果冻影院

Visiting 果冻影院鈥檚 Institute of Cardiovascular Science is a day of firsts for me. I not only test out for the first time, but I also hold a human heart. But I don鈥檛 go into a lab and touch any specimens.听Instead, I put on an Oculus headset, grab two controllers, and enter a virtual operating room.

果冻影院 PhD student Endrit Pajaziti is a co-creator of , a VR app that creates 3D models from patients鈥� CT and MRI scans. VheaRts, which started out as a research tool in 2018, is revolutionising 果冻影院鈥檚 approach to medicine, in both a clinical and educational setting. In the app, doctors and medical trainees are given specialised tools to grab, slice, highlight, and measure the internal anatomy of a heart smaller than the size of an almond.听

鈥淩ecently, we created a network version of the application,鈥� says Pajaziti, a warm final-year doctoral student.. 鈥淣ow, you can put several people in a virtual room to connect in a group session and view the same model remotely, which wouldn't be possible otherwise.鈥澨�

Pajaziti demonstrated the app at his desk at the Institute of Cardiovascular Science, at , December 7th.

In August, 果冻影院 and (GOSH) teamed up virtually with doctors in Rio de Janeiro, using VheaRts to complete one of the most ever recorded.听

Four-year-old twins Bernardo and Arthur Lima were born with fused heads, known as craniopagus twins. The international medical teams spent months using headsets to come together in the same virtual room, where they could visualise and discuss the twins' anatomy. They tested techniques for the separation procedure using interactive models created by the app. Owase Jeelani, the lead paediatric surgeon on the London team, describes it as "space-age stuff."

Owase Jeelani pictured in London connecting with Brazil鈥檚 team via video chat and VheaRts to plan the craniopagus twins鈥� surgery, March 2022. Courtesy of Endrit Pajaziti
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鈥淭he surgeon found it useful because you can see the vasculature from both twins intermingling, and it's a complex network of arteries and veins. That's impossible to visualise from looking at 2D scans,鈥� says Pajaziti, with his headset on, pointing out visible abnormalities on the heart model as I watch alongside.

VheaRts has been used in planning over 50 surgical procedures. Before the separation of the Brazilian twins, the app was used in two previous separation surgeries of twins joined at the head.听

鈥淲ith VR, you can examine any angle, slice into any depth, rotate it 鈥� there is a lot more freedom,鈥� he continues. "It's fulfilling to see people responding well to something you've worked on."听

VheaRts app, a snapshot of doctors working with a patient model, May 20th. Courtesy of Endrit Pajaziti

When most people think of Virtual Reality, they think of gaming. VheaRts was created using the game development software , to use with the commercial Oculus Rift/Quest headsets made by Facebook Technologies. At a price of 拢400, VR headsets are becoming increasingly popular. Market analysts project that the demand for home VR devices will going into 2023. This figure doesn't include the rapidly increasing demand in the medical sector.听

In 2018, George Washington University created that enables surgeons to virtually explore patients鈥� brains and bodies prior to performing a procedure. A found that VR training on the platform improved surgical performance by 230% when compared to traditional teaching methods like 2D scans and 3D printed models. And researchers also found that mean errors in the operating room were .

When it comes to VheaRts, what makes it especially effective is the team鈥檚 ability to work closely with clinicians.听

鈥淰irtual Reality is not the future, it is the present,鈥� said Dr. Beatrice Bonello, a cardiologist and consultant at GOSH, who sits across the hall from Pajaziti.听

鈥淚t's important in paediatrics to have a great understanding, in 3D, of the heart. VR is perfect for this because it has an infinite library. So for education, it's a no-brainer. I wish I had it when I was a trainee. The goal is to have it integrated a hundred percent.鈥澨�

As Dr. Bonello left Pajazit鈥檚 desk, Andrew Cook, Professor of Research and Education in Fetal Cardiac Development, walked into the office behind us, sandwich in hand. Professor Cook put down his lunch and pulled up a chair next to us, excited to speak on VheaRts as an innovative tool in his classroom.听

Cook has run a 3-day 鈥榟ands-on鈥� Cardiac Morphology Course for the past 15 years. The workshop teaches clinicians from a mix of professional backgrounds using 果冻影院鈥檚 鈥榞old-standard鈥� library of anatomical specimens. by 58 participants during this course, to assess VR鈥檚 usability, helpfulness, and level of acceptance in an educational setting.听

Professor Cook (arm raised), leading a lecture using the Oculus headsets, January 2022. Courtesy of Endrit Pajaziti

Cook and Pajaziti report that, 鈥�VheaRts was found to be very intuitive to use by 93% of the participants鈥� and 鈥渙ver 89% of users were 鈥渨illing鈥� or 鈥渧ery willing鈥� to implement a VR setup at their own institutions.鈥�

They also tested the app by hosting seminars in South Africa from London. 鈥淭hey had some headsets on their side and we sent them our application. You have five or six students in South Africa and Cook joins remotely teaching cardiac morphology,鈥� explains Pajaziti.听

During Covid-19, Cook sent undergraduate and postgraduate students Oculus Headsets with VheaRts software downloaded to replicate hands-on lab time.

Professor Cook, leading a lecture using the Oculus headsets during the pandemic, October 2020. Courtesy of Endrit Pajaziti

鈥淚 had a challenge because I couldn't run any anatomy labs. You can show anatomy on Zoom 鈥� we did a lot of that. But then we thought, what else could we do that would give them that three-dimensionality they would see if they were in the lab?鈥� explained Cook, about his MSc modules.

As a result, the team sped up development and began implementing the app in more curricula. Modules held in the virtual classroom look more like the on the Wii than a lecture, as students鈥� avatars bobble around virtual specimens.听

Professor Cook, leading a lecture in the VheaRts app during the pandemic, 2021. Courtesy of Endrit Pajaziti

Although the department has headsets ready, VR training and integration are time-consuming. So Cook and Pajaziti paused using VR as a regular tool in the classroom, but they see VR tools becoming the new normal within the next 10-15 years.听

I ask Cook what he sees as the ideal future for VheaRts: 鈥�Full integration with our teaching,鈥� he says. 鈥淵ou tend to get biased because you've been using it, but I find it very difficult now to go back to lectures. The advantages are unparalleled鈥� if you have to go back to the old method, it's the equivalent of moving from traditional three-millimetre slides to PowerPoint.鈥�

Although I have no experience in VR or heart surgery, Pajaziti teaches me the controls with ease. Within minutes I鈥檓 using a digital laser pointer to flip through real patient models. I learn how to grab and rotate the model with one hand, and hold tools in the other. I can slice a heart in half, see through it, take it apart, and even see where the abnormalities are. This is probably the closest to a surgical room I will ever come to.听

After about 30 minutes with the headset on, I start to feel nauseous and have to take it off. As I lift it off I feel my eyes readjust back to reality, a feeling that does not fade quickly. I later discover this is known as .听

According to , 鈥渟tudies show that more than half of first-time headset users experience this phenomenon within 10 minutes of being exposed to VR.鈥� The symptoms are similar to motion sickness, caused by all the conflicting sensory information.听

Neal Patel, one of Cook and Pajaziti鈥檚 medical students, used VheaRts during his Integrated Cardiovascular module and had a similar experience. 鈥淚t was a new feeling,鈥� he says. I'd say about nearing the 20-minute mark, the headset starts to feel heavy. Your eyes become tired and your head's like, okay, I'd rather take it off. So there are limitations to how long you can use it.鈥澨�

Despite this, Neal argues VheaRts will be a game-changer for medical trainees. 鈥淓ven if it is for 20 minutes, it's definitely a useful experience. To give someone the understanding that you get for 20 minutes in that room would traditionally require hours of reading, describing, and drawing.鈥澨�

VR undoubtedly comes with a learning curve, and the accuracy and efficacy of its training still need to be improved. This makes it difficult to devote the time and resources necessary to reach full integration. VR is still in its infancy and much of its development is uncharted territory.

VR also faces increasing opposition. According to , VR reduces face-to-face communications and lacks the regulatory laws and protocols necessary for widespread integration.听

Despite these challenges, Pajaziti has high hopes for VheaRts beyond 果冻影院. 鈥淲e want to create a business case for virtual reality as an integral service in hospitals. The perfect solution is that your clinician, doctor or surgeon, sitting at their desk, has the images from the scanner on a computer, and the images are immediately transformed into a 3D model without the aid of a person manually doing the segmentation that we do.鈥� To achieve this, Pajaziti says the app must receive more funding and undergo a rigorous regulatory process.听

Once thought to be just science fiction, VR will soon become a part of our daily lives. The pioneering advancements offered by VheaRts prove it is not a matter of if headsets will become inevitable, but when.听

About the author:
Caroline Coyer听started her听multimedia journalism career in her听hometown of New York City, focusing on criminal justice, LGBTQ+ lifestyle, and local community stories. She听recently graduated from NYU, studying Broadcast Journalism and International Relations. After graduating, she went on to work for the New York Post as part of Page Six鈥檚 video team. She is currently听on the Creative Documentary By Practice MFA at 果冻影院, and is part of the inaugural cohort of the听Student Journalism Scheme.