Research profile: Ingela Nyström

In the future, maxillofacial (that is, jaw) surgeons will be able to perform the surgery on the computer before they open the patient. On scanned three-dimensional images of the injured patients, models are made in the computer that give the surgeon better control over how the injury actually looks. What before was invisible under the skin is made visible. "It will mean shorter operating times, better results from the surgery and money saved", says Ingela Nyström, professor of visualization at the Department of Information Technology at Uppsala University.

Ingela Nyström's research concerns mathematics and information technology meeting the medicine. She is a mathematician and a computer scientist, but already as a doctoral student she discovered that her applied mathematics could be useful in medicine. The research was about developing methods for how one could, among other things, analyze shapes in images on the computer.
- When I and my supervisors investigated whether there was any interest in this, it turned out that the radiologists in the hospital were interested in being able to see blood vessels in the computer. We then worked with mathematically looking at where blood vessel narrowing existed.

Ten years ago, they got in touch with maxillofacial surgeons at the Uppsala University Hospital and the collaboration took off. The surgeons needed more accurate methods to plan the surgery.
- Using this methodology - if someone has been injured, for example, in a fall accident or kicked by a horse - you can do a CT scan of the damaged jaw and then put together the broken jaw as in a 3D puzzle in the computer before you performs the actual surgery, explains Ingela.
- What we have built into the system is advanced image analysis and visualization so that you can see how deep an injury is or how crushed a bone piece is before opening up the patient during a surgery. One can say that we make the invisible visible!

Working with mathematics, data and medicine was something that early on felt natural to Ingela.
- I have always wanted to work with people, for me a path could have been to work within healthcare, says Ingela. But if I had NOT studied mathematics, I would have missed it every day, I am in many ways a true scientist. But on the other hand I am not a mathematician who prefers to dig myself into formulas I rather look for usability.

Ingela's grandmother was a little worried when she started to study mathematics, but at the public defense she expressed that mathematics was not that bad, because Ingela could do good in medicine with it.
- Things will go well for you, Ingela, grandmother said to me then.

The focus right now is on continuing the cooperation with the maxillofacial surgeons.
- We have solved the puzzle pieces with bone - to assemble and make implants. But now we also want to study the soft tissues, because one also needs to be able to transplant skin or move muscles and that area is very "unexplored". We have so far started with basic research within this, but not yet found the right funding for the research yet.

The latest research findings are that they can draw on the skin on patient-specific data in the computer. They can identify the skin flap that they must remove and then find the corresponding position on the skin on the inside of the thigh. With the help of the program and scanning from the patient, they can find healthy tissue in a place where there is also a good blood vessel. By attaching the skin flap with a good blood vessel to the face, it heals much faster.
- Plastic surgeons are involved in the development of this method, says Ingela.

It is a real challenge in research to create models that simulate soft tissue, tendons and muscle tissue. Modeling flexible, soft materials is more complex than the rigid skeleton.

The main theme in all Ingela's research is ”accuracy and precision”.
- You have to be mathematically correct because otherwise it will not be good results, she explains. But also accuracy by making sure to handle patient data properly and you also need to be careful in making the computer programs user-friendly so that they work for the surgeons who are going to use them.

The methods that Ingela and her colleagues develop will be able to contribute to shortened times in surgery and better surgical results, which benefits the patients. With this, the methods can also help to save money in healthcare.

The method with the computerized 3D puzzle could also be used for other areas, such as archaeologists who need to puzzle together old urns using fragile pieces of pottery shards.

Now Ingela wants to get the research group to grow. There are several surgeons and doctoral students at the Academic Hospital who are active in the project, but at the Department of Information Technology, the group is small.
- Today we are Fredrik Nysjö, who is a doctoral student, Filip Malmberg, who is a researcher, and I myself, says Ingela. So we need to become more at IT.

Up until now, Ingela has also been head of department for Vi2, the Department of Visual Information and Interaction. Besides getting more time for her research, now that she is leaving the assignment, she looks forward to teaching again.
- Being a teacher is the most fascinating thing you can be! Ingela exclaims. To pass on what I myself have taught to the students.

If you, as a student, are interested in researching in the same area as Ingela, she gives the advice to first invest in learning mathematics and then become a strong programmer. Then you can start building bridges to unite computer science and medicine.

Age: 51
Title: Professor of Visualization
Education: PhD in Computerized Image Analysis in 1997 in Uppsala.
Place of residence: Storvreta
Family: Man and two adult children
Leisure time activities: Travel with family and friends, but are just as well at home and out in the woods or in the stable.
Currently: I am invited to the University of Victoria in Canada in March 2019 to lecture and build research collaborations.
Listening to: I listen to everything - classic, jazz, house and 80's pop depending on mood.
Hidden talent: I'm a pretty good rider. (I started riding as a child and have previously competed in both dressage and jumping. Last fall, the family bought a foal, Crown Princess SH. The goal is now that Sessan will grow up to a tame and confident individual and then we will professionally educate her to a jumping horse.)
Strength: That I think ”right should be right”, which has helped me a lot in research over the years.
Weakness: The same thing - I want the right to be right, which means that people sometimes perceive me as inflexible.
Dream project: Privately, the dream is perhaps about to be realized - to have a horse that goes to the world arenas in jumping. It would be such a fantastic trip to be part of!