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3D and Workflow: Cinematic Rendering Imaging Pearls - Educational Tools | CT Scanning | CT Imaging | CT Scan Protocols - CTisus
Imaging Pearls ❯ 3D and Workflow ❯ Cinematic Rendering

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  • “Acute aortic injuries are not common in the setting of severe blunt trauma, but lead to significant morbidity and mortality. High- quality MDCT with 2D MPRs and 3D rendering are essential to identify aortic trauma and distinguish anatomic variants and other forms of aortic pathology from an acute injury. Misinterpretation of mimics of acute aortic injury can lead to unnecessary arteriography and thoracic surgery. Since most traumatic injuries occur in the distal arch, radiologists must be cognizant of the range of appearances of variants related to the ductus diverticulum. Cinematic rendering (CR) is a new 3D post-processing tool that provides even greater anatomic detail than traditional volume rendering. In this case series, CR is used to impart to radiologists a better understanding of various anatomic configurations that can be seen with a ductus diverticulum.”

    
MDCT of ductus diverticulum: 3D cinematic rendering to enhance understanding of anatomic configuration and avoid misinterpretation as traumatic aortic injury 
Steven P. Rowe1 & Pamela T. Johnson1 & Elliot K. Fishman
Emergency Radiology (2018) 25:209–213
  • “Postprocessing with 2D multiplanar reconstructions and 3D rendering has become standard of care in CT angiography. One of the advantages of volume rendering over maximum intensity projection is the ability to convey 3D anatomic relationships. For complex anatomic configurations like the thoracic aorta and pulmonary arteries, the lighting model in cinematic rendering adds even greater anatomic detail, as demonstrated by these cases.”


    MDCT of ductus diverticulum: 3D cinematic rendering to enhance understanding of anatomic configuration and avoid misinterpretation as traumatic aortic injury 
Steven P. Rowe1 & Pamela T. Johnson1 & Elliot K. Fishman
Emergency Radiology (2018) 25:209–213
  • “One of the most pronounced advantages of cinematic rendering is the production of realistic shadowing effects, allowing for very clear representation of the relative positions of objects within the imaged volume; this is well demonstrated in Fig. 1, where the shadowing from the aortic arch onto the underlying ductus diverticulum and pulmonary arterial vasculature allows the viewer to easily grasp the internal arrangement of these structures. Although the rate of incorrectly diagnosed traumatic aortic injuries was low even in the era when invasive aortography was the primary imaging modality, and has remained low with CT angiography as the frontline modality, the consequences of a missed diagnosis (potential death from massive hemorrhage) or an overcalled finding (unnecessary thoracotomy) underscore the importance of any new technique to improve diagnostic accuracy or diagnostic confidence.”


    MDCT of ductus diverticulum: 3D cinematic rendering to enhance understanding of anatomic configuration and avoid misinterpretation as traumatic aortic injury 
Steven P. Rowe1 & Pamela T. Johnson1 & Elliot K. Fishman
Emergency Radiology (2018) 25:209–213
  • “Since most traumatic injuries occur in the distal arch, radiologists must be cognizant of the range of appearances of variants related to the ductus diverticulum. Cinematic rendering (CR) is a new 3D post-processing tool that provides even greater anatomic detail than traditional volume rendering. In this case series, CR is used to impart to radiologists a better understanding of various anatomic configurations that can be seen with a ductus diverticulum.”


    MDCT of ductus diverticulum: 3D cinematic rendering to enhance understanding of anatomic configuration and avoid misinterpretation as traumatic aortic injury 
Steven P. Rowe1 & Pamela T. Johnson1 & Elliot K. Fishman
Emergency Radiology (2018) 25:209–213
  • “CR has the potential to improve visualization of subtle pancreatic neoplasms, differentiation of solid and cystic pancreatic neoplasms, assessment of local tumor extension and vascular invasion, and visualization of metastatic disease.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “Pancreatic cancer is the third most common cause of cancer death and CT is the most commonly used modality for the initial evaluation of suspected pancreatic cancer. Post-processing of CT data into 2D multiplanar and 3D reconstructions has been shown to improve tumor visualization and assessment of tumor resectability compared to axial slices, and is considered the standard of care. Cinematic rendering is a new 3D- rendering technique that produces photorealistic images, and it has the potential to more accurately depict anatomic detail compared to traditional 3D reconstruction techniques.”

    
Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “Pancreatic cancer is the 12th most common cause of cancer and the 3rd most common cause of cancer death. It is estimated that 53,670 new pancreatic cancer cases will be diagnosed in the United States in 2017. CT is the most commonly used imaging modality for the initial evaluation of suspected pancreatic cancer.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “CR differs from traditional VR in the use of the lighting model. While VR uses a simple ray cast method to generate 3D images, CR uses Monte Carlo path tracing and global illumination model that takes direct and indirect illumination into account. With CR, each pixel is formed by thousands of rays passing through the volumetric dataset and includes effects of light rays from scatter and from voxels adjacent to the paths of the rays.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “The photorealistic quality of CR can accentuate subtle textural change of the pancreatic neoplasm compared to background pancreatic parenchyma, which can improve visualization of subtle cases. CR also provides greater appreciation of the global shape and size of the pancreas. This highlights parenchymal atrophy, which is a useful secondary sign associated with pancreatic adenocarcinoma. The photorealistic images of CR mimic real anatomic specimens that may be more intuitive for non-radiologists and may facilitate communication with referring clinicians and patients.”

    
Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “Just as CR can highlight subtle hypoenhancement and textural change of pancreatic adenocarcinoma, the display settings can be modified to highlight structures with high Hounsfield units, such as neuroendocrine tumors. The wider dynamic range of color and depth helps to improve tumor conspicuity. CR improves depth perception, which can be particularly helpful in visualizing fine internal septations and mural nodularity in cystic pancreatic neoplasms. The improved appreciation of the internal architecture of the cystic pancreatic neoplasms may help in differentiating different types of cystic neoplasms.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “The exquisite vascular maps generated by CR can highlight the extent of vascular invasion (i.e., length of involved vessel, degree of luminal narrowing), which can assist in determining tumor resectability and in determining vascular reconstruction planning. The improved depth perception of CR can assist surgeons in visualizing the pancreatic tumor and the intrinsic vascular anatomy of the pancreatic bed. This is especially important if the patient may be a candidate for laparoscopic- or robot-assisted pancreatic surgery, since these minimally invasive surgery offer limited field of view compared with open surgery.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007/s00261-018-1559-3
  • “There are several limitations of CR technique. CR uses a more complex algorithm compared to VR and requires higher computational power. This requires more powerful workstations and network bandwidth. Each manipulation during interactive rendering requires a new set of calculations, which increases post-processing time. Second, the CR display needs to be optimized to depict the anatomy and pathology of interest. Therefore, CR needs to be performed by the radiologist and the display needs to be tailored to different clinical indications. Lastly, while CR dramatically improves photorealism of the CT images, it is currently unclear whether this photorealism improves diagnostic accuracy and/or patient outcomes. At the current time, the potential role of CR in pancreatic imaging remains speculative. These preliminary observations show potential application of CR in pancreatic imaging, which will require validation in future studies.”

    
Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007s00261-018-1559-3
  • “There are several limitations of CR technique. CR uses a more complex algorithm compared to VR and requires higher computational power. This requires more powerful workstations and network bandwidth. Each manipulation during interactive rendering requires a new set of calculations, which increases post-processing time. Second, the CR display needs to be optimized to depict the anatomy and pathology of interest. Therefore, CR needs to be performed by the radiologist and the display needs to be tailored to different clinical indications.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007s00261-018-1559-3
  • “Lastly, while CR dramatically improves photorealism of the CT images, it is currently unclear whether this photorealism improves diagnostic accuracy and/or patient outcomes. At the current time, the potential role of CR in pancreatic imaging remains speculative. These preliminary observations show potential application of CR in pancreatic imaging, which will require validation in future studies.” 


    Cinematic rendering of pancreatic neoplasms: preliminary observations and opportunities 
Linda C. Chu , Pamela T. Johnson, Elliot K. Fishman 
Abdom Radiol (2018)
https://doi.org/10.1007s00261-018-1559-3
  • “An apparent limitation of CR is illustrated in the 2nd case. While the shadowing effects that arise from the global lighting model that is used contribute to the photorealistic quality of the images, shadowing can also potentially obscure important pathology. Therefore, as with any 3D rendering technique, it is important for the user to examine CR visualizations from multiple different views and to interactively alter the windowing settings to increase and decrease the transparency of overlapping anatomic structures, and to use CR in conjunction with axial display, 2D MPRs, MIP and VR. Other limitations of CR may come to light as the method becomes more widely clinically available.”

    
Cinematic rendering of cardiac CT volumetric data: Principles and initial observations 
Steven P. Rowe, Pamela T. Johnson, Elliot K. Fishman
Journal of Cardiovascular Computed Tomography 12 (2018) 56–59 

  • “CR is a promising method to enhance display volumetric CT data and should prove useful in diagnosis, treatment planning, surgical navigation, trainee education, and patient engagement. However, further study is needed to establish the advantaged and disadvantages of CR in comparison to other 3D methods.”

    
Cinematic rendering of cardiac CT volumetric data: Principles and initial observations 
Steven P. Rowe, Pamela T. Johnson, Elliot K. Fishman
Journal of Cardiovascular Computed Tomography 12 (2018) 56–59 

  • “Additional considerations that refine CR photorealism include the incorporation of shadowing effects that derive from assuming that the light source can be obscured by objects within the visualized volume. Such shadowing is not typically included in traditional VR, although it is possible to incorporate.8 Furthermore, while CR can use one or more unidirectional light sources as is done in VR, more typically an en- vironment map is used (i.e. texture maps that are related to the brightnesses of surfaces within a virtual scene and more accurately reflect realistic lighting scenarios).”

    
Cinematic rendering of cardiac CT volumetric data: Principles and initial observations 
Steven P. Rowe, Pamela T. Johnson, Elliot K. Fishman
Journal of Cardiovascular Computed Tomography 12 (2018) 56–59 

  • “Kawasaki’s disease (KD) is a vasculitis that predominantly affects children and can lead to the development of coronary artery aneurysms. These aneurysms can subsequently thrombose and occlude, which may lead to chest pain and other signs and symptoms of acute coronary syndrome in young patients. Coronary CT angiography, including 3D visualization techniques, is a common modality used in the follow-up of KD patients. In this series of three patients, we present the typical coronary artery imaging findings that can appear in these patients, with an emphasis on the use of the novel 3D technique of cinematic rendering (CR). CR utilizes a different lighting model than other 3D methods and is able to produce highly-detailed, photorealistic images. The potential advantages of CR images in understanding the complex mediastinal vascular anatomy and the relationships of coronary artery aneurysms to other anatomic structures are emphasized.”


    Evaluation of Kawasaki’s disease-associated coronary artery aneurysms with 3D CT cinematic rendering 
Steven P. Rowe1 & Stefan L. Zimmerman1 & Pamela T. Johnson1 & Elliot K. Fishman 
 Emergency Radiology (in press)
  • “The most important potential complication of KD is in- flammatory damage to the coronary arteries, which classically leads to the formation of coronary artery aneurysms. These aneurysms will often undergo vascular remodeling and partial 
thrombosis in order to produce a psuedonormal vascular lu- men. However, progressive thrombosis and other stenotic pro- cesses such as fibrosis can, over time, precipitate cardiac is- chemia that can lead to emergency room presentations for chest pain or other signs of acute coronary syndrome and necessitate invasive and/or surgical interventions. Of note, computed tomography (CT) angiography, including 3D methods such as volume rendering (VR), has been found to provide suitable non-invasive evaluation of the coronary arteries in patients with KD.”


    Evaluation of Kawasaki’s disease-associated coronary artery aneurysms with 3D CT cinematic rendering 
Steven P. Rowe1 & Stefan L. Zimmerman1 & Pamela T. Johnson1 & Elliot K. Fishman 
 Emergency Radiology (in press)
  • “As with other 3D visualization methods, CR would be expected to provide a global overview of the disease process that is not easily appreciated on 2D axial or multi-planar reformatted images. In particular, this may help to identify relatively distal, small caliber sites of aneurysmal enlargement, which stand out with high contrast on the 3D images but can be subtle when only 2D images are viewed. Given the anatomic complexity of the mediastinum with many adjacent vascular structures, it may be that CR has intrinsic advantages relative to other 3D methods in being able to accurately display the relative positions of those structures in a manner that may be more intuitively grasped in comparison to less photorealistic depictions.”


    Evaluation of Kawasaki’s disease-associated coronary artery aneurysms with 3D CT cinematic rendering 
Steven P. Rowe1 & Stefan L. Zimmerman1 & Pamela T. Johnson1 & Elliot K. Fishman 
 Emergency Radiology (in press)
  • “Even if CR demonstrates no, or only marginal, advantages relative to VR in terms of clinical applicability, the photorealistic appeal of these images will almost certainly lead to wide- spread use in trainee and patient education.”


    Evaluation of Kawasaki’s disease-associated coronary artery aneurysms with 3D CT cinematic rendering 
Steven P. Rowe1 & Stefan L. Zimmerman1 & Pamela T. Johnson1 & Elliot K. Fishman 
 Emergency Radiology (in press)
  • “ Cinematic rendering (CR) is a new rendering algorithm that incorporates a more advanced lighting model than that used for VR, to create photorealistic 3D CT images. The post-processing tool is not yet widely available and its ultimate clinical utility has yet to be assessed in well-designed studies. Nonetheless, the striking level of detail and enhanced depiction of 3D anatomic relationships holds potential for improvements in diagnosis, interventional or operative planning and patient centered care.”


    Initial Experience with Cinematic Rendering for Chest Cardiovascular Imaging
Rowe SK, Johnson PT, Fishman EK
Br J Radiol. 2017 Sep 22:20170558.
  • “Nonetheless, the striking level of detail and enhanced depiction of 3D anatomic relationships holds potential for improvements in diagnosis, interventional or operative planning and patient centered care. In this pictorial essay, a series of complex cardiovascular cases are presented to demonstrate the enhanced display capabilities associated with cinematic rendering and the utility to guide patient management and understanding are discussed.”

    
Initial Experience with Cinematic Rendering for Chest Cardiovascular Imaging
Rowe SK, Johnson PT, Fishman EK
Br J Radiol. 2017 Sep 22:20170558.
  • “Nonetheless, the striking level of detail and enhanced depiction of 3D anatomic relationships holds potential for improvements in diagnosis, interventional or operative planning and patient centered care. In this pictorial essay, a series of complex cardiovascular cases are presented to demonstrate the enhanced display capabilities associated with cinematic rendering and the utility to guide patient management and understanding are discussed.”


    Initial Experience with Cinematic Rendering for Chest Cardiovascular Imaging
Rowe SK, Johnson PT, Fishman EK
Br J Radiol. 2017 Sep 22:20170558.
  • “Imaging of thoracic vasculature presents a unique set of challenges owing to the complex relationships between systemic and pulmonary arteries, in addition to artifacts that result from cardiac and respiratory motion. Retrospective and prospective gating can be used to address the motion artifact. For interpretation and display, this anatomic region is best evaluated with rendering algorithms that preserve the 3D relationships of these intertwined arteries. Accordingly, volume rendering and cinematic rendering are the optimal post-processing tools for pulmonary and aortic imaging.”

    
Initial Experience with Cinematic Rendering for Chest Cardiovascular Imaging
Rowe SK, Johnson PT, Fishman EK
Br J Radiol. 2017 Sep 22:20170558.
  • “However, instead of ray casting methods, in which each pixel is formed by one light ray, the algorithm used in cinematic rendering is based on path-tracing methods and the global illumination model which simulate the different paths of billions of photons traveling from all possible directions through a volumetric dataset and their interaction with the volume to form one pixel. As a result, the technique models the real-life physical propagation of light and generates a highly photorealistic 3D image based on the acquired data.”

    
Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique 
Eid M et al.
AJR 2017; 209:370–379
  • “To attain photorealistic quality, high dynamic range rendering light maps are used to create a natural lighting en- vironment by simulating realistic lighting effects from real-world environments, which are then applied to the rendering scene.”

    
Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique 
Eid M et al.
AJR 2017; 209:370–379
  • “Compared with the results of volume rendering, the more realistic light me- ulation of cinematic rendering although it does not affect spatial resolution enhances evaluation of spatial relations, particularly in the through plane. .”


    Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique 
Eid M et al.
AJR 2017; 209:370–379
  • “Cinematic rendering entails the use of complex high dynamic range rendering maps to create a natural lighting environment, as opposed to the synthetic light source of vol- ume rendering. The result of this difference in lighting functions available in cinematic rendering is an overall more lifelike and vi- sually appealing 3D image, compared with a volume-rendered image, that has a focus on improving depth and shape perception .”

    
Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique 
Eid M et al.
AJR 2017; 209:370–379
  • “Although surgical planning is classically done by mentally integrating multiple images, possibly obtained with different modalities, cinematic rendering generates an all-in one highly realistic 3D representation of the structures of interest with a single modality. Image manipulation allows visualization of anatomic details from different perspectives.”


    Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique 
Eid M et al.
AJR 2017; 209:370–379
  • “Moreover, 3D imaging can be a helpful tool for preoperative and postoperative assessment of renal and liver grafts, paricularly in establishing vascular anatomy. The complexity of gastrointestinal anatomy also lends itself to 3D visualization techniques, as already evidenced in virtual colonoscopy. Cinematic rendering may have an adjunct role in detecting gastrointestinal diseases such as occlusions, strictures, herniation, and tumors and aid physicians and surgeons in treatment planning.”

    
Cinematic Rendering in CT: A Novel, Lifelike 3D Visualization Technique 
Eid M et al.
AJR 2017; 209:370–379
  • “Based on our experiments we conclude that stochastic MC based simulation of light transport is an attractive solution to the problem of photo realistic rendering in interactive DVR. Stochastic MC based simulation of light transport is particularly interesting because it allows to integrate various physically based effects into a unified approach without significant effort, whereas other solutions restrict the number of lights, the shape of lights, the camera model, and so forth. Furthermore, due to its sampling nature, problems with aliasing and stepping artifacts are dealt with easily. The proposed solution is able to cope with complex lighting on the fly, and the increased quality of the images help to convey shape and detail.” 


    Interactive direct volume rendering with physically-based lighting 
 T.Kroes et al.
 EUROGRAPHICS 2012 

  • “Based on our experiments we conclude that stochastic MC based simulation of light transport is an attractive solution to the problem of photo realistic rendering in interactive DVR. Stochastic MC based simulation of light transport is particularly interesting because it allows to integrate various physically based effects into a unified approach without significant effort, whereas other solutions restrict the number of lights, the shape of lights, the camera model, and so forth. Furthermore, due to its sampling nature, problems with aliasing and stepping artifacts are dealt with easily. The proposed solution is able to cope with complex lighting on the fly, and the increased quality of the images help to convey shape and detail.” 
 Interactive direct volume rendering with physically-based lighting 
 T.Kroes et al.
 Technical Report 2011-11, Delft University of Technology, Number 2011-11 - 2011
  • Interactive direct volume rendering with physically-based lighting
    T.Kroes et al.
    EUROGRAPHICS 2012 

  • “In contrast to many of the existing approximations, Monte Carlo ray tracing (MCRT), combined with physically based light transport, is able to simulate real-world light interaction without compromising accuracy of light transport computations, thus resulting in more realistic images. Monte Carlo rendering algorithms are capable of dealing with complex lighting, material and camera configurations. It has been demonstrated that MCRT, with suitable modifications addressing hardware peculiarities, can be performed on the the GPU.”


    Exposure Render: An Interactive Photo-Realistic Volume Rendering Framework
Thomas Kroes et al.
 PLOS ONE 7(7): e38586. doi: 10.1371/journal.pone.0038586
  • “In addition to the fact that photo-realistic volume renderings tend to be aesthetically more pleasing, it has been shown that realistic lighting contributes to 3D understanding and can improve depth-related task performance . With this work and the implementation that we have made available, we hope to contribute to the uptake of realistic illumination in interactive direct volume rendering applications.”

    Exposure Render: An Interactive Photo-Realistic Volume Rendering Framework
Thomas Kroes et al.
 PLOS ONE 7(7): e38586. doi: 10.1371/journal.pone.0038586

  • “Volume rendering (VR) represents today’s standard three-dimensional (3-D) image post-processing technique, and often is used to visualize complex anatomical information. Recently, a novel 3-D technique for post-processing of computed tomography (CT) image data has been introduced, which is called cinematic rendering (CR). The objective of this review is to illustrate the image appearance and potential value of CR in comparison with conventional VR in a number of various applications and different anatomical regions. Similar to VR, CR best visualizes high density and high contrast structures such as bones and contrast-enhanced vessels, but at the same time provides a more natural and photo-realistic illumination of the rendered data. Further research will be necessary for determining possible advantages of CR over conventional VR and over two-dimensional (2-D) image post-processing for CT image data.”
  • “Volume rendering (VR) represents today’s standard three-dimensional (3-D) image post-processing technique, and often is used to visualize complex anatomical information. Recently, a novel 3-D technique for post-processing of computed tomography (CT) image data has been introduced, which is called cinematic rendering (CR). The objective of this review is to illustrate the image appearance and potential value of CR in comparison with conventional VR in a number of various applications and different anatomical regions.”


    Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging.
Dappa E et al.
Insights Imaging 2016 Dec;7(6):849-856 

  • “Similar to VR, CR best visualizes high density and high contrast structures such as bones and contrast-enhanced vessels, but at the same time provides a more natural and photo-realistic illumination of the rendered data. Further research will be necessary for determining possible advantages of CR over conventional VR and over two-dimensional (2-D) image post-processing for CT image data.”


    Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging.
Dappa E et al.
Insights Imaging 2016 Dec;7(6):849-856 

  • “As opposed to conventional VR methods, CR solves the multi-dimensional and non-continuous rendering equation to integrate the light scattered from all possible directions along a ray. Thus, path tracing used in CT integrates a huge number of light rays, each with different paths to form each pixel of the rendered image. Since the number of light paths which can be traced is in theory infinite, and tracing of light paths is computationally expensive, Monte-Carlo simulations are used to generate a randomized subset of light paths with an adequate distribution. The final image is obtained iteratively by progressively averaging numerous Monte Carlo samples representing radiance at random positions with light scattered in random directions.”


    Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging.
Dappa E et al.
Insights Imaging 2016 Dec;7(6):849-856
  • “Due to the abovementioned similarities between CR and VR, there are no major differences in the visualization of CT image data when regarding the diagnostic value of the presentation. Similar to VR, we found that particularly high-contrast structures such as contrast-enhanced vessels and bones can be depicted with high quality also with CR. At the same time, we found a major improvement of CR for the perception of depth and soft tissue structures providing a more photo-realistic depiction of human anatomy and disease .”


    Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging.
Dappa E et al.
Insights Imaging 2016 Dec;7(6):849-856
  • “In contrast, CR uses a more complex lighting model taking into account the effect of lighting for other voxels and subsequent reflections as well. Also, the effect of body parts blocking the trace from the artificial light source to other structures introduces shadowing into the images. As a result of the differences in lighting functions—as being illustrated in the representative image examples of this pictorial review—CR images go along with a more natural image impression as compared to conventional VR .”


    Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging.
Dappa E et al.
Insights Imaging 2016 Dec;7(6):849-856
  • “Our initial experience indicates that CR of CT images is particularly impressive when high density and high contrast structures such as bones and contrast-enhanced vessels are to be visualized. The main innovation as compared to conventional VR appear to be the more natural and photo-realistic representation of the CT image data, with an enhanced and more natural depth and shape perception. Future studies should aim at determining whether the CR technique offers advantages over cross-sectional and 3-D CT images in terms of a diagnostic gain .”


    Cinematic rendering - an alternative to volume rendering for 3D computed tomography imaging.
Dappa E et al.
Insights Imaging 2016 Dec;7(6):849-856
  • “CRT, which is similar to conventional VRT, is not primarily intended for diagnostic radiologic image analysis, and therefore it should be used primarily as a tool to deliver visual information in the form of radiologic image reports. Using CRT for forensic visualization might have advantages over using VRT if conveying a high degree of visual realism is of importance. Most of the shortcomings of CRT have to do with the software being an early prototype.”


    Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study.
Ebert LC  et al.
AJR Am J Roentgenol. 2017 Feb;208(2):233-240

  • “The 3D volume-rendering technique (VRT) is commonly used in forensic radiology. Its main function is to explain medical findings to state attorneys, judges, or police representatives. New visualization algorithms permit the generation of almost photorealistic volume renderings of CT datasets. The objective of this study is to present and compare a variety of radiologic findings to illustrate the differences between and the advantages and limitations of the current VRT and the physically based cinematic rendering technique (CRT)..”


    Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study.
Ebert LC  et al.
AJR Am J Roentgenol. 2017 Feb;208(2):233-240

  • BACKGROUND: The interpretation of CT scans for the evaluation of calcaneal fractures is difficult. Three-dimensional (3D) reconstruction (volume rendering technique [VRT]) has been valuable in the evaluation of irregularly shaped bones. However, their value for the analysis of calcaneal fractures is still debated. Therefore, the objective of this study was to assess the effect of additional use of 3D CTs in calcaneal fractures.


    CONCLUSION: The evaluation of CT scans of calcaneal fractures was improved by the additional use of 3D images (VRT).


    Value of 3D Reconstructions of CT Scans for Calcaneal Fracture Assessment.
Roll C et al.
 Foot Ankle Int. 2016 Nov;37(11):1211-1217
  • METHODS: In a prospective multicenter study, the CT data set of 5 different fractures was presented to 57 evaluators. First, the participating surgeons were asked to assess the fractures on the basis of axial, coronal, and sagittal reconstructions using a multiple-choice questionnaire. Second, 3D reconstructions (VRT) were presented. The CT scans were validated by the intraoperative findings and the results were compared to the model solution of 3 foot and ankle surgeons. Intra- and interrater reliabilities were calculated.

    
Value of 3D Reconstructions of CT Scans for Calcaneal Fracture Assessment.
Roll C et al.
 Foot Ankle Int. 2016 Nov;37(11):1211-1217
  • “CRT, which is similar to conventional VRT, is not primarily intended for diagnostic radiologic image analysis, and therefore it should be used primarily as a tool to deliver visual information in the form of radiologic image reports. Using CRT for forensic visualization might have advantages over using VRT if conveying a high degree of visual realism is of importance. Most of the shortcomings of CRT have to do with the software being an early prototype.”

    
Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study 
Ebert LC et al.
AJR 2017; 208:233–240
  • “On the basis of most of the renderings presented, CRT appears to be equal or superior to VRT with respect to the realism and understandability of the visualized findings. Overall, in terms of realism, the difference between the techniques was statistically significant (p < 0.05). Most participants perceived the CRT renderings to be more understandable than the VRT renderings, but that difference was not statistically significant (p > 0.05).”


    Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study 
Ebert LC et al.
AJR 2017; 208:233–240
  • “With the advent of increasingly affordable and increasingly faster computers, VRTs have become the established standard for real-time 3D visualization, offering more image detail and, thus, more realism than SSD. This trend has been fueled by the ever-increasing computational power of workstations and desktop computers.”


    Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study 
Ebert LC et al.
AJR 2017; 208:233–240
  • “Depth-of-field effects display the area around a focal point as a sharp image, and the objects that are closer to or more distant from the focal point are displayed as blurred images. To further increase depth perception, shadows are calculated correct- ly. In addition, the reduction of ambient light exposure in partially occluded areas is simulated (i.e., through ambient occlusion mapping).”

    
Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study 
Ebert LC et al.
AJR 2017; 208:233–240
  • “This prototype CRT already provides some insight into what we do or do not consider to be better images. With these insights, it offers a glimpse into a future where medical image reconstruction might use certain features of photorealism that add clarity for the viewer, such as lens blur, surface appearance, 3D model lighting, and better color distinction.”

    
Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study 
Ebert LC et al.
AJR 2017; 208:233–240
  • “CRT, which is similar to conventional VRT, is not primarily intended for diagnostic radiologic image analysis and thus should be used primarily as a tool to deliver visual information in the form of radiologic image reports.”

    
Forensic 3D Visualization of CT Data Using Cinematic Volume Rendering: A Preliminary Study 
Ebert LC et al.
AJR 2017; 208:233–240
  • “Cinematic rendering produces volume rendered images with photorealistic image quality. It uses a global illumination model, which takes direct and indirect illumination into account when constructing an image, to achieve rendering quality. The mathematical models that describe this visualization technology include complex integral equations that are solved numerically using the Monte Carlo integration. The result of the integration is a numerical rendering algorithm known as path tracing: thousands of light rays are traced to compute the resulting image.”  


    MDCT angiography with 3D rendering: A novel cinematic rendering algorithm for enhanced anatomic detail
Johnson PT, Schneider R, Lugo-Fagundo C, Johnson M, Fishman EK
AJR (submitted)
  • “To achieve photorealistic quality an “environment map” or “light map” must be used as this light source provides realistic effects achieved by real world light scenarios. The light map consists of texture maps containing information on the brightness of surfaces in a virtual scene that allow the reproduction of the light environment in which the map was generated.”  


    MDCT angiography with 3D rendering: A novel cinematic rendering algorithm for enhanced anatomic detail
Johnson PT, Schneider R, Lugo-Fagundo C, Johnson M, Fishman EK
AJR (submitted)
  • “The light model off of which cinematic rendering and classic volume rendering are based when reconstructing the images accounts for the difference between the two technologies. The primary reason why classic volume rendering results in images that are relatively less photorealistic is the use of the local lighting model – only local properties, such as the local gradient, influence the resulting image. Inversely, cinematic rendering assumes the global illumination model, which accounts for the impact that all light rays have on image reproduction.”  


    MDCT angiography with 3D rendering: A novel cinematic rendering algorithm for enhanced anatomic detail
Johnson PT, Schneider R, Lugo-Fagundo C, Johnson M, Fishman EK
AJR (submitted)
  • “Additionally, cinematic rendering and classic volume rendering differ in their respective light sources. The light sources in classical volume rendering are either single unidirectional light sources or multiple light sources. Although cinematic rendering could use the same light sources as those of classic volume rendering, it also uses environment maps to produce the best visual results. Moreover, classic volume rendering assumes that light passing through the transparent participating medium is absorbed. This assumption leads to less realistic images because in reality light particles are scattered in such a medium. Thus, to achieve photorealism, classic volume rendering would have to account for scattering effects.”  


    MDCT angiography with 3D rendering: A novel cinematic rendering algorithm for enhanced anatomic detail
Johnson PT, Schneider R, Lugo-Fagundo C, Johnson M, Fishman EK
AJR (submitted)
  • “In cinematic rendering, the most important parameter available to manipulate the resulting image is the transfer function. A parameter that was already available in classic volume rendering, the transfer function assigns a color and an opacity property to each voxel value. The opacity can be zero, one or any number between zero and one. If the opacity is zero, then the voxel value represents a vacuum that does not influence rendering computation. If the opacity is equal to one, then the voxel value represents a region that is fully opaque.”  


    MDCT angiography with 3D rendering: A novel cinematic rendering algorithm for enhanced anatomic detail
Johnson PT, Schneider R, Lugo-Fagundo C, Johnson M, Fishman EK
AJR (submitted)
  • “The limitations related to cinematic rendering’s photorealistic quality also must be acknowledged. While photorealism improves the image quality and allows for a better perception of structures, it is possible to have scenarios when too much photorealism is bad. For example, if some tissue parts are obstructed from the light source, the tissue becomes darker, which can be very realistic but it can omit information about the vasculature.”  


    MDCT angiography with 3D rendering: A novel cinematic rendering algorithm for enhanced anatomic detail
Johnson PT, Schneider R, Lugo-Fagundo C, Johnson M, Fishman EK
AJR (submitted)
  • Cinematic Rendering: Future Directions
    • Implement algorithm on faster hardware or GPU’s
    • Ability for real time rendering is needed to help develop pre-sets for 3D images
    • GPU based rendering may be needed for interactive displays
    • Study of Cinematic Rendering vs Classic VRT will be necessary for documentation
  • “Cinematic Rendering which computes in real-time the interaction of visible photons with the scanned patient anatomy. The algorithm uses a Monte Carlo path tracing method to generate photorealistic or even hyper-realistic images by light transport simulation along hundreds or thousands of photons paths per pixel through the anatomy using a stochastic process .”

    
Shaping the future through innovations: From medical imaging to precision medicine 
 Comaniciu D et al.
Medical Image Analysis (in press)

  • “The medical data is illuminated using image-based lighting by high-dynamic range lighting environments, which can either be captured photographically or generated synthetically. Photographically captured lighting leads to a very natural appearance of the data when compared to images created using the traditional ray casting method. Such natural lighting in combination with the accurate simulation of photon scattering and absorption, leads to photorealistic images that resemble many shading effects that can be observed in nature, such as soft shadows, ambient occlusion, volumetric scattering and subsurface photon interaction.”

    
Shaping the future through innovations: From medical imaging to precision medicine 
 Comaniciu D et al.
Medical Image Analysis (in press)

  • “While diagnostics will certainly still rely on traditional planar reconstruction based visualization methods, we have strong in- dictations that special diagnostic applications might benefit from the flexibility and expressiveness of the new Cinematic Rendering technology. For instance, a robust demand for such visualization methods can be seen for surgery planning and intraoperative imaging, where a good spatial understanding of the anatomy and processes in the human body is required.”


    Shaping the future through innovations: From medical imaging to precision medicine 
 Comaniciu D et al.
Medical Image Analysis (in press)

  • “The Monte Carlo path tracing integration method solves the following multi-dimensional and non-continuous rendering equation: 








    Shaping the future through innovations: From medical imaging to precision medicine 
 Comaniciu D et al.
Medical Image Analysis (in press)

  • “In the mid-80s, advances in image processing hardware and the integration of new data manipulation techniques led to the simultaneous development of Volume Rendering at the University of North Carolina and at Pixar in San Rafael, whereby the latter had originally been an upshot of work by computer specialists in the Computer Graphics Group at Lucasfilm . The work at Pixar culminated in collaboration with the CT research group at Johns Hopkins Hospital. Today, Volume Rendering is an established post-processing technique for 3-D CT and MR data sets, one used routinely in clinical practice.” 


    Introducing Cinematic Rendering: A Novel Technique for Post-Processing Medical Imaging Data 
Fellner FA
J. Biomedical Science and Engineering, 2016, 9, 170-175
  • “Conventional Volume Rendering techniques employ predefined color, turbidity and brightness values, whereby they proceed under the assumption of an artificial light source. Cinematic Rendering performs a physical simulation of the light diffusion, as a result of which effects such as environmental influences, shadowing, re- fraction, occlusion, dispersion and soft shadows attain a high dynamic range.” 


    Introducing Cinematic Rendering: A Novel Technique for Post-Processing Medical Imaging Data 
Fellner FA
J. Biomedical Science and Engineering, 2016, 9, 170-175
  • “To achieve this, a so-called spherical panorama is recorded—for example, with a reflecting ball—which registers the actual lighting conditions in 
order to apply them to all synthetic elements added later. In comparison to simple ray casting based Volume Rendering, Cinematic Rendering is based on the Monte-Carlo path tracing of volumetric data.”

    
Introducing Cinematic Rendering: A Novel Technique for Post-Processing Medical Imaging Data 
Fellner FA
J. Biomedical Science and Engineering, 2016, 9, 170-175
  • To achieve photorealistic effects, it is further important to use a light source that allows simulating real world light scenarios.  Such a realistic light source is known as “environment map” or “light map” where one has stored for a center point the incoming light for each point on a sphere that surrounds it. This allows reproducing the light environment in which the map was generated.
  • Volume Rendering vs Cinematic Rendering: Differences
    Another difference that has to be mentioned is the light source itself. The light sources used as input for shading computations in classical volume rendering  are typically either directional lights where all light comes from the same direction or using one or multiple point lights. Cinematic rendering could theoretically also use classical light sources, but the best visual results are achieved when using environment maps as a realistic real life light source
  • “We developed a physically-based volume rendering method called Cinematic Rendering which computes in real-time the interaction of visible photons with the scanned patient anatomy. The algorithm uses a Monte Carlo path tracing method to generate photorealistic or even hyper-realistic images by light transport simulation along hundreds or thousands of photons paths per pixel through the anatomy using a stochastic process.”

    
Shaping the future through innovations: From medical imaging to precision medicine.
Comaniciu D et al.
Med Image Anal. 2016 Jun 15 (in press)
  • “The medical data is illuminated using image-based lighting by high-dynamic range lighting environments, which can either be captured photographically or generated synthetically. Photographically captured lighting leads to a very natural appearance of the data when compared to images created using the traditional ray casting method. Such natural lighting in combination with the accurate simulation of photon scattering and absorption, leads to photorealistic images  that resemble many shading effects that can be observed in nature, such as soft shadows, ambient occlusion, volumetric scattering and subsurface photon interaction.”


    Shaping the future through innovations: From medical imaging to precision medicine.
Comaniciu D et al.
Med Image Anal. 2016 Jun 15 (in press)
  • “Fast and robust anatomical concept extraction is a fundamental task in medical image analysis that supports the entire workflow from diagnosis, patient stratification, therapy planning, intervention and follow-up. Current state-of-the art solutions are based on machine learning, being enabled by the availability of large annotated medical databases and the increased computational capabilities . Typical methods use example images of the anatomy of interest to learn a classifier that will be able to discriminate between inputs that contain the target anatomy or something else. Such classifiers can be used to automatically label images, detect landmarks or segment the target object.”


    Shaping the future through innovations: From medical imaging to precision medicine.
Comaniciu D et al.
Med Image Anal. 2016 Jun 15 (in press)
  • “In this paper we discussed recent technologies that will most likely make an important impact on medical imaging. Techniques like Cinematic Rendering will help increasing the sensitivity and specificity of images, by enhancing the pathology conspicuity. Advanced image understanding will streamline the image measurements and image interpretation, by increasing the speed of reading, while introducing more reproducibility in the system.”


    Shaping the future through innovations: From medical imaging to precision medicine.
Comaniciu D et al.
Med Image Anal. 2016 Jun 15 (in press)
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