vEUA

vEUA is a 3D modelling tool developed by Motilent (operating under the Entrolytics platform) for visualising pelvic and perineal anatomy from MRI data. It is designed for clinicians working with complex perianal fistula, Crohn's disease, and colorectal cancer, enabling the creation of anatomically representative 3D models of the sphincters, levator plate, and fistula tracts in under two minutes.

The tool addresses a recognised limitation of conventional written MRI reports, which can be difficult to interpret when describing complex pelvic anatomy. vEUA provides an interactive 3D model that supports communication between surgeons, radiologists, multidisciplinary teams (MDTs), patients, and trainees.

Core Capabilities

• Generates an anatomically representative 3D model of the sphincters, levator plate, and fistula tracts from pelvic MRI in under two minutes.
• Reduces reliance on long written descriptions by providing an interactive visualisation of fistula tracts and branching patterns.
• Highlights the spatial relationship of fistula tracts to the sphincters, levator plate, urethra, and surrounding organs to support operative decision-making.
• Captures quantitative measures of disease activity, including fistula volume, tract tortuosity, and T2 signal changes, to monitor treatment response over time.
• Supports assessment of fibrosis, which can indicate healing as inflammation reduces.
• Applicable to colorectal cancer surgery where detailed anatomical information is needed for complex procedures.
• Provides educational value for trainees and patients who find pelvic anatomy difficult to understand from text reports alone.

Quantitative Disease Assessment with pTRACK

• Fistula tract volumetry, including length and branching, can be measured using Entrolytics standard tooling.
• pTRACK provides summary statistics such as fistula volume and tract tortuosity.
• Includes a suite of tools for completing validated clinical indices, specifically MAGNIFI-CD and Van Assche.
• Detects subtle changes in disease activity earlier than traditional scoring methods.
• MRI signal (e.g. T2) and volume measurements reflect chronicity, fibrosis, and treatment response over time.
• Supports MDTs in assessing treatment effect from biologics and advanced therapies, and in involving patients in decision-making.

Workflow Steps

1. Upload data: The workflow begins with the patient's pelvic MRI dataset in standard DICOM format.
2. Mark up anatomy: A skilled clinical professional uses semi-automatic volumetric segmentation tools to mark up the levator plate, anal sphincters, and fistula tract. vEUA is not an AI; accuracy depends on the user's ability to identify and trace anatomy.
3. Generate model: vEUA interpolates the marked-up anatomy to produce an anatomically representative 3D model in under two minutes.
4. Communicate findings: The 3D model serves as a shared reference for surgeons, radiologists, and patients, supporting treatment planning and MDT discussions.

Intended Users

• Radiologists: To visualise fistula tracts and share findings with clinical colleagues.
• Surgeons: To plan procedures and improve communication with radiologists and patients.
• Multidisciplinary teams (MDTs): To guide complex case discussions.
• Educators and trainees: To better understand pelvic anatomy.

Integration and Compatibility

• Works directly with pelvic MRI datasets using standard DICOM imaging.
• Models can be accessed and shared securely via the Entrolytics viewer, which provides interactive 3D visualisation alongside conventional images.
• Compatible with pTRACK for extended quantitative disease assessment, including volume, tortuosity, signal change, fibrosis measurement, and validated indices.

vEUA is not yet FDA cleared or CE marked and is currently available for investigational use in collaboration with research partners. Motilent is working with clinical collaborators to gather evidence to support future regulatory submissions. The tool was originally developed for surgical and medical management of simple and complex perianal fistula, particularly in Crohn's disease, and is also used in colorectal cancer surgery.