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EDITORIAL

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Issue 1, June 1997

ISSN 1368-1591

The Visible Human Project

A lecture by Dr M. Ackerman, at the London School of Hygiene and Tropical Medicine, as part of the National Science Week.

Dr Michael Ackerman, Project Manager for the National Library of Medicine's Visible Human Project, delivered a comprehensive lecture as part of National Science Week 1997. National Science Week is an educational event for schools and other interested parties, promoting advances and stimulating interest in science and technology. It was refreshing to attend a lecture of such high calibre with no admission fee. Such fees can be prohibitive to a significant part of society - especially students and the unemployed. However, in this case all were welcome and the entire lecture was extremely well received.

The background

Picture the scene in 1986, when National Library of Medicine (NLM) strategists predicted an era in which bibliographic and factual databases, available from the NLM, would be joined by a library of digital images made available over extensive networks. Fortunately this forcasting was not dismissed as a 'Star Trek' notion at the time, but seen as a realistic possibility. Collaboration with medical education consultants led the NLM to 'thoroughly and systematically investigate the technical requirements for and feasibility of instituting a biomedical images library' [1]. The foundations were therefore laid.

In 1989 the NLM Planning Panel on Electronic Image Libraries made the recommendation that the 'NLM should undertake a first project building a digital image library of volumetric data representing a complete, normal adult male and female. This Visible Human Project will include digitised photographic images for cryosectioning, digital images derived from computerised tomography and digital magnetic resonance images of cadavers' [2]. Note the emphasis on 'a first project'; lessons can only be learned retrospectively - too late to implement on the initial project - but allowing subsequent projects to be streamlined.

The overall aim of the Visible Human Project was the acquisition of transverse computerised tomography (CT), Magnetic Resonance Imaging (MRI), and cryosection images of a male and female cadaver at 1 mm intervals. Contiguous slices would allow for inter-registration within each modality and comparisons between modalities. The contract was advertised by the NLM, and ultimately awarded to the University of Colorado at Denver (principal investigators being Victor M. Spitzer PhD and David G. Whitlock MD, PhD.) In his lecture, Dr Ackerman noted that the high response rate from medical institutes reflected the amount of interest and importance of this project.

The complete male data set is 15 GB in size - a formidable, if not overwhelming size in 1986, but not so in the 1990s. The female data set is larger as the cross-sections were obtained at 0.33 mm (rather than 1 mm as in the male) in order to increase the potential for three-dimensional reconstruction. The resultant data set became 40 GB in size.

Ethics

Having given a background to the Project, Dr Ackerman clarified areas which could be of principle concern; namely, the ethics of using a recently deceased body for research rather than organ harvesting. As the male cadaver used in the Project had died by lethal injection, organ toxicity would have contraindicated transplantation. In the case of the female, the husband responded to a nationwide request for a 'sudden death' cadaver with no known pathology that might corrupt the 'normal' anatomy. As the husband gave his permission for the research to proceed on his wife, the ethical position was clear.

Access to information

The quality of the data set is self evident, available in CD and video form, but more importantly, samples can be downloaded from the Internet. Dr Ackerman acknowledged the 'tardiness' of Internet information transfer, and announced the welcome news that the University of Glasgow is soon to become a 'mirror' site to speed up Internet downloads. On World-Wide Web, the images can be found on the NLM Research Projects page, in the Visible Human Project section:

<URL:http://www.nlm.nih.gov/research/visible/visible_human.html>

What cost?

The CD version is available for a very reasonable price. Indeed, it was reassuring throughout this lecture that emphasis was placed, not on commercialism, but on the importance of transferring the data to institutions to further research.

Acquisition of the whole data set entails a licence agreement that includes:

• clarification of the use of the data set
• a commitment to acknowledge the NLM in any publication/research
• a copy of research results is to be given to the NLM

This agreement can be retrieved from NLM's Gopher site, under the Visible Human Project menu, as a text file and as a downloadable WordPerfect file. It is also available from NLM's FTP site. The agreement is found in the 'visible' directory as a WordPerfect file (vhpagree.wp) or as a text file (vhpagree.txt).

Potential uses for the data sets

It will become clear over the next few years from specific projects whether or not the Visible Human has been of fundamental use. It goes without saying that the databases are an invaluable educational aid for students and professionals in the medical and allied health fields.

More exciting still is the potential offered to the Visible Human Project by virtual reality. Will we soon see students practicing 'virtual' surgical techniques, or surgeons learning new techniques before performing them live? Does it open the way to innovative techniques that were not possible before, because practice was not feasible? Perhaps the Visible Human opens a door to future research that could change present patient/surgical management.

Summary

Dr Ackerman delivered a stimulating lecture, with the right amount of emphasis on information transfer and resource availability. One important point that came across is the value of prediction of new technology. Although operational procedures were plausible in 1986 when the Project was tentatively introduced, computer technology could not cope with such large data sets. This did not, however, prevent the Project from proceeding. It was predicted that by the time the data set would be available, computer technology would have caught up. It did. The next stage, the female data set, presented the same computing problems. Again, with faith the Project proceeded and again, computer technology was soon able to cope with the data sets when they were available. How many projects have been shelved or abandoned because the necessary technology was unavailable? It is encouraging to see how this Project advanced from 1986, aided by the courage and conviction of it's members and by the faith that future technology would be there to support it.

I would like to thank Dr Ackerman for his honesty throughout the lecture, and his emphasis and explanations of the compromises that were made. In any research it is just as important to learn from mistakes or problem areas, as from the success of the project.

To conclude, this was a well-delivered, audience-orientated lecture that whet the appetite of most people present to encourage their own technology departments to investigate the Visible Man and Woman without delay.

References

1 National Library of Medicine, Board of Regents (US). Long range plan. Bethesda (MD): The Library; 1987.

2 National Library of Medicine, Board of Regents (US). Electronic imaging: National Library of Medicine long term plan. Bethesda (MD): The Library; 1990 Apr.

Vikki T. Ayton DCR (R)
Superintendent Radiographer, MRI Unit
Kings College Hospital, UK

Society for the Internet in Medicine

Comments to: simq@cybertas.demon.co.uk

Copyright © 1997 Society for the Internet in Medicine. All rights reserved.
Date: May 30, 1997
Document URL: http://www.cybertas.demon.co.uk/simq/issue1/meetings.html