Thanks to Luis Serra for ideas and materials included here. The views expressed are those of the author.
Medicine is one of the major application areas for virtual reality (VR), along with games and scientific visualisation. The medical application of VR was stimulated initially by the need of medical staff to visualise complex medical data, particularly during surgery and for surgery planning, and for medical education and training. These applications have naturally extended to include telemedicine and collaboration, involving sharing information across individual medical staff and across geographical locations. Surgery-related applications of VR fall mainly into three classes: open surgery, endoscopy, and radiosurgery.
Medical education was the first area in which VR made a significant contribution. There are probably two main reasons for this. One is that education is less critical, in terms of patient survival, than is actual surgery or surgery planning. These latter two areas of application remain less developed commercially and more experimental in nature. The other reason is the established technology for applying VR to education in other fields, especially aviation.
Approaches to learning to navigate within a human body have benefitted from techniques developed to train pilots to fly advanced commercial and military aircraft. There are quite strong similarities between the two application fields since both combine the need for great manual dexterity in a 3D environment with life-critical information access and decision making. Although medical "flight simulators" - based on datasets from actual bodies, both dead and alive - do not yet have the same status as those used in aviation training, it seems likely that such a time is not long off. Increased realism, especially in the simulation of body behaviours, combined with enhanced feedback and the difficulties of training these skills in other ways, seem to make this inevitable.
Another area of medical education to which VR is being applied is that of dealing with catastrophic emergencies threatening or damaging the health of large numbers of people: earthquakes, plane crashes, major fires, and so on. Here, rather general VR techniques are used to simulate a disaster scene. Trainee medical and paramedical staff use such environments to learn how to allocate resources, prioritise cases for treatment, and so on. The disaster scene can be walked through, situations are encountered and decisions made.
More recently, the scope of VR applications in medicine has broadened to include physical and psychiatric rehabilitation and, to a lesser extent, diagnosis. VR is proving surprisingly powerful as a therapeutic tool for both mental and physical disabilities.
The scope of this survey reflects the range of medical applications to which VR is being applied, and which is briefly outlined above. Excluded from consideration in this survey are applications in health education for the general public (largely covered by on-line or CD-ROM-based multimedia presentations and not addressed by VR), visualisation of large-scale medical databases (i.e. medical records from large numbers of patients - although VR is being applied in this area), and the application of VR to the architectural design of medical centres.
Section 2 focuses on the techniques that have been applied to meet the needs of medical VR applications.
In Section 3, the main application areas are reviewed.
A considerable industry is developing around medical applications of VR; medicine is seen as a highly profitable area by technology manufacturers because of the high technical requirements combined with the availability of funds for medical purchasing in developed societies. There are a large number of commercial applications and datasets available now, and there is also some freeware that is relevant to medical VR. Sources of relevant applications and datasets, and of information related to medical VR, are outlined in Section 4,
Given the broad and burgeoning scope of medical VR, it is important to be selective in the topics and approaches taken here in Umeå. We have particular needs and areas of expertise, and these should guide the process of selecting suitable niches for local exploitation of medical VR. Section 5 represents an attempt to identify such niches.
Section 6 contains bibliographies of publications relevant to medical VR.
Section 7 provides a glossary of terms in this highly specialised and technical field.