Perspective volume rendering of cross-sectional images for simulated endoscopy and intraparenchymal viewing

The capability of today's clinical scanners to create large quantities of high resolution and near isotropically sampled volume data, coupled with a rapidly improving performance/price ratio of computers, has created the challenge and feasibility of creating new ways to explore cross- sectional medical imagery. Perspective volume rendering (PVR) allows an observer to 'fly- through' image data and view its contents from within for diagnostic and treatment planning purposes. We simulated flights through 14 data sets and, where possible, these were compared to conventional endoscopy. We demonstrated colonic masses and polyps as small as 5 mm, tracheal obstructions and precise positioning of endoluminal stent-grafts. Simulated endoscopy was capable of generating views not possible with conventional endoscopy due to its restrictions on camera location and orientation. Interactive adjustment of tissue opacities permitted views beyond the interior of lumina to reveal other structures such as masses, thrombus, and calcifications. We conclude that PVR is an exciting new technique with the potential to supplement and/or replace some conventional diagnostic imaging procedures. It has further utility for treatment planning and communication with colleagues, and the potential to reduce the number of normal people who would otherwise undergo more invasive procedures without benefit.