The challenges of representing anatomical spatial relations.

Puget, Mejino, Detwiler, Franklin and Brinkley introduce their article “Spatialsymbolic Query Engine in Anatomy” [1] by posing a seemingly straightforward anatomy question: “what vital organs would potentially be impacted by a bullet wound to the abdomen?” More than 50 years ago, such a question may well have been included at the end of a yearlong anatomy course in an essay exam. Such an openended question would have been intended as an invitation to my fellow medical students and me to engage in thought experiments, requiring us to impose various constraints and specifications on such a broad question in order to pursue cogent spatial reasoning. Confronted with such a question, today’s student would most likely turn to the computer. However, he or she would find it challenging, if not impossible, to construct a satisfactory answer. A survey of 100 on-line anatomy information resources [2] found that they were lacking in sufficient quality and depth for levels of learning beyond the memorization of structure names. Despite the growing emphasis on web-based “distance learning” during the intervening 10 years, today it would still be essentially impossible for a student to launch a query such as the question posed by the authors (hereafter the SQE team), let alone find satisfactory answers. The team implies that, by proposing the prototype of a spatial-symbolic query engine (SQE) as a proof of concept, they will, in the long run, make such a task more readily feasible. After the paper was reviewed and accepted, the editor of Methods of Information in Medicine solicited comments from eight additional experts (hereafter commentators) in various fields of biomedical informatics and medical image computing. I am honored to have been invited to introduce the paper along with the experts’ comments, all of which appear in the current issue. I do so as an anatomist, who has taught many generations of young health care professionals, ranging from nursing and medical students to surgical residents. During the last phase of my academic career this experience was enriched by new insights into the time-honored discipline of anatomy through stimulating and productive collaborations with investigators and graduate students in computer science, biomedical informatics and philosophy.