Clinical applications of medical imaging - the 3rd millennium project

Summary form only given. Clinical routine is currently producing a multitude of diagnostic digital images, but only a few are used in computer assisted therapy planning and treatment. The most difficult remaining problem for a full implementation of all possible enhancements of imaging technologies in the clinical routine is the lack of smooth integration into the traditional clinical workflow. Human and methodological hierarchies are not easily changed because clinical routine has been much ritualized for centuries. New approaches are only accepted when there is an obvious benefit to the medical procedure. This can mean better care for the patient but often is related to benefits for health care professionals. The benefit is not necessarily monetary, because health care professionals may be motivated to accept imaging technology also because of theoretical considerations or the desire to improve patient care. In our own experience we know that this process of clinical integration can take years after the primary publication of a new approach to result in imaging technologies supporting diagnostics and therapy planning. Today, a dramatic increase in image resolution can be observed. Due to the rapid technological advances in image acquisition techniques, thousands of images may be acquired in seconds. Thus, the examination of every single slice seems not to be feasible with acceptable efforts, especially having in mind that current developments are heading towards 4D imaging. One way out of this dilemma is three-dimensional visualization. Fast three-dimensional segmentation techniques are required to gain accurate visualization results discriminating anatomical from pathological structures. Medical imaging and image processing can be used both in diagnosis and therapy. Using a computer, existing 2D images can be transformed into interactive 3D volumes, and results from different modalities can be merged. Furthermore, it is possible to extract and display functional areas that were not visible in the primary layered images. As examples of 25 years of research in medical imaging, we want to present novel applications developed in our division in cooperation with our medical partners.