This is the third in a series of articles examining how NIH, among other government agencies, is infusing innovation into the federal workplace.

By some measures, the data captured in Visible Human Project (VHP) is from another era – it dates back some 18 years to 1994. Yet this 20th century data – now available as an iPhone and iPad app – is still innovative enough to be the cornerstone of iAnatomy, one of five winners of the 2011 National Library of Medicine (NLM) “Show Off Your Apps Challenge”.

The VHP is a digital image library of anatomical cross sections at 1 mm intervals representing the complete, normal adult male and female anatomy. Begun in 1989, the male data set was released in 1994 and the female in 1995.

“From middle school to high school to college, nursing school and medical school, students can take advantage of this app to learn anatomy interactively,” declared then-Health and Human Services Chief Technology Officer Todd Park during the awards ceremony. (Park is now U.S. Federal CTO.)

Using the VHP data set, Anouk Stein, M.D., a radiologist and computer programmer, developed iAnatomy for the iPhone and iPad in her Phoenix kitchen. The electronic anatomy atlas has sold 20,000 copies worldwide and allows a student to use their “microsegments of free time to do some real learning.”

“With iAnatomy, learning anatomy interactively with a touchscreen device is a dynamic and engaging,” she explained when receiving her award. “Having it as an app makes the information available anywhere, anytime. Learning is reinforced with multiple quiz modes.”

A Slice of VHP History

“The interesting thing for us is the data set came out in 1994,” Dr. Michael Ackerman, Ph.D., Assistant Director for High Performance Computing and Communications at NLM and a pioneer of the VHP project (pictured below) told AOL Government.

“It’s now 2012 and we are still getting requests to use the data set, sometimes with new ideas at about 5 a week, 18 years later. We thought everybody who wanted it would have it. And it’s worldwide.”

Licenses to access the VHP dataset are free with conditions: the dataset cannot be sold, NLM is given credit, and the licensee lets NLM know how the dataset was used.

Consisting of MRI, CT and anatomical images, the VHP is a reference for the study of human anatomy, a set of common public domain data for testing medical imaging algorithms and a test bed for building network accessible image libraries.

NLM has awarded almost 3,500 free licenses for corporations, universities, medical illustrators, physicians, artists, teachers and others in 64 countries to use the VHP dataset.

The data set has been used for a wide variety of apps – many never envisioned when the project was started, such as the design of ergonomic furniture. As far back as 2004, the VHP data set was cited in the Journal of Medical Informatics & Technologies for its use to study brain tumor growth and the effects of whiplash on the brain after a car accident.

Today, automakers use VHP data to create the virtual crash dummies they use in simulations.

Technology Increases VHP Access

Dr. Ackerman stressed how the spirit of the VHP project was – and is still – based on let’s not worry about the technology, the technology is moving fast enough. Let’s just do it. And the technology will be there, and it always has been there.

“The innovation is, now what do we do with it?” Dr. Ackerman pointed out.

Accessing, storing and carrying the 50 gigabytes of VHP data is no big deal in today’s world of mass storage and “Big Data”. But in 1984 the digital imaging technologies VHP used were just words in the NLM long range plan. And in 1994, when the male data set was released, with CDs not being invented yet, it was estimated that it would take 15,000 floppy disks to store the data.

“In fact one of the questions the Board of Regents had back in 1990 was how would you ever get the data set out of the library?” Dr. Ackerman said.

“Fortunately Board members included engineers from Silicon Valley who promised that “by the time you get the data, we’ll know how to get the data out. Just do the work. Don’t worry; the technology will take care of itself. And it did.”

Then when the first iPods were introduced, the problem of how to get VHP data out of the library was finally solved noted Dr. Ackerman.

“With a 60 gigabyte iPod, I can put the all the Visible Human data on there and there’s still plenty of room for you to put your music.”

Innovative Minds At Work

So, what type of machine would you use to slice a human cadaver into 1 mm slices? How would you photograph these slices? How would you store these digital images? How would you distribute them so they can be used to study anatomy or for some other type of relevant research? BTW, you have to use one cadaver or else the parts won’t fit exactly.

These were the questions facing the VHP team said Dr. Ackerman.

Think about it: the thing that makes using a cadaver to study anatomy difficult and expensive is, well, its lifespan. It’s short. Once a cut is made, there are no do-overs.

“What universities needed was a digital way of studying anatomy, a visual slice-by-slice cross section from head-to-toe,” explained Dr. Ackerman. But the year is 1986. PC technology was the IBM PC XT. 50 gigabytes was truly “Big Data”.

But already the National Library of Medicine long range plan was looking ahead to the time when digital imaging would be a mature technology.

So, exactly what type of “machine” do you need to slice a cadaver into 1mm segments from head-to-toe?

“Answers to those questions evolved into what is now the Visible Human Project,” Dr. Ackerman said.

“Its original purpose was to provide the data necessary so that whoever wanted to study anatomy would have the base data, the original stuff for them to write their educational programs to teach anatomy. But we at the library would supply the original data that they would use. That’s how it came about.”

Cutting Edge Technology

The University of Colorado in Denver won the contract for the VHP among six bidders that represented most of the medical schools in the U.S.

The original plan was to capture it on both 35 mm and 70 mm film and digitize the film said Dr. Ackerman.

“We weren’t sure if we should use positive or negative. So one of those was positive film and one was negative film. We just weren’t sure. What we knew for sure is that we get to do this once and we’d better not screw up.”

In 1992, as the project was getting underway, Dr. Ackerman learned about the digital camera.
“It’s was a black and white camera. They didn’t have color. We had to take a red, green and blue image, three pictures with filters and we’ll put them together to get full color.”

The price then for a 4 megapixel black and white camera in 1992 was $50,000, He recalled. Though digital camera technology certainly has advanced significantly since then, Dr. Ackerman says there are no plans to redo VHP.

Instead, Dr. Ackerman said academic partners want more three dimensional representations of the heart, organs and bones because anatomy is not taught totally with cross sections.

“We put together a software package where you can take any of our Visible Human images or any medical data set and create the three dimensional models on an automated basis from your data or our data,” Dr. Ackerman stated.

“I work for some very good people that allow me to do what I want to do. And that’s what keeps me going. If I have a good idea that I can build the scientific, economic and political case for it, then they are extremely supportive,” he said.

“They did that with Visible Human; and again when we got this idea about the three dimensional software set. It was a tough sell, but they allowed it and they found the money for it. Management got behind it.”