11/17/2017

Visualizing Anatomy Unseen

8:01 minutes

Modern medicine has reached amazing heights, but even in our own basic anatomy, there are secrets we haven’t quite cracked. For one, as bird veterinarian M. Scott Echols explains, doctors have only a rough idea of where all our veins and capillaries are — and that map is just as vague in animals.

“When you have someone who is a specialist, like a hand surgeon, and they tell you, ‘I don’t actually know where those blood vessels are, I know the big ones’ … that kind of makes me concerned,” he says. “It reminds me kind of a hunt-and-peck mission where you go where you think you know things are, but you’re not quite sure.”

Take a look inside a human brain and fly through a rattlesnake’s vascular system with the interactive 3D scans below, courtesy Anatomage. The scans are also available for download. Press the play button to begin!

This scan was provided to Science Friday courtesy of Anatomage. Anatomage is a 3D imaging software company focusing on CT and MRI patient data. High resolution CT scans and Scarlet Imaging’s contrast agent (BriteVu) together are reconstructed in Anatomage’s software to create highly detailed volumetric images of blood vessels and anatomy. These images can be converted into surface models for use in medical device design or 3D printing.

There are already products on the market that can make veins “pop” in CT scans, for example. But Echols says when he tried some of the compounds in his own research, he found they weren’t always dense enough to show up well in images. What’s more, they were expensive, and many — not designed for use in living animals — were highly toxic: After a mishap with one product in his lab, Echols learned it was a noxious mix of lead, mercury and cadmium. “And I thought, surely we can do better than this,” he says.

Echols began experimenting in his own kitchen with nontoxic ingredients. After “a lot of trial and error,” he developed a powder that can be mixed with water and dyed with food coloring. (On his company’s website, the compound — called BriteVu — is described as being a “blend of barium and food-grade ingredients.”)

“Then we mix it up hot and then we inject it into the vascular system of the animals, and as it cools, it solidifies,” he explains. “And then once it’s solidified within the body, it allows us to get 3-D images using CT technology, so we’re able to scan the animal — or individual organs, if we like.”

[Take a peek at the possibilities of biodesign.]

This scan was provided courtesy of Anatomage. Anatomage is a 3D imaging software company focusing on CT and MRI patient data. High resolution CT scans and Scarlet Imaging’s contrast agent (BriteVu) together are reconstructed in Anatomage’s software to create highly detailed volumetric images of blood vessels and anatomy. These images can be converted into surface models for use in medical device design or 3D printing.

BriteVu replaces the blood in veins and can’t be used in living animals. But the images it enables are stunningly lifelike — delicate portraits of an animal’s entire vascular system, down to the tiniest capillaries. Echols’ work is the subject of Science Friday’s newest Macroscope video, “Beauty Beyond Skin Deep.”

“It’s literally like going on a discovery mission every day because depending on the level you want to go down to, you see new things,” Echols says of the scans. “And it takes you back to those old anatomy and histology books. You know, going to veterinary school we learned about all these structures, and you see these images and you think, ‘That’s interesting, how did they even guess what this was?’”

“Well, the reality is, those images don’t quite match up with what we’re seeing,” he adds. “So, this has the potential to really rewrite that information and help people understand in three dimensions what these structures look like.”

—Julia Franz (originally published on PRI.org)

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Segment Guests

M. Scott Echols

Dr. M. Scott Echols is the president of Scarlet Imaging, LLC. He’s based in Salt Lake City, Utah.

Segment Transcript

[MUSIC PLAYING] SPEAKER 1: Why is it that we can use modern medicine to conduct something as complicated as a face transplant, and yet we still don’t know some basic stuff about human anatomy– for example, the veins and the capillaries that make up the vascular system. Doctors only have a rough sense of where those even are. And if it’s true for humans, it’s certainly true for animals as well.

My next guest is a bird surgeon who became frustrated by the fact that he didn’t have a better vascular map of the animals he treated. So he created a product– like a special contract fluid that would do just that. It’s the subject of our latest Macroscope video. Joining me now is Scott Echols, bird veterinarian, and researcher, and President of Scarlet Imaging, LLC. Scott, welcome to Science Friday.

SCOTT ECHOLS: Hi, Ira. Welcome. Thank you for having me on the show.

IRA FLATOW: Oh, you’re very welcome. You know it’s strange to me that we don’t know where all the blood vessels are in the body. Was it that surprising to you?

SCOTT ECHOLS: Yes. And it’s become even more surprising over time, as I have talked with anatomists– surgeons. And I’m talking about the human side, not just the veterinary side. And yes, it is. It’s very surprising. You know, when you have someone who is, say, a specialist, like a hand surgeon, and they tell you, I don’t actually know where those blood vessels are. I know the big ones.

IRA FLATOW: Oh, my goodness.

SCOTT ECHOLS: And that kind of makes me concerned you know. I do surgery, of course. It reminds me of kind of a hunt and peck mission where you go where you think you know things are. But you’re not quite sure.

IRA FLATOW: Let’s talk about how you came at this problem as a bird veterinarian and a surgeon, as you say. Why did you want such an accurate vascular map of a bird’s body?

SCOTT ECHOLS: Well, for one thing, I do a lot of surgeries, and not just on birds– on other animals as well. And I also teach. So when I’m at a conference and I’m teaching someone how to do these surgeries, it’s literally like, well, I say, you’re going to see some stuff here. We don’t know what it’s called. Move that aside.

And there’s some vessels there. We don’t know what those are. Move those this way. And there’s that thing underneath that you’re going after.

And you know, that’s a really crude way to teach. You couldn’t certainly write it down in an organized manner. So what I end up doing is I take video of a lot of my surgeries. And then I teach using the video. And that’s great.

However, I really wanted to name those structures. I wanted to be able to put it in print and say, all right, if you’re going to do this surgery, here’s exactly what you’re going to look for. And the reality is we just didn’t have that information at the time. And this was just a few years ago.

IRA FLATOW: This is Science Friday from PRI, Public Radio International. Talking with Scott Echols, President of Scarlet Imaging. So rather than just sitting there and saying– you know, cursing the darkness– you went ahead and found a way of making great images using a special concoction of your own to inject into the birds and get great images. Tell us about that.

SCOTT ECHOLS: Yes. Well, there’s a little story here. I did actually try a number of the products that were currently on the market. And I was quite frustrated. Either the density was not high enough that I just really couldn’t get the image quality that I wanted. Or what I found out later, a lot of the products were exceedingly toxic.

And a quick story– I was working with a student of mine. And we were injecting one of these compounds into an animal. And the stuff literally exploded in front of us. And it sprayed all over her. She flew backwards.

And we still to the day in the lab have an outline of her body on the wall where this stuff sprayed around her. And it always bothered me. What’s in this? Because the company won’t tell you. Well, ultimately, we found that it’s a mixture of lead, mercury, and cadmium.

And I thought surely we can do better than this. And it was very difficult to work with. It was expensive– on and on.

So I said, there’s got to be a way to make this better. And I literally started in my kitchen. And right next to where we prepare food, I said, first of all, this thing has to be safe, whatever it is.

And I wanted to make sure it was completely nontoxic. And I just started there. And that’s literally how it began.

IRA FLATOW: And so it must have taken hours of experimenting to come up with what you wanted.

SCOTT ECHOLS: Many, many hours.

IRA FLATOW: Many hours. That’s right. And so you came up with a–

SCOTT ECHOLS: A lot of trial and error.

IRA FLATOW: A lot of trial– so you came up with your own mixture that I guess is a trade secret at this point, right, of–

SCOTT ECHOLS: Yes.

IRA FLATOW: And so you take the mixture. You take this liquid. It’s water-based, is it not?

SCOTT ECHOLS: Yes.

IRA FLATOW: And you do what with it to get the–

SCOTT ECHOLS: So we mix it in water. It starts as a–

IRA FLATOW: Right.

SCOTT ECHOLS: I’m sorry, go ahead.

IRA FLATOW: No, go ahead. Now tell us what you do with it and how you get the images.

SCOTT ECHOLS: Oh. So it’s a powder that we mix with water. We can also add in food coloring or fluorescing dye or some preservatives. And then we mix it up hot. And then we inject it into the vascular system of the animals. And as it cools, it solidifies.

So this is a terminal agent. We do not use this on live animals. And then once it’s solidified within the body, it allows us to get 3-D images using CT technology. So we’re able to scan the animal or individual organs if we like. And we can get that.

Essentially, we’re not damaging the tissue. Because we haven’t changed it. We’re just injecting fluid into where the blood was. We’re replacing it with the bright view. And then we CT scan it.

So it gives us these beautiful images. And the very first image– maybe you’ve seen the grey parrot– that’s the one where I said, that’s it. That’s what I want to see. And this is where I want to go.

IRA FLATOW: Not only are the images wonderful– and actually, I should mention it’s our latest Macroscope video at sciencefriday.com/blood. You can go see these images at sciencefriday.com/blood. But you actually get to see the capillaries, right, which people haven’t seen before in great detail.

SCOTT ECHOLS: Yes. And you know what’s fun about this? I mean, it’s literally like going on a discovery mission everyday. Because depending on the level you want to go down to, you see new things.

And it reminds me– it takes me back to those old anatomy and histology books. You know, going to veterinary school, we learned about all these structures. And you see these images. And you think, oh, that’s interesting. You know, how did they even guess what this was?

Well, the reality is those images don’t quite match up with what we’re seeing. So this has the potential to really rewrite that information and help people understand in three dimensions what these structures look like. And for example, I bring up the glomeruli of the capillary’s beds of the kidneys. And we can actually see that– how they’re oriented. And we can even put them in a 3D VR system and go through that–

IRA FLATOW: Wow.

SCOTT ECHOLS: –kidney and look at it. And it’s amazing. It’s absolutely amazing to me.

IRA FLATOW: As I say, you can see Dr. Echols’ images of hidden anatomy. It’s our latest Macroscope video at sciencefriday.com/blood. While there, you can also manipulate and you can download 3D models of the blood vessels inside a rattlesnake, a human head, and then take a journey through a snake’s body.

This is so amazing. That’s at sciencefriday.com/blood. Thank you very much, Dr. Echols, for taking time to be with us today.

SCOTT ECHOLS: Oh, thank you. I appreciate the opportunity.

IRA FLATOW: You’re welcome. Scott Echols, bird veterinarian, researcher, and President of Scarlett Imaging, LLC. Charles Bergquist is our Director. Our Senior Producer, Christopher Intagliata. Our Producers are Alexa Lim, Christie Taylor, Katie Hiler. Our intern is Sushmita Pathak.

And we had technical engineering help today from Rich Kim, Sarah Fischman, and Jack Horowitz. And a big thanks to John Grant and everyone at Louisville Public Media for welcoming us to their studios and home this week. That’s where we’re broadcasting from. And of course, we’re active all week on Facebook, Twitter, Instagram– all the social media. And you can listen to us anytime on Amazon Echo and Google Home. In Louisville, I’m Ira Flatow.

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