Virtual cadaver facilitates abdominopelvic anatomy teaching

Abstract

Purpose CT imaging of the upper abdomen has complex anatomy that can be difficult to parse given similar densities of multiple organs. Understanding of upper abdominal anatomy, limitations of CT imaging, and alternative methods for visualization are important for physicians in multiple surgical and non-surgical fields. We repurposed a novel, open-access resource to facilitate teaching upper abdominal anatomy. Methods This pilot study with medical students had three learning objectives: 1) identify abdominal organs and sub-structures on CT and 3D human cadaver imaging 2) justify why different types of contrast (e.g. oral or IV) are used or can be omitted based on region of interest. 3) Rationalize use of non-CT visualizations such as MRI, endoscopy, or laparotomy for select scenarios. Hybrid in-person and virtual attendance at sessions employing CT images linked with human cadaver image set serially sectioned from Visible Human Project (https://www.nlm.nih.gov/research/visible/visible_human.html). Students identified and outlined structures on CT using three orthogonal planes prior to blending in cadaver images. Facilitated discussion of challenging organ interfaces (e.g. pancreas and duodenum) and techniques to improve contrast or alternative visualization modalities (e.g. MRI or direct visualization). Post-session survey delivered via e-mail same day. Results Seven students attended the pilot session (3 virtually) with five of seven responding to survey (71% response rate). All respondents found the session to be moderately or very helpful and felt that after the session they were moderately or very confident in their ability to identify upper abdominal structures. Regarding the cadaver images, 1 student thought it was very helpful (20%), 3 students thought it was moderately helpful (60%), and 1 student thought it was not at all helpful (20%). Discussion Human cadaver imaging can help facilitate teaching of CT based anatomy in a pilot study of medical students. Additional sessions may better elucidate benefits and limitations. This resource could be adapted for residents identifying hepatobiliary structures, distinguishing prostate apex from genitourinary diaphragm, and differentiating mediastinal nodal levels from vascular spaces. CT imaging of the upper abdomen has complex anatomy that can be difficult to parse given similar densities of multiple organs. Understanding of upper abdominal anatomy, limitations of CT imaging, and alternative methods for visualization are important for physicians in multiple surgical and non-surgical fields. We repurposed a novel, open-access resource to facilitate teaching upper abdominal anatomy. This pilot study with medical students had three learning objectives: 1) identify abdominal organs and sub-structures on CT and 3D human cadaver imaging 2) justify why different types of contrast (e.g. oral or IV) are used or can be omitted based on region of interest. 3) Rationalize use of non-CT visualizations such as MRI, endoscopy, or laparotomy for select scenarios. Hybrid in-person and virtual attendance at sessions employing CT images linked with human cadaver image set serially sectioned from Visible Human Project (https://www.nlm.nih.gov/research/visible/visible_human.html). Students identified and outlined structures on CT using three orthogonal planes prior to blending in cadaver images. Facilitated discussion of challenging organ interfaces (e.g. pancreas and duodenum) and techniques to improve contrast or alternative visualization modalities (e.g. MRI or direct visualization). Post-session survey delivered via e-mail same day. Seven students attended the pilot session (3 virtually) with five of seven responding to survey (71% response rate). All respondents found the session to be moderately or very helpful and felt that after the session they were moderately or very confident in their ability to identify upper abdominal structures. Regarding the cadaver images, 1 student thought it was very helpful (20%), 3 students thought it was moderately helpful (60%), and 1 student thought it was not at all helpful (20%). Human cadaver imaging can help facilitate teaching of CT based anatomy in a pilot study of medical students. Additional sessions may better elucidate benefits and limitations. This resource could be adapted for residents identifying hepatobiliary structures, distinguishing prostate apex from genitourinary diaphragm, and differentiating mediastinal nodal levels from vascular spaces.