Three Dimensional Atlas

Three-dimensional atlas of acupuncture based on Visible Human Wieslaw L. Nowinski, A. Thirunavuukarasuu, Daphenie Ho Biomedical Imaging Lab, Institute of Bioengineering, Singapore 21 Heng Mui Keng Terrace, 119613 Singapore e-mail: [email protected] www.cerefy.com Introduction Acupuncture, being part of the traditional Chinese medicine, is probably the most ancient system of healing, continuously refined during its 5000 year history. It treats disease by puncturing so called acupoints with fine steel needles to stimulate the body’s own healing process. Acupuncture assumes our bodies are covered with lines of energy called meridians or channels. When a symptom arises, it indicates obstruction of the free flow of corresponding energy. Consequently the aim of acupuncture is to remove these obstructions and encourage the vital energy of the body to flow smoothly. This energy, known as Qi, keeps the blood circulating, warms the body, fights disease and keeps our minds and emotions free and uncluttered. There are many diseases treated successfully by acupuncture such as lower backache, arthritic conditions, headaches (including migraine), allergic reactions, and relief of muscle spasms. In addition, there have been clinical trials in the use of acupuncture to treat anxiety disorders and depression. A few theories try to explain how acupuncture works. One of them claims that it raises levels of specific hormones, white blood counts, gamma globulins, and overall anti-body levels resulting in an augmentation of immunity. Numerous references on acupuncture [1, 2, 3] show typically the drawings of the human body with the channels and acupoints in the form of 2D static images with fixed and limited views. To overcome these limitations, we have developed a 3D atlas of acupuncture based on the Visible Human. The atlas is interactive and shows the channels and acupoints in 3D with respect to the body surface. This tool provides several additional features including acupoint labeling, acupoint description, and multi-language support. Materials and methods Twelve body channels with about 400 acupoints have been used to construct the atlas. These are: lung, pericardium, heart, large intestine, sanjiao, small intestine, stomach, gall bladder, urinary bladder spleen, liver, and kidney channels. The channels have been registered with the Visible Human. The positions of the acupoints have been localized on axial images of the VHD based on anatomical and acupuncture landmarks. The third coordinate is obtained from the coordinate of the image. 3D acupoints have been mapped into the surface of the Visible Human body. The acupoints have been arranged according to channels and labeled with English and Chinese names. Results A multi-media application has been developed with surface rendered images precalculated from numerous views, Figure 1. The acupoints have been labeled with English and Chinese names and relevant description. In addition, the Chinese pronunciation of the names of acupoints has been recorded.

The atlas provides an easy and intuitive way of browsing. First, the user selects the channel from the list of 12 body channels and gets the list of the acupoints corresponding to this channel. The channel is displayed in 3D overlaid on the Visible Human. The user can rotate the body to observe the channel from different views. The acupoints are labeled, and the user has two ways of exploring them either by clicking any of them in the image or selecting its name from the index. The name of the selected acupoint is displayed in English and Chinese, and optionally the user can get the description of the acupoint in terms of location, puncture, and indication. In addition, the user may listen to Chinese pronunciation of its name. Discussion This atlas overcomes shortcomings of the existing printed acupuncture atlases as well as provides several new features including 3D channel display, 3D channel-body relationship, easy navigation, multi-media support, and fully labeled acupoints. All these features make the atlas an ideal tool for learning acupuncture, particularly by a layman which is crucial as recently the interest in acupuncture as an alternative way of healing is increasing dramatically.

Figure 1. User interface of the 3D atlas of acupuncture. The stomach channel is selected from the list of 12 body channels. The acupoints of the stomach channel are displayed on the surface rendered image of the Visible Human. The list of stomach channel acupoints is shown on the right. The name of the acupoint selected on the image is displayed in English and Chinese. In addition, a brief description of the selected acupoint is provided in terms of location, puncture, and indication.

The tool has still several shortcomings in terms of contents and functionality. The atlas contains only 12 regular meridians. 8 extra meridians, 12 divergent meridians, and 15 collaterals are not included. The description of the acupoints is quite limited (as the available materials are copyrighted). The relationship of the meridians to the internal structures is missing. Volume rendered images with the segmented and enhanced internal organs would be more useful for this purpose. Similarly, the depth and orientation of puncturing needles is not captured in the presentation. These limitations make the atlas less suitable for clinicians. By incorporating more advanced features such as tactile feedback, the atlas would become more useful for training. Acknowledgements The contribution of Jin Xiao Yang, Chee Chon Hong and Wong Yoon Loong is kindly acknowledged. References 1. Chen E. Cross-sectional Anatomy of Acupoints. Churchill Livingstone, Edinburgh, 1994. 2. Chen J. Anatomical Atlas of Chinese Acupuncture Points. Shandong Science and Technology Press, Jinan, China, 1982. 3. Chung-kuo C, Yen CY. An Outline of Chinese Acupuncture. Foreign Languages Press, Peking, China, 1975.