The Community for Technology Leaders
RSS Icon
Subscribe
Issue No.01 - Jan. (2013 vol.19)
pp: 108-117
C. R. Butson , Depts. of Neurology & Neurosurg., Med. Coll. of Wisconsin, Milwaukee, WI, USA
G. Tamm , DFKI, Saarbrucken, Germany
S. Jain , Dept. of Neurology, Med. Coll. of Wisconsin, Milwaukee, WI, USA
T. Fogal , Interactive Visualization & Data Anal. Group, Intel Visual Comput. Inst., Saarbrucken, Germany
J. Kruger , DFKI, Saarbrucken, Germany
ABSTRACT
In recent years, there has been significant growth in the use of patient-specific models to predict the effects of neuromodulation therapies such as deep brain stimulation (DBS). However, translating these models from a research environment to the everyday clinical workflow has been a challenge, primarily due to the complexity of the models and the expertise required in specialized visualization software. In this paper, we deploy the interactive visualization system ImageVis3D Mobile, which has been designed for mobile computing devices such as the iPhone or iPad, in an evaluation environment to visualize models of Parkinson's disease patients who received DBS therapy. Selection of DBS settings is a significant clinical challenge that requires repeated revisions to achieve optimal therapeutic response, and is often performed without any visual representation of the stimulation system in the patient. We used ImageVis3D Mobile to provide models to movement disorders clinicians and asked them to use the software to determine: 1) which of the four DBS electrode contacts they would select for therapy; and 2) what stimulation settings they would choose. We compared the stimulation protocol chosen from the software versus the stimulation protocol that was chosen via clinical practice (independent of the study). Lastly, we compared the amount of time required to reach these settings using the software versus the time required through standard practice. We found that the stimulation settings chosen using ImageVis3D Mobile were similar to those used in standard of care, but were selected in drastically less time. We show how our visualization system, available directly at the point of care on a device familiar to the clinician, can be used to guide clinical decision making for selection of DBS settings. In our view, the positive impact of the system could also translate to areas other than DBS.
INDEX TERMS
neurophysiology, computational complexity, data visualisation, decision making, diseases, interactive systems, mobile computing, clinical decision making, mobile computing platforms, deep brain stimulation parameters, patient-specific models, neuromodulation therapies, clinical workflow, model complexity, visualization software, interactive visualization system, ImageVis3D mobile, iPhone, iPad, Parkinsons disease patients, DBS therapy, movement disorders clinicians, DBS electrode contacts, stimulation protocol, Satellite broadcasting, Mobile communication, Mobile handsets, Rendering (computer graphics), Electrodes, Computational modeling, Data visualization, clinical decision making, neurophysiology, computational complexity, data visualisation, decision making, diseases, interactive systems, mobile computing, clinical decision making, mobile computing platforms, deep brain stimulation parameters, patient-specific models, neuromodulation therapies, clinical workflow, model complexity, visualization software, interactive visualization system, ImageVis3D mobile, iPhone, iPad, Parkinsons disease patients, DBS therapy, movement disorders clinicians, DBS electrode contacts, stimulation protocol, Satellite broadcasting, Mobile communication, Mobile handsets, Rendering (computer graphics), Electrodes, Computational modeling, Data visualization, Parkinson's disease, Biomedical and medical visualization, mobile and ubiquitous visualization, computational model
CITATION
C. R. Butson, G. Tamm, S. Jain, T. Fogal, J. Kruger, "Evaluation of Interactive Visualization on Mobile Computing Platforms for Selection of Deep Brain Stimulation Parameters", IEEE Transactions on Visualization & Computer Graphics, vol.19, no. 1, pp. 108-117, Jan. 2013, doi:10.1109/TVCG.2012.92
REFERENCES
[1] Apple, "Apple Push Notification Service," http://tinyurl.comApplePushNotification, 2010.
[2] S. Burigat and L. Chittaro, "Location-Aware Visualization of VRML Models in GPS-Based Mobile Guides," Proc. Tenth Int'l Conf. 3D Web Technology (Web3D '05), http://doi.acm.org/10.11451050491.1050499 , pp. 57-64, 2005.
[3] C. Butson and C.C. McIntyre, "Role of Electrode Design on the Volume of Tissue Activated during Deep Brain Stimulation," J. Neural Eng., vol. 3, no. 1, pp. 1-8, 2006.
[4] C.R. Butson, S.E. Cooper, J.M. Henderson, and C.C. McIntyre, "Predicting the Effects of Deep Brain Stimulation with Diffusion Tensor Based Electric Field Models," Proc. Ninth Int'l Conf. Medical Image Computing and Computer-Assisted Intervention (MICCAI '06), vol. 9, no. Pt 2, pp. 429-437, 2006.
[5] C.R. Butson, S.E. Cooper, J.M. Henderson, and C.C. McIntyre, "Patient-Specific Analysis of the Volume of Tissue Activated during Deep Brain Stimulation," NeuroImage, http://linkinghub. elsevier.com/retrieve/ piiS1053811906009669. vol. 34, no. 2, pp. 661-670, 2007.
[6] C.R. Butson, S.E. Cooper, J.M. Henderson, B. Wolgamuth, and C.C. McIntyre, "Probabilistic Analysis of Activation Volumes Generated during Deep Brain Stimulation," NeuroImage, http://www.ncbi.nlm.nih.gov/pubmed20974269 , vol. 54, pp. 2096-2104, 2011.
[7] C.R. Butson, K. Driesslein, S. Hung, M. Matthews, C.J. Sheridan, B.H. Kopell, and J. Bobholz, "Probabilistic Atlas of Neuropsychological Outcomes from Subthalamic Nucleus Deep Brain Stimulation," Proc. Movement Disorders Soc. Congress, 2010.
[8] C.R. Butson, C.B. Maks, and C.C. McIntyre, "Sources and Effects of Electrode Impedance during Deep Brain Stimulation," Clinical Neurophysiology, vol. 117, no. 2, pp. 447-54, 2006.
[9] C.R. Butson and C.C. McIntyre, "Tissue and Electrode Capacitance Reduce Neural Activation Volumes during Deep Brain Stimulation," Clinical Neurophysiology, vol. 116, no. 10, pp. 2490-500, 1388-2457, 2005.
[10] C.R. Butson and C.C. McIntyre, "Differences Among Implanted Pulse Generator Waveforms Cause Variations in the Neural Response to Deep Brain Stimulation," Clinical Neurophysiology, vol. 118, no. 8, pp. 1889-94, 2007.
[11] C.R. Butson and C.C. McIntyre, "Current Steering to Control the Volume of Tissue Activated during Deep Brain Stimulation," Brain Stimulation, vol. 1, no. 1, pp. 7-15, 2008.
[12] B. Buxton, "Multi-Touch Systems that I Have Known and Loved," http://www.billbuxton.commultitouchOverview.html , Jan. 2007.
[13] C. Chang and S. Ger, "Enhancing 3D Graphics on Mobile Devices by Image-Based Rendering," Proc. Third IEEE Pacific Rim Conf. Multimedia: Advances in Multimedia Information Processing (PCM '02), http://www.cs.nthu.edu.tw/chunfapcm2002.pdf , pp. 1105-1111, 2002.
[14] L. Cheng, A. Bhushan, R. Pajarola, and M. El Zarki, "Real-Time 3D Graphics Streaming Using Mpeg-4," Proc. IEEE/ACM Workshop Broadband Wireless Services and Applications, http://www. broadnets.org/2004/workshop-papers/ BroadwiseCheng_L.pdf, 2004.
[15] L. Chittaro, "Visualizing Information on Mobile Devices," Computer, http://dx.doi.org/10.1109MC.2006.109, vol. 39, no. 3, pp. 40-45, 2006.
[16] G.E. Christensen, S.C. Joshi, and M.I. Miller, "Volumetric Transformation of Brain Anatomy," IEEE Trans. Medical Imaging, vol. 16, no. 6, pp. 864-877, 1997.
[17] S. Computing and I.I. (SCI), "SCIRun: A Scientific Computing Problem Solving Environment," http:/www.scirun.org, 2012.
[18] G. Deuschl, C. Schade-Brittinger, P. Krack, J. Volkmann, H. Schafer, K. Botzel, C. Daniels, A. Deutschlander, U. Dillmann, W. Eisner, D. Gruber, W. Hamel, J. Herzog, R. Hilker, S. Klebe, M. Kloss, J. Koy, M. Krause, A. Kupsch, D. Lorenz, S. Lorenzl, H.M. Mehdorn, J.R. Moringlane, W. Oertel, M.O. Pinsker, H. Reichmann, A. Reuss, G.H. Schneider, A. Schnitzler, U. Steude, V. Sturm, L. Timmermann, V. Tronnier, T. Trottenberg, L. Wojtecki, E. Wolf, W. Poewe, and J. Voges, "A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease," The New England J. Medicine, http://www.ncbi.nlm.nih.gov/pubmed16943402 , vol. 355, no. 9, pp. 896-908, 2006.
[19] J.L. Encarnação, M. Frühauf, and T. Kirste, "Mobile Visualization: Challenges and Solution Concepts," Proc. Conf. Computer Applications in Production and Eng. (CAPE '95), http://citeseer.ist.psu. edu159692.html, 1995.
[20] T. Fogal and J. Krüger, "Tuvok - An Architecture for Large Scale Volume Rendering," Proc. 15th Vision, Modeling and Visualization Workshop, http://ivda.cs.uni-saarland.de/fileadmin/ publications/2010VMV2010a.pdf, 2010.
[21] A.M. Frankemolle, J. Wu, A.M. Noecker, C. Voelcker-Rehage, J.C. Ho, J.L. Vitek, C.C. McIntyre, and J.L. Alberts, "Reversing Cognitive-motor Impairments in Parkinson's Disease Patients Using a Computational Modelling Approach to Deep Brain Stimulation Programming," Brain, http://brain.oxfordjournals. org/cgi/content/ abstractawp315v1, vol. 133, no. Pt 3, pp. 746-61, 2010.
[22] M. Hadwiger, J.M. Kniss, C. Rezk-Salama, D. Weiskopf, and K. Engel, Real-Time Vol. Graphics, A. K. Peters Ltd., http:/www. real-time-volume-graphics.org /, 2006.
[23] G. Humphreys, M. Houston, R. Ng, R. Frank, S. Ahern, P.D. Kirchner, and J.T. Klosowski, "Chromium: A Stream-Processing Framework for Interactive Rendering on Clusters," ACM Trans. Graphics, http://doi.acm.org/10.1145566654.566639. vol. 21, no. 3, pp. 693-702, 2002.
[24] K. Hunka, O. Suchowersky, S. Wood, L. Derwent, and Z.H. Kiss, "Nursing Time to Program and Assess Deep Brain Stimulators in Movement Disorder Patients," J. Neuroscience Nursing, http://journals.lww.com/jnnonline/Abstract/ 2005/08000Nursing_ Time_to_Program_and_Assess_Deep_Brain.6.aspx . vol. 37, no. 4, pp. 204-10, 2005.
[25] F. Lamberti and A. Sanna, "A Streaming-Based Solution for Remote Visualization of 3D Graphics on Mobile Devices," IEEE Trans. Visualization and Computer Graphics, http://dx.doi.org/10.1109TVCG.2007.29, vol. 13, no. 2, pp. 247-260, Mar./Apr. 2007.
[26] J. Lluch, R. Gaitán, E. Camahort, and R. Vivó, "Interactive Three-Dimensional Rendering on Mobile Computer Devices," Proc. ACM SIGCHI Int'l Conf. Advances in Computer Entertainment Technology (ACE '05), http://doi.acm.org/10.11451178477. 1178520 , pp. 254-257, 2005.
[27] C.B. Maks, C.R. Butson, B.L. Walter, J.L. Vitek, and C.C. McIntyre, "Deep Brain Stimulation Activation Volumes and Their Association with Neurophysiological Mapping and Therapeutic Outcomes," J. Neurology, Neurosurgery and Psychiatry, vol. 80, http://www.ncbi.nlm.nih.gov/pubmed18403440 , pp. 659-666, 2009.
[28] C.C. McIntyre, S. Mori, D.L. Sherman, N.V. Thakor, and J.L. Vitek, "Electric Field and Stimulating Influence Generated by Deep Brain Stimulation of the Subthalamic Nucleus," Clinical Neurophysiology, vol. 115, no. 3, pp. 589-95, 2004.
[29] A. Meir and B. Rubinsky, "Distributed Network, Wireless and Cloud Computing Enabled 3-D Ultrasound; A New Medical Technology Paradigm," PLoS ONE, http://www.ncbi.nlm.nih. gov/pmc/articles PMC2775631/, vol. 4, no. 11 p. e7974, 2009.
[30] S. Miocinovic, C.B. Maks, A.M. Noecker, C.R. Butson, and C.C. McIntyre, "Cicerone: Deep Brain Stimulation Neurosurgical Navigation Software System," Acta Neurochir Suppl (Wien), vol. 97, pp. 561-567, 2007.
[31] M. Moser and D. Weiskopf, "Interactive Volume Rendering on Mobile Devices," Proc. Workshop Vision, Modelling, and Visualization (VMV '08), http://www.vis.uni-stuttgart.de/weiskopf/ publicationsvmv08.pdf, pp. 217-226, 2008.
[32] M.S. Okun, H.H. Fernandez, S.S. Wu, Kirsch-Darrow, B.L., B.D., F., M. Suelter, C.E. Jacobson, X. Wang, C.W. Gordon, P. Zeilman, J. Romrell, P. Martin, H. Ward, R.L. Rodriguez, and K.D. Foote, "Cognition and Mood in Parkinson's Disease in Subthalamic Nucleus Versus Globus Pallidus Interna Deep Brain Stimulation: The COMPARE Trial," Annals of Neurology, vol. 65, pp. 586-95, 2009.
[33] V. Paelke, C. Reimann, and W. Rosenbach, "A Visualization Design Repository for Mobile Devices," Proc. Second Int'l Conf. Computer Graphics, Virtual Reality, Visualisation and Interaction in Africa (AFRIGRAPH '03), http://doi.acm.org/10.1145602330.602341, pp. 57-62, 2003.
[34] S. Park, W. Kim, and I. Ihm, "Mobile Collaborative Medical Display System," Computer Methods and Programs in Biomedicine, http://dx.doi.org/10.1016j.cmpb.2007.11.012 , vol. 89, no. 3, pp. 248-260, 2008.
[35] J.M. Schwalb and C. Hamani, "The History and Future of Deep Brain Stimulation," Neurotherapeutics, http://www.journals. elsevierhealth.com/ periodicals/nurt/articleS1933-7213(07)00263-2 /, vol. 5, no. 1, pp. 3-13, 2008.
[36] F.M. Weaver, K. Follett, M. Stern, K. Hur, C. Harris, J. Marks, W.J., J. Rothlind, O. Sagher, D. Reda, C.S. Moy, R. Pahwa, K. Burchiel, P. Hogarth, E.C. Lai, J.E. Duda, K. Holloway, A. Samii, S. Horn, J. Bronstein, G. Stoner, J. Heemskerk, and G.D. Huang, "Bilateral Deep Brain Stimulation vs Best Medical Therapy for Patients with Advanced Parkinson Disease: A Randomized Controlled Trial," J. Am. Medical Assoc., http://www.ncbi.nlm.nih.gov/pubmed19126811 , vol. 301, no. 1, pp. 63-73, 2009.
109 ms
(Ver 2.0)

Marketing Automation Platform Marketing Automation Tool