skin reconstruction images. Figure4. CT images 3-D reconstruction result.

(c) Head skin and bone reconstruction.

(d) Head skin, bone construction: overlooking.

Figure 4(a) shows the head skin reconstruction image, (b) is the head bone tissue reconstruction image, (c) and (d) show the skin and bone tissue at the same time reconstruction the image. The display effect of 3-D image can be changed through adjusted transparency in programmed. (e) is the ankle reconstruction image, (f) to (h) show the knee and pelvis reconstruction the image respectively. III. 3-D CT IMAGES CUBOIDS INTERACTIVE CLIPPING A. Application of Interactive with VtkBoxWidget Class Application of the VTK vtkBoxWidget class to construct a cuboids region on the screen, as well as in its centre and six surfaces can be controlled to zoom, move or circumrotate by mouse and other operations, which can be very intuitive to clipping 3-D objects. The use of this class, we must designate a class inherit from vtkCommand to deal with the interaction event. Six planes of BoxWidget will be added as a clipping plane in each interaction end. Therefore, clipping result shows 3-D reconstruction objects by cuboids clipping. Subsequent work is the definition of BoxWidget initial position, as well as surface properties, and so on. B. Experimental Results Some results are shown in Figure 5.

(e) Ankle reconstruction images.

(f) Knee skin reconstruction images.

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angle , , , where 0 as shown in Figure 6.

, 0 , 0 ,

(a) bone clipping 1.

(b) bone clipping 2.

Figure 6. Normal vector schematic diagram.

In Figure 6, cos , cos , cos is called direction

(c) bone clipping 3. (d) bone and skin clipping 1.

cosine of vector OP . Its value can be calculated by the following formula.

a1 a1 = 2 2 2 |OP| a1 + a2 + a3 a a2 cos = 2 = 2 2 2 |OP| a1 + a2 + a3 cos =

cos =
(e) bone and skin clipping 2. (f) bone and skin clipping 3. Figure5. 3-D reconstruction of the head and cuboids clipping.

(2)

a3 a3 = 2 2 |OP| a12 + a2 + a3

Due to direction cosine satisfy relations:

Figure 5 (a) to (c) shows result of using vtkBoxWidget class to cuboids bone clipping, (d) to (f) are bone and skin at the same time clipping. Users can use mouse control of the cuboids six plane and focal point to interactive operation. By simple interactive operations like using mouse, the image scaling, translation and rotation can be realized in real time. It can be very convenient to operate on the 3-D objects clipping. The results of experiment show cuboids clipping can realize the real time interaction clipping of reconstruction object. IV. EXTRACTION OF ANY ANGLE VIRTUAL SLICE A. Virtual Clipping Plane Parameters Setting

cos 2 + cos 2 + cos 2 = 1 , Therefore, in order

to determined normal vector, as long as given the size of any two direction angle and third direction angle quadrant. Let point P on the virtual clipping plane, in order to reduce the computational complexity, initialization P as center point O( M / 2, N / 2, K / 2) of 3-D images which M , N and K denote respectively the number of sampling images along the X, Y and Z direction. In order to obtain other virtual clipping plane image

along normal vector n direction, simply moving initial section along normal vector direction, as shown in Figure 7. Step assumes that the representative movement

A vector n is called the normal vector of a plane if n is perpendicular to the plane. The plane containing the point p ( x0 , y0 , z0 ) and having a normal vector the equation:

distance along normal vector n direction. Step can take positive or negative when the negative denotes along normal vector countermovement. Let be p ( x, y, z ) denotes point p ( x, y , z ) on the virtual clipping plane after moving. Point p and p coordinates relations are shown in equations (3) [29].
' '

n(a1 , a2 , a3 ) can be represented, in point-norm form, by

a1 ( x x0 ) + a2 ( y y0 ) + a3 ( z z0 ) = 0

(1)

In the three-dimensional space, arbitrary plane unit normal vector can be determined by direction

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Figure 7. Virtual clipping plane schematic diagram.

(c) Virtual slice parallel to YZ plane.

x ' = x + Step *cos ' y = y + Step *cos z ' = z + Step *cos

(3)

B. Extraction of Virtual Slice on 3-D CT Images Due to clipping point and direction of virtual clipping plane was determined, it can establish a central axis. Using of the virtual clipping plane identified along this central axis of cutting three-dimensional objects, in the mean while the virtual slice images are displayed. In this way, we can achieve three-dimensional CT image any angle virtual clipping and we can using mouse to carry out interactive operation for clipping plane. At the same time, the virtual slice images are displayed on the screen. VC++6.0 with VTK toolbox are used to reconstruct 3D images using the CT slice sequence in DICOM format. Then extraction of any angle virtual slices on 3-D CT image. Some results are shown in Figure 8.

(d) Any angle virtual slice 1.

(e) Any angle virtual slice 2. Fig. 8. Virtual slice extraction of 3-D CT images.

(a) Virtual slice parallel to XY plane.

Figure 8 (a) to (c) shows result of virtual slice parallel to coordinate plane, (d) and (e) are any angle extraction of virtual slice on 3-D CT images. Users can use mouse control of the 3-D CT images and virtual clipping plane to interactive operation. By simple interactive operations like using mouse, the image scaling, translation and rotation can be realized in real time. The results of experiment show virtual clipping plane can realize the any angle extraction of virtual slice on 3-D CT images. V. QUANTITATIVE MEASUREMENT OF 3-D IMAGES A. Mouse Pick-Up The VTK class library provides vtkPointPicker class to achieve pick-up of point. The principle of pick-up is from observer send out a beam of ray and the location of the mouse was projection to observe objects. The point of projection is use mouse pick-up point. To use this class,

(b) Virtual slice parallel to XZ plane.

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we first to definition a callback function for deal with pick-up event. And then it observed pick-up event in pick-up device. Finally, we regard pick-up device as a specific interaction device so as to it play a role.

(b) Distance measure of knee. Figure10. Distance measure of 3-D CT image. (Length: mm)

The angle is obtained by cosine theorem:

Figure 9. Mouse pick-up of 3-D CT image.

Mouse pick-up of 3-D CT image results are shown in Figure 9, the results show mouse pick-up of 3-D image have high speed, convenient and intuitive advantages. B. Quantitative Measurement of 3-D Space After identify three-dimensional coordinates of the points, we can quantitative measure distance and angle in space. The distance is obtained by following formula:

cos A = (b 2 + c 2 a 2 ) / 2bc (5) Where a , b and c denote respectively the three sides of a triangle, A is angle between b and c .

D = ( x2 x1 ) 2 + ( y2 y1 ) 2 + ( z2 z1 ) 2
and point P2 ( x2 , y2 , z2 ) , x ,

(4)

Where D is the distance between point P 1 ( x1 , y1 , z1 )

y and z is the coordinates

of the point. The distance quantitative measure of 3-D CT image is shown in Figure 10. We developed two small balls and each other through a straight line connection. We can use mouse move two balls to the three-dimensional space anywhere; meanwhile, the distance value between two small balls will be displayed on the screen simultaneously.

Figure 11. Angle measure of 3-D CT image. (Angle: degree)

Similarly, we can develop three small balls. One small ball through straight line connects with other two balls. Therefore, the two straight lines will form an angle, namely measurement angle. Likewise, we can use mouse move three balls to the three-dimensional space anywhere; meanwhile, the measurement angle value will be displayed on the screen simultaneously. The result of 3-D CT image angle quantitative measure is shown in Figure 11. VI. CONCLUSION Medical image analysis is more than just algorithms. Visualization of the original image data and processed results, interaction with the data, as well as the data themselves are also important. In biomedicine, 3-D data are acquired by a multitude of imaging devices (CT, MRI, etc.). In most cases, 3-D images are represented as a sequence of two-dimensional (2-D) parallel image slices. In this paper, we realized three-dimensional of human CT images for a sequence of two-dimensional image

(a) Distance measure of head.

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slices. Furthermore, more complex interaction methods including mouse pick-up, angle and distance quantitative measure in space, cuboids interaction clipping, extraction of any angle virtual slice on 3-D CT images can be realized. These methods can assist doctors to make better and more accurate diagnosis, and we intend to further refine this technique and potential clinical applications in future work. ACKNOWLEDGMENT This study was supported by the National 973 Basic Research Program of China (No. 2010CB732600), with additional support was provided by Major Research Equipment Fund of the Chinese Academy of Sciences and the 2008 Shenzhen Controversial Technology Innovation Research Projects (FG200805230224A), Natural Science Foundation of Guangdong Province, China (8478922035X000700). The authors would like to thank the University of Iowa Carver College of Medicine and Heilongjiang Province Hospital for providing us the CT data sets. REFERENCES
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[29] Haibo Zhang, Three-dimensional Segmentation and Visualization of Computed Tomography, Shandong Normal University Master's degree paper, pp. 3637, 2005. Zhanli Hu received his M.S. degree in biomedical engineering from Harbin Engineering University, Harbin, China, in 2008. Currently, he is a research assistant in the Paul. C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, and also in the Key Laboratory of Biomedical Informatics and Health Engineering, Chinese Academy of Sciences. His research areas have been focused on medical image visualization technology, image processing and X-ray CT technique. Zhanli Hu has published more than 10 journal papers and international conference papers. Jing Zou received her Ph.D. degrees in applied mathematics from Capital Normal University, China. Now, she is an assistant professor in Shenzhen Institute of Advanced Technology, CAS. Her major research centered on X-ray imaging and its applications. Jianbao Gui received his Ph.D. degree from Huazhong University of Science and Technology in 2007 and M.S. degree from Chinese Academy of Science in 2004. Now, he is an assistant professor in Shenzhen Institute of Advanced Technology, CAS. His current research interest focuses on Xray CT imaging technology and its applications in biomedicine. Junyan Rong received the PhD degree in condensed matter physics from Key Laboratory of Nuclear Analytical Techniques and R&D Center, Institute of High Energy Physics, Chinese Academy of Science. She is currently an assistant professor of

Paul.C.Lauterber Research Centre for Biomedical Imaging of Institute of Biomedical and Health Engineering,Shenzhen Institutes of Advanced Technology.Her work is on x-ray digital imaging and 3D image reconstruction. Yanming Li received the master degree in mechatronics engineering from Liaoning Technical University,China.He is currently a research assistant of Shenzhen Institute of Advanced Technology Chinese Academy Sciences.His work is on system control. Dongxing Xi master student in Northwestern Polytechnical University and the major is biomedical engineering. His work is on the CT simulation and the medical imaging. Hairong Zheng received his M.S. degree from Harbin Institute of Technology, China, in 2002, and the Ph.D. degree in mechanical engineering, biomedical engineering division from University of Colorado, Boulder, USA, in 2006. From 2006 to 2007, he joined the University of California Davis first as a postdoctoral fellow, and then as a project scientist in the Biomedical Engineering Department. Currently, he is an associate research fellow and the Center Director in the Paul. C. Lauterbur Research Center for Biomedical Imaging, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences. Dr. Zhengs research areas have been focused on developing advanced biomedical imaging, drug delivery and therapy, and novel medical devices. Dr. Zheng has published more than 30 peer-reviewed journal papers and international conference proceedings. He is a member of IEEE, ASME and BMES.

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