Presurgical simulation before complicated neurosurgery is a state-of-the-art technique, and its usefulness has recently become well known. However, simulation requires complex image processing, which hinders its widespread application. We explored handling the results of interactive computer graphics on the iPad tablet, which can easily be controlled anywhere.
Data from preneurosurgical simulations from 12 patients (4 men, 8 women) who underwent complex brain surgery were loaded onto an iPad. First, DICOM data were loaded using Amira visualization software to create interactive computer graphics, and ParaView, another free visualization software package, was used to convert the results of the simulation to be loaded using the free iPad software KiwiViewer.
The interactive computer graphics created prior to neurosurgery were successfully displayed and smoothly controlled on the iPad in all patients. The number of elements ranged from 3 to 13 (mean 7). The mean original data size was 233 MB, which was reduced to 10.4 MB (4.4 % of original size) after image processing by ParaView. This was increased to 46.6 MB (19.9 %) after decompression in KiwiViewer. Controlling the magnification, transfer, rotation, and selection of translucence in 10 levels of each element were smoothly and easily performed using one or two fingers. The requisite skill to smoothly control the iPad software was acquired within 1.8 trials on average in 12 medical students and 6 neurosurgical residents.
Using an iPad to handle the result of preneurosurgical simulation was extremely useful because it could easily be handled anywhere.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Kamada K, Todo T, Morita A, Masutani Y, Aoki S, Ino K, Kawai K, Kirino T (2005) Functional monitoring for visual pathway using real-time visual evoked potentials and optic-radiation tractography. Neurosurgery 57(1 Suppl):121–127
Kamada K, Sawamura Y, Takeuchi F, Kawaguchi H, Kuriki S, Todo T, Morita A, Masutani Y, Aoki S, Kirino T (2005) Functional identification of the primary motor area by corticospinal tractography. Neurosurgery 56(1 Suppl):98–109
Kin T, Nakatomi H, Shojima M, Tanaka M, Ino K, Mori H, Kunimatsu A, Oyama H, Saito N (2012) A new strategic neurosurgical planning tool for brainstem cavernous malformations using interactive computer graphics with multimodal fusion images. J Neurosurg 117:78–88
Kin T, Oyama H, Kamada K, Aoki S, Ohtomo K, Saito N (2009) Prediction of surgical view of neuromuscular decompression using interactive computer graphics. Neurosurgery 65:121–129
Kin T, Shin M, Oyama H, Kamada K, Kunimatsu A, Momose T, Saito N (2011) Impact of multiorgan fusion imaging and interactive 3-dimensional visualization for intraventricular neuroendoscopic surgery. Neurosurgery 69(ONS Suppl 1):40–48
Takai K, Kin T, Oyama H, Iijima A, Shojima M, Nishido H, Saito N (2011) The use of 3D computer graphics in the diagnosis and treatment of spinal vascular malformations. J Neurosurg Spine 15:654–659
George P, Dumenco L, Dollase R, Taylor JS, Wald HS, Reis SP (2013) Introducing technology into medical education: two pilot studies. Patient Educ Couns 93(3):522–524. doi:10.1016/j.pec.2013.04.018
Luo N, Chapman CG, Patel BK, Woodruff JN, Arora VM (2013) Expectations of iPad use in an internal medicine residency program: Is it worth the “hype”? J Med Internet Res 15(5):e88. doi:10.2196/jmir.2524
Ruparel RK, Brahmbhatt RD, Dove JC, Hutchinson RC, Stauffer JA, Bowers SP, Richie E, Lannen AM, Thiel DD (2014) “iTrainers”—Novel and inexpensive alternatives to traditional laparoscopic box trainers. Urology 83(1):116–120. doi:10.1016/j.urology.2013.09.030
De Oliveira GS Jr, Glassenberg R, Chang R, Fitzgerald P, RJ M (2013) Virtual airway simulation to improve dexterity among novices performing fibreoptic intubation. Anaesthesia 68:1053–1058
Biddiscombe J, Geveci B, Martin K, Moreland K, Thompson D (2007) Time dependent processing in a parallel pipeline architecture. IEEE Trans Vis Comput Graph 13(6):1376–1383. doi:10.1109/TVCG.2007.70600
Biddiscombe J, Soumagne J, Oger G, Guibert D, Piccinali JG (2012) Parallel computational steering for HPC applications using HDF5 files in distributed shared memory. IEEE Trans Vis Comput Graph 18(6):852–864. doi:10.1109/TVCG.2012.63
This work was supported in part by Takeda Science Foundation and grants-in-aid for scientific research awarded to Dr. Maruyama from the Ministry of Education, Science, and Culture of Japan (Grant No. 24592145).
Conflict of interest
The authors declare that they have no conflict of interest.
Electronic supplementary material
Below is the link to the electronic supplementary material.
About this article
Cite this article
Maruyama, K., Kin, T., Saito, T. et al. Neurosurgical simulation by interactive computer graphics on iPad. Int J CARS 9, 1073–1078 (2014) doi:10.1007/s11548-014-0993-0
- Interactive computer graphics