Colorectal cancer is one of the most prevalent and deadly types of cancer worldwide. Its incidence has been increasing, influenced by an ageing population, poor dietary habits and sedentary lifestyles. Despite high cure rates when detected early, diagnosis often occurs at advanced stages, limiting therapeutic efficacy and reducing survival rates. Computed tomography colonography, also known as virtual colonoscopy, is a non-invasive alternative to conventional colonoscopy. This technique enables three-dimensional reconstruction of the colon, providing detailed visualisation of the colonic mucosa and facilitating the detection of polyps and other suspicious lesions.
Home / Publications / Publication
Home / Publications / Publication
VIRTUAL REALITY IN COLONOGRAPHY TO OPTIMISE LESION DETECTION
Publication type: Article Summary
Original title: Controlling Camera Movement in VR Colonography
Article publication date: January 2022
Source: Virtual Reality
Authors: Soraia Paulo, Daniel Medeiros, Daniel Lopes & Joaquim Jorge
What is the goal, target audience, and areas of digital health it addresses?
The study aims to evaluate and compare the impact of different camera control techniques on lesion detection and navigation efficiency during colonography in immersive virtual reality environments. The target audience includes healthcare professionals, namely radiologists and clinicians involved in computed tomography colonography, as well as researchers in the fields of medical imaging, human-computer interaction and digital technologies applied to health. The work falls within the field of digital health, with an emphasis on virtual reality applied to medical image-based diagnosis, user-centred computing, and the development of tools to support early detection and screening of colorectal cancer.
What is the context?
Colorectal cancer is one of the most prevalent and deadly types of cancer worldwide. Its incidence has been increasing, influenced by an ageing population, poor dietary habits and sedentary lifestyles. Despite high cure rates when detected early, diagnosis often occurs at advanced stages, limiting therapeutic efficacy and reducing survival rates.
Computed tomography colonography, also known as virtual colonoscopy, is a non-invasive alternative to conventional colonoscopy. This technique enables three-dimensional reconstruction of the colon, providing detailed visualisation of the colon mucosa (large intestine) and facilitating the detection of polyps and other suspicious lesions.
However, interpreting the images remains a technical and cognitive challenge. The colon anatomy, characterised by multiple curvatures and folds, can compromise the complete visibility of the intestinal wall, leading to potential detection failures. In addition, analysis in two-dimensional interfaces reduces spatial perception and increases cognitive load, highlighting the need for more intuitive, accurate and efficient technological solutions.
What are the current approaches?
Currently, virtual colonography is performed on conventional workstations, where radiologists analyse three-dimensional reconstructions from CT images. Navigation is performed in a two-dimensional environment using a mouse, keyboard, and monitor, simulating a virtual journey through the interior of the colon.
Among the most common camera control techniques are the Fly-Through approach, which simulates a continuous internal journey along the lumen, the Fly-Over technique, which provides an external view of the organ with a broader perspective, and the Unfolded View, which allows the colon surface to be flattened for linear and continuous reading. Although effective, these approaches have limitations, namely greater cognitive load, dependence on two-dimensional interfaces, and the possibility of omitting anomalies in areas that are difficult to access visually.
In this context, virtual reality emerges as a natural evolution of these methodologies, allowing immersive and interactive navigation up to three dimensions, promoting more intuitive and realistic exploration, increasing anatomical perception, visual coverage and, potentially, diagnostic accuracy.
What does innovation consist of? How is the impact of this study assessed?
The innovation in this study consisted of introducing and evaluating the Elevator technique, designed specifically for colonography in immersive virtual reality. This approach was developed to resolve the discrepancy often observed between the user’s actual orientation and the camera’s orientation in the virtual environment, a problem that can compromise spatial perception and navigation fluidity. By continuously aligning the virtual orientation with the user’s physical posture, the Elevator technique promotes a more intuitive and natural exploration of the colon lumen, keeping the user oriented towards the walls in ascending and descending segments and ensuring a more coherent transition between anatomical changes.
In addition to introducing this technique, the study was also innovative in that it transferred traditional colonography navigation methodologies, such as Fly-Through and Fly-Over, to an immersive context. Additionally, the work stands out for its systematic comparison of the three techniques, filling a gap in the literature, which until now has rarely addressed the impact of camera control in virtual reality environments applied to clinical practice.
The impact assessment combined objective and subjective measures. Efficiency was analysed based on task execution time, and effectiveness was analysed based on the detection rate of simulated marks representing lesions, with data processed using non-parametric statistical tests. This quantitative analysis was complemented by usability questionnaires and the Simulator Sickness Questionnaire, ensuring control of factors such as disorientation and visual discomfort. Finally, interviews were conducted with senior radiologists reinforced the clinical relevance of the research, emphasising that, in the medical context, diagnostic accuracy prevails over navigation speed, thus validating the potential of virtual reality as a support tool in the early detection and screening of colorectal cancer.
What are the main results? What is the future of this approach?
The results showed clear differences between the techniques evaluated. Fly-Over had the highest lesion detection rate, with a median of 89.47%, indicating that a broader perspective perpendicular to the colon walls favours the identification of simulated marks, even in more complex anatomical areas. However, this technique involved a longer average navigation time, approximately 305.53 seconds, reflecting a trade-off between accuracy and operational efficiency.
The Fly-Through technique achieved a slightly lower detection rate (79.47%), but stood out for its greater time efficiency, with an average time of 273.91 seconds, and was considered by participants to be the most intuitive and least disorienting approach. The Elevator technique, although conceptually promising, by aligning the virtual orientation with the user’s actual posture, recorded the least favourable overall performance, with a median detection rate of 76.84% and the longest navigation time (322.13 seconds), reflecting the challenges of the first iterations of this approach.
The radiologists consulted emphasised that, in the clinical context, diagnostic accuracy takes priority over examination time, especially in the screening and early detection of colorectal cancer. Thus, a technique such as Fly-Over, although slower, can offer relevant clinical benefits in scenarios with high diagnostic demands.
Regarding the future of this line of research, the study points to the development of hybrid systems that combine the efficiency of Fly-Through with the detection capability of Fly-Over, optimising spatial interaction and user comfort. Integration with artificial intelligence for assisted lesion detection is also envisaged, as well as large-scale validation with specialists and application in real training and clinical practice contexts. These results reinforce that virtual reality applied to colonography is not a futuristic scenario, but an emerging technology with concrete potential to transform diagnosis and training in medical imaging.
Would you like to know all the details?
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Home / Publications / Publication
VIRTUAL REALITY IN COLONOGRAPHY TO OPTIMISE LESION DETECTION
Publication type: Article Summary
Original title: Controlling Camera Movement in VR Colonography
Article publication date: January 2022
Source: Virtual Reality
Authors: Soraia Paulo, Daniel Medeiros, Daniel Lopes & Joaquim Jorge
What is the goal, target audience, and areas of digital health it addresses?
The study aims to evaluate and compare the impact of different camera control techniques on lesion detection and navigation efficiency during colonography in immersive virtual reality environments. The target audience includes healthcare professionals, namely radiologists and clinicians involved in computed tomography colonography, as well as researchers in the fields of medical imaging, human-computer interaction and digital technologies applied to health. The work falls within the field of digital health, with an emphasis on virtual reality applied to medical image-based diagnosis, user-centred computing, and the development of tools to support early detection and screening of colorectal cancer.
What is the context?
Colorectal cancer is one of the most prevalent and deadly types of cancer worldwide. Its incidence has been increasing, influenced by an ageing population, poor dietary habits and sedentary lifestyles. Despite high cure rates when detected early, diagnosis often occurs at advanced stages, limiting therapeutic efficacy and reducing survival rates.
Computed tomography colonography, also known as virtual colonoscopy, is a non-invasive alternative to conventional colonoscopy. This technique enables three-dimensional reconstruction of the colon, providing detailed visualisation of the colon mucosa (large intestine) and facilitating the detection of polyps and other suspicious lesions.
However, interpreting the images remains a technical and cognitive challenge. The colon anatomy, characterised by multiple curvatures and folds, can compromise the complete visibility of the intestinal wall, leading to potential detection failures. In addition, analysis in two-dimensional interfaces reduces spatial perception and increases cognitive load, highlighting the need for more intuitive, accurate and efficient technological solutions.
What are the current approaches?
Currently, virtual colonography is performed on conventional workstations, where radiologists analyse three-dimensional reconstructions from CT images. Navigation is performed in a two-dimensional environment using a mouse, keyboard, and monitor, simulating a virtual journey through the interior of the colon.
Among the most common camera control techniques are the Fly-Through approach, which simulates a continuous internal journey along the lumen, the Fly-Over technique, which provides an external view of the organ with a broader perspective, and the Unfolded View, which allows the colon surface to be flattened for linear and continuous reading. Although effective, these approaches have limitations, namely greater cognitive load, dependence on two-dimensional interfaces, and the possibility of omitting anomalies in areas that are difficult to access visually.
In this context, virtual reality emerges as a natural evolution of these methodologies, allowing immersive and interactive navigation up to three dimensions, promoting more intuitive and realistic exploration, increasing anatomical perception, visual coverage and, potentially, diagnostic accuracy.
What does innovation consist of? How is the impact of this study assessed?
The innovation in this study consisted of introducing and evaluating the Elevator technique, designed specifically for colonography in immersive virtual reality. This approach was developed to resolve the discrepancy often observed between the user’s actual orientation and the camera’s orientation in the virtual environment, a problem that can compromise spatial perception and navigation fluidity. By continuously aligning the virtual orientation with the user’s physical posture, the Elevator technique promotes a more intuitive and natural exploration of the colon lumen, keeping the user oriented towards the walls in ascending and descending segments and ensuring a more coherent transition between anatomical changes.
In addition to introducing this technique, the study was also innovative in that it transferred traditional colonography navigation methodologies, such as Fly-Through and Fly-Over, to an immersive context. Additionally, the work stands out for its systematic comparison of the three techniques, filling a gap in the literature, which until now has rarely addressed the impact of camera control in virtual reality environments applied to clinical practice.
The impact assessment combined objective and subjective measures. Efficiency was analysed based on task execution time, and effectiveness was analysed based on the detection rate of simulated marks representing lesions, with data processed using non-parametric statistical tests. This quantitative analysis was complemented by usability questionnaires and the Simulator Sickness Questionnaire, ensuring control of factors such as disorientation and visual discomfort. Finally, interviews were conducted with senior radiologists reinforced the clinical relevance of the research, emphasising that, in the medical context, diagnostic accuracy prevails over navigation speed, thus validating the potential of virtual reality as a support tool in the early detection and screening of colorectal cancer.
What are the main results? What is the future of this approach?
The results showed clear differences between the techniques evaluated. Fly-Over had the highest lesion detection rate, with a median of 89.47%, indicating that a broader perspective perpendicular to the colon walls favours the identification of simulated marks, even in more complex anatomical areas. However, this technique involved a longer average navigation time, approximately 305.53 seconds, reflecting a trade-off between accuracy and operational efficiency.
The Fly-Through technique achieved a slightly lower detection rate (79.47%), but stood out for its greater time efficiency, with an average time of 273.91 seconds, and was considered by participants to be the most intuitive and least disorienting approach. The Elevator technique, although conceptually promising, by aligning the virtual orientation with the user’s actual posture, recorded the least favourable overall performance, with a median detection rate of 76.84% and the longest navigation time (322.13 seconds), reflecting the challenges of the first iterations of this approach.
The radiologists consulted emphasised that, in the clinical context, diagnostic accuracy takes priority over examination time, especially in the screening and early detection of colorectal cancer. Thus, a technique such as Fly-Over, although slower, can offer relevant clinical benefits in scenarios with high diagnostic demands.
Regarding the future of this line of research, the study points to the development of hybrid systems that combine the efficiency of Fly-Through with the detection capability of Fly-Over, optimising spatial interaction and user comfort. Integration with artificial intelligence for assisted lesion detection is also envisaged, as well as large-scale validation with specialists and application in real training and clinical practice contexts. These results reinforce that virtual reality applied to colonography is not a futuristic scenario, but an emerging technology with concrete potential to transform diagnosis and training in medical imaging.
Would you like to know all the details?
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The growing number of people with anxiety disorders, along with increased awareness of mental health, drives the need for new technological tools that provide remote and continuous monitoring of anxiety and panic disorders. Thus, the…
A Novel Approach for Robotic-assisted Tele-echography
Currently, robotic systems for ultrasound diagnostic procedures fall into two main categories: portable robots that require manual positioning and fully autonomous robotic systems that independently control the ultrasound probe’s orientation and positioning. Portable robots rely…
From Big Data to Big Decisions: How AI Stratifies Cancer Cases by Risk Factors
The CLARIFY Decision Support Platform (DSP) is a responsive web application designed to support decision-making in cancer care through real-time data integration and predictive analytics. Built on Big Data Europe, the platform integrates a variety…
From “Free Text” to Structured Clinical Data: the Foundation for Clinical Decision Support Systems
Currently, the practice of recording clinical information in “free text” offers flexibility, but hinders automatic data extraction, limiting the application of analytical models. Most records are unstructured, and the use of non-standard abbreviations increases ambiguity,…
Artificial Intelligence used in Depression Detection in Cancer Survivors
The goal of the FAITH project (Federated Artificial Intelligence solution for moniToring mental Health status after cancer treatment) is to remotely identify and predict depressive symptoms in cancer survivors using a federated machine learning approach…
Integration of SONHO v2 and SClínico Systems at ULS of Coimbra to Improve Healthcare Services
With more than half a million hospital medical consultations carried out in the first half of 2024, the ULS of Coimbra stands out as an institution dedicated to integrated, high-quality and patient-centered healthcare, with 8…
Elderly Care Ecosystem: an Innovative Platform for Personalized and Efficient Services
The Elderly Care Ecosystem (ECE) is an integration of various digital health technologies, exploring the areas of telehealth and predictive analytics. The goal of this ecosystem is to improve the quality of life for elderly…
Innovative technology that subconsciously relieves anxiety through a scarf
The SCAARF technology aims to offer an alternative method to alleviate anxiety symptoms in a non-intrusive and subconscious way. This technology is an innovative idea in the field of digital health and wearable technology, designed…
Digital Health Interventions: Equity in Hypertension Care for Everyone
Nearly half of all adults in the United States have hypertension, one of the leading risk factors for cardiovascular disease, and only about a quarter (24%) of those people have their hypertension under control. Studies…
Personalization and Technology in Diabetes Management
IPDM has significant potential to improve diabetes management and drive health system reforms to become high-performing, effective, equitable, accessible, and sustainable. Evidence and good practices inspire health system transformation. Adopting person-centred approaches like co-creation and…
Negotiations on the European Health Data Space Advance With the Participation of the SPMS
The European Health Data Space will be a common health data sharing system across the European Union. It foresees the use of data for purposes that benefit people and society. It will ensure citizens have…
Secretary of State Margarida Tavares Emphasizes Digital Innovation in Health Promotion
Margarida Tavares spoke at the opening of the conference ” O Digital na promoção contínua da saúde e do bem-estar”, organized by the Associação para a Promoção e Desenvolvimento da Sociedade da Informação (APDSI) and…
ARS Algarve Modernizes Radiology With AI and New Data Center
The radiology service of ARS Algarve has already performed nearly 29,000 exams using Artificial Intelligence (AI) technology. In recent years, there has been a significant investment in image digitization and data storage, as well as…
European Health Data Space: Unified Access To Health Data In The EU
The COVID-19 pandemic highlighted the importance of digital services in health, but complex rules and increasing cyberattacks make it difficult to share data across Member States; the EHDS, based on several regulations, provides tailor-made rules…
European Commission Amends Digital Europe Programme With an Investment of €762.7 Million
The European Commission has amended the Digital Europe Programme work programmes 2023-2024, investing an additional €762.7 million in Europe’s digital transition and cybersecurity. The digital transition is the main work programme with a budget of…
SPMS Integrates the TEF-Health Initiative
SPMS participates in the TEF-Health initiative as a partner in a consortium composed of 51 entities from 9 European Union countries. This action is co-financed by the European Commission and has a duration of five…
FMUP Creates Inhealth Junior Academy for High School Students
The InHealth Junior Academy — Academia Júnior de Inovação em Saúde is an initiative of the Departamento de Medicina da Comunidade, Informação e Decisão em Saúde da Faculdade de Medicina da Universidade do Porto (FMUP)….
SPMS Represents Portugal as Vice-president of GDHP
The GDHP is an intergovernmental organization in the digital health sector that facilitates cooperation and collaboration between government representatives and the World Health Organization (WHO). Its purpose is to foster policymaking that promote the digitalization…
Digital Transformation of Health at INCoDe.2030 in Tomar
The “National Digital Skills Initiative e.2030, Portugal” (INCoDe.2030) is an initiative that aims to improve the Portuguese population’s level of digital skills, placing Portugal at the level of the most advanced European countries in this…
Braga Hospital Evaluates Memory With Interactive Game in Patients With Multiple Sclerosis
Multiple Sclerosis is known as a chronic disease of the central nervous system, with a wide variety of motor and sensory symptoms that can lead to work disability, socioeconomic burden, and reduced quality of life…
Neurosurgery Teleconsultation Wins Innovation Award
The aim of the BI Award for Innovation in Healthcare is to recognize innovative projects in the healthcare sector that improve the quality of life for the Portuguese people. In 2021, the specific theme was…
HealthData@PT: New SPMS Initiative for Health Data
Action HealthData@PT is launched in the context of the implementation of the European Health Data Space, and is an initiative approved by the European Commission under the EU4Health 2021-2027 programme. This initiative contributes to the…
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