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High Definition Medical Video

No clever title this time. As we have been editing HD projects over the past year we have been collecting sample clips showing surgical and non-surgical training footage. This is just a sample.

The Sony HVR-V1U has proven to be a great camera for use in the sensitive operating room environment. It is lightweight enough to hang over an open incision, the battery life is long and the images are astounding. Given the potential negatives of HDV, we have found it to be a robust format with good color reproduction and ease of editing using Premiere. It is a processor hog and Premiere seems to want to re-index HDV on a regular basis, but the end result is what matters.

As we investigate tapeless ways to capture video including interfacing with new HD medical systems, we are developing some nice material.

But technology aside, as elucidated in this article:

getting great images is as much about knowing what you are looking at as it is knowing how to control your equipment.

For now, enjoy the show. Viewer discretion is advised.

Mike Cohen

Posted by: Mike Cohen on Oct 27, 2009 at 7:56:39 pm high definition, hdv, surgery, hd

Cooking with Gas

Having experimented with HDV as documented in previous posts, this week was one of the first occasions to shoot a full day of open surgery with this format, using the Sony V1U.

In the viewfinder or flip-out LCD screen, one cannot really see a difference in clarity. Focusing is, in fact, more difficult, especially since there is often some distance between the screen and my eyes.

If I lean in too close I could potentially lose my balance, which is usually precarious to begin withstanding on three stacked 1'x2' step stools. Thus I alternate between autofocus and manual focus with frequent use of the push auto button to let the camera check focus.

Let me elaborate. If shooting wide, the autofocus works pretty well, as the background is the primary target. Hands working in the wide shot do not alter the focus too much, due to the focal length. When zoomed to a closeup or extreme closeup, the autofocus goes haywire, always trying to focus on the nearest objects, which inevitably are the constantly moving hands closest to the camera, yet the least important part of the image, although it varies.

Thus, I try to find a moment when the hands are out of the field so I can grab focus on the background, then go to manual until I move the camera. I move the camera a lot.

With a strategy for focus sorted out next comes exposure. I experimented with no zebras as well as the selectable 70% and 100% zebras, just to figure out how the levels relate to iris position. I prefer to shoot with the zebras off normally. As you know, most DV and HDV cameras use an electromechanical iris control, not a true iris ring like on more expensive lenses. I'm not sure if the V1 is electromechanical or pure electronic. In either case, the dial is in an improved location versus the PD170.

The V1U's LCD display does not always produce a discernable difference between slight iris adjustments. Again, I keep iris on manual, but frequently use the auto button to check a level. However the nature of open surgery is a severe contrast ratio that few video cameras can handle with elegance. The highly focused OR lights are pointed at the working area, sometimes only a few square inches, while the skin and blue drapes are bathed in shadow. Thus a wide shot has a bright center surrounded by shadow. If the universe has a bright center, we're on the planet that it's farthest from. Thus again, the auto iris may need to be tweaked to expose what you are actually looking at. If you want to see the setup of the wide shot, you have to live with the bright spot in the middle. In most cases, however, you are on a medium or closeup shot.

Now on to framing. I keep the on-LCD display set to show 4:3 and 80% protection lines.

While the eventual DVD version of an HDV project will likely be 16:9 anamorphic, not 4:3, the presence of the 4:3 reticle gives me a real-time indication of the framing differences from the 4:3 cameras I have been using since the late 1980's. In other words, the shots can in fact be more creative. The law of thirds in widescreen is a beautiful thing.

Next step is to fly home, capture the HDV into a Premiere project, and get editing. I recently discovered that you can start a Premiere project and designate one of your two LCD monitors for full screen monitoring. This does not do DV any favors, but HDV looks as spectacular as it can look without buying an HD monitor and 3rd party card or software. To view HDV at 100% within the Premiere interface is darn near impossible.

Oddly, Premiere does not know to move your windows from the video playback monitor to the active window, so you can get some hidden windows and dialog boxes. Just select one of the default single monitor workspace setups. Premiere CS4 supposedly makes this full screen monitoring much easier.

I tell my friends and family that a day in the OR shooting surgery is some of the most fun I have. The addition of HDV and the nuances described above, aside from keeping me on my toes for 12 hours, makes things really exciting.

That being said, nothing hits the sopt after a long case better than a delightful tray of hospital cafeteria food. Some hospitals actually have fast food restaurants - seems sort of counter intuitive - but many hospitals have pretty good food. It's like being back in the college dining hall. 

Thanks for reading.

Mike Cohen

Posted by: Mike Cohen on Nov 13, 2008 at 7:35:46 pm hdv

Fun with HDV - the Lost Episode

If you have been following my blog, you know that we use a Sony V1U primarily as another DVCAM camera, for most of our shoots. We actually shot a lot of interviews a few weeks ago with our V1 and a rental, in the hopes that matching the two cameras would be easier than trying to match the V1 with a Panasonic camera.

Here is the transcript of a conversation had this week while shooting a surgery:

Doc: So, is that an HD camera?

Me: It shoots HD, but not at the moment. Do you record HD?

Doc: No, the HD scope (medical video camera) doesn't let you record in HD.

Me: Figures. Although you are displaying it on those nice plasma screens in your OR.

Doc: It's nice isn't it.

Me: Not bad, although when you walk right up to the screen it looks kind of grainy.

Doc: What do you think looks better the plasma or the boom mounted LCD?

Me: The LCD. You know, I have an idea. I can shoot the next case in HD (HDV is actually a phrase the average person has never heard, so saying HD results in fewer blank stares) and you are using an HD camera and displaying it in HD - what if I shoot the HD off the screen onto HD. The only analog signal will be the air between the screen and my camera.

Col. Hannibal Smith: Crazy as it sounds, it just might work.

Mr. T: I ain't gettin on no plane.

Sorry, had a brief 80's flashback, stick with me.

Obviously the plasma screen's grainy image won't be as crisp as the LCD, however from my camera's position hovering over the OR bed, I have a pretty straight shot to the plasma screen. I certainly do not expect to get a crystal clear image, however the aspect ratio is the same so it is worth a shot.

Here is a fullest size frame grab Flickr will allow from the experiment (I hope you have eaten recently):

It's not bad is it. Does not actually look very grainy to me, and is certainly better sharpness than DV. We'll call this pseudo-HD.

Here is a smaller version allowed by the COW:

In case you were wondering, that's the prostate being cut away from the pelvic floor. That pink thing in the foreground might be the vas deferens, everyone's favorite structure!

For comparison, here is a frame from the full size DV recording from the same HD camera, taken from DV tape captured into Premiere(confused yet?). The HD surgical camera has S-Video outputs on the back, recording a slightly cropped SD version to whatever format you desire, in my case DV tape. Remember, compare this image to the link above, not the image which is essentially a thumbnail from the full size HDV frame:

Alas, the HDV recorded off plasma display of HD is certainly larger in size than standard DV, which is obvious given HDV's larger image size. However the real question is, is the resolution any better, and would it stand up to HD display and projection, or to printing for that matter. Another future experiment will be to try to record the HD signal from the OR camera to an HDV deck. The HD outputs of the medical video camera control units range from component to DVI. Thus a scan converter which accepts DVI and can output HDV via firewire, a device which probably does not exist, will need to be used. Short of renting an XDCAM deck, the only other choice might be to record directly to a computer.

Also available are seriously expensive Sony medical grade HD recorders - at least we know someone is thinking about recording HD in the OR.

These questions may be answered in a future episode entitled: HDV, it's What's for Dinner.

Or whatever. Must be time for lunch.


PS - If you are interested, here's a link to the full size HDV frame of the image at the top of this article:

Posted by: Mike Cohen on Jun 28, 2008 at 12:05:09 pm hdv

HD Editing Options (ok, HDV if you want to be technical)

Recently I experimented with different HD video editing options, to determine if I should shoot an upcoming project in HD or standard def. I concluded that i will stick with standard def for now. 

I installed the Intensity Pro card. This allows for HDMI capture and monitoring of HDV. I do not have an HDMI (or any HD) monitor, so I could not test that part, and from what I observed, without HDMI monitoring, using the Intensity for HD editing is not so useful.

Capturing HDMI HDV to external SATA drive (350 gig 7200rpm seagate)

You can of course capture native HDV via firewire, and playback on the LCD computer monitor actually looks great. Once you start editing, including titles and effects, the real-time playback really suffers and stutters. This is because HDV is long GOP mpeg, meaning a lot of processing has to happen to play back smooth video - not a problem with one track of video, dissovles and audio, but the more layers the worse it gets.

The Intensity has a compressed intermediary codec, the Blackmagic Design Motion JPEG codec. This captures to the external SATA drive with no dropped frames and plays back smoothly. However, monitoring the video on the computer monitor results in a jagged picture, not very clear monitoring, hence the need for a HDMI monitor.

Using RAID 0

I also tried a SATA RAID 0 array consisting of 2 500gig drives formatted as one 1TB drive. However the SATA cable is going into the onboard SATA port, as opposed to a SATA RAID controller card. This is a fairly cheap RAID enclosure which we acquired through a vendor with no particular need at the time, so for proper HD editing a proper RAID like the ones advertised on this page would probably be better in the long run. 

Again, capture and playback of the m-jpeg codec works smoothly. 

Blackmagic also has 8 bit (4:2:2) and 10 bit (4:4:4) uncompressed HD settings. On the RAID, I could capture the 8 bit variety with no lost frames, however it only plays back a second or two without freezing. On the external SATA solo drive I could only capture a second or two before frames were dropped, but this is to be expected.

Indeed, to do uncompressed HD one would need a RAID controller card, and RAID level 1 formatted drives, with 2,4 or more drives in the RAID. 

Still, the fact that this $400 card can capture compressed HDV and convert it on the fly to uncompressed 1920x1080 HD is pretty impressive. 

Granted, if you are dealing with uncompressed HD, and have invested in large RAID storage systems, you possible are not shooting HDV, but rather XDCAM or DVCPRO HD, or film or Viper etc. Although using any intermediary codec rather than HDV seems like the right move. 

Conclusions, Part 1 

So do I even need the RAID if the m-jpeg codec plays ok off the external SATA drive? Perhaps not - Blackmagic Design says so (they promote firewire 800 drive usage for non-uncompressed HD editing).

So by this point, I convinced myself that cool as it would be to work in HD for this upcoming project, there are too many variables to work efficiently, especially without a deliberate monetary investment to that end. 


The next part of my experiment had to do with getting the edited video back out of the machine, in the various formats we would need: 

Standard Def DVD - you can export to MPEG-2 from the HD project, and get an anamorphic video, which will be correctly formatted by a home DVD player. I have done this with a 16:9 SD project recently.

H.264 720p - This is the standard for web-based HD video, played using Flash 9+ and Quicktime. This export works as expected.

H.264 for those keeping score at home is the same codec used in Blu-Ray, HD-DVD and satellite HD broadcasting, not to mention AVCHD cameras.

Standard Def DV - you can export to either a Blackmagic flavor of DV, or standard Microsoft DV-AVI - either version works.

HDV tape - this one puzzled me up until now, as there is no documentation from Blackmagic or on most user forums about how you get your HD project back to an HDV tape master.  It is actually simple, you make a new HDV native project in Premiere and import the Blackmagic m-jpeg project into the HDV project, open the sequence, and export to tape. Premiere renders out to HDV, activates the deck and lays the program off to tape. There is not a export to HDV function within a Blackmagic HD project. Come to think of it, I don't think there is an export to HDV file function within an HDV native project.

I also tried exporting from the m-jpeg project to a Blackmagic HD 4:2:2 formatted file. The file does not of course play smoothly within premiere, but within windows media player it is a bit better. 

Incidentally, as mentioned above, playing back m-jpeg video within Premiere looks jaggy on the computer monitor, but via windows media player it looks slightly better.

No Audio - a minor inconvenience ;) 

In all of the above proceedings, I could not capture AUDIO via HDMI - which is another reason to stay away from this method of production for the time being, until this can be resolved. Others have had a similar problem. I could try capturing audio via analog and see if that works - another day.

Speaking of Analog...

Another interesting feature of the intensity is the analog inputs and outputs. In addition to the HDMI for capture and monitoring, you can capture SD component and composite or S-Video. 

During HDMI capture from my HDV video deck, I could simultaneously monitor a letterboxed SD signal via the component inputs of the video monitor. 

Also, when laying back my HDV project to HDV tape, I got SD monitoring on the video monitor. 

However, you are supposed to be able to play back the m-jpeg codec within premiere, and simultaneously get component SD video from the timeline. I could not get this to work. If this gets working, it could stand-in for true HD monitoring, and make the Intensity useful in the meantime (assuming the audio bug is resolved of course.)

You can also capture standard definition video via component and work with the m-jpeg and uncompressed standard def blackmagic settings. I did not test the storage bandwidth for SD capture, it would of course be lower than the HD capture. A reason to work uncompressed SD is to avoid DV recompression, especially when doing effects, chroma keying or color correction. Even if you start with DV or DVCAM, presumably capturing as uncompressed for editing has benefits, hence the previously touted Media 100 noncompressed system among other circa 2003 editing systems. Again, you would have to render back to DV to lay off to DV or DVCAM tape. You could also work with Betacam material this way, which is still quite commonly used in the world. 


An alternative workflow, and supposedly more efficient, is to use the Cineform Aspect intermediary codec. This can still capture using HDMI, but it converts on the fly to the Cineform codec, which is compressed but very efficient for editing. They too have a 8 bit 4:2:2 and a 10 bit 4:4:4 version, with a $500 price difference. The 10 bit will do 1920x1080, whereas the 8 bit is limited to HDV, DVCPRO and XDCAM format of 1440 x 1080. 

Cineform will let you render your final edit to an HDV m2t video file, for easy export back to HDV tape. Kudos to Cineform for keeping this part of the workflow in mind.

Cineform's other benefits include built in support for P2, XDCAM EX and RED ONE formats.

Going Native (oh, like no one has used that headline before...)

Up until now I have of course edited DV and HDV natively, with no serious problems. Premiere CS 3 has built-in settings for P2 DVCPRO HD, and there are plug-ins to handle XDCAM HD and EX and presumably other formats, such as the elusive Fisher Price video camera. But these formats are not on my radar yet. 

Thanks for reading, the learning never stops!


Posted by: Mike Cohen on May 21, 2008 at 11:42:57 amComments (1) hdv, blackmagic design, aja, hdmi

The Long Awaited Fun with HD Part 2

In our last episode, we experimented with some HDV footage, converted into various formats including WMV HD, P2 and H.264, all with favorable results. The main point of this exercise, in advance of proposing any HD or HDV projects, was to educate myself about the various flavors of HD and HDV, within the confines and limitations of my current setup and gear.

The next day I received a sample WMV HD file from my client. I assume the file was made by a previous production group, however given the range of oddly conceived medical video devices, it could have been the original format, but this is not likely.

I actually found I could import the WMV HD file into Sorenson Squeeze and output just about anything else. The goal in this exercise was standard def FLV. This worked fine and various bit rates produced expected results.

The next test will be to play H.264/MPEG-4 via the latest Flash Player.

Interesting, aside from the Adobe site, Hulu and a few obscure personal blog type sites, there is not a lot of Flash HD content on the internets, leading me to believe worldwide adoption will be slower than the usual Flash update. Bandwidth and computer power among the masses could be the impetus for a slow vs fast rollout and adoption of HD Flash.

But HD Flash is an exciting development, especially since the reigning champ of online HD, Quicktime, is still not in wide use, at least among my clients. This is a shame, but that's life. We actually had one customer tell us they could not download the podcasts which are part of the online service they subscribe to, because their hospital's IT department does not allow the use of Quicktime.

Incidentally, check out - you can watch old tv shows, some new tv shows, clips of late night shows and selected movies (mostly starring Patrick Swayze and the Rock) for free. I can now get my nightly fix of all time favorite show EMERGENCY!


Posted by: Mike Cohen on Mar 21, 2008 at 3:40:55 pm hdv

Fun with HD - Part I

My first use of HDV was last year. I shot a friend's wedding with a rented V1U in SD, but then shot some HDV footage to see what it looks like.

On my 19" home CRT computer monitor, it was not too impressive and the YouTube version did little for me except attract YouTube hits:

 Next came Oct 2007 when I was asked to rent a HD projector to show some XDCAM recorded surgery in an auditorium. This was surprisingly easy and the results seemed to have more to do with the camera used than anything else.

This week I was asked if I could convert WMV HD files to web video, presumably Flash.

Aside from Microsoft, I have not seen anyone else use WMV HD. COme to think of it, I once purchased the special edition of Terminator 2, which included a WMV HD disc. However due to some odd DRM efforts by Microsoft, I have never gotten it to play, and you cannot view the video outside of the outdated Microsoft player app.

I have read of some COW members giving clients WMV HD files in lieu of a Blu-Ray or HD-DVD disc.

Using a minute of test footage shot with our V1U, I captured it into Premiere CS3 using the HDV 1080i60 project setting. This, of course, saves an MPG file.

Playback at 100% just about fills one of my 2 22" LCD computer monitors, and playback is almost smooth off a USB connected SATA drive. I do have a SATA card in this computer, so I will test playback with the drive actually connected via SATA.

Ok, so with my HDV footage (1440x1080 for those keeping score at home) I exported a segment as a DV-AVI file, which comes out letterboxed in a standard 4:3 AVI file.

Next I exported the same HDV segment to WMV HD. The preset WMV HD settings in CS3 are 1080 24, 1080 25 and 1080 something else, another version of 24, perhaps 1080p.

Not sure how this would affect the original 1080i60 material, I changed the WMV setting to 1080i30.

So now I have a WMV HD file to play with. I imported that into Premiere and exported it from the HDV 1080 project as DV-AVI, letterboxed. The end result is very aliased and unusable, even as web video.

So I made a new project, SD-AVI settings, imported the WMV HD file, resized the clip to be letterboxed within the SD frame, and exported this as DV-AVI. The results are like night and day - very smooth playback with no jaggies.

It seems there are so many variables with this workflow, some trial and error is to be expected, as there was back in 1999 when we were doing lots of Sorenson 3 encoding!

As a final experiment, I opened my HDV project, and exported my segment of original HDV to P2 DVCPRO 1080i (1220x1080?), and imported this MXF file into Premiere. Playback of the MXF file is actually smoother than the HDV original within the HDV project. Likewise, in a P2 1080 project, the P2 MXF made from the HDV plays better than the HDV file in the P2 project.

Converting HDV to P2 DVCPRO HD appears to be similar to capturing HDV directly to ProRes or AIC as is possible on the Mac. On the PC however one can only capture HDV to HDV without a card. Perhaps a better analogy is converting HDV to Cineform.

All this being said, I have an Intensity card which I have not installed yet. This card will capture HDV straight to one of several Blackmagic codecs. Presumably one would then export an edit back to HDV to go back to HDV tape, or export to SD-DV to go to SD DV tape, or likewise export to DVCPRO if one needed to make a broadcast master.

The Intensity will play out in real time via Component and HDMI. My HDV deck has component inputs, but I do not know if this accepts HD component and converts on the fly back to HDV during recording, or if these component inputs are SD. The manual is nonspecific. Likewise, the HDMI port on the deck appears to be output only.

So many mysteries awaiting answers in the forthcoming post: Fun with HD: Part II. Date and time to be determined. 

Posted by: Mike Cohen on Mar 6, 2008 at 5:21:19 pm hdv, blackmagic design

I have a passion for my job, which entails training for medical professionals such as surgeons, nurses and administrators, not to mention various industries.

Technology is great, but how you apply your skills is what pays the bills.

Years ago I canceled my Media 100 support contract upon discovering what a treasure trove of helpful advice can be found on the Creative COW website. I am proud to be a part of this fantastic community.

In my blog I talk a little about media production, a lot about travel and workflow, and occasionally about cooking, nature and my four-legged friends.

Follow me on Twitter: med_ed_mike

I'm also on LinkedIn if you can't get enough of me!


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