Medical imaging: A journey inside the human body with Cinematic VRT

7 Dec 2017

Cinematic VRT. Image: syngo.via/Siemens Healthineers

Siemens Healthineers is using a technique deployed in the film industry to develop a revolutionary method of looking inside the human body.

The Cinematic Volume Rendering Technique, or Cinematic VRT, is a research visualisation technology that enables 3D photo-realistic images to be produced of the human body, and marks a quantum leap in terms of 3D medical imaging. The question is how this technology came to be developed.

It all began with the idea of utilising the effects that have become run-of-the-mill in the film industry for producing realistic-looking computer animations. Klaus Engel, who carries out research into imaging technologies at Siemens Healthineers, even had an exact figure in mind: Gollum from the blockbuster movie The Lord of the Rings. This creature’s realistic appearance can be attributed to the image-based technique of shading. This means, for instance, a spherical panorama is captured using a reflective sphere. This records the current light environment that is then applied later on to all the synthetic elements that are added.

‘Our images can provide a completely new view of tissue structures. This allows a doctor, for instance, to gain a very precise overview of a fracture right before an operation’

This technique is also the prerequisite for the images that Engel, Robert Schneider and their team are creating of the human body. In the past, they would first fiddle around, develop, scrap and reinvent until they had finally written the algorithms to enable them to produce a computer-based, photo-realistic view inside the body. “Based on the results from the film industry, we called our procedure ‘cinematic’,” explained Engel.

The main attraction is that existing procedures such as computer tomography (CT) and magnetic resonance imaging (MRI) provide the raw data that Cinematic VRT technology can use to generate astounding images. “Cinematic VRT basically operates as a virtual camera. The program makes it possible to hide soft tissue, muscles and blood vessels, giving a clear view of the bone structure,” explained Engel. But it goes even further than this. The person viewing the image can, for instance, hide or add tissue, thereby gaining a completely different view inside the body.

Innovation equals benefit

So, what is the point of the whole thing? Engel sees its main benefit in improving planning for surgery, as well as part of communication between doctors and the dialogue with patients. “Our images can provide a completely new view of tissue structures. This allows a doctor, for instance, to gain a very precise overview of a fracture right before an operation,” he explained. “The doctor can also visualise for the patient in a very striking way that is easy to understand what this fracture looks like.”

The use of Cinematic VRT is still not permitted as a technique for visualising clinical findings but the trial phase, involving customers and scientists across the globe, is running flat out.


Large aneurysm and blood vessels in the brain produced with Cinematic VRT. Image: Radiologie im Israelitschen Krankenhaus, Hamburg, Germany

“We’re making Cinematic VRT available as a product via our imaging software platform syngo.via VB20. We’re collaborating very closely with our customers in exchanging data so that requirements originate from practice,” continued Engel.

This approach is also confirmed by Prof Franz Fellner, director of radiology at Linz General Hospital, Austria, and president of the Upper Austria Medical Association: “It will be interesting to see whether Cinematic VRT has the potential to become a routine procedure in everyday clinical practice. I think that, in this respect, Cinematic VRT will possibly herald a new era.”

Fellner was one of the first people to use this technique and he helped the inventors at Siemens to adapt Cinematic VRT for anatomical training courses. The aim is to obtain an application that can display images of inside the human body in a clear manner that anyone can understand. For the past two years, this has been done at Deep Space 8K in the Ars Electronica Center in Linz in order to create interactive anatomy lectures for a general audience and for trainees in medical professions.

In late 2016, Siemens named Engel Inventor of the Year in the Single Outstanding Invention category.

By Bernward Bodenstedt, Siemens Healthineers

A version of this article originally appeared in the Siemens Healthineers magazine

The statements by Siemens’ customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no ‘typical’ hospital and many variables exist (eg hospital size, case mix, level of IT adoption), there can be no guarantee that other customers will achieve the same results.