THE VIRGINIAN-PILOT
Copyright (c) 1996, Landmark Communications, Inc.
DATE: Monday, July 22, 1996 TAG: 9607200134
SECTION: BUSINESS WEEKLY PAGE: 10 EDITION: FINAL
TYPE: Cover Story
SOURCE: BY JAMES SCHULTZ, STAFF WRITER
DATELINE: RICHMOND LENGTH: 119 lines
Layer by layer, medical student John Stewart strips away skin and muscle, down to the bone, for an inside view of a human torso. No blood appears on his computer screen, though. That's one detail his new 3-D software omits.
Stewart, a graduate of Old Dominion University and a former aerospace engineer at NASA Langley Research Center in Hampton, has created a program called IsoView that could speed surgery, lessen recuperation times and, eventually, reduce hospitalization costs.
``This is kind of like starting a car company,'' said Stewart, now studying at the Medical College of Virginia. ``I had to do a lot of base-level work to get where I am now. Now we're starting to go into areas that no one has explored.''
IsoView takes two-dimensional images produced by X-ray machines and digital medical scanners and produces full-color, three-dimensional renderings. The pictures, displayed on computer, can be rotated 360 degrees. Pieces can be partially or completely peeled away for an up-close-and-personal inner view.
Using such techniques, physicians could plot surgeries more effectively, pinpoint trouble spots and determine which surgical instruments or treatments would stand the best chance of success.
While IsoView is first intended for neurosurgery - operating on the brain is particularly difficult because of its shape and structure - in two years Stewart plans more refined versions that could be used for other parts of the human body.
The final product would likely cost between $20,000 and $25,000. And because the IsoView images are digital, they can be sent over telephone lines to doctors and hospitals all over the world in minutes: a vital step in the practice of so-called telemedicine.
``There are similar types of things,'' said Dr. Kathryn Holloway, a neurosurgeon at the Medical College of Virginia. ``I haven't seen any that work as well as John's.''
This past January, Holloway said, she used a version of Stewart's software to pinpoint the location of a tumor at the top of a patient's spine, right under the man's skull. The resultant 3-D display enabled her to successfully excise the growth, with a minimum of physical trauma.
Half a year later, Holloway says her patient is doing just fine.
``John is quite a remarkable young man,'' she said. ``He's taken two pretty diverse fields and has married them. Once (the program) is fully integrated, I think it will take off quite rapidly.''
Stewart, 29, says that ever since he can remember, he has been intrigued by science and the process of problem-solving.
The seeds for his current work were sown during a three-year stint at NASA Langley that began after his graduation from ODU in 1990. He and colleagues at the Hampton aerospace complex used computers to simulate conditions aircraft would encounter in flight.
Their software created a series of 3-D grids around a virtual airplane's surface, enabling designers to measure the effects of air flow on and over that surface. Before moving into wind tunnels for actual testing of models, engineers would thus have the opportunity to gauge such factors as lift, drag, pressure distribution, aerodynamic heating and structural integrity.
As enjoyable and satisfying as the work was, Stewart says he felt unfulfilled.
``I looked 10 years down the road and decided that I wanted to contribute more,'' Stewart said. ``I always hoped to go into something more humanitarian. Did I really want to spend my life doing engineering work and feel like I'd never really be helping people?''
He realized, Stewart said, that he had the ability and desire to become a doctor. And that he could take what he had learned at Langley and adapt it for medical use.
``Langley taught me how to program well,'' he said. ``I learned how to create three-dimensional models. If I had never been at Langley, I would never be involved in this research.''
Stewart has made a believer out of Albert C. Young, chairman of the AAROTEC Group, a technical and engineering services company in Fairfax County. The firm, which has specialized in airport planning, design and development, is moving aggressively into the field of 3-D lithography, which creates physical models of everything from consumer products to components used in cars and airplanes.
Young says he's interested in Stewart's software because it can be adapted to produce models for court cases - a jury could see and hold a plastic model of the post-autopsy skull of a murder victim to see exactly how the fatal blow was delivered - or in the manufacture of medical prostheses, like replacement hip and knee joints.
``We've surveyed the entire medical imaging industry in the United States,'' Young said. ``His work is the best that's been done. It makes all others totally obsolete.''
Stewart has also attracted the attention of Surgical Navigation Technology in Boulder, Colo. According to Kurt Smith, the company's chief technology officer, the great benefit of Stewart's work lies in its potential range of uses.
Surgical Navigation, for example, makes a $250,000 device it calls Stealth Station. The device tracks the location of surgical instruments inside the body using infrared technology similar to that employed in TV remote controls. With Stewart's software, the operation of the company's machine could be vastly improved. Other, more sophisticated versions could ultimately be developed.
``We're in the infancy of image-guided surgery,'' Smith said. ``Right now we're supplying a hammer to the surgeon. What John's doing is supplying a customized tool.''
Stewart knows he has his work cut out for him. He has several years of academic work ahead, plus internship and residency requirements in neurosurgery to complete. That's not to mention figuring how to best commercialize his breakthrough programs.
Stewart figures he'll be 40 by the time he attains his goal: a clinical practice with time for research in neurosurgery.
``I have a finite number of years to live, he said. ``I could have been sitting in front of a computer and managing projects and people. Or I could be doing the things I love to do. This is exactly the place I want to be.'' ILLUSTRATION: KEN BENNETT PHOTOS
THE MAN
John Stewart, a medical student at the Medical College of Virginia,
has adapted to medicine the computer skills he used as an aeorspace
engineer at NASA Langley Research Center in Hampton.
HIS MACHINE
Stewart's computer program IsoView takes two-dimensional images
produced by X-ray machines machines and digital medical scanners and
produces full-color, three-dimensional renderings. by CNB