Image and Vision Computing 23 (2005) 19

www.elsevier.com/locate/imavis

Localization of acupoints on a head based on a 3D virtual body

Lei Zhenga, Binjie Qina, Tiange Zhuanga,*, Ulf Tiedeb, Karl Heinz Hohneb
b

a
Department of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
Institute of Medical Informatics (IMI), University Hospital Hamburg-Eppendorf, Hamburg, Germany

Received 11 February 2004; received in revised form 15 March 2004; accepted 31 March 2004

Abstract
Modern computer science allows powerful and versatile computer-based knowledge representations of acupuncture, one part of
Traditional Chinese Medicine. For further research and development of acupuncture therapy, it is critical to define where to accurately
localize acupoints onto such a computer based pictorial representation of the human body. Using the segmentation and 3D visualization of
the VOXEL-MAN software system, original work for localizing the acupoints on a head based of a virtual body is reported in this paper.
The proposed 2D acupoint description links the description taken from literature for locating acupoints in Traditional Chinese Medicine to
the data in the absolute reference frame of a 3D virtual body. It offers a simple and useful way for the localization of acupoints on a 3D model,
especially one derived from the data from Visible Human Project.
q 2004 Elsevier B.V. All rights reserved.
Keywords: Traditional Chinese Medicine; Acupuncture and moxibustion; Localization of acupoints; Three-dimensional body model; Visible Human Project;
VOXEL-MAN

1. Introduction
The science of acupuncture and moxibustion is an
important part of Traditional Chinese Medicine Chinese
people have accepted it for thousands of years, because of
its magic curative effect, simple operation, low cost, and
few side effects. Now, use of the science of acupuncture and
moxibustion has even spread all over the world.
Acupuncture therapy heavily depends upon the precise
placement of the acupuncture needle at the proper point
on the body surface. Some of them are vital. Such points
are defined within the context of blood vessels and
nerves. Positioning errors in acupuncture treatment can
cause medical accidents. Therefore the accurate localization of acupoints is a key issue in the acupuncture
research.
In traditional medicine, knowledge on acupuncture is
described in books and atlases, such as the anatomical charts
of acupuncture and moxibustion. However, modern computer science, especially computerized three-dimensional
models [1,2], allows new, more standardized and reproducible computer-based representations of the human body.
* Corresponding author.
E-mail address: tgzhuang@sjtu.edu.cn (T.G. Zhuang).
0262-8856/$ - see front matter q 2004 Elsevier B.V. All rights reserved.
doi:10.1016/j.imavis.2004.03.005

We expect that the use of such models will not only

decisively advance learning and teaching acupuncture, but
also substantially contribute to the research concerning
Traditional Chinese Medicine (TCM) theory.
One of these models is the VOXEL-MAN [3] system,
which consists of a voxel based spatial model of the human
body linked to a semantic network containing the descriptive information. One of the prerequisites, however, for
making use of this model for acupuncture, we need to
transfer the classical qualitative description of the acupoints
into the computer-based model. With the example of the
human head we therefore propose in this paper algorithms
for transferring the localizations of the acupoints of the
human head from classical atlases and books to the
computer based model.

2. Pre-processing
Spatial knowledge representation in medical imaging
and computer graphics is totally different from what is used
in the literature for locating acupoints in TCM. The first uses
an absolute reference frame, which has almost no relation to
the image content, while the latter employs a relative
reference frame relative to constituents of the body.

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

Furthermore, computer based volume models are

discretized in voxels. In current research, a voxel of the
VOXEL-MAN is e.g. 1.08 mm in each dimension [3].
However, the basic unit for a relative reference frame used
by traditional acupoint localization is usually defined by
Bone Proportional Measurement [4] between landmarks
on the human body. It makes the acupoint position suitable
for everybody, no matter whether the boy is thin or fat or tall
or short.
To locate acupoints on a 3D human body model
accurately, we design a temporary reference frame (TRF)
to relate the absolute reference frame (ARF) of 3D medical
images to the relative reference frame (RRF) used in
traditional acupoint localization methods.
2.1. General definition
On a body or body image, we define the axis x of TRF as
the orientation from right to left, the axis y from anterior to
posterior and the axis z from inferior to superior Especially,
in this paper, we set the origin of TRF on the midpoint
between the two eyebrows, as shown in Fig. 1.

The central i; j; k-moment of P

the three dimensional
digital image is defined as mijk x;y;z x 2 gx i y 2 gy j
z 2 gz k f x; y; z: So the principal axes of the image can be
defined as the eigenvectors of the matrix
2
3
m020 m002
2m110
2m101
6
7
I6
m200 m002
2m011 7
4 2m110
5:
2m101

2m011

m200 m020

To a symmetry 3D image, the centroid is on the median

longitudinal plane, while one of the principal axes of the image
is parallel to the normal direction of the median longitudinal
plane, as shown in Fig. 2.
Given the centroid gx ; gy ; gz and the normal direction
px ; py ; pz T ; the parameters of the median longitudinal plane
equation ax by cz 1 are:
2 3
2 3
px
a
6 7
6 7
1
6p 7
6b7
1
4 5
px gx py gy pz gx 4 y 5
c
pz
Now, the resulted median longitudinal plane is considered
to be the plane yz of TRF.

2.2. Plane yz

2.3. Axis z and plane xz

One property of a human body is its left-right symmetry,

which is also expressed on the human body image. A method
based on the use of moments could help us to find the
median longitudinal plane [5].
The i; P
j; k-moment of a three-dimensional digital image
is mijk x;y;z xi yj zk f x; y; z; where f x; y; z is the grey
value function of the image. So the centroid gx ; gy ; gz
is given by the first-order moments, that is gx ; gy ; gz
m100 =m000 ; m010 =m000 ; m001 =m000 :

In order to define the axis z and the plane xz of TRF, we

proceed with the following steps:
With the midpoint between the two eyebrows (point A)
and the corners of mouth (point B and C), the plane ABC
could be determined
The intersecting line between the plane ABC and
the plane yz defined above is considered as the axis z
of TRF.

Fig. 1. Definition of TRF (1). Left: the position of the origin on a 3D virtual body. Right: the direction of the axes with the same view angle as the left.

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

Fig. 2. The symmetry property of a virtual head. Left: a symmetry slice of the head. Right: the principal axes of the virtual head, while P1 is considered to point
out the normal direction of the median longitudinal section.

The plane through the axis z; which is perpendicular to

the plane yz; is determined as the plane xz; as shown in
Fig. 3.
Given point AxA ; yA ; zA ; point BxB ; yB ; zB ; point
CxC ; yC ; zC and the median longitudinal plane, the plane
yzayz x byz y cyz z 1; then the intersecting point of
the line BC and the plane yz; point A0 xA0 ; yA0 ; zA0 ; satisfies
the following simultaneous equations

xA0 2 xB
z 0 2 zB
A
xC 2 xB
zC 2 zB

2c

From Eqs. (2a) (2c), the coordinate vector is

2

xA0

6 7 6
6 yA0 7 6 yC 2yB xB 2xC
4 5 4
zA 0

zC 2zB

0
xB 2xC

321 2

7 6
7
7 6 xB yC 2xC yB 7:
5 4
5
xB zC 2xC zB

ayz xA0 byz yA0 cyz zA0

2a

The axis z coinciding with the line A0 A could be expressed as

the equation:

xA0 2 xB
y 0 2 yB
A
xC 2 xB
yC 2 yB

2b

x2xA
y2yA
z2zA

:
xA0 2xA yA0 2yA zA0 2zA

Fig. 3. Definition of TRF (2). Left: the position of the reference points (point A; B and C). Right: the relationship of the points, axes and planes. Note: point B
and C are not always on the plane xz:

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

The plane xz; in which point A and point A0 are located,

could be described as axz xbxz ycxz z 1: The parameters axz ;bxz and cxz here satisfy the following simultaneous equations:
axz ayz bxz byz cxz cyz 0

3a

axz xA0 bxz yA0 cxz zA0 1

3b

axz xA bxz yA cxz zA 0

3c

Thus we get
2

axz

6 7 6
6 bxz 7 6 xA0 yA0
4 5 4
cxz

321 2 3
0
7 6 7
6 7
zA0 7
5 4 1 5:

ayz byz cyz

2.4. Reference frame transformation

ayz ; byz ; cyz

ux1 ; ux2 ; ux3 q :
a2yz b2yz c2yz
The direction of y is calculated by the vector product of
u0z and u0x ; as uy uy1 ; uy2 ; uy3 uz ux : Based on these
three vectors, we can form the coordinate rotation matrix
from ARF to TRF [6], that is
ux1

6
6u
6 y1
R6
6
6 uz1
4
0

ux2

ux3

uy2

uy3

uz2

uz3

7
07
7
7
7
07
5
1

32

76
6
07
7 60
76
76
6
07
5 40
1
0

0
1
0
0

32 3
x
76 7
6
7
0 2yA 7 6 y 7
7
76 7
76 7
6 7
1 2zA 7
54z5
1
0
1
4c

0 2xA

3. Methods

!
The vector A0 A defines the direction of z of TRF, with
the
unit vector uz uz1 ; uz2 ; uz3
! corresponding
!
A0 A=lA0 Al: The direction of x could be determined by
the normal to the plane yz; and the corresponding unit
vector is ux

expressing the transformation

to the P0 x0 ; y0 ; z0 in TRF is

The complete coordinate transformation is then the

composite matrix RT; while the coordinate transformation
from TRF to ARF is RT21 :

x A y A zA

So the complete equation

from the Px; y; z in ARF
2 3
2 03
x
x
6 7
6 7
6y7
6 y0 7
6 7
6 7
6 7 RT6 7
6 7
6 07
6z7
6z 7
4 5
4 5
1
1
2
ux1 ux2 ux3
6
6u
6 y1 uy2 uy3
6
6
6 uz1 uz2 uz3
4
0
0
0

The traditional methods for acupoints localization are

based on the measurement along the surface of a body with
cun, a traditional Chinese measure which varies in length
for different parts of the body. In common parlance, it is said
that: An acupoint is located at a distance of some cun from
a certain landmark in particular direction. [4]. For
example, acupoint Quchai (BL 4) of the Bladder Meridian
of Foot-Taiyang is on the head, 0.5 cun within the hairline,
1.5 cun lateral to Shenting (DU 24), a point that is 0.5 cun
directly above the midpoint of the anterior hairline, as
shown in Fig. 4. The advantage of this kind of description is
that we can ignore the rugged and uneven feature of a
human body surface. The landmarks for localizing acupoints are obvious, relatively fixed and universal to
everybody, though there are some individual differences.
Similarly, for the reasons above, the reconstructed
surface from varied raw data would be totally different. If
using the 3D coordinates directly to express the position for

4a

The origin of TRF is AxA ; yA ; zA Then the coordinate

translation matrix from ARF to TRF is
2

6
60
6
T 6
6
60
4
0

0 0
1 0
0 1
0 0

2xA

7
2yA 7
7
7
7
2zA 7
5
1

4b
Fig. 4. Several Acupoint labels from TCM.

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

each acupoint, it is difficult to apply the experience from the

TCM methods and hard to resolve the individual/data
differences. To solve the problems mentioned here, a 2D
acupoint description system is taken.
3.1. 2D acupoint description
Given a definite viewing direction, all visible points on
body surface have one projection plane that is perpendicular
to this direction These visible points have corresponding
projection points in this plane, and each projection point
could be back-projected to the body surface to get the
corresponding 3D coordinate.
In current research, there are three projection planes on
head for the 2D acupoint description system, as shown in
Fig. 5.
Plane a is specially for locating the acupoints in the face.
It is a rectangle and covers the projection of the forehead,
the lower jaw and the outer canthi.
Plane b is corresponding to the acupoints on the tophead. It is part of a cylinder and covers the projection of
the forehead, the occiput and the temples.
Plane g is for localizing acupoints on the side of the head.
It looks like a disk and is the projection plane of the
surface around the ear.

For the acupoints in different regions, corresponding

localization models are employed to describe them in TRF
based on the knowledge from TCM. When you need to
display acupoints on virtual human body, each point could
be back-projected to the body surface to get its 3D
coordinates. From now on, for convenience, the acupoints
localization is within the framework of 2D coordinate
description.
3.2. Model of median longitudinal circle
Traditionally the vertical cun on the head is defined as
the surface distance from the anterior hairline to the
posterior hairline The right image of Fig. 6 shows the
definition of vertical cun in Bone Proportional Measurement, a commonly used method for locating acupoints.
Accordingly, the model of the median longitudinal circle is
given as follows.
Three points A; D and E; which are from the fixed
median longitudinal plane (plane yz), are taken to
determine the median longitudinal circle. As mentioned
above, point A is the midpoint between the two
eyebrows. Referring to Fig. 6, point D is the point at
the tip of the body in plane yz; which is easy to be
identified. It is a little bit complicated to get the third
point E; for neither tomograms nor 3D volume could

Fig. 5. 2D Acupoint description.

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

Fig. 6. Model of median longitudinal circle. Left: the reference points (point A; D and E) on median longitudinal circle. Right: definition of vertical cun
from TCM.

show the hairlines. Now we try to tackle the problem in

another way. Generally, there is a groove between the
lower lip and the chin in the face. Through this groove
there is a plane parallel to the plane xy: Then the
intersecting point between this plane and the median
longitudinal plane at back is defined as the point E: Point
E could be considered as the midpoint of posterior
hairline.
Suppose point A; D and E are on the median longitudinal
circle, the center of the circle, point Ox0 ; y0 ; z0 ; satisfies the
relation:
xi 2 x0 2 yi 2 y0 2 zi 2 z0 2 r 2 ;
5a
i A; D; E


 x 0 2 x A y 0 2 y A z0 2 zA 




 xD 2 xA yD 2 yA zD 2 zA  0
5b




x 2x
y 2y
z 2z 
E

where r is the radius of the median longitudinal circle.

Eq. (5a) indicates that the distances between O and the other
three points are equal. Eq. (5b) means point O is also on the
median longitudinal plane defined by point A; D and E:
Under the standards of Bone Proportional Measurement,
on the intersecting arc line between the head surface and the
median longitudinal plane, as Fig. 6 shows, the anterior
hairline is identified by a distance of 3 cun from the
midpoint of two eyebrows (point A), while point E is located
at a distance of 15 cunfrom point A: That means, we can
define the length of arc AOE as 15 cun on median
longitudinal circle.
Through the arc AOE; the cylinder that is perpendicular
to the plane yz of TRF is considered to be the projection
plane b: And 1/15 of arc AOE is taken as the vertical cun
standard on the head of a 3D human body model.

3.3. Model of face meshes

Under the standard of Bone Proportional Measurement, it
is 9 cun in horizontal between two corners of hairline As
hair cannot be displayed on a 3D medical image, we try to
find another way to determine the horizontal cun.
Let us look at some examples from the traditional
methods at first [4,7]. Referring to Fig. 4, Shenting (DU 24)
is 0.5 cun directly above the midpoint of anterior hairline.
Touwei (ST 8) is at the hairline of the forehead, 4.5 cun
lateral to Shenting (DU 24). And Toulinqi (GB 15) is 0.5
cun within the anterior hairline directly above the pupil, on
the midpoint of the line connecting Shenting (DU 24) and
Touwei (ST 8). From the description above, we can
conclude that the pupil (point F) is 2.25 cun lateral to the
median longitudinal plane. We determine horizontal cun in
the face based on this knowledge.
The coordinate plane xz is considered to be the projection
plane a: Dividing the horizontal length of line AF by 2.25 is
taken as the horizontal cun standard in the face. With the
horizontal cun standard for the face and the vertical cun
standard for the head, we get the model of face meshes on
the projection plane a; as shown in Fig. 7.
3.4. Model of bone projection
Usually the acupoints on the side-head are set using the
landmarks on the surface. Accordingly the model of bone
projection is applied to locate such acupoints, as shown in
Fig. 8.
3D medical volume of a human body not only shows the
surface of a body, but also contains its inner structures The
projection of some bone landmarks on plane yz could be tags
for localizing acupoints on 3D images. We define that

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

Fig. 7. Model of face meshes. Left: the position of the reference point F: Right: the coordinate meshes in the face of the 3D virtual body.

the position of mastoid process as point G; which is at a

distance of 3 cun from point A in the direction y [4,7].
The part of the plane yz; which is in the median
longitudinal circle, is considered to be the projection plane
g: And 1/3 of the length of line AG in direction y is the
horizontal cun standard on the side of the head of a 3D
human body model.

the hairline, 1.5 cun lateral to a point that is 0.5 cun

directly above the midpoint of the anterior hairline [4] So
it is on the top-head, with the coordinates 1.5 cun in
horizontal and 0.5 cun in vertical from the origin point A
on plane b; as:

Name

Number

4. Results

Vertical

1.5

0.5

With the knowledge of traditional methods for locating

acupoints, we get a standardized 2D description of
acupoints in TRF.

Quchai

4.1. Standardized 2D description

The 2D description of all the 63 acupoints on head

surface is listed in the appendix. The list is suitable to any
individual, if we can get enough information about point A
to point G mentioned above from the image data.

For example, in typical acupoint terminology, acupoint

Quchai (BL 4) is described as: on head, 0.5 cun within

BL 4

Location (cun)
Horizontal

Fig. 8. Model of bone projection. Left: the position of the reference point G: Right: the coordinate meshes on the side-head of the 3D virtual body.

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

Fig. 9. 3D description of Acupoints. Left: based on VOXEL-MAN: brain and skull. Right: based on VOXEL-MAN: visible human.

4.2. 3D expression
Finally, as shown in Fig. 9, after back-projection, a set
of acupoints on the head of the 3D virtual body are
clearly displayed. Especially, some work has been
done based on the data from Visible Human Project
(VHP) [2].

5. Discussion
Although acupuncture has a history of more than two
thousand years, up to now, there are only a few references
relating acupuncture to modern computer-based imaging.
The development of VHP and VOXEL-MAN give us the
opportunity to explore a new field like 3D medical imaging
integrated with acupuncture. This paper tries to offer a
simple and useful way to systemically localize acupoints on
the 3D virtual body.

There are a total of 63 acupoints on the surface of the

head. It is troublesome to localize them one by one on
the virtual body. Meanwhile, because of the limitation of the
visual angle of the 3D image, the lack of being able to touch
the virtual body, and the quality of the visualization, even an
expert has to take some time to accurately localize an
acupoint on an image. The method proposed in this paper
lets the operator point out seven obvious landmarks
manually, and then systemically present the localization of
all acupoints.
Originally the method proposed here has been developed using the data of VOXEL-MAN: Brain and Skull.
To check the validation of the procedure, more work has
been done using the data of VOXEL-MAN: Visible
Human. The result seems to be acceptable to the doctors
we asked.
Of course, the work expressed in this paper is just
the beginning in a new field. The coordinates of the
acupoints under the standardized 2D description listed in

Table A1
Position of Acupoints in the face (Plane a)
Name

Quanliao
Chengqi
Sibai
Juliao
Dicang
Kouheliao
Yingxiang
Chengjiang

Number

SI 18
ST 1
ST 2
ST 3
ST 4
LI 19
LI 20
RN 24

Location (cun)

Name

Horizontal

Vertical

3.5
2.25
2.25
2.25
2.25
0.75
1.1
0

2
1
1.5
2.3
3.3
2.5
2
4

Suliao
Shuigou
Duiduan
Jingming
Zanzhu
Sizhukong
Tongziliao

Number

DU 25
DU 26
DU 27
BL 1
BL 2
SJ 23
GB 1

Location (cun)
Horizontal

Vertical

0
0
0
0.75
0.75
4.5
4.5

1.8
2.5
3
0.8
0
0
1

L. Zheng et al. / Image and Vision Computing 23 (2005) 19

Table A2
Position of Acupoints on the top-head (Plane b)
Name

Number

Yamen
Fengfu
Naohu
Qiangjian
Houding
Baihui
Qianding
Xinhui
Shangxing
Shenting
Meichong
Quchai
Wuchu
Chengguang

DU 15
DU 16
DU 17
DU 18
DU 19
DU 20
DU 21
DU 22
DU 23
DU 24
BL 3
BL 4
BL 5
BL 6

Location (cun)

Name

Horizontal

Vertical

0
0
0
0
0
0
0
0
0
0
0.75
1.5
1.5
1.5

11.5
11
9.5
8
6.5
5
3.5
2
1
0.5
0.5
0.5
1
2.5

Tongtian
Luoque
Yuzhen
Tianzhu
Benshen
Yangbai
Toulinqi
Muchuang
Zhengying
Chengling
Naokong
Fengchi
Touwei

Number

Location (cun)
Horizontal

Vertical

BL 7
BL 8
BL 9
BL 10
GB 13
GB 14
GB 15
GB 16
GB 17
GB 18
GB 19
GB 20
ST 8

1.5
1.5
1.3
1.3
3
2.25
2.25
2.25
2.25
2.25
2.25
2.25
4.5

4
5.5
9.5
12
0.5
-2
0.5
1.5
2.5
4
9.5
11
0.5

Number

Location (cun)

Table A3
Position of Acupoints on the side-head (Plane g)
Name

Daying
Jiache
Xiaguan
Tinggong
Yifeng
Qimai
Luxi
Jiaosun
Ermen
Erheliao
Tinghui

Number

ST 5
ST 6
ST 7
SI 19
SJ 17
SJ 18
SJ 19
SJ 20
SJ 21
SJ 22
GB 2

Location (cun)

Name

Horizontal

Vertical

1.3
1.8
2
2.3
2.6
3.5
3.5
3.2
2.3
2.5
2.2

4.2
3.8
2.5
2.5
3.5
3
2
1.2
2.3
1.5
2.8

the appendix could be further adjusted, if they were applied

to more data.

Acknowledgements
We thank Martin Riemer and Andreas Pommert, IMI,
University Hospital Hamburg-Eppendorf, Germany,
for technical supporting of the VOXEL-MAN. We are
also grateful to Zhenguo Yan, who substantially provides the
knowledge of the Traditional Chinese Medicine.

Appendix A
Tables A1 A3

Shangguan
(Touwei)
Hanyan
Xuanlu
Xuanli
Qubin
Shuaigu
Tianchong
Fubai
Touqiaoyin
Wangu

GB 3
ST 8
GB 4
GB 5
GB 6
GB 7
GB 8
GB 9
GB 10
GB 11
GB 12

Horizontal

Vertical

2
2
2.1
2.2
2.3
2.5
3.2
3.7
4
4
3.5

1.8
-1
-0.5
0
0.5
1.2
-0.3
-0.3
1
2.3
3.5

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