Medical anatomical illustration - the history of the study of the human body in atlases of 5 centuries. Final part
In the previous three posts ( 1 , 2 , 3) we talked about how the art of anatomical illustration followed the development of medicine and publishing technology. Over the past five centuries, lithography has replaced the engraving, and offset printing has replaced it - this, of course, is a significant change, but such progress may seem ridiculous against the backdrop of a real revolution that has taken place before our eyes. It became possible three-dimensional modeling and the creation of manuals with any level of detail, in which the image can be zoomed in, rotated in all planes, peered into any corner and disassembled into layers. However, while this can be seen mainly in science fiction films, and specialists are content with low-quality models and old books on anatomy. Why - let's try to explain.
Decline in quality with the advent of new technologies
Anatomical illustration played a serious role in the development of science, as it made it possible to accumulate and transmit knowledge about the structure of the human body. Now anatomy has already taken place as a science, although the structure of individual parts of the body is still being specified - for example, there are new ligaments in the knee. Research methods are being improved, from tomography to microscopy. Physiology, histology, new surgical and diagnostic manipulations, the study of pathological processes and conditions supplemented the anatomy, so that the need for competent visualization did not disappear anywhere. On the other hand, it became possible to create three-dimensional models and interactive illustrations. However, as many illustrators note, truly competent and accurate work is very rare. Compared with striking examples from the past, modern anatomical illustration often looks less detailed and elaborated.
Above: drawings from the atlas of Jean-Baptiste Sarlandier, 1837 edition ( source ). Below: illustrations from the contemporary atlas of Todd Olson , released in 2008.
We asked two well-known scientific illustrators Chris Rockley and Karl Wesker to talk a little about what the quality of illustrator's work depends on and why now it is often inferior to what was created in past centuries.
Chris writes that this field of activity requires serious knowledge directly in the field of science:
“One of the possible reasons that modern scientific illustration often looks rustic, in the absence of special training and understanding of the scientific specifics of the object of sketching. I know many scientists who prefer to make images themselves for this reason. I have been teaching science and field drawing at the University of Newcastle in Australia and in selected groups since 2008. One of the things that I note in artists is the lack of knowledge of basic anatomy and observation skills. As soon as you inform them that you need to draw what you see, and not what you suppose, everything becomes clearer, and students begin to see the details and tiny things that slipped away before that. The same goes for medical illustration. We were very lucky at the university, because we had an anatomical laboratory, which made it possible to use real and plasticized corpses for work. Almost like Leonardo da Vinci. ”
Karl Wesker has worked on the Prometheus atlas illustrations , published by Thieme, and the Winking Skull interactive tutorial . He, among other things, indicates the desire of publishers to receive illustrations as quickly as possible:
“The main source for the anatomical illustrations of Prometheus was the study of sections and dissections of the human body. Plus, I have a good library of old and new anatomical books. Here it is necessary to mention the works of Jean Marc Bourgerie ( Atlas of Human Anatomy and Surgery, XIX century ), Gustav Brezike , Karl Toldt and Werner Spaltholtz .
With the advent of computer illustrations, quality has fallen. Publishers are interested in simple and cheap vector graphics. We have been working on Prometheus for 14 years. Now, no publishing house wants to invest so much time and money. ”
In previous posts, we have given many examples of how work on one atlas became the work of the life of an artist or anatomist. This applies primarily to the early stages of the development of anatomy, the times of Eustache, Fabricius or Casseri, when scientists and illustrators worked, focusing on the results of the autopsies, which they themselves carried out. Now it’s not so easy to imagine an artist or a 3D-modeler who will cut corpses and create an illustration or model based on anatomical preparations obtained personally. Meanwhile, this approach made it possible to create illustrations of a fundamentally different level.
However, Karl Wesker does not lose optimism and sees huge potential for anatomical illustration in new computer graphics technologies:
“I think that the quality of illustrations has fallen for a long time, since not all artists could fully master the techniques of drawing on a computer, which was required by publishers.
In principle, now scientific or medical illustration involves the possession of three things: knowledge of the anatomy or structure of the depicted object, the ability to draw and the skill of working in specialized computer programs.
I am sure that something will happen and will change the current state of things in our field. One way or another, I think that the next technical revolution has already begun with the development of three-dimensional graphics, despite the fact that now we are seeing only quite primitive works. ”
Illustrations from the Atlas of Prometheus. ( Source )
The technical side of the issue
More and more often, printed textbooks give way to interactive manuals - both for working in a browser and in the form of mobile applications. The number of authors and companies developing interactive anatomical manuals, both for working in a browser and in the format of applications for a tablet or phone, is growing. Obviously, in this work, the application of three-dimensional graphics and visualization opens up fundamentally new possibilities. After all, the model can be rotated, scaled and studied, removing or adding individual layers or elements, not to mention the ability to show the work of various organs or systems in motion. However, while the modeling potential is revealed only to a small part.
If we talk about mobile educational applications, among them deserve attention: Visible Body , Muscle System Pro, Pocket Anatomy , Essential Anatomy , 3D Brain . In addition to the above, there are a great many others, the comparison and comparison of which requires a separate post. For acquaintance it is possible to follow this and this overview links. However, the quality of graphics and the refinement of models and structures in modern applications leaves a lot of room for improvement.
Screenshots from Essential Anatomy , Pocket Anatomy, and Visible Body apps .
The problem of three-dimensional graphics is that it is impossible to use very detailed anatomical 3D models, since working with them requires significant computational resources, not only when creating, but also, more importantly, when viewing. In this regard, application and widget developers have to compromise. If you make a scalable rotating model, you have to significantly sacrifice quality, as can be seen in the example of the Zygote Body project : despite the fact that Zygote is the author and developer of one of the most high-quality and accurate 3D human body models available on the market, the result presented in the widget, it looks pretty rude:
In addition, the model’s presentation technology involves downloading 3D data to the user's computer, which carries certain risks of further extraction and unauthorized use of the author’s model.
All these circumstances lead to the fact that there has not yet been a breakthrough in detail and quality, which, it would seem, promise modern technology.
Left: illustration from the atlas K.-L. Bonami, P. Brock, and E. Bo (1844). On the right is a screenshot of the graphic from the “ Human Bones 3D ” mobile application . We suggest that the reader himself go, for example, to Google play and look through illustrations from applications for “ anatomy textbook for medical institutes ”, comparing them with examples from our previous posts.
We encountered similar problems during the development of anatomical widgets, so we will talk more about the difficulties that have arisen and the possible ways to solve them using our own example.
In a discussion of one of our previous posts on virus modeling, we already said that it takes several minutes to render a single frame at our accepted level of quality, for example, a human brain model on a modern graphics station (dual Intel xeon 2687w), while for smooth rotation of the model by the user needs to produce a minimum of 15 frames per second.
Things are a little better with the calculation on professional graphics cards, and not on the CPU. But all these are solutions worth thousands of dollars that are not on the user’s side. Moreover, even they will not cope with the task to the fullest. A number of models of maximum complexity, such as the HIV or Ebola virus models, cannot be visualized on the user side because of the large number of high-poly objects in their composition. There are also solutions in the form of specialized environments such as Unity, which allow you to create interactive content for presentation on the network, but they require the user to install the plug-in, and as a result, are less universal. Although, in fairness, they can be eliminated by the criterion of quality.
For these reasons, we chose the option with preliminary calculation and sending the user ready-made graphics without delay. Of course, there are disadvantages - a restriction on the freedom of rotation of models, a large amount of traffic to transmit images at high resolutions. But if the interaction logic and user scenario are well thought out, then the first “minus” can be almost eliminated by adding, say, transparency changes, the appearance of the necessary signatures, slices to the visualization itself, which will saturate the final product with information and allow solving the problem optimally.
One way or another, the creation of anatomical three-dimensional models is not only extremely interesting, but also very laborious, since it involves many stages from finding the correct references to developing widgets and plugins that organize working with the model for the end user. Recently, we have completed work on a new system for creating educational web applications. One of our widgets allows you to view the model of the human skull from different sides, find individual bones in the model, by clicking on their name or find out the name of the bone in one of five languages, by clicking on the model, and also contains a description of all the elements.
Screenshot of the widget.
In this case, our initiative in this area, like that of our colleagues, is to create free high-quality educational interactive materials of a new generation, which would use the capabilities of modern technologies and eliminate the drawbacks mentioned by Karl Wesker and Chris Rockley. We will definitely tell you more about this in one of the following posts.
Three-dimensional modeling in anatomy and medicine: where next?
Non-invasive methods for studying the structure of the body and individual organs, such as tomography or 3D x-ray, can help three-dimensional modeling .
In the not-so-old days, it was not possible to find out what this or that internal organ looks like by cutting the body. Modern technologies allow you to do this, and then use the result to create models, including those printed on a 3D printer. Such commercially available models are made by Zygote, which has already been mentioned. One of these projects is called Solid 3D Male Body. The authors write that when creating the models, they used computed tomography data and tried to comply with the parameters that are as close as possible to the parameters of the human body. Such models can be not only useful for educational purposes, but also useful, for example, to designers who develop shoes, clothes, as well as orthopedic appliances or interfaces that directly interact with parts of the human body. We use the data of tomograms in solving local problems, as the references of the native relative position, sizes and shapes in high-quality high-detailed modeling.
However, so far the technologies for reconstruction and visualization of tomography results are far from ideal and do not immediately give a clear and understandable picture to a layman. There is no doubt that the need for professional 3D-modelers to create educational three-dimensional anatomical graphics will always be.
A picture with a three-dimensional reconstruction of a CT scan of a skull with a Le Forum fracture. ( Wikipedia ) You can compare the detail and comprehensibility with this video .
On the other hand, three-dimensional modeling based on medical research of specific patients can directly be useful in the treatment of certain diseases. Models of vertebrae and even fragments of the skullprinted on 3D printers are already used in transplantology. This is very convenient because it makes it easy to make the implant in the most suitable shape. Most likely, these technologies will be actively developed, and, apparently, in the direction of truly amazing stories like the printing of scaffolds , on which whole cloned organs such as the liver, kidneys or heart can grow.
Another possible application is the creation and printing of models of human embryos in the early stages of development. It sounds ambiguous, but such a procedure, for example, can help blind parents to get an idea of how their baby looks in the womb .
Another advantage of modeling over a static image is that it makes it easier to create animated snippets and videos. From an educational point of view, this is another level up, since animated images describe physiological processes, medical manipulations or injuries and fractures an order of magnitude better . Even when using a static model of camera movement, the audio sequence and signatures can give a ton of information and correctly place emphasis. However, talking about anatomical animation also clearly deserves a separate post.
