Gunshot wound (GSW) penetration trauma affects thousands of patients and emergency centers every year. Many patients receive a radiology diagnosis that leads to successful, life-saving reconstructive surgery. Accurate mapping and identification of bullet trajectories is critical for identifying organ injury and guiding surgical decision-making. This thesis explores whether an interactive 3D case study could improve radiology residents’ understanding of penetration trauma and ballistic injuries by extending radiology education beyond traditional diagnostic interfaces and static case study presentations.

A patient CT dataset was segmented in 3D Slicer to sculpt high-resolution anatomical models aligned with the original imaging data. These models were integrated into an interactive educational prototype developed in Unity. A scalable, interactive module structure was developed using a step-based state recording and playback system to easily store information, such as model and CT slice visibility, opacity, camera position, and teaching content availability. This framework can support any DICOM dataset, models, and teaching content. Users navigate through the case using forward and backward controls, while the system recalls stored states and transitions between views. Visualization techniques commonly used in medical illustration, including layered transparency, labels with leader lines, and didactic color, were translated into the real-time rendering engine.

Chief radiology residents from Johns Hopkins and the University of Maryland participated in informal user-testing interviews. Feedback indicated that the 3D models were valuable for providing a global spatial overview of the bullet trajectory and the anatomical structures involved. All participants suggested that the module would be particularly useful for first-year radiology residents as an introductory teaching tool. Some participants noted that the teaching content emphasized ballistic or physiologic explanations of injury rather than the terminology typically used in radiologic diagnostic practice.

Overall, initial feedback suggests that the prototype has potential as an educational resource for teaching ballistic trauma. Future work will evaluate this interactive case study for the radiologic diagnosis of ballistics injuries in a formal IRB-approved study, addressing a current educational gap by integrating didactic 3D visualizations with imaging data.