Stereogram of the Living Heart, Lung, and Adjacent Structures
Ulrich Stock
Round 1
Reviewer 1 Report
Thank you for submitting your original paper. In this time, it is hard to accept your paper without medical image analysis. You should discuss your paper adding knowledge and novelty from medical image analysis.
Author Response
<Reviewer 1>Thank you for submitting your original paper. In this time, it is hard to accept your paper without medical image analysis. You should discuss your paper adding knowledge and novelty from medical image analysis.
Reply: All of our three-dimensional volume rendered images in the figures are not digitally created cartoons or illustrations, but they are reconstructed from computed tomographic data obtained from real patients. Thus, these reflects real living anatomy, and of course they are all sophisticated medical images.
Reviewer 2 Report
Very nice concept for 3D visualisation of cardiac and lung structures. Unfortunately I don't have a anaglyphic glasses handy to fully enjoy the concept during my review. I have some minor comments:
1. The title should be changed to 'Stereogram of the living heart and Lug or adjacent structures'
2. The authors should share more details on the time required to do the ECG gated CT and the following calculations.
3. Paragraph 5 is discussion and not conclusion.
4. Some minor English spellcheck and final reading is recommended
Author Response
<Reviewer 2>
Very nice concept for 3D visualisation of cardiac and lung structures. Unfortunately I don't have a anaglyphic glasses handy to fully enjoy the concept during my review. I have some minor comments:
Reply: Thank you very much. It is actually one of the limitations that we cannot provide anaglyphic glasses to readers. I hope readers can enjoy these figures with cross-eyed methods at least, but we also acknowledge that not everyone is used to that. Those are the limitations as we have discussed in the material.
1. The title should be changed to 'Stereogram of the living heart and Lug or adjacent structures'
Reply: We changed the title according to your suggestion:
Stereogram of the Living Heart, Lung, and Adjacent Structures
2. The authors should share more details on the time required to do the ECG gated CT and the following calculations.
Reply: We have added following sentences in Section 5, Discussion:
The preparation of stereograms is straightforward.
Generally, it takes less than one hour from the acquisition of the computed tomographic data to the image reconstruction and generation of stereograms.
3. Paragraph 5 is discussion and not conclusion.
Reply: Thank you very much for your catch. This error was generated by the publisher. We corrected it.
4. Some minor English spellcheck and final reading is recommended
Reply: Although we have used professional charged English editing service before submission, we will ask them final check before resubmission according to your comment, thank you.
Reviewer 3 Report
- simple visualization radiological technique, well written article
- stereopsis and anagliphs are not commonly known ophtamological concepts. It would be nice to put an abstract graphic example on the ophthalmological mechanism
- Mention the importance of 3D printing in structural heart surgery
- clear, well done methods
- I would enhance it by enlarging the example image of the spider view, it seems to me a good example
- I didn't understand, should these images be seen with 3D glasses?
Author Response
<Reviewer 3>
- simple visualization radiological technique, well written article
Reply: Thank you for your positive comment.
- stereopsis and anagliphs are not commonly known ophtamological concepts. It would be nice to put an abstract graphic example on the ophthalmological mechanism
Reply: Thank you for your thoughtful suggestion. We confess that initially we prepared such graphic example, but eventually we needed to decide to remove it as our figure numbers count too much. We explained the concept as best as we could in the section 2, and multiple papers we cited in this paper clearly showed such graphic example schemes. Thus, we would like to ask your indulgence about this, as it is far more important to show real stereograms as much as we can.
- Mention the importance of 3D printing in structural heart surgery
Reply: We added following sentences in Section 5, Discussion:
Once high-quality volume-rendered images are obtained, three-dimensional datasets can be readily applied to stereograms, three-dimensional printing, three-dimensional projectors/monitors, and virtual reality applications to obtain depth perception. Each ap-plication has its own advantages and disadvantages in terms of user-friendliness, cost performance, and clinical relevance. Specifically, only three-dimensional printing can provide real three-dimensional feature with realistic textures of the reconstructed struc-tures. Thus, three-dimensional printing is useful for surgical planning and simulation of the procedure [33, 34]. On the other hand, if the heart is exclusively printed out, as is gen-erally the case, it automatically loses the three-dimensional relationships with surround-ing structures. This is a similar problem in the setting of real cardiac dissection. In this regard, it is of additional value that virtual three-dimensional applications, as shown in the present figures reconstructed from living hearts, can retain the physiological relation-ships with adjacent structures. This is feasible because the heart does not need to be “re-moved” from the thorax to create these images.
- clear, well done methods
Reply: Thank you for your careful evaluation.
- I would enhance it by enlarging the example image of the spider view, it seems to me a good example
Reply: We totally concur. The spider image is the one that we would love to share with cardiac interventionists as when the authors are young trainees, none of them could not see the spider view in correct fashion. We have requested to enlarge all the figures as page-wide size, which was approved by the editorial office.
- I didn't understand, should these images be seen with 3D glasses?
Reply: You are correct, for the anaglyphs at third panel in each figure, anaglyphic glasses (red/cyan) are necessary. That is the MAJOR limitation of the anaglyph. In this regard, cross-eyed method should be easier as it needs no equipment, but not everyone is used to it. Anyway, the glasses are far cheaper (< 1 buck) compared to purchasing a headgear required for virtual reality applications, ordering 3D printing, and getting 3D monitor/projector. We sincerely hope the readers would try to get the glasses, as the depth perception obtained by the glasses is so striking! We specified that point in the figure legend as follows:
To see the anaglyph, anaglyphic glasses (red/cyan) are required.
