Three-Dimensional Liver Surgery Simulation: Computer-Assisted Surgical Planning with Three-Dimensional Simulation Software and Three-Dimensional Printing^.

PubMed

Oshiro, Yukio; Ohkohchi, Nobuhiro

2017-06-01

To perform accurate hepatectomy without injury, it is necessary to understand the anatomical relationship among the branches of Glisson's sheath, hepatic veins, and tumor. In Japan, three-dimensional (3D) preoperative simulation for liver surgery is becoming increasingly common, and liver 3D modeling and 3D hepatectomy simulation by 3D analysis software for liver surgery have been covered by universal healthcare insurance since 2012. Herein, we review the history of virtual hepatectomy using computer-assisted surgery (CAS) and our research to date, and we discuss the future prospects of CAS. We have used the SYNAPSE VINCENT medical imaging system (Fujifilm Medical, Tokyo, Japan) for 3D visualization and virtual resection of the liver since 2010. We developed a novel fusion imaging technique combining 3D computed tomography (CT) with magnetic resonance imaging (MRI). The fusion image enables us to easily visualize anatomic relationships among the hepatic arteries, portal veins, bile duct, and tumor in the hepatic hilum. In 2013, we developed an original software, called Liversim, which enables real-time deformation of the liver using physical simulation, and a randomized control trial has recently been conducted to evaluate the use of Liversim and SYNAPSE VINCENT for preoperative simulation and planning. Furthermore, we developed a novel hollow 3D-printed liver model whose surface is covered with frames. This model is useful for safe liver resection, has better visibility, and the production cost is reduced to one-third of a previous model. Preoperative simulation and navigation with CAS in liver resection are expected to help planning and conducting a surgery and surgical education. Thus, a novel CAS system will contribute to not only the performance of reliable hepatectomy but also to surgical education.

Defining Ebstein's malformation using three-dimensional echocardiography.

PubMed

Vettukattil, Joseph J; Bharucha, Tara; Anderson, Robert H

2007-12-01

Ebstein's malformation is difficult to visualise, for both the echocardiographer and the surgeon. The essence of the problem in Ebstein's malformation is the deviation of the hingepoints of the leaflets towards the junctions of the inlet and apical trabecular parts of the right ventricle. Three-dimensional echocardiography offers new insights into the morphology and function of malformed valves, and allows elucidation of all the features. It allows clear visualisation of the valve leaflets, showing the precise morphology of the valve leaflets, the extent of their formation, the level of their attachment, and their degree of coaptation. Visualisation of the mechanism of regurgitation or stenosis is possible, as is more accurate quantification of the regurgitant jet or jets. Subchordal apparatus may be seen more clearly using three-dimensional echocardiography, and their functional anatomy understood. The multiplanar review modality allows examination of the three-dimensional data set even in patients with sub-optimal echocardiographic imaging. Previously, much of this information could only be well-understood at the time of surgery or post mortem, meaning that the majority of the specimens fully examined were at the poorly functioning end of the spectrum. This information is of use in furthering our understanding of this complex lesion as it functions in vivo, and demonstrating which anatomical pathology is significant in producing functional and physiological consequences. It is also of use for the clinician in selecting which patients are amenable to surgical intervention, for either single or biventricular repair, and for the surgeon in planning how to approach the operation. Correlation between three-dimensional echocardiographic findings and surgical findings has already been established, but the effect of this enhanced anatomical knowledge on surgical planning and surgical outcome requires further investigation.

Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning.

PubMed

Yuan, Peng; Mai, Huaming; Li, Jianfu; Ho, Dennis Chun-Yu; Lai, Yingying; Liu, Siting; Kim, Daeseung; Xiong, Zixiang; Alfi, David M; Teichgraeber, John F; Gateno, Jaime; Xia, James J

2017-12-01

There are many proven problems associated with traditional surgical planning methods for orthognathic surgery. To address these problems, we developed a computer-aided surgical simulation (CASS) system, the AnatomicAligner, to plan orthognathic surgery following our streamlined clinical protocol. The system includes six modules: image segmentation and three-dimensional (3D) reconstruction, registration and reorientation of models to neutral head posture, 3D cephalometric analysis, virtual osteotomy, surgical simulation, and surgical splint generation. The accuracy of the system was validated in a stepwise fashion: first to evaluate the accuracy of AnatomicAligner using 30 sets of patient data, then to evaluate the fitting of splints generated by AnatomicAligner using 10 sets of patient data. The industrial gold standard system, Mimics, was used as the reference. When comparing the results of segmentation, virtual osteotomy and transformation achieved with AnatomicAligner to the ones achieved with Mimics, the absolute deviation between the two systems was clinically insignificant. The average surface deviation between the two models after 3D model reconstruction in AnatomicAligner and Mimics was 0.3 mm with a standard deviation (SD) of 0.03 mm. All the average surface deviations between the two models after virtual osteotomy and transformations were smaller than 0.01 mm with a SD of 0.01 mm. In addition, the fitting of splints generated by AnatomicAligner was at least as good as the ones generated by Mimics. We successfully developed a CASS system, the AnatomicAligner, for planning orthognathic surgery following the streamlined planning protocol. The system has been proven accurate. AnatomicAligner will soon be available freely to the boarder clinical and research communities.

Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning

PubMed Central

Yuan, Peng; Mai, Huaming; Li, Jianfu; Ho, Dennis Chun-Yu; Lai, Yingying; Liu, Siting; Kim, Daeseung; Xiong, Zixiang; Alfi, David M.; Teichgraeber, John F.; Gateno, Jaime

2017-01-01

Purpose There are many proven problems associated with traditional surgical planning methods for orthognathic surgery. To address these problems, we developed a computer-aided surgical simulation (CASS) system, the AnatomicAligner, to plan orthognathic surgery following our streamlined clinical protocol. Methods The system includes six modules: image segmentation and three-dimensional (3D) reconstruction, registration and reorientation of models to neutral head posture, 3D cephalometric analysis, virtual osteotomy, surgical simulation, and surgical splint generation. The accuracy of the system was validated in a stepwise fashion: first to evaluate the accuracy of AnatomicAligner using 30 sets of patient data, then to evaluate the fitting of splints generated by AnatomicAligner using 10 sets of patient data. The industrial gold standard system, Mimics, was used as the reference. Result When comparing the results of segmentation, virtual osteotomy and transformation achieved with AnatomicAligner to the ones achieved with Mimics, the absolute deviation between the two systems was clinically insignificant. The average surface deviation between the two models after 3D model reconstruction in AnatomicAligner and Mimics was 0.3 mm with a standard deviation (SD) of 0.03 mm. All the average surface deviations between the two models after virtual osteotomy and transformations were smaller than 0.01 mm with a SD of 0.01 mm. In addition, the fitting of splints generated by AnatomicAligner was at least as good as the ones generated by Mimics. Conclusion We successfully developed a CASS system, the AnatomicAligner, for planning orthognathic surgery following the streamlined planning protocol. The system has been proven accurate. AnatomicAligner will soon be available freely to the boarder clinical and research communities. PMID:28432489

Study of impacts of different evaluation criteria on gamma pass rates in VMAT QA using MatriXX and EPID

NASA Astrophysics Data System (ADS)

Noufal, Manthala Padannayil; Abdullah, Kallikuzhiyil Kochunny; Niyas, Puzhakkal; Subha, Pallimanhayil Abdul Raheem

2017-12-01

Aim: This study evaluates the impacts of using different evaluation criteria on gamma pass rates in two commercially available QA methods employed for the verification of VMAT plans using different hypothetical planning target volumes (PTVs) and anatomical regions. Introduction: Volumetric modulated arc therapy (VMAT) is a widely accepted technique to deliver highly conformal treatment in a very efficient manner. As their level of complexity is high in comparison to intensity-modulated radiotherapy (IMRT), the implementation of stringent quality assurance (QA) before treatment delivery is of paramount importance. Material and Methods: Two sets of VMAT plans were generated using Eclipse planning systems, one with five different complex hypothetical three-dimensional PTVs and one including three anatomical regions. The verification of these plans was performed using a MatriXX ionization chamber array embedded inside a MultiCube phantom and a Varian EPID dosimetric system attached to a Clinac iX. The plans were evaluated based on the 3%/3 mm, 2%/2 mm, and 1%/1 mm global gamma criteria and with three low-dose threshold values (0%, 10%, and 20%). Results: The gamma pass rates were above 95% in all VMAT plans, when the 3%/3mm gamma criterion was used and no threshold was applied. In both systems, the pass rates decreased as the criteria become stricter. Higher pass rates were observed when no threshold was applied and they tended to decrease for 10% and 20% thresholds. Conclusion: The results confirm the suitability of the equipments used and the validity of the plans. The study also confirmed that the threshold settings greatly affect the gamma pass rates, especially for lower gamma criteria.

The female knee: anatomic variations.

PubMed

Conley, Sheryl; Rosenberg, Aaron; Crowninshield, Roy

2007-01-01

Traditional knee implants have been designed "down the middle,"based on the combined average size and shape of male and female knee anatomy.Sex-based research in the field of orthopaedics has led to new understanding of the anatomic differences between the sexes and the associated implications for women undergoing total knee arthroplasty. Through the use of a comprehensive bone morphology atlas that utilizes novel three-dimensional computed tomography analysis technology, significant anatomic differences have been documented in the shape and size of female knees compared with male knees. This research identifies three notable anatomic differences in the female population: a less prominent anterior condyle, an increased Q angle, and a reduced medial-lateral:anterior-posterior aspect ratio.

Transforming Clinical Imaging Data for Virtual Reality Learning Objects

ERIC Educational Resources Information Center

Trelease, Robert B.; Rosset, Antoine

2008-01-01

Advances in anatomical informatics, three-dimensional (3D) modeling, and virtual reality (VR) methods have made computer-based structural visualization a practical tool for education. In this article, the authors describe streamlined methods for producing VR "learning objects," standardized interactive software modules for anatomical sciences…

Explorable Three-Dimensional Digital Model of the Female Pelvis, Pelvic Contents, and Perineum for Anatomical Education

ERIC Educational Resources Information Center

Sergovich, Aimee; Johnson, Marjorie; Wilson, Timothy D.

2010-01-01

The anatomy of the pelvis is complex, multilayered, and its three-dimensional organization is conceptually difficult for students to grasp. The aim of this project was to create an explorable and projectable stereoscopic, three-dimensional (3D) model of the female pelvis and pelvic contents for anatomical education. The model was created using…

Multiple brain atlas database and atlas-based neuroimaging system.

PubMed

Nowinski, W L; Fang, A; Nguyen, B T; Raphel, J K; Jagannathan, L; Raghavan, R; Bryan, R N; Miller, G A

1997-01-01

For the purpose of developing multiple, complementary, fully labeled electronic brain atlases and an atlas-based neuroimaging system for analysis, quantification, and real-time manipulation of cerebral structures in two and three dimensions, we have digitized, enhanced, segmented, and labeled the following print brain atlases: Co-Planar Stereotaxic Atlas of the Human Brain by Talairach and Tournoux, Atlas for Stereotaxy of the Human Brain by Schaltenbrand and Wahren, Referentially Oriented Cerebral MRI Anatomy by Talairach and Tournoux, and Atlas of the Cerebral Sulci by Ono, Kubik, and Abernathey. Three-dimensional extensions of these atlases have been developed as well. All two- and three-dimensional atlases are mutually preregistered and may be interactively registered with an actual patient's data. An atlas-based neuroimaging system has been developed that provides support for reformatting, registration, visualization, navigation, image processing, and quantification of clinical data. The anatomical index contains about 1,000 structures and over 400 sulcal patterns. Several new applications of the brain atlas database also have been developed, supported by various technologies such as virtual reality, the Internet, and electronic publishing. Fusion of information from multiple atlases assists the user in comprehensively understanding brain structures and identifying and quantifying anatomical regions in clinical data. The multiple brain atlas database and atlas-based neuroimaging system have substantial potential impact in stereotactic neurosurgery and radiotherapy by assisting in visualization and real-time manipulation in three dimensions of anatomical structures, in quantitative neuroradiology by allowing interactive analysis of clinical data, in three-dimensional neuroeducation, and in brain function studies.

Mid-twentieth-century anatomical transparencies and the depiction of three-dimensional form.

PubMed

Wall, Shelley

2010-11-01

Before the advent of digital visualization, the "anatomical transparency"--layered images of organ systems, printed on a transparent medium--flourished in the mid-twentieth century as an interactive means to represent complex anatomical relationships to medical professionals and lay audiences. This article introduces the transparency work of medical illustrators Gladys McHugh and Ernest W. Beck, situating it in the historical context of strategies to represent three-dimensional anatomical relationships using print media.

Educational utility of advanced three-dimensional virtual imaging in evaluating the anatomical configuration of the frontal recess.

PubMed

Agbetoba, Abib; Luong, Amber; Siow, Jin Keat; Senior, Brent; Callejas, Claudio; Szczygielski, Kornel; Citardi, Martin J

2017-02-01

Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups. Each subject underwent learning of frontal recess anatomy with both traditional 2-dimensional (2D) learning methods using a standard Digital Imaging and Communications in Medicine (DICOM) viewing software (RadiAnt Dicom Viewer Version 1.9.16) and 3-dimensional (3D) learning utilizing a novel preoperative virtual planning software (Scopis Building Blocks), with one half learning with the 2D method first and the other half learning with the 3D method first. Four questionnaires that included a total of 20 items were scored for subjects' self-assessment on knowledge of frontal recess and frontal sinus drainage pathway anatomy following each learned modality. A 2-sample Wilcoxon rank-sum test was used in the statistical analysis comparing the 2 groups. Most trainees (89%) believed that the virtual 3D planning software significantly improved their understanding of the spatial orientation of the frontal sinus drainage pathway. Incorporation of virtual 3D planning surgical software may help augment trainees' understanding and spatial orientation of the frontal recess and sinus anatomy. The potential increase in trainee proficiency and comprehension theoretically may translate to improved surgical skill and patient outcomes and in reduced surgical time. © 2016 ARS-AAOA, LLC.

Model-based surgical planning and simulation of cranial base surgery.

PubMed

Abe, M; Tabuchi, K; Goto, M; Uchino, A

1998-11-01

Plastic skull models of seven individual patients were fabricated by stereolithography from three-dimensional data based on computed tomography bone images. Skull models were utilized for neurosurgical planning and simulation in the seven patients with cranial base lesions that were difficult to remove. Surgical approaches and areas of craniotomy were evaluated using the fabricated skull models. In preoperative simulations, hand-made models of the tumors, major vessels and nerves were placed in the skull models. Step-by-step simulation of surgical procedures was performed using actual surgical tools. The advantages of using skull models to plan and simulate cranial base surgery include a better understanding of anatomic relationships, preoperative evaluation of the proposed procedure, increased understanding by the patient and family, and improved educational experiences for residents and other medical staff. The disadvantages of using skull models include the time and cost of making the models. The skull models provide a more realistic tool that is easier to handle than computer-graphic images. Surgical simulation using models facilitates difficult cranial base surgery and may help reduce surgical complications.

[Research progress of three-dimensional digital model for repair and reconstruction of knee joint].

PubMed

Tong, Lu; Li, Yanlin; Hu, Meng

2013-01-01

To review recent advance in the application and research of three-dimensional digital knee model. The recent original articles about three-dimensional digital knee model were extensively reviewed and analyzed. The digital three-dimensional knee model can simulate the knee complex anatomical structure very well. Based on this, there are some developments of new software and techniques, and good clinical results are achieved. With the development of computer techniques and software, the knee repair and reconstruction procedure has been improved, the operation will be more simple and its accuracy will be further improved.

SU-F-T-499: Anatomic Features for Selection of Electronic Tissue Compensation Radiotherapy in Early-Stage Breast Cancer Patients After Breast-Conserving Surgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Song, Y; Gan, L; Chen, X

Purpose: To explore the correlations between anatomic features and dose-volumetric parameters in 3DCRT and eComp whole breast irradiation and identify the feasibility of anatomic parameters to predict the planning method selection. Methods: We compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and electronic tissue compensation (eComp) for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing dose to lung, heart, and skin. Statistical analyses were performed betweenmore » critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS). Results: Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. To keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. Conclusion: The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost. This study was supported by National Natural Science Foundation of China (NO. 31420103915) and Chongqing Health and Family Planning Commission Project (2015MSXM012).« less

Technical aspects of virtual liver resection planning.

PubMed

Glombitza, G; Lamadé, W; Demiris, A M; Göpfert, M R; Mayer, A; Bahner, M L; Meinzer, H P; Richter, G; Lehnert, T; Herfarth, C

1998-01-01

Operability of a liver tumor is depending on its three dimensional relation to the intrahepatic vascular trees which define autonomously functioning liver (sub-)segments. Precise operation planning is complicated by anatomic variability, distortion of the vascular trees by the tumor or preceding liver resections. Because of the missing possibility to track the deformation of the liver during the operation an integration of the resection planning system into an intra-operative navigation system is not feasible. So the main task of an operation planning system in this domain is a quantifiable patient selection by exact prediction of post-operative liver function and a quantifiable resection proposal. The system quantifies the organ structures and resection volumes by means of absolute and relative values. It defines resection planes depending on security margins and the vascular trees and presents the data in visualized form as a 3D movie. The new 3D operation planning system offers quantifiable liver resection proposals based on individualized liver anatomy. The results are visualized in digital movies as well as in quantitative reports.

Cardiac 3D Printing and its Future Directions.

PubMed

Vukicevic, Marija; Mosadegh, Bobak; Min, James K; Little, Stephen H

2017-02-01

Three-dimensional (3D) printing is at the crossroads of printer and materials engineering, noninvasive diagnostic imaging, computer-aided design, and structural heart intervention. Cardiovascular applications of this technology development include the use of patient-specific 3D models for medical teaching, exploration of valve and vessel function, surgical and catheter-based procedural planning, and early work in designing and refining the latest innovations in percutaneous structural devices. In this review, we discuss the methods and materials being used for 3D printing today. We discuss the basic principles of clinical image segmentation, including coregistration of multiple imaging datasets to create an anatomic model of interest. With applications in congenital heart disease, coronary artery disease, and surgical and catheter-based structural disease, 3D printing is a new tool that is challenging how we image, plan, and carry out cardiovascular interventions. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

A Proposed Maneuver to Guide Transseptal Puncture Using Real-Time Three-Dimensional Transesophageal Echocardiography: Pilot Study.

PubMed

Mahmoud, Hani M; Al-Ghamdi, Mohammed A; Ghabashi, Abdullah E; Anwar, Ashraf M

2015-01-01

Aim of Study. To assess the feasibility of a new proposed maneuver "RATLe-90" using real-time three-dimensional transesophageal echocardiography (RT-3DTEE) for anatomically oriented visualization of the interatrial septum (IAS) in guiding the transseptal puncture TSP. Methods. The study included 20 patients (mean age, 60.2 ± 6.7 years; 60% males) who underwent TSP for different indications. RT-3DTEE was used to guide TSP. The proposed maneuver RATLe-90 (Rotate-Anticlockwise-Tilt-Left-90) was applied in all cases to have the anatomically oriented en face view of the IAS from the right atrial (RA) aspect. Having this anatomically oriented view, we guided the TSP catheter towards the proper puncture site according to the planned procedure. Results. Using the RATLe-90 maneuver, the anatomically oriented en face view of the IAS from the RA was obtained in all patients. We were able to guide the puncture catheter to the proper puncture site on the IAS. The 3D images obtained were clearly understood by both echocardiographers and interventionists. The RATLe-90 maneuver acquisition time was 19.9 ± 1.6 seconds. The time-to-tent was 64.8 ± 16.3 seconds. Less TEE probe manipulations were needed while guiding the TSP. Conclusions. Application of RT3D-TEE during TSP using RATLe-90 maneuver is feasible with shorter fluoroscopy time and minimizing TEE probe manipulations.

The assessment of virtual reality for human anatomy instruction

NASA Technical Reports Server (NTRS)

Benn, Karen P.

1994-01-01

This research project seeks to meet the objective of science training by developing, assessing, and validating virtual reality as a human anatomy training medium. In ideal situations, anatomic models, computer-based instruction, and cadaver dissection are utilized to augment the traditional methods of instruction. At many institutions, lack of financial resources limits anatomy instruction to textbooks and lectures. However, human anatomy is three dimensional, unlike the one dimensional depiction found in textbooks and the two dimensional depiction found on the computer. Virtual reality is a breakthrough technology that allows one to step through the computer screen into a three dimensional world. This technology offers many opportunities to enhance science education. Therefore, a virtual testing environment of the abdominopelvic region of a human cadaver was created to study the placement of body parts within the nine anatomical divisions of the abdominopelvic region and the four abdominal quadrants.

Definition of the supraclavicular and infraclavicular nodes: implications for three-dimensional CT-based conformal radiation therapy.

PubMed

Madu, C N; Quint, D J; Normolle, D P; Marsh, R B; Wang, E Y; Pierce, L J

2001-11-01

To delineate with computed tomography (CT) the anatomic regions containing the supraclavicular (SCV) and infraclavicular (IFV) nodal groups, to define the course of the brachial plexus, to estimate the actual radiation dose received by these regions in a series of patients treated in the traditional manner, and to compare these doses to those received with an optimized dosimetric technique. Twenty patients underwent contrast material-enhanced CT for the purpose of radiation therapy planning. CT scans were used to study the location of the SCV and IFV nodal regions by using outlining of readily identifiable anatomic structures that define the nodal groups. The brachial plexus was also outlined by using similar methods. Radiation therapy doses to the SCV and IFV were then estimated by using traditional dose calculations and optimized planning. A repeated measures analysis of covariance was used to compare the SCV and IFV depths and to compare the doses achieved with the traditional and optimized methods. Coverage by the 90% isodose surface was significantly decreased with traditional planning versus conformal planning as the depth to the SCV nodes increased (P < .001). Significantly decreased coverage by using the 90% isodose surface was demonstrated for traditional planning versus conformal planning with increasing IFV depth (P = .015). A linear correlation was found between brachial plexus depth and SCV depth up to 7 cm. Conformal optimized planning provided improved dosimetric coverage compared with standard techniques.

SU-F-I-50: Finite Element-Based Deformable Image Registration of Lung and Heart

DOE Office of Scientific and Technical Information (OSTI.GOV)

Penjweini, R; Kim, M; Zhu, T

Purpose: Photodynamic therapy (PDT) is used after surgical resection to treat the microscopic disease for malignant pleural mesothelioma and to increase survival rates. Although accurate light delivery is imperative to PDT efficacy, the deformation of the pleural volume during the surgery impacts the delivered light dose. To facilitate treatment planning, we use a finite-element-based (FEM) deformable image registration to quantify the anatomical variation of lung and heart volumes between CT pre-(or post-) surgery and surface contours obtained during PDT using an infrared camera-based navigation system (NDI). Methods: NDI is used during PDT to obtain the information of the cumulative lightmore » fluence on every cavity surface point that is being treated. A wand, comprised of a modified endotrachial tube filled with Intralipid and an optical fiber inside the tube, is used to deliver the light during PDT. The position of the treatment is tracked using an attachment with nine reflective passive markers that are seen by the NDI system. Then, the position points are plotted as three-dimensional volume of the pleural cavity using Matlab and Meshlab. A series of computed tomography (CT) scans of the lungs and heart, in the same patient, are also acquired before and after the surgery. The NDI and CT contours are imported into COMSOL Multiphysics, where the FEM-based deformable image registration is obtained. The NDI and CT contours acquired during and post-PDT are considered as the reference, and the Pre-PDT CT contours are used as the target, which will be deformed. Results: Anatomical variation of the lung and heart volumes, taken at different times from different imaging devices, was determined by using our model. The resulting three-dimensional deformation map along x, y and z-axes was obtained. Conclusion: Our model fuses images acquired by different modalities and provides insights into the variation in anatomical structures over time.« less

Variations of the superficial middle cerebral vein: classification using three-dimensional CT angiography.

PubMed

Suzuki, Y; Matsumoto, K

2000-05-01

Classification of variations of the superficial middle cerebral vein (SMCV) remains ambiguous. We propose a new classification system based on embryologic development for preoperative examination. Three-dimensional CT angiography was used to evaluate 500 SMCVs (in 250 patients). The outflow vessels from the SMCV were classified into seven types on the basis of embryologic development. The 3D CT angiograms in axial stereoscopic and oblique views and multiple intensity projection images were evaluated by the same neurosurgeon on two occasions. Inconsistent interpretations were regarded as equivocal. Three-dimensional CT angiography clearly depicted the SMCV running along the lesser wing or the middle cranial fossa. However, the outflow vessel could not be confirmed as the sphenoparietal, cavernous, or emissary type in 39 (8%) of the sides. SMCVs running in the middle cranial fossa to join the transverse sinus or superior petrosal sinus were accurately identified. SMCVs were present in 456 sides: 62% entered the sphenoparietal sinus or the cavernous sinus and 12% joined the emissary vein. Nine vessels were the superior petrosal type, 10 the basal type, 12 the squamosal type, and 44 the undeveloped type. Three-dimensional CT angiography can depict the vessels and their anatomic relationship to the bone structure, allowing identification of the SMCV variant in individual patients. Preoperative planning for skull base surgery requires such information to reduce the invasiveness of the procedure. With the use of our classification system, 3D CT angiography can provide exact and practical information concerning the SMCV.

The 360 photography: a new anatomical insight of the sphenoid bone. Interest for anatomy teaching and skull base surgery.

PubMed

Jacquesson, Timothée; Mertens, Patrick; Berhouma, Moncef; Jouanneau, Emmanuel; Simon, Emile

2017-01-01

Skull base architecture is tough to understand because of its 3D complex shape and its numerous foramen, reliefs or joints. It is especially true for the sphenoid bone whom central location hinged with most of skull base components is unique. Recently, technological progress has led to develop new pedagogical tools. This way, we bought a new real-time three-dimensional insight of the sphenoid bone that could be useful for the teacher, the student and the surgeon. High-definition photography was taken all around an isolated dry skull base bone prepared with Beauchêne's technique. Pictures were then computed to provide an overview with rotation and magnification on demand. From anterior, posterior, lateral or oblique views and from in out looks, anatomical landmarks and subtleties were described step by step. Thus, the sella turcica, the optic canal, the superior orbital fissure, the sphenoid sinus, the vidian canal, pterygoid plates and all foramen were clearly placed relative to the others at each face of the sphenoid bone. In addition to be the first report of the 360 Photography tool, perspectives are promising as the development of a real-time interactive tridimensional space featuring the sphenoid bone. It allows to turn around the sphenoid bone and to better understand its own special shape, numerous foramen, neurovascular contents and anatomical relationships. This new technological tool may further apply for surgical planning and mostly for strengthening a basic anatomical knowledge firstly introduced.

A three-dimensional digital atlas of the dura mater based on human head MRI.

PubMed

Yang, Zhirong; Guo, Zhilin

2015-03-30

The goal of this paper was to design a three-dimensional (3D) digital dural atlas of the human brain for assisting neurosurgeons during the planning of an operation, medical research and teaching activities in neurosurgical anatomy. The 176 sagittal head magnetic resonance(MR) images of a 54-year-old female who suffered from the left posterior fossa tumor were processed and outlined, based on which a 3D dural model was created using the softwares of 3ds-max and Mimics. Then the model and images/anatomy photos were matched using the softwares of Z-brush and Photoshop to form the 3-D dural atlas. Dural anatomic photographs were needed to produce the 3D atlas in dural vault and skull base areas. The 3D dural atlas of the brain and related structures was successfully constructed using 73 dural delineations, the contours of dural model match very well on the dural structures of the original images in three orthogonal (axial, coronal and sagittal view) MR cross-sections. The atlas can be arbitrarily rotated and viewed from any direction. It can also be zoomed in and out directly using the zoom function. We successfully generated a 3D dural atlas of human brain, which can be used for repeated observation and research without limitations of time and shortage of corpses. In addition, the atlas has many potential applications in operative planning, surgical training, teaching activities, and so on. Copyright © 2014 Elsevier B.V. All rights reserved.

Percutaneous Transcatheter Mitral Valve Replacement: Patient-specific Three-dimensional Computer-based Heart Model and Prototyping.

PubMed

Vaquerizo, Beatriz; Theriault-Lauzier, Pascal; Piazza, Nicolo

2015-12-01

Mitral regurgitation is the most prevalent valvular heart disease worldwide. Despite the widespread availability of curative surgical intervention, a considerable proportion of patients with severe mitral regurgitation are not referred for treatment, largely due to the presence of left ventricular dysfunction, advanced age, and comorbid illnesses. Transcatheter mitral valve replacement is a promising therapeutic alternative to traditional surgical valve replacement. The complex anatomical and pathophysiological nature of the mitral valvular complex, however, presents significant challenges to the successful design and implementation of novel transcatheter mitral replacement devices. Patient-specific 3-dimensional computer-based models enable accurate assessment of the mitral valve anatomy and preprocedural simulations for transcatheter therapies. Such information may help refine the design features of novel transcatheter mitral devices and enhance procedural planning. Herein, we describe a novel medical image-based processing tool that facilitates accurate, noninvasive assessment of the mitral valvular complex, by creating precise three-dimensional heart models. The 3-dimensional computer reconstructions are then converted to a physical model using 3-dimensional printing technology, thereby enabling patient-specific assessment of the interaction between device and patient. It may provide new opportunities for a better understanding of the mitral anatomy-pathophysiology-device interaction, which is of critical importance for the advancement of transcatheter mitral valve replacement. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Three-dimensional mapping in the electrophysiological laboratory.

PubMed

Maury, Philippe; Monteil, Benjamin; Marty, Lilian; Duparc, Alexandre; Mondoly, Pierre; Rollin, Anne

2018-06-07

Investigation and catheter ablation of cardiac arrhythmias are currently still based on optimal knowledge of arrhythmia mechanisms in relation to the cardiac anatomy involved, in order to target their crucial components. Currently, most complex arrhythmias are investigated using three-dimensional electroanatomical navigation systems, because these are felt to optimally integrate both the anatomical and electrophysiological features of a given arrhythmia in a given patient. In this article, we review the technical background of available three-dimensional electroanatomical navigation systems, and their potential use in complex ablations. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Dorello's Canal for Laymen: A Lego-Like Presentation.

PubMed

Ezer, Haim; Banerjee, Anirban Deep; Thakur, Jai Deep; Nanda, Anil

2012-06-01

Objective Dorello's canal was first described by Gruber in 1859, and later by Dorello. Vail also described the anatomy of Dorello's canal. In the preceding century, Dorello's canal was clinically important, in understanding sixth nerve palsy and nowadays it is mostly important for skull base surgery. The understanding of the three dimensional anatomy, of this canal is very difficult to understand, and there is no simple explanation for its anatomy and its relationship with adjacent structures. We present a simple, Lego-like, presentation of Dorello's canal, in a stepwise manner. Materials and Methods Dorello's canal was dissected in five formalin-fixed cadaver specimens (10 sides). The craniotomy was performed, while preserving the neural and vascular structures associated with the canal. A 3D model was created, to explain the canal's anatomy. Results Using the petrous pyramid, the sixth nerve, the cavernous sinus, the trigeminal ganglion, the petorclival ligament and the posterior clinoid, the three-dimensional structure of Dorello's canal was defined. This simple representation aids in understanding the three dimensional relationship of Dorello's canal to its neighboring structures. Conclusion Dorello's canal with its three dimensional structure and relationship to its neighboring anatomical structures could be reconstructed using a few anatomical building blocks. This method simplifies the understanding of this complex anatomical structure, and could be used for teaching purposes for aspiring neurosurgeons, and anatomy students.

Dorello's Canal for Laymen: A Lego-Like Presentation

PubMed Central

Ezer, Haim; Banerjee, Anirban Deep; Thakur, Jai Deep; Nanda, Anil

2012-01-01

Objective Dorello's canal was first described by Gruber in 1859, and later by Dorello. Vail also described the anatomy of Dorello's canal. In the preceding century, Dorello's canal was clinically important, in understanding sixth nerve palsy and nowadays it is mostly important for skull base surgery. The understanding of the three dimensional anatomy, of this canal is very difficult to understand, and there is no simple explanation for its anatomy and its relationship with adjacent structures. We present a simple, Lego-like, presentation of Dorello's canal, in a stepwise manner. Materials and Methods Dorello's canal was dissected in five formalin-fixed cadaver specimens (10 sides). The craniotomy was performed, while preserving the neural and vascular structures associated with the canal. A 3D model was created, to explain the canal's anatomy. Results Using the petrous pyramid, the sixth nerve, the cavernous sinus, the trigeminal ganglion, the petorclival ligament and the posterior clinoid, the three-dimensional structure of Dorello's canal was defined. This simple representation aids in understanding the three dimensional relationship of Dorello's canal to its neighboring structures. Conclusion Dorello's canal with its three dimensional structure and relationship to its neighboring anatomical structures could be reconstructed using a few anatomical building blocks. This method simplifies the understanding of this complex anatomical structure, and could be used for teaching purposes for aspiring neurosurgeons, and anatomy students. PMID:23730547

Technique of semiautomatic surface reconstruction of the visible Korean human data using commercial software.

PubMed

Park, Jin Seo; Shin, Dong Sun; Chung, Min Suk; Hwang, Sung Bae; Chung, Jinoh

2007-11-01

This article describes the technique of semiautomatic surface reconstruction of anatomic structures using widely available commercial software. This technique would enable researchers to promptly and objectively perform surface reconstruction, creating three-dimensional anatomic images without any assistance from computer engineers. To develop the technique, we used data from the Visible Korean Human project, which produced digitalized photographic serial images of an entire cadaver. We selected 114 anatomic structures (skin [1], bones [32], knee joint structures [7], muscles [60], arteries [7], and nerves [7]) from the 976 anatomic images which were generated from the left lower limb of the cadaver. Using Adobe Photoshop, the selected anatomic structures in each serial image were outlined, creating a segmented image. The Photoshop files were then converted into Adobe Illustrator files to prepare isolated segmented images, so that the contours of the structure could be viewed independent of the surrounding anatomy. Using Alias Maya, these isolated segmented images were then stacked to construct a contour image. Gaps between the contour lines were filled with surfaces, and three-dimensional surface reconstruction could be visualized with Rhinoceros. Surface imperfections were then corrected to complete the three-dimensional images in Alias Maya. We believe that the three-dimensional anatomic images created by these methods will have widespread application in both medical education and research. 2007 Wiley-Liss, Inc

[Localization of perforators in the lower leg by digital antomy imaging methods].

PubMed

Wei, Peng; Ma, Liang-Liang; Fang, Ye-Dong; Xia, Wei-Zhi; Ding, Mao-Chao; Mei, Jin

2012-03-01

To offer both the accurate three-dimensional anatomical information and algorithmic morphology of perforators in the lower leg for perforator flaps design. The cadaver was injected with a modified lead oxide-gelatin mixture. Radiography was first performed and the images were analyzed using the software Photoshop and Scion Image. Then spiral CT scan was also performed and 3-dimensional images were reconstructed with MIMICS 10.01 software. There are (27 +/- 4) perforators whose outer diameter > or = 0.5 mm ( average, 0.8 +/- 0.2 mm). The average pedicle length within the superficial fascia is (37.3 +/- 18.6) mm. The average supplied area of each perforator is (49.5 +/- 25.5) cm2. The three-dimensional model displayed accurate morphology structure and three-dimensional distribution of the perforator-to- perforator and perforator-to-source artery. The 3D reconstruction model can clearly show the geometric, local details and three-dimensional distribution. It is a considerable method for the study of morphological characteristics of the individual perforators in human calf and preoperative planning of the perforator flap.

Volume rendering based on magnetic resonance imaging: advances in understanding the three-dimensional anatomy of the human knee

PubMed Central

Anastasi, Giuseppe; Bramanti, Placido; Di Bella, Paolo; Favaloro, Angelo; Trimarchi, Fabio; Magaudda, Ludovico; Gaeta, Michele; Scribano, Emanuele; Bruschetta, Daniele; Milardi, Demetrio

2007-01-01

The choice of medical imaging techniques, for the purpose of the present work aimed at studying the anatomy of the knee, derives from the increasing use of images in diagnostics, research and teaching, and the subsequent importance that these methods are gaining within the scientific community. Medical systems using virtual reality techniques also offer a good alternative to traditional methods, and are considered among the most important tools in the areas of research and teaching. In our work we have shown some possible uses of three-dimensional imaging for the study of the morphology of the normal human knee, and its clinical applications. We used the direct volume rendering technique, and created a data set of images and animations to allow us to visualize the single structures of the human knee in three dimensions. Direct volume rendering makes use of specific algorithms to transform conventional two-dimensional magnetic resonance imaging sets of slices into see-through volume data set images. It is a technique which does not require the construction of intermediate geometric representations, and has the advantage of allowing the visualization of a single image of the full data set, using semi-transparent mapping. Digital images of human structures, and in particular of the knee, offer important information about anatomical structures and their relationships, and are of great value in the planning of surgical procedures. On this basis we studied seven volunteers with an average age of 25 years, who underwent magnetic resonance imaging. After elaboration of the data through post-processing, we analysed the structure of the knee in detail. The aim of our investigation was the three-dimensional image, in order to comprehend better the interactions between anatomical structures. We believe that these results, applied to living subjects, widen the frontiers in the areas of teaching, diagnostics, therapy and scientific research. PMID:17645453

Tumor resection at the pelvis using three-dimensional planning and patient-specific instruments: a case series.

PubMed

Jentzsch, Thorsten; Vlachopoulos, Lazaros; Fürnstahl, Philipp; Müller, Daniel A; Fuchs, Bruno

2016-09-21

Sarcomas are associated with a relatively high local recurrence rate of around 30 % in the pelvis. Inadequate surgical margins are the most important reason. However, obtaining adequate margins is particularly difficult in this anatomically demanding region. Recently, three-dimensional (3-D) planning, printed models, and patient-specific instruments (PSI) with cutting blocks have been introduced to improve the precision during surgical tumor resection. This case series illustrates these modern 3-D tools in pelvic tumor surgery. The first consecutive patients with 3-D-planned tumor resection around the pelvis were included in this retrospective study at a University Hospital in 2015. Detailed information about the clinical presentation, imaging techniques, preoperative planning, intraoperative surgical procedures, and postoperative evaluation is provided for each case. The primary outcome was tumor-free resection margins as assessed by a postoperative computed tomography (CT) scan of the specimen. The secondary outcomes were precision of preoperative planning and complications. Four patients with pelvic sarcomas were included in this study. The mean follow-up was 7.8 (range, 6.0-9.0) months. The combined use of preoperative planning with 3-D techniques, 3-D-printed models, and PSI for osteotomies led to higher precision (maximal (max) error of 0.4 centimeters (cm)) than conventional 3-D planning and freehand osteotomies (max error of 2.8 cm). Tumor-free margins were obtained where measurable (n = 3; margins were not assessable in a patient with curettage). Two insufficiency fractures were noted postoperatively. Three-dimensional planning as well as the intraoperative use of 3-D-printed models and PSI are valuable for complex sarcoma resection at the pelvis. Three-dimensionally printed models of the patient anatomy may help visualization and precision. PSI with cutting blocks help perform very precise osteotomies for adequate resection margins.

Postoperative outcomes of two- and three-dimensional planning in orthognathic surgery: A comparative study.

PubMed

Wu, Ting-Yu; Lin, Hsiu-Hsia; Lo, Lun-Jou; Ho, Cheng-Ting

2017-08-01

Compared with conventional two-dimensional (2D) planning, three-dimensional (3D) planning in orthognathic surgery yields more accurate anatomical information and enables the precise positioning of maxillary and mandibular segments, particularly for patients with facial asymmetry. Accordingly, surgical outcomes achieved using 3D planning should be superior. This study determined the differences between the 2D and 3D planning techniques by comparing their surgical outcomes. In this retrospective study, patients who underwent surgery following the traditional 2D planning technique were classified into the 2D planning group. Patients in whom the 2D plan was transferred to a 3D system after surgical simulation were classified into the 3D planning group. Surgical outcomes were compared using cephalometric measurements and patient perception of the results. In the 3D planning group, more favorable results were observed in frontal symmetry, change in the angle between the orbital and occlusal lines, frontal ramus inclination, and the distances from the mandibular central incisor and menton to the midsagittal line. No significant differences were observed in the lateral profiles (SNA, SNB, ANB, and angle convexity) of the two groups. Patient satisfaction was favorable in the two groups, but more patients in the 3D planning group reported being very satisfied. The 3D planning technique provided superior overall outcomes. The study findings can be used to augment clinical planning and surgical execution when using a conventional approach. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

[Three-dimensional endoscopic endonasal study of skull base anatomy].

PubMed

Abarca-Olivas, Javier; Monjas-Cánovas, Irene; López-Álvarez, Beatriz; Lloret-García, Jaime; Sanchez-del Campo, Jose; Gras-Albert, Juan Ramon; Moreno-López, Pedro

2014-01-01

Training in dissection of the paranasal sinuses and the skull base is essential for anatomical understanding and correct surgical techniques. Three-dimensional (3D) visualisation of endoscopic skull base anatomy increases spatial orientation and allows depth perception. To show endoscopic skull base anatomy based on the 3D technique. We performed endoscopic dissection in cadaveric specimens fixed with formalin and with the Thiel technique, both prepared using intravascular injection of coloured material. Endonasal approaches were performed with conventional 2D endoscopes. Then we applied the 3D anaglyph technique to illustrate the pictures in 3D. The most important anatomical structures and landmarks of the sellar region under endonasal endoscopic vision are illustrated in 3D images. The skull base consists of complex bony and neurovascular structures. Experience with cadaver dissection is essential to understand complex anatomy and develop surgical skills. A 3D view constitutes a useful tool for understanding skull base anatomy. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

Principles and Planning in Nasal and Facial Reconstruction: Making a Normal Face.

PubMed

Menick, Frederick J

2016-06-01

After reading this article, the participant should be able to: 1. Understand the rationale and value of principles of facial reconstruction in the complex patient. 2. Understand the importance of diagnosis and planning. 3. Appreciate the value of surgical staging. 4. Modify tissues to the requirements of the defect. 5. Know how to treat ischemic cover and lining complications. 6. Learn methods of late revision. It is easy to be overwhelmed by a complex defect. What to do? How? When? In what order? Success is determined by careful planning, guided by principles. The aesthetic and anatomical deficiencies must be identified. Then, what is absent, both visually and anatomically, and what is missing must be determined. What are the priorities? What is the best timing for each stage? What are the available options and what will be the likely result? Should I choose another option? How can the surgeon maintain vascularity, transfer tissue, and improve tissue quality and contour? What are potential backup salvage maneuvers? Sound surgical principles based on the contributions of Gillies and Millard provide strategic instructions that help the surgeon "make sense" of a complex problem. They provide coordinated rules that clarify the diagnosis, planning, timing, and stages of repair. These should be combined with a regional unit approach to facial repair that provides tactical rules to establish the skin quality, border outline, and three-dimensional shape of the normal face.

Dosimetric study of the protection level of the bone marrow in patients with cervical or endometrial cancer for three radiotherapy techniques - 3D CRT, IMRT and VMAT. Study protocol.

NASA Astrophysics Data System (ADS)

Jodda, Agata; Urbański, Bartosz; Piotrowski, Tomasz; Malicki, Julian

2016-03-01

Background: The paper shows the methodology of an in-phantom study of the protection level of the bone marrow in patients with cervical or endometrial cancer for three radiotherapy techniques: three-dimensional conformal radiotherapy, intensity modulated radiotherapy, and volumetric modulated arc therapy, preceded by the procedures of image guidance. Methods/Design: The dosimetric evaluation of the doses will be performed in an in-house multi-element anthropomorphic phantom of the female pelvic area created by three-dimensional printing technology. The volume and position of the structures will be regulated according to the guidelines from the Bayesian network. The input data for the learning procedure of the model will be obtained from the retrospective analysis of imaging data obtained for 96 patients with endometrial cancer or cervical cancer treated with radiotherapy in our centre in 2008-2013. Three anatomical representations of the phantom simulating three independent clinical cases will be chosen. Five alternative treatment plans (1 × three-dimensional conformal radiotherapy, 2 × intensity modulated radiotherapy and 2 × volumetric modulated arc therapy) will be created for each representation. To simulate image-guided radiotherapy, ten specific recombinations will be designated, for each anatomical representation separately, reflecting possible changes in the volume and position of the phantom components. Discussion: The comparative analysis of planned measurements will identify discrepancies between calculated doses and doses that were measured in the phantom. Finally, differences between the doses cumulated in the hip plates performed by different techniques simulating the gynaecological patients' irradiation of dose delivery will be established. The results of this study will form the basis of the prospective clinical trial that will be designed for the assessment of hematologic toxicity and its correlation with the doses cumulated in the hip plates, for gynaecologic patients undergoing radiation therapy.

A novel approach for determining three-dimensional acetabular orientation: results from two hundred subjects.

PubMed

Higgins, Sean W; Spratley, E Meade; Boe, Richard A; Hayes, Curtis W; Jiranek, William A; Wayne, Jennifer S

2014-11-05

The inherently complex three-dimensional morphology of both the pelvis and acetabulum create difficulties in accurately determining acetabular orientation. Our objectives were to develop a reliable and accurate methodology for determining three-dimensional acetabular orientation and to utilize it to describe relevant characteristics of a large population of subjects without apparent hip pathology. High-resolution computed tomography studies of 200 patients previously receiving pelvic scans for indications not related to orthopaedic conditions were selected from our institution's database. Three-dimensional models of each osseous pelvis were generated to extract specific anatomical data sets. A novel computational method was developed to determine standard measures of three-dimensional acetabular orientation within an automatically identified anterior pelvic plane reference frame. Automatically selected points on the osseous ridge of the acetabulum were used to generate a best-fit plane for describing acetabular orientation. Our method showed excellent interobserver and intraobserver agreement (an intraclass correlation coefficient [ICC] of >0.999) and achieved high levels of accuracy. A significant difference between males and females in both anteversion (average, 3.5°; 95% confidence interval [CI], 1.9° to 5.1° across all angular definitions; p < 0.0001) and inclination (1.4°; 95% CI, 0.6° to 2.3° for anatomic angular definition; p < 0.002) was observed. Intrapatient asymmetry in anatomic measures showed bilateral differences in anteversion (maximum, 12.1°) and in inclination (maximum, 10.9°). Significant differences in acetabular orientation between the sexes can be detected only with accurate measurements that account for the entire acetabulum. While a wide range of interpatient acetabular orientations was observed, the majority of subjects had acetabula that were relatively symmetrical in both inclination and anteversion. A highly accurate and reproducible method for determining the orientation of the acetabulum's aperture will benefit both surgeons and patients, by further refining the distinctions between normal and abnormal hip characteristics. Enhanced understanding of the acetabulum could be useful in the diagnostic, planning, and execution stages for surgical procedures of the hip or in advancing the design of new implant systems. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Strategic planning for aircraft noise route impact analysis: A three dimensional approach

NASA Technical Reports Server (NTRS)

Bragdon, C. R.; Rowan, M. J.; Ahuja, K. K.

1993-01-01

The strategic routing of aircraft through navigable and controlled airspace to minimize adverse noise impact over sensitive areas is critical in the proper management and planning of the U.S. based airport system. A major objective of this phase of research is to identify, inventory, characterize, and analyze the various environmental, land planning, and regulatory data bases, along with potential three dimensional software and hardware systems that can be potentially applied for an impact assessment of any existing or planned air route. There are eight data bases that have to be assembled and developed in order to develop three dimensional aircraft route impact methodology. These data bases which cover geographical information systems, sound metrics, land use, airspace operational control measures, federal regulations and advisories, census data, and environmental attributes have been examined and aggregated. A three dimensional format is necessary for planning, analyzing space and possible noise impact, and formulating potential resolutions. The need to develop this three dimensional approach is essential due to the finite capacity of airspace for managing and planning a route system, including airport facilities. It appears that these data bases can be integrated effectively into a strategic aircraft noise routing system which should be developed as soon as possible, as part of a proactive plan applied to our FAA controlled navigable airspace for the United States.

Preoperative planning and real-time assisted navigation by three-dimensional individual digital model in partial nephrectomy with three-dimensional laparoscopic system.

PubMed

Wang, Dongwen; Zhang, Bin; Yuan, Xiaobin; Zhang, Xuhui; Liu, Chen

2015-09-01

To evaluate the feasibility and effectiveness of preoperative planning and real-time assisted surgical navigation for three-dimensional laparoscopic partial nephrectomy under the guidance of three-dimensional individual digital model (3D-IDM) created using three-dimensional medical image reconstructing and guiding system (3D-MIRGS). Between May 2012 and February 2014, 44 patients with cT1 renal tumors underwent retroperitoneal laparoscopic partial nephrectomy (LPN) using a three-dimensional laparoscopic system. The 3D-IDMs were created using the 3D-MIRGS in 21 patients (3D-MIRGS group) between February 2013 and February 2014. After preoperative planning, operations were real-time assisted using composite 3D-IDMs, which were fused with two-dimensional retrolaparoscopic images. The remaining 23 patients underwent surgery without 3D-MIRGS between May 2012 and February 2013; 14 of these patients were selected as a control group. Preoperative aspects and dimensions used for an anatomical score, "radius; exophytic/endophytic; nearness; anterior/posterior; location" nephrometry score, tumor size, operative time (OT), segmental renal artery clamping (SRAC) time, estimated blood loss (EBL), postoperative hospitalization, the preoperative serum creatinine level and ipsilateral glomerular filtration rate (GFR), as well as postoperative 6-month data were compared between groups. All the SRAC procedures were technically successful, and each targeted tumor was excised completely; final pathological margin results were negative. The OT was shorter (159.0 vs. 193.2 min; p < 0.001), and EBL (148.1 vs. 176.1 mL; p < 0.001) was reduced in the 3D-MIRGS group compared with controls. No statistically significant differences in SRAC time or postoperative hospitalization were found between the groups. Neither group showed any statistically significant increases in serum creatinine level or decreases in ipsilateral GFR postoperatively. Preoperative planning and real-time assisted surgical navigation using the 3D-IDM reconstructed from 3D-MIRGS and combined with the 3D laparoscopic system can facilitate LPN and result in precise SRAC and accurate excision of tumor that is both effective and safe.

Importance of preoperative imaging with 64-row three-dimensional multidetector computed tomography for safer video-assisted thoracic surgery in lung cancer.

PubMed

Akiba, Tadashi; Marushima, Hideki; Harada, Junta; Kobayashi, Susumu; Morikawa, Toshiaki

2009-01-01

Video-assisted thoracic surgery (VATS) has recently been adopted for complicated anatomical lung resections. During these thoracoscopic procedures, surgeons view the operative field on a two-dimensional (2-D) video monitor and cannot palpate the organ directly, thus frequently encountering anatomical difficulties. This study aimed to estimate the usefulness of preoperative three-dimensional (3-D) imaging of thoracic organs. We compared the preoperative 64-row three-dimensional multidetector computed tomography (3DMDCT) findings of lung cancer-affected thoracic organs to the operative findings. In comparison to the operative findings, the branches of pulmonary arteries, veins, and bronchi were well defined in the 3D-MDCT images of 27 patients. 3D-MDCT imaging is useful for preoperatively understanding the individual thoracic anatomy in lung cancer surgery. This modality can therefore contribute to safer anatomical pulmonary operations, especially in VATS.

Three-Dimensional Printing: Custom-Made Implants for Craniomaxillofacial Reconstructive Surgery

PubMed Central

Matias, Mariana; Zenha, Horácio; Costa, Horácio

2017-01-01

Craniomaxillofacial reconstructive surgery is a challenging field. First it aims to restore primary functions and second to preserve craniofacial anatomical features like symmetry and harmony. Three-dimensional (3D) printed biomodels have been widely adopted in medical fields by providing tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. Craniomaxillofacial reconstructive surgery was one of the first areas to implement 3D printing technology in their practice. Biomodeling has been used in craniofacial reconstruction of traumatic injuries, congenital disorders, tumor removal, iatrogenic injuries (e.g., decompressive craniectomies), orthognathic surgery, and implantology. 3D printing has proven to improve and enable an optimization of preoperative planning, develop intraoperative guidance tools, reduce operative time, and significantly improve the biofunctional and the aesthetic outcome. This technology has also shown great potential in enriching the teaching of medical students and surgical residents. The aim of this review is to present the current status of 3D printing technology and its practical and innovative applications, specifically in craniomaxillofacial reconstructive surgery, illustrated with two clinical cases where the 3D printing technology was successfully used. PMID:28523082

Application of two segmentation protocols during the processing of virtual images in rapid prototyping: ex vivo study with human dry mandibles.

PubMed

Ferraz, Eduardo Gomes; Andrade, Lucio Costa Safira; dos Santos, Aline Rode; Torregrossa, Vinicius Rabelo; Rubira-Bullen, Izabel Regina Fischer; Sarmento, Viviane Almeida

2013-12-01

The aim of this study was to evaluate the accuracy of virtual three-dimensional (3D) reconstructions of human dry mandibles, produced from two segmentation protocols ("outline only" and "all-boundary lines"). Twenty virtual three-dimensional (3D) images were built from computed tomography exam (CT) of 10 dry mandibles, in which linear measurements between anatomical landmarks were obtained and compared to an error probability of 5 %. The results showed no statistically significant difference among the dry mandibles and the virtual 3D reconstructions produced from segmentation protocols tested (p = 0,24). During the designing of a virtual 3D reconstruction, both "outline only" and "all-boundary lines" segmentation protocols can be used. Virtual processing of CT images is the most complex stage during the manufacture of the biomodel. Establishing a better protocol during this phase allows the construction of a biomodel with characteristics that are closer to the original anatomical structures. This is essential to ensure a correct preoperative planning and a suitable treatment.

Use of 3D reconstruction cloacagrams and 3D printing in cloacal malformations.

PubMed

Ahn, Jennifer J; Shnorhavorian, Margarett; Amies Oelschlager, Anne-Marie E; Ripley, Beth; Shivaram, Giridhar M; Avansino, Jeffrey R; Merguerian, Paul A

2017-08-01

Cloacal anomalies are complex to manage, and the anatomy affects prognosis and management. Assessment historically includes examination under anesthesia, and genitography is often performed, but these do not consistently capture three-dimensional (3D) detail or spatial relationships of the anatomic structures. Three-dimensional reconstruction cloacagrams can provide a high level of detail including channel measurements and the level of the cloaca (<3 cm vs. >3 cm), which typically determines the approach for surgical reconstruction and can impact long-term prognosis. Yet this imaging modality has not yet been directly compared with intra-operative or endoscopic findings. Our objective was to compare 3D reconstruction cloacagrams with endoscopic and intraoperative findings, as well as to describe the use of 3D printing to create models for surgical planning and education. An IRB-approved retrospective review of all cloaca patients seen by our multi-disciplinary program from 2014 to 2016 was performed. All patients underwent examination under anesthesia, endoscopy, 3D reconstruction cloacagram, and subsequent reconstructive surgery at a later date. Patient characteristics, intraoperative details, and measurements from endoscopy and cloacagram were reviewed and compared. One of the 3D cloacagrams was reformatted for 3D printing to create a model for surgical planning. Four patients were included for review, with the Figure illustrating 3D cloacagram results. Measurements of common channel length and urethral length were similar between modalities, particularly with confirming the level of cloaca. No patient experienced any complications or adverse effects from cloacagram or endoscopy. A model was successfully created from cloacagram images with the use of 3D printing technology. Accurate preoperative assessment for cloacal anomalies is important for counseling and surgical planning. Three-dimensional cloacagrams have been shown to yield a high level of anatomic detail. Here, cloacagram measurements are shown to correlate well with endoscopic and intraoperative findings with regards to level of cloaca and Müllerian development. Measurement discrepancies may be due to technical variation indicating a need for further evaluation. The translation of the cloacagram images into a 3D printed model demonstrates potential applications of these models for pre-operative planning and education of both families and trainees. In our series, 3D reconstruction cloacagrams yielded accurate measurements of urethral length and level of cloaca common channel and urethral length, similar to those found on endoscopy. Three-dimensional models can be printed from using cloacagram images, and may be useful for surgical planning and education. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

The importance of spatial ability and mental models in learning anatomy

NASA Astrophysics Data System (ADS)

Chatterjee, Allison K.

As a foundational course in medical education, gross anatomy serves to orient medical and veterinary students to the complex three-dimensional nature of the structures within the body. Understanding such spatial relationships is both fundamental and crucial for achievement in gross anatomy courses, and is essential for success as a practicing professional. Many things contribute to learning spatial relationships; this project focuses on a few key elements: (1) the type of multimedia resources, particularly computer-aided instructional (CAI) resources, medical students used to study and learn; (2) the influence of spatial ability on medical and veterinary students' gross anatomy grades and their mental models; and (3) how medical and veterinary students think about anatomy and describe the features of their mental models to represent what they know about anatomical structures. The use of computer-aided instruction (CAI) by gross anatomy students at Indiana University School of Medicine (IUSM) was assessed through a questionnaire distributed to the regional centers of the IUSM. Students reported using internet browsing, PowerPoint presentation software, and email on a daily bases to study gross anatomy. This study reveals that first-year medical students at the IUSM make limited use of CAI to study gross anatomy. Such studies emphasize the importance of examining students' use of CAI to study gross anatomy prior to development and integration of electronic media into the curriculum and they may be important in future decisions regarding the development of alternative learning resources. In order to determine how students think about anatomical relationships and describe the features of their mental models, personal interviews were conducted with select students based on students' ROT scores. Five typologies of the characteristics of students' mental models were identified and described: spatial thinking, kinesthetic approach, identification of anatomical structures, problem solving strategies, and study methods. Students with different levels of spatial ability visualize and think about anatomy in qualitatively different ways, which is reflected by the features of their mental models. Low spatial ability students thought about and used two-dimensional images from the textbook. They possessed basic two-dimensional models of anatomical structures; they placed emphasis on diagrams and drawings in their studies; and they re-read anatomical problems many times before answering. High spatial ability students thought fully in three-dimensional and imagined rotation and movement of the structures; they made use of many types of images and text as they studied and solved problems. They possessed elaborate three-dimensional models of anatomical structures which they were able to manipulate to solve problems; and they integrated diagrams, drawings, and written text in their studies. Middle spatial ability students were a mix between both low and high spatial ability students. They imagined two-dimensional images popping out of the flat paper to become more three-dimensional, but still relied on drawings and diagrams. Additionally, high spatial ability students used a higher proportion of anatomical terminology than low spatial ability or middle spatial ability students. This provides additional support to the premise that high spatial students' mental models are a complex mixture of imagistic representations and propositional representations that incorporate correct anatomical terminology. Low spatial ability students focused on the function of structures and ways to group information primarily for the purpose of recall. This supports the theory that low spatial students' mental models will be characterized by more on imagistic representations that are general in nature. (Abstract shortened by UMI.)

Three-dimensional modelling and three-dimensional printing in pediatric and congenital cardiac surgery.

PubMed

Kiraly, Laszlo

2018-04-01

Three-dimensional (3D) modelling and printing methods greatly support advances in individualized medicine and surgery. In pediatric and congenital cardiac surgery, personalized imaging and 3D modelling presents with a range of advantages, e.g., better understanding of complex anatomy, interactivity and hands-on approach, possibility for preoperative surgical planning and virtual surgery, ability to assess expected results, and improved communication within the multidisciplinary team and with patients. 3D virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios. For the lack of critical mass of evidence, controlled randomized trials, however, most of these general benefits remain anecdotal. For an individual surgical case-scenario, prior knowledge, preparedness and possibility of emulation are indispensable in raising patient-safety. It is advocated that added value of 3D printing in healthcare could be raised by establishment of a multidisciplinary centre of excellence (COE). Policymakers, research scientists, clinicians, as well as health care financers and local entrepreneurs should cooperate and communicate along a legal framework and established scientific guidelines for the clinical benefit of patients, and towards financial sustainability. It is expected that besides the proven utility of 3D printed patient-specific anatomical models, 3D printing will have a major role in pediatric and congenital cardiac surgery by providing individually customized implants and prostheses, especially in combination with evolving techniques of bioprinting.

Three-dimensional modelling and three-dimensional printing in pediatric and congenital cardiac surgery

PubMed Central

2018-01-01

Three-dimensional (3D) modelling and printing methods greatly support advances in individualized medicine and surgery. In pediatric and congenital cardiac surgery, personalized imaging and 3D modelling presents with a range of advantages, e.g., better understanding of complex anatomy, interactivity and hands-on approach, possibility for preoperative surgical planning and virtual surgery, ability to assess expected results, and improved communication within the multidisciplinary team and with patients. 3D virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios. For the lack of critical mass of evidence, controlled randomized trials, however, most of these general benefits remain anecdotal. For an individual surgical case-scenario, prior knowledge, preparedness and possibility of emulation are indispensable in raising patient-safety. It is advocated that added value of 3D printing in healthcare could be raised by establishment of a multidisciplinary centre of excellence (COE). Policymakers, research scientists, clinicians, as well as health care financers and local entrepreneurs should cooperate and communicate along a legal framework and established scientific guidelines for the clinical benefit of patients, and towards financial sustainability. It is expected that besides the proven utility of 3D printed patient-specific anatomical models, 3D printing will have a major role in pediatric and congenital cardiac surgery by providing individually customized implants and prostheses, especially in combination with evolving techniques of bioprinting. PMID:29770294

SU-E-J-111: Finite Element-Based Deformable Image Registration of Pleural Cavity for Photodynamic Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Penjweini, R; Zhu, T

Purpose: The pleural volumes will deform during surgery portion of the pleural photodynamic therapy (PDT) of lung cancer when the pleural cavity is opened. This impact the delivered dose when using highly conformal treatment techniques. In this study, a finite element-based (FEM) deformable image registration is used to quantify the anatomical variation between the contours for the pleural cavities obtained in the operating room and those determined from pre-surgery computed tomography (CT) scans. Methods: An infrared camera-based navigation system (NDI) is used during PDT to track the anatomical changes and contour the lung and chest cavity. A series of CTsmore » of the lungs, in the same patient, are also acquired before the surgery. The structure contour of lung and the CTs are processed and contoured in Matlab and MeshLab. Then, the contours are imported into COMSOL Multiphysics 5.0, where the FEM-based deformable image registration is obtained using the deformed mesh - moving mesh (ALE) model. The NDI acquired lung contour is considered as the reference contour, and the CT contour is used as the target one, which will be deformed. Results: The reconstructed three-dimensional contours from both NDI and CT can be converted to COMSOL so that a three-dimensional ALE model can be developed. The contours can be registered using COMSOL ALE moving mesh model, which takes into account the deformation along x, y and z-axes. The deformed contour has good matches to the reference contour after the dynamic matching process. The resulting 3D deformation map can be used to obtain the locations of other critical anatomic structures, e.g., heart, during surgery. Conclusion: Deformable image registration can fuse images acquired by different modalities. It provides insights into the development of phenomenon and variation in normal anatomical structures over time. The initial assessments of three-dimensional registration show good agreement.« less

Automatic construction of subject-specific human airway geometry including trifurcations based on a CT-segmented airway skeleton and surface

PubMed Central

Miyawaki, Shinjiro; Tawhai, Merryn H.; Hoffman, Eric A.; Wenzel, Sally E.; Lin, Ching-Long

2016-01-01

We propose a method to construct three-dimensional airway geometric models based on airway skeletons, or centerlines (CLs). Given a CT-segmented airway skeleton and surface, the proposed CL-based method automatically constructs subject-specific models that contain anatomical information regarding branches, include bifurcations and trifurcations, and extend from the trachea to terminal bronchioles. The resulting model can be anatomically realistic with the assistance of an image-based surface; alternatively a model with an idealized skeleton and/or branch diameters is also possible. This method systematically identifies and classifies trifurcations to successfully construct the models, which also provides the number and type of trifurcations for the analysis of the airways from an anatomical point of view. We applied this method to 16 normal and 16 severe asthmatic subjects using their computed tomography images. The average distance between the surface of the model and the image-based surface was 11% of the average voxel size of the image. The four most frequent locations of trifurcations were the left upper division bronchus, left lower lobar bronchus, right upper lobar bronchus, and right intermediate bronchus. The proposed method automatically constructed accurate subject-specific three-dimensional airway geometric models that contain anatomical information regarding branches using airway skeleton, diameters, and image-based surface geometry. The proposed method can construct (i) geometry automatically for population-based studies, (ii) trifurcations to retain the original airway topology, (iii) geometry that can be used for automatic generation of computational fluid dynamics meshes, and (iv) geometry based only on a skeleton and diameters for idealized branches. PMID:27704229

Role of Cone Beam Computed Tomography in Diagnosis and Treatment Planning in Dentistry: An Update.

PubMed

Shukla, Sagrika; Chug, Ashi; Afrashtehfar, Kelvin I

2017-11-01

Accurate diagnosis and treatment planning are the backbone of any medical therapy; for this reason, cone beam computed tomography (CBCT) was introduced and has been widely used. CBCT technology provides a three-dimensional image viewing, enabling exact location and extent of lesions or any anatomical region. For the very same reason, CBCT can not only be used for surgical fields but also for fields such as endodontics, prosthodontics, and orthodontics for appropriate treatment planning and effective dental care. The aim and clinical significance of this review are to update dental clinicians on the CBCT applications in each dental specialty for an appropriate diagnosis and more predictable treatment.

Multimodal system for the planning and guidance of bronchoscopy

NASA Astrophysics Data System (ADS)

Higgins, William E.; Cheirsilp, Ronnarit; Zang, Xiaonan; Byrnes, Patrick

2015-03-01

Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Modern X-ray computed-tomography (CT) scanners provide three-dimensional (3D) high-resolution chest images, positron emission tomography (PET) scanners give complementary molecular imaging data, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the-art bronchoscopes permit minimally invasive tissue sampling, with vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. In addition, image-guided intervention (IGI) systems have proven their utility for CT-based planning and guidance of bronchoscopy. Unfortunately, no IGI system exists that integrates all sources effectively through the complete lung-cancer staging work flow. This paper presents a prototype of a computer-based multimodal IGI system that strives to fill this need. The system combines a wide range of automatic and semi-automatic image-processing tools for multimodal data fusion and procedure planning. It also provides a flexible graphical user interface for follow-on guidance of bronchoscopy/EBUS. Human-study results demonstrate the system's potential.

Application of MSCTA combined with VRT in the operation of cervical dumbbell tumors

PubMed Central

Wang, Wan; Lin, Jia; Knosp, Engelbert; Zhao, Yuanzheng; Xiu, Dianhui; Guo, Yongchuan

2015-01-01

Cervical dumbbell tumor poses great difficulties for neurosurgical treatment and incurs remarkable local recurrence rate as the formidable problem for neurosurgery. However, as the routine preoperative evaluation scheme, MRI and CT failed to reveal the mutual three-dimensional relationships between tumor and adjacent structures. Here, we report the clinical application of MSCTA and VRT in three-dimensional reconstruction of cervical dumbbell tumors. From January 2012 to July 2014, 24 patients diagnosed with cervical dumbbell tumor were retrospectively analyzed. All patients enrolled were indicated for preoperative MSCTA/VRT image reconstruction to explore the three-dimensional stereoscopic anatomical relationships among neuroma, spinal cord and vertebral artery to achieve optimal surgical approach from multiple configurations and surgical practice. Three-dimensional mutual anatomical relationships among tumor, adjacent vessels and vertebrae were vividly reconstructed by MSCTA/VRT in all patients in accordance with intraoperative findings. Multiple configurations for optimal surgical approach contribute to total resection of tumor, minimal damage to vessels and nerves, and maximal maintenance of cervical spine stability. Preoperative MSCTA/VRT contributes to reconstruction of three-dimensional stereoscopic anatomical relationships between cervical dumbbell tumor and adjacent structures for optimal surgical approach by multiple configurations and reduction of intraoperative damages and postoperative complications. PMID:26550385

Application of MSCTA combined with VRT in the operation of cervical dumbbell tumors.

PubMed

Wang, Wan; Lin, Jia; Knosp, Engelbert; Zhao, Yuanzheng; Xiu, Dianhui; Guo, Yongchuan

2015-01-01

Cervical dumbbell tumor poses great difficulties for neurosurgical treatment and incurs remarkable local recurrence rate as the formidable problem for neurosurgery. However, as the routine preoperative evaluation scheme, MRI and CT failed to reveal the mutual three-dimensional relationships between tumor and adjacent structures. Here, we report the clinical application of MSCTA and VRT in three-dimensional reconstruction of cervical dumbbell tumors. From January 2012 to July 2014, 24 patients diagnosed with cervical dumbbell tumor were retrospectively analyzed. All patients enrolled were indicated for preoperative MSCTA/VRT image reconstruction to explore the three-dimensional stereoscopic anatomical relationships among neuroma, spinal cord and vertebral artery to achieve optimal surgical approach from multiple configurations and surgical practice. Three-dimensional mutual anatomical relationships among tumor, adjacent vessels and vertebrae were vividly reconstructed by MSCTA/VRT in all patients in accordance with intraoperative findings. Multiple configurations for optimal surgical approach contribute to total resection of tumor, minimal damage to vessels and nerves, and maximal maintenance of cervical spine stability. Preoperative MSCTA/VRT contributes to reconstruction of three-dimensional stereoscopic anatomical relationships between cervical dumbbell tumor and adjacent structures for optimal surgical approach by multiple configurations and reduction of intraoperative damages and postoperative complications.

Three-dimensional printed prototypes refine the anatomy of post-modified Norwood-1 complex aortic arch obstruction and allow presurgical simulation of the repair.

PubMed

Kiraly, Laszlo; Tofeig, Magdi; Jha, Neerod Kumar; Talo, Haitham

2016-02-01

Three-dimensional (3D) printed prototypes of malformed hearts have been used for education, communication, presurgical planning and simulation. We present a case of a 5-month old infant with complex obstruction at the neoaortic to transverse arch and descending aortic junction following the neonatal modified Norwood-1 procedure for hypoplastic left heart syndrome. Digital 3D models were created from a routine 64-slice CT dataset; then life-size solid and magnified hollow models were printed with a 3D printer. The solid model provided further insights into details of the anatomy, whereas the surgical approach and steps of the operation were simulated on the hollow model. Intraoperative assessment confirmed the anatomical accuracy of the 3D models. The operation was performed in accordance with preoperative simulation: sliding autologous flaps achieved relief of the obstruction without additional patching. Knowledge gained from the models fundamentally contributed to successful outcome and improved patient safety. This case study presents an effective use of 3D models in exploring complex spatial relationship at the aortic arch and in simulation-based planning of the operative procedure. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

3D Printing Provides a Precise Approach in the Treatment of Tetralogy of Fallot, Pulmonary Atresia with Major Aortopulmonary Collateral Arteries.

PubMed

Anwar, Shafkat; Rockefeller, Toby; Raptis, Demetrios A; Woodard, Pamela K; Eghtesady, Pirooz

2018-02-03

Patients with tetralogy of Fallot, pulmonary atresia, and multiple aortopulmonary collateral arteries (Tet PA MAPCAs) have a wide spectrum of anatomy and disease severity. Management of these patients can be challenging and often require multiple high-risk surgical and interventional catheterization procedures. These interventions are made challenging by complex anatomy that require the proceduralist to mentally reconstruct three-dimensional anatomic relationships from two-dimensional images. Three-dimensional (3D) printing is an emerging medical technology that provides added benefits in the management of patients with Tet PA MAPCAs. When used in combination with current diagnostic modalities and procedures, 3D printing provides a precise approach to the management of these challenging, high-risk patients. Specifically, 3D printing enables detailed surgical and interventional planning prior to the procedure, which may improve procedural outcomes, decrease complications, and reduce procedure-related radiation dose and contrast load.

Three-dimensional computed tomography reconstruction for operative planning in robotic segmentectomy: a pilot study

PubMed Central

Le Moal, Julien; Peillon, Christophe; Dacher, Jean-Nicolas

2018-01-01

Background The objective of our pilot study was to assess if three-dimensional (3D) reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy. Methods Between 2014 and 2015, 3D reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain 3D reconstruction, the surgeon uploaded the anonymized computed tomography (CT) image of the patient to the secured Visible Patient™ server and then downloaded the model after completion. Results Nine segmentectomies were performed between 2014 and 2015 using a pre-operative 3D model. All 3D reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique. Conclusions We have shown that operative planning by 3D CT using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. Its impact on reducing complications and improving surgical efficiency is the object of an ongoing study. PMID:29600049

Three-dimensional computed tomography reconstruction for operative planning in robotic segmentectomy: a pilot study.

PubMed

Le Moal, Julien; Peillon, Christophe; Dacher, Jean-Nicolas; Baste, Jean-Marc

2018-01-01

The objective of our pilot study was to assess if three-dimensional (3D) reconstruction performed by Visible Patient™ could be helpful for the operative planning, efficiency and safety of robot-assisted segmentectomy. Between 2014 and 2015, 3D reconstructions were provided by the Visible Patient™ online service and used for the operative planning of robotic segmentectomy. To obtain 3D reconstruction, the surgeon uploaded the anonymized computed tomography (CT) image of the patient to the secured Visible Patient™ server and then downloaded the model after completion. Nine segmentectomies were performed between 2014 and 2015 using a pre-operative 3D model. All 3D reconstructions met our expectations: anatomical accuracy (bronchi, arteries, veins, tumor, and the thoracic wall with intercostal spaces), accurate delimitation of each segment in the lobe of interest, margin resection, free space rotation, portability (smartphone, tablet) and time saving technique. We have shown that operative planning by 3D CT using Visible Patient™ reconstruction is useful in our practice of robot-assisted segmentectomy. The main disadvantage is the high cost. Its impact on reducing complications and improving surgical efficiency is the object of an ongoing study.

Practical, computer-aided registration of multiple, three-dimensional, magnetic-resonance observations of the human brain

DOE Office of Scientific and Technical Information (OSTI.GOV)

Diegert, C.; Sanders, J.A.; Orrison, W.W. Jr.

1992-12-31

Researchers working with MR observations generally agree that far more information is available in a volume (3D) observation than is considered for diagnosis. The key to the new alignment method is in basing it on available information on surfaces. Using the skin surface is effective a robust algorithm can reliably extract this surface from almost any scan of the head, and a human operator`s exquisite sensitivity to facial features is allows him to manually align skin surfaces with precision. Following the definitions, we report on a preliminary experiment where we align three MR observations taken during a single MR examination,more » each weighting arterial, venous, and tissue features. When accurately aligned, a neurosurgeon can use these features as anatomical landmarks for planning and executing interventional procedures.« less

Three-dimensional topographic fiber tract anatomy of the cerebrum.

PubMed

Yagmurlu, Kaan; Vlasak, Alexander L; Rhoton, Albert L

2015-06-01

The fiber tracts of the cerebrum may be a more important determinant of resection limits than the cortex. Better knowledge of the 3-dimensional (3-D) anatomic organization of the fiber pathways is important in planning safe and accurate surgery for lesions within the cerebrum. To examine the topographic anatomy of fiber tracts and subcortical gray matter of the human cerebrum and their relationships with consistent cortical, ventricular, and nuclear landmarks. Twenty-five formalin-fixed human brains and 4 whole cadaveric heads were examined by fiber dissection technique and ×6 to ×40 magnification. The fiber tracts and central core structures, including the insula and basal ganglia, were examined and their relationships captured in 3-D photography. The depth between the surface of the cortical gyri and selected fiber tracts was measured. The topographic relationships of the important association, projection, and commissural fasciculi within the cerebrum and superficial cortical landmarks were identified. Important landmarks with consistent relationships to the fiber tracts were the cortical gyri and sulci, limiting sulci of the insula, nuclear masses in the central core, and lateral ventricles. The fiber tracts were also organized in a consistent pattern in relation to each other. The anatomic findings are briefly compared with functional data from clinicoradiological analysis and intraoperative stimulation of fiber tracts. An understanding of the 3-D anatomic organization of the fiber tracts of the brain is essential in planning safe and accurate cerebral surgery.

Modelling and Manufacturing of a 3D Printed Trachea for Cricothyroidotomy Simulation.

PubMed

Doucet, Gregory; Ryan, Stephen; Bartellas, Michael; Parsons, Michael; Dubrowski, Adam; Renouf, Tia

2017-08-18

Cricothyroidotomy is a life-saving medical procedure that allows for tracheal intubation. Most current cricothyroidotomy simulation models are either expensive or not anatomically accurate and provide the learner with an unrealistic simulation experience. The goal of this project is to improve current simulation techniques by utilizing rapid prototyping using 3D printing technology and expert opinions to develop inexpensive and anatomically accurate trachea simulators. In doing so, emergency cricothyroidotomy simulation can be made accessible, accurate, cost-effective and reproducible. Three-dimensional modelling software was used in conjunction with a desktop three-dimensional (3D) printer to design and manufacture an anatomically accurate model of the cartilage within the trachea (thyroid cartilage, cricoid cartilage, and the tracheal rings). The initial design was based on dimensions found in studies of tracheal anatomical configuration. This ensured that the landmarking necessary for emergency cricothyroidotomies was designed appropriately. Several revisions of the original model were made based on informal opinion from medical professionals to establish appropriate anatomical accuracy of the model for use in rural/remote cricothyroidotomy simulation. Using an entry-level desktop 3D printer, a low cost tracheal model was successfully designed that can be printed in less than three hours for only $1.70 Canadian dollars (CAD). Due to its anatomical accuracy, flexibility and durability, this model is great for use in emergency medicine simulation training. Additionally, the model can be assembled in conjunction with a membrane to simulate tracheal ligaments. Skin has been simulated as well to enhance the realism of the model. The result is an accurate simulation that will provide users with an anatomically correct model to practice important skills used in emergency airway surgery, specifically landmarking, incision and intubation. This design is a novel and easy to manufacture and reproduce, high fidelity trachea model that can be used by educators with limited resources.

Modelling and Manufacturing of a 3D Printed Trachea for Cricothyroidotomy Simulation

PubMed Central

Ryan, Stephen; Bartellas, Michael; Parsons, Michael; Dubrowski, Adam; Renouf, Tia

2017-01-01

Cricothyroidotomy is a life-saving medical procedure that allows for tracheal intubation. Most current cricothyroidotomy simulation models are either expensive or not anatomically accurate and provide the learner with an unrealistic simulation experience. The goal of this project is to improve current simulation techniques by utilizing rapid prototyping using 3D printing technology and expert opinions to develop inexpensive and anatomically accurate trachea simulators. In doing so, emergency cricothyroidotomy simulation can be made accessible, accurate, cost-effective and reproducible. Three-dimensional modelling software was used in conjunction with a desktop three-dimensional (3D) printer to design and manufacture an anatomically accurate model of the cartilage within the trachea (thyroid cartilage, cricoid cartilage, and the tracheal rings). The initial design was based on dimensions found in studies of tracheal anatomical configuration. This ensured that the landmarking necessary for emergency cricothyroidotomies was designed appropriately. Several revisions of the original model were made based on informal opinion from medical professionals to establish appropriate anatomical accuracy of the model for use in rural/remote cricothyroidotomy simulation. Using an entry-level desktop 3D printer, a low cost tracheal model was successfully designed that can be printed in less than three hours for only $1.70 Canadian dollars (CAD). Due to its anatomical accuracy, flexibility and durability, this model is great for use in emergency medicine simulation training. Additionally, the model can be assembled in conjunction with a membrane to simulate tracheal ligaments. Skin has been simulated as well to enhance the realism of the model. The result is an accurate simulation that will provide users with an anatomically correct model to practice important skills used in emergency airway surgery, specifically landmarking, incision and intubation. This design is a novel and easy to manufacture and reproduce, high fidelity trachea model that can be used by educators with limited resources. PMID:29057187

Heuristic problems in defining the three-dimensional arrangement of the ventricular myocytes.

PubMed

Anderson, Robert H; Ho, Siew Yen; Sanchez-Quintana, Damian; Redmann, Klaus; Lunkenheimer, Paul P

2006-06-01

There is lack of consensus concerning the three-dimensional arrangement of the myocytes within the ventricular muscle masses. Bioengineers are seeking to model the structure of the heart. Although the success of such models depends on the accuracy of the anatomic evidence, most of them have been based on concepts that are far from anatomical reality, which ignore many significant previous accounts of anatomy presented over the past 400 years. During the 19th century, Pettigrew emphasized that the heart was built on the basis of a modified blood vessel rather than in the form of skeletal muscles. This fact was reemphasized by Lev and Simkins as well as Grant in the 20th century, but the caveats listed by these authors have been ignored by proponents of two current concepts, which state either that the myocardium is arranged in the form of a "unique myocardial band," or that the walls of the ventricles are sequestrated in uniform fashion by laminar sheets of fibrous tissue extending from epicardium to endocardium. These two concepts are themselves incompatible and are further at variance with the majority of anatomic studies, which have emphasized the regional heterogeneity to be found in the three-dimensional packing of the myocytes within a supporting matrix of fibrous tissue. We reemphasize the significance of this three-dimensional muscular mesh, showing how the presence of intruding aggregates of myocytes extending in oblique transmural fashion also contends against the notion that all myocytes are orientated with their long axes parallel to the epicardial and enodcardial surfaces.

Reproducibility of three-dimensional cephalometric landmarks in cone-beam and low-dose computed tomography.

PubMed

Olszewski, R; Frison, L; Wisniewski, M; Denis, J M; Vynckier, S; Cosnard, G; Zech, F; Reychler, H

2013-01-01

The purpose of this study is to compare the reproducibility of three-dimensional cephalometric landmarks on three-dimensional computed tomography (3D-CT) surface rendering using clinical protocols based on low-dose (35-mAs) spiral CT and cone-beam CT (I-CAT). The absorbed dose levels for radiosensitive organs in the maxillofacial region during exposure in both 3D-CT protocols were also assessed. The study population consisted of ten human dry skulls examined with low-dose CT and cone-beam CT. Two independent observers identified 24 cephalometric anatomic landmarks at 13 sites on the 3D-CT surface renderings using both protocols, with each observer repeating the identification 1 month later. A total of 1,920 imaging measurements were performed. Thermoluminescent dosimeters were placed at six sites around the thyroid gland, the submandibular glands, and the eyes in an Alderson phantom to measure the absorbed dose levels. When comparing low-dose CT and cone-beam CT protocols, the cone-beam CT protocol proved to be significantly more reproducible for four of the 13 anatomical sites. There was no significant difference between the protocols for the other nine anatomical sites. Both low-dose and cone-beam CT protocols were equivalent in dose absorption to the eyes and submandibular glands. However, thyroid glands were more irradiated with low-dose CT. Cone-beam CT was more reproducible and procured less irradiation to the thyroid gland than low-dose CT. Cone-beam CT should be preferred over low-dose CT for developing three-dimensional bony cephalometric analyses.

Application of 3-Dimensional Printing in a Case of Osteogenesis Imperfecta for Patient Education, Anatomic Understanding, Preoperative Planning, and Intraoperative Evaluation.

PubMed

Eisenmenger, Laura B; Wiggins, Richard H; Fults, Daniel W; Huo, Eugene J

2017-11-01

The techniques and applications of 3-dimensional (3D) printing have progressed at a fast pace. In the last 10 years, there has been significant progress in applying this technology to medical applications. We present a case of osteogenesis imperfecta in which treatment was aided by prospectively using patient-specific, anatomically accurate 3D prints of the calvaria. The patient-specific, anatomically accurate 3D prints were used in the clinic and in the operating room to augment patient education, improve surgical decision making, and enhance preoperative planning. A 41-year-old woman with osteogenesis imperfecta and an extensive neurosurgical history presented for cranioplasty revision. Computed tomography (CT) data obtained as part of routine preoperative imaging were processed into a 3D model. The 3D patient-specific models were used in the clinic for patient education and in the operating room for preoperative visualization, planning, and intraoperative evaluation of anatomy. The patient reported the 3D models improved her understanding and comfort with the planned surgery when compared with discussing the procedure with the neurosurgeon or viewing the CT images with a neuroradiologist. The neurosurgeon reported an improved understanding of the patient's anatomy and potential cause of patient symptoms as well as improved preoperative planning compared with viewing the CT imaging alone. The neurosurgeon also reported an improvement in the planned surgical approach with a better intraoperative visualization and confirmation of the regions of planned calvarial resection. The use of patient-specific, anatomically accurate 3D prints may improve patient education, surgeon understanding and visualization, preoperative decision making, and intraoperative management. Copyright © 2017 Elsevier Inc. All rights reserved.

Medical 3D Printing for the Radiologist

PubMed Central

Mitsouras, Dimitris; Liacouras, Peter; Imanzadeh, Amir; Giannopoulos, Andreas A.; Cai, Tianrun; Kumamaru, Kanako K.; George, Elizabeth; Wake, Nicole; Caterson, Edward J.; Pomahac, Bohdan; Ho, Vincent B.; Grant, Gerald T.

2015-01-01

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article. ©RSNA, 2015 PMID:26562233

"Black Bone" MRI: a novel imaging technique for 3D printing.

PubMed

Eley, Karen A; Watt-Smith, Stephen R; Golding, Stephen J

2017-03-01

Three-dimensionally printed anatomical models are rapidly becoming an integral part of pre-operative planning of complex surgical cases. We have previously reported the "Black Bone" MRI technique as a non-ionizing alternative to CT. Segmentation of bone becomes possible by minimizing soft tissue contrast to enhance the bone-soft tissue boundary. The objectives of this study were to ascertain the potential of utilizing this technique to produce three-dimensional (3D) printed models. "Black Bone" MRI acquired from adult volunteers and infants with craniosynostosis were 3D rendered and 3D printed. A custom phantom provided a surrogate marker of accuracy permitting comparison between direct measurements and 3D printed models created by segmenting both CT and "Black Bone" MRI data sets using two different software packages. "Black Bone" MRI was successfully utilized to produce 3D models of the craniofacial skeleton in both adults and an infant. Measurements of the cube phantom and 3D printed models demonstrated submillimetre discrepancy. In this novel preliminary study exploring the potential of 3D printing from "Black Bone" MRI data, the feasibility of producing anatomical 3D models has been demonstrated, thus offering a potential non-ionizing alterative to CT for the craniofacial skeleton.

Medical 3D Printing for the Radiologist.

PubMed

Mitsouras, Dimitris; Liacouras, Peter; Imanzadeh, Amir; Giannopoulos, Andreas A; Cai, Tianrun; Kumamaru, Kanako K; George, Elizabeth; Wake, Nicole; Caterson, Edward J; Pomahac, Bohdan; Ho, Vincent B; Grant, Gerald T; Rybicki, Frank J

2015-01-01

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article. (©)RSNA, 2015.

Augmented reality navigation in open surgery for hilar cholangiocarcinoma resection with hemihepatectomy using video-based in situ three-dimensional anatomical modeling: A case report.

PubMed

Tang, Rui; Ma, Longfei; Xiang, Canhong; Wang, Xuedong; Li, Ang; Liao, Hongen; Dong, Jiahong

2017-09-01

Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature. A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks. Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma. Three-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference. No serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results. AR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system.

Review of ultrasound image guidance in external beam radiotherapy: I. Treatment planning and inter-fraction motion management

NASA Astrophysics Data System (ADS)

Fontanarosa, Davide; van der Meer, Skadi; Bamber, Jeffrey; Harris, Emma; O'Shea, Tuathan; Verhaegen, Frank

2015-02-01

In modern radiotherapy, verification of the treatment to ensure the target receives the prescribed dose and normal tissues are optimally spared has become essential. Several forms of image guidance are available for this purpose. The most commonly used forms of image guidance are based on kilovolt or megavolt x-ray imaging. Image guidance can also be performed with non-harmful ultrasound (US) waves. This increasingly used technique has the potential to offer both anatomical and functional information. This review presents an overview of the historical and current use of two-dimensional and three-dimensional US imaging for treatment verification in radiotherapy. The US technology and the implementation in the radiotherapy workflow are described. The use of US guidance in the treatment planning process is discussed. The role of US technology in inter-fraction motion monitoring and management is explained, and clinical studies of applications in areas such as the pelvis, abdomen and breast are reviewed. A companion review paper (O’Shea et al 2015 Phys. Med. Biol. submitted) will extensively discuss the use of US imaging for intra-fraction motion quantification and novel applications of US technology to RT.

Review of ultrasound image guidance in external beam radiotherapy: I. Treatment planning and inter-fraction motion management.

PubMed

Fontanarosa, Davide; van der Meer, Skadi; Bamber, Jeffrey; Harris, Emma; O'Shea, Tuathan; Verhaegen, Frank

2015-02-07

In modern radiotherapy, verification of the treatment to ensure the target receives the prescribed dose and normal tissues are optimally spared has become essential. Several forms of image guidance are available for this purpose. The most commonly used forms of image guidance are based on kilovolt or megavolt x-ray imaging. Image guidance can also be performed with non-harmful ultrasound (US) waves. This increasingly used technique has the potential to offer both anatomical and functional information.This review presents an overview of the historical and current use of two-dimensional and three-dimensional US imaging for treatment verification in radiotherapy. The US technology and the implementation in the radiotherapy workflow are described. The use of US guidance in the treatment planning process is discussed. The role of US technology in inter-fraction motion monitoring and management is explained, and clinical studies of applications in areas such as the pelvis, abdomen and breast are reviewed. A companion review paper (O'Shea et al 2015 Phys. Med. Biol. submitted) will extensively discuss the use of US imaging for intra-fraction motion quantification and novel applications of US technology to RT.

Imaging of congenital chest wall deformities

PubMed Central

Bhaludin, Basrull N; Naaseri, Sahar; Di Chiara, Francesco; Jordan, Simon; Padley, Simon

2016-01-01

To identify the anatomy and pathology of chest wall malformations presenting for consideration for corrective surgery or as a possible chest wall “mass”, and to review the common corrective surgical procedures. Congenital chest wall deformities are caused by anomalies of chest wall growth, leading to sternal depression or protrusion, or are related to failure of normal spine or rib development. Cross-sectional imaging allows appreciation not only of the involved structures but also assessment of the degree of displacement or deformity of adjacent but otherwise normal structures and differentiation between anatomical deformity and neoplasia. In some cases, CT is also useful for surgical planning. The use of three-dimensional reconstructions, utilizing a low-dose technique, provides important information for the surgeon to discuss the nature of anatomical abnormalities and planned corrections with the patient and often with their parents. In this pictorial essay, we discuss the radiological features of the commonest congenital chest wall deformities and illustrate pre- and post-surgical appearances for those undergoing surgical correction. PMID:26916279

Needle path planning and steering in a three-dimensional non-static environment using two-dimensional ultrasound images

PubMed Central

Vrooijink, Gustaaf J.; Abayazid, Momen; Patil, Sachin; Alterovitz, Ron; Misra, Sarthak

2015-01-01

Needle insertion is commonly performed in minimally invasive medical procedures such as biopsy and radiation cancer treatment. During such procedures, accurate needle tip placement is critical for correct diagnosis or successful treatment. Accurate placement of the needle tip inside tissue is challenging, especially when the target moves and anatomical obstacles must be avoided. We develop a needle steering system capable of autonomously and accurately guiding a steerable needle using two-dimensional (2D) ultrasound images. The needle is steered to a moving target while avoiding moving obstacles in a three-dimensional (3D) non-static environment. Using a 2D ultrasound imaging device, our system accurately tracks the needle tip motion in 3D space in order to estimate the tip pose. The needle tip pose is used by a rapidly exploring random tree-based motion planner to compute a feasible needle path to the target. The motion planner is sufficiently fast such that replanning can be performed repeatedly in a closed-loop manner. This enables the system to correct for perturbations in needle motion, and movement in obstacle and target locations. Our needle steering experiments in a soft-tissue phantom achieves maximum targeting errors of 0.86 ± 0.35 mm (without obstacles) and 2.16 ± 0.88 mm (with a moving obstacle). PMID:26279600

Three-Dimensional Printed Modeling of Diffuse Low-Grade Gliomas and Associated White Matter Tract Anatomy.

PubMed

Thawani, Jayesh P; Singh, Nickpreet; Pisapia, Jared M; Abdullah, Kalil G; Parker, Drew; Pukenas, Bryan A; Zager, Eric L; Verma, Ragini; Brem, Steven

2017-04-01

Diffuse low-grade gliomas (DLGGs) represent several pathological entities that infiltrate and invade cortical and subcortical structures in the brain. To describe methods for rapid prototyping of DLGGs and surgically relevant anatomy. Using high-definition imaging data and rapid prototyping technologies, we were able to generate 3 patient DLGGs to scale and represent the associated white matter tracts in 3 dimensions using advanced diffusion tensor imaging techniques. This report represents a novel application of 3-dimensional (3-D) printing in neurosurgery and a means to model individualized tumors in 3-D space with respect to subcortical white matter tract anatomy. Faculty and resident evaluations of this technology were favorable at our institution. Developing an understanding of the anatomic relationships existing within individuals is fundamental to successful neurosurgical therapy. Imaging-based rapid prototyping may improve on our ability to plan for and treat complex neuro-oncologic pathology. Copyright © 2017 by the Congress of Neurological Surgeons

Utility and Scope of Rapid Prototyping in Patients with Complex Muscular Ventricular Septal Defects or Double-Outlet Right Ventricle: Does it Alter Management Decisions?

PubMed

Bhatla, Puneet; Tretter, Justin T; Ludomirsky, Achi; Argilla, Michael; Latson, Larry A; Chakravarti, Sujata; Barker, Piers C; Yoo, Shi-Joon; McElhinney, Doff B; Wake, Nicole; Mosca, Ralph S

2017-01-01

Rapid prototyping facilitates comprehension of complex cardiac anatomy. However, determining when this additional information proves instrumental in patient management remains a challenge. We describe our experience with patient-specific anatomic models created using rapid prototyping from various imaging modalities, suggesting their utility in surgical and interventional planning in congenital heart disease (CHD). Virtual and physical 3-dimensional (3D) models were generated from CT or MRI data, using commercially available software for patients with complex muscular ventricular septal defects (CMVSD) and double-outlet right ventricle (DORV). Six patients with complex anatomy and uncertainty of the optimal management strategy were included in this study. The models were subsequently used to guide management decisions, and the outcomes reviewed. 3D models clearly demonstrated the complex intra-cardiac anatomy in all six patients and were utilized to guide management decisions. In the three patients with CMVSD, one underwent successful endovascular device closure following a prior failed attempt at transcatheter closure, and the other two underwent successful primary surgical closure with the aid of 3D models. In all three cases of DORV, the models provided better anatomic delineation and additional information that altered or confirmed the surgical plan. Patient-specific 3D heart models show promise in accurately defining intra-cardiac anatomy in CHD, specifically CMVSD and DORV. We believe these models improve understanding of the complex anatomical spatial relationships in these defects and provide additional insight for pre/intra-interventional management and surgical planning.

Patient-specific surgical planning and hemodynamic computational fluid dynamics optimization through free-form haptic anatomy editing tool (SURGEM).

PubMed

Pekkan, Kerem; Whited, Brian; Kanter, Kirk; Sharma, Shiva; de Zelicourt, Diane; Sundareswaran, Kartik; Frakes, David; Rossignac, Jarek; Yoganathan, Ajit P

2008-11-01

The first version of an anatomy editing/surgical planning tool (SURGEM) targeting anatomical complexity and patient-specific computational fluid dynamics (CFD) analysis is presented. Novel three-dimensional (3D) shape editing concepts and human-shape interaction technologies have been integrated to facilitate interactive surgical morphology alterations, grid generation and CFD analysis. In order to implement "manual hemodynamic optimization" at the surgery planning phase for patients with congenital heart defects, these tools are applied to design and evaluate possible modifications of patient-specific anatomies. In this context, anatomies involve complex geometric topologies and tortuous 3D blood flow pathways with multiple inlets and outlets. These tools make it possible to freely deform the lumen surface and to bend and position baffles through real-time, direct manipulation of the 3D models with both hands, thus eliminating the tedious and time-consuming phase of entering the desired geometry using traditional computer-aided design (CAD) systems. The 3D models of the modified anatomies are seamlessly exported and meshed for patient-specific CFD analysis. Free-formed anatomical modifications are quantified using an in-house skeletization based cross-sectional geometry analysis tool. Hemodynamic performance of the systematically modified anatomies is compared with the original anatomy using CFD. CFD results showed the relative importance of the various surgically created features such as pouch size, vena cave to pulmonary artery (PA) flare and PA stenosis. An interactive surgical-patch size estimator is also introduced. The combined design/analysis cycle time is used for comparing and optimizing surgical plans and improvements are tabulated. The reduced cost of patient-specific shape design and analysis process, made it possible to envision large clinical studies to assess the validity of predictive patient-specific CFD simulations. In this paper, model anatomical design studies are performed on a total of eight different complex patient specific anatomies. Using SURGEM, more than 30 new anatomical designs (or candidate configurations) are created, and the corresponding user times presented. CFD performances for eight of these candidate configurations are also presented.

Role of a computer-generated three-dimensional laryngeal model in anatomy teaching for advanced learners.

PubMed

Tan, S; Hu, A; Wilson, T; Ladak, H; Haase, P; Fung, K

2012-04-01

(1) To investigate the efficacy of a computer-generated three-dimensional laryngeal model for laryngeal anatomy teaching; (2) to explore the relationship between students' spatial ability and acquisition of anatomical knowledge; and (3) to assess participants' opinion of the computerised model. Forty junior doctors were randomised to undertake laryngeal anatomy study supplemented by either a three-dimensional computer model or two-dimensional images. Outcome measurements comprised a laryngeal anatomy test, the modified Vandenberg and Kuse mental rotation test, and an opinion survey. Mean scores ± standard deviations for the anatomy test were 15.7 ± 2.0 for the 'three dimensions' group and 15.5 ± 2.3 for the 'standard' group (p = 0.7222). Pearson's correlation between the rotation test scores and the scores for the spatial ability questions in the anatomy test was 0.4791 (p = 0.086, n = 29). Opinion survey answers revealed significant differences in respondents' perceptions of the clarity and 'user friendliness' of, and their preferences for, the three-dimensional model as regards anatomical study. The three-dimensional computer model was equivalent to standard two-dimensional images, for the purpose of laryngeal anatomy teaching. There was no association between students' spatial ability and functional anatomy learning. However, students preferred to use the three-dimensional model.

Three-dimensional volume rendering of the ankle based on magnetic resonance images enables the generation of images comparable to real anatomy.

PubMed

Anastasi, Giuseppe; Cutroneo, Giuseppina; Bruschetta, Daniele; Trimarchi, Fabio; Ielitro, Giuseppe; Cammaroto, Simona; Duca, Antonio; Bramanti, Placido; Favaloro, Angelo; Vaccarino, Gianluigi; Milardi, Demetrio

2009-11-01

We have applied high-quality medical imaging techniques to study the structure of the human ankle. Direct volume rendering, using specific algorithms, transforms conventional two-dimensional (2D) magnetic resonance image (MRI) series into 3D volume datasets. This tool allows high-definition visualization of single or multiple structures for diagnostic, research, and teaching purposes. No other image reformatting technique so accurately highlights each anatomic relationship and preserves soft tissue definition. Here, we used this method to study the structure of the human ankle to analyze tendon-bone-muscle relationships. We compared ankle MRI and computerized tomography (CT) images from 17 healthy volunteers, aged 18-30 years (mean 23 years). An additional subject had a partial rupture of the Achilles tendon. The MRI images demonstrated superiority in overall quality of detail compared to the CT images. The MRI series accurately rendered soft tissue and bone in simultaneous image acquisition, whereas CT required several window-reformatting algorithms, with loss of image data quality. We obtained high-quality digital images of the human ankle that were sufficiently accurate for surgical and clinical intervention planning, as well as for teaching human anatomy. Our approach demonstrates that complex anatomical structures such as the ankle, which is rich in articular facets and ligaments, can be easily studied non-invasively using MRI data.

Three-dimensional volume rendering of the ankle based on magnetic resonance images enables the generation of images comparable to real anatomy

PubMed Central

Anastasi, Giuseppe; Cutroneo, Giuseppina; Bruschetta, Daniele; Trimarchi, Fabio; Ielitro, Giuseppe; Cammaroto, Simona; Duca, Antonio; Bramanti, Placido; Favaloro, Angelo; Vaccarino, Gianluigi; Milardi, Demetrio

2009-01-01

We have applied high-quality medical imaging techniques to study the structure of the human ankle. Direct volume rendering, using specific algorithms, transforms conventional two-dimensional (2D) magnetic resonance image (MRI) series into 3D volume datasets. This tool allows high-definition visualization of single or multiple structures for diagnostic, research, and teaching purposes. No other image reformatting technique so accurately highlights each anatomic relationship and preserves soft tissue definition. Here, we used this method to study the structure of the human ankle to analyze tendon–bone–muscle relationships. We compared ankle MRI and computerized tomography (CT) images from 17 healthy volunteers, aged 18–30 years (mean 23 years). An additional subject had a partial rupture of the Achilles tendon. The MRI images demonstrated superiority in overall quality of detail compared to the CT images. The MRI series accurately rendered soft tissue and bone in simultaneous image acquisition, whereas CT required several window-reformatting algorithms, with loss of image data quality. We obtained high-quality digital images of the human ankle that were sufficiently accurate for surgical and clinical intervention planning, as well as for teaching human anatomy. Our approach demonstrates that complex anatomical structures such as the ankle, which is rich in articular facets and ligaments, can be easily studied non-invasively using MRI data. PMID:19678857

3D printing from cardiovascular CT: a practical guide and review

PubMed Central

Birbara, Nicolette S.; Hussain, Tarique; Greil, Gerald; Foley, Thomas A.; Pather, Nalini

2017-01-01

Current cardiovascular imaging techniques allow anatomical relationships and pathological conditions to be captured in three dimensions. Three-dimensional (3D) printing, or rapid prototyping, has also become readily available and made it possible to transform virtual reconstructions into physical 3D models. This technology has been utilised to demonstrate cardiovascular anatomy and disease in clinical, research and educational settings. In particular, 3D models have been generated from cardiovascular computed tomography (CT) imaging data for purposes such as surgical planning and teaching. This review summarises applications, limitations and practical steps required to create a 3D printed model from cardiovascular CT. PMID:29255693

Low-cost Method for Obtaining Medical Rapid Prototyping Using Desktop 3D printing: A Novel Technique for Mandibular Reconstruction Planning.

PubMed

Velasco, Ignacio; Vahdani, Soheil; Ramos, Hector

2017-09-01

Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries. Three patients with benign mandible tumors were included in this study after obtaining informed consent. All patient's maxillofacial CT scan data was processed by segmentation and isolation software and mandible MRP was printed using our desktop 3D printer. These models were used for preoperative surgical planning and prebending of the reconstruction plate. MRP created by desktop 3D printer is a cost-efficient, quick and easily produced appliance for the planning of reconstructive surgery. It can contribute in patient orientation and helping them in a better understanding of their condition and proposed surgical treatment. It helps surgeons for pre-operative planning in the resection or reconstruction cases and represent an excellent tool in academic setting for residents training. The pre-bended reconstruction plate based on MRP, resulted in decreased surgery time, cost and anesthesia risks on the patients. Key words: 3D printing, medical modeling, rapid prototype, mandibular reconstruction, ameloblastoma.

Statistical Analysis of Interactive Surgical Planning Using Shape Descriptors in Mandibular Reconstruction with Fibular Segments

PubMed Central

2016-01-01

This study was performed to quantitatively analyze medical knowledge of, and experience with, decision-making in preoperative virtual planning of mandibular reconstruction. Three shape descriptors were designed to evaluate local differences between reconstructed mandibles and patients’ original mandibles. We targeted an asymmetrical, wide range of cutting areas including the mandibular sidepiece, and defined a unique three-dimensional coordinate system for each mandibular image. The generalized algorithms for computing the shape descriptors were integrated into interactive planning software, where the user can refine the preoperative plan using the spatial map of the local shape distance as a visual guide. A retrospective study was conducted with two oral surgeons and two dental technicians using the developed software. The obtained 120 reconstruction plans show that the participants preferred a moderate shape distance rather than optimization to the smallest. We observed that a visually plausible shape could be obtained when considering specific anatomical features (e.g., mental foramen. mandibular midline). The proposed descriptors can be used to multilaterally evaluate reconstruction plans and systematically learn surgical procedures. PMID:27583465

The production of digital and printed resources from multiple modalities using visualization and three-dimensional printing techniques.

PubMed

Shui, Wuyang; Zhou, Mingquan; Chen, Shi; Pan, Zhouxian; Deng, Qingqiong; Yao, Yong; Pan, Hui; He, Taiping; Wang, Xingce

2017-01-01

Virtual digital resources and printed models have become indispensable tools for medical training and surgical planning. Nevertheless, printed models of soft tissue organs are still challenging to reproduce. This study adopts open source packages and a low-cost desktop 3D printer to convert multiple modalities of medical images to digital resources (volume rendering images and digital models) and lifelike printed models, which are useful to enhance our understanding of the geometric structure and complex spatial nature of anatomical organs. Neuroimaging technologies such as CT, CTA, MRI, and TOF-MRA collect serial medical images. The procedures for producing digital resources can be divided into volume rendering and medical image reconstruction. To verify the accuracy of reconstruction, this study presents qualitative and quantitative assessments. Subsequently, digital models are archived as stereolithography format files and imported to the bundled software of the 3D printer. The printed models are produced using polylactide filament materials. We have successfully converted multiple modalities of medical images to digital resources and printed models for both hard organs (cranial base and tooth) and soft tissue organs (brain, blood vessels of the brain, the heart chambers and vessel lumen, and pituitary tumor). Multiple digital resources and printed models were provided to illustrate the anatomical relationship between organs and complicated surrounding structures. Three-dimensional printing (3DP) is a powerful tool to produce lifelike and tangible models. We present an available and cost-effective method for producing both digital resources and printed models. The choice of modality in medical images and the processing approach is important when reproducing soft tissue organs models. The accuracy of the printed model is determined by the quality of organ models and 3DP. With the ongoing improvement of printing techniques and the variety of materials available, 3DP will become an indispensable tool in medical training and surgical planning.

Use of cone beam computed tomography in implant dentistry: the International Congress of Oral Implantologists consensus report.

PubMed

Benavides, Erika; Rios, Hector F; Ganz, Scott D; An, Chang-Hyeon; Resnik, Randolph; Reardon, Gayle Tieszen; Feldman, Steven J; Mah, James K; Hatcher, David; Kim, Myung-Jin; Sohn, Dong-Seok; Palti, Ady; Perel, Morton L; Judy, Kenneth W M; Misch, Carl E; Wang, Hom-Lay

2012-04-01

The International Congress of Oral Implantologists has supported the development of this consensus report involving the use of Cone Beam Computed Tomography (CBCT) in implant dentistry with the intent of providing scientifically based guidance to clinicians regarding its use as an adjunct to traditional imaging modalities. The literature regarding CBCT and implant dentistry was systematically reviewed. A PubMed search that included studies published between January 1, 2000, and July 31, 2011, was conducted. Oral presentations, in conjunction with these studies, were given by Dr. Erika Benavides, Dr. Scott Ganz, Dr. James Mah, Dr. Myung-Jin Kim, and Dr. David Hatcher at a meeting of the International Congress of Oral Implantologists in Seoul, Korea, on October 6-8, 2011. The studies published could be divided into four main groups: diagnostics, implant planning, surgical guidance, and postimplant evaluation. The literature supports the use of CBCT in dental implant treatment planning particularly in regards to linear measurements, three-dimensional evaluation of alveolar ridge topography, proximity to vital anatomical structures, and fabrication of surgical guides. Areas such as CBCT-derived bone density measurements, CBCT-aided surgical navigation, and postimplant CBCT artifacts need further research. ICOI RECOMMENDATIONS: All CBCT examinations, as all other radiographic examinations, must be justified on an individualized needs basis. The benefits to the patient for each CBCT scan must outweigh the potential risks. CBCT scans should not be taken without initially obtaining thorough medical and dental histories and performing a comprehensive clinical examination. CBCT should be considered as an imaging alternative in cases where the projected implant receptor or bone augmentation site(s) are suspect, and conventional radiography may not be able to assess the true regional three-dimensional anatomical presentation. The smallest possible field of view should be used, and the entire image volume should be interpreted.

The role of PET in target localization for radiotherapy treatment planning.

PubMed

Rembielak, Agata; Price, Pat

2008-02-01

Positron emission tomography (PET) is currently accepted as an important tool in oncology, mostly for diagnosis, staging and restaging purposes. It provides a new type of information in radiotherapy, functional rather than anatomical. PET imaging can also be used for target volume definition in radiotherapy treatment planning. The need for very precise target volume delineation has arisen with the increasing use of sophisticated three-dimensional conformal radiotherapy techniques and intensity modulated radiation therapy. It is expected that better delineation of the target volume may lead to a significant reduction in the irradiated volume, thus lowering the risk of treatment complications (smaller safety margins). Better tumour visualisation also allows a higher dose of radiation to be applied to the tumour, which may lead to better tumour control. The aim of this article is to review the possible use of PET imaging in the radiotherapy of various cancers. We focus mainly on non-small cell lung cancer, lymphoma and oesophageal cancer, but also include current opinion on the use of PET-based planning in other tumours including brain, uterine cervix, rectum and prostate.

A systematic review of clinical value of three-dimensional printing in renal disease.

PubMed

Sun, Zhonghua; Liu, Dongting

2018-04-01

The aim of this systematic review is to analyse current literature related to the clinical value of three-dimensional (3D) printed models in renal disease. A literature search of PubMed and Scopus databases was performed to identify studies reporting the clinical application and usefulness of 3D printed models in renal disease. Fifteen studies were found to meet the selection criteria and were included in the analysis. Eight of them provided quantitative assessments with five studies focusing on dimensional accuracy of 3D printed models in replicating renal anatomy and tumour, and on measuring tumour volume between 3D printed models and original source images and surgical specimens, with mean difference less than 10%. The other three studies reported that the use of 3D printed models significantly enhanced medical students and specialists' ability to identify anatomical structures when compared to two-dimensional (2D) images alone; and significantly shortened intraoperative ultrasound duration compared to without use of 3D printed models. Seven studies provided qualitative assessments of the usefulness of 3D printed kidney models with findings showing that 3D printed models improved patient's understanding of renal anatomy and pathology; improved medical trainees' understanding of renal malignant tumours when compared to viewing medical images alone; and assisted surgical planning and simulation of renal surgical procedures with significant reductions of intraoperative complications. The cost and time associated with 3D printed kidney model production was reported in 10 studies, with costs ranging from USD$100 to USD$1,000, and duration of 3D printing production up to 31 h. The entire process of 3D printing could take up to a few days. This review shows that 3D printed kidney models are accurate in delineating renal anatomical structures and renal tumours with high accuracy. Patient-specific 3D printed models serve as a useful tool in preoperative planning and simulation of surgical procedures for treatment of renal tumours. Further studies with inclusion of more cases and with a focus on reducing the cost and 3D model production time deserve to be investigated.

A systematic review of clinical value of three-dimensional printing in renal disease

PubMed Central

2018-01-01

The aim of this systematic review is to analyse current literature related to the clinical value of three-dimensional (3D) printed models in renal disease. A literature search of PubMed and Scopus databases was performed to identify studies reporting the clinical application and usefulness of 3D printed models in renal disease. Fifteen studies were found to meet the selection criteria and were included in the analysis. Eight of them provided quantitative assessments with five studies focusing on dimensional accuracy of 3D printed models in replicating renal anatomy and tumour, and on measuring tumour volume between 3D printed models and original source images and surgical specimens, with mean difference less than 10%. The other three studies reported that the use of 3D printed models significantly enhanced medical students and specialists’ ability to identify anatomical structures when compared to two-dimensional (2D) images alone; and significantly shortened intraoperative ultrasound duration compared to without use of 3D printed models. Seven studies provided qualitative assessments of the usefulness of 3D printed kidney models with findings showing that 3D printed models improved patient’s understanding of renal anatomy and pathology; improved medical trainees’ understanding of renal malignant tumours when compared to viewing medical images alone; and assisted surgical planning and simulation of renal surgical procedures with significant reductions of intraoperative complications. The cost and time associated with 3D printed kidney model production was reported in 10 studies, with costs ranging from USD$100 to USD$1,000, and duration of 3D printing production up to 31 h. The entire process of 3D printing could take up to a few days. This review shows that 3D printed kidney models are accurate in delineating renal anatomical structures and renal tumours with high accuracy. Patient-specific 3D printed models serve as a useful tool in preoperative planning and simulation of surgical procedures for treatment of renal tumours. Further studies with inclusion of more cases and with a focus on reducing the cost and 3D model production time deserve to be investigated. PMID:29774184

Registration of planar bioluminescence to magnetic resonance and x-ray computed tomography images as a platform for the development of bioluminescence tomography reconstruction algorithms.

PubMed

Beattie, Bradley J; Klose, Alexander D; Le, Carl H; Longo, Valerie A; Dobrenkov, Konstantine; Vider, Jelena; Koutcher, Jason A; Blasberg, Ronald G

2009-01-01

The procedures we propose make possible the mapping of two-dimensional (2-D) bioluminescence image (BLI) data onto a skin surface derived from a three-dimensional (3-D) anatomical modality [magnetic resonance (MR) or computed tomography (CT)] dataset. This mapping allows anatomical information to be incorporated into bioluminescence tomography (BLT) reconstruction procedures and, when applied using sources visible to both optical and anatomical modalities, can be used to evaluate the accuracy of those reconstructions. Our procedures, based on immobilization of the animal and a priori determined fixed projective transforms, should be more robust and accurate than previously described efforts, which rely on a poorly constrained retrospectively determined warping of the 3-D anatomical information. Experiments conducted to measure the accuracy of the proposed registration procedure found it to have a mean error of 0.36+/-0.23 mm. Additional experiments highlight some of the confounds that are often overlooked in the BLT reconstruction process, and for two of these confounds, simple corrections are proposed.

Immediate breast reconstruction with anatomical implants following mastectomy: The radiation perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ben-David, Merav, E-mail: Merav.ben-david@sheba.health.gov.il; Sackler School of Medicine, Tel Aviv University, Tel Aviv; Granot, Hila

2016-07-01

Immediate implant-based breast reconstruction followed by postmastectomy radiation therapy (PMRT) is controversial because of the risk of compromised treatment plans and concerns regarding cosmetic outcomes. We evaluated the effects of immediate direct-to-implant breast reconstruction with anatomical implants on the quality of PMRT delivered by 3-dimensional conformal radiotherapy (3D-CRT). In this retrospective, single-institution study, patients who had undergone reconstruction with direct anatomic implant, performed by a single surgeon, received 3D-CRT between 2008 and 2013. For each patient, 2 plans (including or excluding internal mammary nodes [IMN]) were created and calculated. The primary end point was the dose distribution among reconstructed breasts,more » heart, lungs, and IMNs, and between right and left breasts. Of 29 consecutive patients, 11 received right-sided and 18 received left-sided PMRT to a total dose of 50 Gy. For plans excluding IMN coverage, mean D{sub mean} for right and left reconstructed breasts was 49.09 Gy (98.2% of the prescribed dose) and 48.51 Gy (97.0%), respectively. For plans including IMNs, mean D{sub mean} was 49.15 Gy (98.3%) for right and 48.46 Gy (96.9%) for left reconstructed breasts; the mean IMN D{sub mean} was 47.27 Gy (right) and 47.89 Gy (left). Heart D{sub mean} was below 1.56 Gy for all plans. Mean total lung volume receiving a dose of ≥ 20 Gy was 13.80% to 19.47%. PMRT can be delivered effectively and safely by 3D-CRT after direct-to-implant breast reconstruction with anatomical implants, even if patients require IMN treatment.« less

Advanced 3-dimensional planning in neurosurgery.

PubMed

Ferroli, Paolo; Tringali, Giovanni; Acerbi, Francesco; Schiariti, Marco; Broggi, Morgan; Aquino, Domenico; Broggi, Giovanni

2013-01-01

During the past decades, medical applications of virtual reality technology have been developing rapidly, ranging from a research curiosity to a commercially and clinically important area of medical informatics and technology. With the aid of new technologies, the user is able to process large amounts of data sets to create accurate and almost realistic reconstructions of anatomic structures and related pathologies. As a result, a 3-diensional (3-D) representation is obtained, and surgeons can explore the brain for planning or training. Further improvement such as a feedback system increases the interaction between users and models by creating a virtual environment. Its use for advanced 3-D planning in neurosurgery is described. Different systems of medical image volume rendering have been used and analyzed for advanced 3-D planning: 1 is a commercial "ready-to-go" system (Dextroscope, Bracco, Volume Interaction, Singapore), whereas the others are open-source-based software (3-D Slicer, FSL, and FreesSurfer). Different neurosurgeons at our institution experienced how advanced 3-D planning before surgery allowed them to facilitate and increase their understanding of the complex anatomic and pathological relationships of the lesion. They all agreed that the preoperative experience of virtually planning the approach was helpful during the operative procedure. Virtual reality for advanced 3-D planning in neurosurgery has achieved considerable realism as a result of the available processing power of modern computers. Although it has been found useful to facilitate the understanding of complex anatomic relationships, further effort is needed to increase the quality of the interaction between the user and the model.

Which Tibial Tray Design Achieves Maximum Coverage and Ideal Rotation: Anatomic, Symmetric, or Asymmetric? An MRI-based study.

PubMed

Stulberg, S David; Goyal, Nitin

2015-10-01

Two goals of tibial tray placement in TKA are to maximize coverage and establish proper rotation. Our purpose was to utilize MRI information obtained as part of PSI planning to determine the impact of tibial tray design on the relationship between coverage and rotation. MR images for 100 consecutive knees were uploaded into PSI software. Preoperative planning software was used to evaluate 3 different tray designs: anatomic, symmetric, and asymmetric. Approximately equally good coverage was achieved with all three trays. However, the anatomic compared to symmetric/asymmetric trays required less malrotation (0.3° vs 3.0/2.4°; P < 0.001), with a higher proportion of cases within 5° of neutral (97% vs 73/77%; P < 0.001). In this study, the anatomic tibia optimized the relationship between coverage and rotation. Copyright © 2015 Elsevier Inc. All rights reserved.

Changes in Regional Ventilation During Treatment and Dosimetric Advantages of CT Ventilation Image Guided Radiation Therapy for Locally Advanced Lung Cancer.

PubMed

Yamamoto, Tokihiro; Kabus, Sven; Bal, Matthieu; Bzdusek, Karl; Keall, Paul J; Wright, Cari; Benedict, Stanley H; Daly, Megan E

2018-05-04

Lung functional image guided radiation therapy (RT) that avoids irradiating highly functional regions has potential to reduce pulmonary toxicity following RT. Tumor regression during RT is common, leading to recovery of lung function. We hypothesized that computed tomography (CT) ventilation image-guided treatment planning reduces the functional lung dose compared to standard anatomic image-guided planning in 2 different scenarios with or without plan adaptation. CT scans were acquired before RT and during RT at 2 time points (16-20 Gy and 30-34 Gy) for 14 patients with locally advanced lung cancer. Ventilation images were calculated by deformable image registration of four-dimensional CT image data sets and image analysis. We created 4 treatment plans at each time point for each patient: functional adapted, anatomic adapted, functional unadapted, and anatomic unadapted plans. Adaptation was performed at 2 time points. Deformable image registration was used for accumulating dose and calculating a composite of dose-weighted ventilation used to quantify the lung accumulated dose-function metrics. The functional plans were compared with the anatomic plans for each scenario separately to investigate the hypothesis at a significance level of 0.05. Tumor volume was significantly reduced by 20% after 16 to 20 Gy (P = .02) and by 32% after 30 to 34 Gy (P < .01) on average. In both scenarios, the lung accumulated dose-function metrics were significantly lower in the functional plans than in the anatomic plans without compromising target volume coverage and adherence to constraints to critical structures. For example, functional planning significantly reduced the functional mean lung dose by 5.0% (P < .01) compared to anatomic planning in the adapted scenario and by 3.6% (P = .03) in the unadapted scenario. This study demonstrated significant reductions in the accumulated dose to the functional lung with CT ventilation image-guided planning compared to anatomic image-guided planning for patients showing tumor regression and changes in regional ventilation during RT. Copyright © 2018 Elsevier Inc. All rights reserved.

The Development of a Virtual 3D Model of the Renal Corpuscle from Serial Histological Sections for E-Learning Environments

ERIC Educational Resources Information Center

Roth, Jeremy A.; Wilson, Timothy D.; Sandig, Martin

2015-01-01

Histology is a core subject in the anatomical sciences where learners are challenged to interpret two-dimensional (2D) information (gained from histological sections) to extrapolate and understand the three-dimensional (3D) morphology of cells, tissues, and organs. In gross anatomical education 3D models and learning tools have been associated…

Evaluation by medical students of the educational value of multi-material and multi-colored three-dimensional printed models of the upper limb for anatomical education.

PubMed

Mogali, Sreenivasulu Reddy; Yeong, Wai Yee; Tan, Heang Kuan Joel; Tan, Gerald Jit Shen; Abrahams, Peter H; Zary, Nabil; Low-Beer, Naomi; Ferenczi, Michael Alan

2018-01-01

For centuries, cadaveric material has been the cornerstone of anatomical education. For reasons of changes in curriculum emphasis, cost, availability, expertise, and ethical concerns, several medical schools have replaced wet cadaveric specimens with plastinated prosections, plastic models, imaging, and digital models. Discussions about the qualities and limitations of these alternative teaching resources are on-going. We hypothesize that three-dimensional printed (3DP) models can replace or indeed enhance existing resources for anatomical education. A novel multi-colored and multi-material 3DP model of the upper limb was developed based on a plastinated upper limb prosection, capturing muscles, nerves, arteries and bones with a spatial resolution of ∼1 mm. This study aims to examine the educational value of the 3DP model from the learner's point of view. Students (n = 15) compared the developed 3DP models with the plastinated prosections, and provided their views on their learning experience using 3DP models using a survey and focus group discussion. Anatomical features in 3DP models were rated as accurate by all students. Several positive aspects of 3DP models were highlighted, such as the color coding by tissue type, flexibility and that less care was needed in the handling and examination of the specimen than plastinated specimens which facilitated the appreciation of relations between the anatomical structures. However, students reported that anatomical features in 3DP models are less realistic compared to the plastinated specimens. Multi-colored, multi-material 3DP models are a valuable resource for anatomical education and an excellent adjunct to wet cadaveric or plastinated prosections. Anat Sci Educ 11: 54-64. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Three-Dimensional Display Technologies for Anatomical Education: A Literature Review

NASA Astrophysics Data System (ADS)

Hackett, Matthew; Proctor, Michael

2016-08-01

Anatomy is a foundational component of biological sciences and medical education and is important for a variety of clinical tasks. To augment current curriculum and improve students' spatial knowledge of anatomy, many educators, anatomists, and researchers use three-dimensional (3D) visualization technologies. This article reviews 3D display technologies and their associated assessments for anatomical education. In the first segment, the review covers the general function of displays employing 3D techniques. The second segment of the review highlights the use and assessment of 3D technology in anatomical education, focusing on factors such as knowledge gains, student perceptions, and cognitive load. The review found 32 articles on the use of 3D displays in anatomical education and another 38 articles on the assessment of 3D displays. The review shows that the majority (74 %) of studies indicate that the use of 3D is beneficial for many tasks in anatomical education, and that student perceptions are positive toward the technology.

Advanced virtual endoscopy for endoscopic transsphenoidal pituitary surgery.

PubMed

Wolfsberger, Stefan; Neubauer, André; Bühler, Katja; Wegenkittl, Rainer; Czech, Thomas; Gentzsch, Stephan; Böcher-Schwarz, Hans-Gerd; Knosp, Engelbert

2006-11-01

Virtual endoscopy (vE) is the navigation of a camera through a virtual anatomical space that is computationally reconstructed from radiological image data. Inside this three-dimensional space, arbitrary movements and adaptations of viewing parameters are possible. Thereby, vE can be used for noninvasive diagnostic purposes and for simulation of surgical tasks. This article describes the development of an advanced system of vE for endoscopic transsphenoidal pituitary surgery and its application to teaching, training, and in the routine clinical setting. The vE system was applied to a series of 35 patients with pituitary pathology (32 adenomas, three Rathke's cleft cysts) operated endoscopically via the transsphenoidal route at the Department of Neurosurgery of the Medical University Vienna between 2004 and 2006. The virtual endoscopic images correlated well with the intraoperative view. For the transsphenoidal approach, vE improved intraoperative orientation by depicting anatomical landmarks and variations. For planning a safe and tailored opening of the sellar floor, transparent visualization of the pituitary adenoma and the normal gland in relation to the internal carotid arteries was useful. According to our experience, vE can be a valuable tool for endoscopic transsphenoidal pituitary surgery for training purposes and preoperative planning. For the novice, it can act as a simulator for endoscopic anatomy and for training surgical tasks. For the experienced pituitary surgeon, vE can depict the individual patient's anatomy, and may, therefore, improve intraoperative orientation. By prospectively visualizing unpredictable anatomical variations, vE may increase the safety of this surgical procedure.

Integration of 3D 1H-magnetic resonance spectroscopy data into neuronavigation systems for tumor biopsies

NASA Astrophysics Data System (ADS)

Kanberoglu, Berkay; Moore, Nina Z.; Frakes, David; Karam, Lina J.; Debbins, Josef P.; Preul, Mark C.

2013-03-01

Many important applications in clinical medicine can benefit from the fusion of spectroscopy data with anatomical images. For example, the correlation of metabolite profiles with specific regions of interest in anatomical tumor images can be useful in characterizing and treating heterogeneous tumors that appear structurally homogeneous. Such applications can build on the correlation of data from in-vivo Proton Magnetic Resonance Spectroscopy Imaging (1HMRSI) with data from genetic and ex-vivo Nuclear Magnetic Resonance spectroscopy. To establish that correlation, tissue samples must be neurosurgically extracted from specifically identified locations with high accuracy. Toward that end, this paper presents new neuronavigation technology that enhances current clinical capabilities in the context of neurosurgical planning and execution. The proposed methods improve upon the current state-of-the-art in neuronavigation through the use of detailed three dimensional (3D) 1H-MRSI data. MRSI spectra are processed and analyzed, and specific voxels are selected based on their chemical contents. 3D neuronavigation overlays are then generated and applied to anatomical image data in the operating room. Without such technology, neurosurgeons must rely on memory and other qualitative resources alone for guidance in accessing specific MRSI-identified voxels. In contrast, MRSI-based overlays provide quantitative visual cues and location information during neurosurgery. The proposed methods enable a progressive new form of online MRSI-guided neuronavigation that we demonstrate in this study through phantom validation and clinical application.

A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery

PubMed Central

Job, Alan Varkey; Chen, Jing; Baek, Jung Hwan

2018-01-01

Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting. PMID:29503698

A Review of Current Clinical Applications of Three-Dimensional Printing in Spine Surgery.

PubMed

Cho, Woojin; Job, Alan Varkey; Chen, Jing; Baek, Jung Hwan

2018-02-01

Three-dimensional (3D) printing is a transformative technology with a potentially wide range of applications in the field of orthopaedic spine surgery. This article aims to review the current applications, limitations, and future developments of 3D printing technology in orthopaedic spine surgery. Current preoperative applications of 3D printing include construction of complex 3D anatomic models for improved visual understanding, preoperative surgical planning, and surgical simulations for resident education. Intraoperatively, 3D printers have been successfully used in surgical guidance systems and in the creation of patient specific implantable devices. Furthermore, 3D printing is revolutionizing the field of regenerative medicine and tissue engineering, allowing construction of biocompatible scaffolds suitable for cell growth and vasculature. Advances in printing technology and evidence of positive clinical outcomes are needed before there is an expansion of 3D printing applied to the clinical setting.

Augmented reality navigation in open surgery for hilar cholangiocarcinoma resection with hemihepatectomy using video-based in situ three-dimensional anatomical modeling

PubMed Central

Tang, Rui; Ma, Longfei; Xiang, Canhong; Wang, Xuedong; Li, Ang; Liao, Hongen; Dong, Jiahong

2017-01-01

Abstract Rationale: Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature. Patient concerns: A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks. Diagnoses: Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma. Intervention: Three-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference. Outcomes: No serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results. Lessons: AR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system. PMID:28906410

Development of quantitative analysis method for stereotactic brain image: assessment of reduced accumulation in extent and severity using anatomical segmentation.

PubMed

Mizumura, Sunao; Kumita, Shin-ichiro; Cho, Keiichi; Ishihara, Makiko; Nakajo, Hidenobu; Toba, Masahiro; Kumazaki, Tatsuo

2003-06-01

Through visual assessment by three-dimensional (3D) brain image analysis methods using stereotactic brain coordinates system, such as three-dimensional stereotactic surface projections and statistical parametric mapping, it is difficult to quantitatively assess anatomical information and the range of extent of an abnormal region. In this study, we devised a method to quantitatively assess local abnormal findings by segmenting a brain map according to anatomical structure. Through quantitative local abnormality assessment using this method, we studied the characteristics of distribution of reduced blood flow in cases with dementia of the Alzheimer type (DAT). Using twenty-five cases with DAT (mean age, 68.9 years old), all of whom were diagnosed as probable Alzheimer's disease based on NINCDS-ADRDA, we collected I-123 iodoamphetamine SPECT data. A 3D brain map using the 3D-SSP program was compared with the data of 20 cases in the control group, who age-matched the subject cases. To study local abnormalities on the 3D images, we divided the whole brain into 24 segments based on anatomical classification. We assessed the extent of an abnormal region in each segment (rate of the coordinates with a Z-value that exceeds the threshold value, in all coordinates within a segment), and severity (average Z-value of the coordinates with a Z-value that exceeds the threshold value). This method clarified orientation and expansion of reduced accumulation, through classifying stereotactic brain coordinates according to the anatomical structure. This method was considered useful for quantitatively grasping distribution abnormalities in the brain and changes in abnormality distribution.

Anatomical characteristics of southern pine stemwood

Treesearch

Elaine T. Howard; Floyd G. Manwiller

1968-01-01

To obtain a definitive description of the wood and anatomy of all 10 species of southern pine, juvenile, intermediate, and mature wood was sampled at three heights in one tree of each species and examined under a light microscope. Photographs and three-dimensional drawings were made to illustrate the morphology. No significant anatomical differences were found...

Freeform fabrication of tissue-simulating phantom for potential use of surgical planning in conjoined twins separation surgery.

PubMed

Shen, Shuwei; Wang, Haili; Xue, Yue; Yuan, Li; Zhou, Ximing; Zhao, Zuhua; Dong, Erbao; Liu, Bin; Liu, Wendong; Cromeens, Barrett; Adler, Brent; Besner, Gail; Xu, Ronald X

2017-09-08

Preoperative assessment of tissue anatomy and accurate surgical planning is crucial in conjoined twin separation surgery. We developed a new method that combines three-dimensional (3D) printing, assembling, and casting to produce anatomic models of high fidelity for surgical planning. The related anatomic features of the conjoined twins were captured by computed tomography (CT), classified as five organ groups, and reconstructed as five computer models. Among these organ groups, the skeleton was produced by fused deposition modeling (FDM) using acrylonitrile-butadiene-styrene. For the other four organ groups, shell molds were prepared by FDM and cast with silica gel to simulate soft tissues, with contrast enhancement pigments added to simulate different CT and visual contrasts. The produced models were assembled, positioned firmly within a 3D printed shell mold simulating the skin boundary, and cast with transparent silica gel. The produced phantom was subject to further CT scan in comparison with that of the patient data for fidelity evaluation. Further data analysis showed that the produced model reassembled the geometric features of the original CT data with an overall mean deviation of less than 2 mm, indicating the clinical potential to use this method for surgical planning in conjoined twin separation surgery.

Digital preservation of anatomical variation: 3D-modeling of embalmed and plastinated cadaveric specimens using uCT and MRI.

PubMed

Moore, Colin W; Wilson, Timothy D; Rice, Charles L

2017-01-01

Anatomy educators have an opportunity to teach anatomical variations as a part of medical and allied health curricula using both cadaveric and three-dimensional (3D) digital models of these specimens. Beyond published cadaveric case reports, anatomical variations identified during routine gross anatomy dissection can be powerful teaching tools and a medium to discuss several anatomical sub-disciplines from embryology to medical imaging. The purpose of this study is to document how cadaveric anatomical variation identified during routine dissection can be scanned using medical imaging techniques to create two-dimensional axial images and interactive 3D models for teaching and learning of anatomical variations. Three cadaveric specimens (2 formalin embalmed, 1 plastinated) depicting anatomical variations and an embryological malformation were scanned using magnetic resonance imaging (MRI) and micro-computed tomography (μCT) for visualization in cross-section and for creation of 3D volumetric models. Results provide educational options to enable visualization and facilitate learning of anatomical variations from cross-sectional scans. Furthermore, the variations can be highlighted, digitized, modeled and manipulated using 3D imaging software and viewed in the anatomy laboratory in conjunction with traditional anatomical dissection. This study provides an example for anatomy educators to teach and describe anatomical variations in the undergraduate medical curriculum. Copyright © 2016 Elsevier GmbH. All rights reserved.

The Production of Anatomical Teaching Resources Using Three-Dimensional (3D) Printing Technology

ERIC Educational Resources Information Center

McMenamin, Paul G.; Quayle, Michelle R.; McHenry, Colin R.; Adams, Justin W.

2014-01-01

The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection-based teaching in medical and allied health professional training programs has been in part due to the financial…

Virtual Cerebral Ventricular System: An MR-Based Three-Dimensional Computer Model

ERIC Educational Resources Information Center

Adams, Christina M.; Wilson, Timothy D.

2011-01-01

The inherent spatial complexity of the human cerebral ventricular system, coupled with its deep position within the brain, poses a problem for conceptualizing its anatomy. Cadaveric dissection, while considered the gold standard of anatomical learning, may be inadequate for learning the anatomy of the cerebral ventricular system; even with…

A modified transcondylar screw to accommodate anatomical skull base variations.

PubMed

Ghaly, R F; Lissounov, A

2017-01-01

Occipitocervical instability may be attributed to congenital, bony/ligamentous abnormalities, trauma, neoplasm, degenerative bone disease, and failed atlantoaxial fixation. Indications for occipitocervical fixation include the prevention of disabling pain, cranial nerve dysfunction, paralysis, or even sudden death. The screw trajectory for the modified transcondylar screw (mTCS) is optimally planned utilizing a three-dimensional skull reconstructed image. The modified mTCS technique is helpful where there is a loss of bone, such as after prior suboccipital craniotomy and/or an inadequate occipital condyle. The new proposed technique is similar to the classical transcondylar screw placement but follows a deeper course along the bony lip of foramen magnum toward clivus from a dorsolateral approach. The modified mTCS technique allows for direct visualization and, therefore, helps to avoid damage to the hypoglossal nerve and lateral aspect of brain stem.

WE-G-16A-01: Evolution of Radiation Treatment Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rothenberg, L; Mohan, R; Van Dyk, J

Welcome and Introduction - Lawrence N. Rothenberg This symposium is one a continuing series of presentations at AAPM Annual Meetings on the historical aspects of medical physics, radiology, and radiation oncology that have been organized by the AAPM History Committee. Information on previous presentations including “Early Developments in Teletherapy” (Indianapolis 2013), “Historical Aspects of Cross-Sectional Imaging” (Charlotte 2012), “Historical Aspects of Brachytherapy” (Vancouver 2011), “50 Years of Women in Medical Physics” (Houston 2008), and “Roentgen's Early Investigations” (Minneapolis 2007) can be found in the Education Section of the AAPM Website. The Austin 2014 History Symposium will be on “Evolution ofmore » Radiation Treatment Planning.” Overview - Radhe Mohan Treatment planning is one of the most critical components in the chain of radiation therapy of cancers. Treatment plans of today contain a wide variety of sophisticated information conveying the potential clinical effectiveness of the designed treatment to practitioners. Examples of such information include dose distributions superimposed on three- or even four-dimensional anatomic images; dose volume histograms, dose, dose-volume and dose-response indices for anatomic structures of interest; etc. These data are used for evaluating treatment plans and for making treatment decisions. The current state-of-the-art has evolved from the 1940s era when the dose to the tumor and normal tissues was estimated approximately by manual means. However, the symposium will cover the history of the field from the late-1950's, when computers were first introduced for treatment planning, to the present state involving the use of high performance computing and advanced multi-dimensional anatomic, functional and biological imaging, focusing only on external beam treatment planning. The symposium will start with a general overview of the treatment planning process including imaging, structure delineation, assignment of dose requirements, consideration of uncertainties, selection of beam configurations and shaping of beams, and calculations, optimization and evaluation of dose distributions. This will be followed by three presentations covering the evolution of treatment planning, which parallels the evolution of computers, availability of advanced volumetric imaging and the development of novel technologies such as dynamic multi-leaf collimators and online image guidance. This evolution will be divided over three distinct periods - prior to 1970's, the 2D era; from 1980 to the mid-1990's, the 3D era; and from the mid 1990's to today, the IMRT era. When the World was Flat: The Two-Dimensional Radiation Therapy Era” - Jacob Van Dyk In the 2D era, anatomy was defined with the aid of solder wires, special contouring devices and projection x-rays. Dose distributions were calculated manually from single field, flat surface isodoses on transparencies. Precalculated atlases of generic dose distributions were produced by the International Atomic Energy Agency. Massive time-shared main frames and mini-computers were used to compute doses at individual points or dose distributions in a single plane. Beam shapes were generally rectangular, with wedges, missing tissue compensators and occasional blocks to shield critical structures. Dose calculations were measurement-based or they used primary and scatter calculations based on scatter-air ratio methodologies. Dose distributions were displayed on line printers as alpha-numeric character maps or isodose patterns made with pen plotters. More than Pretty Pictures: 3D Treatment Planning and Conformal Therapy - Benedick A. Fraass The introduction of computed tomography allowed the delineation of anatomy three-dimensionally and, supported partly by contracts from the National Cancer Institute, made possible the introduction and clinical use of 3D treatment planning, leading to development and use of 3D conformal therapy in the 1980's. 3D computer graphics and 3D anatomical structure definitions made possible Beam's Eye View (BEV) displays, making conformal beam shaping and much more sophisticated beam arrangements possible. These conformal plans significantly improved target dose coverage as well as normal tissue sparing. The use of dose volume histograms, gross/clinical/planning target volumes, MRI and PET imaging, multileaf collimators, and computer-controlled treatment delivery made sophisticated planning approaches practical. The significant improvements in dose distributions and analysis achievable with 3D conformal therapy made possible formal dose escalation and normal tissue tolerance clinical studies that set new and improved expectations for improved local control and decreasing complications in many clinical sites. From the Art to the State of the Art: Inverse Planning and IMRT - Thomas R. Bortfeld While the potential of intensity modulation was recognized in the mid- 1980's, intensity-modulated radiotherapy (IMRT) did not become a reality until the mid-1990's. Broad beams of photons could be sub-divided into narrow beamlets whose intensities could be determined using sophisticated optimization algorithms to appropriately balance tumor dose with normal tissue sparing. The development of dynamic multi-leaf collimators (on conventional linear accelerators as well as in helical delivery devices) enabled the efficient delivery of IMRT. The evolution of IMRT planning is continuing in the form of Volumetric Modulated Arc Therapy (VMAT) and through advanced optimization tools, such as multi-criteria optimization, automated IMRT planning, and robust optimization to protect dose distributions against uncertainties. IMRT also facilitates “dose painting” in which different sub-volumes of the target are prescribed different doses. Clearly, these advancements are being made possible by the increasing power and lower cost of computers and developments in other fields such as imaging and operations research. Summary - Radhe Mohan The history does not end here. The advancement of treatment planning is expected to continue, leading to further automation and improvements in conformality and robustness of dose distributions, particularly in the area of particle therapy. Radiobiological modeling will gain emphasis as part of the planning process. Learning Objectives: The scope of changes in technology and the capabilities of radiation treatment planning The impact of these changes in the quality of treatment plans and optimality of dose distributions The impact of development in other fields (imaging, computers, operations research, etc.) on the evolution of radiation treatment planning.« less

Diagnostic ability of computed tomography using DentaScan software in endodontics: case reports.

PubMed

Siotia, Jaya; Gupta, Sunil K; Acharya, Shashi R; Saraswathi, Vidya

2011-01-01

Radiographic examination is essential in diagnosis and treatment planning in endodontics. Conventional radiographs depict structures in two dimensions only. The ability to assess the area of interest in three dimensions is advantageous. Computed tomography is an imaging technique which produces three-dimensional images of an object by taking a series of two-dimensional sectional X-ray images. DentaScan is a computed tomography software program that allows the mandible and maxilla to be imaged in three planes: axial, panoramic, and cross-sectional. As computed tomography is used in endodontics, DentaScan can play a wider role in endodontic diagnosis. It provides valuable information in the assessment of the morphology of the root canal, diagnosis of root fractures, internal and external resorptions, pre-operative assessment of anatomic structures etc. The aim of this article is to explore the clinical usefulness of computed tomography and DentaScan in endodontic diagnosis, through a series of four cases of different endodontic problems.

Three-Dimensional Analysis of the Ear Morphology.

PubMed

Modabber, Ali; Galster, Helmut; Peters, Florian; Möhlhenrich, Stephan Christian; Kniha, Kristian; Knobe, Matthias; Hölzle, Frank; Ghassemi, Alireza

2018-06-01

For surgical treatment of the face, detailed surgical planning is necessary to avoid later unaesthetic results. Most of the studies in the literature concentrate on the ears' anatomy during childhood and adolescence. Nearly no study evaluates the anatomy of ears of people aged 50 or older. It was our aim to measure and evaluate the ear's anatomy in Caucasians between the ages of 21 and 65. Three-dimensional scans of 240 volunteers were taken. The subjects were divided into groups of males and females and each of them into three groups by age (21-35, 36-50, 51-65). Landmarks were placed in these scans. Distances, relations and angles between them were recorded. The distance between the subaurale and superaurale significantly increases (p < 0.001) during the aging process in males and females. Also, the width of the ear, measured between the preaurale and postaurale, significantly increased (p = 0.007) with advancing age. When the length of the ear is divided into four parts by anatomical landmarks, it extended the most in the lower quadrant with increasing subject age. The ear of Caucasians does not stop changing its shape during adulthood. Even after the body has stopped growing, the ear still does. With the measured values in this study, it should be possible for the surgeon to plan the operation in advance and achieve satisfactory aesthetic outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Atlas of the thoracic lymph nodal delineation and recommendations for lymph nodal CTV of esophageal squamous cell cancer in radiation therapy from China.

PubMed

Huang, Wei; Huang, Yong; Sun, Jujie; Liu, Xibin; Zhang, Jian; Zhou, Tao; Zhang, Baijiang; Li, Baosheng

2015-07-01

To construct an anatomical atlas of thoracic lymph node regions of esophageal cancer (EC) based on definitions from The Japan Esophageal Society (JES) and generate a consensus to delineate the nodal clinical target volume (CTVn) for elective nodal radiation (ENI) of esophageal squamous cell carcinoma (ESCC). An interdisciplinary group including two dedicated radiation oncologists, an experienced radiologist, a pathologist and two thoracic surgeons were gathered to generate a three-dimensional radiological description for the mediastinal lymph node regions of EC on axial CT scans. Then the radiological boundaries of lymph node regions were validated by a relatively large number of physicians in multiple institutions. An atlas of detailed anatomic boundaries of lymph node station No. 105-114 was defined on axial CT, along with illustrations. From the previous work, the study provided a guide of CTVn contouring for ENI of thoracic ESCC from a single center. It is feasible to use such an atlas of thoracic lymph node stations for radiotherapy planning. A phase III study based on the atlas is ongoing in China to measure quantitatively the ENI received by patients with ESCC. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Face and content validation of a novel three-dimensional printed temporal bone for surgical skills development.

PubMed

Da Cruz, M J; Francis, H W

2015-07-01

To assess the face and content validity of a novel synthetic, three-dimensional printed temporal bone for surgical skills development and training. A synthetic temporal bone was printed using composite materials and three-dimensional printing technology. Surgical trainees were asked to complete three structured temporal bone dissection exercises. Attitudes and impressions were then assessed using a semi-structured questionnaire. Previous cadaver and real operating experiences were used as a reference. Trainees' experiences of the synthetic temporal bone were analysed in terms of four domains: anatomical realism, usefulness as a training tool, task-based usefulness and overall reactions. Responses across all domains indicated a high degree of acceptance, suggesting that the three-dimensional printed temporal bone was a useful tool in skills development. A sophisticated three-dimensional printed temporal bone that demonstrates face and content validity was developed. The efficiency in cost savings coupled with low associated biohazards make it likely that the printed temporal bone will be incorporated into traditional temporal bone skills development programmes in the near future.

Low-cost Method for Obtaining Medical Rapid Prototyping Using Desktop 3D printing: A Novel Technique for Mandibular Reconstruction Planning

PubMed Central

Vahdani, Soheil; Ramos, Hector

2017-01-01

Background Three-dimensional (3D) printing is relatively a new technology with clinical applications, which enable us to create rapid accurate prototype of the selected anatomic region, making it possible to plan complex surgery and pre-bend hardware for individual surgical cases. This study aimed to express our experience with the use of medical rapid prototype (MRP) of the maxillofacial region created by desktop 3D printer and its application in maxillofacial reconstructive surgeries. Material and Methods Three patients with benign mandible tumors were included in this study after obtaining informed consent. All patient’s maxillofacial CT scan data was processed by segmentation and isolation software and mandible MRP was printed using our desktop 3D printer. These models were used for preoperative surgical planning and prebending of the reconstruction plate. Conclusions MRP created by desktop 3D printer is a cost-efficient, quick and easily produced appliance for the planning of reconstructive surgery. It can contribute in patient orientation and helping them in a better understanding of their condition and proposed surgical treatment. It helps surgeons for pre-operative planning in the resection or reconstruction cases and represent an excellent tool in academic setting for residents training. The pre-bended reconstruction plate based on MRP, resulted in decreased surgery time, cost and anesthesia risks on the patients. Key words:3D printing, medical modeling, rapid prototype, mandibular reconstruction, ameloblastoma. PMID:29075412

An Anatomical Study of Maxillary-Zygomatic Complex Using Three-Dimensional Computerized Tomography-Based Zygomatic Implantation

PubMed Central

Zhao, Shijie; Liu, Hui; Sun, Zhipeng; Wang, Jianwei

2017-01-01

Objective To obtain anatomical data of maxillary-zygomatic complex based on simulating the zygomatic implantation using cadaver heads and three-dimensional computerized tomography (3D-CT). Methods Simulating zygomatic implantation was performed using seven cadaver heads and 3D-CT images from forty-eight adults. After measuring the maxillary-zygomatic complex, we analyzed the position between the implantation path and the maxillary sinus cavity as well as the distance between the implantation path and the zygomatic nerve. Results The distance from the starting point to the endpoint of the implant was 56.85 ± 5.35 mm in cadaver heads and 58.15 ± 7.37 mm in 3D-CT images. For the most common implantation path (80.20%), the implant went through the maxillary sinus cavity completely. The projecting points of the implant axis (IA) on the surface of zygoma were mainly located in the region of frontal process of zygomatic bone close to the lateral orbital wall. The distances between IA and zygomatic nerve in 53 sides were shorter than 2 mm. Conclusion The simulating zygomatic implantation on cadaver skulls and 3D-CT imaging provided useful anatomical data of the maxillary-zygomatic complex. It is necessary to take care to avoid the zygomatic nerve injury during implantation, because it frequently appears on the route of implantation. PMID:29376077

The production of anatomical teaching resources using three-dimensional (3D) printing technology.

PubMed

McMenamin, Paul G; Quayle, Michelle R; McHenry, Colin R; Adams, Justin W

2014-01-01

The teaching of anatomy has consistently been the subject of societal controversy, especially in the context of employing cadaveric materials in professional medical and allied health professional training. The reduction in dissection-based teaching in medical and allied health professional training programs has been in part due to the financial considerations involved in maintaining bequest programs, accessing human cadavers and concerns with health and safety considerations for students and staff exposed to formalin-containing embalming fluids. This report details how additive manufacturing or three-dimensional (3D) printing allows the creation of reproductions of prosected human cadaver and other anatomical specimens that obviates many of the above issues. These 3D prints are high resolution, accurate color reproductions of prosections based on data acquired by surface scanning or CT imaging. The application of 3D printing to produce models of negative spaces, contrast CT radiographic data using segmentation software is illustrated. The accuracy of printed specimens is compared with original specimens. This alternative approach to producing anatomically accurate reproductions offers many advantages over plastination as it allows rapid production of multiple copies of any dissected specimen, at any size scale and should be suitable for any teaching facility in any country, thereby avoiding some of the cultural and ethical issues associated with cadaver specimens either in an embalmed or plastinated form. © 2014 American Association of Anatomists.

Do Three-dimensional Visualization and Three-dimensional Printing Improve Hepatic Segment Anatomy Teaching? A Randomized Controlled Study.

PubMed

Kong, Xiangxue; Nie, Lanying; Zhang, Huijian; Wang, Zhanglin; Ye, Qiang; Tang, Lei; Li, Jianyi; Huang, Wenhua

2016-01-01

Hepatic segment anatomy is difficult for medical students to learn. Three-dimensional visualization (3DV) is a useful tool in anatomy teaching, but current models do not capture haptic qualities. However, three-dimensional printing (3DP) can produce highly accurate complex physical models. Therefore, in this study we aimed to develop a novel 3DP hepatic segment model and compare the teaching effectiveness of a 3DV model, a 3DP model, and a traditional anatomical atlas. A healthy candidate (female, 50-years old) was recruited and scanned with computed tomography. After three-dimensional (3D) reconstruction, the computed 3D images of the hepatic structures were obtained. The parenchyma model was divided into 8 hepatic segments to produce the 3DV hepatic segment model. The computed 3DP model was designed by removing the surrounding parenchyma and leaving the segmental partitions. Then, 6 experts evaluated the 3DV and 3DP models using a 5-point Likert scale. A randomized controlled trial was conducted to evaluate the educational effectiveness of these models compared with that of the traditional anatomical atlas. The 3DP model successfully displayed the hepatic segment structures with partitions. All experts agreed or strongly agreed that the 3D models provided good realism for anatomical instruction, with no significant differences between the 3DV and 3DP models in each index (p > 0.05). Additionally, the teaching effects show that the 3DV and 3DP models were significantly better than traditional anatomical atlas in the first and second examinations (p < 0.05). Between the first and second examinations, only the traditional method group had significant declines (p < 0.05). A novel 3DP hepatic segment model was successfully developed. Both the 3DV and 3DP models could improve anatomy teaching significantly. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Exploring the simulation requirements for virtual regional anesthesia training

NASA Astrophysics Data System (ADS)

Charissis, V.; Zimmer, C. R.; Sakellariou, S.; Chan, W.

2010-01-01

This paper presents an investigation towards the simulation requirements for virtual regional anaesthesia training. To this end we have developed a prototype human-computer interface designed to facilitate Virtual Reality (VR) augmenting educational tactics for regional anaesthesia training. The proposed interface system, aims to compliment nerve blocking techniques methods. The system is designed to operate in real-time 3D environment presenting anatomical information and enabling the user to explore the spatial relation of different human parts without any physical constrains. Furthermore the proposed system aims to assist the trainee anaesthetists so as to build a mental, three-dimensional map of the anatomical elements and their depictive relationship to the Ultra-Sound imaging which is used for navigation of the anaesthetic needle. Opting for a sophisticated approach of interaction, the interface elements are based on simplified visual representation of real objects, and can be operated through haptic devices and surround auditory cues. This paper discusses the challenges involved in the HCI design, introduces the visual components of the interface and presents a tentative plan of future work which involves the development of realistic haptic feedback and various regional anaesthesia training scenarios.

Visualization of Stereoscopic Anatomic Models of the Paranasal Sinuses and Cervical Vertebrae from the Surgical and Procedural Perspective

ERIC Educational Resources Information Center

Chen, Jian; Smith, Andrew D.; Khan, Majid A.; Sinning, Allan R.; Conway, Marianne L.; Cui, Dongmei

2017-01-01

Recent improvements in three-dimensional (3D) virtual modeling software allows anatomists to generate high-resolution, visually appealing, colored, anatomical 3D models from computed tomography (CT) images. In this study, high-resolution CT images of a cadaver were used to develop clinically relevant anatomic models including facial skull, nasal…

Three-dimensional automatic computer-aided evaluation of pleural effusions on chest CT images

NASA Astrophysics Data System (ADS)

Bi, Mark; Summers, Ronald M.; Yao, Jianhua

2011-03-01

The ability to estimate the volume of pleural effusions is desirable as it can provide information about the severity of the condition and the need for thoracentesis. We present here an improved version of an automated program to measure the volume of pleural effusions using regular chest CT images. First, the lungs are segmented using region growing, mathematical morphology, and anatomical knowledge. The visceral and parietal layers of the pleura are then extracted based on anatomical landmarks, curve fitting and active contour models. The liver and compressed tissues are segmented out using thresholding. The pleural space is then fitted to a Bezier surface which is subsequently projected onto the individual two-dimensional slices. Finally, the volume of the pleural effusion is quantified. Our method was tested on 15 chest CT studies and validated against three separate manual tracings. The Dice coefficients were 0.74+/-0.07, 0.74+/-0.08, and 0.75+/-0.07 respectively, comparable to the variation between two different manual tracings.

A Modified Microsurgical Endoscopic-Assisted Transpedicular Corpectomy of the Thoracic Spine Based on Virtual 3-Dimensional Planning.

PubMed

Archavlis, Eleftherios; Schwandt, Eike; Kosterhon, Michael; Gutenberg, Angelika; Ulrich, Peter; Nimer, Amr; Giese, Alf; Kantelhardt, Sven Rainer

2016-07-01

The main difficulties of transpedicular corpectomies are lack of space for vertebral body replacement in the neighborhood of critical structures, the necessity for sacrifice of nerve roots in the thoracic spine. and the extent of hemorrhage due to venous epidural bleeding. We present a modified technique of transpedicular corpectomy by using an endoscopic-assisted microsurgical technique performed through a single posterior approach. A 3-dimensional (3D) preoperative reconstruction could be helpful in the planning for this complex anatomic region. Surface and volume 3D reconstruction were performed by Amira or the Dextroscope. The clinical experience of this study includes 7 cases, 2 with an unstable burst fracture and 5 with metastatic destructive vertebral body disease, all with significant retropulsion and obstruction of the spinal canal. We performed a comparison with a conventional cohort of transpedicular thoracic corpectomies. Qualitative parameters of the 3D virtual reality planning included degree of bone removal and distance from critical structures such as myelon and implant diameter. Parameters were met in each case, with demonstration of optimal positioning of the implant without neurological complications. In all patients, the endoscope was a significant help in identifying the origins of active bleeding, residual tumor, extent of bone removal, facilitating cage insertion in a minimally invasive way, and helping to avoid root sacrifice on both sides. Microsurgical endoscopic-assisted transpedicular corpectomy may prove valuable in enhancing the safety of corpectomy in destructive vertebral body disease. The 3D virtual anatomic model greatly facilitated the preoperative planning. Copyright © 2016 Elsevier Inc. All rights reserved.

An interactive, web-based tool for learning anatomic landmarks.

PubMed

Hallgren, Richard C; Parkhurst, Perrin E; Monson, Carol L; Crewe, Nancy M

2002-03-01

To evaluate the effectiveness of a Web-based interactive teaching tool that uses self-assessment exercises with real-time feedback to aid students' learning in a gross anatomy class. A total of 107 of 124 first-year medical students at one school were enrolled in the study. Students were divided into three groups: Group 1 (n = 63) received introductory material and activated their Web-based accounts; Group 2 (n = 44) received introductory material but did not activate their Web-based accounts; and Group 3 (n = 17) were not enrolled in the study and received no introductory material. Students in Group 1 had access to a graphic showing the locations of anatomic landmarks, a drill exercise, and a self-evaluation exercise. Students' ability to identify the anatomic landmarks on a 30-question midterm and a 30-question final exam were compared among the groups. The mean scores of students in Group 1 (midterm = 28.5, final = 28.1) were significantly higher than were the mean scores of students in Group 2 (midterm = 26.8, p <.001; final = 26.9, p <.017) and Group 3 (midterm = 24.8, p <.001; final = 26.4, p <.007). The Web-based tool was effective in improving students' scores on anatomic landmark exams. Future studies will determine whether the tool aids students in identifying structures located in three-dimensional space within regions such as the cranium and the abdominal cavity.

Three-Dimensional Display Technologies for Anatomical Education: A Literature Review

ERIC Educational Resources Information Center

Hackett, Matthew; Proctor, Michael

2016-01-01

Anatomy is a foundational component of biological sciences and medical education and is important for a variety of clinical tasks. To augment current curriculum and improve students' spatial knowledge of anatomy, many educators, anatomists, and researchers use three-dimensional (3D) visualization technologies. This article reviews 3D display…

Medical three-dimensional printing opens up new opportunities in cardiology and cardiac surgery.

PubMed

Bartel, Thomas; Rivard, Andrew; Jimenez, Alejandro; Mestres, Carlos A; Müller, Silvana

2018-04-14

Advanced percutaneous and surgical procedures in structural and congenital heart disease require precise pre-procedural planning and continuous quality control. Although current imaging modalities and post-processing software assists with peri-procedural guidance, their capabilities for spatial conceptualization remain limited in two- and three-dimensional representations. In contrast, 3D printing offers not only improved visualization for procedural planning, but provides substantial information on the accuracy of surgical reconstruction and device implantations. Peri-procedural 3D printing has the potential to set standards of quality assurance and individualized healthcare in cardiovascular medicine and surgery. Nowadays, a variety of clinical applications are available showing how accurate 3D computer reformatting and physical 3D printouts of native anatomy, embedded pathology, and implants are and how they may assist in the development of innovative therapies. Accurate imaging of pathology including target region for intervention, its anatomic features and spatial relation to the surrounding structures is critical for selecting optimal approach and evaluation of procedural results. This review describes clinical applications of 3D printing, outlines current limitations, and highlights future implications for quality control, advanced medical education and training.

Plastic Surgery Applications Using Three-Dimensional Planning and Computer-Assisted Design and Manufacturing.

PubMed

Pfaff, Miles J; Steinbacher, Derek M

2016-03-01

Three-dimensional analysis and planning is a powerful tool in plastic and reconstructive surgery, enabling improved diagnosis, patient education and communication, and intraoperative transfer to achieve the best possible results. Three-dimensional planning can increase efficiency and accuracy, and entails five core components: (1) analysis, (2) planning, (3) virtual surgery, (4) three-dimensional printing, and (5) comparison of planned to actual results. The purpose of this article is to provide an overview of three-dimensional virtual planning and to provide a framework for applying these systems to clinical practice. Therapeutic, V.

Deformable medical image registration of pleural cavity for photodynamic therapy by using finite-element based method

NASA Astrophysics Data System (ADS)

Penjweini, Rozhin; Kim, Michele M.; Dimofte, Andrea; Finlay, Jarod C.; Zhu, Timothy C.

2016-03-01

When the pleural cavity is opened during the surgery portion of pleural photodynamic therapy (PDT) of malignant mesothelioma, the pleural volume will deform. This impacts the delivered dose when using highly conformal treatment techniques. To track the anatomical changes and contour the lung and chest cavity, an infrared camera-based navigation system (NDI) is used during PDT. In the same patient, a series of computed tomography (CT) scans of the lungs are also acquired before the surgery. The reconstructed three-dimensional contours from both NDI and CTs are imported into COMSOL Multiphysics software, where a finite element-based (FEM) deformable image registration is obtained. The CT contour is registered to the corresponding NDI contour by overlapping the center of masses and aligning their orientations. The NDI contour is considered as the reference contour, and the CT contour is used as the target one, which will be deformed. Deformed Geometry model is applied in COMSOL to obtain a deformed target contour. The distortion of the volume at X, Y and Z is mapped to illustrate the transformation of the target contour. The initial assessment shows that FEM-based image deformable registration can fuse images acquired by different modalities. It provides insights into the deformation of anatomical structures along X, Y and Z-axes. The deformed contour has good matches to the reference contour after the dynamic matching process. The resulting three-dimensional deformation map can be used to obtain the locations of other critical anatomic structures, e.g., heart, during surgery.

Image-Guided Radiation Therapy: the potential for imaging science research to improve cancer treatment outcomes

NASA Astrophysics Data System (ADS)

Williamson, Jeffrey

2008-03-01

The role of medical imaging in the planning and delivery of radiation therapy (RT) is rapidly expanding. This is being driven by two developments: Image-guided radiation therapy (IGRT) and biological image-based planning (BIBP). IGRT is the systematic use of serial treatment-position imaging to improve geometric targeting accuracy and/or to refine target definition. The enabling technology is the integration of high-performance three-dimensional (3D) imaging systems, e.g., onboard kilovoltage x-ray cone-beam CT, into RT delivery systems. IGRT seeks to adapt the patient's treatment to weekly, daily, or even real-time changes in organ position and shape. BIBP uses non-anatomic imaging (PET, MR spectroscopy, functional MR, etc.) to visualize abnormal tissue biology (angiogenesis, proliferation, metabolism, etc.) leading to more accurate clinical target volume (CTV) delineation and more accurate targeting of high doses to tissue with the highest tumor cell burden. In both cases, the goal is to reduce both systematic and random tissue localization errors (2-5 mm for conventional RT) conformality so that planning target volume (PTV) margins (varying from 8 to 20 mm in conventional RT) used to ensure target volume coverage in the presence of geometric error, can be substantially reduced. Reduced PTV expansion allows more conformal treatment of the target volume, increased avoidance of normal tissue and potential for safe delivery of more aggressive dose regimens. This presentation will focus on the imaging science challenges posed by the IGRT and BIBP. These issues include: Development of robust and accurate nonrigid image-registration (NIR) tools: Extracting locally nonlinear mappings that relate, voxel-by-voxel, one 3D anatomic representation of the patient to differently deformed anatomies acquired at different time points, is essential if IGRT is to move beyond simple translational treatment plan adaptations. NIR is needed to map segmented and labeled anatomy from the pretreatment planning images to each daily treatment position image and to deformably map delivered dose distributions computed on each time instance of deformed anatomy, back to the reference 3D anatomy. Because biological imaging must be performed offline, NIR is needed to deformably map these images onto CT images acquired during treatment. Reducing target and organ contouring errors: As IGRT significantly reduces impact of differences between planning and treatment anatomy, RT targeting accuracy becomes increasingly dominated by the remaining systematic treatment-preparation errors, chiefly error in delineating the clinical target volume (CTV) and organs-at-risk. These delineation errors range from 1 mm to 5 mm. No single solution to this problem exists. For BIBP, a better understanding of tumor cell density vs. signal intensity is required. For anatomic CT imaging, improved image reconstruction techniques that improve contrast-to-noise ratio, reduce artifacts due to limited projection data, and incorporate prior information are promising. More sophisticated alternatives to the current concept fixed boundary anatomic structures are needed, e.g., probabilistic CTV representations that incorporate delineation uncertainties. Quantifying four-dimensional (4D) anatomy: For adaptive treatment planning to produce an optimal time sequence of delivery parameters, a 4D anatomic representation, the spatial trajectory through time of each tissue voxel, is needed. One approach is to use sequences of deformation vector fields derived by non-rigidly registering each treatment image to the reference planning CT. One problem to be solved is prediction of future deformed anatomies from past behavior so that time delays inherent in any adaptive replanning feedback loop can be overcome. Another unsolved problem is quantification 4D anatomy uncertainties and how to incorporate such uncertainties into the treatment planning process to avoid geometric ``miss'' of the target tissue.

Comparison of three aids for teaching lumbar surgical anatomy.

PubMed

Das, S; Mitchell, P

2013-08-01

Reduced surgeons' training time has resulted in a need to increase the speed of learning. Currently, anatomy education involves traditional (textbooks, physical models, cadaveric dissection/prosection) and recent (electronic) techniques. As yet there are no available data comparing their performance. The performance of three anatomical training aids at teaching the surgical anatomy of the lumbar spinal was compared. The aids used were paper-based images, a three-dimensional plastic model and a semitransparent computer model. Fifty one study subjects were recruited from a population of junior doctors, nurses, medical and nursing students. Three study groups were created which differed in the order of presenting the aids. For each subject, spinal anatomy was revised by the investigator, teaching them the anatomy using each aid. They were specifically taught the locations of the intervertebral disc, pedicles and nerve roots in the lateral recesses. They then drew these structures on a response sheet (three response sheets per subject). The computer model was the best at allowing subjects accurately to determine structure location followed by the paper-based images, the plastic model was the worst. Accuracy improved with successive models used but this trend was not significant. Subjects were not versed in spinal anatomy beforehand, so meaningful baseline measures were not available. The educational performance of surgical anatomical training aids can be measured and compared. A computer generated 3 dimensional model gave the best results with paper-based images second and the plastic model third.

A Bayesian approach to the creation of a study-customized neonatal brain atlas

PubMed Central

Zhang, Yajing; Chang, Linda; Ceritoglu, Can; Skranes, Jon; Ernst, Thomas; Mori, Susumu; Miller, Michael I.; Oishi, Kenichi

2014-01-01

Atlas-based image analysis (ABA), in which an anatomical “parcellation map” is used for parcel-by-parcel image quantification, is widely used to analyze anatomical and functional changes related to brain development, aging, and various diseases. The parcellation maps are often created based on common MRI templates, which allow users to transform the template to target images, or vice versa, to perform parcel-by-parcel statistics, and report the scientific findings based on common anatomical parcels. The use of a study-specific template, which represents the anatomical features of the study population better than common templates, is preferable for accurate anatomical labeling; however, the creation of a parcellation map for a study-specific template is extremely labor intensive, and the definitions of anatomical boundaries are not necessarily compatible with those of the common template. In this study, we employed a Volume-based Template Estimation (VTE) method to create a neonatal brain template customized to a study population, while keeping the anatomical parcellation identical to that of a common MRI atlas. The VTE was used to morph the standardized parcellation map of the JHU-neonate-SS atlas to capture the anatomical features of a study population. The resultant “study-customized” T1-weighted and diffusion tensor imaging (DTI) template, with three-dimensional anatomical parcellation that defined 122 brain regions, was compared with the JHU-neonate-SS atlas, in terms of the registration accuracy. A pronounced increase in the accuracy of cortical parcellation and superior tensor alignment were observed when the customized template was used. With the customized atlas-based analysis, the fractional anisotropy (FA) detected closely approximated the manual measurements. This tool provides a solution for achieving normalization-based measurements with increased accuracy, while reporting scientific findings in a consistent framework. PMID:25026155

Skeletal Muscle Fascicle Arrangements Can Be Reconstructed Using a Laplacian Vector Field Simulation

PubMed Central

Choi, Hon Fai; Blemker, Silvia S.

2013-01-01

Skeletal muscles are characterized by a large diversity in anatomical architecture and function. Muscle force and contraction are generated by contractile fiber cells grouped in fascicle bundles, which transmit the mechanical action between origin and insertion attachments of the muscle. Therefore, an adequate representation of fascicle arrangements in computational models of skeletal muscles is important, especially when investigating three-dimensional muscle deformations in finite element models. However, obtaining high resolution in vivo measurements of fascicle arrangements in skeletal muscles is currently still challenging. This motivated the development of methods in previous studies to generate numerical representations of fascicle trajectories using interpolation templates. Here, we present an alternative approach based on the hypothesis of a rotation and divergence free (Laplacian) vector field behavior which reflects observed physical characteristics of fascicle trajectories. To obtain this representation, the Laplace equation was solved in anatomical reconstructions of skeletal muscle shapes based on medical images using a uniform flux boundary condition on the attachment areas. Fascicle tracts were generated through a robust flux based tracing algorithm. The concept of this approach was demonstrated in two-dimensional synthetic examples of typical skeletal muscle architectures. A detailed evaluation was performed in an example of the anatomical human tibialis anterior muscle which showed an overall agreement with measurements from the literature. The utility and capability of the proposed method was further demonstrated in other anatomical examples of human skeletal muscles with a wide range of muscle shapes and attachment morphologies. PMID:24204878

Three-dimensional mapping of the lateral ventricles in autism

PubMed Central

Vidal, Christine N.; Nicolsonln, Rob; Boire, Jean-Yves; Barra, Vincent; DeVito, Timothy J.; Hayashi, Kiralee M.; Geaga, Jennifer A.; Drost, Dick J.; Williamson, Peter C.; Rajakumar, Nagalingam; Toga, Arthur W.; Thompson, Paul M.

2009-01-01

In this study, a computational mapping technique was used to examine the three-dimensional profile of the lateral ventricles in autism. T1-weighted three-dimensional magnetic resonance images of the brain were acquired from 20 males with autism (age: 10.1 ± 3.5 years) and 22 male control subjects (age: 10.7 ± 2.5 years). The lateral ventricles were delineated manually and ventricular volumes were compared between the two groups. Ventricular traces were also converted into statistical three-dimensional maps, based on anatomical surface meshes. These maps were used to visualize regional morphological differences in the thickness of the lateral ventricles between patients and controls. Although ventricular volumes measured using traditional methods did not differ significantly between groups, statistical surface maps revealed subtle, highly localized reductions in ventricular size in patients with autism in the left frontal and occipital horns. These localized reductions in the lateral ventricles may result from exaggerated brain growth early in life. PMID:18502618

Regular three-dimensional presentations improve in the identification of surgical liver anatomy - a randomized study.

PubMed

Müller-Stich, Beat P; Löb, Nicole; Wald, Diana; Bruckner, Thomas; Meinzer, Hans-Peter; Kadmon, Martina; Büchler, Markus W; Fischer, Lars

2013-09-25

Three-dimensional (3D) presentations enhance the understanding of complex anatomical structures. However, it has been shown that two dimensional (2D) "key views" of anatomical structures may suffice in order to improve spatial understanding. The impact of real 3D images (3Dr) visible only with 3D glasses has not been examined yet. Contrary to 3Dr, regular 3D images apply techniques such as shadows and different grades of transparency to create the impression of 3D.This randomized study aimed to define the impact of both the addition of key views to CT images (2D+) and the use of 3Dr on the identification of liver anatomy in comparison with regular 3D presentations (3D). A computer-based teaching module (TM) was used. Medical students were randomized to three groups (2D+ or 3Dr or 3D) and asked to answer 11 anatomical questions and 4 evaluative questions. Both 3D groups had animated models of the human liver available to them which could be moved in all directions. 156 medical students (57.7% female) participated in this randomized trial. Students exposed to 3Dr and 3D performed significantly better than those exposed to 2D+ (p < 0.01, ANOVA). There were no significant differences between 3D and 3Dr and no significant gender differences (p > 0.1, t-test). Students randomized to 3D and 3Dr not only had significantly better results, but they also were significantly faster in answering the 11 anatomical questions when compared to students randomized to 2D+ (p < 0.03, ANOVA). Whether or not "key views" were used had no significant impact on the number of correct answers (p > 0.3, t-test). This randomized trial confirms that regular 3D visualization improve the identification of liver anatomy.

Applied anatomic site study of palatal anchorage implants using cone beam computed tomography.

PubMed

Lai, Ren-fa; Zou, Hui; Kong, Wei-dong; Lin, Wei

2010-06-01

The purpose of this study was to conduct quantitative research on bone height and bone mineral density of palatal implant sites for implantation, and to provide reference sites for safe and stable palatal implants. Three-dimensional reformatting images were reconstructed by cone beam computed tomography (CBCT) in 34 patients, aged 18 to 35 years, using EZ Implant software. Bone height was measured at 20 sites of interest on the palate. Bone mineral density was measured at the 10 sites with the highest implantation rate, classified using K-mean cluster analysis based on bone height and bone mineral density. According to the cluster analysis, 10 sites were classified into three clusters. Significant differences in bone height and bone mineral density were detected between these three clusters (P<0.05). The greatest bone height was obtained in cluster 2, followed by cluster 1 and cluster 3. The highest bone mineral density was found in cluster 3, followed by cluster 1 and cluster 2. CBCT plays an important role in pre-surgical treatment planning. CBCT is helpful in identifying safe and stable implantation sites for palatal anchorage.

Three-Dimensional Virtual Sonographic Cystoscopy for Detection of Ureterocele in Duplicated Collecting Systems in Children.

PubMed

Nabavizadeh, Behnam; Mozafarpour, Sarah; Hosseini Sharifi, Seyed Hossein; Nabavizadeh, Reza; Abbasioun, Reza; Kajbafzadeh, Abdol-Mohammad

2018-03-01

Ureterocele is a sac-like dilatation of terminal ureter. Precise anatomic delineation is of utmost importance to proceed with the surgical plan, particularly in the ectopic subtype. However, the level of ureterocele extension is not always elucidated by the existing imaging modalities and even by conventional cystoscopy, which is considered as the gold standard for evaluation of ureterocele. This study aims to evaluate the accuracy of three-dimensional virtual sonographic cystoscopy (VSC) in the characterization of ureterocele in duplex collecting systems. Sixteen children with a mean age of 5.1 (standard deviation 1.96) years with transabdominal ultrasonography-proven duplex system and ureterocele were included. They underwent VSC by a single pediatric radiologist. All of them subsequently had conventional cystoscopy, and the results were compared in terms of ureterocele features including anatomy, number, size, location, and extension. Three-dimensional VSC was well tolerated in all cases without any complication. Image quality was suboptimal in 2 of 16 patients. Out of the remaining 14 cases, VSC had a high accuracy in characterization of the ureterocele features (93%). Only the extension of one ureterocele was not precisely detected by VSC. The results of this study suggest three-dimensional sonography as a promising noninvasive diagnostic modality in the evaluation of ectopic ureterocele in children. © 2017 by the American Institute of Ultrasound in Medicine.

Preservation of three-dimensional anatomy in phosphatized fossil arthropods enriches evolutionary inference.

PubMed

Schwermann, Achim H; Dos Santos Rolo, Tomy; Caterino, Michael S; Bechly, Günter; Schmied, Heiko; Baumbach, Tilo; van de Kamp, Thomas

2016-02-05

External and internal morphological characters of extant and fossil organisms are crucial to establishing their systematic position, ecological role and evolutionary trends. The lack of internal characters and soft-tissue preservation in many arthropod fossils, however, impedes comprehensive phylogenetic analyses and species descriptions according to taxonomic standards for Recent organisms. We found well-preserved three-dimensional anatomy in mineralized arthropods from Paleogene fissure fillings and demonstrate the value of these fossils by utilizing digitally reconstructed anatomical structure of a hister beetle. The new anatomical data facilitate a refinement of the species diagnosis and allowed us to reject a previous hypothesis of close phylogenetic relationship to an extant congeneric species. Our findings suggest that mineralized fossils, even those of macroscopically poor preservation, constitute a rich but yet largely unexploited source of anatomical data for fossil arthropods.

Tooth segmentation system with intelligent editing for cephalometric analysis

NASA Astrophysics Data System (ADS)

Chen, Shoupu

2015-03-01

Cephalometric analysis is the study of the dental and skeletal relationship in the head, and it is used as an assessment and planning tool for improved orthodontic treatment of a patient. Conventional cephalometric analysis identifies bony and soft-tissue landmarks in 2D cephalometric radiographs, in order to diagnose facial features and abnormalities prior to treatment, or to evaluate the progress of treatment. Recent studies in orthodontics indicate that there are persistent inaccuracies and inconsistencies in the results provided using conventional 2D cephalometric analysis. Obviously, plane geometry is inappropriate for analyzing anatomical volumes and their growth; only a 3D analysis is able to analyze the three-dimensional, anatomical maxillofacial complex, which requires computing inertia systems for individual or groups of digitally segmented teeth from an image volume of a patient's head. For the study of 3D cephalometric analysis, the current paper proposes a system for semi-automatically segmenting teeth from a cone beam computed tomography (CBCT) volume with two distinct features, including an intelligent user-input interface for automatic background seed generation, and a graphics processing unit (GPU) acceleration mechanism for three-dimensional GrowCut volume segmentation. Results show a satisfying average DICE score of 0.92, with the use of the proposed tooth segmentation system, by 15 novice users who segmented a randomly sampled tooth set. The average GrowCut processing time is around one second per tooth, excluding user interaction time.

Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application

PubMed Central

Okolo, Brando; Popp, Uwe

2018-01-01

Additive manufacturing (AM) is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D) virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI) are well-established processes in the surgical fields. Polyetheretherketone (PEEK) has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF) technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a “biomimetic” design. PMID:29713642

Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application.

PubMed

Honigmann, Philipp; Sharma, Neha; Okolo, Brando; Popp, Uwe; Msallem, Bilal; Thieringer, Florian M

2018-01-01

Additive manufacturing (AM) is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D) virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI) are well-established processes in the surgical fields. Polyetheretherketone (PEEK) has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF) technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a "biomimetic" design.

SU-E-T-279: Realization of Three-Dimensional Conformal Dose Planning in Prostate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Z; Jiang, S; Yang, Z

2014-06-01

Purpose: Successful clinical treatment in prostate brachytherapy is largely dependent on the effectiveness of pre-surgery dose planning. Conventional dose planning method could hardly arrive at a satisfy result. In this abstract, a three-dimensional conformal localized dose planning method is put forward to ensure the accuracy and effectiveness of pre-implantation dose planning. Methods: Using Monte Carlo method, the pre-calculated 3-D dose map for single source is obtained. As for multiple seeds dose distribution, the maps are combined linearly to acquire the 3-D distribution. The 3-D dose distribution is exhibited in the form of isodose surface together with reconstructed 3-D organs groupmore » real-timely. Then it is possible to observe the dose exposure to target volume and normal tissues intuitively, thus achieving maximum dose irradiation to treatment target and minimum healthy tissues damage. In addition, the exfoliation display of different isodose surfaces can be realized applying multi-values contour extraction algorithm based on voxels. The needles could be displayed in the system by tracking the position of the implanted seeds in real time to conduct block research in optimizing insertion trajectory. Results: This study extends dose planning from two-dimensional to three-dimensional, realizing the three-dimensional conformal irradiation, which could eliminate the limitations of 2-D images and two-dimensional dose planning. A software platform is developed using VC++ and Visualization Toolkit (VTK) to perform dose planning. The 3-D model reconstruction time is within three seconds (on a Intel Core i5 PC). Block research could be conducted to avoid inaccurate insertion into sensitive organs or internal obstructions. Experiments on eight prostate cancer cases prove that this study could make the dose planning results more reasonable. Conclusion: The three-dimensional conformal dose planning method could improve the rationality of dose planning by safely reducing the large target margin and avoiding dose dead zones for prostate cancer treatment. 1) National Natural Science Foundation of People's Republic of China (No. 51175373); 2) New Century Educational Talents Plan of Chinese Education Ministry (NCET-10-0625); 3) Scientific and Technological Major Project, Tianjin (No. 12ZCDZSY10600)« less

The Impact of Stereoscopic Imagery and Motion on Anatomical Structure Recognition and Visual Attention Performance

ERIC Educational Resources Information Center

Remmele, Martin; Schmidt, Elena; Lingenfelder, Melissa; Martens, Andreas

2018-01-01

Gross anatomy is located in a three-dimensional space. Visualizing aspects of structures in gross anatomy education should aim to provide information that best resembles their original spatial proportions. Stereoscopic three-dimensional imagery might offer possibilities to implement this aim, though some research has revealed potential impairments…

Analysis of Traditional versus Three-Dimensional Augmented Curriculum on Anatomical Learning Outcome Measures

ERIC Educational Resources Information Center

Peterson, Diana Coomes; Mlynarczyk, Gregory S.A.

2016-01-01

This study examined whether student learning outcome measures are influenced by the addition of three-dimensional and digital teaching tools to a traditional dissection and lecture learning format curricula. The study was performed in a semester long graduate level course that incorporated both gross anatomy and neuroanatomy curricula. Methods…

Image-guided brachytherapy for cervical cancer: analysis of D2 cc hot spot in three-dimensional and anatomic factors affecting D2 cc hot spot in organs at risk.

PubMed

Kim, Robert Y; Dragovic, Alek F; Whitley, Alexander C; Shen, Sui

2014-01-01

To analyze the D2 cc hot spot in three-dimensional CT and anatomic factors affecting the D2 cc hot spot in organs at risk (OARs). Thirty-one patients underwent pelvic CT scan after insertion of the applicator. High-dose-rate treatment planning was performed with standard loading patterns. The D2 cc structures in OARs were generated in three dimensional if the total equivalent dose in 2 Gy exceeded our defined dose limits (hot spot). The location of D2 cc hot spot was defined as the center of the largest D2 cc fragment. The relationship between the hot spot and the applicator position was reported in Digital Imaging and Communication in Medicine coordinates. The location of sigmoid, small bowel, and bladder D2 cc hot spots was around the endocervix: The mean location of sigmoid hot spot for lateral view was 1.6 cm posteriorly and 2.3 cm superiorly (Y, 1.6 and Z, 2.3), small bowel was 1.6 cm anteriorly and 2.7 cm superiorly (Y, -1.6 and Z, 2.7). The mean location of bladder hot spot was 1.6 cm anteriorly and 1.6 cm superiorly (Y, -1.6 and Z, 1.6). These hot spots were near the plane of Point A (X, 2.0 or -2.0; Y, 0; and Z, 2.0). The mean location of rectal hot spot was 1.6 cm posteriorly and 1.9 cm inferiorly (Y, 1.6 and Z, -1.9). D2 cc hot spot was affected by uterine wall thickness, uterine tandem position, fibroids, bladder fullness, bowel gas, and vaginal packing. Because of the location of the D2 cc hot spots, larger tumors present a challenge for adequate tumor coverage with a conventional brachytherapy applicator without an interstitial implant. Additionally, anatomic factors were identified which affect the D2 cc hot spot in OARs. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Cluster-based upper body marker models for three-dimensional kinematic analysis: Comparison with an anatomical model and reliability analysis.

PubMed

Boser, Quinn A; Valevicius, Aïda M; Lavoie, Ewen B; Chapman, Craig S; Pilarski, Patrick M; Hebert, Jacqueline S; Vette, Albert H

2018-04-27

Quantifying angular joint kinematics of the upper body is a useful method for assessing upper limb function. Joint angles are commonly obtained via motion capture, tracking markers placed on anatomical landmarks. This method is associated with limitations including administrative burden, soft tissue artifacts, and intra- and inter-tester variability. An alternative method involves the tracking of rigid marker clusters affixed to body segments, calibrated relative to anatomical landmarks or known joint angles. The accuracy and reliability of applying this cluster method to the upper body has, however, not been comprehensively explored. Our objective was to compare three different upper body cluster models with an anatomical model, with respect to joint angles and reliability. Non-disabled participants performed two standardized functional upper limb tasks with anatomical and cluster markers applied concurrently. Joint angle curves obtained via the marker clusters with three different calibration methods were compared to those from an anatomical model, and between-session reliability was assessed for all models. The cluster models produced joint angle curves which were comparable to and highly correlated with those from the anatomical model, but exhibited notable offsets and differences in sensitivity for some degrees of freedom. Between-session reliability was comparable between all models, and good for most degrees of freedom. Overall, the cluster models produced reliable joint angles that, however, cannot be used interchangeably with anatomical model outputs to calculate kinematic metrics. Cluster models appear to be an adequate, and possibly advantageous alternative to anatomical models when the objective is to assess trends in movement behavior. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Design of cross-sectional anatomical model focused on drainage pathways of paranasal sinuses].

PubMed

Zha, Y; Lv, W; Gao, Y L; Zhu, Z Z; Gao, Z Q

2018-05-01

Objective: To design and produce cross-sectional anatomical models of paranasal sinuses for the purpose of demonstrating drainage pathways of each nasal sinus for the young doctors. Method: We reconstructed the three-dimensional model of sinuses area based on CT scan data, and divided it into 5 thick cross-sectional anatomy models by 4 coronal plane，which cross middle points of agger nasi cell, ethmoid bulla, posterior ethmoid sinuses and sphenoid sinus respectively. Then a 3D printerwas used to make anatomical cross-sectional anatomical models. Result: Successfully produced a digital 3D printing cross-sectional models of paranasal sinuses. Sinus drainage pathways were observed on the models. Conclusion: The cross-sectional anatomical models made by us can exactly and intuitively demonstrate the ostia of each sinus cell and they can help the young doctors to understand and master the key anatomies and relationships which are important to the endoscopic sinus surgery. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

Automatic Testing and Assessment of Neuroanatomy Using a Digital Brain Atlas: Method and Development of Computer- and Mobile-Based Applications

ERIC Educational Resources Information Center

Nowinski, Wieslaw L.; Thirunavuukarasuu, Arumugam; Ananthasubramaniam, Anand; Chua, Beng Choon; Qian, Guoyu; Nowinska, Natalia G.; Marchenko, Yevgen; Volkau, Ihar

2009-01-01

Preparation of tests and student's assessment by the instructor are time consuming. We address these two tasks in neuroanatomy education by employing a digital media application with a three-dimensional (3D), interactive, fully segmented, and labeled brain atlas. The anatomical and vascular models in the atlas are linked to "Terminologia…

Three-dimensional printing in cardiac surgery and interventional cardiology: a single-centre experience.

PubMed

Schmauss, Daniel; Haeberle, Sandra; Hagl, Christian; Sodian, Ralf

2015-06-01

In individual cases, routine preoperative imaging might not be sufficient for optimal planning of cardiovascular procedures. Three-dimensional printing (3D), a widely used technique to build life-like replicas of anatomical structures that has proven value in different medical disciplines, might overcome these shortcomings. However, data on 3D printing in cardiovascular medicine are limited to single reports. This stimulated us to present our single-centre experience with 3D printing models in cardiac surgery and interventional cardiology. Between the years 2006 and 2013, we fabricated 3D printing models using preoperative computed tomography or magnetic resonance imaging data in paediatric and adult cardiac surgery, as well as interventional cardiology. We present the 8 most representative cases. The models were very helpful for perioperative planning and orientation, as well as simulation of procedures due to the exact and life-like illustration of the cardiovascular anatomy. The fabrication of 3D printing models is feasible for perioperative planning and simulation in a variety of complex cases in paediatric and adult cardiac surgery, as well as in interventional cardiology. Further studies including more patients and providing more data are expected to demonstrate that the use of 3D printing may decrease morbidity and mortality of complex, non-routine procedures in cardiovascular medicine. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Techniques on semiautomatic segmentation using the Adobe Photoshop

NASA Astrophysics Data System (ADS)

Park, Jin Seo; Chung, Min Suk; Hwang, Sung Bae

2005-04-01

The purpose of this research is to enable anybody to semiautomatically segment the anatomical structures in the MRIs, CTs, and other medical images on the personal computer. The segmented images are used for making three-dimensional images, which are helpful in medical education and research. To achieve this purpose, the following trials were performed. The entire body of a volunteer was MR scanned to make 557 MRIs, which were transferred to a personal computer. On Adobe Photoshop, contours of 19 anatomical structures in the MRIs were semiautomatically drawn using MAGNETIC LASSO TOOL; successively, manually corrected using either LASSO TOOL or DIRECT SELECTION TOOL to make 557 segmented images. In a likewise manner, 11 anatomical structures in the 8,500 anatomcial images were segmented. Also, 12 brain and 10 heart anatomical structures in anatomical images were segmented. Proper segmentation was verified by making and examining the coronal, sagittal, and three-dimensional images from the segmented images. During semiautomatic segmentation on Adobe Photoshop, suitable algorithm could be used, the extent of automatization could be regulated, convenient user interface could be used, and software bugs rarely occurred. The techniques of semiautomatic segmentation using Adobe Photoshop are expected to be widely used for segmentation of the anatomical structures in various medical images.

Presentation of Anatomical Variations Using the Aurasma Mobile App

PubMed Central

Bézard, Georg; Lozanoff, Beth K; Labrash, Steven; Lozanoff, Scott

2015-01-01

Knowledge of anatomical variations is critical to avoid clinical complications and it enables an understanding of morphogenetic mechanisms. Depictions are comprised of photographs or illustrations often limiting appreciation of three-dimensional (3D) spatial relationships. The purpose of this study is to describe an approach for presenting anatomical variations utilizing video clips emphasizing 3D anatomical relationships delivered on personal electronic devices. An aberrant right subclavian artery (ARSA) was an incidental finding in a routine dissection of an 89-year-old man cadaver during a medical student instructional laboratory. The specimen was photographed and physical measurements were recorded. Three-dimensional models were lofted and rendered with Maya software and converted as Quicktime animations. Photographs of the first frame of the animations were recorded and registered with Aurasma Mobile App software (www.aurasma.com). Resulting animations were viewed on mobile devices. The ARSA model can be manipulated on the mobile device enabling the student to view and appreciate spatial relationships. Model elements can be de-constructed to provide even greater spatial resolution of anatomical relationships. Animations provide a useful approach for visualizing anatomical variations. Future work will be directed at creating a library of variants and underlying mechanism of formation for presentation through the Aurasma application. PMID:26793410

Building 3D anatomical model of coiling of the internal carotid artery derived from CT angiographic data.

PubMed

Govsa, Figen; Yagdi, Tahir; Ozer, Mehmet Asim; Eraslan, Cenk; Alagoz, Ahmet Kemal

2017-02-01

The purpose of this study is to recreate live patient arterial anomalies using new recent application of three-dimensional (3D) printed anatomical models. Another purpose of building such models is to evaluate the effectiveness of angiographic data. With the help of the DICOM files from computed tomographic angiography (CT-A), we were able to build a printed model of variant course of the internal carotid artery (ICA). Images of coiling of the ICA taken by CT-A, were then converted into 3D images using Google SketchUp free software, and the images were saved in stereolithography format. Imaging helped us conduct the examination in details with reference to geometrical features of ICA, degree of curve, its extension, location and presence of loop. Challenging vascular anatomy was exposed with models of adverse curve of carotid anatomy, including highly angulated necks, conical necks, short necks, tortuous carotid arteries, and narrowed carotid lumens. It assisted us to comprehend spatial anatomy configuration of life-like models. 3D model can be very effective in cases when anatomical difficulties are detected through the CT-A, and therefore, a tactile approach is demanded preoperatively. 3D life-like models serve as an essential office-based tool in vascular surgery as they assist surgeons in preoperative planning, develop intraoperative guidance, teach both the patients and the surgical trainees, and simulate to show patient-specific procedures in medical field.

Development of a precision multimodal surgical navigation system for lung robotic segmentectomy

PubMed Central

Soldea, Valentin; Lachkar, Samy; Rinieri, Philippe; Sarsam, Mathieu; Bottet, Benjamin; Peillon, Christophe

2018-01-01

Minimally invasive sublobar anatomical resection is becoming more and more popular to manage early lung lesions. Robotic-assisted thoracic surgery (RATS) is unique in comparison with other minimally invasive techniques. Indeed, RATS is able to better integrate multiple streams of information including advanced imaging techniques, in an immersive experience at the level of the robotic console. Our aim was to describe three-dimensional (3D) imaging throughout the surgical procedure from preoperative planning to intraoperative assistance and complementary investigations such as radial endobronchial ultrasound (R-EBUS) and virtual bronchoscopy for pleural dye marking. All cases were operated using the DaVinci SystemTM. Modelisation was provided by Visible Patient™ (Strasbourg, France). Image integration in the operative field was achieved using the Tile Pro multi display input of the DaVinci console. Our experience was based on 114 robotic segmentectomies performed between January 2012 and October 2017. The clinical value of 3D imaging integration was evaluated in 2014 in a pilot study. Progressively, we have reached the conclusion that the use of such an anatomic model improves the safety and reliability of procedures. The multimodal system including 3D imaging has been used in more than 40 patients so far and demonstrated a perfect operative anatomic accuracy. Currently, we are developing an original virtual reality experience by exploring 3D imaging models at the robotic console level. The act of operating is being transformed and the surgeon now oversees a complex system that improves decision making. PMID:29785294

Development of a precision multimodal surgical navigation system for lung robotic segmentectomy.

PubMed

Baste, Jean Marc; Soldea, Valentin; Lachkar, Samy; Rinieri, Philippe; Sarsam, Mathieu; Bottet, Benjamin; Peillon, Christophe

2018-04-01

Minimally invasive sublobar anatomical resection is becoming more and more popular to manage early lung lesions. Robotic-assisted thoracic surgery (RATS) is unique in comparison with other minimally invasive techniques. Indeed, RATS is able to better integrate multiple streams of information including advanced imaging techniques, in an immersive experience at the level of the robotic console. Our aim was to describe three-dimensional (3D) imaging throughout the surgical procedure from preoperative planning to intraoperative assistance and complementary investigations such as radial endobronchial ultrasound (R-EBUS) and virtual bronchoscopy for pleural dye marking. All cases were operated using the DaVinci System TM . Modelisation was provided by Visible Patient™ (Strasbourg, France). Image integration in the operative field was achieved using the Tile Pro multi display input of the DaVinci console. Our experience was based on 114 robotic segmentectomies performed between January 2012 and October 2017. The clinical value of 3D imaging integration was evaluated in 2014 in a pilot study. Progressively, we have reached the conclusion that the use of such an anatomic model improves the safety and reliability of procedures. The multimodal system including 3D imaging has been used in more than 40 patients so far and demonstrated a perfect operative anatomic accuracy. Currently, we are developing an original virtual reality experience by exploring 3D imaging models at the robotic console level. The act of operating is being transformed and the surgeon now oversees a complex system that improves decision making.

Preservation of three-dimensional anatomy in phosphatized fossil arthropods enriches evolutionary inference

PubMed Central

Schwermann, Achim H; dos Santos Rolo, Tomy; Caterino, Michael S; Bechly, Günter; Schmied, Heiko; Baumbach, Tilo; van de Kamp, Thomas

2016-01-01

External and internal morphological characters of extant and fossil organisms are crucial to establishing their systematic position, ecological role and evolutionary trends. The lack of internal characters and soft-tissue preservation in many arthropod fossils, however, impedes comprehensive phylogenetic analyses and species descriptions according to taxonomic standards for Recent organisms. We found well-preserved three-dimensional anatomy in mineralized arthropods from Paleogene fissure fillings and demonstrate the value of these fossils by utilizing digitally reconstructed anatomical structure of a hister beetle. The new anatomical data facilitate a refinement of the species diagnosis and allowed us to reject a previous hypothesis of close phylogenetic relationship to an extant congeneric species. Our findings suggest that mineralized fossils, even those of macroscopically poor preservation, constitute a rich but yet largely unexploited source of anatomical data for fossil arthropods. DOI: http://dx.doi.org/10.7554/eLife.12129.001 PMID:26854367

Rapid prototyping raw models on the basis of high resolution computed tomography lung data for respiratory flow dynamics.

PubMed

Giesel, Frederik L; Mehndiratta, Amit; von Tengg-Kobligk, Hendrik; Schaeffer, A; Teh, Kevin; Hoffman, E A; Kauczor, Hans-Ulrich; van Beek, E J R; Wild, Jim M

2009-04-01

Three-dimensional image reconstruction by volume rendering and rapid prototyping has made it possible to visualize anatomic structures in three dimensions for interventional planning and academic research. Volumetric chest computed tomography was performed on a healthy volunteer. Computed tomographic images of the larger bronchial branches were segmented by an extended three-dimensional region-growing algorithm, converted into a stereolithography file, and used for computer-aided design on a laser sintering machine. The injection of gases for respiratory flow modeling and measurements using magnetic resonance imaging were done on a hollow cast. Manufacturing the rapid prototype took about 40 minutes and included the airway tree from trackea to segmental bronchi (fifth generation). The branching of the airways are clearly visible in the (3)He images, and the radial imaging has the potential to elucidate the airway dimensions. The results for flow patterns in the human bronchial tree using the rapid-prototype model with hyperpolarized helium-3 magnetic resonance imaging show the value of this model for flow phantom studies.

Defining the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus: a pilot study.

PubMed

Abu-Rustum, Reem S; Ziade, M Fouad; Abu-Rustum, Sameer E

2012-09-01

Our study aims at investigating the spatial relationships between eight anatomic planes in the 11+6 to 13+6 weeks fetus. This is a retrospective pilot study where three-dimensional and four-dimensional stored data sets were manipulated to retrieve eight anatomic planes starting from the midsagittal plane of the fetus. Standardization of volumes was performed at the level of the transverse abdominal circumference plane. Parallel shift was utilized and the spatial relationships between eight anatomic planes were established. The median and the range were calculated for each of the planes, and they were evaluated as a function of the fetal crown-rump length. P < 0.05 was considered statistically significant. A total of 63 volume data sets were analyzed. The eight anatomic planes were found to adhere to normal distribution curves, and most of the planes were in a definable relationship to each other with statistically significant correlations. To our knowledge, this is the first study to describe the possible spatial relationships between eight two-dimensional anatomic planes in the 11+6 to 13+6 weeks fetus, utilizing a standardized approach. Defining these spatial relationships may serve as the first step for the potential future development of automation software for fetal anatomic assessment at 11+6 to 13+6 weeks. © 2012 John Wiley & Sons, Ltd.

A computer-guided bone block harvesting procedure: a proof-of-principle case report and technical notes.

PubMed

De Stavola, Luca; Fincato, Andrea; Albiero, Alberto Maria

2015-01-01

During autogenous mandibular bone harvesting, there is a risk of damage to anatomical structures, as the surgeon has no three-dimensional control of the osteotomy planes. The aim of this proof-of-principle case report is to describe a procedure for harvesting a mandibular bone block that applies a computer-guided surgery concept. A partially dentate patient who presented with two vertical defects (one in the maxilla and one in the mandible) was selected for an autogenous mandibular bone block graft. The bone block was planned using a computer-aided design process, with ideal bone osteotomy planes defined beforehand to prevent damage to anatomical structures (nerves, dental roots, etc) and to generate a surgical guide, which defined the working directions in three dimensions for the bone-cutting instrument. Bone block dimensions were planned so that both defects could be repaired. The projected bone block was 37.5 mm in length, 10 mm in height, and 5.7 mm in thickness, and it was grafted in two vertical bone augmentations: an 8 × 21-mm mandibular defect and a 6.5 × 18-mm defect in the maxilla. Supraimposition of the preoperative and postoperative computed tomographic images revealed a procedure accuracy of 0.25 mm. This computer-guided bone harvesting technique enables clinicians to obtain sufficient autogenous bone to manage multiple defects safely.

Clinical application of three-dimensional printing to the management of complex univentricular hearts with abnormal systemic or pulmonary venous drainage.

PubMed

McGovern, Eimear; Kelleher, Eoin; Snow, Aisling; Walsh, Kevin; Gadallah, Bassem; Kutty, Shelby; Redmond, John M; McMahon, Colin J

2017-09-01

In recent years, three-dimensional printing has demonstrated reliable reproducibility of several organs including hearts with complex congenital cardiac anomalies. This represents the next step in advanced image processing and can be used to plan surgical repair. In this study, we describe three children with complex univentricular hearts and abnormal systemic or pulmonary venous drainage, in whom three-dimensional printed models based on CT data assisted with preoperative planning. For two children, after group discussion and examination of the models, a decision was made not to proceed with surgery. We extend the current clinical experience with three-dimensional printed modelling and discuss the benefits of such models in the setting of managing complex surgical problems in children with univentricular circulation and abnormal systemic or pulmonary venous drainage.

The potential for machine learning algorithms to improve and reduce the cost of 3-dimensional printing for surgical planning.

PubMed

Huff, Trevor J; Ludwig, Parker E; Zuniga, Jorge M

2018-05-01

3D-printed anatomical models play an important role in medical and research settings. The recent successes of 3D anatomical models in healthcare have led many institutions to adopt the technology. However, there remain several issues that must be addressed before it can become more wide-spread. Of importance are the problems of cost and time of manufacturing. Machine learning (ML) could be utilized to solve these issues by streamlining the 3D modeling process through rapid medical image segmentation and improved patient selection and image acquisition. The current challenges, potential solutions, and future directions for ML and 3D anatomical modeling in healthcare are discussed. Areas covered: This review covers research articles in the field of machine learning as related to 3D anatomical modeling. Topics discussed include automated image segmentation, cost reduction, and related time constraints. Expert commentary: ML-based segmentation of medical images could potentially improve the process of 3D anatomical modeling. However, until more research is done to validate these technologies in clinical practice, their impact on patient outcomes will remain unknown. We have the necessary computational tools to tackle the problems discussed. The difficulty now lies in our ability to collect sufficient data.

Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments

PubMed Central

Lau, Ivan Wen Wen; Liu, Dongting; Xu, Lei; Fan, Zhanming

2018-01-01

Objective Current diagnostic assessment tools remain suboptimal in demonstrating complex morphology of congenital heart disease (CHD). This limitation has posed several challenges in preoperative planning, communication in medical practice, and medical education. This study aims to investigate the dimensional accuracy and the clinical value of 3D printed model of CHD in the above three areas. Methods Using cardiac computed tomography angiography (CCTA) data, a patient-specific 3D model of a 20-month-old boy with double outlet right ventricle was printed in Tango Plus material. Pearson correlation coefficient was used to evaluate correlation of the quantitative measurements taken at analogous anatomical locations between the CCTA images pre- and post-3D printing. Qualitative analysis was conducted by distributing surveys to six health professionals (two radiologists, two cardiologists and two cardiac surgeons) and three medical academics to assess the clinical value of the 3D printed model in these three areas. Results Excellent correlation (r = 0.99) was noted in the measurements between CCTA and 3D printed model, with a mean difference of 0.23 mm. Four out of six health professionals found the model to be useful in facilitating preoperative planning, while all of them thought that the model would be invaluable in enhancing patient-doctor communication. All three medical academics found the model to be helpful in teaching, and thought that the students will be able to learn the pathology quicker with better understanding. Conclusion The complex cardiac anatomy can be accurately replicated in flexible material using 3D printing technology. 3D printed heart models could serve as an excellent tool in facilitating preoperative planning, communication in medical practice, and medical education, although further studies with inclusion of more clinical cases are needed. PMID:29561912

CAVEman: Standardized Anatomical Context for Biomedical Data Mapping

ERIC Educational Resources Information Center

Turinsky, Andrei L.; Fanea, Elena; Trinh, Quang; Wat, Stephen; Hallgrimsson, Benedikt; Dong, Xiaoli; Shu, Xueling; Stromer, Julie N.; Hill, Jonathan W.; Edwards, Carol; Grosenick, Brenda; Yajima, Masumi; Sensen, Christoph W.

2008-01-01

The authors have created a software system called the CAVEman, for the visual integration and exploration of heterogeneous anatomical and biomedical data. The CAVEman can be applied for both education and research tasks. The main component of the system is a three-dimensional digital atlas of the adult male human anatomy, structured according to…

A three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses.

PubMed

Fatone, Stefania; Johnson, William Brett; Tucker, Kerice

2016-04-01

Misalignment of an articulated ankle-foot orthosis joint axis with the anatomic joint axis may lead to discomfort, alterations in gait, and tissue damage. Theoretical, two-dimensional models describe the consequences of misalignments, but cannot capture the three-dimensional behavior of ankle-foot orthosis use. The purpose of this project was to develop a model to describe the effects of ankle-foot orthosis ankle joint misalignment in three dimensions. Computational simulation. Three-dimensional scans of a leg and ankle-foot orthosis were incorporated into a link segment model where the ankle-foot orthosis joint axis could be misaligned with the anatomic ankle joint axis. The leg/ankle-foot orthosis interface was modeled as a network of nodes connected by springs to estimate interface pressure. Motion between the leg and ankle-foot orthosis was calculated as the ankle joint moved through a gait cycle. While the three-dimensional model corroborated predictions of the previously published two-dimensional model that misalignments in the anterior -posterior direction would result in greater relative motion compared to misalignments in the proximal -distal direction, it provided greater insight showing that misalignments have asymmetrical effects. The three-dimensional model has been incorporated into a freely available computer program to assist others in understanding the consequences of joint misalignments. Models and simulations can be used to gain insight into functioning of systems of interest. We have developed a three-dimensional model to assess the effect of ankle joint axis misalignments in ankle-foot orthoses. The model has been incorporated into a freely available computer program to assist understanding of trainees and others interested in orthotics. © The International Society for Prosthetics and Orthotics 2014.

The Various Applications of 3D Printing in Cardiovascular Diseases.

PubMed

El Sabbagh, Abdallah; Eleid, Mackram F; Al-Hijji, Mohammed; Anavekar, Nandan S; Holmes, David R; Nkomo, Vuyisile T; Oderich, Gustavo S; Cassivi, Stephen D; Said, Sameh M; Rihal, Charanjit S; Matsumoto, Jane M; Foley, Thomas A

2018-05-10

To highlight the various applications of 3D printing in cardiovascular disease and discuss its limitations and future direction. Use of handheld 3D printed models of cardiovascular structures has emerged as a facile modality in procedural and surgical planning as well as education and communication. Three-dimensional (3D) printing is a novel imaging modality which involves creating patient-specific models of cardiovascular structures. As percutaneous and surgical therapies evolve, spatial recognition of complex cardiovascular anatomic relationships by cardiologists and cardiovascular surgeons is imperative. Handheld 3D printed models of cardiovascular structures provide a facile and intuitive road map for procedural and surgical planning, complementing conventional imaging modalities. Moreover, 3D printed models are efficacious educational and communication tools. This review highlights the various applications of 3D printing in cardiovascular diseases and discusses its limitations and future directions.

The potential of polymer gel dosimeters for 3D MR-IGRT quality assurance

NASA Astrophysics Data System (ADS)

Roed, Y.; Ding, Y.; Wen, Z.; Wang, J.; Pinsky, L.; Ibbott, G.

2017-05-01

Advances in radiotherapy technology have enabled more accurate delivery of radiation doses to anatomically complex tumor volumes, while sparing surrounding tissues. The most recent advanced treatment modality combines a radiation delivery system (either Cobalt-60 therapy heads or linear accelerator) with a diagnostic magnetic resonance (MR) scanner to perform MR-image guided radiotherapy (MR-IGRT). For a radiation treatment plan to be delivered successfully with MR-IGRT the compliance with previously established criteria to validate the passing of such plans has to be confirmed. Due to the added strong magnetic field a new set of quality assurance standards has to be developed. Ideal detectors are MR-compatible, can capture complex dose distributions and can be read out with MRI. Polymer gels were investigated as potential three dimensional MR-IGRT quality assurance detectors.

3D cinematic rendering of the calvarium, maxillofacial structures, and skull base: preliminary observations.

PubMed

Rowe, Steven P; Zinreich, S James; Fishman, Elliot K

2018-06-01

Three-dimensional (3D) visualizations of volumetric data from CT have gained widespread clinical acceptance and are an important method for evaluating complex anatomy and pathology. Recently, cinematic rendering (CR), a new 3D visualization methodology, has become available. CR utilizes a lighting model that allows for the production of photorealistic images from isotropic voxel data. Given how new this technique is, studies to evaluate its clinical utility and any potential advantages or disadvantages relative to other 3D methods such as volume rendering have yet to be published. In this pictorial review, we provide examples of normal calvarial, maxillofacial, and skull base anatomy and pathological conditions that highlight the potential for CR images to aid in patient evaluation and treatment planning. The highly detailed images and nuanced shadowing that are intrinsic to CR are well suited to the display of the complex anatomy in this region of the body. We look forward to studies with CR that will ascertain the ultimate value of this methodology to evaluate calvarium, maxillofacial, and skull base morphology as well as other complex anatomic structures.

Human cartilage tissue fabrication using three-dimensional inkjet printing technology.

PubMed

Cui, Xiaofeng; Gao, Guifang; Yonezawa, Tomo; Dai, Guohao

2014-06-10

Bioprinting, which is based on thermal inkjet printing, is one of the most attractive enabling technologies in the field of tissue engineering and regenerative medicine. With digital control cells, scaffolds, and growth factors can be precisely deposited to the desired two-dimensional (2D) and three-dimensional (3D) locations rapidly. Therefore, this technology is an ideal approach to fabricate tissues mimicking their native anatomic structures. In order to engineer cartilage with native zonal organization, extracellular matrix composition (ECM), and mechanical properties, we developed a bioprinting platform using a commercial inkjet printer with simultaneous photopolymerization capable for 3D cartilage tissue engineering. Human chondrocytes suspended in poly(ethylene glycol) diacrylate (PEGDA) were printed for 3D neocartilage construction via layer-by-layer assembly. The printed cells were fixed at their original deposited positions, supported by the surrounding scaffold in simultaneous photopolymerization. The mechanical properties of the printed tissue were similar to the native cartilage. Compared to conventional tissue fabrication, which requires longer UV exposure, the viability of the printed cells with simultaneous photopolymerization was significantly higher. Printed neocartilage demonstrated excellent glycosaminoglycan (GAG) and collagen type II production, which was consistent with gene expression. Therefore, this platform is ideal for accurate cell distribution and arrangement for anatomic tissue engineering.

A Three-Dimensional Statistical Average Skull: Application of Biometric Morphing in Generating Missing Anatomy.

PubMed

Teshima, Tara Lynn; Patel, Vaibhav; Mainprize, James G; Edwards, Glenn; Antonyshyn, Oleh M

2015-07-01

The utilization of three-dimensional modeling technology in craniomaxillofacial surgery has grown exponentially during the last decade. Future development, however, is hindered by the lack of a normative three-dimensional anatomic dataset and a statistical mean three-dimensional virtual model. The purpose of this study is to develop and validate a protocol to generate a statistical three-dimensional virtual model based on a normative dataset of adult skulls. Two hundred adult skull CT images were reviewed. The average three-dimensional skull was computed by processing each CT image in the series using thin-plate spline geometric morphometric protocol. Our statistical average three-dimensional skull was validated by reconstructing patient-specific topography in cranial defects. The experiment was repeated 4 times. In each case, computer-generated cranioplasties were compared directly to the original intact skull. The errors describing the difference between the prediction and the original were calculated. A normative database of 33 adult human skulls was collected. Using 21 anthropometric landmark points, a protocol for three-dimensional skull landmarking and data reduction was developed and a statistical average three-dimensional skull was generated. Our results show the root mean square error (RMSE) for restoration of a known defect using the native best match skull, our statistical average skull, and worst match skull was 0.58, 0.74, and 4.4  mm, respectively. The ability to statistically average craniofacial surface topography will be a valuable instrument for deriving missing anatomy in complex craniofacial defects and deficiencies as well as in evaluating morphologic results of surgery.

Hip dysplasia, pelvic obliquity, and scoliosis in cerebral palsy: a qualitative analysis using 3D CT reconstruction

NASA Astrophysics Data System (ADS)

Russ, Mark D.; Abel, Mark F.

1998-06-01

Five patients with cerebral palsy, hip dysplasia, pelvic obliquity, and scoliosis were evaluated retrospectively using three dimensional computed tomography (3DCT) scans of the proximal femur, pelvis, and lumbar spine to qualitatively evaluate their individual deformities by measuring a number of anatomical landmarks. Three dimensional reconstructions of the data were visualized, analyzed, and then manipulated interactively to perform simulated osteotomies of the proximal femur and pelvis to achieve surgical correction of the hip dysplasia. Severe deformity can occur in spastic cerebral palsy, with serious consequences for the quality of life of the affected individuals and their families. Controversy exists regarding the type, timing and efficacy of surgical intervention for correction of hip dysplasia in this population. Other authors have suggested 3DCT studies are required to accurately analyze acetabular deficiency, and that this data allows for more accurate planning of reconstructive surgery. It is suggested here that interactive manipulation of the data to simulate the proposed surgery is a clinically useful extension of the analysis process and should also be considered as an essential part of the pre-operative planning to assure that the appropriate procedure is chosen. The surgical simulation may reduce operative time and improve surgical correction of the deformity.

Creating vascular models by postprocessing computed tomography angiography images: a guide for anatomical education.

PubMed

Govsa, Figen; Ozer, Mehmet Asim; Sirinturk, Suzan; Eraslan, Cenk; Alagoz, Ahmet Kemal

2017-08-01

A new application of teaching anatomy includes the use of computed tomography angiography (CTA) images to create clinically relevant three-dimensional (3D) printed models. The purpose of this article is to review recent innovations on the process and the application of 3D printed models as a tool for using under and post-graduate medical education. Images of aortic arch pattern received by CTA were converted into 3D images using the Google SketchUp free software and were saved in stereolithography format. Using a 3D printer (Makerbot), a model mode polylactic acid material was printed. A two-vessel left aortic arch was identified consisting of the brachiocephalic trunk and left subclavian artery. The life-like 3D models were rotated 360° in all axes in hand. The early adopters in education and clinical practices have embraced the medical imaging-guided 3D printed anatomical models for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between the anatomical structures. Printed vascular models are used to assist in preoperative planning, develop intraoperative guidance tools, and to teach patients surgical trainees in surgical practice.

Three-Dimensional Printing of X-Ray Computed Tomography Datasets with Multiple Materials Using Open-Source Data Processing

ERIC Educational Resources Information Center

Sander, Ian M.; McGoldrick, Matthew T.; Helms, My N.; Betts, Aislinn; van Avermaete, Anthony; Owers, Elizabeth; Doney, Evan; Liepert, Taimi; Niebur, Glen; Liepert, Douglas; Leevy, W. Matthew

2017-01-01

Advances in three-dimensional (3D) printing allow for digital files to be turned into a "printed" physical product. For example, complex anatomical models derived from clinical or pre-clinical X-ray computed tomography (CT) data of patients or research specimens can be constructed using various printable materials. Although 3D printing…

[Rapid prototyping: a very promising method].

PubMed

Haverman, T M; Karagozoglu, K H; Prins, H-J; Schulten, E A J M; Forouzanfar, T

2013-03-01

Rapid prototyping is a method which makes it possible to produce a three-dimensional model based on two-dimensional imaging. Various rapid prototyping methods are available for modelling, such as stereolithography, selective laser sintering, direct laser metal sintering, two-photon polymerization, laminated object manufacturing, three-dimensional printing, three-dimensional plotting, polyjet inkjet technology,fused deposition modelling, vacuum casting and milling. The various methods currently being used in the biomedical sector differ in production, materials and properties of the three-dimensional model which is produced. Rapid prototyping is mainly usedforpreoperative planning, simulation, education, and research into and development of bioengineering possibilities.

Stereolithographic biomodelling to create tangible hard copies of the ethmoidal labyrinth air cells based on the visible human project.

PubMed

Kapakin, S

2011-02-01

Rapid prototyping (RP), or stereolithography, is a new clinical application area, which is used to obtain accurate three-dimensional physical replicas of complex anatomical structures. The aim of this study was to create tangible hard copies of the ethmoidal labyrinth air cells (ELACs) with stereolithographic biomodelling. The visible human dataset (VHD) was used as the input imaging data. The Surfdriver software package was applied to these images to reconstruct the ELACs as three-dimensional DXF (data exchange file) models. These models were post-processed in 3D-Doctor software for virtual reality modelling language (VRML) and STL (Standard Triangulation Language) formats. Stereolithographic replicas were manufactured in a rapid prototyping machine by using the STL format. The total number of ELACs was 21. The dimensions of the ELACs on the right and left sides were 52.91 x 13.00 x 28.68 mm and 53.79 x 12.42 x 28.55 mm, respectively. The total volume of the ELACs was 4771.1003 mm(3). The mean ELAC distance was 27.29 mm from the nasion and 71.09 mm from the calotte topologically. In conclusion, the combination of Surfdriver and 3D-Doctor could be effectively used for manufacturing 3D solid models from serial sections of anatomical structures. Stereolithographic anatomical models provide an innovative and complementary tool for students, researchers, and surgeons to apprehend these anatomical structures tangibly. The outcomes of these attempts can provide benefits in terms of the visualization, perception, and interpretation of the structures in anatomy teaching and prior to surgical interventions.

The development, assessment and validation of virtual reality for human anatomy instruction

NASA Technical Reports Server (NTRS)

Marshall, Karen Benn

1996-01-01

This research project seeks to meet the objective of science training by developing, assessing, validating and utilizing VR as a human anatomy training medium. Current anatomy instruction is primarily in the form of lectures and usage of textbooks. In ideal situations, anatomic models, computer-based instruction, and cadaver dissection are utilized to augment traditional methods of instruction. At many institutions, lack of financial resources limits anatomy instruction to textbooks and lectures. However, human anatomy is three-dimensional, unlike the one-dimensional depiction found in textbooks and the two-dimensional depiction found on the computer. Virtual reality allows one to step through the computer screen into a 3-D artificial world. The primary objective of this project is to produce a virtual reality application of the abdominopelvic region of a human cadaver that can be taken back to the classroom. The hypothesis is that an immersive learning environment affords quicker anatomic recognition and orientation and a greater level of retention in human anatomy instruction. The goal is to augment not replace traditional modes of instruction.

A method of measuring three-dimensional scapular attitudes using the optotrak probing system.

PubMed

Hébert, L J; Moffet, H; McFadyen, B J; St-Vincent, G

2000-01-01

To develop a method to obtain accurate three-dimensional scapular attitudes and to assess their concurrent validity and reliability. In this methodological study, the three-dimensional scapular attitudes were calculated in degrees, using a rotation matrix (cyclic Cardanic sequence), from spatial coordinates obtained with the probing of three non colinear landmarks first on an anatomical model and second on a healthy subject. Although abnormal movement of the scapula is related to shoulder impingement syndrome, it is not clearly understood whether or not scapular motion impairment is a predisposing factor. Characterization of three-dimensional scapular attitudes in planes and at joint angles for which sub-acromial impingement is more likely to occur is not known. The Optotrak probing system was used. An anatomical model of the scapula was built and allowed us to impose scapular attitudes of known direction and magnitude. A local coordinate reference system was defined with three non colinear anatomical landmarks to assess accuracy and concurrent validity of the probing method with fixed markers. Axial rotation angles were calculated from a rotation matrix using a cyclic Cardanic sequence of rotations. The same three non colinear body landmarks were digitized on one healthy subject and the three dimensional scapular attitudes obtained were compared between sessions in order to assess the reliability. The measure of three dimensional scapular attitudes calculated from data using the Optotrak probing system was accurate with means of the differences between imposed and calculated rotation angles ranging from 1.5 degrees to 4.2 degrees. Greatest variations were observed around the third axis of the Cardanic sequence associated with posterior-anterior transverse rotations. The mean difference between the Optotrak probing system method and fixed markers was 1.73 degrees showing a good concurrent validity. Differences between the two methods were generally very low for one and two direction displacements and the largest discrepancies were observed for imposed displacements combining movement about the three axes. The between sessions variation of three dimensional scapular attitudes was less than 10% for most of the arm positions adopted by a healthy subject suggesting a good reliability. The Optotrak probing system used with a standardized protocol lead to accurate, valid and reliable measures of scapular attitudes. Although abnormal range of motion of the scapula is often related to shoulder pathologies, reliable outcome measures to quantify three-dimensional scapular motion on subjects are not available. It is important to establish a standardized protocol to characterize three-dimensional scapular motion on subjects using a method for which the accuracy and validity are known. The method used in the present study has provided such a protocol and will now allow to verify to what extent, scapular motion impairment is linked to the development of specific shoulder pathologies.

Student perceptions of an upper-level, undergraduate human anatomy laboratory course without cadavers.

PubMed

Wright, Shirley J

2012-01-01

Several programs in health professional education require or are considering requiring upper-level human anatomy as prerequisite for their applicants. Undergraduate students are confronted with few institutions offering such a course, in part because of the expense and logistical issues associated with a cadaver-based human anatomy course. This study describes the development of and student reactions to an upper-level human anatomy laboratory course for undergraduate students that used a regional approach and contemporary, alternative teaching methods to a cadaver-based course. The alternative pedagogy to deliver the curriculum included use of commercially available, three-dimensional anatomical virtual dissection software, anatomical models coupled with a learning management system to offer Web-based learning, and a new laboratory manual with collaborative exercises designed to develop the student's anatomical skills and collaborative team skills. A Likert-scale survey with open-ended questions was used to ascertain student perceptions of the course and its various aspects. Students perceived that the noncadaver-based, upper-level human anatomy course with an engaging, regional approach is highly valuable in their learning of anatomy. anatomy. Copyright © 2012 American Association of Anatomists.

Low-Dimensional Statistics of Anatomical Variability via Compact Representation of Image Deformations.

PubMed

Zhang, Miaomiao; Wells, William M; Golland, Polina

2016-10-01

Using image-based descriptors to investigate clinical hypotheses and therapeutic implications is challenging due to the notorious "curse of dimensionality" coupled with a small sample size. In this paper, we present a low-dimensional analysis of anatomical shape variability in the space of diffeomorphisms and demonstrate its benefits for clinical studies. To combat the high dimensionality of the deformation descriptors, we develop a probabilistic model of principal geodesic analysis in a bandlimited low-dimensional space that still captures the underlying variability of image data. We demonstrate the performance of our model on a set of 3D brain MRI scans from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Our model yields a more compact representation of group variation at substantially lower computational cost than models based on the high-dimensional state-of-the-art approaches such as tangent space PCA (TPCA) and probabilistic principal geodesic analysis (PPGA).

Segmenting Brain Tissues from Chinese Visible Human Dataset by Deep-Learned Features with Stacked Autoencoder

PubMed Central

Zhao, Guangjun; Wang, Xuchu; Niu, Yanmin; Tan, Liwen; Zhang, Shao-Xiang

2016-01-01

Cryosection brain images in Chinese Visible Human (CVH) dataset contain rich anatomical structure information of tissues because of its high resolution (e.g., 0.167 mm per pixel). Fast and accurate segmentation of these images into white matter, gray matter, and cerebrospinal fluid plays a critical role in analyzing and measuring the anatomical structures of human brain. However, most existing automated segmentation methods are designed for computed tomography or magnetic resonance imaging data, and they may not be applicable for cryosection images due to the imaging difference. In this paper, we propose a supervised learning-based CVH brain tissues segmentation method that uses stacked autoencoder (SAE) to automatically learn the deep feature representations. Specifically, our model includes two successive parts where two three-layer SAEs take image patches as input to learn the complex anatomical feature representation, and then these features are sent to Softmax classifier for inferring the labels. Experimental results validated the effectiveness of our method and showed that it outperformed four other classical brain tissue detection strategies. Furthermore, we reconstructed three-dimensional surfaces of these tissues, which show their potential in exploring the high-resolution anatomical structures of human brain. PMID:27057543

Segmenting Brain Tissues from Chinese Visible Human Dataset by Deep-Learned Features with Stacked Autoencoder.

PubMed

Zhao, Guangjun; Wang, Xuchu; Niu, Yanmin; Tan, Liwen; Zhang, Shao-Xiang

2016-01-01

Cryosection brain images in Chinese Visible Human (CVH) dataset contain rich anatomical structure information of tissues because of its high resolution (e.g., 0.167 mm per pixel). Fast and accurate segmentation of these images into white matter, gray matter, and cerebrospinal fluid plays a critical role in analyzing and measuring the anatomical structures of human brain. However, most existing automated segmentation methods are designed for computed tomography or magnetic resonance imaging data, and they may not be applicable for cryosection images due to the imaging difference. In this paper, we propose a supervised learning-based CVH brain tissues segmentation method that uses stacked autoencoder (SAE) to automatically learn the deep feature representations. Specifically, our model includes two successive parts where two three-layer SAEs take image patches as input to learn the complex anatomical feature representation, and then these features are sent to Softmax classifier for inferring the labels. Experimental results validated the effectiveness of our method and showed that it outperformed four other classical brain tissue detection strategies. Furthermore, we reconstructed three-dimensional surfaces of these tissues, which show their potential in exploring the high-resolution anatomical structures of human brain.

Levator hiatal area as a risk factor for cystocele recurrence after surgery: a prospective study.

PubMed

Vergeldt, T F M; Notten, K J B; Weemhoff, M; van Kuijk, S M J; Mulder, F E M; Beets-Tan, R G; Vliegen, R F A; Gondrie, E T C M; Bergmans, M G M; Roovers, J P W R; Kluivers, K B

2015-07-01

To investigate whether increased levator hiatal area, measured preoperatively, was independently associated with anatom-ical cystocele recurrence 12 months after anterior colporrhaphy. Multicentre prospective cohort study. Nine teaching hospitals in the Netherlands. Women planned for conventional anterior colporrhaphy without mesh. Women underwent physical examination, translabial three-dimensional (3D) ultrasound and magnetic resonance imaging (MRI) prior to surgery. At 12 months after surgery the physical examination was repeated. Women with and without anatomical cystocele recurrence were compared to assess the association with levator hiatal area on 3D ultrasound, levator hiatal area on MRI, and potential confounding factors. The receiver operating characteristic (ROC) curve was created to quantify the discriminative ability of using levator hiatal area to predict anatomical cystocele recurrence. Of 139 included women, 76 (54.7%) had anatomical cystocele recurrence. Preoperative stage 3 or 4 and increased levator hiatal area during Valsalva on ultrasound were significantly associated with cystocele recurrence, with odds ratios of 3.47 (95% confidence interval, 95% CI 1.66-7.28) and 1.06 (95% CI 1.01-1.11) respectively. The area under the ROC curve was 0.60 (95% CI 0.51-0.70) for levator hiatal area during Valsalva on ultrasound, and 0.65 (95% CI 0.55-0.71) for preoperative Pelvic Organ Prolapse Quantification (POP-Q) stage. Increased levator hiatal area during Valsalva on ultrasound prior to surgery and preoperative stage 3 or 4 are independent risk factors for anatomical cystocele recurrence after anterior colporrhaphy; however, increased levator hiatal area as the sole factor for predicting anatomical cystocele recurrence after surgery shows poor test characteristics. © 2015 Royal College of Obstetricians and Gynaecologists.

Surgical planning and manual image fusion based on 3D model facilitate laparoscopic partial nephrectomy for intrarenal tumors.

PubMed

Chen, Yuanbo; Li, Hulin; Wu, Dingtao; Bi, Keming; Liu, Chunxiao

2014-12-01

Construction of three-dimensional (3D) model of renal tumor facilitated surgical planning and imaging guidance of manual image fusion in laparoscopic partial nephrectomy (LPN) for intrarenal tumors. Fifteen patients with intrarenal tumors underwent LPN between January and December 2012. Computed tomography-based reconstruction of the 3D models of renal tumors was performed using Mimics 12.1 software. Surgical planning was performed through morphometry and multi-angle visual views of the tumor model. Two-step manual image fusion superimposed 3D model images onto 2D laparoscopic images. The image fusion was verified by intraoperative ultrasound. Imaging-guided laparoscopic hilar clamping and tumor excision was performed. Manual fusion time, patient demographics, surgical details, and postoperative treatment parameters were analyzed. The reconstructed 3D tumor models accurately represented the patient's physiological anatomical landmarks. The surgical planning markers were marked successfully. Manual image fusion was flexible and feasible with fusion time of 6 min (5-7 min). All surgeries were completed laparoscopically. The median tumor excision time was 5.4 min (3.5-10 min), whereas the median warm ischemia time was 25.5 min (16-32 min). Twelve patients (80 %) demonstrated renal cell carcinoma on final pathology, and all surgical margins were negative. No tumor recurrence was detected after a media follow-up of 1 year (3-15 months). The surgical planning and two-step manual image fusion based on 3D model of renal tumor facilitated visible-imaging-guided tumor resection with negative margin in LPN for intrarenal tumor. It is promising and moves us one step closer to imaging-guided surgery.

Sentinel Lymph Node Biopsy: Quantification of Lymphedema Risk Reduction

DTIC Science & Technology

2006-10-01

dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int J Radiat Oncol Biol Phys...techniques based on conventional photon beams, intensity modulated photon beams and proton beams for therapy of intact breast. Radiother Oncol. Feb...Harris JR. Three-dimensional internal mammary lymphoscintigraphy: implications for radiation therapy treatment planning for breast carcinoma. Int J

[Study of the appearance difference of lower complete denture between functional and anatomic impression techniques].

PubMed

Zhong, Qun; Wu, Xue-yin; Shen, Qing-yi; Shen, Qing-ping

2012-04-01

To compare the difference in oblique external ridge, oblique internal ridge and alveolar process crest of lower complete denture base made through functional impression and anatomic impression techniques. Fifteen patients were chosen to treat with two kinds of complete dentures through functional impression and anatomic impression technique respectively. 3D laser scanner was used to scan the three-dimensional model of the denture base and the differences of the surface structural between two techniques in alveolar process crest, external and internal oblique ridges were analyzed, using paired t test with SPSS 12.0 software package. Between the two techniques, there were significant differences in the areas of internal and external oblique ridge(P<0.01); there was no significant difference in the main support areas(P>0.05). The results explain why there is less tenderness when functional impression technique is applied. The differences measured also indicate that sufficient buffering should be made in external and internal oblique ridge areas in clinic.

Effects of lung disease on the three-dimensional structure and air flow pattern in the human airway tree

NASA Astrophysics Data System (ADS)

van de Moortele, Tristan; Nemes, Andras; Wendt, Christine; Coletti, Filippo

2016-11-01

The morphological features of the airway tree directly affect the air flow features during breathing, which determines the gas exchange and inhaled particle transport. Lung disease, Chronic Obstructive Pulmonary Disease (COPD) in this study, affects the structural features of the lungs, which in turn negatively affects the air flow through the airways. Here bronchial tree air volume geometries are segmented from Computed Tomography (CT) scans of healthy and diseased subjects. Geometrical analysis of the airway centerlines and corresponding cross-sectional areas provide insight into the specific effects of COPD on the airway structure. These geometries are also used to 3D print anatomically accurate, patient specific flow models. Three-component, three-dimensional velocity fields within these models are acquired using Magnetic Resonance Imaging (MRI). The three-dimensional flow fields provide insight into the change in flow patterns and features. Additionally, particle trajectories are determined using the velocity fields, to identify the fate of therapeutic and harmful inhaled aerosols. Correlation between disease-specific and patient-specific anatomical features with dysfunctional airflow patterns can be achieved by combining geometrical and flow analysis.

The 3D Printing of the Paralyzed Vocal Fold: Added Value in Injection Laryngoplasty.

PubMed

Hamdan, Abdul-Latif; Haddad, Ghassan; Haydar, Ali; Hamade, Ramsey

2017-08-18

Three-dimensional (3D) printing has had numerous applications in various disciplines, especially otolaryngology. We report the first case of a high-fidelity 3D-printed model of the vocal cords of a patient with unilateral vocal cord paralysis in need of injection laryngoplasty. A case report was carried out. A tailored 3D-printed anatomically precise models for injection laryngoplasty has the potential to enhance preoperative planning, resident teaching, and patient education. A 3D printing model of the paralyzed vocal cord has an added value in the preoperative assessment of patients undergoing injection laryngoplasty. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty.

PubMed

Inoue, Daisuke; Kabata, Tamon; Maeda, Toru; Kajino, Yoshitomo; Fujita, Kenji; Hasegawa, Kazuhiro; Yamamoto, Takashi; Takagi, Tomoharu; Ohmori, Takaaki; Tsuchiya, Hiroyuki

2015-12-01

It would be ideal if surgeons could precisely confirm whether the planned femoral component achieves the best fit and fill of implant and femur. However, the cortico-cancellous interfaces can be difficult to standardize using plain radiography, and therefore, determining the contact state is a subjective decision by the examiner. Few reports have described the use of CT-based three-dimensional templating software to quantify the contact state of stem and femur in detail. The purpose of this study was to use three-dimensional templating software to quantify the implant-femur contact state and develop a technique to analyze the initial fixation pattern of a cementless femoral stem. We conducted a retrospective review of 55 hips in 53 patients using a short proximal fit-and-fill anatomical stem (APS Natural-Hip™ System). All femurs were examined by density mapping which can visualize and digitize the contact state. We evaluated the contact state of implant and femur by using density mapping. The varus group (cases that had changed varus 2° by 3 months after surgery) consisted of 11 hips. The varus group showed no significant difference with regard to cortical contact in the proximal medial portion (Gruen 7), but the contact area in the distal portion (Gruen 3 and Gruen 5) was significantly lower than that of non-varus group. Density mapping showed that the stem only has to be press-fit to the medial calcar, but also must fill the distal portion of the implant in order to achieve the ideal contact state. Our results indicated that quantifying the contact state of implant and femur by using density mapping is a useful technique to accurately analyze the fixation pattern of a cementless femoral stem.

Stereoscopic virtual reality models for planning tumor resection in the sellar region.

PubMed

Wang, Shou-sen; Zhang, Shang-ming; Jing, Jun-jie

2012-11-28

It is difficult for neurosurgeons to perceive the complex three-dimensional anatomical relationships in the sellar region. To investigate the value of using a virtual reality system for planning resection of sellar region tumors. The study included 60 patients with sellar tumors. All patients underwent computed tomography angiography, MRI-T1W1, and contrast enhanced MRI-T1W1 image sequence scanning. The CT and MRI scanning data were collected and then imported into a Dextroscope imaging workstation, a virtual reality system that allows structures to be viewed stereoscopically. During preoperative assessment, typical images for each patient were chosen and printed out for use by the surgeons as references during surgery. All sellar tumor models clearly displayed bone, the internal carotid artery, circle of Willis and its branches, the optic nerve and chiasm, ventricular system, tumor, brain, soft tissue and adjacent structures. Depending on the location of the tumors, we simulated the transmononasal sphenoid sinus approach, transpterional approach, and other approaches. Eleven surgeons who used virtual reality models completed a survey questionnaire. Nine of the participants said that the virtual reality images were superior to other images but that other images needed to be used in combination with the virtual reality images. The three-dimensional virtual reality models were helpful for individualized planning of surgery in the sellar region. Virtual reality appears to be promising as a valuable tool for sellar region surgery in the future.

SU-C-210-05: Evaluation of Robustness: Dosimetric Effects of Anatomical Changes During Fractionated Radiation Treatment of Pancreatic Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Horst, A van der; Houweling, A C; Bijveld, M M C

2015-06-15

Purpose: Pancreatic tumors show large interfractional position variations. In addition, changes in gastrointestinal air volume and body contour take place during treatment. We aim to investigate the robustness of the clinical treatment plans by quantifying the dosimetric effects of these anatomical changes. Methods: Calculations were performed for up to now 3 pancreatic cancer patients who had intratumoral fiducials for daily CBCT-based positioning during their 3-week treatment. For each patient, deformable image registration of the planning CT was used to assign Hounsfield Units to each of the 13—15 CBCTs; air volumes and body contour were copied from CBCT. The clinical treatmentmore » plan was used (CTV-PTV margin = 10 mm; 36Gy; 10MV; 1 arc VMAT). Fraction dose distributions were calculated and accumulated. The V95% of the clinical target volume (CTV) and planning target volume (PTV) were analyzed, as well as the dose to stomach, duodenum and liver. Dose accumulation was done for patient positioning based on the fiducials (as clinically used) as well as for positioning based on bony anatomy. Results: For all three patients, the V95% of the CTV remained 100%, for both fiducial- and bony anatomy-based positioning. For fiducial-based positioning, dose to duodenum en stomach showed no discernable differences with planned dose. For bony anatomy-based positioning, the PTV V95% of the patient with the largest systematic difference in tumor position (patient 1) decreased to 85%; the liver Dmax increased from 33.5Gy (planned) to 35.5Gy. Conclusion: When using intratumoral fiducials, CTV dose coverage was only mildly affected by the daily anatomical changes. When using bony anatomy for patient positioning, we found a decline in PTV dose coverage due to the interfractional tumor position variations. Photon irradiation treatment plans for pancreatic tumors are robust to variations in body contour and gastrointestinal gas, but the use of fiducial-based daily position verification is imperative. This work was supported by the foundation Bergh in het Zadel through the Dutch Cancer Society (KWF Kankerbestrijding) project No. UVA 2011-5271.« less

Anatomic Optical Coherence Tomography of Upper Airways

NASA Astrophysics Data System (ADS)

Chin Loy, Anthony; Jing, Joseph; Zhang, Jun; Wang, Yong; Elghobashi, Said; Chen, Zhongping; Wong, Brian J. F.

The upper airway is a complex and intricate system responsible for respiration, phonation, and deglutition. Obstruction of the upper airways afflicts an estimated 12-18 million Americans. Pharyngeal size and shape are important factors in the pathogenesis of airway obstructions. In addition, nocturnal loss in pharyngeal muscular tone combined with high pharyngeal resistance can lead to collapse of the airway and periodic partial or complete upper airway obstruction. Anatomical optical coherence tomography (OCT) has the potential to provide high-speed three-dimensional tomographic images of the airway lumen without the use of ionizing radiation. In this chapter we describe the methods behind endoscopic OCT imaging and processing to generate full three dimensional anatomical models of the human airway which can be used in conjunction with numerical simulation methods to assess areas of airway obstruction. Combining this structural information with flow dynamic simulations, we can better estimate the site and causes of airway obstruction and better select and design surgery for patients with obstructive sleep apnea.

A tool for multi-scale modelling of the renal nephron

PubMed Central

Nickerson, David P.; Terkildsen, Jonna R.; Hamilton, Kirk L.; Hunter, Peter J.

2011-01-01

We present the development of a tool, which provides users with the ability to visualize and interact with a comprehensive description of a multi-scale model of the renal nephron. A one-dimensional anatomical model of the nephron has been created and is used for visualization and modelling of tubule transport in various nephron anatomical segments. Mathematical models of nephron segments are embedded in the one-dimensional model. At the cellular level, these segment models use models encoded in CellML to describe cellular and subcellular transport kinetics. A web-based presentation environment has been developed that allows the user to visualize and navigate through the multi-scale nephron model, including simulation results, at the different spatial scales encompassed by the model description. The Zinc extension to Firefox is used to provide an interactive three-dimensional view of the tubule model and the native Firefox rendering of scalable vector graphics is used to present schematic diagrams for cellular and subcellular scale models. The model viewer is embedded in a web page that dynamically presents content based on user input. For example, when viewing the whole nephron model, the user might be presented with information on the various embedded segment models as they select them in the three-dimensional model view. Alternatively, the user chooses to focus the model viewer on a cellular model located in a particular nephron segment in order to view the various membrane transport proteins. Selecting a specific protein may then present the user with a description of the mathematical model governing the behaviour of that protein—including the mathematical model itself and various simulation experiments used to validate the model against the literature. PMID:22670210

Anatomical location differences between mutated and wild-type isocitrate dehydrogenase 1 in low-grade gliomas.

PubMed

Yu, Jinhua; Shi, Zhifeng; Ji, Chunhong; Lian, Yuxi; Wang, Yuanyuan; Chen, Liang; Mao, Ying

2017-10-01

Anatomical location of gliomas has been considered as a factor implicating the contributions of a specific precursor cells during the tumor growth. Isocitrate dehydrogenase 1 (IDH1) is a pathognomonic biomarker with a significant impact on the development of gliomas and remarkable prognostic effect. The correlation between anatomical location of tumor and IDH1 states for low-grade gliomas was analyzed quantitatively in this study. Ninety-two patients diagnosed of low-grade glioma pathologically were recruited in this study, including 65 patients with IDH1-mutated glioma and 27 patients with wide-type IDH1. A convolutional neural network was designed to segment the tumor from three-dimensional magnetic resonance imaging images. Voxel-based lesion symptom mapping was then employed to study the tumor location distribution differences between gliomas with mutated and wild-type IDH1. In order to characterize the location differences quantitatively, the Automated Anatomical Labeling Atlas was used to partition the standard brain atlas into 116 anatomical volumes of interests (AVOIs). The percentages of tumors with different IDH1 states in 116 AVOIs were calculated and compared. Support vector machine and AdaBoost algorithms were used to estimate the IDH1 status based on the 116 location features of each patient. Experimental results proved that the quantitative tumor location measurement could be a very important group of imaging features in biomarker estimation based on radiomics analysis of glioma.

Evaluation by Medical Students of the Educational Value of Multi-Material and Multi-Colored Three-Dimensional Printed Models of the Upper Limb for Anatomical Education

ERIC Educational Resources Information Center

Mogali, Sreenivasulu Reddy; Yeong, Wai Yee; Tan, Heang Kuan Joel; Tan, Gerald Jit Shen; Abrahams, Peter H.; Zary, Nabil; Low-Beer, Naomi; Ferenczi, Michael Alan

2018-01-01

For centuries, cadaveric material has been the cornerstone of anatomical education. For reasons of changes in curriculum emphasis, cost, availability, expertise, and ethical concerns, several medical schools have replaced wet cadaveric specimens with plastinated prosections, plastic models, imaging, and digital models. Discussions about the…

Craniofacial Anomalies And Biostereometrics

NASA Astrophysics Data System (ADS)

Christiansen, Richard L.

1980-07-01

Man's oral-facial structures are vital for the functions of breathing, mastication, swallowing, vision, and communication. When defective development of these tissues occurs, function becomes impaired and the anatomic features of the afflicted individual will frequently deviate from the norm. This error of form and function will classify the individual as being physically and psychosocially handicapped. The successful habilitation regimen of the handicapped person depends on the accurate analysis of both craniofacial anatomy and physiology of these individuals, as well as psychological implications of the disfigurement. Biostereometrics can contribute to the establishment of operationally valid measures for assessing the severity of the handicapping conditions. The heterogeneous nature of diverse disfigurement suggest that an improved classification of malformations would be beneficial. Three-dimensional analysis may also have significant influence on the accuracy of the diagnosis, and the establishment of a biologically sound treatment plan. Biostereometrics will contribute more fully if the three-dimensional surface analysis can be coordinated with a study of 1) the underlying skeletal structures, and 2) the operational musculature. Increased communication between the stereometric experts and the biological scientists should accelerate the application of this technique to the health problem.

The current status and future prospects of computer-assisted hip surgery.

PubMed

Inaba, Yutaka; Kobayashi, Naomi; Ike, Hiroyuki; Kubota, So; Saito, Tomoyuki

2016-03-01

The advances in computer assistance technology have allowed detailed three-dimensional preoperative planning and simulation of preoperative plans. The use of a navigation system as an intraoperative assistance tool allows more accurate execution of the preoperative plan, compared to manual operation without assistance of the navigation system. In total hip arthroplasty using CT-based navigation, three-dimensional preoperative planning with computer software allows the surgeon to determine the optimal angle of implant placement at which implant impingement is unlikely to occur in the range of hip joint motion necessary for daily activities of living, and to determine the amount of three-dimensional correction for leg length and offset. With the use of computer navigation for intraoperative assistance, the preoperative plan can be precisely executed. In hip osteotomy using CT-based navigation, the navigation allows three-dimensional preoperative planning, intraoperative confirmation of osteotomy sites, safe performance of osteotomy even under poor visual conditions, and a reduction in exposure doses from intraoperative fluoroscopy. Positions of the tips of chisels can be displayed on the computer monitor during surgery in real time, and staff other than the operator can also be aware of the progress of surgery. Thus, computer navigation also has an educational value. On the other hand, its limitations include the need for placement of trackers, increased radiation exposure from preoperative CT scans, and prolonged operative time. Moreover, because the position of a bone fragment cannot be traced after osteotomy, methods to find its precise position after its movement need to be developed. Despite the need to develop methods for the postoperative evaluation of accuracy for osteotomy, further application and development of these systems are expected in the future. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Automatic pose correction for image-guided nonhuman primate brain surgery planning

NASA Astrophysics Data System (ADS)

Ghafurian, Soheil; Chen, Antong; Hines, Catherine; Dogdas, Belma; Bone, Ashleigh; Lodge, Kenneth; O'Malley, Stacey; Winkelmann, Christopher T.; Bagchi, Ansuman; Lubbers, Laura S.; Uslaner, Jason M.; Johnson, Colena; Renger, John; Zariwala, Hatim A.

2016-03-01

Intracranial delivery of recombinant DNA and neurochemical analysis in nonhuman primate (NHP) requires precise targeting of various brain structures via imaging derived coordinates in stereotactic surgeries. To attain targeting precision, the surgical planning needs to be done on preoperative three dimensional (3D) CT and/or MR images, in which the animals head is fixed in a pose identical to the pose during the stereotactic surgery. The matching of the image to the pose in the stereotactic frame can be done manually by detecting key anatomical landmarks on the 3D MR and CT images such as ear canal and ear bar zero position. This is not only time intensive but also prone to error due to the varying initial poses in the images which affects both the landmark detection and rotation estimation. We have introduced a fast, reproducible, and semi-automatic method to detect the stereotactic coordinate system in the image and correct the pose. The method begins with a rigid registration of the subject images to an atlas and proceeds to detect the anatomical landmarks through a sequence of optimization, deformable and multimodal registration algorithms. The results showed similar precision (maximum difference of 1.71 in average in-plane rotation) to a manual pose correction.

Three- and four-dimensional reconstruction of intra-cardiac anatomy from two-dimensional magnetic resonance images.

PubMed

Miquel, M E; Hill, D L G; Baker, E J; Qureshi, S A; Simon, R D B; Keevil, S F; Razavi, R S

2003-06-01

The present study was designed to evaluate the feasibility and clinical usefulness of three-dimensional (3D) reconstruction of intra-cardiac anatomy from a series of two-dimensional (2D) MR images using commercially available software. Sixteen patients (eight with structurally normal hearts but due to have catheter radio-frequency ablation of atrial tachyarrhythmias and eight with atrial septal defects (ASD) due for trans-catheter closure) and two volunteers were imaged at 1T. For each patient, a series of ECG-triggered images (5 mm thick slices, 2-3 mm apart) were acquired during breath holding. Depending on image quality, T1- or T2-weighted spin-echo images or gradient-echo cine images were used. The 3D reconstruction was performed off-line: the blood pools within cardiac chambers and great vessels were semi-automatically segmented, their outer surface was extracted using a marching cube algorithm and rendered. Intra- and inter-observer variability, effect of breath-hold position and differences between pulse sequences were assessed by imaging a volunteer. The 3D reconstructions were assessed by three cardiologists and compared with the 2D MR images and with 2D and 3D trans-esophagal and intra-cardiac echocardiography obtained during interventions. In every case, an anatomically detailed 3D volume was obtained. In the two patients where a 3 mm interval between slices was used, the resolution was not as good but it was still possible to visualize all the major anatomical structures. Spin-echo images lead to reconstructions more detailed than those obtained from gradient-echo images. However, gradient-echo images are easier to segment due to their greater contrast. Furthermore, because images were acquired at least at ten points in the cardiac cycles for every slice it was possible to reconstruct a cine loop and, for example, to visualize the evolution of the size and margins of the ASD during the cardiac cycle. 3D reconstruction proved to be an effective way to assess the relationship between the different parts of the cardiac anatomy. The technique was useful in planning interventions in these patients.

New horizons for study of the cardiopulmonary and circulatory systems. [image reconstruction techniques

NASA Technical Reports Server (NTRS)

Wood, E. H.

1976-01-01

The paper discusses the development of computer-controlled three-dimensional reconstruction techniques designed to determine the dynamic changes in the true shape and dimensions of the epi- and endocardial surfaces of the heart, along with variable time base (stop-action to real-time) displays of the transmural distribution of the coronary microcirculation and the three-dimensional anatomy of the macrovasculature in all regions of the body throughout individual cardiac and/or respiratory cycles. A technique for reconstructing a cross section of the heart from multiplanar videoroentgenograms is outlined. The capability of high spatial and high temporal resolution scanning videodensitometry makes possible measurement of the appearance, mean transit and clearance of roentgen opaque substances in three-dimensional space through the myocardium with a degree of simultaneous anatomic and temporal resolution not obtainable by current isotope techniques. The distribution of a variety of selected chemical elements or biologic materials within a body portion can also be determined.

Aligning Microtomography Analysis with Traditional Anatomy for a 3D Understanding of the Host-Parasite Interface – Phoradendron spp. Case Study

PubMed Central

Teixeira-Costa, Luíza; Ceccantini, Gregório C. T.

2016-01-01

The complex endophytic structure formed by parasitic plant species often represents a challenge in the study of the host-parasite interface. Even with the large amounts of anatomical slides, a three-dimensional comprehension of the structure may still be difficult to obtain. In the present study we applied the High Resolution X-ray Computed Tomography (HRXCT) analysis along with usual plant anatomy techniques in order to compare the infestation pattern of two mistletoe species of the genus Phoradendron. Additionally, we tested the use of contrasting solutions in order to improve the detection of the parasite’s endophytic tissue. To our knowledge, this is the first study to show the three-dimensional structure of host-mistletoe interface by using HRXCT technique. Results showed that Phoradendron perrottetii growing on the host Tapirira guianensis forms small woody galls with a restricted endophytic system. The sinkers were short and eventually grouped creating a continuous interface with the host wood. On the other hand, the long sinkers of P. bathyoryctum penetrate deeply into the wood of Cedrela fissilis branching in all directions throughout the woody gall area, forming a spread-out infestation pattern. The results indicate that the HRXCT is indeed a powerful approach to understand the endophytic system of parasitic plants. The combination of three-dimensional models of the infestation with anatomical analysis provided a broader understanding of the host-parasite connection. Unique anatomic features are reported for the sinkes of P. perrottetii, while the endophytic tissue of P. bathyoryctum conformed to general anatomy observed for other species of this genus. These differences are hypothesized to be related to the three-dimensional structure of each endophytic system and the communication stablished with the host. PMID:27630661

The biomechanical analysis of three-dimensional distal radius fracture model with different fixed splints.

PubMed

Hua, Zhen; Wang, Jian-Wei; Lu, Zhen-Fei; Ma, Jian-Wei; Yin, Heng

2018-01-01

The distal radius fracture is one of the common clinical fractures. At present, there are no reports regarding application of the finite element method in studying the mechanism of Colles fracture and the biomechanical behavior when using splint fixation. To explore the mechanism of Colles fracture and the biomechanical behavior when using different fixed splints. Based on the CT scanning images of forearm for a young female volunteer, by using model construction technology combined with RPOE and ANSYS software, a 3-D distal radius fracture forearm finite element model with a real shape and bioactive materials is built. The material tests are performed to obtain the mechanical properties of the paper-based splint, the willow splint and the anatomical splint. The numerical results are compared with the experimental results to verify the correctness of the presented model. Based on the verified model, the stress distribution of different tissues are analyzed. Finally, the clinical tests are performed to observe and verify that the anatomical splint is the best fit for human body. Using the three kinds of splints, the transferred bone stress focus on the distal radius and ulna, which is helpful to maintain the stability of fracture. Also the stress is accumulated in the distal radius which may be attributed to flexion position. Such stress distribution may be helpful to maintain the ulnar declination. By comparing the simulation results with the experimental observations, the anatomical splint has the best fitting to the limb, which can effectively avoid the local compression. The anatomical splint is the most effective for fixing and curing the fracture. The presented model can provide theoretical basis and technical guide for further investigating mechanism of distal radius fracture and clinical application of anatomical splint.

Bioprinting Cartilage Tissue from Mesenchymal Stem Cells and PEG Hydrogel.

PubMed

Gao, Guifang; Hubbell, Karen; Schilling, Arndt F; Dai, Guohao; Cui, Xiaofeng

2017-01-01

Bioprinting based on thermal inkjet printing is one of the most attractive enabling technologies for tissue engineering and regeneration. During the printing process, cells, scaffolds , and growth factors are rapidly deposited to the desired two-dimensional (2D) and three-dimensional (3D) locations. Ideally, the bioprinted tissues are able to mimic the native anatomic structures in order to restore the biological functions. In this study, a bioprinting platform for 3D cartilage tissue engineering was developed using a commercially available thermal inkjet printer with simultaneous photopolymerization . The engineered cartilage demonstrated native zonal organization, ideal extracellular matrix (ECM ) composition, and proper mechanical properties. Compared to the conventional tissue fabrication approach, which requires extended UV exposure, the viability of the printed cells with simultaneous photopolymerization was significantly higher. Printed neocartilage demonstrated excellent glycosaminoglycan (GAG) and collagen type II production, which was consistent with gene expression profile. Therefore, this platform is ideal for anatomic tissue engineering with accurate cell distribution and arrangement.

PARTIAL RESTRAINING FORCE INTRODUCTION METHOD FOR DESIGNING CONSTRUCTION COUNTERMESURE ON ΔB METHOD

NASA Astrophysics Data System (ADS)

Nishiyama, Taku; Imanishi, Hajime; Chiba, Noriyuki; Ito, Takao

Landslide or slope failure is a three-dimensional movement phenomenon, thus a three-dimensional treatment makes it easier to understand stability. The ΔB method (simplified three-dimensional slope stability analysis method) is based on the limit equilibrium method and equals to an approximate three-dimensional slope stability analysis that extends two-dimensional cross-section stability analysis results to assess stability. This analysis can be conducted using conventional spreadsheets or two-dimensional slope stability computational software. This paper describes the concept of the partial restraining force in-troduction method for designing construction countermeasures using the distribution of the restraining force found along survey lines, which is based on the distribution of survey line safety factors derived from the above-stated analysis. This paper also presents the transverse distributive method of restraining force used for planning ground stabilizing on the basis of the example analysis.

An Elaborate Data Set Characterizing the Mechanical Response of the Foot

PubMed Central

Erdemir, Ahmet; Sirimamilla, Pavana A.; Halloran, Jason P.; van den Bogert, Antonie J.

2010-01-01

Background Mechanical properties of the foot are responsible for its normal function and play a role in various clinical problems. Specifically, we are interested in quantification of foot mechanical properties to assist the development of computational models for movement analysis and detailed simulations of tissue deformation. Current available data are specific to a foot region and the loading scenarios are limited to a single direction. A data set that incorporates regional response, to quantify individual function of foot components, as well as overall response, to illustrate their combined operation, does not exist. Furthermore, combined three-dimensional loading scenarios while measuring the complete three-dimensional deformation response are lacking. When combined with an anatomical image data set, development of anatomically realistic and mechanically validated models becomes possible. Therefore, the goal of this study was to record and disseminate the mechanical response of a foot specimen, supported by imaging data. Method of Approach Robotic testing was conducted at the rear foot, forefoot, metatarsal heads, and the foot as a whole. Complex foot deformations were induced by single mode loading, e.g. compression, and combined loading, e.g. compression and shear. Small and large indenters were used for heel and metatarsal head loading; an elevated platform was utilized to isolate the rear foot and forefoot; and a full platform compressed the whole foot. Three-dimensional tool movements and reaction loads were recorded simultaneously. Computed tomography scans of the same specimen were collected for anatomical reconstruction a-priori. Results Three-dimensional mechanical response of the specimen was nonlinear and viscoelastic. A low stiffness region was observed starting with contact between the tool and foot regions, increasing with loading. Loading and unloading response portrayed hysteresis. Loading range ensured capturing the toe and linear regions of the load deformation curves for the dominant loading direction, with the rates approximating those of walking. Conclusion A large data set was successfully obtained to characterize the overall as well as regional mechanical response of an intact foot specimen under single and combined loads. Medical imaging complemented the mechanical testing data to establish the potential relationship between the anatomical architecture and mechanical response, and for further development of foot models that are mechanically realistic and anatomically consistent. This combined data set has been documented and disseminated in the public domain to promote future development in foot biomechanics. PMID:19725699

A topological multilayer model of the human body.

PubMed

Barbeito, Antonio; Painho, Marco; Cabral, Pedro; O'Neill, João

2015-11-04

Geographical information systems deal with spatial databases in which topological models are described with alphanumeric information. Its graphical interfaces implement the multilayer concept and provide powerful interaction tools. In this study, we apply these concepts to the human body creating a representation that would allow an interactive, precise, and detailed anatomical study. A vector surface component of the human body is built using a three-dimensional (3-D) reconstruction methodology. This multilayer concept is implemented by associating raster components with the corresponding vector surfaces, which include neighbourhood topology enabling spatial analysis. A root mean square error of 0.18 mm validated the three-dimensional reconstruction technique of internal anatomical structures. The expansion of the identification and the development of a neighbourhood analysis function are the new tools provided in this model.

Usefulness of the advanced neuroimaging protocol based on plain and gadolinium-enhanced constructive interference in steady state images for gamma knife radiosurgery and planning microsurgical procedures for skull base tumors.

PubMed

Hayashi, Motohiro; Chernov, Mikhail F; Tamura, Noriko; Yomo, Shoji; Tamura, Manabu; Horiba, Ayako; Izawa, Masahiro; Muragaki, Yoshihiro; Iseki, Hiroshi; Okada, Yoshikazu; Ivanov, Pavel; Régis, Jean; Takakura, Kintomo

2013-01-01

Gamma Knife radiosurgery (GKS) is currently performed with 0.1 mm preciseness, which can be designated microradiosurgery. It requires advanced methods for visualizing the target, which can be effectively attained by a neuroimaging protocol based on plain and gadolinium-enhanced constructive interference in steady state (CISS) images. Since 2003, the following thin-sliced images are routinely obtained before GKS of skull base lesions in our practice: axial CISS, gadolinium-enhanced axial CISS, gadolinium-enhanced axial modified time-of-flight (TOF), and axial computed tomography (CT). Fusion of "bone window" CT and magnetic resonance imaging (MRI), and detailed three-dimensional (3D) delineation of the anatomical structures are performed with the Leksell GammaPlan (Elekta Instruments AB). Recently, a similar technique has been also applied to evaluate neuroanatomy before open microsurgical procedures. Plain CISS images permit clear visualization of the cranial nerves in the subarachnoid space. Gadolinium-enhanced CISS images make the tumor "lucid" but do not affect the signal intensity of the cranial nerves, so they can be clearly delineated in the vicinity to the lesion. Gadolinium-enhanced TOF images are useful for 3D evaluation of the interrelations between the neoplasm and adjacent vessels. Fusion of "bone window" CT and MRI scans permits simultaneous assessment of both soft tissue and bone structures and allows 3D estimation and correction of MRI distortion artifacts. Detailed understanding of the neuroanatomy based on application of the advanced neuroimaging protocol permits performance of highly conformal and selective radiosurgical treatment. It also allows precise planning of the microsurgical procedures for skull base tumors.

Anatomical robust optimization to account for nasal cavity filling variation during intensity-modulated proton therapy: a comparison with conventional and adaptive planning strategies

NASA Astrophysics Data System (ADS)

van de Water, Steven; Albertini, Francesca; Weber, Damien C.; Heijmen, Ben J. M.; Hoogeman, Mischa S.; Lomax, Antony J.

2018-01-01

The aim of this study is to develop an anatomical robust optimization method for intensity-modulated proton therapy (IMPT) that accounts for interfraction variations in nasal cavity filling, and to compare it with conventional single-field uniform dose (SFUD) optimization and online plan adaptation. We included CT data of five patients with tumors in the sinonasal region. Using the planning CT, we generated for each patient 25 ‘synthetic’ CTs with varying nasal cavity filling. The robust optimization method available in our treatment planning system ‘Erasmus-iCycle’ was extended to also account for anatomical uncertainties by including (synthetic) CTs with varying patient anatomy as error scenarios in the inverse optimization. For each patient, we generated treatment plans using anatomical robust optimization and, for benchmarking, using SFUD optimization and online plan adaptation. Clinical target volume (CTV) and organ-at-risk (OAR) doses were assessed by recalculating the treatment plans on the synthetic CTs, evaluating dose distributions individually and accumulated over an entire fractionated 50 GyRBE treatment, assuming each synthetic CT to correspond to a 2 GyRBE fraction. Treatment plans were also evaluated using actual repeat CTs. Anatomical robust optimization resulted in adequate CTV doses (V95%  ⩾  98% and V107%  ⩽  2%) if at least three synthetic CTs were included in addition to the planning CT. These CTV requirements were also fulfilled for online plan adaptation, but not for the SFUD approach, even when applying a margin of 5 mm. Compared with anatomical robust optimization, OAR dose parameters for the accumulated dose distributions were on average 5.9 GyRBE (20%) higher when using SFUD optimization and on average 3.6 GyRBE (18%) lower for online plan adaptation. In conclusion, anatomical robust optimization effectively accounted for changes in nasal cavity filling during IMPT, providing substantially improved CTV and OAR doses compared with conventional SFUD optimization. OAR doses can be further reduced by using online plan adaptation.

Using three-dimensional computational modeling to compare the geometrical fitness of two kinds of proximal femoral intramedullary nail for Chinese femur.

PubMed

Zhang, Sheng; Zhang, Kairui; Wang, Yimin; Feng, Wei; Wang, Bowei; Yu, Bin

2013-01-01

The aim of this study was to use three-dimensional (3D) computational modeling to compare the geometric fitness of these two kinds of proximal femoral intramedullary nails in the Chinese femurs. Computed tomography (CT) scans of a total of 120 normal adult Chinese cadaveric femurs were collected for analysis. With the three-dimensional (3D) computational technology, the anatomical fitness between the nail and bone was quantified according to the impingement incidence, maximum thicknesses and lengths by which the nail was protruding into the cortex in the virtual bone model, respectively, at the proximal, middle, and distal portions of the implant in the femur. The results showed that PFNA-II may fit better for the Chinese proximal femurs than InterTan, and the distal portion of InterTan may perform better than that of PFNA-II; the anatomic fitness of both nails for Chinese patients may not be very satisfactory. As a result, both implants need further modifications to meet the needs of the Chinese population.

Automatic detection of patient identification and positioning errors in radiation therapy treatment using 3-dimensional setup images.

PubMed

Jani, Shyam S; Low, Daniel A; Lamb, James M

2015-01-01

To develop an automated system that detects patient identification and positioning errors between 3-dimensional computed tomography (CT) and kilovoltage CT planning images. Planning kilovoltage CT images were collected for head and neck (H&N), pelvis, and spine treatments with corresponding 3-dimensional cone beam CT and megavoltage CT setup images from TrueBeam and TomoTherapy units, respectively. Patient identification errors were simulated by registering setup and planning images from different patients. For positioning errors, setup and planning images were misaligned by 1 to 5 cm in the 6 anatomical directions for H&N and pelvis patients. Spinal misalignments were simulated by misaligning to adjacent vertebral bodies. Image pairs were assessed using commonly used image similarity metrics as well as custom-designed metrics. Linear discriminant analysis classification models were trained and tested on the imaging datasets, and misclassification error (MCE), sensitivity, and specificity parameters were estimated using 10-fold cross-validation. For patient identification, our workflow produced MCE estimates of 0.66%, 1.67%, and 0% for H&N, pelvis, and spine TomoTherapy images, respectively. Sensitivity and specificity ranged from 97.5% to 100%. MCEs of 3.5%, 2.3%, and 2.1% were obtained for TrueBeam images of the above sites, respectively, with sensitivity and specificity estimates between 95.4% and 97.7%. MCEs for 1-cm H&N/pelvis misalignments were 1.3%/5.1% and 9.1%/8.6% for TomoTherapy and TrueBeam images, respectively. Two-centimeter MCE estimates were 0.4%/1.6% and 3.1/3.2%, respectively. MCEs for vertebral body misalignments were 4.8% and 3.6% for TomoTherapy and TrueBeam images, respectively. Patient identification and gross misalignment errors can be robustly and automatically detected using 3-dimensional setup images of different energies across 3 commonly treated anatomical sites. Copyright © 2015 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

A reusable anatomically segmented digital mannequin for public health communication.

PubMed

Fujieda, Kaori; Okubo, Kosaku

2016-01-01

The ongoing development of world wide web technologies has facilitated a change in health communication, which has now become bi-directional and encompasses people with diverse backgrounds. To enable an even greater role for medical illustrations, a data set, BodyParts3D, has been generated and its data set can be used by anyone to create and exchange customised three-dimensional (3D) anatomical images. BP3D comprises more than 3000 3D object files created by segmenting a digital mannequin in accordance with anatomical naming conventions. This paper describes the methodologies and features used to generate an anatomically correct male mannequin.

Three-dimensional circumferential liposuction of the overweight or obese upper arm.

PubMed

Hong, Yoon Gi; Sim, Hyung Bo; Lee, Mu Young; Seo, Sang Won; Chang, Choong Hyun; Yeo, Kwan Koo; Kim, June-kyu

2012-06-01

Due to recent trends in liposuction, anatomic consideration of the body's fatty layers is essential. Based on this knowledge, a circumferential approach to achieving maximal aesthetic results is highlighted. In the upper arm, aspiration of fat from only the posterolateral region can result in skin flaccidity and disharmony of the overall balance of the upper arm contour. Different suction techniques were applied depending on the degree of fat accumulation. If necessary, the operation area was extended around the axillary and scapular regions to overcome the limitations of the traditional method and to achieve optimal effects. To maximize skin contracture and redraping, the authors developed three-dimensional circumferential liposuction (3D-CL) based on two concepts: circumferential aspiration of the upper arm, to which was applied different fluid infiltration and liposuction techniques in three anatomic compartments (anteromedial, anterolateral, and posterolateral), and extension of liposuction to the periaxillar and parascarpular areas. A total of 57 female patients underwent liposuction of their excess arm fat using this technique. The authors achieved their aesthetic goals of a straightened inferior brachial border and a more slender body contour. Complications occurred for five patients including irregularity, incision-site scar, and transient pigmentation. Through 3D-CL, the limitations of traditional upper arm liposuction were overcome, and a slender arm contour with a straightened inferior brachial border was produced. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at http://www.springer.com/00266.

Planning surgical reconstruction in Treacher-Collins syndrome using virtual simulation.

PubMed

Nikkhah, Dariush; Ponniah, Allan; Ruff, Cliff; Dunaway, David

2013-11-01

Treacher-Collins syndrome is a rare autosomal dominant condition of varying phenotypic expression. The surgical correction in this syndrome is difficult, and the approach varies between craniofacial departments worldwide. The authors aimed to design standardized tools for planning orbitozygomatic and mandibular reconstruction in Treacher-Collins syndrome using geometric morphometrics. The Great Ormond Street Hospital database was retrospectively identified for patients with Treacher-Collins syndrome. Thirteen children (aged 2 to 15 years) who had suitable preoperative three-dimensional computed tomographic head scans were included. Six Treacher-Collins syndrome three-dimensional computed tomographic head scans were quantitatively compared using a template of 96 anatomically defined landmarks to 26 age-matched normal dry skulls. Thin-plate spline videos illustrated the characteristic deformities of retromicrognathia and maxillary and orbitozygomatic hypoplasia in the Treacher-Collins syndrome population. Geometric morphometrics was used in the virtual reconstruction of the orbitozygomatic and mandibular region in Treacher-Collins syndrome patients. Intrarater and interrater reliability of the landmarks was acceptable and within a standard deviation of less than 1 mm on 97 percent and 100 percent of 10 repeated scans, respectively. Virtual normalization of the Treacher-Collins syndrome skull effectively describes characteristic skeletal deformities and provides a useful guide to surgical reconstruction. Size-matched stereolithographic templates derived from thin-plate spline warps can provide effective intraoperative templates for zygomatic and mandibular reconstruction in the Treacher-Collins syndrome patient. Diagnostic, V.

Segmentation of radiographic images under topological constraints: application to the femur.

PubMed

Gamage, Pavan; Xie, Sheng Quan; Delmas, Patrice; Xu, Wei Liang

2010-09-01

A framework for radiographic image segmentation under topological control based on two-dimensional (2D) image analysis was developed. The system is intended for use in common radiological tasks including fracture treatment analysis, osteoarthritis diagnostics and osteotomy management planning. The segmentation framework utilizes a generic three-dimensional (3D) model of the bone of interest to define the anatomical topology. Non-rigid registration is performed between the projected contours of the generic 3D model and extracted edges of the X-ray image to achieve the segmentation. For fractured bones, the segmentation requires an additional step where a region-based active contours curve evolution is performed with a level set Mumford-Shah method to obtain the fracture surface edge. The application of the segmentation framework to analysis of human femur radiographs was evaluated. The proposed system has two major innovations. First, definition of the topological constraints does not require a statistical learning process, so the method is generally applicable to a variety of bony anatomy segmentation problems. Second, the methodology is able to handle both intact and fractured bone segmentation. Testing on clinical X-ray images yielded an average root mean squared distance (between the automatically segmented femur contour and the manual segmented ground truth) of 1.10 mm with a standard deviation of 0.13 mm. The proposed point correspondence estimation algorithm was benchmarked against three state-of-the-art point matching algorithms, demonstrating successful non-rigid registration for the cases of interest. A topologically constrained automatic bone contour segmentation framework was developed and tested, providing robustness to noise, outliers, deformations and occlusions.

Functional Strain-Line Pattern in the Human Left Ventricle

NASA Astrophysics Data System (ADS)

Pedrizzetti, Gianni; Kraigher-Krainer, Elisabeth; De Luca, Alessio; Caracciolo, Giuseppe; Mangual, Jan O.; Shah, Amil; Toncelli, Loira; Domenichini, Federico; Tonti, Giovanni; Galanti, Giorgio; Sengupta, Partho P.; Narula, Jagat; Solomon, Scott

2012-07-01

Analysis of deformations in terms of principal directions appears well suited for biological tissues that present an underlying anatomical structure of fiber arrangement. We applied this concept here to study deformation of the beating heart in vivo analyzing 30 subjects that underwent accurate three-dimensional echocardiographic recording of the left ventricle. Results show that strain develops predominantly along the principal direction with a much smaller transversal strain, indicating an underlying anisotropic, one-dimensional contractile activity. The strain-line pattern closely resembles the helical anatomical structure of the heart muscle. These findings demonstrate that cardiac contraction occurs along spatially variable paths and suggest a potential clinical significance of the principal strain concept for the assessment of mechanical cardiac function. The same concept can help in characterizing the relation between functional and anatomical properties of biological tissues, as well as fiber-reinforced engineered materials.

Quantitative three-dimensional photoacoustic tomography of the finger joints: an in vivo study

NASA Astrophysics Data System (ADS)

Sun, Yao; Sobel, Eric; Jiang, Huabei

2009-11-01

We present for the first time in vivo full three-dimensional (3-D) photoacoustic tomography (PAT) of the distal interphalangeal joint in a human subject. Both absorbed energy density and absorption coefficient images of the joint are quantitatively obtained using our finite-element-based photoacoustic image reconstruction algorithm coupled with the photon diffusion equation. The results show that major anatomical features in the joint along with the side arteries can be imaged with a 1-MHz transducer in a spherical scanning geometry. In addition, the cartilages associated with the joint can be quantitatively differentiated from the phalanx. This in vivo study suggests that the 3-D PAT method described has the potential to be used for early diagnosis of joint diseases such as osteoarthritis and rheumatoid arthritis.

Usefulness of three-dimensional full-scale modeling of surgery for a giant cell tumor of the cervical spine.

PubMed

Yamazaki, M; Akazawa, T; Okawa, A; Koda, M

2007-03-01

Case report. To report a case with giant cell tumor (GCT) of C6 vertebra, in which three-dimensional (3-D) full-scale modeling of the cervical spine was useful for preoperative planning and intraoperative navigation. A university hospital in Japan. A 27-year-old man with a GCT involving the C6 vertebra presented with severe neck pain. The C6 vertebra was collapsed and the tumor had infiltrated around both vertebral arteries (VAs). A single-stage operation combining anterior and posterior surgical procedures was scheduled to resect the tumor and stabilize the spine. To evaluate the anatomic structures within the surgical fields, we produced a 3-D full-scale model from the computed tomography angiography data. The 3-D full-scale model clearly showed the relationships between the destroyed C6 vertebra and the deviations in the courses of both VAs. Using the model, we were able to identify the anatomic landmarks around the VAs during anterior surgery and to successfully resect the tumor. During the posterior surgery, we were able to determine accurate starting points for the pedicle screws. Anterior iliac bone graft from C5 to C7 and posterior fixation with a rod and screw system from C4 to T2 were performed without any complications. Postoperatively, the patient experienced relief of his neck pain. The 3-D full-scale model was useful for simultaneously evaluating the destruction of the vertebral bony structures and the deviations in the courses of the VAs during surgery for GCT involving the cervical spine.

Knowledge-based IMRT planning for individual liver cancer patients using a novel specific model.

PubMed

Yu, Gang; Li, Yang; Feng, Ziwei; Tao, Cheng; Yu, Zuyi; Li, Baosheng; Li, Dengwang

2018-03-27

The purpose of this work is to benchmark RapidPlan against clinical plans for liver Intensity-modulated radiotherapy (IMRT) treatment of patients with special anatomical characteristics, and to investigate the prediction capability of the general model (Model-G) versus our specific model (Model-S). A library consisting of 60 liver cancer patients with IMRT planning was used to set up two models (Model-S, Model-G), using the RapidPlan knowledge-based planning system. Model-S consisted of 30 patients with special anatomical characteristics where the distance from planning target volume (PTV) to the right kidney was less than three centimeters and Model-G was configurated using all 60 patients in this library. Knowledge-based IMRT plans were created for the evaluation group formed of 13 patients similar to those included in Model-S by Model-G, Model-S and manually (M), named RPG-plans, RPS-plans and M-plans, respectively. The differences in the dose-volume histograms (DVHs) were compared, not only between RP-plans and their respective M-plans, but also between RPG-plans and RPS-plans. For all 13 patients, RapidPlan could automatically produce clinically acceptable plans. Comparing RP-plans to M-plans, RP-plans improved V 95% of PTV and had greater dose sparing in the right kidney. For the normal liver, RPG-plans delivered similar doses, while RPS-plans delivered a higher dose than M-plans. With respect to RapidPlan models, RPS-plans had better conformity index (CI) values and delivered lower doses to the right kidney V 20Gy and maximizing point doses to spinal cord, while delivering higher doses to the normal liver. The study shows that RapidPlan can create high-quality plans, and our specific model can improve the CI of PTV, resulting in more sparing of OAR in IMRT for individual liver cancer patients.

[3D FSPGR (fast spoiled gradient echo) magnetic resonance imaging in the diagnosis of focal cortical dysplasia in children].

PubMed

Alikhanov, A A; Sinitsyn, V E; Perepelova, E M; Mukhin, K Iu; Demushkina, A A; Omarova, M O; Piliia, S V

2001-01-01

Small dysplastic lesions of the cerebral cortex are often missed by conventional MRI methods. The identification of subtle structural abnormalities by traditional multiplanar rectilinear slices is often limited by the complex convolutional pattern of the brain. We used a method of FSPGR (fast spoiled gradient-echo) of three-dimensional MRI data that improves the anatomical display of the sulcal structure of the hemispheric convexities. It also reduces the asymmetric sampling of gray-white matter that may lead to false-positive results. We present 5 from 12 patients with dysplastic cortical lesions in whom conventional two-dimensional and three-dimensional MRI with multiplanar reformatting was initially considered normal. Subsequent studies using 3D FSPGR identified various types of focal cortical dysplasia in all. These results indicate that an increase in the detection of subtle focal dysplastic lesions may be accomplished when one improves the anatomical display of the brain sulcal structure by performing 3D FSPGR.

Feasibility of creating a high-resolution 3D diffusion tensor imaging based atlas of the human brainstem: A case study at 11.7T

PubMed Central

Aggarwal, Manisha; Zhang, Jiangyang; Pletnikova, Olga; Crain, Barbara; Troncoso, Juan; Mori, Susumu

2013-01-01

A three-dimensional stereotaxic atlas of the human brainstem based on high resolution ex vivo diffusion tensor imaging (DTI) is introduced. The atlas consists of high resolution (125–255 μm isotropic) three-dimensional DT images of the formalin-fixed brainstem acquired at 11.7T. The DTI data revealed microscopic neuroanatomical details, allowing three-dimensional visualization and reconstruction of fiber pathways including the decussation of the pyramidal tract fibers, and interdigitating fascicles of the corticospinal and transverse pontine fibers. Additionally, strong grey-white matter contrasts in the apparent diffusion coefficient (ADC) maps enabled precise delineation of grey matter nuclei in the brainstem, including the cranial nerve and the inferior olivary nuclei. Comparison with myelin-stained histology shows that at the level of resolution achieved in this study, the structural details resolved with DTI contrasts in the brainstem were comparable to anatomical delineation obtained with histological sectioning. Major neural structures delineated from DTI contrasts in the brainstem are segmented and three-dimensionally reconstructed. Further, the ex vivo DTI data are nonlinearly mapped to a widely-used in vivo human brain atlas, to construct a high-resolution atlas of the brainstem in the Montreal Neurological Institute (MNI) stereotaxic coordinate space. The results demonstrate the feasibility of developing a 3D DTI based atlas for detailed characterization of brainstem neuroanatomy with high resolution and contrasts, which will be a useful resource for research and clinical applications. PMID:23384518

Intraoperative Two- and Three-Dimensional Transesophageal Echocardiography in Combined Myectomy-Mitral Operations for Hypertrophic Cardiomyopathy.

PubMed

Nampiaparampil, Robert G; Swistel, Daniel G; Schlame, Michael; Saric, Muhamed; Sherrid, Mark V

2018-03-01

Transesophageal echocardiography is essential in guiding the surgical approach for patients with obstructive hypertrophic cardiomyopathy. Septal hypertrophy, elongated mitral valve leaflets, and abnormalities of the subvalvular apparatus are prominent features, all of which may contribute to left ventricular outflow tract obstruction. Surgery aims to alleviate the obstruction via an extended myectomy, often with an intervention on the mitral valve and subvalvular apparatus. The goal of intraoperative echocardiography is to assess the anatomic pathology and pathophysiology in order to achieve a safe intraoperative course and a successful repair. This guide summarizes the systematic evaluation of these patients to determine the best surgical plan. Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Stereolithography: a potential new tool in forensic medicine.

PubMed

Dolz, M S; Cina, S J; Smith, R

2000-06-01

Stereolithography is a computer-mediated method that can be used to quickly create anatomically correct three-dimensional epoxy and acrylic resin models from various types of medical data. Multiple imaging modalities can be exploited, including computed tomography and magnetic resonance imaging. The technology was first developed and used in 1986 to overcome limitations in previous computer-aided manufacturing/milling techniques. Stereolithography is presently used to accurately reproduce both the external and internal anatomy of body structures. Current medical uses of stereolithography include preoperative planning of orthopedic and maxillofacial surgeries, the fabrication of custom prosthetic devices; and the assessment of the degree of bony and soft-tissue injury caused by trauma. We propose that there is a useful, as yet untapped, potential for this technology in forensic medicine.

Compared to X-ray, three-dimensional computed tomography measurement is a reproducible radiographic method for normal proximal humerus.

PubMed

Jia, Xiaoyang; Chen, Yanxi; Qiang, Minfei; Zhang, Kun; Li, Haobo; Jiang, Yuchen; Zhang, Yijie

2016-07-15

Accurate comprehension of the normal humeral morphology is crucial for anatomical reconstruction in shoulder arthroplasty. However, traditional morphological measurements for humerus were mainly based on cadaver and radiography. The purpose of this study was to provide a series of precise and repeatable parameters of the normal proximal humerus for arthroplasty, based on the three-dimensional (3-D) measurements. Radiographic and 3-D computed tomography (CT) measurements of the proximal humerus were performed in a sample of 120 consecutive adults. Sex differences, two image modalities differences, and correlations of the parameters were evaluated. Intra- and inter-observer reproducibility was evaluated using intraclass correlation coefficients (ICCs). In the male group, all parameters except the neck-shaft angle of humerus, based on 3-D CT images, were greater than those in the female group (P < 0.05). All variables were significantly different between two image modalities (P < 0.05). In 3-D CT measurement, all parameters expect neck-shaft angle had correlation with each other (P < 0.001), particularly between two diameters of the humeral head (r = 0.907). All parameters in the 3-D CT measurement had excellent reproducibility (ICC range, 0.878 to 0.936) that was higher than those in the radiographs (ICC range, 0.741 to 0.858). The present study suggested that 3-D CT was more reproducible than plain radiography in the assessment of morphology of the normal proximal humerus. Therefore, this reproducible modality could be utilized in the preoperative planning. Our data could serve as an effective guideline for humeral component selection and improve the design of shoulder prosthesis.

Statistical Analyses of Femur Parameters for Designing Anatomical Plates.

PubMed

Wang, Lin; He, Kunjin; Chen, Zhengming

2016-01-01

Femur parameters are key prerequisites for scientifically designing anatomical plates. Meanwhile, individual differences in femurs present a challenge to design well-fitting anatomical plates. Therefore, to design anatomical plates more scientifically, analyses of femur parameters with statistical methods were performed in this study. The specific steps were as follows. First, taking eight anatomical femur parameters as variables, 100 femur samples were classified into three classes with factor analysis and Q-type cluster analysis. Second, based on the mean parameter values of the three classes of femurs, three sizes of average anatomical plates corresponding to the three classes of femurs were designed. Finally, based on Bayes discriminant analysis, a new femur could be assigned to the proper class. Thereafter, the average anatomical plate suitable for that new femur was selected from the three available sizes of plates. Experimental results showed that the classification of femurs was quite reasonable based on the anatomical aspects of the femurs. For instance, three sizes of condylar buttress plates were designed. Meanwhile, 20 new femurs are judged to which classes the femurs belong. Thereafter, suitable condylar buttress plates were determined and selected.

Performance of a Novel Repositioning Head Frame for Gamma Knife Perfexion and Image-Guided Linac-Based Intracranial Stereotactic Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ruschin, Mark, E-mail: Mark.Ruschin@rmp.uhn.on.c; Department of Radiation Oncology, University of Toronto, Toronto; Nayebi, Nazanin

2010-09-01

Purpose: To evaluate the geometric positioning and immobilization performance of a vacuum bite-block repositioning head frame (RHF) system for Perfexion (PFX-SRT) and linac-based intracranial image-guided stereotactic radiotherapy (SRT). Methods and Materials: Patients with intracranial tumors received linac-based image-guided SRT using the RHF for setup and immobilization. Three hundred thirty-three fractions of radiation were delivered in 12 patients. The accuracy of the RHF was estimated for linac-based SRT with online cone-beam CT (CBCT) and for PFX-SRT with a repositioning check tool (RCT) and offline CBCT. The RCT's ability to act as a surrogate for anatomic position was estimated through comparison tomore » CBCT image matching. Immobilization performance was evaluated daily with pre- and postdose delivery CBCT scans and RCT measurements. Results: The correlation coefficient between RCT- and CBCT-reported displacements was 0.59, 0.75, 0.79 (Right, Superior, and Anterior, respectively). For image-guided linac-based SRT, the mean three-dimensional (3D) setup error was 0.8 mm with interpatient ({Sigma}) and interfraction ({sigma}) variations of 0.1 and 0.4 mm, respectively. For PFX-SRT, the initial, uncorrected mean 3D positioning displacement in stereotactic coordinates was 2.0 mm, with {Sigma} = 1.1 mm and {sigma} = 0.8 mm. Considering only RCT setups <1mm (PFX action level) the mean 3D positioning displacement reduced to 1.3 mm, with {Sigma} = 0.9 mm and {sigma} = 0.4 mm. The largest contributing systematic uncertainty was in the superior-inferior direction (mean displacement = -0.5 mm; {Sigma} = 0.9 mm). The largest mean rotation was 0.6{sup o} in pitch. The mean 3D intrafraction motion was 0.4 {+-} 0.3 mm. Conclusion: The RHF provides excellent immobilization for intracranial SRT and PFX-SRT. Some small systematic uncertainties in stereotactic positioning exist and must be considered when generating PFX-SRT treatment plans. The RCT provides reasonable surrogacy for internal anatomic displacement.« less

[Extraction of buildings three-dimensional information from high-resolution satellite imagery based on Barista software].

PubMed

Zhang, Pei-feng; Hu, Yuan-man; He, Hong-shi

2010-05-01

The demand for accurate and up-to-date spatial information of urban buildings is becoming more and more important for urban planning, environmental protection, and other vocations. Today's commercial high-resolution satellite imagery offers the potential to extract the three-dimensional information of urban buildings. This paper extracted the three-dimensional information of urban buildings from QuickBird imagery, and validated the precision of the extraction based on Barista software. It was shown that the extraction of three-dimensional information of the buildings from high-resolution satellite imagery based on Barista software had the advantages of low professional level demand, powerful universality, simple operation, and high precision. One pixel level of point positioning and height determination accuracy could be achieved if the digital elevation model (DEM) and sensor orientation model had higher precision and the off-Nadir View Angle was relatively perfect.

Making education effective and fun: stations-based approach to teaching radiology and anatomy to third-year medical students.

PubMed

Arya, Rahul; Morrison, Trevor; Zumwalt, Ann; Shaffer, Kitt

2013-10-01

A hands-on stations-based approach to teaching anatomy to third-year medical students is used at Boston University. The goal of our study was to demonstrate that such an interactive, team-based approach to teaching anatomy would be well received and be helpful in recall, comprehension, and reinforcement of anatomy learned in the first year of medical school. Each radiology-anatomy correlation lab was focused on one particular anatomic part, such as skull base, pelvis, coronary anatomy, etc. Four stations, including a three-dimensional model, computer, ultrasound, and posters, were created for each lab. Informed consent was obtained before online survey dissemination to assess the effectiveness and quality of radiology-anatomy correlation lab. This study was approved by our institutional institutional review board, and data were analyzed using a χ(2) test. Survey data were collected from February 2010 through March 2012. The response rate was 33.5%. Overall, the highest percentage of students (46%) found the three-dimensional model station to be the most valuable. The computer station was most helpful in recall of the anatomic principles from the first year of medical school. Regarding the quality of the anatomy lab, less than 2% of the students thought that the images were of poor quality or the material presented was not clinically relevant. Our results indicate that an interactive, team-based approach to teaching anatomy was well received by the medical students. It was engaging and students were able to benefit from it in multiple ways. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Three-dimensional finite element analysis of occipitocervical fixation using an anterior occiput-to-axis locking plate system: a pilot study.

PubMed

Cai, Xianhua; Yu, Yang; Liu, Zhichao; Zhang, Meichao; Huang, Weibing

2014-08-01

Although there are many techniques for occipitocervical fixation, there have been no reports regarding occipitocervical fixation via the use of an anterior anatomical locking plate system. The biomechanics of this new system were analyzed by a three-dimensional finite element to provide a theoretical basis for clinical application. This was a modeling study. We studied a 27-year-old healthy male volunteer in whom cervical disease was excluded via X-ray examination. The states of stress and strain of these two internal fixation devices were analyzed. A three-dimensional finite element model of normal occiput-C2 was established based on the anatomical data from a Chinese population. An unstable model of occipital-cervical region was established by subtracting several unit structures from the normal model. An anterior occiput-to-axis locking titanium plate system was then applied and an anterior occiput-to-axis screw fixation was performed on the unstable model. Limitation of motion was performed on the surface of the fixed model, and physiological loads were imposed on the surface of the skull base. Under various loads from different directions, the peak values of displacement of the anterior occiput-to-axis locking titanium plate system decreased 15.5%, 12.5%, 14.4%, and 23.7%, respectively, under the loads of flexion, extension, lateral bending, and axial rotation. Compared with the anterior occiput-to-axis screw fixation, the peak values of stress of the anterior occiput-to-axis locking titanium plate system also decreased 3.9%, 2.9%, 9.7%, and 7.2%, respectively, under the loads of flexion, extension, lateral bending, and axial rotation. The anterior occiput-to-axis locking titanium plate system proved superior to the anterior occiput-to-axis screw system both in the stress distribution and fixation stability based on finite element analysis. It provides a new clinical option for anterior occipitocervical fixation. Copyright © 2014 Elsevier Inc. All rights reserved.

SU-C-BRD-07: Three-Dimensional Dose Reconstruction in the Presence of Inhomogeneities Using Fast EPID-Based Back-Projection Method

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ren, Q; Cao, R; Pei, X

2015-06-15

Purpose: Three-dimensional dose verification can detect errors introduced by the treatment planning system (TPS) or differences between planned and delivered dose distribution during the treatment. The aim of the study is to extend a previous in-house developed three-dimensional dose reconstructed model in homogeneous phantom to situtions in which tissue inhomogeneities are present. Methods: The method was based on the portal grey images from an electronic portal imaging device (EPID) and the relationship between beamlets and grey-scoring voxels at the position of the EPID. The relationship was expressed in the form of grey response matrix that was quantified using thickness-dependence scattermore » kernels determined by series of experiments. From the portal grey-value distribution information measured by the EPID the two-dimensional incident fluence distribution was reconstructed based on the grey response matrix using a fast iterative algorithm. The accuracy of this approach was verified using a four-field intensity-modulated radiotherapy (IMRT) plan for the treatment of lung cancer in anthopomorphic phantom. Each field had between twenty and twenty-eight segments and was evaluated by comparing the reconstructed dose distribution with the measured dose. Results: The gamma-evaluation method was used with various evaluation criteria of dose difference and distance-to-agreement: 3%/3mm and 2%/2 mm. The dose comparison for all irradiated fields showed a pass rate of 100% with the criterion of 3%/3mm, and a pass rate of higher than 92% with the criterion of 2%/2mm. Conclusion: Our experimental results demonstrate that our method is capable of accurately reconstructing three-dimensional dose distribution in the presence of inhomogeneities. Using the method, the combined planning and treatment delivery process is verified, offing an easy-to-use tool for the verification of complex treatments.« less

[3-dimensional models of actual or simulated cesarean sections].

PubMed

Patzak, B; Schaller, A

2001-01-01

Following upon an etymological and historical introduction, this report refers to two three-dimensional wax models of Caesarean sections, which have recently been acquired by the Pathological-anatomical Federal Museum in Vienna. Information is given on origin, dating and kind of production; questions of indication and operation technique, and--when in doubt--obduction technique, are being considered.

Four-dimensional computed tomography-based treatment planning for intensity-modulated radiation therapy and proton therapy for distal esophageal cancer.

PubMed

Zhang, Xiaodong; Zhao, Kuai-le; Guerrero, Thomas M; McGuire, Sean E; Yaremko, Brian; Komaki, Ritsuko; Cox, James D; Hui, Zhouguang; Li, Yupeng; Newhauser, Wayne D; Mohan, Radhe; Liao, Zhongxing

2008-09-01

To compare three-dimensional (3D) and four-dimensional (4D) computed tomography (CT)-based treatment plans for proton therapy or intensity-modulated radiation therapy (IMRT) for esophageal cancer in terms of doses to the lung, heart, and spinal cord and variations in target coverage and normal tissue sparing. The IMRT and proton plans for 15 patients with distal esophageal cancer were designed from the 3D average CT scans and then recalculated on 10 4D CT data sets. Dosimetric data were compared for tumor coverage and normal tissue sparing. Compared with IMRT, median lung volumes exposed to 5, 10, and 20 Gy and mean lung dose were reduced by 35.6%, 20.5%, 5.8%, and 5.1 Gy for a two-beam proton plan and by 17.4%, 8.4%, 5%, and 2.9 Gy for a three-beam proton plan. The greater lung sparing in the two-beam proton plan was achieved at the expense of less conformity to the target (conformity index [CI], 1.99) and greater irradiation of the heart (heart-V40, 41.8%) compared with the IMRT plan(CI, 1.55, heart-V40, 35.7%) or the three-beam proton plan (CI, 1.46, heart-V40, 27.7%). Target coverage differed by more than 2% between the 3D and 4D plans for patients with substantial diaphragm motion in the three-beam proton and IMRT plans. The difference in spinal cord maximum dose between 3D and 4D plans could exceed 5 Gy for the proton plans partly owing to variations in stomach gas filling. Proton therapy provided significantly better sparing of lung than did IMRT. Diaphragm motion and stomach gas-filling must be considered in evaluating target coverage and cord doses.

The application of 3D image processing to studies of the musculoskeletal system

NASA Astrophysics Data System (ADS)

Hirsch, Bruce Elliot; Udupa, Jayaram K.; Siegler, Sorin; Winkelstein, Beth A.

2009-10-01

Three dimensional renditions of anatomical structures are commonly used to improve visualization, surgical planning, and patient education. However, such 3D images also contain information which is not readily apparent, and which can be mined to elucidate, for example, such parameters as joint kinematics, spacial relationships, and distortions of those relationships with movement. Here we describe two series of experiments which demonstrate the functional application of 3D imaging. The first concerns the joints of the ankle complex, where the usual description of motions in the talocrural joint is shown to be incomplete, and where the roles of the anterior talofibular and calcaneofibular ligaments are clarified in ankle sprains. Also, the biomechanical effects of two common surgical procedures for repairing torn ligaments were examined. The second series of experiments explores changes in the anatomical relationships between nerve elements and the cervical vertebrae with changes in neck position. They provide preliminary evidence that morphological differences may exist between asymptomatic subjects and patients with radiculopathy in certain positions, even when conventional imaging shows no difference.

Single calibration multiplane stereo-PIV: the effect of mitral valve orientation on three-dimensional flow in a left ventricle model

NASA Astrophysics Data System (ADS)

Saaid, Hicham; Segers, Patrick; Novara, Matteo; Claessens, Tom; Verdonck, Pascal

2018-03-01

The characterization of flow patterns in the left ventricle may help the development and interpretation of flow-based parameters of cardiac function and (patho-)physiology. Yet, in vivo visualization of highly dynamic three-dimensional flow patterns in an opaque and moving chamber is a challenging task. This has been shown in several recent multidisciplinary studies where in vivo imaging methods are often complemented by in silico solutions, or by in vitro methods. Because of its distinctive features, particle image velocimetry (PIV) has been extensively used to investigate flow dynamics in the cardiovascular field. However, full volumetric PIV data in a dynamically changing geometry such as the left ventricle remain extremely scarce, which justifies the present study. An investigation of the left ventricle flow making use of a customized cardiovascular simulator is presented; a multiplane scanning-stereoscopic PIV setup is used, which allows for the measurement of independent planes across the measurement volume. Due to the accuracy in traversing the illumination and imaging systems, the present setup allows to reconstruct the flow in a 3D volume performing only one single calibration. The effects of the orientation of a prosthetic mitral valve in anatomical and anti-anatomical configurations have been investigated during the diastolic filling time. The measurement is performed in a phase-locked manner; the mean velocity components are presented together with the vorticity and turbulent kinetic energy maps. The reconstructed 3D flow structures downstream the bileaflet mitral valve are shown, which provides additional insight of the highly three-dimensional flow.

Three-Dimensional Imaging of the Mouse Organ of Corti Cytoarchitecture for Mechanical Modeling

NASA Astrophysics Data System (ADS)

Puria, Sunil; Hartman, Byron; Kim, Jichul; Oghalai, John S.; Ricci, Anthony J.; Liberman, M. Charles

2011-11-01

Cochlear models typically use continuous anatomical descriptions and homogenized parameters based on two-dimensional images for describing the organ of Corti. To produce refined models based more closely on the actual cochlear cytoarchitecture, three-dimensional morphometric parameters of key mechanical structures are required. Towards this goal, we developed and compared three different imaging methods: (1) A fixed cochlear whole-mount preparation using the fluorescent dye Cellmask®, which is a molecule taken up by cell membranes and clearly delineates Deiters' cells, outer hair cells, and the phalangeal process, imaged using confocal microscopy; (2) An in situ fixed preparation with hair cells labeled using anti-prestin and supporting structures labeled using phalloidin, imaged using two-photon microscopy; and (3) A membrane-tomato (mT) mouse with fluorescent proteins expressed in all cell membranes, which enables two-photon imaging of an in situ live preparation with excellent visualization of the organ of Corti. Morphometric parameters including lengths, diameters, and angles, were extracted from 3D cellular surface reconstructions of the resulting images. Preliminary results indicate that the length of the phalangeal processes decreases from the first (inner most) to third (outer most) row of outer hair cells, and that their length also likely varies from base to apex and across species.

A scalable method to improve gray matter segmentation at ultra high field MRI.

PubMed

Gulban, Omer Faruk; Schneider, Marian; Marquardt, Ingo; Haast, Roy A M; De Martino, Federico

2018-01-01

High-resolution (functional) magnetic resonance imaging (MRI) at ultra high magnetic fields (7 Tesla and above) enables researchers to study how anatomical and functional properties change within the cortical ribbon, along surfaces and across cortical depths. These studies require an accurate delineation of the gray matter ribbon, which often suffers from inclusion of blood vessels, dura mater and other non-brain tissue. Residual segmentation errors are commonly corrected by browsing the data slice-by-slice and manually changing labels. This task becomes increasingly laborious and prone to error at higher resolutions since both work and error scale with the number of voxels. Here we show that many mislabeled, non-brain voxels can be corrected more efficiently and semi-automatically by representing three-dimensional anatomical images using two-dimensional histograms. We propose both a uni-modal (based on first spatial derivative) and multi-modal (based on compositional data analysis) approach to this representation and quantify the benefits in 7 Tesla MRI data of nine volunteers. We present an openly accessible Python implementation of these approaches and demonstrate that editing cortical segmentations using two-dimensional histogram representations as an additional post-processing step aids existing algorithms and yields improved gray matter borders. By making our data and corresponding expert (ground truth) segmentations openly available, we facilitate future efforts to develop and test segmentation algorithms on this challenging type of data.

A scalable method to improve gray matter segmentation at ultra high field MRI

PubMed Central

De Martino, Federico

2018-01-01

High-resolution (functional) magnetic resonance imaging (MRI) at ultra high magnetic fields (7 Tesla and above) enables researchers to study how anatomical and functional properties change within the cortical ribbon, along surfaces and across cortical depths. These studies require an accurate delineation of the gray matter ribbon, which often suffers from inclusion of blood vessels, dura mater and other non-brain tissue. Residual segmentation errors are commonly corrected by browsing the data slice-by-slice and manually changing labels. This task becomes increasingly laborious and prone to error at higher resolutions since both work and error scale with the number of voxels. Here we show that many mislabeled, non-brain voxels can be corrected more efficiently and semi-automatically by representing three-dimensional anatomical images using two-dimensional histograms. We propose both a uni-modal (based on first spatial derivative) and multi-modal (based on compositional data analysis) approach to this representation and quantify the benefits in 7 Tesla MRI data of nine volunteers. We present an openly accessible Python implementation of these approaches and demonstrate that editing cortical segmentations using two-dimensional histogram representations as an additional post-processing step aids existing algorithms and yields improved gray matter borders. By making our data and corresponding expert (ground truth) segmentations openly available, we facilitate future efforts to develop and test segmentation algorithms on this challenging type of data. PMID:29874295

Dosimetric aspects of breast radiotherapy with three-dimensional and intensity-modulated radiotherapy helical tomotherapy planning modules

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yadav, Poonam; Service of Radiation Therapy, University of Wisconsin Aspirus Cancer Center, Wisconsin Rapids, WI; Yan, Yue, E-mail: yyan5@mdanderson.org

In this work, we investigated the dosimetric differences between the intensity-modulated radiotherapy (IMRT) plans and the three-dimensional (3D) helical plans based on the TomoTherapy system. A total of 15 patients with supine setup were randomly selected from the data base. For patients with lumpectomy planning target volume (PTV), regional lymph nodes were also included as part of the target. For dose sparing, the significant differences between the helical IMRT and helical 3D were only found in the heart and contralateral breast. For the dose to the heart, helical IMRT reduced the maximum point dose by 6.98 Gy compared to themore » helical 3D plan (p = 0.01). For contralateral breast, the helical IMRT plans significantly reduced the maximum point dose by 5.6 Gy compared to the helical 3D plan. However, compared to the helical 3D plan, the helical IMRT plan increased the volume for lower dose (13.08% increase in V{sub 5} {sub Gy}, p = 0.01). In general, there are no significant differences in dose sparing between helical IMRT and helical 3D plans.« less

Development of a 3D ultrasound-guided system for thermal ablation of liver tumors

NASA Astrophysics Data System (ADS)

Neshat, Hamid R. S.; Cool, Derek W.; Barker, Kevin; Gardi, Lori; Kakani, Nirmal; Fenster, Aaron

2013-03-01

Two-dimensional ultrasound (2D US) imaging is commonly used for diagnostic and intraoperative guidance of interventional abdominal procedures including percutaneous thermal ablation of focal liver tumors with radiofrequency (RF) or microwave (MW) induced energy. However, in many situations 2D US may not provide enough anatomical detail and guidance information. Therefore, intra-procedural CT or MR imaging are used in many centers for guidance purposes. These modalities are costly and are mainly utilized to confirm tool placement rather than guiding the insertion. Three-dimensional ultrasound (3D US) has been introduced to address these issues. In this paper, we present our integrated solution to provide 3D US images using a newly developed mechanical transducer with a large field-ofview and without the need for external tracking devices to combine diagnostic and planning information of different modalities for intraoperative guidance. The system provides tools to segment the target(s), plan the treatment, and detect the ablation applicators during the procedure for guiding purposes. We present experimental results used to ensure that our system generates accurate measurements and our early clinical evaluation results. The results suggest that 3D US used for focal liver ablation can provide a more reliable planning and guidance tool compared to 2D US only, and in many cases offers comparable measurements to other alternatives at significantly lower cost, faster time and with no harmful radiation.

Neuronavigation using three-dimensional proton magnetic resonance spectroscopy data.

PubMed

Kanberoglu, Berkay; Moore, Nina Z; Frakes, David; Karam, Lina J; Debbins, Josef P; Preul, Mark C

2014-01-01

Applications in clinical medicine can benefit from fusion of spectroscopy data with anatomical imagery. For example, new 3-dimensional (3D) spectroscopy techniques allow for improved correlation of metabolite profiles with specific regions of interest in anatomical tumor images, which can be useful in characterizing and treating heterogeneous tumors that appear structurally homogeneous. We sought to develop a clinical workflow and uniquely capable custom software tool to integrate advanced 3-tesla 3D proton magnetic resonance spectroscopic imaging ((1)H-MRSI) into industry standard image-guided neuronavigation systems, especially for use in brain tumor surgery. (1)H-MRSI spectra from preoperative scanning on 15 patients with recurrent or newly diagnosed meningiomas were processed and analyzed, and specific voxels were selected based on their chemical contents. 3D neuronavigation overlays were then generated and applied to anatomical image data in the operating room. The proposed 3D methods fully account for scanner calibration and comprise tools that we have now made publicly available. The new methods were quantitatively validated through a phantom study and applied successfully to mitigate biopsy uncertainty in a clinical study of meningiomas. The proposed methods improve upon the current state of the art in neuronavigation through the use of detailed 3D (1)H-MRSI data. Specifically, 3D MRSI-based overlays provide comprehensive, quantitative visual cues and location information during neurosurgery, enabling a progressive new form of online spectroscopy-guided neuronavigation. © 2014 S. Karger AG, Basel.

Dosimetric comparison between proton beam therapy and photon radiation therapy for locally advanced non-small cell lung cancer.

PubMed

Wu, Chen-Ta; Motegi, Atsushi; Motegi, Kana; Hotta, Kenji; Kohno, Ryosuke; Tachibana, Hidenobu; Kumagai, Motoki; Nakamura, Naoki; Hojo, Hidehiro; Niho, Seiji; Goto, Koichi; Akimoto, Tetsuo

2016-08-10

To assess the feasibility of proton beam therapy for the patients with locally advanced non-small lung cancer. The dosimetry was analyzed retrospectively to calculate the doses to organs at risk, such as the lung, heart, esophagus and spinal cord. A dosimetric comparison between proton beam therapy and dummy photon radiotherapy (three-dimensional conformal radiotherapy) plans was performed. Dummy intensity-modulated radiotherapy plans were also generated for the patients for whom curative three-dimensional conformal radiotherapy plans could not be generated. Overall, 33 patients with stage III non-small cell lung cancer were treated with proton beam therapy between December 2011 and August 2014. The median age of the eligible patients was 67 years (range: 44-87 years). All the patients were treated with chemotherapy consisting of cisplatin/vinorelbine or carboplatin. The median prescribed dose was 60 GyE (range: 60-66 GyE). The mean normal lung V20 GyE was 23.6% (range: 14.9-32%), and the mean normal lung dose was 11.9 GyE (range: 6.0-19 GyE). The mean esophageal V50 GyE was 25.5% (range: 0.01-63.6%), the mean heart V40 GyE was 13.4% (range: 1.4-29.3%) and the mean maximum spinal cord dose was 40.7 GyE (range: 22.9-48 GyE). Based on dummy three-dimensional conformal radiotherapy planning, 12 patients were regarded as not being suitable for radical thoracic three-dimensional conformal radiotherapy. All the dose parameters of proton beam therapy, except for the esophageal dose, were lower than those for the dummy three-dimensional conformal radiotherapy plans. In comparison to the intensity-modulated radiotherapy plan, proton beam therapy also achieved dose reduction in the normal lung. None of the patients experienced grade 4 or worse non-hematological toxicities. Proton beam therapy for patients with stage III non-small cell lung cancer was feasible and was superior to three-dimensional conformal radiotherapy for several dosimetric parameters. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Novel Solution for Massive Glenoid Defects in Shoulder Arthroplasty: A Patient-Specific Glenoid Vault Reconstruction System.

PubMed

Dines, David M; Gulotta, Lawrence; Craig, Edward V; Dines, Joshua S

Complex glenoid deformities present the most difficult challenges in shoulder arthroplasty. These deformities may be caused by severe degenerative or congenital deformity, posttraumatic anatomy, tumor, or, in most cases, bone loss after glenoid failure in anatomical total shoulder arthroplasty. Methods of treating severe bone loss have included inlay and onlay bone-graft options with augmented fixation and, in severe cases, salvage hemiarthroplasty with limited goal expectations. Unfortunately, none of these methods has provided consistently satisfactory reproducible results. In fact, each has had high rates of failure and complications. Borrowing from hip and knee arthroplasty surgeons' experience in using CAD/CAM (computer-aided design/computer-aided manufacturing) patient-specific implants to fill significant bony defects, Dr. D. M. Dines developed a glenoid vault reconstruction system (VRS) in conjunction with the Comprehensive Shoulder Arthroplasty System (Zimmer Biomet) to treat severe glenoid bone deficiency. The VRS is patient-specific; each case involves making a preoperative plan based on 3-dimensional reconstruction of a 2-dimensional computed tomography scan. The patient-specific implant and instrumentation that are created are used to reconstruct the deformed glenoid in an anatomical position without the need for additional bone graft. In this article, we describe the implant and its indications, technical aspects of production, and surgical technique.

Three-Dimensional Printing and Its Applications in Otorhinolaryngology-Head and Neck Surgery.

PubMed

Crafts, Trevor D; Ellsperman, Susan E; Wannemuehler, Todd J; Bellicchi, Travis D; Shipchandler, Taha Z; Mantravadi, Avinash V

2017-06-01

Objective Three-dimensional (3D)-printing technology is being employed in a variety of medical and surgical specialties to improve patient care and advance resident physician training. As the costs of implementing 3D printing have declined, the use of this technology has expanded, especially within surgical specialties. This article explores the types of 3D printing available, highlights the benefits and drawbacks of each methodology, provides examples of how 3D printing has been applied within the field of otolaryngology-head and neck surgery, discusses future innovations, and explores the financial impact of these advances. Data Sources Articles were identified from PubMed and Ovid MEDLINE. Review Methods PubMed and Ovid Medline were queried for English articles published between 2011 and 2016, including a few articles prior to this time as relevant examples. Search terms included 3-dimensional printing, 3 D printing, otolaryngology, additive manufacturing, craniofacial, reconstruction, temporal bone, airway, sinus, cost, and anatomic models. Conclusions Three-dimensional printing has been used in recent years in otolaryngology for preoperative planning, education, prostheses, grafting, and reconstruction. Emerging technologies include the printing of tissue scaffolds for the auricle and nose, more realistic training models, and personalized implantable medical devices. Implications for Practice After the up-front costs of 3D printing are accounted for, its utilization in surgical models, patient-specific implants, and custom instruments can reduce operating room time and thus decrease costs. Educational and training models provide an opportunity to better visualize anomalies, practice surgical technique, predict problems that might arise, and improve quality by reducing mistakes.

Three-dimensional computed topography analysis of a patient with an unusual anatomy of the maxillary second and third molars.

PubMed

Zhao, Jin; Li, Yan; Yang, Zhi-Wei; Wang, Wei; Meng, Yan

2011-10-01

We present a case of a patient with rare anatomy of a maxillary second molar with three mesiobuccal root canals and a maxillary third molar with four separate roots, identified using multi-slice computed topography (CT) and three-dimensional reconstruction techniques. The described case enriched/might enrich our knowledge about possible anatomical aberrations of maxillary molars. In addition, we demonstrate the role of multi-slice CT as an objective tool for confirmatory diagnosis and successful endodontic management.

Patient-specific catheter shaping for the minimally invasive closure of the left atrial appendage.

PubMed

Graf, Eva C; Ott, Ilka; Praceus, Julian; Bourier, Felix; Lueth, Tim C

2018-06-01

The minimally invasive closure of the left atrial appendage is a promising alternative to anticoagulation for stroke prevention in patients suffering from atrial fibrillation. One of the challenges of this procedure is the correct positioning and the coaxial alignment of the tip of the catheter sheath to the implant landing zone. In this paper, a novel preoperative planning system is proposed that allows patient-individual shaping of catheters to facilitate the correct positioning of the catheter sheath by offering a patient-specific catheter shape. Based on preoperative three-dimensional image data, anatomical points and the planned implant position are marked interactively and a patient-specific catheter shape is calculated if the standard catheter is not considered as suitable. An approach to calculate a catheter shape with four bends by maximization of the bending radii is presented. Shaping of the catheter is supported by a bending form that is automatically generated in the planning program and can be directly manufactured by using additive manufacturing methods. The feasibility of the planning and shaping of the catheter could be successfully shown using six data sets. The patient-specific catheters were tested in comparison with standard catheters by physicians on heart models. In four of the six tested models, the participating physicians rated the patient-individual catheters better than the standard catheter. The novel approach for preoperatively planned and shaped patient-specific catheters designed for the minimally invasive closure of the left atrial appendage could be successfully implemented and a feasibility test showed promising results in anatomies that are difficult to access with the standard catheter.

Ephaptic conduction in a cardiac strand model with 3D electrodiffusion

PubMed Central

Mori, Yoichiro; Fishman, Glenn I.; Peskin, Charles S.

2008-01-01

We study cardiac action potential propagation under severe reduction in gap junction conductance. We use a mathematical model of cellular electrical activity that takes into account both three-dimensional geometry and ionic concentration effects. Certain anatomical and biophysical parameters are varied to see their impact on cardiac action potential conduction velocity. This study uncovers quantitative features of ephaptic propagation that differ from previous studies based on one-dimensional models. We also identify a mode of cardiac action potential propagation in which the ephaptic and gap-junction-mediated mechanisms alternate. Our study demonstrates the usefulness of this modeling approach for electrophysiological systems especially when detailed membrane geometry plays an important role. PMID:18434544

Soft Tissue Structure Modelling for Use in Orthopaedic Applications and Musculoskeletal Biomechanics

NASA Astrophysics Data System (ADS)

Audenaert, E. A.; Mahieu, P.; van Hoof, T.; Pattyn, C.

2009-12-01

We present our methodology for the three-dimensional anatomical and geometrical description of soft tissues, relevant for orthopaedic surgical applications and musculoskeletal biomechanics. The technique involves the segmentation and geometrical description of muscles and neurovascular structures from high-resolution computer tomography scanning for the reconstruction of generic anatomical models. These models can be used for quantitative interpretation of anatomical and biomechanical aspects of different soft tissue structures. This approach should allow the use of these data in other application fields, such as musculoskeletal modelling, simulations for radiation therapy, and databases for use in minimally invasive, navigated and robotic surgery.

The impact of the fabrication method on the three-dimensional accuracy of an implant surgery template.

PubMed

Matta, Ragai-Edward; Bergauer, Bastian; Adler, Werner; Wichmann, Manfred; Nickenig, Hans-Joachim

2017-06-01

The use of a surgical template is a well-established method in advanced implantology. In addition to conventional fabrication, computer-aided design and computer-aided manufacturing (CAD/CAM) work-flow provides an opportunity to engineer implant drilling templates via a three-dimensional printer. In order to transfer the virtual planning to the oral situation, a highly accurate surgical guide is needed. The aim of this study was to evaluate the impact of the fabrication method on the three-dimensional accuracy. The same virtual planning based on a scanned plaster model was used to fabricate a conventional thermo-formed and a three-dimensional printed surgical guide for each of 13 patients (single tooth implants). Both templates were acquired individually on the respective plaster model using an optical industrial white-light scanner (ATOS II, GOM mbh, Braunschweig, Germany), and the virtual datasets were superimposed. Using the three-dimensional geometry of the implant sleeve, the deviation between both surgical guides was evaluated. The mean discrepancy of the angle was 3.479° (standard deviation, 1.904°) based on data from 13 patients. Concerning the three-dimensional position of the implant sleeve, the highest deviation was in the Z-axis at 0.594 mm. The mean deviation of the Euclidian distance, dxyz, was 0.864 mm. Although the two different fabrication methods delivered statistically significantly different templates, the deviations ranged within a decimillimeter span. Both methods are appropriate for clinical use. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

[Bone drilling simulation by three-dimensional imaging].

PubMed

Suto, Y; Furuhata, K; Kojima, T; Kurokawa, T; Kobayashi, M

1989-06-01

The three-dimensional display technique has a wide range of medical applications. Pre-operative planning is one typical application: in orthopedic surgery, three-dimensional image processing has been used very successfully. We have employed this technique in pre-operative planning for orthopedic surgery, and have developed a simulation system for bone-drilling. Positive results were obtained by pre-operative rehearsal; when a region of interest is indicated by means of a mouse on the three-dimensional image displayed on the CRT, the corresponding region appears on the slice image which is displayed simultaneously. Consequently, the status of the bone-drilling is constantly monitored. In developing this system, we have placed emphasis on the quality of the reconstructed three-dimensional images, on fast processing, and on the easy operation of the surgical planning simulation.

Voxel-based population analysis for correlating local dose and rectal toxicity in prostate cancer radiotherapy

NASA Astrophysics Data System (ADS)

Acosta, Oscar; Drean, Gael; Ospina, Juan D.; Simon, Antoine; Haigron, Pascal; Lafond, Caroline; de Crevoisier, Renaud

2013-04-01

The majority of current models utilized for predicting toxicity in prostate cancer radiotherapy are based on dose-volume histograms. One of their main drawbacks is the lack of spatial accuracy, since they consider the organs as a whole volume and thus ignore the heterogeneous intra-organ radio-sensitivity. In this paper, we propose a dose-image-based framework to reveal the relationships between local dose and toxicity. In this approach, the three-dimensional (3D) planned dose distributions across a population are non-rigidly registered into a common coordinate system and compared at a voxel level, therefore enabling the identification of 3D anatomical patterns, which may be responsible for toxicity, at least to some extent. Additionally, different metrics were employed in order to assess the quality of the dose mapping. The value of this approach was demonstrated by prospectively analyzing rectal bleeding (⩾Grade 1 at 2 years) according to the CTCAE v3.0 classification in a series of 105 patients receiving 80 Gy to the prostate by intensity modulated radiation therapy (IMRT). Within the patients presenting bleeding, a significant dose excess (6 Gy on average, p < 0.01) was found in a region of the anterior rectal wall. This region, close to the prostate (1 cm), represented less than 10% of the rectum. This promising voxel-wise approach allowed subregions to be defined within the organ that may be involved in toxicity and, as such, must be considered during the inverse IMRT planning step.

An Automatic Segmentation and Classification Framework Based on PCNN Model for Single Tooth in MicroCT Images.

PubMed

Wang, Liansheng; Li, Shusheng; Chen, Rongzhen; Liu, Sze-Yu; Chen, Jyh-Cheng

2016-01-01

Accurate segmentation and classification of different anatomical structures of teeth from medical images plays an essential role in many clinical applications. Usually, the anatomical structures of teeth are manually labelled by experienced clinical doctors, which is time consuming. However, automatic segmentation and classification is a challenging task because the anatomical structures and surroundings of the tooth in medical images are rather complex. Therefore, in this paper, we propose an effective framework which is designed to segment the tooth with a Selective Binary and Gaussian Filtering Regularized Level Set (GFRLS) method improved by fully utilizing three dimensional (3D) information, and classify the tooth by employing unsupervised learning Pulse Coupled Neural Networks (PCNN) model. In order to evaluate the proposed method, the experiments are conducted on the different datasets of mandibular molars and the experimental results show that our method can achieve better accuracy and robustness compared to other four state of the art clustering methods.

A segmentation and classification scheme for single tooth in MicroCT images based on 3D level set and k-means+.

PubMed

Wang, Liansheng; Li, Shusheng; Chen, Rongzhen; Liu, Sze-Yu; Chen, Jyh-Cheng

2017-04-01

Accurate classification of different anatomical structures of teeth from medical images provides crucial information for the stress analysis in dentistry. Usually, the anatomical structures of teeth are manually labeled by experienced clinical doctors, which is time consuming. However, automatic segmentation and classification is a challenging task because the anatomical structures and surroundings of the tooth in medical images are rather complex. Therefore, in this paper, we propose an effective framework which is designed to segment the tooth with a Selective Binary and Gaussian Filtering Regularized Level Set (GFRLS) method improved by fully utilizing 3 dimensional (3D) information, and classify the tooth by employing unsupervised learning i.e., k-means++ method. In order to evaluate the proposed method, the experiments are conducted on the sufficient and extensive datasets of mandibular molars. The experimental results show that our method can achieve higher accuracy and robustness compared to other three clustering methods. Copyright © 2016 Elsevier Ltd. All rights reserved.

The oldest anatomical handmade skull of the world c. 1508: 'the ugliness of growing old' attributed to Leonardo da Vinci.

PubMed

Missinne, Stefaan J

2014-06-01

The author discusses a previously unknown early sixteenth-century renaissance handmade anatomical miniature skull. The small, naturalistic skull made from an agate (calcedonia) stone mixture (mistioni) shows remarkable osteologic details. Dr. Saban was the first to link the skull to Leonardo. The three-dimensional perspective of and the search for the senso comune are discussed. Anatomical errors both in the drawings of Leonardo and this skull are presented. The article ends with the issue of physiognomy, his grotesque faces, the Perspective Communis and his experimenting c. 1508 with the stone mixture and the human skull. Evidence, including the Italian scale based on Crazie and Braccia, chemical analysis leading to a mine in Volterra and Leonardo's search for the soul in the skull are presented. Written references in the inventory of Salai (1524), the inventory of the Villa Riposo (Raffaello Borghini 1584) and Don Ambrogio Mazenta (1635) are reviewed. The author attributes the skull c. 1508 to Leonardo da Vinci.

Establishment of a database of fetal congenital heart malformations and preliminary investigation of its clinical application.

PubMed

Gao, Jun-Xue; Pei, Qiu-Yan; Li, Yun-Tao; Yang, Zhen-Juan

2015-06-01

The aim of this study was to create a database of anatomical ultrathin cross-sectional images of fetal hearts with different congenital heart diseases (CHDs) and preliminarily to investigate its clinical application. Forty Chinese fetal heart samples from induced labor due to different CHDs were cut transversely at 60-μm thickness. All thoracic organs were removed from the thoracic cavity after formalin fixation, embedded in optimum cutting temperature compound, and then frozen at -25°C for 2 hours. Subsequently, macro shots of the frozen serial sections were obtained using a digital camera in order to build a database of anatomical ultrathin cross-sectional images. Images in the database clearly displayed the fetal heart structures. After importing the images into three-dimensional software, the following functions could be realized: (1) based on the original database of transverse sections, databases of sagittal and coronal sections could be constructed; and (2) the original and constructed databases could be displayed continuously and dynamically, and rotated in arbitrary angles. They could also be displayed synchronically. The aforementioned functions of the database allowed for the retrieval of images and three-dimensional anatomy characteristics of the different fetal CHDs, and virtualization of fetal echocardiography findings. A database of 40 different cross-sectional fetal CHDs was established. An extensive database library of fetal CHDs, from which sonographers and students can study the anatomical features of fetal CHDs and virtualize fetal echocardiography findings via either centralized training or distance education, can be established in the future by accumulating further cases. Copyright © 2015. Published by Elsevier B.V.

Three-Dimensional Path Planning for Uninhabited Combat Aerial Vehicle Based on Predator-Prey Pigeon-Inspired Optimization in Dynamic Environment.

PubMed

Zhang, Bo; Duan, Haibin

2017-01-01

Three-dimension path planning of uninhabited combat aerial vehicle (UCAV) is a complicated optimal problem, which mainly focused on optimizing the flight route considering the different types of constrains under complex combating environment. A novel predator-prey pigeon-inspired optimization (PPPIO) is proposed to solve the UCAV three-dimension path planning problem in dynamic environment. Pigeon-inspired optimization (PIO) is a new bio-inspired optimization algorithm. In this algorithm, map and compass operator model and landmark operator model are used to search the best result of a function. The prey-predator concept is adopted to improve global best properties and enhance the convergence speed. The characteristics of the optimal path are presented in the form of a cost function. The comparative simulation results show that our proposed PPPIO algorithm is more efficient than the basic PIO, particle swarm optimization (PSO), and different evolution (DE) in solving UCAV three-dimensional path planning problems.

Evaluation of mathematical algorithms for automatic patient alignment in radiosurgery.

PubMed

Williams, Kenneth M; Schulte, Reinhard W; Schubert, Keith E; Wroe, Andrew J

2015-06-01

Image registration techniques based on anatomical features can serve to automate patient alignment for intracranial radiosurgery procedures in an effort to improve the accuracy and efficiency of the alignment process as well as potentially eliminate the need for implanted fiducial markers. To explore this option, four two-dimensional (2D) image registration algorithms were analyzed: the phase correlation technique, mutual information (MI) maximization, enhanced correlation coefficient (ECC) maximization, and the iterative closest point (ICP) algorithm. Digitally reconstructed radiographs from the treatment planning computed tomography scan of a human skull were used as the reference images, while orthogonal digital x-ray images taken in the treatment room were used as the captured images to be aligned. The accuracy of aligning the skull with each algorithm was compared to the alignment of the currently practiced procedure, which is based on a manual process of selecting common landmarks, including implanted fiducials and anatomical skull features. Of the four algorithms, three (phase correlation, MI maximization, and ECC maximization) demonstrated clinically adequate (ie, comparable to the standard alignment technique) translational accuracy and improvements in speed compared to the interactive, user-guided technique; however, the ICP algorithm failed to give clinically acceptable results. The results of this work suggest that a combination of different algorithms may provide the best registration results. This research serves as the initial groundwork for the translation of automated, anatomy-based 2D algorithms into a real-world system for 2D-to-2D image registration and alignment for intracranial radiosurgery. This may obviate the need for invasive implantation of fiducial markers into the skull and may improve treatment room efficiency and accuracy. © The Author(s) 2014.

Three-dimensional study of pectoralis major muscle and tendon architecture.

PubMed

Fung, Lillia; Wong, Brian; Ravichandiran, Kajeandra; Agur, Anne; Rindlisbacher, Tim; Elmaraghy, Amr

2009-05-01

A thorough understanding of the normal structural anatomy of the pectoralis major (PM) is of paramount importance in the planning of PM tendon transfers or repairs following traumatic PM tears. However, there is little consensus regarding the complex musculotendinous architecture of the PM in the anatomic or surgical literature. The purpose of this study is to model and quantify the three-dimensional architecture of the pectoralis muscle and tendon. Eleven formalin embalmed cadaveric specimens were examined: five (2M/3F) were serially dissected, digitized, and modeled in 3D using Autodesk Maya; six (4M/2F) were dissected and photographed. The PM tendon consisted of longer anterior and shorter posterior layers that were continuous inferiorly. The muscle belly consisted of an architecturally uniform clavicular head (CH) and a segmented sternal head (SH) with 6-7 segments. The most inferior SH segment in all specimens was found to fold anteriorly forming a trough that cradled the inferior aspect of the adjacent superior segment. No twisting of either the PM muscle or tendon was noted. Within the CH, the fiber bundle lengths (FBL) were found to increase from superior to inferior, whereas the mean FBLs of SH were greatest in segments 3-5 found centrally. The mean lateral pennation angle was greater in the CH (29.4 +/- 6.9 degrees ) than in the SH (20.6 +/- 2.7 degrees ). The application of these findings could form the basis of future studies to optimize surgical planning and functional recovery of repair/reconstruction procedures.

Computational Flow Modeling of Human Upper Airway Breathing

NASA Astrophysics Data System (ADS)

Mylavarapu, Goutham

Computational modeling of biological systems have gained a lot of interest in biomedical research, in the recent past. This thesis focuses on the application of computational simulations to study airflow dynamics in human upper respiratory tract. With advancements in medical imaging, patient specific geometries of anatomically accurate respiratory tracts can now be reconstructed from Magnetic Resonance Images (MRI) or Computed Tomography (CT) scans, with better and accurate details than traditional cadaver cast models. Computational studies using these individualized geometrical models have advantages of non-invasiveness, ease, minimum patient interaction, improved accuracy over experimental and clinical studies. Numerical simulations can provide detailed flow fields including velocities, flow rates, airway wall pressure, shear stresses, turbulence in an airway. Interpretation of these physical quantities will enable to develop efficient treatment procedures, medical devices, targeted drug delivery etc. The hypothesis for this research is that computational modeling can predict the outcomes of a surgical intervention or a treatment plan prior to its application and will guide the physician in providing better treatment to the patients. In the current work, three different computational approaches Computational Fluid Dynamics (CFD), Flow-Structure Interaction (FSI) and Particle Flow simulations were used to investigate flow in airway geometries. CFD approach assumes airway wall as rigid, and relatively easy to simulate, compared to the more challenging FSI approach, where interactions of airway wall deformations with flow are also accounted. The CFD methodology using different turbulence models is validated against experimental measurements in an airway phantom. Two case-studies using CFD, to quantify a pre and post-operative airway and another, to perform virtual surgery to determine the best possible surgery in a constricted airway is demonstrated. The unsteady Large Eddy simulations (LES) and a steady Reynolds Averaged Navier Stokes (RANS) approaches in CFD modeling are discussed. The more challenging FSI approach is modeled first in simple two-dimensional anatomical geometry and then extended to simplified three dimensional geometry and finally in three dimensionally accurate geometries. The concepts of virtual surgery and the differences to CFD are discussed. Finally, the influence of various drug delivery parameters on particle deposition efficiency in airway anatomy are investigated through particle-flow simulations in a nasal airway model.

[Construction and validation of a three-dimensional finite element model of cranio-maxillary complex with sutures in unilateral cleft lip and palate patient].

PubMed

Wu, Zhi-fang; Lei, Yong-hua; Li, Wen-jie; Liao, Sheng-hui; Zhao, Zi-jin

2013-02-01

To explore an effective method to construct and validate a finite element model of the unilateral cleft lip and palate(UCLP) craniomaxillary complex with sutures, which could be applied in further three-dimensional finite element analysis (FEA). One male patient aged 9 with left complete lip and palate cleft was selected and CT scan was taken at 0.75mm intervals on the skull. The CT data was saved in Dicom format, which was, afterwards, imported into Software Mimics 10.0 to generate a three-dimensional anatomic model. Then Software Geomagic Studio 12.0 was used to match, smoothen and transfer the anatomic model into a CAD model with NURBS patches. Then, 12 circum-maxillary sutures were integrated into the CAD model by Solidworks (2011 version). Finally meshing by E-feature Biomedical Modeler was done and a three-dimensional finite element model with sutures was obtained. A maxillary protraction force (500 g per side, 20° downward and forward from the occlusal plane) was applied. Displacement and stress distribution of some important craniofacial structures were measured and compared with the results of related researches in the literature. A three-dimensional finite element model of UCLP craniomaxillary complex with 12 sutures was established from the CT scan data. This simulation model consisted of 206 753 individual elements with 260 662 nodes, which was a more precise simulation and a better representation of human craniomaxillary complex than the formerly available FEA models. By comparison, this model was proved to be valid. It is an effective way to establish the three-dimensional finite element model of UCLP cranio-maxillary complex with sutures from CT images with the help of the following softwares: Mimics 10.0, Geomagic Studio 12.0, Solidworks and E-feature Biomedical Modeler.

Interactive 3D visualization tools for stereotactic atlas-based functional neurosurgery

NASA Astrophysics Data System (ADS)

St. Jean, Philippe; Kasrai, Reza; Clonda, Diego; Sadikot, Abbas F.; Evans, Alan C.; Peters, Terence M.

1998-06-01

Many of the critical basal ganglia structures are not distinguishable on anatomical magnetic resonance imaging (MRI) scans, even though they differ in functionality. In order to provide the neurosurgeon with this missing information, a deformable volumetric atlas of the basal ganglia has been created from the Shaltenbrand and Wahren atlas of cryogenic slices. The volumetric atlas can be non-linearly deformed to an individual patient's MRI. To facilitate the clinical use of the atlas, a visualization platform has been developed for pre- and intra-operative use which permits manipulation of the merged atlas and MRI data sets in two- and three-dimensional views. The platform includes graphical tools which allow the visualization of projections of the leukotome and other surgical tools with respect to the atlas data, as well as pre- registered images from any other imaging modality. In addition, a graphical interface has been designed to create custom virtual lesions using computer models of neurosurgical tools for intra-operative planning. To date 17 clinical cases have been successfully performed using the described system.

Evaluating mental workload of two-dimensional and three-dimensional visualization for anatomical structure localization.

PubMed

Foo, Jung-Leng; Martinez-Escobar, Marisol; Juhnke, Bethany; Cassidy, Keely; Hisley, Kenneth; Lobe, Thom; Winer, Eliot

2013-01-01

Visualization of medical data in three-dimensional (3D) or two-dimensional (2D) views is a complex area of research. In many fields 3D views are used to understand the shape of an object, and 2D views are used to understand spatial relationships. It is unclear how 2D/3D views play a role in the medical field. Using 3D views can potentially decrease the learning curve experienced with traditional 2D views by providing a whole representation of the patient's anatomy. However, there are challenges with 3D views compared with 2D. This current study expands on a previous study to evaluate the mental workload associated with both 2D and 3D views. Twenty-five first-year medical students were asked to localize three anatomical structures--gallbladder, celiac trunk, and superior mesenteric artery--in either 2D or 3D environments. Accuracy and time were taken as the objective measures for mental workload. The NASA Task Load Index (NASA-TLX) was used as a subjective measure for mental workload. Results showed that participants viewing in 3D had higher localization accuracy and a lower subjective measure of mental workload, specifically, the mental demand component of the NASA-TLX. Results from this study may prove useful for designing curricula in anatomy education and improving training procedures for surgeons.

Probabilistic modeling of anatomical variability using a low dimensional parameterization of diffeomorphisms.

PubMed

Zhang, Miaomiao; Wells, William M; Golland, Polina

2017-10-01

We present an efficient probabilistic model of anatomical variability in a linear space of initial velocities of diffeomorphic transformations and demonstrate its benefits in clinical studies of brain anatomy. To overcome the computational challenges of the high dimensional deformation-based descriptors, we develop a latent variable model for principal geodesic analysis (PGA) based on a low dimensional shape descriptor that effectively captures the intrinsic variability in a population. We define a novel shape prior that explicitly represents principal modes as a multivariate complex Gaussian distribution on the initial velocities in a bandlimited space. We demonstrate the performance of our model on a set of 3D brain MRI scans from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Our model yields a more compact representation of group variation at substantially lower computational cost than the state-of-the-art method such as tangent space PCA (TPCA) and probabilistic principal geodesic analysis (PPGA) that operate in the high dimensional image space. Copyright © 2017 Elsevier B.V. All rights reserved.

Mobile robots IV; Proceedings of the Meeting, Philadelphia, PA, Nov. 6, 7, 1989

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wolfe, W.J.; Chun, W.H.

1990-01-01

The present conference on mobile robot systems discusses high-speed machine perception based on passive sensing, wide-angle optical ranging, three-dimensional path planning for flying/crawling robots, navigation of autonomous mobile intelligence in an unstructured natural environment, mechanical models for the locomotion of a four-articulated-track robot, a rule-based command language for a semiautonomous Mars rover, and a computer model of the structured light vision system for a Mars rover. Also discussed are optical flow and three-dimensional information for navigation, feature-based reasoning trail detection, a symbolic neural-net production system for obstacle avoidance and navigation, intelligent path planning for robot navigation in an unknown environment,more » behaviors from a hierarchical control system, stereoscopic TV systems, the REACT language for autonomous robots, and a man-amplifying exoskeleton.« less

Presurgical nasoalveolar molding for cleft lip and palate: the application of digitally designed molds.

PubMed

Shen, Congcong; Yao, Caroline A; Magee, William; Chai, Gang; Zhang, Yan

2015-06-01

The authors present a novel nasoalveolar molding protocol by prefabricating sets of nasoalveolar molding appliances using three-dimensional technology. Prospectively, 17 infants with unilateral complete cleft lip and palate underwent the authors' protocol before primary cheiloplasty. An initial nasoalveolar molding appliance was created based on the patient's first and only in-person maxillary cast, produced from a traditional intraoral dental impression. Thereafter, each patient's molding course was simulated using computer software that aimed to narrow the alveolar gap by 1 mm each week by rotating the greater alveolar segment. A maxillary cast of each predicted molding stage was created using three-dimensional printing. Subsequent appliances were constructed in advance, based on the series of computer-generated casts. Each patient had a total three clinic visits spaced 1 month apart. Anthropometric measurements and bony segment volumes were recorded before and after treatment. Alveolar cleft widths narrowed significantly (p < 0.01), soft-tissue volume of each segment expanded (p < 0.01), and the arc of the alveolus became more contiguous across the cleft (p < 0.01). One patient required a new appliance at the second visit because of bleeding and discomfort. Eleven patients had mucosal irritation and two experienced minor mucosal ulceration. Three-dimensional technology can precisely represent anatomic structures in pediatric clefts. Results from the authors' algorithm are equivalent to those of traditional nasoalveolar molding therapies; however, the number of required clinic visits and appliance adjustments decreased. As three-dimensional technology costs decrease, multidisciplinary teams may design customized nasoalveolar molding treatment with improved efficiency and less burden to medical staff, patients, and families. Therapeutic, IV.

Functional Image-Guided Radiotherapy Planning in Respiratory-Gated Intensity-Modulated Radiotherapy for Lung Cancer Patients With Chronic Obstructive Pulmonary Disease

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kimura, Tomoki, E-mail: tkkimura@hiroshima-u.ac.jp; Nishibuchi, Ikuno; Murakami, Yuji

2012-03-15

Purpose: To investigate the incorporation of functional lung image-derived low attenuation area (LAA) based on four-dimensional computed tomography (4D-CT) into respiratory-gated intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) in treatment planning for lung cancer patients with chronic obstructive pulmonary disease (COPD). Methods and Materials: Eight lung cancer patients with COPD were the subjects of this study. LAA was generated from 4D-CT data sets according to CT values of less than than -860 Hounsfield units (HU) as a threshold. The functional lung image was defined as the area where LAA was excluded from the image of the total lung.more » Two respiratory-gated radiotherapy plans (70 Gy/35 fractions) were designed and compared in each patient as follows: Plan A was an anatomical IMRT or VMAT plan based on the total lung; Plan F was a functional IMRT or VMAT plan based on the functional lung. Dosimetric parameters (percentage of total lung volume irradiated with {>=}20 Gy [V20], and mean dose of total lung [MLD]) of the two plans were compared. Results: V20 was lower in Plan F than in Plan A (mean 1.5%, p = 0.025 in IMRT, mean 1.6%, p = 0.044 in VMAT) achieved by a reduction in MLD (mean 0.23 Gy, p = 0.083 in IMRT, mean 0.5 Gy, p = 0.042 in VMAT). No differences were noted in target volume coverage and organ-at-risk doses. Conclusions: Functional IGRT planning based on LAA in respiratory-guided IMRT or VMAT appears to be effective in preserving a functional lung in lung cancer patients with COPD.« less

Three-dimensional printing of X-ray computed tomography datasets with multiple materials using open-source data processing.

PubMed

Sander, Ian M; McGoldrick, Matthew T; Helms, My N; Betts, Aislinn; van Avermaete, Anthony; Owers, Elizabeth; Doney, Evan; Liepert, Taimi; Niebur, Glen; Liepert, Douglas; Leevy, W Matthew

2017-07-01

Advances in three-dimensional (3D) printing allow for digital files to be turned into a "printed" physical product. For example, complex anatomical models derived from clinical or pre-clinical X-ray computed tomography (CT) data of patients or research specimens can be constructed using various printable materials. Although 3D printing has the potential to advance learning, many academic programs have been slow to adopt its use in the classroom despite increased availability of the equipment and digital databases already established for educational use. Herein, a protocol is reported for the production of enlarged bone core and accurate representation of human sinus passages in a 3D printed format using entirely consumer-grade printers and a combination of free-software platforms. The comparative resolutions of three surface rendering programs were also determined using the sinuses, a human body, and a human wrist data files to compare the abilities of different software available for surface map generation of biomedical data. Data shows that 3D Slicer provided highest compatibility and surface resolution for anatomical 3D printing. Generated surface maps were then 3D printed via fused deposition modeling (FDM printing). In conclusion, a methodological approach that explains the production of anatomical models using entirely consumer-grade, fused deposition modeling machines, and a combination of free software platforms is presented in this report. The methods outlined will facilitate the incorporation of 3D printed anatomical models in the classroom. Anat Sci Educ 10: 383-391. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Modeling and analysis of visual digital impact model for a Chinese human thorax.

PubMed

Zhu, Jin; Wang, Kai-Ming; Li, Shu; Liu, Hai-Yan; Jing, Xiao; Li, Xiao-Fang; Liu, Yi-He

2017-01-01

To establish a three-dimensional finite element model of the human chest for engineering research on individual protection. Computed tomography (CT) scanning data were used for three-dimensional reconstruction with the medical image reconstruction software Mimics. The finite element method (FEM) preprocessing software ANSYS ICEM CFD was used for cell mesh generation, and the relevant material behavior parameters of all of the model's parts were specified. The finite element model was constructed with the FEM software, and the model availability was verified based on previous cadaver experimental data. A finite element model approximating the anatomical structure of the human chest was established, and the model's simulation results conformed to the results of the cadaver experiment overall. Segment data of the human body and specialized software can be utilized for FEM model reconstruction to satisfy the need for numerical analysis of shocks to the human chest in engineering research on body mechanics.

Three-dimensional printing of complex biological structures by freeform reversible embedding of suspended hydrogels

PubMed Central

Hinton, Thomas J.; Jallerat, Quentin; Palchesko, Rachelle N.; Park, Joon Hyung; Grodzicki, Martin S.; Shue, Hao-Jan; Ramadan, Mohamed H.; Hudson, Andrew R.; Feinberg, Adam W.

2015-01-01

We demonstrate the additive manufacturing of complex three-dimensional (3D) biological structures using soft protein and polysaccharide hydrogels that are challenging or impossible to create using traditional fabrication approaches. These structures are built by embedding the printed hydrogel within a secondary hydrogel that serves as a temporary, thermoreversible, and biocompatible support. This process, termed freeform reversible embedding of suspended hydrogels, enables 3D printing of hydrated materials with an elastic modulus <500 kPa including alginate, collagen, and fibrin. Computer-aided design models of 3D optical, computed tomography, and magnetic resonance imaging data were 3D printed at a resolution of ~200 μm and at low cost by leveraging open-source hardware and software tools. Proof-of-concept structures based on femurs, branched coronary arteries, trabeculated embryonic hearts, and human brains were mechanically robust and recreated complex 3D internal and external anatomical architectures. PMID:26601312

Generation of an Atlas of the Proximal Femur and Its Application to Trabecular Bone Analysis

PubMed Central

Carballido-Gamio, Julio; Folkesson, Jenny; Karampinos, Dimitrios C.; Baum, Thomas; Link, Thomas M.; Majumdar, Sharmila; Krug, Roland

2013-01-01

Automatic placement of anatomically corresponding volumes of interest and comparison of parameters against a standard of reference are essential components in studies of trabecular bone. Only recently, in vivo MR images of the proximal femur, an important fracture site, could be acquired with high-spatial resolution. The purpose of this MRI trabecular bone study was two-fold: (1) to generate an atlas of the proximal femur to automatically place anatomically corresponding volumes of interest in a population study and (2) to demonstrate how mean models of geodesic topological analysis parameters can be generated to be used as potential standard of reference. Ten females were used to generate the atlas and geodesic topological analysis models, and 10 females were used to demonstrate the atlas-based trabecular bone analysis. All alignments were based on three-dimensional (3D) multiresolution affine transformations followed by 3D multiresolution free-form deformations. Mean distances less than 1 mm between aligned femora, and sharp edges in the atlas and in fused gray-level images of registered femora indicated that the anatomical variability was well accommodated and explained by the free-form deformations. PMID:21432904

Computed Tomographic Angiographic Perforator Localization for Virtual Surgical Planning of Osteocutaneous Fibular Free Flaps in Head and Neck Reconstruction.

PubMed

Ettinger, Kyle S; Alexander, Amy E; Arce, Kevin

2018-04-10

Virtual surgical planning (VSP), computer-aided design and computer-aided modeling, and 3-dimensional printing are 3 distinct technologies that have become increasingly used in head and neck oncology and microvascular reconstruction. Although each of these technologies has long been used for treatment planning in other surgical disciplines, such as craniofacial surgery, trauma surgery, temporomandibular joint surgery, and orthognathic surgery, its widespread use in head and neck reconstructive surgery remains a much more recent event. In response to the growing trend of VSP being used for the planning of fibular free flaps in head and neck reconstruction, some surgeons have questioned the technology's implementation based on its inadequacy in addressing other reconstructive considerations beyond hard tissue anatomy. Detractors of VSP for head and neck reconstruction highlight its lack of capability in accounting for multiple reconstructive factors, such as recipient vessel selection, vascular pedicle reach, need for dead space obliteration, and skin paddle perforator location. It is with this premise in mind that the authors report on a straightforward technique for anatomically localizing peroneal artery perforators during VSP for osteocutaneous fibular free flaps in which bone and a soft tissue skin paddle are required for ablative reconstruction. The technique allows for anatomic perforator localization during the VSP session based solely on data existent at preoperative computed tomographic angiography (CTA); it does not require any modifications to preoperative clinical workflows. It is the authors' presumption that many surgeons in the field are unaware of this planning capability within the context of modern VSP for head and neck reconstruction. The primary purpose of this report is to introduce and further familiarize surgeons with the technique of CTA perforator localization as a method of improving intraoperative fidelity for VSP of osteocutaneous fibular free flaps. Copyright © 2018. Published by Elsevier Inc.

Anatomical education and surgical simulation based on the Chinese Visible Human: a three-dimensional virtual model of the larynx region.

PubMed

Liu, Kaijun; Fang, Binji; Wu, Yi; Li, Ying; Jin, Jun; Tan, Liwen; Zhang, Shaoxiang

2013-09-01

Anatomical knowledge of the larynx region is critical for understanding laryngeal disease and performing required interventions. Virtual reality is a useful method for surgical education and simulation. Here, we assembled segmented cross-section slices of the larynx region from the Chinese Visible Human dataset. The laryngeal structures were precisely segmented manually as 2D images, then reconstructed and displayed as 3D images in the virtual reality Dextrobeam system. Using visualization and interaction with the virtual reality modeling language model, a digital laryngeal anatomy instruction was constructed using HTML and JavaScript languages. The volume larynx models can thus display an arbitrary section of the model and provide a virtual dissection function. This networked teaching system of the digital laryngeal anatomy can be read remotely, displayed locally, and manipulated interactively.

Three-dimensional multimodality fusion imaging as an educational and planning tool for deep-seated meningiomas.

PubMed

Sato, Mitsuru; Tateishi, Kensuke; Murata, Hidetoshi; Kin, Taichi; Suenaga, Jun; Takase, Hajime; Yoneyama, Tomohiro; Nishii, Toshiaki; Tateishi, Ukihide; Yamamoto, Tetsuya; Saito, Nobuhito; Inoue, Tomio; Kawahara, Nobutaka

2018-06-26

The utility of surgical simulation with three-dimensional multimodality fusion imaging (3D-MFI) has been demonstrated. However, its potential in deep-seated brain lesions remains unknown. The aim of this study was to investigate the impact of 3D-MFI in deep-seated meningioma operations. Fourteen patients with deeply located meningiomas were included in this study. We constructed 3D-MFIs by fusing high-resolution magnetic resonance (MR) and computed tomography (CT) images with a rotational digital subtraction angiogram (DSA) in all patients. The surgical procedure was simulated by 3D-MFI prior to operation. To assess the impact on neurosurgical education, the objective values of surgical simulation by 3D-MFIs/virtual reality (VR) video were evaluated. To validate the quality of 3D-MFIs, intraoperative findings were compared. The identification rate (IR) and positive predictive value (PPV) for the tumor feeding arteries and involved perforating arteries and veins were also assessed for quality assessment of 3D-MFI. After surgical simulation by 3D-MFIs, near-total resection was achieved in 13 of 14 (92.9%) patients without neurological complications. 3D-MFIs significantly contributed to the understanding of surgical anatomy and optimal surgical view (p < .0001) and learning how to preserve critical vessels (p < .0001) and resect tumors safety and extensively (p < .0001) by neurosurgical residents/fellows. The IR of 3D-MFI for tumor-feeding arteries and perforating arteries and veins was 100% and 92.9%, respectively. The PPV of 3D-MFI for tumor-feeding arteries and perforating arteries and veins was 98.8% and 76.5%, respectively. 3D-MFI contributed to learn skull base meningioma surgery. Also, 3D-MFI provided high quality to identify critical anatomical structures within or adjacent to deep-seated meningiomas. Thus, 3D-MFI is promising educational and surgical planning tool for meningiomas in deep-seated regions.

Application of Magnetic Resonance Imaging and Three-Dimensional Treatment Planning in the Treatment of Orbital Lymphoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rudoltz, Marc S.; Ayyangar, Komanduri; Mohiuddin, Mohammed

Radiotherapy for lymphoma of the orbit must be individualized for each patient and clinical setting. Most techniques focus on optimizing the dose to the tumor while sparing the lens. This study describes a technique utilizing magnetic resonance imaging (MRI) and three dimensional (3D) planning in the treatment of orbital lymphoma. A patient presented with an intermediate grade lymphoma of the right orbit. The prescribed tumor dose was 4050 cGy in 18 fractions. Three D planning was carried out and tumor volumes, retina, and lens were subsequently outlined. Dose calculations including dose volume histograms of the target, retina, and lens weremore » then performed. Part of the retina was outside of the treatment volume while 50% of the retina received 90% or more of the prescribed dose. The patient was clinically NED when last seen 2 years following therapy with no treatment-related morbidity. Patients with lymphomas of the orbit can be optimally treated using MRI based 3D treatment planning.« less

Evaluation of a stereoscopic camera-based three-dimensional viewing workstation for ophthalmic surgery.

PubMed

Bhadri, Prashant R; Rowley, Adrian P; Khurana, Rahul N; Deboer, Charles M; Kerns, Ralph M; Chong, Lawrence P; Humayun, Mark S

2007-05-01

To evaluate the effectiveness of a prototype stereoscopic camera-based viewing system (Digital Microsurgical Workstation, three-dimensional (3D) Vision Systems, Irvine, California, USA) for anterior and posterior segment ophthalmic surgery. Institutional-based prospective study. Anterior and posterior segment surgeons performed designated standardized tasks on porcine eyes after training on prosthetic plastic eyes. Both anterior and posterior segment surgeons were able to complete tasks requiring minimal or moderate stereoscopic viewing. The results indicate that the system provides improved ergonomics. Improvements in key viewing performance areas would further enhance the value over a conventional operating microscope. The performance of the prototype system is not at par with the planned commercial system. With continued development of this technology, the three- dimensional system may be a novel viewing system in ophthalmic surgery with improved ergonomics with respect to traditional microscopic viewing.

Mycorrhizal synthesis between Boletus edulis species complex and rockroses (Cistus sp.).

PubMed

Águeda, Beatriz; Parladé, Javier; Fernández-Toirán, Luz Marina; Cisneros, Óscar; de Miguel, Ana María; Modrego, María Pilar; Martínez-Peña, Fernando; Pera, Joan

2008-10-01

Ectomycorrhizas of Boletus aereus, Boletus edulis, and Boletus reticulatus were synthesized with Cistus sp. under laboratory conditions using synthesis tubes filled with a mixture of sterilized peat-vermiculite and nutrient solution. The fungal strains isolated from sporocarps were identified by molecular techniques. The inoculated seedlings were grown for 4-5 months. The ectomycorrhizas formed were described based on standard morphological and anatomical characters. The three ectomycorrhizas described were very similar, with white monopodial-pinnate morphology, a three-layered plectenchymatous mantle on plan view and boletoid rhizomorphs.

Interfraction Displacement of Primary Tumor and Involved Lymph Nodes Relative to Anatomic Landmarks in Image Guided Radiation Therapy of Locally Advanced Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jan, Nuzhat; Balik, Salim; Hugo, Geoffrey D.

Purpose: To analyze primary tumor (PT) and lymph node (LN) position changes relative to each other and relative to anatomic landmarks during conventionally fractionated radiation therapy for patients with locally advanced lung cancer. Methods and Materials: In 12 patients with locally advanced non-small cell lung cancer PT, LN, carina, and 1 thoracic vertebra were manually contoured on weekly 4-dimensional fan-beam CT scans. Systematic and random interfraction displacements of all contoured structures were identified in the 3 cardinal directions, and resulting setup margins were calculated. Time trends and the effect of volume changes on displacements were analyzed. Results: Three-dimensional displacement vectorsmore » and systematic/random interfraction displacements were smaller for carina than for vertebra both for PT and LN. For PT, mean (SD) 3-dimensional displacement vectors with carina-based alignment were 7 (4) mm versus 9 (5) mm with bony anatomy (P<.0001). For LN, smaller displacements were found with carina- (5 [3] mm, P<.0001) and vertebra-based (6 [3] mm, P=.002) alignment compared with using PT for setup (8 [5] mm). Primary tumor and LN displacements relative to bone and carina were independent (P>.05). Displacements between PT and bone (P=.04) and between PT and LN (P=.01) were significantly correlated with PT volume regression. Displacements between LN and carina were correlated with LN volume change (P=.03). Conclusions: Carina-based setup results in a more reproducible PT and LN alignment than bony anatomy setup. Considering the independence of PT and LN displacement and the impact of volume regression on displacements over time, repeated CT imaging even with PT-based alignment is recommended in locally advanced disease.« less

3D-printing techniques in a medical setting: a systematic literature review.

PubMed

Tack, Philip; Victor, Jan; Gemmel, Paul; Annemans, Lieven

2016-10-21

Three-dimensional (3D) printing has numerous applications and has gained much interest in the medical world. The constantly improving quality of 3D-printing applications has contributed to their increased use on patients. This paper summarizes the literature on surgical 3D-printing applications used on patients, with a focus on reported clinical and economic outcomes. Three major literature databases were screened for case series (more than three cases described in the same study) and trials of surgical applications of 3D printing in humans. 227 surgical papers were analyzed and summarized using an evidence table. The papers described the use of 3D printing for surgical guides, anatomical models, and custom implants. 3D printing is used in multiple surgical domains, such as orthopedics, maxillofacial surgery, cranial surgery, and spinal surgery. In general, the advantages of 3D-printed parts are said to include reduced surgical time, improved medical outcome, and decreased radiation exposure. The costs of printing and additional scans generally increase the overall cost of the procedure. 3D printing is well integrated in surgical practice and research. Applications vary from anatomical models mainly intended for surgical planning to surgical guides and implants. Our research suggests that there are several advantages to 3D-printed applications, but that further research is needed to determine whether the increased intervention costs can be balanced with the observable advantages of this new technology. There is a need for a formal cost-effectiveness analysis.

Creation of three-dimensional craniofacial standards from CBCT images

NASA Astrophysics Data System (ADS)

Subramanyan, Krishna; Palomo, Martin; Hans, Mark

2006-03-01

Low-dose three-dimensional Cone Beam Computed Tomography (CBCT) is becoming increasingly popular in the clinical practice of dental medicine. Two-dimensional Bolton Standards of dentofacial development are routinely used to identify deviations from normal craniofacial anatomy. With the advent of CBCT three dimensional imaging, we propose a set of methods to extend these 2D Bolton Standards to anatomically correct surface based 3D standards to allow analysis of morphometric changes seen in craniofacial complex. To create 3D surface standards, we have implemented series of steps. 1) Converting bi-plane 2D tracings into set of splines 2) Converting the 2D splines curves from bi-plane projection into 3D space curves 3) Creating labeled template of facial and skeletal shapes and 4) Creating 3D average surface Bolton standards. We have used datasets from patients scanned with Hitachi MercuRay CBCT scanner providing high resolution and isotropic CT volume images, digitized Bolton Standards from age 3 to 18 years of lateral and frontal male, female and average tracings and converted them into facial and skeletal 3D space curves. This new 3D standard will help in assessing shape variations due to aging in young population and provide reference to correct facial anomalies in dental medicine.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lafata, K; Ren, L; Wu, Q

Purpose: To develop a data-mining methodology based on quantum clustering and machine learning to predict expected dosimetric endpoints for lung SBRT applications based on patient-specific anatomic features. Methods: Ninety-three patients who received lung SBRT at our clinic from 2011–2013 were retrospectively identified. Planning information was acquired for each patient, from which various features were extracted using in-house semi-automatic software. Anatomic features included tumor-to-OAR distances, tumor location, total-lung-volume, GTV and ITV. Dosimetric endpoints were adopted from RTOG-0195 recommendations, and consisted of various OAR-specific partial-volume doses and maximum point-doses. First, PCA analysis and unsupervised quantum-clustering was used to explore the feature-space tomore » identify potentially strong classifiers. Secondly, a multi-class logistic regression algorithm was developed and trained to predict dose-volume endpoints based on patient-specific anatomic features. Classes were defined by discretizing the dose-volume data, and the feature-space was zero-mean normalized. Fitting parameters were determined by minimizing a regularized cost function, and optimization was performed via gradient descent. As a pilot study, the model was tested on two esophageal dosimetric planning endpoints (maximum point-dose, dose-to-5cc), and its generalizability was evaluated with leave-one-out cross-validation. Results: Quantum-Clustering demonstrated a strong separation of feature-space at 15Gy across the first-and-second Principle Components of the data when the dosimetric endpoints were retrospectively identified. Maximum point dose prediction to the esophagus demonstrated a cross-validation accuracy of 87%, and the maximum dose to 5cc demonstrated a respective value of 79%. The largest optimized weighting factor was placed on GTV-to-esophagus distance (a factor of 10 greater than the second largest weighting factor), indicating an intuitively strong correlation between this feature and both endpoints. Conclusion: This pilot study shows that it is feasible to predict dose-volume endpoints based on patient-specific anatomic features. The developed methodology can potentially help to identify patients at risk for higher OAR doses, thus improving the efficiency of treatment planning. R01-184173.« less

Spatial Ability, Gender, and the Ability To Visualize Anatomy in Three Dimensions.

ERIC Educational Resources Information Center

Provo, Judy A.; Lamar, Carlton H.; Newby, Timothy J.

This research aims to devise an intervention that can enhance three-dimensional anatomical understanding and develop testing instruments that can be used to measure this understanding. First year veterinary medicine students (N=62) participated in a study that explored: (1) whether participants who use a cross section for learning the anatomy of…

Using a Cross Section to Train Veterinary Students To Visualize Anatomical Structures in Three Dimensions.

ERIC Educational Resources Information Center

Provo, Judy; Lamar, Carlton; Newby, Timothy

2002-01-01

Uses a cross section to enhance three-dimensional knowledge of the anatomy of a canine head. Involves (n=124) veterinary students dissecting the head and experimental groups also identifying structures on a cross section of the head. Reports a positive impact of this experience on participant students. (Contains 52 references.) (Author/YDS)

Improved Interactive Medical-Imaging System

NASA Technical Reports Server (NTRS)

Ross, Muriel D.; Twombly, Ian A.; Senger, Steven

2003-01-01

An improved computational-simulation system for interactive medical imaging has been invented. The system displays high-resolution, three-dimensional-appearing images of anatomical objects based on data acquired by such techniques as computed tomography (CT) and magnetic-resonance imaging (MRI). The system enables users to manipulate the data to obtain a variety of views for example, to display cross sections in specified planes or to rotate images about specified axes. Relative to prior such systems, this system offers enhanced capabilities for synthesizing images of surgical cuts and for collaboration by users at multiple, remote computing sites.

Automatic repositioning of jaw segments for three-dimensional virtual treatment planning of orthognathic surgery.

PubMed

Santos, Rodrigo Mologni Gonçalves Dos; De Martino, José Mario; Passeri, Luis Augusto; Attux, Romis Ribeiro de Faissol; Haiter Neto, Francisco

2017-09-01

To develop a computer-based method for automating the repositioning of jaw segments in the skull during three-dimensional virtual treatment planning of orthognathic surgery. The method speeds up the planning phase of the orthognathic procedure, releasing surgeons from laborious and time-consuming tasks. The method finds the optimal positions for the maxilla, mandibular body, and bony chin in the skull. Minimization of cephalometric differences between measured and standard values is considered. Cone-beam computed tomographic images acquired from four preoperative patients with skeletal malocclusion were used for evaluating the method. Dentofacial problems of the four patients were rectified, including skeletal malocclusion, facial asymmetry, and jaw discrepancies. The results show that the method is potentially able to be used in routine clinical practice as support for treatment-planning decisions in orthognathic surgery. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Improved Virtual Planning for Bimaxillary Orthognathic Surgery.

PubMed

Hatamleh, Muhanad; Turner, Catherine; Bhamrah, Gurprit; Mack, Gavin; Osher, Jonas

2016-09-01

Conventional model surgery planning for bimaxillary orthognathic surgery can be laborious, time-consuming and may contain potential errors; hence three-dimensional (3D) virtual orthognathic planning has been proven to be an efficient, reliable, and cost-effective alternative. In this report, the 3D planning is described for a patient presenting with a Class III incisor relationship on a Skeletal III base with pan facial asymmetry complicated by reverse overjet and anterior open bite. A combined scan data of direct cone beam computer tomography and indirect dental scan were used in the planning. Additionally, a new method of establishing optimum intercuspation by scanning dental casts in final occlusion and positioning it to the composite-scans model was shown. Furthermore, conventional model surgery planning was carried out following in-house protocol. Intermediate and final intermaxillary splints were produced following the conventional method and 3D printing. Three-dimensional planning showed great accuracy and treatment outcome and reduced laboratory time in comparison with the conventional method. Establishing the final dental occlusion on casts and integrating it in final 3D planning enabled us to achieve the best possible intercuspation.

SU-D-BRB-01: A Predictive Planning Tool for Stereotactic Radiosurgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Palefsky, S; Roper, J; Elder, E

Purpose: To demonstrate the feasibility of a predictive planning tool which provides SRS planning guidance based on simple patient anatomical properties: PTV size, PTV shape and distance from critical structures. Methods: Ten framed SRS cases treated at Winship Cancer Institute of Emory University were analyzed to extract data on PTV size, sphericity (shape), and distance from critical structures such as the brainstem and optic chiasm. The cases consisted of five pairs. Each pair consisted of two cases with a similar diagnosis (such as pituitary adenoma or arteriovenous malformation) that were treated with different techniques: DCA, or IMRS. A Naive Bayesmore » Classifier was trained on this data to establish the conditions under which each treatment modality was used. This model was validated by classifying ten other randomly-selected cases into DCA or IMRS classes, calculating the probability of each technique, and comparing results to the treated technique. Results: Of the ten cases used to validate the model, nine had their technique predicted correctly. The three cases treated with IMRS were all identified as such. Their probabilities of being treated with IMRS ranged between 59% and 100%. Six of the seven cases treated with DCA were correctly classified. These probabilities ranged between 51% and 95%. One case treated with DCA was incorrectly predicted to be an IMRS plan. The model’s confidence in this case was 91%. Conclusion: These findings indicate that a predictive planning tool based on simple patient anatomical properties can predict the SRS technique used for treatment. The algorithm operated with 90% accuracy. With further validation on larger patient populations, this tool may be used clinically to guide planners in choosing an appropriate treatment technique. The prediction algorithm could also be adapted to guide selection of treatment parameters such as treatment modality and number of fields for radiotherapy across anatomical sites.« less

SU-G-206-16: Investigation of Dosimetric Consequence Via Cone-Beam CT Based Dose Reconstruction in Hepatocellular Carcinoma Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, P; Gang, Y; Qin, S

2016-06-15

Purpose: Many patients with technically unresectable or medically inoperable hepatocellular carcinoma (HCC) had hepatic dosimetric variations as a result of inter-fraction anatomical deformation. This study was conducted to assess the hepatic dosimetric consequences via reconstructing weekly dose in HCC patients receiving three dimensional conformal radiation therapy. Methods: Twenty-one HCC patients with 21 planning CT (pCT) scans and 63 weekly Cone-beam CT (CBCT) scans were enrolled in this investigation. Among them, six patients had been diagnosed of radiation induced liver disease (RILD) and the other fifteen patients had good prognosis after treatment. And each patient had three weekly CBCT before re-planning.more » In reconstructing CBCT-based weekly dose, we registered pCT to CBCT to provide the correct Hounsfield units for the CBCT using gradient-based deformable image registration (DIR), and this modified CBCT (mCBCT) were introduced to enable dose calculation.To obtain the weekly dosimetric consequences, the initial plan beam configurations and dose constraints were re-applied to mCBCT for performing dose calculation, and the mCBCT were extrapolated to 25 fractions. Besides, the manually delineated contour was propagated automatically onto the mCBCT of the new patient by exploiting the deformation vectors field, and the reconstructed weekly dose was mapped back to pCT to understand the dose distribution difference. Also, weekly dosimetric variations were compared with the hepatic radiation tolerance in terms of D50 and Dmean. Results: Among the twenty-one patients, the three weekly D50 increased by 0.7Gy, 5.1Gy and 6.1Gy, respectively, and Dmean increased by 0.9%, 4.7% and 5.5%, respectively. For patients with RILD, the average values of the third weekly D50 and Dmean were both high than hepatic radiation tolerance, while the values of patients without RILD were below. Conclusion: The planned dose on pCT was not a real dose to the liver, and the liver overdose increased the risk of RILD. The author would like to express great thanks to Lei Xing, Daniel S Kapp and Yong Yang in the Stanford University School of Medicine for their valuable suggestions to this work. This work is supported by NSFC(61471226), China Postdoctoral Science Foundation (2015T80739,2014M551949) and research funding from Shandong Province (JQ201516).« less

Accuracy of open-source software segmentation and paper-based printed three-dimensional models.

PubMed

Szymor, Piotr; Kozakiewicz, Marcin; Olszewski, Raphael

2016-02-01

In this study, we aimed to verify the accuracy of models created with the help of open-source Slicer 3.6.3 software (Surgical Planning Lab, Harvard Medical School, Harvard University, Boston, MA, USA) and the Mcor Matrix 300 paper-based 3D printer. Our study focused on the accuracy of recreating the walls of the right orbit of a cadaveric skull. Cone beam computed tomography (CBCT) of the skull was performed (0.25-mm pixel size, 0.5-mm slice thickness). Acquired DICOM data were imported into Slicer 3.6.3 software, where segmentation was performed. A virtual model was created and saved as an .STL file and imported into Netfabb Studio professional 4.9.5 software. Three different virtual models were created by cutting the original file along three different planes (coronal, sagittal, and axial). All models were printed with a Selective Deposition Lamination Technology Matrix 300 3D printer using 80 gsm A4 paper. The models were printed so that their cutting plane was parallel to the paper sheets creating the model. Each model (coronal, sagittal, and axial) consisted of three separate parts (∼200 sheets of paper each) that were glued together to form a final model. The skull and created models were scanned with a three-dimensional (3D) optical scanner (Breuckmann smart SCAN) and were saved as .STL files. Comparisons of the orbital walls of the skull, the virtual model, and each of the three paper models were carried out with GOM Inspect 7.5SR1 software. Deviations measured between the models analysed were presented in the form of a colour-labelled map and covered with an evenly distributed network of points automatically generated by the software. An average of 804.43 ± 19.39 points for each measurement was created. Differences measured in each point were exported as a .csv file. The results were statistically analysed using Statistica 10, with statistical significance set at p < 0.05. The average number of points created on models for each measurement was 804.43 ± 19.39; however, deviation in some of the generated points could not be calculated, and those points were excluded from further calculations. From 94% to 99% of the measured absolute deviations were <1 mm. The mean absolute deviation between the skull and virtual model was 0.15 ± 0.11 mm, between the virtual and printed models was 0.15 ± 0.12 mm, and between the skull and printed models was 0.24 ± 0.21 mm. Using the optical scanner and specialized inspection software for measurements of accuracy of the created parts is recommended, as it allows one not only to measure 2-dimensional distances between anatomical points but also to perform more clinically suitable comparisons of whole surfaces. However, it requires specialized software and a very accurate scanner in order to be useful. Threshold-based, manually corrected segmentation of orbital walls performed with 3D Slicer software is accurate enough to be used for creating a virtual model of the orbit. The accuracy of the paper-based Mcor Matrix 300 3D printer is comparable to those of other commonly used 3-dimensional printers and allows one to create precise anatomical models for clinical use. The method of dividing the model into smaller parts and sticking them together seems to be quite accurate, although we recommend it only for creating small, solid models with as few parts as possible to minimize shift associated with gluing. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Take away body parts! An investigation into the use of 3D-printed anatomical models in undergraduate anatomy education.

PubMed

Smith, Claire F; Tollemache, Nicholas; Covill, Derek; Johnston, Malcolm

2018-01-01

Understanding the three-dimensional (3D) nature of the human form is imperative for effective medical practice and the emergence of 3D printing creates numerous opportunities to enhance aspects of medical and healthcare training. A recently deceased, un-embalmed donor was scanned through high-resolution computed tomography. The scan data underwent segmentation and post-processing and a range of 3D-printed anatomical models were produced. A four-stage mixed-methods study was conducted to evaluate the educational value of the models in a medical program. (1) A quantitative pre/post-test to assess change in learner knowledge following 3D-printed model usage in a small group tutorial; (2) student focus group (3) a qualitative student questionnaire regarding personal student model usage (4) teaching faculty evaluation. The use of 3D-printed models in small-group anatomy teaching session resulted in a significant increase in knowledge (P = 0.0001) when compared to didactic 2D-image based teaching methods. Student focus groups yielded six key themes regarding the use of 3D-printed anatomical models: model properties, teaching integration, resource integration, assessment, clinical imaging, and pathology and anatomical variation. Questionnaires detailed how students used the models in the home environment and integrated them with anatomical learning resources such as textbooks and anatomy lectures. In conclusion, 3D-printed anatomical models can be successfully produced from the CT data set of a recently deceased donor. These models can be used in anatomy education as a teaching tool in their own right, as well as a method for augmenting the curriculum and complementing established learning modalities, such as dissection-based teaching. Anat Sci Educ 11: 44-53. © 2017 American Association of Anatomists. © 2017 American Association of Anatomists.

Effects of Instructional Strategies Using Cross Sections on the Recognition of Anatomical Structures in Correlated CT and MR Images

ERIC Educational Resources Information Center

Khalil, Mohammed K.; Paas, Fred; Johnson, Tristan E.; Su, Yung K.; Payer, Andrew F.

2008-01-01

This research is an effort to best utilize the interactive anatomical images for instructional purposes based on cognitive load theory. Three studies explored the differential effects of three computer-based instructional strategies that use anatomical cross-sections to enhance the interpretation of radiological images. These strategies include:…

From ancient to avant-garde: a review of traditional and modern multimodal approaches to surgical anatomy education.

PubMed

Hu, Minhao; Wattchow, David; de Fontgalland, Dayan

2018-03-01

The landscape of surgical anatomy education is progressively changing. Traditional methods, such as cadaveric dissection and didacticism are being increasingly phased out in undergraduate courses for multimodal approaches incorporating problem-based learning, radiology and computer-based simulations. Although effective at clinically contextualizing and integrating anatomical information, these approaches may be a poor substitute for fostering a grasp of foundational 'pure' anatomy. Dissection is ideal for this purpose and hence remains the cornerstone of anatomical education. However, novel methods and technological advancements continually give way to adjuncts such as cadaveric surgery, three-dimensional printing, virtual simulation and live surgical streaming, which have demonstrated significant efficacy alone or alongside dissection. Therefore, although divergent paradigms of 'new versus old' approaches have engulfed and divided the community, educators should seek to integrate the ancient and avant-garde to comprehensively satisfy all of the modern anatomy learner's educational needs. © 2017 Royal Australasian College of Surgeons.

Anatomical Reproducibility of a Head Model Molded by a Three-dimensional Printer

PubMed Central

KONDO, Kosuke; NEMOTO, Masaaki; MASUDA, Hiroyuki; OKONOGI, Shinichi; NOMOTO, Jun; HARADA, Naoyuki; SUGO, Nobuo; MIYAZAKI, Chikao

We prepared rapid prototyping models of heads with unruptured cerebral aneurysm based on image data of computed tomography angiography (CTA) using a three-dimensional (3D) printer. The objective of this study was to evaluate the anatomical reproducibility and accuracy of these models by comparison with the CTA images on a monitor. The subjects were 22 patients with unruptured cerebral aneurysm who underwent preoperative CTA. Reproducibility of the microsurgical anatomy of skull bone and arteries, the length and thickness of the main arteries, and the size of cerebral aneurysm were compared between the CTA image and rapid prototyping model. The microsurgical anatomy and arteries were favorably reproduced, apart from a few minute regions, in the rapid prototyping models. No significant difference was noted in the measured lengths of the main arteries between the CTA image and rapid prototyping model, but errors were noted in their thickness (p < 0.001). A significant difference was also noted in the longitudinal diameter of the cerebral aneurysm (p < 0.01). Regarding the CTA image as the gold standard, reproducibility of the microsurgical anatomy of skull bone and main arteries was favorable in the rapid prototyping models prepared using a 3D printer. It was concluded that these models are useful tools for neurosurgical simulation. The thickness of the main arteries and size of cerebral aneurysm should be comprehensively judged including other neuroimaging in consideration of errors. PMID:26119896

Combining transrectal ultrasound and CT for image-guided adaptive brachytherapy of cervical cancer: Proof of concept.

PubMed

Nesvacil, Nicole; Schmid, Maximilian P; Pötter, Richard; Kronreif, Gernot; Kirisits, Christian

To investigate the feasibility of a treatment planning workflow for three-dimensional image-guided cervix cancer brachytherapy, combining volumetric transrectal ultrasound (TRUS) for target definition with CT for dose optimization to organs at risk (OARs), for settings with no access to MRI. A workflow for TRUS/CT-based volumetric treatment planning was developed, based on a customized system including ultrasound probe, stepper unit, and software for image volume acquisition. A full TRUS/CT-based workflow was simulated in a clinical case and compared with MR- or CT-only delineation. High-risk clinical target volume was delineated on TRUS, and OARs were delineated on CT. Manually defined tandem/ring applicator positions on TRUS and CT were used as a reference for rigid registration of the image volumes. Treatment plan optimization for TRUS target and CT organ volumes was performed and compared to MRI and CT target contours. TRUS/CT-based contouring, applicator reconstruction, image fusion, and treatment planning were feasible, and the full workflow could be successfully demonstrated. The TRUS/CT plan fulfilled all clinical planning aims. Dose-volume histogram evaluation of the TRUS/CT-optimized plan (high-risk clinical target volume D 90 , OARs D 2cm³ for) on different image modalities showed good agreement between dose values reported for TRUS/CT and MRI-only reference contours and large deviations for CT-only target parameters. A TRUS/CT-based workflow for full three-dimensional image-guided cervix brachytherapy treatment planning seems feasible and may be clinically comparable to MRI-based treatment planning. Further development to solve challenges with applicator definition in the TRUS volume is required before systematic applicability of this workflow. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Design of an advanced flight planning system

NASA Technical Reports Server (NTRS)

Sorensen, J. A.; Goka, T.

1985-01-01

The demand for both fuel conservation and four-dimensional traffic management require that the preflight planning process be designed to account for advances in airborne flight management and weather forecasting. The steps and issues in designing such an advanced flight planning system are presented. Focus is placed on the different optimization options for generating the three-dimensional reference path. For the cruise phase, one can use predefined jet routes, direct routes based on a network of evenly spaced grid points, or a network where the grid points are existing navaid locations. Each choice has its own problem in determining an optimum solution. Finding the reference path is further complicated by choice of cruise altitude levels, use of a time-varying weather field, and requiring a fixed time-of-arrival (four-dimensional problem).

Dental implant imaging: TeraRecon's Dental 3D Cone Beam Computed Tomography System.

PubMed

Garg, Arun K

2007-06-01

Early in the development of implant technology, conventional dental imaging techniques were limited for evaluating the patient for implant surgery. During the treatment-planning phase, the recipient bed is routinely assessed by visual examination and palpation, as well as by periapical and panoramic radiology. These two imaging modalities provide a two-dimensional image of the mesiodistal and occlusoapical dimensions of the edentulous regions where the implants might be placed. When adequate occlusoapical bone height is available for endosteal implants, the buccolingual width and angulation of the available bone are the most important criteria for implant selection and success. However, neither buccolingual width nor angulation can be visualized on most traditional radiographs. Although clinical examination and traditional radiographs may be adequate for patients with wide residual ridges that exhibit sufficient bone crestal to the mandibular nerve and maxillary sinus, these methods do not allow for the precise measurement of the buccolingual dimension of the bone or assessment of the location of unanticipated undercuts. Because of these concerns, it is necessary to view the recipient site in a plane through the arch of the maxilla or mandible in the region of the proposed implants. Implant surgeons soon recognized that, for the optimum placement of implants, cross-sectional views of the maxilla and mandible are the ideal means for providing necessary preoperative information. For complex cases where multiple implants are required or where anatomical measurements are crucial, but also increasingly for more routine cases, more and more clinicians are recommending CT scan imaging procedure such as that offered by TeraRecon's Dental CBCT system. Because of its ability to reconstruct a fully three-dimensional model of the maxilla and mandible, CBCT provides a highly sophisticated format for precisely defining the jaw structure and locating critical anatomic structures. CBCT scans, in conjunction with software that renders immediate treatment plans using the most real and accurate information, provide the most precise radiographic modality currently available for the evaluation of patients for oral implants.

Comparison of patient-specific instruments with standard surgical instruments in determining glenoid component position: a randomized prospective clinical trial.

PubMed

Hendel, Michael D; Bryan, Jason A; Barsoum, Wael K; Rodriguez, Eric J; Brems, John J; Evans, Peter J; Iannotti, Joseph P

2012-12-05

Glenoid component malposition for anatomic shoulder replacement may result in complications. The purpose of this study was to define the efficacy of a new surgical method to place the glenoid component. Thirty-one patients were randomized for glenoid component placement with use of either novel three-dimensional computed tomographic scan planning software combined with patient-specific instrumentation (the glenoid positioning system group), or conventional computed tomographic scan, preoperative planning, and surgical technique, utilizing instruments provided by the implant manufacturer (the standard surgical group). The desired position of the component was determined preoperatively. Postoperatively, a computed tomographic scan was used to define and compare the actual implant location with the preoperative plan. In the standard surgical group, the average preoperative glenoid retroversion was -11.3° (range, -39° to 17°). In the glenoid positioning system group, the average glenoid retroversion was -14.8° (range, -27° to 7°). When the standard surgical group was compared with the glenoid positioning system group, patient-specific instrumentation technology significantly decreased (p < 0.05) the average deviation of implant position for inclination and medial-lateral offset. Overall, the average deviation in version was 6.9° in the standard surgical group and 4.3° in the glenoid positioning system group. The average deviation in inclination was 11.6° in the standard surgical group and 2.9° in the glenoid positioning system group. The greatest benefit of patient-specific instrumentation was observed in patients with retroversion in excess of 16°; the average deviation was 10° in the standard surgical group and 1.2° in the glenoid positioning system group (p < 0.001). Preoperative planning and patient-specific instrumentation use resulted in a significant improvement in the selection and use of the optimal type of implant and a significant reduction in the frequency of malpositioned glenoid implants. Novel three-dimensional preoperative planning, coupled with patient and implant-specific instrumentation, allows the surgeon to better define the preoperative pathology, select the optimal implant design and location, and then accurately execute the plan at the time of surgery.

Can virtual reality improve anatomy education? A randomised controlled study of a computer-generated three-dimensional anatomical ear model.

PubMed

Nicholson, Daren T; Chalk, Colin; Funnell, W Robert J; Daniel, Sam J

2006-11-01

The use of computer-generated 3-dimensional (3-D) anatomical models to teach anatomy has proliferated. However, there is little evidence that these models are educationally effective. The purpose of this study was to test the educational effectiveness of a computer-generated 3-D model of the middle and inner ear. We reconstructed a fully interactive model of the middle and inner ear from a magnetic resonance imaging scan of a human cadaver ear. To test the model's educational usefulness, we conducted a randomised controlled study in which 28 medical students completed a Web-based tutorial on ear anatomy that included the interactive model, while a control group of 29 students took the tutorial without exposure to the model. At the end of the tutorials, both groups were asked a series of 15 quiz questions to evaluate their knowledge of 3-D relationships within the ear. The intervention group's mean score on the quiz was 83%, while that of the control group was 65%. This difference in means was highly significant (P < 0.001). Our findings stand in contrast to the handful of previous randomised controlled trials that evaluated the effects of computer-generated 3-D anatomical models on learning. The equivocal and negative results of these previous studies may be due to the limitations of these studies (such as small sample size) as well as the limitations of the models that were studied (such as a lack of full interactivity). Given our positive results, we believe that further research is warranted concerning the educational effectiveness of computer-generated anatomical models.

A virtual reality atlas of craniofacial anatomy.

PubMed

Smith, Darren M; Oliker, Aaron; Carter, Christina R; Kirov, Miro; McCarthy, Joseph G; Cutting, Court B

2007-11-01

Head and neck anatomy is complex and represents an educational challenge to the student. Conventional two-dimensional illustrations inherently fall short in conveying intricate anatomical relationships that exist in three dimensions. A gratis three-dimensional virtual reality atlas of craniofacial anatomy is presented in an effort to address the paucity of readily accessible and customizable three-dimensional educational material available to the student of head and neck anatomy. Three-dimensional model construction was performed in Alias Maya 4.5 and 6.0. A basic three-dimensional skull model was altered to include surgical landmarks and proportions. Some of the soft tissues were adapted from previous work, whereas others were constructed de novo. Texturing was completed with Adobe Photoshop 7.0 and Maya. The Internet application was designed in Viewpoint Enliven 1.0. A three-dimensional computer model of craniofacial anatomy (bone and soft tissue) was completed. The model is compatible with many software packages and can be accessed by means of the Internet or downloaded to a personal computer. As the three-dimensional meshes are publicly available, they can be extensively manipulated by the user, even at the polygonal level. Three-dimensional computer graphics has yet to be fully exploited for head and neck anatomy education. In this context, the authors present a publicly available computer model of craniofacial anatomy. This model may also find applications beyond clinical medicine. The model can be accessed gratis at the Plastic and Reconstructive Surgery Web site or obtained as a three-dimensional mesh, also gratis, by contacting the authors.

Anatomically Realistic Three-Dimensional Meshes of the Pelvic Floor & Anal Canal for Finite Element Analysis

PubMed Central

Noakes, Kimberley F.; Bissett, Ian P.; Pullan, Andrew J.; Cheng, Leo K.

2014-01-01

Three anatomically realistic meshes, suitable for finite element analysis, of the pelvic floor and anal canal regions have been developed to provide a framework with which to examine the mechanics, via finite element analysis of normal function within the pelvic floor. Two cadaver-based meshes were produced using the Visible Human Project (male and female) cryosection data sets, and a third mesh was produced based on MR image data from a live subject. The Visible Man (VM) mesh included 10 different pelvic structures while the Visible Woman and MRI meshes contained 14 and 13 structures respectively. Each image set was digitized and then finite element meshes were created using an iterative fitting procedure with smoothing constraints calculated from ‘L’-curves. These weights produced accurate geometric meshes of each pelvic structure with average Root Mean Square (RMS) fitting errors of less than 1.15 mm. The Visible Human cadaveric data provided high resolution images, however, the cadaveric meshes lacked the normal dynamic form of living tissue and suffered from artifacts related to postmortem changes. The lower resolution MRI mesh was able to accurately portray structure of the living subject and paves the way for dynamic, functional modeling. PMID:18317929

A Case Series of Rapid Prototyping and Intraoperative Imaging in Orbital Reconstruction

PubMed Central

Lim, Christopher G.T.; Campbell, Duncan I.; Cook, Nicholas; Erasmus, Jason

2014-01-01

In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure. This article aims to demonstrate the potential clinical and cost saving benefits when both these technologies are used in orbital reconstruction which minimize the need for revision surgery. PMID:26000080

A case series of rapid prototyping and intraoperative imaging in orbital reconstruction.

PubMed

Lim, Christopher G T; Campbell, Duncan I; Cook, Nicholas; Erasmus, Jason

2015-06-01

In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure. This article aims to demonstrate the potential clinical and cost saving benefits when both these technologies are used in orbital reconstruction which minimize the need for revision surgery.

Landmark-based elastic registration using approximating thin-plate splines.

PubMed

Rohr, K; Stiehl, H S; Sprengel, R; Buzug, T M; Weese, J; Kuhn, M H

2001-06-01

We consider elastic image registration based on a set of corresponding anatomical point landmarks and approximating thin-plate splines. This approach is an extension of the original interpolating thin-plate spline approach and allows to take into account landmark localization errors. The extension is important for clinical applications since landmark extraction is always prone to error. Our approach is based on a minimizing functional and can cope with isotropic as well as anisotropic landmark errors. In particular, in the latter case it is possible to include different types of landmarks, e.g., unique point landmarks as well as arbitrary edge points. Also, the scheme is general with respect to the image dimension and the order of smoothness of the underlying functional. Optimal affine transformations as well as interpolating thin-plate splines are special cases of this scheme. To localize landmarks we use a semi-automatic approach which is based on three-dimensional (3-D) differential operators. Experimental results are presented for two-dimensional as well as 3-D tomographic images of the human brain.

Two-dimensional planning can result in internal rotation of the femoral component in total knee arthroplasty.

PubMed

Okamoto, Shigetoshi; Mizu-uchi, Hideki; Okazaki, Ken; Hamai, Satoshi; Tashiro, Yasutaka; Nakahara, Hiroyuki; Iwamoto, Yukihide

2016-01-01

The first purpose of this study was to compare the reproducibility of two-dimensional (2D) and three-dimensional (3D) measurements for preoperative planning of the femoral side in total knee arthroplasty (TKA). The second purpose was to evaluate the factors affecting the differences between the 2D and 3D measurements. Two-dimensional and 3D measurements for preoperative planning of the femoral side in TKA were evaluated in 75 varus knees with osteoarthritis. The femoral valgus angle, defined as the angle between the mechanical and anatomical axes of the femur, and the clinical rotation angle and surgical rotation angle, defined by the angles between the posterior condylar line and the clinical or surgical transepicondylar axes, respectively, were analysed using 2D (radiographs and axial CT slices) and 3D (3D bone models reconstructed from CT images) measurements. For all variables, 3D measurements were more reliable and reproducible than 2D measurements. The medians and ranges of the clinical rotation angle and surgical rotation angle were 6.6° (-1.7° to 12.1°) and 2.3° (-2.5° to 8.6°) in 2D, and 7.1° (2.7° to 11.4°) and 3.0° (-2.0° to 7.5°) in 3D. Varus/valgus alteration of the CT scanning direction relative to the mechanical axis affected the difference in clinical rotation angles between 2D and 3D measurements. Significantly, smaller values of the clinical rotation angle and surgical rotation angle were obtained by 2D compared to 3D measurements, which could result in internal rotation of the femoral component even if the surgeon performs the bone cutting precisely. Regarding clinical relevance, first, this study confirmed the reliability of 3D measurements. Second, it underscored the risk of internal rotation of the femoral component when using 2D measurement, even with precise bone cutting technique. These results will help surgeons avoid malpositioning of the femoral component if 2D measurements are used for preoperative planning in TKA. Prospective comparative study, Level Ш.

Experimental study of quantitative assessment of left ventricular mass with contrast enhanced real-time three-dimensional echocardiography.

PubMed

Zhuang, Lei; Wang, Xin-Fang; Xie, Ming-Xing; Chen, Li-Xin; Fei, Hong-Wen; Yang, Ying; Wang, Jing; Huang, Run-Qing; Chen, Ou-Di; Wang, Liang-Yu

2004-01-01

To evaluate the feasibility and accuracy of measurement of left ventricular mass with intravenous contrast enhanced real-time three-dimensional (RT3D) echocardiography in the experimental setting. RT3D echocardiography was performed in 13 open-chest mongrel dogs before and after intravenous infusion of a perfluorocarbon contrast agent. Left ventricular myocardium volume was measured according to the apical four-plane method provided by TomTec 4D cardio-View RT1.0 software, then the left ventricular mass was calculated as the myocardial volume multiplied by the relative density of myocardium. Correlative analysis and paired t-test were performed between left ventricular mass obtained from RT3D echocardiography and the anatomic measurements. Anatomic measurement of total left ventricular mass was 55.6 +/- 9.3 g, whereas RT3D echocardiographic calculation of left ventricular mass before and after intravenous perfluorocarbon contrast agent was 57.5 +/- 11.4 and 55.5 +/- 9.3 g, respectively. A significant correlation was observed between the RT3D echocardiographic estimates of total left ventricular mass and the corresponding anatomic measurements (r = 0.95). A strong correlation was found between RT3D echocardiographic estimates of left ventricular mass with perfluorocarbon contrast and the anatomic results (r = 0.99). Analysis of intraobserver and interobserver variability showed strong indexes of agreement in the measurement of left ventricular mass with pre and post-contrast RT3D echocardiography. Measurements of left ventricular mass derived from RT3D echocardiography with and without intravenous contrast showed a significant correlation with the anatomic results. Contrast enhanced RT3D echocardiography permitted better visualization of the endocardial border, which would provide a more accurate and reliable means of determining left ventricular myocardial mass in the experimental setting.

Assessment of mitral apparatus in patients with acute inferoposterior myocardial infarction and ischaemic mitral regurgitation with two-dimensional echocardiography from anatomically correct imaging planes.

PubMed

Mėlinytė, Karolina; Valuckiene, Živile; Jurkevičius, Renaldas

2017-01-01

Ischaemic mitral regurgitation (IMR) is associated with adverse prognosis after myocardial infarction (MI) as a result of left ventricular remodelling and geometric deformation of the mitral apparatus (MA). The aim of this study was to assess MA from anatomically correct imaging planes in acute inferoposterior MI and IMR. Ninety-three patients with no structural cardiac valve abnormalities and the first acute inferoposterior MI were prospectively enrolled into the study. Two-dimensional transthoracic echocardiography for MA assessment was performed within 48 h of presentation after reperfusion therapy. Based on the degree of mitral regurgitation (MR), patients were divided into either a no significant MR (NMR) group (n = 52 with no or mild, grade 0-I MR) or an IMR group (n = 41 with grade ≥ 2 MR). The control group consisted of 45 healthy individuals. Ischaemic MR was related with dilatation of the left ventricle chambers, decrease in ejection fraction, increase in mitral annulus diameter and area, and changes in subvalvular apparatus when compared with the NMR group or healthy individuals. Ischaemic MR in acute inferoposterior MI is related with worse lesions in MA geometry that cause insufficiency of mitral valve function.

[A new concept in digestive surgery: the computer assisted surgical procedure, from virtual reality to telemanipulation].

PubMed

Marescaux, J; Clément, J M; Nord, M; Russier, Y; Tassetti, V; Mutter, D; Cotin, S; Ayache, N

1997-11-01

Surgical simulation increasingly appears to be an essential aspect of tomorrow's surgery. The development of a hepatic surgery simulator is an advanced concept calling for a new writing system which will transform the medical world: virtual reality. Virtual reality extends the perception of our five senses by representing more than the real state of things by the means of computer sciences and robotics. It consists of three concepts: immersion, navigation and interaction. Three reasons have led us to develop this simulator: the first is to provide the surgeon with a comprehensive visualisation of the organ. The second reason is to allow for planning and surgical simulation that could be compared with the detailed flight-plan for a commercial jet pilot. The third lies in the fact that virtual reality is an integrated part of the concept of computer assisted surgical procedure. The project consists of a sophisticated simulator which has to include five requirements: visual fidelity, interactivity, physical properties, physiological properties, sensory input and output. In this report we will describe how to get a realistic 3D model of the liver from bi-dimensional 2D medical images for anatomical and surgical training. The introduction of a tumor and the consequent planning and virtual resection is also described, as are force feedback and real-time interaction.

Three-dimensional echocardiographic assessment of the repaired mitral valve.

PubMed

Maslow, Andrew; Mahmood, Feroze; Poppas, Athena; Singh, Arun

2014-02-01

This study examined the geometric changes of the mitral valve (MV) after repair using conventional and three-dimensional echocardiography. Prospective evaluation of consecutive patients undergoing mitral valve repair. Tertiary care university hospital. Fifty consecutive patients scheduled for elective repair of the mitral valve for regurgitant disease. Intraoperative transesophageal echocardiography. Assessments of valve area (MVA) were performed using two-dimensional planimetry (2D-Plan), pressure half-time (PHT), and three-dimensional planimetry (3D-Plan). In addition, the direction of ventricular inflow was assessed from the three-dimensional imaging. Good correlations (r = 0.83) and agreement (-0.08 +/- 0.43 cm(2)) were seen between the MVA measured with 3D-Plan and PHT, and were better than either compared to 2D-Plan. MVAs were smaller after repair of functional disease repaired with an annuloplasty ring. After repair, ventricular inflow was directed toward the lateral ventricular wall. Subgroup analysis showed that the change in inflow angle was not different after repair of functional disease (168 to 171 degrees) as compared to those presenting with degenerative disease (168 to 148 degrees; p<0.0001). Three-dimensional imaging provides caregivers with a unique ability to assess changes in valve function after mitral valve repair. Copyright © 2014 Elsevier Inc. All rights reserved.

Planning of vessel grafts for reconstructive surgery in congenital heart diseases

NASA Astrophysics Data System (ADS)

Rietdorf, U.; Riesenkampff, E.; Schwarz, T.; Kuehne, T.; Meinzer, H.-P.; Wolf, I.

2010-02-01

The Fontan operation is a surgical treatment for patients with severe congenital heart diseases, where a biventricular correction of the heart can't be achieved. In these cases, a uni-ventricular system is established. During the last step of surgery a tunnel segment is placed to connect the inferior caval vein directly with the pulmonary artery, bypassing the right atrium and ventricle. Thus, the existing ventricle works for the body circulation, while the venous blood is passively directed to the pulmonary arteries. Fontan tunnels can be placed intra- and extracardially. The location, length and shape of the tunnel must be planned accurately. Furthermore, if the tunnel is placed extracardially, it must be positioned between other anatomical structures without constraining them. We developed a software system to support planning of the tunnel location, shape, and size, making pre-operative preparation of the tunnel material possible. The system allows for interactive placement and adjustment of the tunnel, affords a three-dimensional visualization of the virtual Fontan tunnel inside the thorax, and provides a quantification of the length, circumferences and diameters of the tunnel segments. The visualization and quantification can be used to plan and prepare the tunnel material for surgery in order to reduce the intra-operative time and to improve the fit of the tunnel patch.

Using 3D printed models for planning and guidance during endovascular intervention: a technical advance.

PubMed

Itagaki, Michael W

2015-01-01

Three-dimensional (3D) printing applications in medicine have been limited due to high cost and technical difficulty of creating 3D printed objects. It is not known whether patient-specific, hollow, small-caliber vascular models can be manufactured with 3D printing, and used for small vessel endoluminal testing of devices. Manufacture of anatomically accurate, patient-specific, small-caliber arterial models was attempted using data from a patient's CT scan, free open-source software, and low-cost Internet 3D printing services. Prior to endovascular treatment of a patient with multiple splenic artery aneurysms, a 3D printed model was used preoperatively to test catheter equipment and practice the procedure. A second model was used intraoperatively as a reference. Full-scale plastic models were successfully produced. Testing determined the optimal puncture site for catheter positioning. A guide catheter, base catheter, and microcatheter combination selected during testing was used intraoperatively with success, and the need for repeat angiograms to optimize image orientation was minimized. A difficult and unconventional procedure was successful in treating the aneurysms while preserving splenic function. We conclude that creation of small-caliber vascular models with 3D printing is possible. Free software and low-cost printing services make creation of these models affordable and practical. Models are useful in preoperative planning and intraoperative guidance.

Simplified three-dimensional model provides anatomical insights in lizards' caudal autotomy as printed illustration.

PubMed

De Amorim, Joana D C G; Travnik, Isadora; De Sousa, Bernadete M

2015-03-01

Lizards' caudal autotomy is a complex and vastly employed antipredator mechanism, with thorough anatomic adaptations involved. Due to its diminished size and intricate structures, vertebral anatomy is hard to be clearly conveyed to students and researchers of other areas. Three-dimensional models are prodigious tools in unveiling anatomical nuances. Some of the techniques used to create them can produce irregular and complicated forms, which despite being very accurate, lack didactical uniformity and simplicity. Since both are considered fundamental characteristics for comprehension, a simplified model could be the key to improve learning. The model here presented depicts the caudal osteology of Tropidurus itambere, and was designed to be concise, in order to be easily assimilated, yet complete, not to compromise the informative aspect. The creation process requires only basic skills in manipulating polygons in 3D modeling softwares, in addition to the appropriate knowledge of the structure to be modeled. As reference for the modeling, we used microscopic observation and a photograph database of the caudal structures. This way, no advanced laboratory equipment was needed and all biological materials were preserved for future research. Therefore, we propose a wider usage of simplified 3D models both in the classroom and as illustrations for scientific publications.

Three-Dimensional Analysis and Surgical Planning in Craniomaxillofacial Surgery.

PubMed

Steinbacher, Derek M

2015-12-01

Three-dimensional (3D) analysis and planning are powerful tools in craniofacial and reconstructive surgery. The elements include 1) analysis, 2) planning, 3) virtual surgery, 4) 3D printouts of guides or implants, and 5) verification of actual to planned results. The purpose of this article is to review different applications of 3D planning in craniomaxillofacial surgery. Case examples involving 3D analysis and planning were reviewed. Common threads pertaining to all types of reconstruction are highlighted and contrasted with unique aspects specific to new applications in craniomaxillofacial surgery. Six examples of 3D planning are described: 1) cranial reconstruction, 2) craniosynostosis, 3) midface advancement, 4) mandibular distraction, 5) mandibular reconstruction, and 6) orthognathic surgery. Planning in craniomaxillofacial surgery is useful and has applicability across different procedures and reconstructions. Three-dimensional planning and virtual surgery enhance efficiency, accuracy, creativity, and reproducibility in craniomaxillofacial surgery. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Three-Dimensional Printing Surgical Applications.

PubMed

AlAli, Ahmad B; Griffin, Michelle F; Butler, Peter E

2015-01-01

Three-dimensional printing, a technology used for decades in the industrial field, gains a lot of attention in the medical field for its potential benefits. With advancement of desktop printers, this technology is accessible and a lot of research is going on in the medical field. To evaluate its application in surgical field, which may include but not limited to surgical planning, surgical education, implants, and prosthesis, which are the focus of this review. Research was conducted by searching PubMed, Web of science, and other reliable sources. We included original articles and excluded articles based on animals, those more than 10 years old, and those not in English. These articles were evaluated, and relevant studies were included in this review. Three-dimensional printing shows a potential benefit in surgical application. Printed implants were used in patient in a few cases and show successful results; however, longer follow-up and more trials are needed. Surgical and medical education is believed to be more efficient with this technology than the current practice. Printed surgical instrument and surgical planning are also believed to improve with three-dimensional printing. Three-dimensional printing can be a very powerful tool in the near future, which can aid the medical field that is facing a lot of challenges and obstacles. However, despite the reported results, further research on larger samples and analytical measurements should be conducted to ensure this technology's impact on the practice.

Comparative evaluation of two-dimensional radiography and three dimensional computed tomography based dose-volume parameters for high-dose-rate intracavitary brachytherapy of cervical cancer: a prospective study.

PubMed

Madan, Renu; Pathy, Sushmita; Subramani, Vellaiyan; Sharma, Seema; Mohanti, Bidhu Kalyan; Chander, Subhash; Thulkar, Sanjay; Kumar, Lalit; Dadhwal, Vatsla

2014-01-01

Dosimetric comparison of two dimensional (2D) radiography and three-dimensional computed tomography (3D-CT) based dose distributions with high-dose-rate (HDR) intracavitry radiotherapy (ICRT) for carcinoma cervix, in terms of target coverage and doses to bladder and rectum. Sixty four sessions of HDR ICRT were performed in 22 patients. External beam radiotherapy to pelvis at a dose of 50 Gray in 27 fractions followed by HDR ICRT, 21 Grays to point A in 3 sessions, one week apart was planned . All patients underwent 2D-orthogonal and 3D-CT simulation for each session. Treatment plans were generated using 2D-orthogonal images and dose prescription was made at point A. 3D plans were generated using 3D-CT images after delineating target volume and organs at risk. Comparative evaluation of 2D and 3D treatment planning was made for each session in terms of target coverage (dose received by 90%, 95% and 100% of the target volume: D90, D95 and D100 respectively) and doses to bladder and rectum: ICRU-38 bladder and rectum point dose in 2D planning and dose to 0.1cc, 1cc, 2cc, 5cc, and 10cc of bladder and rectum in 3D planning. Mean doses received by 100% and 90% of the target volume were 4.24 ± 0.63 and 4.9 ± 0.56 Gy respectively. Doses received by 0.1cc, 1cc and 2cc volume of bladder were 2.88 ± 0.72, 2.5 ± 0.65 and 2.2 ± 0.57 times more than the ICRU bladder reference point. Similarly, doses received by 0.1cc, 1cc and 2cc of rectum were 1.80 ± 0.5, 1.48 ± 0.41 and 1.35 ± 0.37 times higher than ICRU rectal reference point. Dosimetric comparative evaluation of 2D and 3D CT based treatment planning for the same brachytherapy session demonstrates underestimation of OAR doses and overestimation of target coverage in 2D treatment planning.

Automatic anatomical segmentation of the liver by separation planes

NASA Astrophysics Data System (ADS)

Boltcheva, Dobrina; Passat, Nicolas; Agnus, Vincent; Jacob-Da, Marie-Andrée, , Col; Ronse, Christian; Soler, Luc

2006-03-01

Surgical planning in oncological liver surgery is based on the location of the 8 anatomical segments according to Couinaud's definition and tumors inside these structures. The detection of the boundaries between the segments is then the first step of the preoperative planning. The proposed method, devoted to binary images of livers segmented from CT-scans, has been designed to delineate these segments. It automatically detects a set of landmarks using a priori anatomical knowledge and differential geometry criteria. These landmarks are then used to position the Couinaud's segments. Validations performed on 7 clinical cases tend to prove that the method is reliable for most of these separation planes.

Textural analysis of optical coherence tomography skin images: quantitative differentiation between healthy and cancerous tissues

NASA Astrophysics Data System (ADS)

Adabi, Saba; Conforto, Silvia; Hosseinzadeh, Matin; Noe, Shahryar; Daveluy, Steven; Mehregan, Darius; Nasiriavanaki, Mohammadreza

2017-02-01

Optical Coherence Tomography (OCT) offers real-time high-resolution three-dimensional images of tissue microstructures. In this study, we used OCT skin images acquired from ten volunteers, neither of whom had any skin conditions addressing the features of their anatomic location. OCT segmented images are analyzed based on their optical properties (attenuation coefficient) and textural image features e.g., contrast, correlation, homogeneity, energy, entropy, etc. Utilizing the information and referring to their clinical insight, we aim to make a comprehensive computational model for the healthy skin. The derived parameters represent the OCT microstructural morphology and might provide biological information for generating an atlas of normal skin from different anatomic sites of human skin and may allow for identification of cell microstructural changes in cancer patients. We then compared the parameters of healthy samples with those of abnormal skin and classified them using a linear Support Vector Machines (SVM) with 82% accuracy.

Three-dimensional reconstruction of the topographical cerebral surface anatomy for presurgical planning with free OsiriX Software.

PubMed

Harput, Mehmet V; Gonzalez-Lopez, Pablo; Türe, Uğur

2014-09-01

During surgery for intrinsic brain lesions, it is important to distinguish the pathological gyrus from the surrounding normal sulci and gyri. This task is usually tedious because of the pia-arachnoid membranes with their arterial and venous complexes that obscure the underlying anatomy. Moreover, most tumors grow in the white matter without initially distorting the cortical anatomy, making their direct visualization more difficult. To create and evaluate a simple and free surgical planning tool to simulate the anatomy of the surgical field with and without vessels. We used free computer software (OsiriX Medical Imaging Software) that allowed us to create 3-dimensional reconstructions of the cerebral surface with and without cortical vessels. These reconstructions made use of magnetic resonance images from 51 patients with neocortical supratentorial lesions operated on over a period of 21 months (June 2011 to February 2013). The 3-dimensional (3-D) anatomic images were compared with the true surgical view to evaluate their accuracy. In all patients, the landmarks determined by 3-D reconstruction were cross-checked during surgery with high-resolution ultrasonography; in select cases, they were also checked with indocyanine green videoangiography. The reconstructed neurovascular structures were confirmed intraoperatively in all patients. We found this technique to be extremely useful in achieving pure lesionectomy, as it defines tumor's borders precisely. A 3-D reconstruction of the cortical surface can be easily created with free OsiriX software. This technique helps the surgeon perfect the mentally created 3-D picture of the tumor location to carry out cleaner, safer surgeries.

Three-dimensional finite element modelling of muscle forces during mastication.

PubMed

Röhrle, Oliver; Pullan, Andrew J

2007-01-01

This paper presents a three-dimensional finite element model of human mastication. Specifically, an anatomically realistic model of the masseter muscles and associated bones is used to investigate the dynamics of chewing. A motion capture system is used to track the jaw motion of a subject chewing standard foods. The three-dimensional nonlinear deformation of the masseter muscles are calculated via the finite element method, using the jaw motion data as boundary conditions. Motion-driven muscle activation patterns and a transversely isotropic material law, defined in a muscle-fibre coordinate system, are used in the calculations. Time-force relationships are presented and analysed with respect to different tasks during mastication, e.g. opening, closing, and biting, and are also compared to a more traditional one-dimensional model. The results strongly suggest that, due to the complex arrangement of muscle force directions, modelling skeletal muscles as conventional one-dimensional lines of action might introduce a significant source of error.

Generating Neuron Geometries for Detailed Three-Dimensional Simulations Using AnaMorph.

PubMed

Mörschel, Konstantin; Breit, Markus; Queisser, Gillian

2017-07-01

Generating realistic and complex computational domains for numerical simulations is often a challenging task. In neuroscientific research, more and more one-dimensional morphology data is becoming publicly available through databases. This data, however, only contains point and diameter information not suitable for detailed three-dimensional simulations. In this paper, we present a novel framework, AnaMorph, that automatically generates water-tight surface meshes from one-dimensional point-diameter files. These surface triangulations can be used to simulate the electrical and biochemical behavior of the underlying cell. In addition to morphology generation, AnaMorph also performs quality control of the semi-automatically reconstructed cells coming from anatomical reconstructions. This toolset allows an extension from the classical dimension-reduced modeling and simulation of cellular processes to a full three-dimensional and morphology-including method, leading to novel structure-function interplay studies in the medical field. The developed numerical methods can further be employed in other areas where complex geometries are an essential component of numerical simulations.

What is dorso-lateral in the subthalamic Nucleus (STN)?--a topographic and anatomical consideration on the ambiguous description of today's primary target for deep brain stimulation (DBS) surgery.

PubMed

Coenen, Volker A; Prescher, Andreas; Schmidt, Thorsten; Picozzi, Piero; Gielen, Frans L H

2008-11-01

The most frequently used target for DBS in advanced Parkinson Disease (PD) is the sensorimotor subthalamic nucleus (STN), anatomically referred to as dorso-lateral STN [3]. Ambiguities arise, regarding the true meaning of this description in the STN. Does "dorsal" indicate posterior or superior? At its best, this definition assigns two directions in space to a three-dimensional structure. This paper evaluates the ambiguity and describes the sensorimotor part of the STN in stereotactic space.

Emerging Applications of Bedside 3D Printing in Plastic Surgery

PubMed Central

Chae, Michael P.; Rozen, Warren M.; McMenamin, Paul G.; Findlay, Michael W.; Spychal, Robert T.; Hunter-Smith, David J.

2015-01-01

Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice. PMID:26137465

Emerging Applications of Bedside 3D Printing in Plastic Surgery.

PubMed

Chae, Michael P; Rozen, Warren M; McMenamin, Paul G; Findlay, Michael W; Spychal, Robert T; Hunter-Smith, David J

2015-01-01

Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing intraoperative guidance tools, teaching patients and surgical trainees, and producing patient-specific prosthetics in everyday surgical practice.

Influence of Objective Three-Dimensional Measures and Movement Images on Surgeon Treatment Planning for Lip Revision Surgery

PubMed Central

Trotman, Carroll-Ann; Phillips, Ceib; Faraway, Julian J.; Hartman, Terry; van Aalst, John A.

2013-01-01

Objective To determine whether a systematic evaluation of facial soft tissues of patients with cleft lip and palate, using facial video images and objective three-dimensional measurements of movement, change surgeons’ treatment plans for lip revision surgery. Design Prospective longitudinal study. Setting The University of North Carolina School of Dentistry. Patients, Participants A group of patients with repaired cleft lip and palate (n = 21), a noncleft control group (n = 37), and surgeons experienced in cleft care. Interventions Lip revision. Main Outcome Measures (1) facial photographic images; (2) facial video images during animations; (3) objective three-dimensional measurements of upper lip movement based on z scores; and (4) objective dynamic and visual three-dimensional measurement of facial soft tissue movement. Results With the use of the video images plus objective three-dimensional measures, changes were made to the problem list of the surgical treatment plan for 86% of the patients (95% confidence interval, 0.64 to 0.97) and the surgical goals for 71% of the patients (95% confidence interval, 0.48 to 0.89). The surgeon group varied in the percentage of patients for whom the problem list was modified, ranging from 24% (95% confidence interval, 8% to 47%) to 48% (95% confidence interval, 26% to 70%) of patients, and the percentage for whom the surgical goals were modified, ranging from 14% (94% confidence interval, 3% to 36%) to 48% (95% confidence interval, 26% to 70%) of patients. Conclusions For all surgeons, the additional assessment components of the systematic valuation resulted in a change in clinical decision making for some patients. PMID:23855676

Three-dimensional visual guidance improves the accuracy of calculating right ventricular volume with two-dimensional echocardiography

NASA Technical Reports Server (NTRS)

Dorosz, Jennifer L.; Bolson, Edward L.; Waiss, Mary S.; Sheehan, Florence H.

2003-01-01

Three-dimensional guidance programs have been shown to increase the reproducibility of 2-dimensional (2D) left ventricular volume calculations, but these systems have not been tested in 2D measurements of the right ventricle. Using magnetic fields to identify the probe location, we developed a new 3-dimensional guidance system that displays the line of intersection, the plane of intersection, and the numeric angle of intersection between the current image plane and previously saved scout views. When used by both an experienced and an inexperienced sonographer, this guidance system increases the accuracy of the 2D right ventricular volume measurements using a monoplane pyramidal model. Furthermore, a reconstruction of the right ventricle, with a computed volume similar to the calculated 2D volume, can be displayed quickly by tracing a few anatomic structures on 2D scans.

Accuracy and predictability in use of AO three-dimensionally preformed titanium mesh plates for posttraumatic orbital reconstruction: a pilot study.

PubMed

Scolozzi, Paolo; Momjian, Armen; Heuberger, Joris; Andersen, Elene; Broome, Martin; Terzic, Andrej; Jaques, Bertrand

2009-07-01

The aim of this study was to prospectively evaluate the accuracy and predictability of new three-dimensionally preformed AO titanium mesh plates for posttraumatic orbital wall reconstruction.We analyzed the preoperative and postoperative clinical and radiologic data of 10 patients with isolated blow-out orbital fractures. Fracture locations were as follows: floor (N = 7; 70%), medial wall (N = 1; 1%), and floor/medial wall (N = 2; 2%). The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures. A three-dimensional preformed AO titanium mesh plate (0.4 mm in thickness) was selected according to the size of the defect previously measured on the preoperative computed tomographic (CT) scan examination and fixed at the inferior orbital rim with 1 or 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative CT scan. Coronal CT scan slices were used to measure bony orbital volume using OsiriX Medical Image software. Reconstructed versus uninjured orbital volume were statistically correlated.Nine patients (90%) had a successful treatment outcome without complications. One patient (10%) developed a mechanical limitation of upward gaze with a resulting handicapping diplopia requiring hardware removal. Postoperative orbital CT scan showed an anatomic three-dimensional placement of the orbital mesh plates in all of the patients. Volume data of the reconstructed orbit fitted that of the contralateral uninjured orbit with accuracy to within 2.5 cm(3). There was no significant difference in volume between the reconstructed and uninjured orbits.This preliminary study has demonstrated that three-dimensionally preformed AO titanium mesh plates for posttraumatic orbital wall reconstruction results in (1) a high rate of success with an acceptable rate of major clinical complications (10%) and (2) an anatomic restoration of the bony orbital contour and volume that closely approximates that of the contralateral uninjured orbit.

Comparison of anatomy-based, fluence-based and aperture-based treatment planning approaches for VMAT

NASA Astrophysics Data System (ADS)

Rao, Min; Cao, Daliang; Chen, Fan; Ye, Jinsong; Mehta, Vivek; Wong, Tony; Shepard, David

2010-11-01

Volumetric modulated arc therapy (VMAT) has the potential to reduce treatment times while producing comparable or improved dose distributions relative to fixed-field intensity-modulated radiation therapy. In order to take full advantage of the VMAT delivery technique, one must select a robust inverse planning tool. The purpose of this study was to evaluate the effectiveness and efficiency of VMAT planning techniques of three categories: anatomy-based, fluence-based and aperture-based inverse planning. We have compared these techniques in terms of the plan quality, planning efficiency and delivery efficiency. Fourteen patients were selected for this study including six head-and-neck (HN) cases, and two cases each of prostate, pancreas, lung and partial brain. For each case, three VMAT plans were created. The first VMAT plan was generated based on the anatomical geometry. In the Elekta ERGO++ treatment planning system (TPS), segments were generated based on the beam's eye view (BEV) of the target and the organs at risk. The segment shapes were then exported to Pinnacle3 TPS followed by segment weight optimization and final dose calculation. The second VMAT plan was generated by converting optimized fluence maps (calculated by the Pinnacle3 TPS) into deliverable arcs using an in-house arc sequencer. The third VMAT plan was generated using the Pinnacle3 SmartArc IMRT module which is an aperture-based optimization method. All VMAT plans were delivered using an Elekta Synergy linear accelerator and the plan comparisons were made in terms of plan quality and delivery efficiency. The results show that for cases of little or modest complexity such as prostate, pancreas, lung and brain, the anatomy-based approach provides similar target coverage and critical structure sparing, but less conformal dose distributions as compared to the other two approaches. For more complex HN cases, the anatomy-based approach is not able to provide clinically acceptable VMAT plans while highly conformal dose distributions were obtained using both aperture-based and fluence-based inverse planning techniques. The aperture-based approach provides improved dose conformity than the fluence-based technique in complex cases.

Procedure Planning: Anatomical Determinants of Strategy

PubMed Central

Hanratty, Colm; Walsh, Simon

2014-01-01

In contemporary practice there are three main methods that can be employed when attempting to open a chronic total occlusion (CTO) of a coronary artery; antegrade or retrograde wire escalation, antegrade dissection re-entry and retrograde dissection re-entry. This editorial will attempt to clarify the anatomical features that can be identified to help when deciding which of these strategies to employ initially and help understand the reasons for this decision. PMID:24694102

A combination of three-dimensional printing and computer-assisted virtual surgical procedure for preoperative planning of acetabular fracture reduction.

PubMed

Zeng, Canjun; Xing, Weirong; Wu, Zhanglin; Huang, Huajun; Huang, Wenhua

2016-10-01

Treatment of acetabular fractures remains one of the most challenging tasks that orthopaedic surgeons face. An accurate assessment of the injuries and preoperative planning are essential for an excellent reduction. The purpose of this study was to evaluate the feasibility, accuracy and effectiveness of performing 3D printing technology and computer-assisted virtual surgical procedures for preoperative planning in acetabular fractures. We hypothesised that more accurate preoperative planning using 3D printing models will reduce the operation time and significantly improve the outcome of acetabular fracture repair. Ten patients with acetabular fractures were recruited prospectively and examined by CT scanning. A 3-D model of each acetabular fracture was reconstructed with MIMICS14.0 software from the DICOM file of the CT data. Bone fragments were moved and rotated to simulate fracture reduction and restore the pelvic integrity with virtual fixation. The computer-assisted 3D image of the reduced acetabula was printed for surgery simulation and plate pre-bending. The postoperative CT scan was performed to compare the consistency of the preoperative planning with the surgical implants by 3D-superimposition in MIMICS14.0, and evaluated by Matta's method. Computer-based pre-operations were precisely mimicked and consistent with the actual operations in all cases. The pre-bent fixation plates had an anatomical shape specifically fit to the individual pelvis without further bending or adjustment at the time of surgery and fracture reductions were significantly improved. Seven out of 10 patients had a displacement of fracture reduction of less than 1mm; 3 cases had a displacement of fracture reduction between 1 and 2mm. The 3D printing technology combined with virtual surgery for acetabular fractures is feasible, accurate, and effective leading to improved patient-specific preoperative planning and outcome of real surgery. The results provide useful technical tips in planning pelvic surgeries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Predictive parameters for selection of electronic tissue compensation radiotherapy in early-stage breast cancer patients after breast-conserving surgery.

PubMed

Song, Yanbo; Zhang, Miao; Gan, Lu; Chen, Xiaopin; Zhang, Tao; Yue, Ning J; Goyal, Sharad; Haffty, Bruce; Ren, Guosheng

2016-05-31

Electronic tissue compensation (eComp) is an external beam planning technique allowing user to manually generate dynamic beam fluence to produce more uniform or modulated dose distribution. In this study, we compared the effectiveness between conventional three-dimensional conformal radiotherapy (3DCRT) and eComp for whole breast irradiation. 3DCRT and eComp planning techniques were used to generate treatment plans for 60 whole breast patients, respectively. The planning goal was to cover 95% of the planning target volume (PTV) with 95% of the prescription dose while minimizing doses to lung, heart, and skin. Comparing to 3DCRT plans, on the average, eComp treatment planning process was about 7 minutes longer, but resulted in lower lung V20Gy, lower mean skin dose, with similar heart dose. The benefits were more pronounced for larger breast patients. Statistical analyses were performed between critical organ doses and patient anatomic features, i.e., central lung distance (CLD), maximal heart distance (MHD), maximal heart length (MHL) and breast separation (BS) to explore any correlations and planning method selection. It was found that to keep the lung V20Gy lower than 20% and mean skin dose lower than 85% of the prescription dose, eComp was the preferred method for patients with more than 2.3 cm CLD or larger than 22.5 cm BS. The study results may be useful in providing a handy criterion in clinical practice allowing us to easily choose between different planning techniques to satisfy the planning goal with minimal increase in complexity and cost.

A Biomechanical Modeling Guided CBCT Estimation Technique

PubMed Central

Zhang, You; Tehrani, Joubin Nasehi; Wang, Jing

2017-01-01

Two-dimensional-to-three-dimensional (2D-3D) deformation has emerged as a new technique to estimate cone-beam computed tomography (CBCT) images. The technique is based on deforming a prior high-quality 3D CT/CBCT image to form a new CBCT image, guided by limited-view 2D projections. The accuracy of this intensity-based technique, however, is often limited in low-contrast image regions with subtle intensity differences. The solved deformation vector fields (DVFs) can also be biomechanically unrealistic. To address these problems, we have developed a biomechanical modeling guided CBCT estimation technique (Bio-CBCT-est) by combining 2D-3D deformation with finite element analysis (FEA)-based biomechanical modeling of anatomical structures. Specifically, Bio-CBCT-est first extracts the 2D-3D deformation-generated displacement vectors at the high-contrast anatomical structure boundaries. The extracted surface deformation fields are subsequently used as the boundary conditions to drive structure-based FEA to correct and fine-tune the overall deformation fields, especially those at low-contrast regions within the structure. The resulting FEA-corrected deformation fields are then fed back into 2D-3D deformation to form an iterative loop, combining the benefits of intensity-based deformation and biomechanical modeling for CBCT estimation. Using eleven lung cancer patient cases, the accuracy of the Bio-CBCT-est technique has been compared to that of the 2D-3D deformation technique and the traditional CBCT reconstruction techniques. The accuracy was evaluated in the image domain, and also in the DVF domain through clinician-tracked lung landmarks. PMID:27831866

Comparative study of anatomical normalization errors in SPM and 3D-SSP using digital brain phantom.

PubMed

Onishi, Hideo; Matsutake, Yuki; Kawashima, Hiroki; Matsutomo, Norikazu; Amijima, Hizuru

2011-01-01

In single photon emission computed tomography (SPECT) cerebral blood flow studies, two major algorithms are widely used statistical parametric mapping (SPM) and three-dimensional stereotactic surface projections (3D-SSP). The aim of this study is to compare an SPM algorithm-based easy Z score imaging system (eZIS) and a 3D-SSP system in the errors of anatomical standardization using 3D-digital brain phantom images. We developed a 3D-brain digital phantom based on MR images to simulate the effects of head tilt, perfusion defective region size, and count value reduction rate on the SPECT images. This digital phantom was used to compare the errors of anatomical standardization by the eZIS and the 3D-SSP algorithms. While the eZIS allowed accurate standardization of the images of the phantom simulating a head in rotation, lateroflexion, anteflexion, or retroflexion without angle dependency, the standardization by 3D-SSP was not accurate enough at approximately 25° or more head tilt. When the simulated head contained perfusion defective regions, one of the 3D-SSP images showed an error of 6.9% from the true value. Meanwhile, one of the eZIS images showed an error as large as 63.4%, revealing a significant underestimation. When required to evaluate regions with decreased perfusion due to such causes as hemodynamic cerebral ischemia, the 3D-SSP is desirable. In a statistical image analysis, we must reconfirm the image after anatomical standardization by all means.

Using 3D Printing to Create Personalized Brain Models for Neurosurgical Training and Preoperative Planning.

PubMed

Ploch, Caitlin C; Mansi, Chris S S A; Jayamohan, Jayaratnam; Kuhl, Ellen

2016-06-01

Three-dimensional (3D) printing holds promise for a wide variety of biomedical applications, from surgical planning, practicing, and teaching to creating implantable devices. The growth of this cheap and easy additive manufacturing technology in orthopedic, plastic, and vascular surgery has been explosive; however, its potential in the field of neurosurgery remains underexplored. A major limitation is that current technologies are unable to directly print ultrasoft materials like human brain tissue. In this technical note, the authors present a new technology to create deformable, personalized models of the human brain. The method combines 3D printing, molding, and casting to create a physiologically, anatomically, and tactilely realistic model based on magnetic resonance images. Created from soft gelatin, the model is easy to produce, cost-efficient, durable, and orders of magnitude softer than conventionally printed 3D models. The personalized brain model cost $50, and its fabrication took 24 hours. In mechanical tests, the model stiffness (E = 25.29 ± 2.68 kPa) was 5 orders of magnitude softer than common 3D printed materials, and less than an order of magnitude stiffer than mammalian brain tissue (E = 2.64 ± 0.40 kPa). In a multicenter surgical survey, model size (100.00%), visual appearance (83.33%), and surgical anatomy (81.25%) were perceived as very realistic. The model was perceived as very useful for patient illustration (85.00%), teaching (94.44%), learning (100.00%), surgical training (95.00%), and preoperative planning (95.00%). With minor refinements, personalized, deformable brain models created via 3D printing will improve surgical training and preoperative planning with the ultimate goal to provide accurate, customized, high-precision treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

A three-dimensional axis for the study of femoral neck orientation

PubMed Central

Bonneau, Noémie; Libourel, Paul-Antoine; Simonis, Caroline; Puymerail, Laurent; Baylac, Michel; Tardieu, Christine; Gagey, Olivier

2012-01-01

A common problem in the quantification of the orientation of the femoral neck is the difficulty to determine its true axis; however, this axis is typically estimated visually only. Moreover, the orientation of the femoral neck is commonly analysed using angles that are dependent on anatomical planes of reference and only quantify the orientation in two dimensions. The purpose of this study is to establish a method to determine the three-dimensional orientation of the femoral neck using a three-dimensional model. An accurate determination of the femoral neck axis requires a reconsideration of the complex architecture of the proximal femur. The morphology of the femoral neck results from both the medial and arcuate trabecular systems, and the asymmetry of the cortical bone. Given these considerations, two alternative models, in addition to the cylindrical one frequently assumed, were tested. The surface geometry of the femoral neck was subsequently used to fit one cylinder, two cylinders and successive cross-sectional ellipses. The model based on successive ellipses provided a significantly smaller average deviation than the two other models (P < 0.001) and reduced the observer-induced measurement error. Comparisons with traditional measurements and analyses on a sample of 91 femora were also performed to assess the validity of the model based on successive ellipses. This study provides a semi-automatic and accurate method for the determination of the functional three-dimensional femoral neck orientation avoiding the use of a reference plane. This innovative method has important implications for future studies that aim to document and understand the change in the orientation of the femoral neck associated with the acquisition of a bipedal gait in humans. Moreover, the precise determination of the three-dimensional orientation has implications in current research involved in developing clinical applications in diagnosis, hip surgery and rehabilitation. PMID:22967192

Integration of genomic and medical data into a 3D atlas of human anatomy.

PubMed

Turinsky, Andrei L; Fanea, Elena; Trinh, Quang; Dong, Xiaoli; Stromer, Julie N; Shu, Xueling; Wat, Stephen; Hallgrímsson, Benedikt; Hill, Jonathan W; Edwards, Carol; Grosenick, Brenda; Yajima, Masumi; Sensen, Christoph W

2008-01-01

We have developed a framework for the visual integration and exploration of multi-scale biomedical data, which includes anatomical and molecular components. We have also created a Java-based software system that integrates molecular information, such as gene expression data, into a three-dimensional digital atlas of the male adult human anatomy. Our atlas is structured according to the Terminologia Anatomica. The underlying data-indexing mechanism uses open standards and semantic ontology-processing tools to establish the associations between heterogeneous data types. The software system makes an extensive use of virtual reality visualization.

Optical monitoring of scoliosis by 3D medical laser scanner

NASA Astrophysics Data System (ADS)

Rodríguez-Quiñonez, Julio C.; Sergiyenko, Oleg Yu.; Preciado, Luis C. Basaca; Tyrsa, Vera V.; Gurko, Alexander G.; Podrygalo, Mikhail A.; Lopez, Moises Rivas; Balbuena, Daniel Hernandez

2014-03-01

Three dimensional recording of the human body surface or anatomical areas have gained importance in many medical applications. In this paper, our 3D Medical Laser Scanner is presented. It is based on the novel principle of dynamic triangulation. We analyze the method of operation, medical applications, orthopedically diseases as Scoliosis and the most common types of skin to employ the system the most proper way. It is analyzed a group of medical problems related to the application of optical scanning in optimal way. Finally, experiments are conducted to verify the performance of the proposed system and its method uncertainty.

Software for project-based learning of robot motion planning

NASA Astrophysics Data System (ADS)

Moll, Mark; Bordeaux, Janice; Kavraki, Lydia E.

2013-12-01

Motion planning is a core problem in robotics concerned with finding feasible paths for a given robot. Motion planning algorithms perform a search in the high-dimensional continuous space of robot configurations and exemplify many of the core algorithmic concepts of search algorithms and associated data structures. Motion planning algorithms can be explained in a simplified two-dimensional setting, but this masks many of the subtleties and complexities of the underlying problem. We have developed software for project-based learning of motion planning that enables deep learning. The projects that we have developed allow advanced undergraduate students and graduate students to reflect on the performance of existing textbook algorithms and their own variations on such algorithms. Formative assessment has been conducted at three institutions. The core of the software used for this teaching module is also used within the Robot Operating System, a widely adopted platform by the robotics research community. This allows for transfer of knowledge and skills to robotics research projects involving a large variety robot hardware platforms.

Relationship between Lateral Femoral Bowing and Varus Knee Deformity Based on Two-Dimensional Assessment of Side-to-Side Differences.

PubMed

Cho, Myung-Rae; Lee, Young Sik; Choi, Won-Kee

2018-03-01

The objective was to evaluate the relationship between side-to-side differences of lateral femoral bowing and varus knee deformity based on two-dimensional (2D) assessment in unilateral total knee arthroplasty (TKA). A total of 143 patients with varus knee osteoarthritis who underwent unilateral TKA were enrolled. We evaluated the side-to-side differences of the frontal lower limb alignment by assessing lateral femoral bowing, anatomical medial distal femoral angle, and anatomical medial proximal tibial angle (aMPTA). The average values of all anatomical indices were significantly different between the operated side and the non-operated side (p＜0.05). The side-to-side difference in hip knee ankle (HKA) angle had a statistically significant correlation with that in lateral femoral bowing (intraclass correlation coefficient, 0.259; p=0.002) and that in aMPTA. Linear regression analysis showed 0.199° of side-to-side difference in lateral femoral bowing was associated with 1° of side-to-side difference in bilateral HKA angle. The side-to-side difference in lateral femoral bowing showed a tendency to increase in proportion to varus knee deformity based on 2D assessment in unilateral TKA patients.

Automatic learning-based beam angle selection for thoracic IMRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amit, Guy; Marshall, Andrea; Purdie, Thomas G., E-mail: tom.purdie@rmp.uhn.ca

Purpose: The treatment of thoracic cancer using external beam radiation requires an optimal selection of the radiation beam directions to ensure effective coverage of the target volume and to avoid unnecessary treatment of normal healthy tissues. Intensity modulated radiation therapy (IMRT) planning is a lengthy process, which requires the planner to iterate between choosing beam angles, specifying dose–volume objectives and executing IMRT optimization. In thorax treatment planning, where there are no class solutions for beam placement, beam angle selection is performed manually, based on the planner’s clinical experience. The purpose of this work is to propose and study a computationallymore » efficient framework that utilizes machine learning to automatically select treatment beam angles. Such a framework may be helpful for reducing the overall planning workload. Methods: The authors introduce an automated beam selection method, based on learning the relationships between beam angles and anatomical features. Using a large set of clinically approved IMRT plans, a random forest regression algorithm is trained to map a multitude of anatomical features into an individual beam score. An optimization scheme is then built to select and adjust the beam angles, considering the learned interbeam dependencies. The validity and quality of the automatically selected beams evaluated using the manually selected beams from the corresponding clinical plans as the ground truth. Results: The analysis included 149 clinically approved thoracic IMRT plans. For a randomly selected test subset of 27 plans, IMRT plans were generated using automatically selected beams and compared to the clinical plans. The comparison of the predicted and the clinical beam angles demonstrated a good average correspondence between the two (angular distance 16.8° ± 10°, correlation 0.75 ± 0.2). The dose distributions of the semiautomatic and clinical plans were equivalent in terms of primary target volume coverage and organ at risk sparing and were superior over plans produced with fixed sets of common beam angles. The great majority of the automatic plans (93%) were approved as clinically acceptable by three radiation therapy specialists. Conclusions: The results demonstrated the feasibility of utilizing a learning-based approach for automatic selection of beam angles in thoracic IMRT planning. The proposed method may assist in reducing the manual planning workload, while sustaining plan quality.« less

A surgical robot with augmented reality visualization for stereoelectroencephalography electrode implantation.

PubMed

Zeng, Bowei; Meng, Fanle; Ding, Hui; Wang, Guangzhi

2017-08-01

Using existing stereoelectroencephalography (SEEG) electrode implantation surgical robot systems, it is difficult to intuitively validate registration accuracy and display the electrode entry points (EPs) and the anatomical structure around the electrode trajectories in the patient space to the surgeon. This paper proposes a prototype system that can realize video see-through augmented reality (VAR) and spatial augmented reality (SAR) for SEEG implantation. The system helps the surgeon quickly and intuitively confirm the registration accuracy, locate EPs and visualize the internal anatomical structure in the image space and patient space. We designed and developed a projector-camera system (PCS) attached to the distal flange of a robot arm. First, system calibration is performed. Second, the PCS is used to obtain the point clouds of the surface of the patient's head, which are utilized for patient-to-image registration. Finally, VAR is produced by merging the real-time video of the patient and the preoperative three-dimensional (3D) operational planning model. In addition, SAR is implemented by projecting the planning electrode trajectories and local anatomical structure onto the patient's scalp. The error of registration, the electrode EPs and the target points are evaluated on a phantom. The fiducial registration error is [Formula: see text] mm (max 1.22 mm), and the target registration error is [Formula: see text] mm (max 1.18 mm). The projection overlay error is [Formula: see text] mm, and the TP error after the pre-warped projection is [Formula: see text] mm. The TP error caused by a surgeon's viewpoint deviation is also evaluated. The presented system can help surgeons quickly verify registration accuracy during SEEG procedures and can provide accurate EP locations and internal structural information to the surgeon. With more intuitive surgical information, the surgeon may have more confidence and be able to perform surgeries with better outcomes.

Modeling prostate anatomy from multiple view TRUS images for image-guided HIFU therapy.

PubMed

Penna, Michael A; Dines, Kris A; Seip, Ralf; Carlson, Roy F; Sanghvi, Narendra T

2007-01-01

Current planning methods for transrectal high-intensity focused ultrasound treatment of prostate cancer rely on manually defining treatment regions in 15-20 sector transrectal ultrasound (TRUS) images of the prostate. Although effective, it is desirable to reduce user interaction time by identifying functionally related anatomic structures (segmenting), then automatically laying out treatment sites using these structures as a guide. Accordingly, a method has been developed to effectively generate solid three-dimensional (3-D) models of the prostate, urethra, and rectal wall from boundary trace data. Modeling the urethra and rectal wall are straightforward, but modeling the prostate is more difficult and has received much attention in the literature. New results presented here are aimed at overcoming many of the limitations of previous approaches to modeling the prostate while using boundary traces obtained via manual tracing in as few as 5 sector and 3 linear images. The results presented here are based on a new type of surface, the Fourier ellipsoid, and the use of sector and linear TRUS images. Tissue-specific 3-D models will ultimately permit finer control of energy deposition and more selective destruction of cancerous regions while sparing critical neighboring structures.

Region based route planning - Multi-abstraction route planning based on intermediate level vision processing

NASA Technical Reports Server (NTRS)

Doshi, Rajkumar S.; Lam, Raymond; White, James E.

1989-01-01

Intermediate and high level processing operations are performed on vision data for the organization of images into more meaningful, higher-level topological representations by means of a region-based route planner (RBRP). The RBRP operates in terrain scenarios where some or most of the terrain is occluded, proceeding without a priori maps on the basis of two-dimensional representations and gradient-and-roughness information. Route planning is accomplished by three successive abstractions and yields a detailed point-by-point path by searching only within the boundaries of relatively small regions.

Corrective Osteotomy for Symptomatic Clavicle Malunion Using Patient-specific Osteotomy and Reduction Guides.

PubMed

Haefeli, Mathias; Schenkel, Matthias; Schumacher, Ralf; Eid, Karim

2017-09-01

Midshaft clavicular fractures are often treated nonoperatively with good reported clinical outcome in a majority of patients. However, malunion with shortening of the affected clavicle is not uncommon. Shortening of the clavicle has been shown to affect shoulder strength and kinematics with alteration of scapular position. Whereas the exact clinical impact of these factors is unknown, the deformity may lead to cosmetic and functional impairment as for example pain with weight-bearing on the shoulder girdle. Other reported complications of clavicular malunion include thoracic outlet syndrome, subclavicular vein thrombosis, and axillary plexus compression. Corrective osteotomy has therefore been recommended for symptomatic clavicular malunions, generally using plain x-rays for planning the necessary elongation. Particularly in malunited multifragmentary fractures it may be difficult to exactly determine the plane of osteotomy intraoperatively to restore the precise anatomic shape of the clavicle. We present a technique for corrective osteotomy using preoperative computer planning and 3-dimensional printed patient-specific intraoperative osteotomy and reduction guides based on the healthy contralateral clavicle.

Locoregional and Microvascular Free Tissue Reconstruction of the Lateral Skull Base.

PubMed

Arnaoutakis, Demetri; Kadakia, Sameep; Abraham, Manoj; Lee, Thomas; Ducic, Yadranko

2017-11-01

The goals of reconstruction following any oncologic extirpation are preservation of function, restoration of cosmesis, and avoidance of morbidity. Anatomically, the lateral skull base is complex and conceptually intricate due to its three-dimensional morphology. The temporal bone articulates with five other cranial bones and forms many sutures and foramina through which pass critical neural and vascular structures. Remnant defects following resection of lateral skull base tumors are often not amenable to primary closure. As such, numerous techniques have been described for reconstruction including local rotational muscle flaps, pedicled flaps with skin paddle, or free tissue transfer. In this review, the advantages and disadvantages of each reconstructive method will be discussed as well as their potential complications.

Virtual temporal bone: an interactive 3-dimensional learning aid for cranial base surgery.

PubMed

Kockro, Ralf A; Hwang, Peter Y K

2009-05-01

We have developed an interactive virtual model of the temporal bone for the training and teaching of cranial base surgery. The virtual model was based on the tomographic data of the Visible Human Project. The male Visible Human's computed tomographic data were volumetrically reconstructed as virtual bone tissue, and the individual photographic slices provided the basis for segmentation of the middle and inner ear structures, cranial nerves, vessels, and brainstem. These structures were created by using outlining and tube editing tools, allowing structural modeling either directly on the basis of the photographic data or according to information from textbooks and cadaver dissections. For training and teaching, the virtual model was accessed in the previously described 3-dimensional workspaces of the Dextroscope or Dextrobeam (Volume Interactions Pte, Ltd., Singapore), whose interfaces enable volumetric exploration from any perspective and provide virtual tools for drilling and measuring. We have simulated several cranial base procedures including approaches via the floor of the middle fossa and the lateral petrous bone. The virtual model suitably illustrated the core facts of anatomic spatial relationships while simulating different stages of bone drilling along a variety of surgical corridors. The system was used for teaching during training courses to plan and discuss operative anatomy and strategies. The Virtual Temporal Bone and its surrounding 3-dimensional workspace provide an effective way to study the essential surgical anatomy of this complex region and to teach and train operative strategies, especially when used as an adjunct to cadaver dissections.

SU-E-J-127: Real-Time Dosimetric Assessment for Adaptive Head-And-Neck Treatment Via A GPU-Based Deformable Image Registration Framework

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qi, S; Neylon, J; Chen, A

2014-06-01

Purposes: To systematically monitor anatomic variations and their dosimetric consequences during head-and-neck (H'N) radiation therapy using a GPU-based deformable image registration (DIR) framework. Methods: Eleven H'N IMRT patients comprised the subject population. The daily megavoltage CT and weekly kVCT scans were acquired for each patient. The pre-treatment CTs were automatically registered with their corresponding planning CT through an in-house GPU-based DIR framework. The deformation of each contoured structure was computed to account for non-rigid change in the patient setup. The Jacobian determinant for the PTVs and critical structures was used to quantify anatomical volume changes. Dose accumulation was performed tomore » determine the actual delivered dose and dose accumulation. A landmark tool was developed to determine the uncertainty in the dose distribution due to registration error. Results: Dramatic interfraction anatomic changes leading to dosimetric variations were observed. During the treatment courses of 6–7 weeks, the parotid gland volumes changed up to 34.7%, the center-of-mass displacement of the two parotids varied in the range of 0.9–8.8mm. Mean doses were within 5% and 3% of the planned mean doses for all PTVs and CTVs, respectively. The cumulative minimum/mean/EUD doses were lower than the planned doses by 18%, 2%, and 7%, respectively for the PTV1. The ratio of the averaged cumulative cord maximum doses to the plan was 1.06±0.15. The cumulative mean doses assessed by the weekly kVCTs were significantly higher than the planned dose for the left-parotid (p=0.03) and right-parotid gland (p=0.006). The computation time was nearly real-time (∼ 45 seconds) for registering each pre-treatment CT to the planning CT and dose accumulation with registration accuracy (for kVCT) at sub-voxel level (<1.5mm). Conclusions: Real-time assessment of anatomic and dosimetric variations is feasible using the GPU-based DIR framework. Clinical implementation of this technology may enable timely plan adaption and potentially lead to improved outcome.« less

Three-Dimensional Printing Surgical Applications

PubMed Central

Griffin, Michelle F.; Butler, Peter E.

2015-01-01

Introduction: Three-dimensional printing, a technology used for decades in the industrial field, gains a lot of attention in the medical field for its potential benefits. With advancement of desktop printers, this technology is accessible and a lot of research is going on in the medical field. Objective: To evaluate its application in surgical field, which may include but not limited to surgical planning, surgical education, implants, and prosthesis, which are the focus of this review. Methods: Research was conducted by searching PubMed, Web of science, and other reliable sources. We included original articles and excluded articles based on animals, those more than 10 years old, and those not in English. These articles were evaluated, and relevant studies were included in this review. Discussion: Three-dimensional printing shows a potential benefit in surgical application. Printed implants were used in patient in a few cases and show successful results; however, longer follow-up and more trials are needed. Surgical and medical education is believed to be more efficient with this technology than the current practice. Printed surgical instrument and surgical planning are also believed to improve with three-dimensional printing. Conclusion: Three-dimensional printing can be a very powerful tool in the near future, which can aid the medical field that is facing a lot of challenges and obstacles. However, despite the reported results, further research on larger samples and analytical measurements should be conducted to ensure this technology's impact on the practice. PMID:26301002

Three-dimensional printed trileaflet valve conduits using biological hydrogels and human valve interstitial cells.

PubMed

Duan, B; Kapetanovic, E; Hockaday, L A; Butcher, J T

2014-05-01

Tissue engineering has great potential to provide a functional de novo living valve replacement, capable of integration with host tissue and growth. Among various valve conduit fabrication techniques, three-dimensional (3-D) bioprinting enables deposition of cells and hydrogels into 3-D constructs with anatomical geometry and heterogeneous mechanical properties. Successful translation of this approach, however, is constrained by the dearth of printable and biocompatible hydrogel materials. Furthermore, it is not known how human valve cells respond to these printed environments. In this study, 3-D printable formulations of hybrid hydrogels are developed, based on methacrylated hyaluronic acid (Me-HA) and methacrylated gelatin (Me-Gel), and used to bioprint heart valve conduits containing encapsulated human aortic valvular interstitial cells (HAVIC). Increasing Me-Gel concentration resulted in lower stiffness and higher viscosity, facilitated cell spreading, and better maintained HAVIC fibroblastic phenotype. Bioprinting accuracy was dependent upon the relative concentrations of Me-Gel and Me-HA, but when optimized enabled the fabrication of a trileaflet valve shape accurate to the original design. HAVIC encapsulated within bioprinted heart valves maintained high viability, and remodeled the initial matrix by depositing collagen and glyosaminoglycans. These findings represent the first rational design of bioprinted trileaflet valve hydrogels that regulate encapsulated human VIC behavior. The use of anatomically accurate living valve scaffolds through bioprinting may accelerate understanding of physiological valve cell interactions and progress towards de novo living valve replacements. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Virtual reality in urban water management: communicating urban flooding with particle-based CFD simulations.

PubMed

Winkler, Daniel; Zischg, Jonatan; Rauch, Wolfgang

2018-01-01

For communicating urban flood risk to authorities and the public, a realistic three-dimensional visual display is frequently more suitable than detailed flood maps. Virtual reality could also serve to plan short-term flooding interventions. We introduce here an alternative approach for simulating three-dimensional flooding dynamics in large- and small-scale urban scenes by reaching out to computer graphics. This approach, denoted 'particle in cell', is a particle-based CFD method that is used to predict physically plausible results instead of accurate flow dynamics. We exemplify the approach for the real flooding event in July 2016 in Innsbruck.

Unsupervised definition of the tibia-femoral joint regions of the human knee and its applications to cartilage analysis

NASA Astrophysics Data System (ADS)

Tamez-Peña, José G.; Barbu-McInnis, Monica; Totterman, Saara

2006-03-01

Abnormal MR findings including cartilage defects, cartilage denuded areas, osteophytes, and bone marrow edema (BME) are used in staging and evaluating the degree of osteoarthritis (OA) in the knee. The locations of the abnormal findings have been correlated to the degree of pain and stiffness of the joint in the same location. The definition of the anatomic region in MR images is not always an objective task, due to the lack of clear anatomical features. This uncertainty causes variance in the location of the abnormality between readers and time points. Therefore, it is important to have a reproducible system to define the anatomic regions. This works present a computerized approach to define the different anatomic knee regions. The approach is based on an algorithm that uses unique features of the femur and its spatial relation in the extended knee. The femur features are found from three dimensional segmentation maps of the knee. From the segmentation maps, the algorithm automatically divides the femur cartilage into five anatomic regions: trochlea, medial weight bearing area, lateral weight bearing area, posterior medial femoral condyle, and posterior lateral femoral condyle. Furthermore, the algorithm automatically labels the medial and lateral tibia cartilage. The unsupervised definition of the knee regions allows a reproducible way to evaluate regional OA changes. This works will present the application of this automated algorithm for the regional analysis of the cartilage tissue.

The effect of dental artifacts, contrast media, and experience on interobserver contouring variations in head and neck anatomy.

PubMed

O'Daniel, Jennifer C; Rosenthal, David I; Garden, Adam S; Barker, Jerry L; Ahamad, Anesa; Ang, K Kian; Asper, Joshua A; Blanco, Angel I; de Crevoisier, Renaud; Holsinger, F Christopher; Patel, Chirag B; Schwartz, David L; Wang, He; Dong, Lei

2007-04-01

To investigate interobserver variability in the delineation of head-and-neck (H&N) anatomic structures on CT images, including the effects of image artifacts and observer experience. Nine observers (7 radiation oncologists, 1 surgeon, and 1 physician assistant) with varying levels of H&N delineation experience independently contoured H&N gross tumor volumes and critical structures on radiation therapy treatment planning CT images alongside reference diagnostic CT images for 4 patients with oropharynx cancer. Image artifacts from dental fillings partially obstructed 3 images. Differences in the structure volumes, center-of-volume positions, and boundary positions (1 SD) were measured. In-house software created three-dimensional overlap distributions, including all observers. The effects of dental artifacts and observer experience on contouring precision were investigated, and the need for contrast media was assessed. In the absence of artifacts, all 9 participants achieved reasonable precision (1 SD < or =3 mm all boundaries). The structures obscured by dental image artifacts had larger variations when measured by the 3 metrics (1 SD = 8 mm cranial/caudal boundary). Experience improved the interobserver consistency of contouring for structures obscured by artifacts (1 SD = 2 mm cranial/caudal boundary). Interobserver contouring variability for anatomic H&N structures, specifically oropharyngeal gross tumor volumes and parotid glands, was acceptable in the absence of artifacts. Dental artifacts increased the contouring variability, but experienced participants achieved reasonable precision even with artifacts present. With a staging contrast CT image as a reference, delineation on a noncontrast treatment planning CT image can achieve acceptable precision.

Techniques of stapler-based navigational thoracoscopic segmentectomy using virtual assisted lung mapping (VAL-MAP)

PubMed Central

Murayama, Tomonori; Nakajima, Jun

2016-01-01

Anatomical segmentectomies play an important role in oncological lung resection, particularly for ground-glass types of primary lung cancers. This operation can also be applied to metastatic lung tumors deep in the lung. Virtual assisted lung mapping (VAL-MAP) is a novel technique that allows for bronchoscopic multi-spot dye markings to provide “geometric information” to the lung surface, using three-dimensional virtual images. In addition to wedge resections, VAL-MAP has been found to be useful in thoracoscopic segmentectomies, particularly complex segmentectomies, such as combined subsegmentectomies or extended segmentectomies. There are five steps in VAL-MAP-assisted segmentectomies: (I) “standing” stitches along the resection lines; (II) cleaning hilar anatomy; (III) confirming hilar anatomy; (IV) going 1 cm deeper; (V) step-by-step stapling technique. Depending on the anatomy, segmentectomies can be classified into linear (lingular, S6, S2), V- or U-shaped (right S1, left S3, S2b + S3a), and three dimensional (S7, S8, S9, S10) segmentectomies. Particularly three dimensional segmentectomies are challenging in the complexity of stapling techniques. This review focuses on how VAL-MAP can be utilized in segmentectomy, and how this technique can assist the stapling process in even the most challenging ones. PMID:28066675

Bayesian reconstruction and use of anatomical a priori information for emission tomography

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bowsher, J.E.; Johnson, V.E.; Turkington, T.G.

1996-10-01

A Bayesian method is presented for simultaneously segmenting and reconstructing emission computed tomography (ECT) images and for incorporating high-resolution, anatomical information into those reconstructions. The anatomical information is often available from other imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI). The Bayesian procedure models the ECT radiopharmaceutical distribution as consisting of regions, such that radiopharmaceutical activity is similar throughout each region. It estimates the number of regions, the mean activity of each region, and the region classification and mean activity of each voxel. Anatomical information is incorporated by assigning higher prior probabilities to ECT segmentations inmore » which each ECT region stays within a single anatomical region. This approach is effective because anatomical tissue type often strongly influences radiopharmaceutical uptake. The Bayesian procedure is evaluated using physically acquired single-photon emission computed tomography (SPECT) projection data and MRI for the three-dimensional (3-D) Hoffman brain phantom. A clinically realistic count level is used. A cold lesion within the brain phantom is created during the SPECT scan but not during the MRI to demonstrate that the estimation procedure can detect ECT structure that is not present anatomically.« less

Three-dimensional study of pelvic asymmetry on anatomical specimens and its clinical perspectives.

PubMed

Boulay, Christophe; Tardieu, Christine; Bénaim, Charles; Hecquet, Jérome; Marty, Catherine; Prat-Pradal, Dominique; Legaye, Jean; Duval-Beaupère, Ginette; Pélissier, Jacques

2006-01-01

The aim of this study was to assess pelvic asymmetry (i.e. to determine whether the right iliac bone and the right part of the sacrum are mirror images of the left), both quantitatively and qualitatively, using three-dimensional measurements. Pelvic symmetry was described osteologically using a common reference coordinate system for a large sample of pelvises. Landmarks were established on 12 anatomical specimens with an electromagnetic Fastrak system. Seventy-one paired variables were tested with a paired t-test and a non-parametric test (Wilcoxon). A Pearson correlation matrix between the right and left values of the same variable was applied exclusively to values that were significantly asymmetric in order to calculate a dimensionless asymmetry index, ABGi, for each variable. Fifteen variables were significantly asymmetric and correlated with the right vs. left sides for the following anatomical regions: sacrum, iliac blades, iliac width, acetabulum and the superior lunate surface of the acetabulum. ABGi values above a threshold of +/- 4.8% were considered significantly asymmetric in seven variables of the pelvic area. Total asymmetry involving the right and the left pelvis seems to follow a spiral path in the pelvis; in the upper part, the iliac blades rotate clockwise, and in the lower part, the pubic symphysis rotates anticlockwise. Thus, pelvic asymmetry may be evaluated in clinical examinations by measuring iliac crest orientation.

Three-dimensional study of pelvic asymmetry on anatomical specimens and its clinical perspectives

PubMed Central

Boulay, Christophe; Tardieu, Christine; Bénaim, Charles; Hecquet, Jérome; Marty, Catherine; Prat-Pradal, Dominique; Legaye, Jean; Duval-Beaupère, Ginette; Pélissier, Jacques

2006-01-01

The aim of this study was to assess pelvic asymmetry (i.e. to determine whether the right iliac bone and the right part of the sacrum are mirror images of the left), both quantitatively and qualitatively, using three-dimensional measurements. Pelvic symmetry was described osteologically using a common reference coordinate system for a large sample of pelvises. Landmarks were established on 12 anatomical specimens with an electromagnetic Fastrak system. Seventy-one paired variables were tested with a paired t-test and a non-parametric test (Wilcoxon). A Pearson correlation matrix between the right and left values of the same variable was applied exclusively to values that were significantly asymmetric in order to calculate a dimensionless asymmetry index, ABGi, for each variable. Fifteen variables were significantly asymmetric and correlated with the right vs. left sides for the following anatomical regions: sacrum, iliac blades, iliac width, acetabulum and the superior lunate surface of the acetabulum. ABGi values above a threshold of ± 4.8% were considered significantly asymmetric in seven variables of the pelvic area. Total asymmetry involving the right and the left pelvis seems to follow a spiral path in the pelvis; in the upper part, the iliac blades rotate clockwise, and in the lower part, the pubic symphysis rotates anticlockwise. Thus, pelvic asymmetry may be evaluated in clinical examinations by measuring iliac crest orientation. PMID:16420376

Three-dimensional hard and soft tissue imaging of the human cochlea by scanning laser optical tomography (SLOT)

PubMed Central

Mohebbi, Saleh; Andrade, José; Nolte, Lena; Meyer, Heiko; Heisterkamp, Alexander; Majdani, Omid

2017-01-01

The present study focuses on the application of scanning laser optical tomography (SLOT) for visualization of anatomical structures inside the human cochlea ex vivo. SLOT is a laser-based highly efficient microscopy technique which allows for tomographic imaging of the internal structure of transparent specimens. Thus, in the field of otology this technique is best convenient for an ex vivo study of the inner ear anatomy. For this purpose, the preparation before imaging comprises decalcification, dehydration as well as optical clearing of the cochlea samples in toto. Here, we demonstrate results of SLOT imaging visualizing hard and soft tissue structures with an optical resolution of down to 15 μm using extinction and autofluorescence as contrast mechanisms. Furthermore, the internal structure can be analyzed nondestructively and quantitatively in detail by sectioning of the three-dimensional datasets. The method of X-ray Micro Computed Tomography (μCT) has been previously applied to explanted cochlea and is solely based on absorption contrast. An advantage of SLOT is that it uses visible light for image formation and thus provides a variety of contrast mechanisms known from other light microscopy techniques, such as fluorescence or scattering. We show that SLOT data is consistent with μCT anatomical data and provides additional information by using fluorescence. We demonstrate that SLOT is applicable for cochlea with metallic cochlear implants (CI) that would lead to significant artifacts in μCT imaging. In conclusion, the present study demonstrates the capability of SLOT for resolution visualization of cleared human cochleae ex vivo using multiple contrast mechanisms and lays the foundation for a broad variety of additional studies. PMID:28873437

Factors Influencing Undergraduate Students' Acceptance of a Haptic Interface for Learning Gross Anatomy

ERIC Educational Resources Information Center

Yeom, Soonja; Choi-Lundberg, Derek L.; Fluck, Andrew Edward; Sale, Arthur

2017-01-01

Purpose: This study aims to evaluate factors influencing undergraduate students' acceptance of a computer-aided learning resource using the Phantom Omni haptic stylus to enable rotation, touch and kinaesthetic feedback and display of names of three-dimensional (3D) human anatomical structures on a visual display. Design/methodology/approach: The…

How Spatial Abilities and Dynamic Visualizations Interplay When Learning Functional Anatomy with 3D Anatomical Models

ERIC Educational Resources Information Center

Berney, Sandra; Bétrancourt, Mireille; Molinari, Gaëlle; Hoyek, Nady

2015-01-01

The emergence of dynamic visualizations of three-dimensional (3D) models in anatomy curricula may be an adequate solution for spatial difficulties encountered with traditional static learning, as they provide direct visualization of change throughout the viewpoints. However, little research has explored the interplay between learning material…

Development of an Interactive Anatomical Three-Dimensional Eye Model

ERIC Educational Resources Information Center

Allen, Lauren K.; Bhattacharyya, Siddhartha; Wilson, Timothy D.

2015-01-01

The discrete anatomy of the eye's intricate oculomotor system is conceptually difficult for novice students to grasp. This is problematic given that this group of muscles represents one of the most common sites of clinical intervention in the treatment of ocular motility disorders and other eye disorders. This project was designed to develop a…

[Neurosurgical planning using osirix software].

PubMed

Jaimovich, Sebastián Gastón; Guevara, Martin; Pampin, Sergio; Jaimovich, Roberto; Gardella, Javier Luis

2014-01-01

Anatomical individuality is key to reduce surgical trauma and obtain a better outcome. Nowadays, the advances in neuroimaging has allowed us to analyze this anatomical individuality and to plan the surgery. With this objective, we present our experience with the OsiriX software. We present three different applications as example of forty procedures performed. Case 1: Patient with a premotor cortex convexity parasagittal meningioma; Case 2: Patient with a nonfunctioning pituitary macroadenoma operated on 2 years ago in another institution, achieving a partial resection by a transsphenoidal approach; Case 3: Patient with bilateral middle cerebellar peduncles lesions. OsiriX Software was used for surgical planning. Volumetric CT and MRI images were fused and 3D reconstruction images obtained, to analyze anatomical relationships, measure distances, coordinates and trajectories, among other features. OsiriX software is a useful, open-source and free software tool that provides the surgeon with valuable information. It allows to study individual patient's anatomy and plan a surgical approach in a fast, simple, inexpensive and safety way. In Case 1 the software let us analyze the relationship of the tumor with the surrounding structures in order to minimize the approach's morbidity. In Case 2, to understand the unique anatomic characteristics of an already operated patient giving us important information regarding pathways and need for extra bone removal, achieving a complete tumor resection by an endoscopic transnasal approach. In Case 3, allowed us to obtain the stereotactic coordinates and trajectory for a not visualizable CT scan lesion. When expensive neuronavigation systems are not available, OsiriX is an alternative for neurosurgical planning, with the aim of reducing trauma and surgical morbidity.

Deformable Dose Reconstruction to Optimize the Planning and Delivery of Liver Cancer Radiotherapy

NASA Astrophysics Data System (ADS)

Velec, Michael

The precise delivery of radiation to liver cancer patients results in improved control with higher tumor doses and minimized normal tissues doses. A margin of normal tissue around the tumor requires irradiation however to account for treatment delivery uncertainties. Daily image-guidance allows targeting of the liver, a surrogate for the tumor, to reduce geometric errors. However poor direct tumor visualization, anatomical deformation and breathing motion introduce uncertainties between the planned dose, calculated on a single pre-treatment computed tomography image, and the dose that is delivered. A novel deformable image registration algorithm based on tissue biomechanics was applied to previous liver cancer patients to track targets and surrounding organs during radiotherapy. Modeling these daily anatomic variations permitted dose accumulation, thereby improving calculations of the delivered doses. The accuracy of the algorithm to track dose was validated using imaging from a deformable, 3-dimensional dosimeter able to optically track absorbed dose. Reconstructing the delivered dose revealed that 70% of patients had substantial deviations from the initial planned dose. An alternative image-guidance technique using respiratory-correlated imaging was simulated, which reduced both the residual tumor targeting errors and the magnitude of the delivered dose deviations. A planning and delivery strategy for liver radiotherapy was then developed that minimizes the impact of breathing motion, and applied a margin to account for the impact of liver deformation during treatment. This margin is 38% smaller on average than the margin used clinically, and permitted an average dose-escalation to liver tumors of 9% for the same risk of toxicity. Simulating the delivered dose with deformable dose reconstruction demonstrated the plans with smaller margins were robust as 90% of patients' tumors received the intended dose. This strategy can be readily implemented with widely available technologies and thus can potentially improve local control for liver cancer patients receiving radiotherapy.

[Mathematical model of oblique three-dimensional intertrochanteric detorsion varus-forming osteotomy of the femur by the Bernbeck method in surgical treatment of congenital hip dysplasia in children].

PubMed

Bohatyrewicz, A

1992-01-01

Whenever the conservative procedure fails to bring about congruence of the dysplastic hip joint, an operative procedure becomes indispensable. In Orthopaedic Clinic of the Pomeranian Medical Academy in Szczecin we implement the oblique three-dimensional intertrochanteric detorsion and varus forming osteotomy after Bernbeck in order to correct the proximal end of the femoral bone. Precise determination of the plane to be cut, prior to the operative procedure, simplifies and shortens the operation itself and facilitates the achieving of the planned angular values in all three planes. Mathematical model of osteotomy according to Bernbeck considering required angles of correction as well as angles determining the plane of osteotomy was worked out. In collaboration of the Szczecin Technical University, a simple computer program was elaborated which allowed the presentation of the results in the form of tables. With the help of tables the optimal cutting plane was chosen and created correct biomechanical and anatomical conditions as well as optimal conditions for stable osteosynthesis of dissected fragments of the femoral bone. That type of osteotomy is useful in most operative correcrions of the dysplastic hip joint (not great varus formation connected with relatively extensive detorsion). The achieved congruence in the 22 dysplastic hip joints operated on was the most important condition for their later physiological development. Short post-operative observations confirm the value of described mathematic model.

Usefulness of Three-Dimensional Modeling in Surgical Planning, Resident Training, and Patient Education.

PubMed

Andolfi, Ciro; Plana, Alejandro; Kania, Patrick; Banerjee, P Pat; Small, Stephen

2017-05-01

Imaging has a critical impact on surgical decision making and three-dimensional (3D) digital models of patient pathology can now be made commercially. We developed a 3D digital model of a cancer of the head of the pancreas by integrating actual CT data with 3D modeling process. After this process, the virtual pancreatic model was also produced using a high-quality 3D printer. A 56-year-old female with pancreatic head adenocarcinoma presented with biliary obstruction and jaundice. The CT scan showed a borderline resectable tumor with a clear involvement of the gastroduodenal artery but doubtful relationships with the hepatic artery. Our team in collaboration with the Immersive Touch team used multiple series from the CT and segmented the relevant anatomy to understand the physical location of the tumor. An STL file was then developed and printed. Reconstructing and compositing the different series together enhanced the imaging, which allowed clearer observations of the relationship between the mass and the blood vessels, and evidence that the tumor was unresectable. Data files were converted for printing a 100% size rendering model, used for didactic purposes and to discuss with the patient. This study showed that (1) reconstructing enhanced traditional imaging by merging and modeling different series together for a 3D view with diverse angles and transparency, allowing the observation of previously unapparent anatomical details; (2) with this new technology surgeons and residents can preobserve their planned surgical intervention, explore the patient-specific anatomy, and sharpen their procedure choices; (3) high-quality 3D printed models are increasingly useful not only in the clinical realm but also for personalized patient education.

Scapular flap for maxillectomy defect reconstruction and preliminary results using three-dimensional modeling.

PubMed

Modest, Mara C; Moore, Eric J; Abel, Kathryn M Van; Janus, Jeffrey R; Sims, John R; Price, Daniel L; Olsen, Kerry D

2017-01-01

Discuss current techniques utilizing the scapular tip and subscapular system for free tissue reconstruction of maxillary defects and highlight the impact of medical modeling on these techniques with a case series. Case review series at an academic hospital of patients undergoing maxillectomy + thoracodorsal scapula composite free flap (TSCF) reconstruction. Three-dimensional (3D) models were used in the last five cases. 3D modeling, surgical, functional, and aesthetic outcomes were reviewed. Nine patients underwent TSCF reconstruction for maxillectomy defects (median age = 43 years; range, 19-66 years). Five patients (55%) had a total maxillectomy (TM) ± orbital exenteration, whereas four patients (44%) underwent subtotal palatal maxillectomy. For TM, the contralateral scapula tip was positioned with its natural concavity recreating facial contour. The laterally based vascular pedicle was ideally positioned for facial vessel anastomosis. For subtotal-palatal defect, an ipsilateral flap was harvested, but inset with the convex surface facing superiorly. Once 3D models were available from our anatomic modeling lab, they were used for intraoperative planning of the last five patients. Use of the model intraoperatively improved efficiency and allowed for better contouring/plating of the TSCF. At last follow-up, all patients had good functional outcomes. Aesthetic outcomes were more successful in patients where 3D-modeling was used (100% vs. 50%). There were no flap failures. Median follow-up >1 month was 5.2 months (range, 1-32.7 months). Reconstruction of maxillectomy defects is complex. Successful aesthetic and functional outcomes are critical to patient satisfaction. The TSCF is a versatile flap. Based on defect type, choosing laterality is crucial for proper vessel orientation and outcomes. The use of internally produced 3D models has helped refine intraoperative contouring and flap inset, leading to more successful outcomes. 4. Laryngoscope, 127:E8-E14, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Preoperative (3-dimensional) computed tomography lung reconstruction before anatomic segmentectomy or lobectomy for stage I non-small cell lung cancer.

PubMed

Chan, Ernest G; Landreneau, James R; Schuchert, Matthew J; Odell, David D; Gu, Suicheng; Pu, Jiantao; Luketich, James D; Landreneau, Rodney J

2015-09-01

Accurate cancer localization and negative resection margins are necessary for successful segmentectomy. In this study, we evaluate a newly developed software package that permits automated segmentation of the pulmonary parenchyma, allowing 3-dimensional assessment of tumor size, location, and estimates of surgical margins. A pilot study using a newly developed 3-dimensional computed tomography analytic software package was performed to retrospectively evaluate preoperative computed tomography images of patients who underwent segmentectomy (n = 36) or lobectomy (n = 15) for stage 1 non-small cell lung cancer. The software accomplishes an automated reconstruction of anatomic pulmonary segments of the lung based on bronchial arborization. Estimates of anticipated surgical margins and pulmonary segmental volume were made on the basis of 3-dimensional reconstruction. Autosegmentation was achieved in 72.7% (32/44) of preoperative computed tomography images with slice thicknesses of 3 mm or less. Reasons for segmentation failure included local severe emphysema or pneumonitis, and lower computed tomography resolution. Tumor segmental localization was achieved in all autosegmented studies. The 3-dimensional computed tomography analysis provided a positive predictive value of 87% in predicting a marginal clearance greater than 1 cm and a 75% positive predictive value in predicting a margin to tumor diameter ratio greater than 1 in relation to the surgical pathology assessment. This preoperative 3-dimensional computed tomography analysis of segmental anatomy can confirm the tumor location within an anatomic segment and aid in predicting surgical margins. This 3-dimensional computed tomography information may assist in the preoperative assessment regarding the suitability of segmentectomy for peripheral lung cancers. Published by Elsevier Inc.

Applications of Three-Dimensional Printing in Surgery.

PubMed

Li, Chi; Cheung, Tsz Fung; Fan, Vei Chen; Sin, Kin Man; Wong, Chrisity Wai Yan; Leung, Gilberto Ka Kit

2017-02-01

Three-dimensional (3D) printing is a rapidly advancing technology in the field of surgery. This article reviews its contemporary applications in 3 aspects of surgery, namely, surgical planning, implants and prostheses, and education and training. Three-dimensional printing technology can contribute to surgical planning by depicting precise personalized anatomy and thus a potential improvement in surgical outcome. For implants and prosthesis, the technology might overcome the limitations of conventional methods such as visual discrepancy from the recipient's body and unmatching anatomy. In addition, 3D printing technology could be integrated into medical school curriculum, supplementing the conventional cadaver-based education and training in anatomy and surgery. Future potential applications of 3D printing in surgery, mainly in the areas of skin, nerve, and vascular graft preparation as well as ear reconstruction, are also discussed. Numerous trials and studies are still ongoing. However, scientists and clinicians are still encountering some limitations of the technology including high cost, long processing time, unsatisfactory mechanical properties, and suboptimal accuracy. These limitations might potentially hamper the applications of this technology in daily clinical practice.

4D BADA-based Trajectory Generator and 3D Guidance Algorithm

NASA Technical Reports Server (NTRS)

Palacios, Eduardo Sepulveda; Johnson, Marcus A.

2013-01-01

This paper presents a hybrid integration between aerodynamic, airline procedures and other BADA-based (Base of Aircraft Data) coefficients with a classical aircraft dynamic model. This paper also describes a three-dimensional guidance algorithm implemented in order to produce commands for the aircraft to follow a flight plan. The software chosen for this work is MATLAB.

In vivo study of the surgical anatomy of the axilla.

PubMed

Khan, A; Chakravorty, A; Gui, G P H

2012-06-01

Classical anatomical descriptions fail to describe variants often observed in the axilla as they are based on studies that looked at individual structures in isolation or textbooks of cadaveric dissections. The presence of variant anatomy heightens the risk of iatrogenic injury. The aim of this study was to document the nature and frequency of these anatomical variations based on in vivo peroperative surgical observations. Detailed anatomical relationships were documented prospectively during consecutive axillary dissections. Relationships between the thoracodorsal pedicle, course of the lateral thoracic vein, presence of latissimus dorsi muscle slips, variations in axillary and angular vein anatomy, and origins and branching of the intercostobrachial nerve were recorded. Among a total of 73 axillary dissections, 43 (59 per cent) revealed at least one anatomical variant. Most notable variants included aberrant courses of the thoracodorsal nerve in ten patients (14 per cent)--three variants; lateral thoracic vein in 12 patients (16 per cent)--four variants; bifid axillary veins in ten patients (14 per cent); latissimus dorsi muscle slips in four patients (5 per cent); and variants in intercostobrachial nerve origins and branching in 26 patients (36 per cent). The angular vein, a subscapular vein tributary, was found to be a constant axillary structure. Variations in axillary anatomical structures are common. Poor understanding of these variants can affect the adequacy of oncological clearance, lead to vascular injury, compromise planned microvascular procedures and result in chronic pain or numbness from nerve injury. Surgeons should be aware of the common anatomical variants to facilitate efficient and safe axillary surgery. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Three-dimensional modeling of flexible pavements : research implementation plan.

DOT National Transportation Integrated Search

2006-02-14

Many of the asphalt pavement analysis programs are based on linear elastic models. A linear viscoelastic models : would be superior to linear elastic models for analyzing the response of asphalt concrete pavements to loads. There : is a need to devel...

Diffusion spectral imaging modules correlate with EEG LORETA neuroimaging modules.

PubMed

Thatcher, Robert W; North, Duane M; Biver, Carl J

2012-05-01

The purpose of this study was to test the hypothesis that the highest temporal correlations between 3-dimensional EEG current source density corresponds to anatomical Modules of high synaptic connectivity. Eyes closed and eyes open EEG was recorded from 19 scalp locations with a linked ears reference from 71 subjects age 13-42 years. LORETA was computed from 1 to 30 Hz in 2,394 cortical gray matter voxels that were grouped into six anatomical Modules corresponding to the ROIs in the Hagmann et al.'s [2008] diffusion spectral imaging (DSI) study. All possible cross-correlations between voxels within a DSI Module were compared with the correlations between Modules. The Hagmann et al. [ 2008] Module correlation structure was replicated in the correlation structure of EEG three-dimensional current source density. EEG Temporal correlation between brain regions is related to synaptic density as measured by diffusion spectral imaging. Copyright © 2011 Wiley-Liss, Inc.

Stemless shoulder arthroplasty: a literature review

PubMed Central

PETRICCIOLI, DARIO; BERTONE, CELESTE; MARCHI, GIACOMO

2015-01-01

The design of humeral implants for shoulder arthroplasty has evolved over the years. The new-generation modular shoulder prostheses have an anatomical humeral stem that replicates the three-dimensional parameters of the proximal humerus. An anatomical reconstruction is the best way to restore stability and mobility of the prosthetic shoulder and improve implant durability. However, a perfect anatomical match is not always possible in, for example, patients with post-traumatic osteoarthritis of the shoulder and deformities in the metaphyseal region. To avoid stem-related complications while retaining the advantages of the fourth generation of shoulder implants, different stemless implants have been developed. The stemless shoulder prosthesis is a new concept in shoulder arthroplasty. The authors review the indications, surgical technique, clinical and radiological midterm results, and complications of these humeral implants. PMID:26151038

Novel Three-Dimensional Image Fusion Software to Facilitate Guidance of Complex Cardiac Catheterization : 3D image fusion for interventions in CHD.

PubMed

Goreczny, Sebastian; Dryzek, Pawel; Morgan, Gareth J; Lukaszewski, Maciej; Moll, Jadwiga A; Moszura, Tomasz

2017-08-01

We report initial experience with novel three-dimensional (3D) image fusion software for guidance of transcatheter interventions in congenital heart disease. Developments in fusion imaging have facilitated the integration of 3D roadmaps from computed tomography or magnetic resonance imaging datasets. The latest software allows live fusion of two-dimensional (2D) fluoroscopy with pre-registered 3D roadmaps. We reviewed all cardiac catheterizations guided with this software (Philips VesselNavigator). Pre-catheterization imaging and catheterization data were collected focusing on fusion of 3D roadmap, intervention guidance, contrast and radiation exposure. From 09/2015 until 06/2016, VesselNavigator was applied in 34 patients for guidance (n = 28) or planning (n = 6) of cardiac catheterization. In all 28 patients successful 2D-3D registration was performed. Bony structures combined with the cardiovascular silhouette were used for fusion in 26 patients (93%), calcifications in 9 (32%), previously implanted devices in 8 (29%) and low-volume contrast injection in 7 patients (25%). Accurate initial 3D roadmap alignment was achieved in 25 patients (89%). Six patients (22%) required realignment during the procedure due to distortion of the anatomy after introduction of stiff equipment. Overall, VesselNavigator was applied successfully in 27 patients (96%) without any complications related to 3D image overlay. VesselNavigator was useful in guidance of nearly all of cardiac catheterizations. The combination of anatomical markers and low-volume contrast injections allowed reliable 2D-3D registration in the vast majority of patients.

Two- versus three-dimensional imaging in subjects with unerupted maxillary canines.

PubMed

Botticelli, Susanna; Verna, Carlalberta; Cattaneo, Paolo M; Heidmann, Jens; Melsen, Birte

2011-08-01

The aim of this study was to evaluate whether there is any difference in the diagnostic information provided by conventional two-dimensional (2D) images or by three-dimensional (3D) cone beam computed tomography (CBCT) in subjects with unerupted maxillary canines. Twenty-seven patients (17 females and 10 males, mean age 11.8 years) undergoing orthodontic treatment with 39 impacted or retained maxillary canines were included. For each canine, two different digital image sets were obtained: (1) A 2D image set including a panoramic radiograph, a lateral cephalogram, and the available periapical radiographs with different projections and (2) A 3D image set obtained with CBCT. Both sets of images were submitted, in a single-blind randomized order, to eight dentists. A questionnaire was used to assess the position of the canine, the presence of root resorption, the difficulty of the case, treatment choice options, and the quality of the images. Data analysis was performed using the McNemar-Bowker test for paired data, Kappa statistics, and paired t-tests. The findings demonstrated a difference in the localization of the impacted canines between the two techniques, which can be explained by factors affecting the conventional 2D radiographs such as distortion, magnification, and superimposition of anatomical structures situated in different planes of space. The increased precision in the localization of the canines and the improved estimation of the space conditions in the arch obtained with CBCT resulted in a difference in diagnosis and treatment planning towards a more clinically orientated approach.

Cross-sectional anatomy, computed tomography and magnetic resonance imaging of the head of common dolphin (Delphinus delphis) and striped dolphin (Stenella coeruleoalba).

PubMed

Alonso-Farré, J M; Gonzalo-Orden, M; Barreiro-Vázquez, J D; Barreiro-Lois, A; André, M; Morell, M; Llarena-Reino, M; Monreal-Pawlowsky, T; Degollada, E

2015-02-01

Computed tomography (CT) and low-field magnetic resonance imaging (MRI) were used to scan seven by-caught dolphin cadavers, belonging to two species: four common dolphins (Delphinus delphis) and three striped dolphins (Stenella coeruleoalba). CT and MRI were obtained with the animals in ventral recumbency. After the imaging procedures, six dolphins were frozen at -20°C and sliced in the same position they were examined. Not only CT and MRI scans, but also cross sections of the heads were obtained in three body planes: transverse (slices of 1 cm thickness) in three dolphins, sagittal (5 cm thickness) in two dolphins and dorsal (5 cm thickness) in two dolphins. Relevant anatomical structures were identified and labelled on each cross section, obtaining a comprehensive bi-dimensional topographical anatomy guide of the main features of the common and the striped dolphin head. Furthermore, the anatomical cross sections were compared with their corresponding CT and MRI images, allowing an imaging identification of most of the anatomical features. CT scans produced an excellent definition of the bony and air-filled structures, while MRI allowed us to successfully identify most of the soft tissue structures in the dolphin's head. This paper provides a detailed anatomical description of the head structures of common and striped dolphins and compares anatomical cross sections with CT and MRI scans, becoming a reference guide for the interpretation of imaging studies. © 2014 Blackwell Verlag GmbH.

Trajectory Generation and Path Planning for Autonomous Aerobots

NASA Technical Reports Server (NTRS)

Sharma, Shivanjli; Kulczycki, Eric A.; Elfes, Alberto

2007-01-01

This paper presents global path planning algorithms for the Titan aerobot based on user defined waypoints in 2D and 3D space. The algorithms were implemented using information obtained through a planner user interface. The trajectory planning algorithms were designed to accurately represent the aerobot's characteristics, such as minimum turning radius. Additionally, trajectory planning techniques were implemented to allow for surveying of a planar area based solely on camera fields of view, airship altitude, and the location of the planar area's perimeter. The developed paths allow for planar navigation and three-dimensional path planning. These calculated trajectories are optimized to produce the shortest possible path while still remaining within realistic bounds of airship dynamics.

Three-dimensional printing: review of application in medicine and hepatic surgery.

PubMed

Yao, Rui; Xu, Gang; Mao, Shuang-Shuang; Yang, Hua-Yu; Sang, Xin-Ting; Sun, Wei; Mao, Yi-Lei

2016-12-01

Three-dimensional (3D) printing (3DP) is a rapid prototyping technology that has gained increasing recognition in many different fields. Inherent accuracy and low-cost property enable applicability of 3DP in many areas, such as manufacturing, aerospace, medical, and industrial design. Recently, 3DP has gained considerable attention in the medical field. The image data can be quickly turned into physical objects by using 3DP technology. These objects are being used across a variety of surgical specialties. The shortage of cadaver specimens is a major problem in medical education. However, this concern has been solved with the emergence of 3DP model. Custom-made items can be produced by using 3DP technology. This innovation allows 3DP use in preoperative planning and surgical training. Learning is difficult among medical students because of the complex anatomical structures of the liver. Thus, 3D visualization is a useful tool in anatomy teaching and hepatic surgical training. However, conventional models do not capture haptic qualities. 3DP can produce highly accurate and complex physical models. Many types of human or animal differentiated cells can be printed successfully with the development of 3D bio-printing technology. This progress represents a valuable breakthrough that exhibits many potential uses, such as research on drug metabolism or liver disease mechanism. This technology can also be used to solve shortage of organs for transplant in the future.

Three-dimensional printing: technologies, applications, and limitations in neurosurgery.

PubMed

Pucci, Josephine U; Christophe, Brandon R; Sisti, Jonathan A; Connolly, Edward S

2017-09-01

Three-dimensional (3D) printers are a developing technology penetrating a variety of markets, including the medical sector. Since its introduction to the medical field in the late 1980s, 3D printers have constructed a range of devices, such as dentures, hearing aids, and prosthetics. With the ultimate goals of decreasing healthcare costs and improving patient care and outcomes, neurosurgeons are utilizing this dynamic technology, as well. Digital Imaging and Communication in Medicine (DICOM) can be translated into Stereolithography (STL) files, which are then read and methodically built by 3D Printers. Vessels, tumors, and skulls are just a few of the anatomical structures created in a variety of materials, which enable surgeons to conduct research, educate surgeons in training, and improve pre-operative planning without risk to patients. Due to the infancy of the field and a wide range of technologies with varying advantages and disadvantages, there is currently no standard 3D printing process for patient care and medical research. In an effort to enable clinicians to optimize the use of additive manufacturing (AM) technologies, we outline the most suitable 3D printing models and computer-aided design (CAD) software for 3D printing in neurosurgery, their applications, and the limitations that need to be overcome if 3D printers are to become common practice in the neurosurgical field. Copyright © 2017 Elsevier Inc. All rights reserved.

Three-dimensional printing: review of application in medicine and hepatic surgery

PubMed Central

Yao, Rui; Xu, Gang; Mao, Shuang-Shuang; Yang, Hua-Yu; Sang, Xin-Ting; Sun, Wei; Mao, Yi-Lei

2016-01-01

Three-dimensional (3D) printing (3DP) is a rapid prototyping technology that has gained increasing recognition in many different fields. Inherent accuracy and low-cost property enable applicability of 3DP in many areas, such as manufacturing, aerospace, medical, and industrial design. Recently, 3DP has gained considerable attention in the medical field. The image data can be quickly turned into physical objects by using 3DP technology. These objects are being used across a variety of surgical specialties. The shortage of cadaver specimens is a major problem in medical education. However, this concern has been solved with the emergence of 3DP model. Custom-made items can be produced by using 3DP technology. This innovation allows 3DP use in preoperative planning and surgical training. Learning is difficult among medical students because of the complex anatomical structures of the liver. Thus, 3D visualization is a useful tool in anatomy teaching and hepatic surgical training. However, conventional models do not capture haptic qualities. 3DP can produce highly accurate and complex physical models. Many types of human or animal differentiated cells can be printed successfully with the development of 3D bio-printing technology. This progress represents a valuable breakthrough that exhibits many potential uses, such as research on drug metabolism or liver disease mechanism. This technology can also be used to solve shortage of organs for transplant in the future. PMID:28154775

Impact of Three-Dimensional Printed Pelvicaliceal System Models on Residents' Understanding of Pelvicaliceal System Anatomy Before Percutaneous Nephrolithotripsy Surgery: A Pilot Study.

PubMed

Atalay, Hasan Anıl; Ülker, Volkan; Alkan, İlter; Canat, Halil Lütfi; Özkuvancı, Ünsal; Altunrende, Fatih

2016-10-01

To investigate the impact of three-dimensional (3D) printed pelvicaliceal system models on residents' understanding of pelvicaliceal system anatomy before percutaneous nephrolithotripsy (PCNL). Patients with unilateral complex renal stones indicating PCNL were selected. Usable data of patients were obtained from CT-scans in Digital Imaging and Communications in Medicine (DICOM) format. Mimics software version 16.0 (Materialise, Belgium) was used for segmentation and extraction of pelvicaliceal systems (PCSs). All DICOM-formatted files were converted to the stereolithography file format. Finally, fused deposition modeling was used to create plasticine 3D models of PCSs. A questionnaire was designed so that residents could assess the 3D models' effects on their understanding of the anatomy of the pelvicaliceal system before PCNL (Fig. 3). Five patients' anatomically accurate models of the human renal collecting system were effectively generated (Figs. 1 and 2). After presentation of the 3D models, residents were 86% and 88% better at determining the number of anterior and posterior calices, respectively, 60% better at understanding stone location, and 64% better at determining optimal entry calix into the collecting system (Fig. 5). Generating kidney models of PCSs using 3D printing technology is feasible, and the models were accepted by residents as aids in surgical planning and understanding of pelvicaliceal system anatomy before PCNL.

Technical note: a landmark-based approach to the study of the ear ossicles using ultra-high-resolution X-ray computed tomography data.

PubMed

Schmidt, Jodi L; Cole, Theodore M; Silcox, Mary T

2011-08-01

Previous study of the ear ossicles in Primates has demonstrated that they vary on both functional and phylogenetic bases. Such studies have generally employed two-dimensional linear measurements rather than three-dimensional data. The availability of Ultra- high-resolution X-ray computed tomography (UhrCT) has made it possible to accurately image the ossicles so that broadly accepted methodologies for acquiring and studying morphometric data can be applied. Using UhrCT data also allows for the ossicular chain to be studied in anatomical position, so that it is possible to consider the spatial and size relationships of all three bones. One issue impeding the morphometric study of the ear ossicles is a lack of broadly recognized landmarks. Distinguishing landmarks on the ossicles is difficult in part because there are only two areas of articulation in the ossicular chain, one of which (the malleus/incus articulation) has a complex three-dimensional form. A measurement error study is presented demonstrating that a suite of 16 landmarks can be precisely located on reconstructions of the ossicles from UhrCT data. Estimates of measurement error showed that most landmarks were highly replicable, with an average CV for associated interlandmark distances of less than 3%. The positions of these landmarks are chosen to reflect not only the overall shape of the bones in the chain and their relative positions, but also functional parameters. This study should provide a basis for further examination of the smallest bones in the body in three dimensions. Copyright © 2011 Wiley-Liss, Inc.

Reducing 4D CT artifacts using optimized sorting based on anatomic similarity.

PubMed

Johnston, Eric; Diehn, Maximilian; Murphy, James D; Loo, Billy W; Maxim, Peter G

2011-05-01

Four-dimensional (4D) computed tomography (CT) has been widely used as a tool to characterize respiratory motion in radiotherapy. The two most commonly used 4D CT algorithms sort images by the associated respiratory phase or displacement into a predefined number of bins, and are prone to image artifacts at transitions between bed positions. The purpose of this work is to demonstrate a method of reducing motion artifacts in 4D CT by incorporating anatomic similarity into phase or displacement based sorting protocols. Ten patient datasets were retrospectively sorted using both the displacement and phase based sorting algorithms. Conventional sorting methods allow selection of only the nearest-neighbor image in time or displacement within each bin. In our method, for each bed position either the displacement or the phase defines the center of a bin range about which several candidate images are selected. The two dimensional correlation coefficients between slices bordering the interface between adjacent couch positions are then calculated for all candidate pairings. Two slices have a high correlation if they are anatomically similar. Candidates from each bin are then selected to maximize the slice correlation over the entire data set using the Dijkstra's shortest path algorithm. To assess the reduction of artifacts, two thoracic radiation oncologists independently compared the resorted 4D datasets pairwise with conventionally sorted datasets, blinded to the sorting method, to choose which had the least motion artifacts. Agreement between reviewers was evaluated using the weighted kappa score. Anatomically based image selection resulted in 4D CT datasets with significantly reduced motion artifacts with both displacement (P = 0.0063) and phase sorting (P = 0.00022). There was good agreement between the two reviewers, with complete agreement 34 times and complete disagreement 6 times. Optimized sorting using anatomic similarity significantly reduces 4D CT motion artifacts compared to conventional phase or displacement based sorting. This improved sorting algorithm is a straightforward extension of the two most common 4D CT sorting algorithms.

Magnetic resonance imaging-three-dimensional printing technology fabricates customized scaffolds for brain tissue engineering

PubMed Central

Fu, Feng; Qin, Zhe; Xu, Chao; Chen, Xu-yi; Li, Rui-xin; Wang, Li-na; Peng, Ding-wei; Sun, Hong-tao; Tu, Yue; Chen, Chong; Zhang, Sai; Zhao, Ming-liang; Li, Xiao-hong

2017-01-01

Conventional fabrication methods lack the ability to control both macro- and micro-structures of generated scaffolds. Three-dimensional printing is a solid free-form fabrication method that provides novel ways to create customized scaffolds with high precision and accuracy. In this study, an electrically controlled cortical impactor was used to induce randomized brain tissue defects. The overall shape of scaffolds was designed using rat-specific anatomical data obtained from magnetic resonance imaging, and the internal structure was created by computer-aided design. As the result of limitations arising from insufficient resolution of the manufacturing process, we magnified the size of the cavity model prototype five-fold to successfully fabricate customized collagen-chitosan scaffolds using three-dimensional printing. Results demonstrated that scaffolds have three-dimensional porous structures, high porosity, highly specific surface areas, pore connectivity and good internal characteristics. Neural stem cells co-cultured with scaffolds showed good viability, indicating good biocompatibility and biodegradability. This technique may be a promising new strategy for regenerating complex damaged brain tissues, and helps pave the way toward personalized medicine. PMID:28553343

A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography

PubMed Central

Kumta, Samir; Kumta, Monica; Jain, Leena; Purohit, Shrirang; Ummul, Rani

2015-01-01

Introduction: Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Materials and Methods: Stereolithographic template-assisted reconstruction was used on 11 patients for the reconstruction of the mandible/maxilla primarily following tumour excision and secondarily for the realignment of post-traumatic malunited fractures or deformity corrections. Data obtained from the computed tomography (CT) scans with 1-mm resolution were converted into a computer-aided design (CAD) using the CT Digital Imaging and Communications in Medicine (DICOM) data. Once a CAD model was constructed, it was converted into a stereolithographic format and then processed by the rapid prototyping technology to produce the physical anatomical model using a resin. This resin model replicates the native mandible, which can be thus used off table as a guide for modelling the bone grafts. Discussion: This conversion of two-dimensional (2D) data from CT scan into 3D models is a very precise guide to shaping the bone grafts. Further, this CAD can reconstruct the defective half of the mandible using the mirror image principle, and the normal anatomical model can be created to aid secondary reconstructions. Conclusion: This novel approach allows a precise translation of the treatment plan directly to the surgical field. It is also an important teaching tool for implant moulding and fixation, and helps in patient counselling. PMID:26933279

A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography.

PubMed

Kumta, Samir; Kumta, Monica; Jain, Leena; Purohit, Shrirang; Ummul, Rani

2015-01-01

Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Stereolithographic template-assisted reconstruction was used on 11 patients for the reconstruction of the mandible/maxilla primarily following tumour excision and secondarily for the realignment of post-traumatic malunited fractures or deformity corrections. Data obtained from the computed tomography (CT) scans with 1-mm resolution were converted into a computer-aided design (CAD) using the CT Digital Imaging and Communications in Medicine (DICOM) data. Once a CAD model was constructed, it was converted into a stereolithographic format and then processed by the rapid prototyping technology to produce the physical anatomical model using a resin. This resin model replicates the native mandible, which can be thus used off table as a guide for modelling the bone grafts. This conversion of two-dimensional (2D) data from CT scan into 3D models is a very precise guide to shaping the bone grafts. Further, this CAD can reconstruct the defective half of the mandible using the mirror image principle, and the normal anatomical model can be created to aid secondary reconstructions. This novel approach allows a precise translation of the treatment plan directly to the surgical field. It is also an important teaching tool for implant moulding and fixation, and helps in patient counselling.

Time-efficient high-resolution whole-brain three-dimensional macromolecular proton fraction mapping

PubMed Central

Yarnykh, Vasily L.

2015-01-01

Purpose Macromolecular proton fraction (MPF) mapping is a quantitative MRI method that reconstructs parametric maps of a relative amount of macromolecular protons causing the magnetization transfer (MT) effect and provides a biomarker of myelination in neural tissues. This study aimed to develop a high-resolution whole-brain MPF mapping technique utilizing a minimal possible number of source images for scan time reduction. Methods The described technique is based on replacement of an actually acquired reference image without MT saturation by a synthetic one reconstructed from R1 and proton density maps, thus requiring only three source images. This approach enabled whole-brain three-dimensional MPF mapping with isotropic 1.25×1.25×1.25 mm3 voxel size and scan time of 20 minutes. The synthetic reference method was validated against standard MPF mapping with acquired reference images based on data from 8 healthy subjects. Results Mean MPF values in segmented white and gray matter appeared in close agreement with no significant bias and small within-subject coefficients of variation (<2%). High-resolution MPF maps demonstrated sharp white-gray matter contrast and clear visualization of anatomical details including gray matter structures with high iron content. Conclusions Synthetic reference method improves resolution of MPF mapping and combines accurate MPF measurements with unique neuroanatomical contrast features. PMID:26102097

Accuracy of three-dimensional, paper-based models generated using a low-cost, three-dimensional printer.

PubMed

Olszewski, Raphael; Szymor, Piotr; Kozakiewicz, Marcin

2014-12-01

Our study aimed to determine the accuracy of a low-cost, paper-based 3D printer by comparing a dry human mandible to its corresponding three-dimensional (3D) model using a 3D measuring arm. One dry human mandible and its corresponding printed model were evaluated. The model was produced using DICOM data from cone beam computed tomography. The data were imported into Maxilim software, wherein automatic segmentation was performed, and the STL file was saved. These data were subsequently analysed, repaired, cut and prepared for printing with netfabb software. These prepared data were used to create a paper-based model of a mandible with an MCor Matrix 300 printer. Seventy-six anatomical landmarks were chosen and measured 20 times on the mandible and the model using a MicroScribe G2X 3D measuring arm. The distances between all the selected landmarks were measured and compared. Only landmarks with a point inaccuracy less than 30% were used in further analyses. The mean absolute difference for the selected 2016 measurements was 0.36 ± 0.29 mm. The mean relative difference was 1.87 ± 3.14%; however, the measurement length significantly influenced the relative difference. The accuracy of the 3D model printed using the paper-based, low-cost 3D Matrix 300 printer was acceptable. The average error was no greater than that measured with other types of 3D printers. The mean relative difference should not be considered the best way to compare studies. The point inaccuracy methodology proposed in this study may be helpful in future studies concerned with evaluating the accuracy of 3D rapid prototyping models. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Post-operative 3D CT feedback improves accuracy and precision in the learning curve of anatomic ACL femoral tunnel placement.

PubMed

Sirleo, Luigi; Innocenti, Massimo; Innocenti, Matteo; Civinini, Roberto; Carulli, Christian; Matassi, Fabrizio

2018-02-01

To evaluate the feedback from post-operative three-dimensional computed tomography (3D-CT) on femoral tunnel placement in the learning process, to obtain an anatomic anterior cruciate ligament (ACL) reconstruction. A series of 60 consecutive patients undergoing primary ACL reconstruction using autologous hamstrings single-bundle outside-in technique were prospectively included in the study. ACL reconstructions were performed by the same trainee-surgeon during his learning phase of anatomic ACL femoral tunnel placement. A CT scan with dedicated tunnel study was performed in all patients within 48 h after surgery. The data obtained from the CT scan were processed into a three-dimensional surface model, and a true medial view of the lateral femoral condyle was used for the femoral tunnel placement analysis. Two independent examiners analysed the tunnel placements. The centre of femoral tunnel was measured using a quadrant method as described by Bernard and Hertel. The coordinates measured were compared with anatomic coordinates values described in the literature [deep-to-shallow distance (X-axis) 28.5%; high-to-low distance (Y-axis) 35.2%]. Tunnel placement was evaluated in terms of accuracy and precision. After each ACL reconstruction, results were shown to the surgeon to receive an instant feedback in order to achieve accurate correction and improve tunnel placement for the next surgery. Complications and arthroscopic time were also recorded. Results were divided into three consecutive series (1, 2, 3) of 20 patients each. A trend to placing femoral tunnel slightly shallow in deep-to-shallow distance and slightly high in high-to-low distance was observed in the first and the second series. A progressive improvement in tunnel position was recorded from the first to second series and from the second to the third series. Both accuracy (+52.4%) and precision (+55.7%) increased from the first to the third series (p < 0.001). Arthroscopic time decreased from a mean of 105 min in the first series to 57 min in the third series (p < 0.001). After 50 ACL reconstructions, a satisfactory anatomic femoral tunnel was reached. Feedback from post-operative 3D-CT is effective in the learning process to improve accuracy and precision of femoral tunnel placement in order to obtain anatomic ACL reconstruction and helps to reduce also arthroscopic time and learning curve. For clinical relevance, trainee-surgeons should use feedback from post-operative 3DCT to learn anatomic ACL femoral tunnel placement and apply it appropriately. Consecutive case series, Level IV.

Microvasculature of the Olfactory Organ in the Japanese Monkey (Macaca fuscata fuscata)

NASA Astrophysics Data System (ADS)

Okada, Shigenori; Schraufnagel, Dean E.

2002-06-01

Olfaction is an important and primitive sense. As its importance has changed with evolution, anatomic adjustments have occurred in its structure and vasculature. Primates are a family of vertebrates that have had to develop their visual system to adapt to the arboreal environment and have evolved from a macrosmatic to a microsmatic species as the optic system has enlarged. This has resulted in anatomic changes of a small but critical area at the base of the brain. This paper describes the three-dimensional vascular anatomy of the olfactory organ of the Japanese monkey (Macaca fuscata fuscata). This is best understood by dividing the organ into three parts: the olfactory tract, olfactory bulb, and olfactory nerves in the nasal mucosa. The bulb can be partitioned into an outer or cortical part and inner or medullary part. The vasculature and tissue were examined grossly and with light microscopy and scanning electron microscopy of vascular corrosion casts. The olfactory tract and bulb were supplied by an arteriole from the anterior cerebral artery on each side. The tract was supplied by capillaries running spirally with a coarse network. At the olfactory bulb, the arteriole ramified into the intracortical and medullary branches that formed capillary networks. The bulbar intracortical capillaries were divided into two layers with different densities and vascular patterns. The capillaries of the superficial layer had a ladder-like pattern. The branches that ran into the medulla of the olfactory bulb were more widely spaced. Twigs from the posterior ethmoidal artery ran along the nerve fiber and formed intra- and extrafascicular networks. Each region of the olfactory organ had characteristic three-dimensional vascular patterns that were related to their cellular architecture.

Comparative Three-Dimensional Morphology of Baleen: Cross-Sectional Profiles and Volume Measurements Using CT Images.

PubMed

Jensen, Megan M; Saladrigas, Amalia H; Goldbogen, Jeremy A

2017-11-01

Baleen whales are obligate filter feeders, straining prey-laden seawater through racks of keratinized baleen plates. Despite the importance of baleen to the ecology and natural history of these animals, relatively little work has been done on baleen morphology, particularly with regard to the three-dimensional morphology and structure of baleen. We used computed tomography (CT) scanning to take 3D images of six baleen specimens representing five species, including three complete racks. With these images, we described the three-dimensional shape of the baleen plates using cross-sectional profiles from within the gum tissue to the tip of the plates. We also measured the percentage of each specimen that was composed of either keratinized plate material or was void space between baleen plates, and thus available for seawater flow. Baleen plates have a complex three-dimensional structure with curvature that varies across the anterior-posterior, proximal-distal, and medial-lateral (lingual-labial) axes. These curvatures also vary with location along the baleen rack, and between species. Cross-sectional profiles resemble backwards-facing airfoils, and some specimens display S-shaped, or reflexed, camber. Within a baleen specimen, the intra-baleen void volume correlates with the average bristle diameter for a species, suggesting that essentially, thinner plates (with more space between them for flow) have thinner bristles. Both plate curvature and the relative proportions of plate and void volumes are likely to have implications for the mechanics of mysticete filtration, and future studies are needed to determine the particular functions of these morphological characters. Anat Rec, 300:1942-1952, 2017. © 2017 The Authors The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists. © 2017 The Authors The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.

Integration of Computed Tomography and Three-Dimensional Echocardiography for Hybrid Three-Dimensional Printing in Congenital Heart Disease.

PubMed

Gosnell, Jordan; Pietila, Todd; Samuel, Bennett P; Kurup, Harikrishnan K N; Haw, Marcus P; Vettukattil, Joseph J

2016-12-01

Three-dimensional (3D) printing is an emerging technology aiding diagnostics, education, and interventional, and surgical planning in congenital heart disease (CHD). Three-dimensional printing has been derived from computed tomography, cardiac magnetic resonance, and 3D echocardiography. However, individually the imaging modalities may not provide adequate visualization of complex CHD. The integration of the strengths of two or more imaging modalities has the potential to enhance visualization of cardiac pathomorphology. We describe the feasibility of hybrid 3D printing from two imaging modalities in a patient with congenitally corrected transposition of the great arteries (L-TGA). Hybrid 3D printing may be useful as an additional tool for cardiologists and cardiothoracic surgeons in planning interventions in children and adults with CHD.

A new aiming guide can create the tibial tunnel at favorable position in transtibial pullout repair for the medial meniscus posterior root tear.

PubMed

Furumatsu, T; Kodama, Y; Fujii, M; Tanaka, T; Hino, T; Kamatsuki, Y; Yamada, K; Miyazawa, S; Ozaki, T

2017-05-01

Injuries to the medial meniscus (MM) posterior root lead to accelerated cartilage degeneration of the knee. An anatomic placement of the MM posterior root attachment is considered to be critical in transtibial pullout repair of the medial meniscus posterior root tear (MMPRT). However, tibial tunnel creation at the anatomic attachment of the MM posterior root is technically difficult using a conventional aiming device. The aim of this study was to compare two aiming guides. We hypothesized that a newly-developed guide, specifically designed, creates the tibial tunnel at an adequate position rather than a conventional device. Twenty-six patients underwent transtibial pullout repairs. Tibial tunnel creation was performed using the Multi-use guide (8 cases) or the PRT guide that had a narrow twisting/curving shape (18 cases). Three-dimensional computed tomography images of the tibial surface were evaluated using the Tsukada's measurement method postoperatively. Expected anatomic center of the MM posterior root attachment and tibial tunnel center were evaluated using the percentage-based posterolateral location on the tibial surface. Percentage distance between anatomic center and tunnel center was calculated. Anatomic center of the MM posterior root footprint located at a position of 78.5% posterior and 39.4% lateral. Both tunnels were anteromedial but tibial tunnel center located at a more favorable position in the PRT group: percentage distance was significantly smaller in the PRT guide group (8.7%) than in the Multi-use guide group (13.1%). The PRT guide may have great advantage to achieve a more anatomic location of the tibial tunnel in MMPRT pullout repair. III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

A high-resolution probabilistic in vivo atlas of human subcortical brain nuclei

PubMed Central

Pauli, Wolfgang M.; Nili, Amanda N.; Tyszka, J. Michael

2018-01-01

Recent advances in magnetic resonance imaging methods, including data acquisition, pre-processing and analysis, have benefited research on the contributions of subcortical brain nuclei to human cognition and behavior. At the same time, these developments have led to an increasing need for a high-resolution probabilistic in vivo anatomical atlas of subcortical nuclei. In order to address this need, we constructed high spatial resolution, three-dimensional templates, using high-accuracy diffeomorphic registration of T1- and T2- weighted structural images from 168 typical adults between 22 and 35 years old. In these templates, many tissue boundaries are clearly visible, which would otherwise be impossible to delineate in data from individual studies. The resulting delineations of subcortical nuclei complement current histology-based atlases. We further created a companion library of software tools for atlas development, to offer an open and evolving resource for the creation of a crowd-sourced in vivo probabilistic anatomical atlas of the human brain. PMID:29664465

Colour flow and motion imaging.

PubMed

Evans, D H

2010-01-01

Colour flow imaging (CFI) is an ultrasound imaging technique whereby colour-coded maps of tissue velocity are superimposed on grey-scale pulse-echo images of tissue anatomy. The most widespread use of the method is to image the movement of blood through arteries and veins, but it may also be used to image the motion of solid tissue. The production of velocity information is technically more demanding than the production of the anatomical information, partly because the target of interest is often blood, which backscatters significantly less power than solid tissues, and partly because several transmit-receive cycles are necessary for each velocity estimate. This review first describes the various components of basic CFI systems necessary to generate the velocity information and to combine it with anatomical information. It then describes a number of variations on the basic autocorrelation technique, including cross-correlation-based techniques, power Doppler, Doppler tissue imaging, and three-dimensional (3D) Doppler imaging. Finally, a number of limitations of current techniques and some potential solutions are reviewed.

Anatomical placement of the human eyeball in the orbit--validation using CT scans of living adults and prediction for facial approximation.

PubMed

Guyomarc'h, Pierre; Dutailly, Bruno; Couture, Christine; Coqueugniot, Hélène

2012-09-01

Accuracy of forensic facial approximation and superimposition techniques relies on the knowledge of anatomical correlations between soft and hard tissues. Recent studies by Stephan and collaborators (6,8,10) reviewed traditional guidelines leading to a wrong placement of the eyeball in the orbit. As those statements are based on a small cadaver sample, we propose a validation of these findings on a large database (n = 375) of living people. Computed tomography scans of known age and sex subjects were used to collect landmarks on three-dimensional surfaces and DICOM with TIVMI. Results confirmed a more superior and lateral position of the eyeball relatively to the orbital rims. Orbital height and breadth were used to compute regression formulae and proportional placement using percentages to find the most probable position of the eyeball in the orbit. A size-related sexual dimorphism was present but did not impact on the prediction accuracy. © 2012 American Academy of Forensic Sciences.

Evidence for a distributed hierarchy of action representation in the brain

PubMed Central

Grafton, Scott T.; de C. Hamilton, Antonia F.

2007-01-01

Complex human behavior is organized around temporally distal outcomes. Behavioral studies based on tasks such as normal prehension, multi-step object use and imitation establish the existence of relative hierarchies of motor control. The retrieval errors in apraxia also support the notion of a hierarchical model for representing action in the brain. In this review, three functional brain imaging studies of action observation using the method of repetition suppression are used to identify a putative neural architecture that supports action understanding at the level of kinematics, object centered goals and ultimately, motor outcomes. These results, based on observation, may match a similar functional anatomic hierarchy for action planning and execution. If this is true, then the findings support a functional anatomic model that is distributed across a set of interconnected brain areas that are differentially recruited for different aspects of goal oriented behavior, rather than a homogeneous mirror neuron system for organizing and understanding all behavior. PMID:17706312

Dosimetric Comparison between Three-Dimensional Magnetic Resonance Imaging-Guided and Conventional Two-Dimensional Point A-Based Intracavitary Brachytherapy Planning for Cervical Cancer

PubMed Central

Ren, Juan; Yuan, Wei; Wang, Ruihua; Wang, Qiuping; Li, Yi; Xue, Chaofan; Yan, Yanli; Ma, Xiaowei; Tan, Li; Liu, Zi

2016-01-01

Objective The purpose of this study was to comprehensively compare the 3-dimensional (3D) magnetic resonance imaging (MRI)-guided and conventional 2-dimensional (2D) point A-based intracavitary brachytherapy (BT) planning for cervical cancer with regard to target dose coverage and dosages to adjacent organs-at risk (OARs). Methods A total of 79 patients with cervical cancer were enrolled to receive 2D point A-based BT planning and then immediately to receive 3D planning between October 2011 and April 2013 at the First Hospital Affiliated to Xi’an Jiao Tong University (Xi’an, China). The dose-volume histogram (DVH) parameters for gross tumor volume (GTV), high-risk clinical target volume (HR-CTV), intermediate-risk clinical target volume (IR-CTV) and OARs were compared between the 2D and 3D planning. Results In small tumors, there was no significant difference in most of the DVHs between 2D and 3D planning (all p>0.05). While in big tumors, 3D BT planning significantly increased the DVHs for most of the GTV, HR-CTV and IR-CTV, and some OARs compared with 2D planning (all P<0.05). In 3D planning, DVHs for GTV, HR-CTV, IR-CTV and some OARs were significantly higher in big tumors than in small tumors (all p<0.05). In contrast, in 2D planning, DVHs for almost all of the HR-CTV and IR-CTV were significantly lower in big tumors (all p<0.05). In eccentric tumors, 3D planning significantly increased dose coverage but decreased dosages to OARs compared with 2D planning (p<0.05). In tumors invading adjacent tissues, the target dose coverage in 3D planning was generally significantly higher than in 2D planning (P<0.05); the dosages to the adjacent rectum and bladder were significantly higher but those to sigmoid colon were lower in 3D planning (all P<0.05). Conclusions 3D MRI image-guided BT planning exhibits advantages over 2D planning in a complex way, generally showing advantages for the treatment of cervical cancer except small tumors. PMID:27611853

3D Segmentation with an application of level set-method using MRI volumes for image guided surgery.

PubMed

Bosnjak, A; Montilla, G; Villegas, R; Jara, I

2007-01-01

This paper proposes an innovation in the application for image guided surgery using a comparative study of three different method of segmentation. This segmentation method is faster than the manual segmentation of images, with the advantage that it allows to use the same patient as anatomical reference, which has more precision than a generic atlas. This new methodology for 3D information extraction is based on a processing chain structured of the following modules: 1) 3D Filtering: the purpose is to preserve the contours of the structures and to smooth the homogeneous areas; several filters were tested and finally an anisotropic diffusion filter was used. 2) 3D Segmentation. This module compares three different methods: Region growing Algorithm, Cubic spline hand assisted, and Level Set Method. It then proposes a Level Set-based on the front propagation method that allows the making of the reconstruction of the internal walls of the anatomical structures of the brain. 3) 3D visualization. The new contribution of this work consists on the visualization of the segmented model and its use in the pre-surgery planning.

Improved planning of endoscopic sinonasal surgery from 3-dimensional images with Osirix® and stereolithography.

PubMed

Sánchez-Gómez, Serafín; Herrero-Salado, Tomás F; Maza-Solano, Juan M; Ropero-Romero, Francisco; González-García, Jaime; Ambrosiani-Fernández, Jesús

2015-01-01

The high variability of sinonasal anatomy requires the best knowledge of its three-dimensional (3D) conformation to perform surgery more safely and efficiently. The aim of the study was to validate the utility of Osirix® and stereolithography in improving endoscopic sinonasal surgery planning. Osirix® was used as a viewer and Digital Imaging and Communications in Medicine (DICOM) 3D imaging manager to improve planning for 114 sinonasal endoscopic operations with polyposis (86) and chronic rhinosinusitis (CRS) (28). Stereolithography rapid prototyping was used for 7 frontoethmoidal mucoceles. Using Osirix® and stereolithography, a greater number of anatomical structures were identified and this was done faster, with a statistically-significant clinical-radiological correlation (P<.01) compared with 2D CT plates. With a share of more than 75% of surgery performed by residents, surgical time was reduced by 38±12.3min in CRS and 42±27.9 in sinonasal polyposis. The fourth-year residents reached 100% surgical competence in critical surgical milestones with 16 surgeries (CI 12-19). The systematic use of Osirix® for visualisation and treatment of 3D sinonasal images from DICOM data files, along with the surgical team's ability to manipulate them as virtual reality, allows surgeons to perform endoscopic sinonasal surgery with greater confidence and in less time than using 2D images. Residents also achieve surgical competence faster, more safely and with fewer complications. This beneficial impact is increased when the surgical team has stereolithography rapid prototyping in more complex cases. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

TH-E-17A-06: Anatomical-Adaptive Compressed Sensing (AACS) Reconstruction for Thoracic 4-Dimensional Cone-Beam CT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shieh, C; Kipritidis, J; OBrien, R

2014-06-15

Purpose: The Feldkamp-Davis-Kress (FDK) algorithm currently used for clinical thoracic 4-dimensional (4D) cone-beam CT (CBCT) reconstruction suffers from noise and streaking artifacts due to projection under-sampling. Compressed sensing theory enables reconstruction of under-sampled datasets via total-variation (TV) minimization, but TV-minimization algorithms such as adaptive-steepest-descent-projection-onto-convex-sets (ASD-POCS) often converge slowly and are prone to over-smoothing anatomical details. These disadvantages can be overcome by incorporating general anatomical knowledge via anatomy segmentation. Based on this concept, we have developed an anatomical-adaptive compressed sensing (AACS) algorithm for thoracic 4D-CBCT reconstruction. Methods: AACS is based on the ASD-POCS framework, where each iteration consists of a TV-minimizationmore » step and a data fidelity constraint step. Prior to every AACS iteration, four major thoracic anatomical structures - soft tissue, lungs, bony anatomy, and pulmonary details - were segmented from the updated solution image. Based on the segmentation, an anatomical-adaptive weighting was applied to the TV-minimization step, so that TV-minimization was enhanced at noisy/streaky regions and suppressed at anatomical structures of interest. The image quality and convergence speed of AACS was compared to conventional ASD-POCS using an XCAT digital phantom and a patient scan. Results: For the XCAT phantom, the AACS image represented the ground truth better than the ASD-POCS image, giving a higher structural similarity index (0.93 vs. 0.84) and lower absolute difference (1.1*10{sup 4} vs. 1.4*10{sup 4}). For the patient case, while both algorithms resulted in much less noise and streaking than FDK, the AACS image showed considerably better contrast and sharpness of the vessels, tumor, and fiducial marker than the ASD-POCS image. In addition, AACS converged over 50% faster than ASD-POCS in both cases. Conclusions: The proposed AACS algorithm was shown to reconstruct thoracic 4D-CBCT images more accurately and with faster convergence compared to ASD-POCS. The superior image quality and rapid convergence makes AACS promising for future clinical use.« less

Production of Accurate Skeletal Models of Domestic Animals Using Three-Dimensional Scanning and Printing Technology

ERIC Educational Resources Information Center

Li, Fangzheng; Liu, Chunying; Song, Xuexiong; Huan, Yanjun; Gao, Shansong; Jiang, Zhongling

2018-01-01

Access to adequate anatomical specimens can be an important aspect in learning the anatomy of domestic animals. In this study, the authors utilized a structured light scanner and fused deposition modeling (FDM) printer to produce highly accurate animal skeletal models. First, various components of the bovine skeleton, including the femur, the…

ANIMATED SERIAL SECTIONS, A TEACHING AID FOR ORAL HISTOLOGY AND EMBRYOLOGY.

ERIC Educational Resources Information Center

HAYDEN, JESS; AND OTHERS

THE RELATIVE EFFECTIVENESS OF TWO TYPES OF VISUAL MEDIA FOR THE DEVELOPMENT OF A THREE-DIMENSIONAL CONCEPT OF A GIVEN ANATOMICAL REGION WAS INVESTIGATED. EXPERIMENTAL AND CONTROL GROUPS WERE RANDOMLY SELECTED FROM 119 FIRST-YEAR MEDICAL AND DENTAL STUDENTS IN AN HISTOLOGY CLASS. BOTH GROUPS ATTENDED THE SAME ONE-HOUR LECTURE. FOLLOWING THE LECTURE…

From Vesalius to Virtual Reality: How Embodied Cognition Facilitates the Visualization of Anatomy

ERIC Educational Resources Information Center

Jang, Susan

2010-01-01

This study examines the facilitative effects of embodiment of a complex internal anatomical structure through three-dimensional ("3-D") interactivity in a virtual reality ("VR") program. Since Shepard and Metzler's influential 1971 study, it has been known that 3-D objects (e.g., multiple-armed cube or external body parts) are visually and…

A Head in Virtual Reality: Development of A Dynamic Head and Neck Model

ERIC Educational Resources Information Center

Nguyen, Ngan; Wilson, Timothy D.

2009-01-01

Advances in computer and interface technologies have made it possible to create three-dimensional (3D) computerized models of anatomical structures for visualization, manipulation, and interaction in a virtual 3D environment. In the past few decades, a multitude of digital models have been developed to facilitate complex spatial learning of the…

Health Information Retrieval Tool (HIRT)

PubMed Central

Nyun, Mra Thinzar; Ogunyemi, Omolola; Zeng, Qing

2002-01-01

The World Wide Web (WWW) is a powerful way to deliver on-line health information, but one major problem limits its value to consumers: content is highly distributed, while relevant and high quality information is often difficult to find. To address this issue, we experimented with an approach that utilizes three-dimensional anatomic models in conjunction with free-text search.

Automated Discrimination Method of Muscular and Subcutaneous Fat Layers Based on Tissue Elasticity

NASA Astrophysics Data System (ADS)

Inoue, Masahiro; Fukuda, Osamu; Tsubai, Masayoshi; Muraki, Satoshi; Okumura, Hiroshi; Arai, Kohei

Balance between human body composition, e.g. bones, muscles, and fat, is a major and basic indicator of personal health. Body composition analysis using ultrasound has been developed rapidly. However, interpretation of echo signal is conducted manually, and accuracy and confidence in interpretation requires experience. This paper proposes an automated discrimination method of tissue boundaries for measuring the thickness of subcutaneous fat and muscular layers. A portable one-dimensional ultrasound device was used in this study. The proposed method discriminated tissue boundaries based on tissue elasticity. Validity of the proposed method was evaluated in twenty-one subjects (twelve women, nine men; aged 20-70 yr) at three anatomical sites. Experimental results show that the proposed method can achieve considerably high discrimination performance.

Dedicated ultrasound speckle tracking to study tendon displacement

NASA Astrophysics Data System (ADS)

Korstanje, Jan-Wiebe H.; Selles, Ruud W.; Stam, Henk J.; Hovius, Steven E. R.; Bosch, Johan G.

2009-02-01

Ultrasound can be used to study tendon and muscle movement. However, quantization is mostly based on manual tracking of anatomical landmarks such as the musculotendinous junction, limiting the applicability to a small number of muscle-tendon units. The aim of this study is to quantify tendon displacement without employing anatomical landmarks, using dedicated speckle tracking in long B-mode image sequences. We devised a dedicated two-dimensional multikernel block-matching scheme with subpixel accuracy to handle large displacements over long sequences. Images were acquired with a Philips iE33 with a 7 MHz linear array and a VisualSonics Vevo 770 using a 40 MHz mechanical probe. We displaced the flexor digitorum superficialis of two pig cadaver forelegs with three different velocities (4,10 and 16 mm/s) over 3 distances (5, 10, 15 mm). As a reference, we manually determined the total displacement of an injected hyperechogenic bullet in the tendons. We automatically tracked tendon parts with and without markers and compared results to the true displacement. Using the iE33, mean tissue displacement underestimations for the three different velocities were 2.5 +/- 1.0%, 1.7 +/- 1.1% and 0.7 +/- 0.4%. Using the Vevo770, mean tissue displacement underestimations were 0.8 +/- 1.3%, 0.6 +/- 0.3% and 0.6 +/- 0.3%. Marker tracking displacement underestimations were only slightly smaller, showing limited tracking drift for non-marker tendon tissue as well as for markers. This study showed that our dedicated speckle tracking can quantify extensive tendon displacement with physiological velocities without anatomical landmarks with good accuracy for different types of ultrasound configurations. This technique allows tracking of a much larger range of muscle-tendon units than by using anatomical landmarks.

High Resolution Three-Dimensional MR Imaging of the Skull Base: Compartments, Boundaries, and Critical Structures.

PubMed

Blitz, Ari Meir; Aygun, Nafi; Herzka, Daniel A; Ishii, Masaru; Gallia, Gary L

2017-01-01

High-resolution 3D MRI of the skull base allows for a more detailed and accurate assessment of normal anatomic structures as well as the location and extent of skull base pathologies than has previously been possible. This article describes the techniques employed for high-resolution skull base MRI including pre- and post-contrast constructive interference in the steady state (CISS) imaging and their utility for evaluation of the many small structures of the skull base, focusing on those regions and concepts most pertinent to localization of cranial nerve palsies and in providing pre-operative guidance and post-operative assessment. The concept of skull base compartments as a means of conceptualizing the various layers of the skull base and their importance in assessment of masses of the skull base is discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation

PubMed Central

Lonic, Daniel; Pai, Betty Chien-Jung; Yamaguchi, Kazuaki; Chortrakarnkij, Peerasak; Lin, Hsiu-Hsia; Lo, Lun-Jou

2016-01-01

Background Although conventional two-dimensional (2D) methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D) simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method. Patients and Methods This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years). All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment. Results 83.3% of 2D plans were modified, mostly concerning yaw (63.3%) and midline (36.7%) adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation. Conclusion Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D planning. PMID:27002726

Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation.

PubMed

Lonic, Daniel; Pai, Betty Chien-Jung; Yamaguchi, Kazuaki; Chortrakarnkij, Peerasak; Lin, Hsiu-Hsia; Lo, Lun-Jou

2016-01-01

Although conventional two-dimensional (2D) methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D) simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method. This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years). All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment. 83.3% of 2D plans were modified, mostly concerning yaw (63.3%) and midline (36.7%) adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation. Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D planning.

Spatiotemporal Features of the Three-Dimensional Architectural Landscape in Qingdao, China.

PubMed

Zhang, Peifeng

2015-01-01

The evolution and development of the three-dimensional (3D) architectural landscape is the basis of proper urban planning, eco-environment construction and the improvement of environmental quality. This paper presents the spatiotemporal characteristics of the 3D architectural landscape of the Shinan and Shibei districts in Qingdao, China, based on buildings' 3D information extracted from Quickbird images from 2003 to 2012, supported by Barista, landscape metrics and GIS. The results demonstrated that: (1) Shinan and Shibei districts expanded vertically and urban land use intensity increased noticeably from year to year. (2) Significant differences in the 3D architectural landscape existed among the western, central and eastern regions, and among the 26 sub-districts over the study period. The differentiation was consistent with the diverse development history, function and planning of the two districts. Finally, we found that population correlates positively with the variation in the 3D architectural landscape. This research provides an important reference for related studies, urban planning and eco-city construction.

Spatiotemporal Features of the Three-Dimensional Architectural Landscape in Qingdao, China

PubMed Central

Zhang, Peifeng

2015-01-01

The evolution and development of the three-dimensional (3D) architectural landscape is the basis of proper urban planning, eco-environment construction and the improvement of environmental quality. This paper presents the spatiotemporal characteristics of the 3D architectural landscape of the Shinan and Shibei districts in Qingdao, China, based on buildings’ 3D information extracted from Quickbird images from 2003 to 2012, supported by Barista, landscape metrics and GIS. The results demonstrated that: (1) Shinan and Shibei districts expanded vertically and urban land use intensity increased noticeably from year to year. (2) Significant differences in the 3D architectural landscape existed among the western, central and eastern regions, and among the 26 sub-districts over the study period. The differentiation was consistent with the diverse development history, function and planning of the two districts. Finally, we found that population correlates positively with the variation in the 3D architectural landscape. This research provides an important reference for related studies, urban planning and eco-city construction. PMID:26361016

[Leonardo da Vinci the first human body imaging specialist. A brief communication on the thorax oseum images].

PubMed

Cicero, Raúl; Criales, José Luis; Cardoso, Manuel

2009-01-01

The impressive development of computed tomography (CT) techniques such as the three dimensional helical CT produces a spatial image of the thoracic skull. At the beginning of the 16th century Leonardo da Vinci drew with great precision the thorax oseum. These drawings show an outstanding similarity with the images obtained by three dimensional helical CT. The cumbersome task of the Renaissance genius is a prime example of the careful study of human anatomy. Modern imaging techniques require perfect anatomic knowledge of the human body in order to generate exact interpretations of images. Leonardo's example is alive for anybody devoted to modern imaging studies.

Interactive multiobjective optimization for anatomy-based three-dimensional HDR brachytherapy

NASA Astrophysics Data System (ADS)

Ruotsalainen, Henri; Miettinen, Kaisa; Palmgren, Jan-Erik; Lahtinen, Tapani

2010-08-01

In this paper, we present an anatomy-based three-dimensional dose optimization approach for HDR brachytherapy using interactive multiobjective optimization (IMOO). In brachytherapy, the goals are to irradiate a tumor without causing damage to healthy tissue. These goals are often conflicting, i.e. when one target is optimized the other will suffer, and the solution is a compromise between them. IMOO is capable of handling multiple and strongly conflicting objectives in a convenient way. With the IMOO approach, a treatment planner's knowledge is used to direct the optimization process. Thus, the weaknesses of widely used optimization techniques (e.g. defining weights, computational burden and trial-and-error planning) can be avoided, planning times can be shortened and the number of solutions to be calculated is small. Further, plan quality can be improved by finding advantageous trade-offs between the solutions. In addition, our approach offers an easy way to navigate among the obtained Pareto optimal solutions (i.e. different treatment plans). When considering a simulation model of clinical 3D HDR brachytherapy, the number of variables is significantly smaller compared to IMRT, for example. Thus, when solving the model, the CPU time is relatively short. This makes it possible to exploit IMOO to solve a 3D HDR brachytherapy optimization problem. To demonstrate the advantages of IMOO, two clinical examples of optimizing a gynecologic cervix cancer treatment plan are presented.

Cranial reconstruction: 3D biomodel and custom-built implant created using additive manufacturing.

PubMed

Jardini, André Luiz; Larosa, Maria Aparecida; Maciel Filho, Rubens; Zavaglia, Cecília Amélia de Carvalho; Bernardes, Luis Fernando; Lambert, Carlos Salles; Calderoni, Davi Reis; Kharmandayan, Paulo

2014-12-01

Additive manufacturing (AM) technology from engineering has helped to achieve several advances in the medical field, particularly as far as fabrication of implants is concerned. The use of AM has made it possible to carry out surgical planning and simulation using a three-dimensional physical model which accurately represents the patient's anatomy. AM technology enables the production of models and implants directly from a 3D virtual model, facilitating surgical procedures and reducing risks. Furthermore, AM has been used to produce implants designed for individual patients in areas of medicine such as craniomaxillofacial surgery, with optimal size, shape and mechanical properties. This work presents AM technologies which were applied to design and fabricate a biomodel and customized implant for the surgical reconstruction of a large cranial defect. A series of computed tomography data was obtained and software was used to extract the cranial geometry. The protocol presented was used to create an anatomic biomodel of the bone defect for surgical planning and, finally, the design and manufacture of the patient-specific implant. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

3D Printing: current use in facial plastic and reconstructive surgery.

PubMed

Hsieh, Tsung-Yen; Dedhia, Raj; Cervenka, Brian; Tollefson, Travis T

2017-08-01

To review the use of three-dimensional (3D) printing in facial plastic and reconstructive surgery, with a focus on current uses in surgical training, surgical planning, clinical outcomes, and biomedical research. To evaluate the limitations and future implications of 3D printing in facial plastic and reconstructive surgery. Studies reviewed demonstrated 3D printing applications in surgical planning including accurate anatomic biomodels, surgical cutting guides in reconstruction, and patient-specific implants fabrication. 3D printing technology also offers access to well tolerated, reproducible, and high-fidelity/patient-specific models for surgical training. Emerging research in 3D biomaterial printing have led to the development of biocompatible scaffolds with potential for tissue regeneration in reconstruction cases involving significant tissue absence or loss. Major limitations of utilizing 3D printing technology include time and cost, which may be offset by decreased operating times and collaboration between departments to diffuse in-house printing costs SUMMARY: The current state of the literature shows promising results, but has not yet been validated by large studies or randomized controlled trials. Ultimately, further research and advancements in 3D printing technology should be supported as there is potential to improve resident training, patient care, and surgical outcomes.

An Accurate and Dynamic Computer Graphics Muscle Model

NASA Technical Reports Server (NTRS)

Levine, David Asher

1997-01-01

A computer based musculo-skeletal model was developed at the University in the departments of Mechanical and Biomedical Engineering. This model accurately represents human shoulder kinematics. The result of this model is the graphical display of bones moving through an appropriate range of motion based on inputs of EMGs and external forces. The need existed to incorporate a geometric muscle model in the larger musculo-skeletal model. Previous muscle models did not accurately represent muscle geometries, nor did they account for the kinematics of tendons. This thesis covers the creation of a new muscle model for use in the above musculo-skeletal model. This muscle model was based on anatomical data from the Visible Human Project (VHP) cadaver study. Two-dimensional digital images from the VHP were analyzed and reconstructed to recreate the three-dimensional muscle geometries. The recreated geometries were smoothed, reduced, and sliced to form data files defining the surfaces of each muscle. The muscle modeling function opened these files during run-time and recreated the muscle surface. The modeling function applied constant volume limitations to the muscle and constant geometry limitations to the tendons.

Design and Development of a Megavoltage CT Scanner for Radiation Therapy.

NASA Astrophysics Data System (ADS)

Chen, Ching-Tai

A Varian 4 MeV isocentric therapy accelerator has been modified to perform also as a CT scanner. The goal is to provide low cost computed tomography capability for use in radiotherapy. The system will have three principal uses. These are (i) to provide 2- and 3-dimensional maps of electron density distribution for CT assisted therapy planning, (ii) to aid in patient set up by providing sectional views of the treatment volume and high contrast scout-mode verification images and (iii) to provide a means for periodically checking the patients anatomical conformation against what was used to generate the original therapy plan. The treatment machine was modified by mounting an array of detectors on a frame bolted to the counter weight end of the gantry in such a manner as to define a 'third generation' CT Scanner geometry. The data gathering is controlled by a Z-80 based microcomputer system which transfers the x-ray transmission data to a general purpose PDP 11/34 for processing. There a series of calibration processes and a logarithmic conversion are performed to get projection data. After reordering the projection data to an equivalent parallel beam sinogram format a convolution algorithm is employed to construct the image from the equivalent parallel projection data. Results of phantom studies have shown a spatial resolution of 2.6 mm and an electron density discrimination of less than 1% which are sufficiently good for accurate therapy planning. Results also show that the system is linear to within the precision of our measurement ((DBLTURN).75%) over a wide range of electron densities corresponding to those found in body tissues. Animal and human images are also presented to demonstrate that the system's imaging capability is sufficient to allow the necessary visualization of anatomy.

Anatomic Mesenchymal Stem Cell-Based Engineered Cartilage Constructs for Biologic Total Joint Replacement

PubMed Central

Saxena, Vishal; Kim, Minwook; Keah, Niobra M.; Neuwirth, Alexander L.; Stoeckl, Brendan D.; Bickard, Kevin; Restle, David J.; Salowe, Rebecca; Wang, Margaret Ye; Steinberg, David R.

2016-01-01

Cartilage has a poor healing response, and few viable options exist for repair of extensive damage. Hyaluronic acid (HA) hydrogels seeded with mesenchymal stem cells (MSCs) polymerized through UV crosslinking can generate functional tissue, but this crosslinking is not compatible with indirect rapid prototyping utilizing opaque anatomic molds. Methacrylate-modified polymers can also be chemically crosslinked in a cytocompatible manner using ammonium persulfate (APS) and N,N,N′,N′-tetramethylethylenediamine (TEMED). The objectives of this study were to (1) compare APS/TEMED crosslinking with UV crosslinking in terms of functional maturation of MSC-seeded HA hydrogels; (2) generate an anatomic mold of a complex joint surface through rapid prototyping; and (3) grow anatomic MSC-seeded HA hydrogel constructs using this alternative crosslinking method. Juvenile bovine MSCs were suspended in methacrylated HA (MeHA) and crosslinked either through UV polymerization or chemically with APS/TEMED to generate cylindrical constructs. Minipig porcine femoral heads were imaged using microCT, and anatomic negative molds were generated by three-dimensional printing using fused deposition modeling. Molded HA constructs were produced using the APS/TEMED method. All constructs were cultured for up to 12 weeks in a chemically defined medium supplemented with TGF-β3 and characterized by mechanical testing, biochemical assays, and histologic analysis. Both UV- and APS/TEMED-polymerized constructs showed increasing mechanical properties and robust proteoglycan and collagen deposition over time. At 12 weeks, APS/TEMED-polymerized constructs had higher equilibrium and dynamic moduli than UV-polymerized constructs, with no differences in proteoglycan or collagen content. Molded HA constructs retained their hemispherical shape in culture and demonstrated increasing mechanical properties and proteoglycan and collagen deposition, especially at the edges compared to the center of these larger constructs. Immunohistochemistry showed abundant collagen type II staining and little collagen type I staining. APS/TEMED crosslinking can be used to produce MSC-seeded HA-based neocartilage and can be used in combination with rapid prototyping techniques to generate anatomic MSC-seeded HA constructs for use in filling large and anatomically complex chondral defects or for biologic joint replacement. PMID:26871863

A novel method to acquire 3D data from serial 2D images of a dental cast

NASA Astrophysics Data System (ADS)

Yi, Yaxing; Li, Zhongke; Chen, Qi; Shao, Jun; Li, Xinshe; Liu, Zhiqin

2007-05-01

This paper introduced a newly developed method to acquire three-dimensional data from serial two-dimensional images of a dental cast. The system consists of a computer and a set of data acquiring device. The data acquiring device is used to take serial pictures of the a dental cast; an artificial neural network works to translate two-dimensional pictures to three-dimensional data; then three-dimensional image can reconstruct by the computer. The three-dimensional data acquiring of dental casts is the foundation of computer-aided diagnosis and treatment planning in orthodontics.

A three-dimensional visualization preoperative treatment planning system for microwave ablation in liver cancer: a simulated experimental study.

PubMed

Liu, Fangyi; Cheng, Zhigang; Han, Zhiyu; Yu, Xiaoling; Yu, Mingan; Liang, Ping

2017-06-01

To evaluate the application value of three-dimensional (3D) visualization preoperative treatment planning system (VPTPS) for microwave ablation (MWA) in liver cancer. The study was a simulated experimental study using the CT imaging data of patients in DICOM format in a model. Three students (who learn to interventional ultrasound for less than 1 year) and three experts (who have more than 5 years of experience in ablation techniques) in MWA performed the preoperative planning for 39 lesions (mean diameter 3.75 ± 1.73 cm) of 32 patients using two-dimensional (2D) image planning method and 3D VPTPS, respectively. The number of planning insertions, planning ablation rate, and damage rate to surrounding structures were compared between2D image planning group and 3D VPTPS group. There were fewer planning insertions, lower ablation rate and higher damage rate to surrounding structures in 2D image planning group than 3D VPTPS group for both students and experts. When using the 2D ultrasound planning method, students could carry out fewer planning insertions and had a lower ablation rate than the experts (p < 0.001). However, there was no significant difference in planning insertions, the ablation rate, and the incidence of damage to the surrounding structures between students and experts using 3D VPTPS. 3DVPTPS enables inexperienced physicians to have similar preoperative planning results to experts, and enhances students' preoperative planning capacity, which may improve the therapeutic efficacy and reduce the complication of MWA.

Femoral articular shape and geometry. A three-dimensional computerized analysis of the knee.

PubMed

Siu, D; Rudan, J; Wevers, H W; Griffiths, P

1996-02-01

An average, three-dimensional anatomic shape and geometry of the distal femur were generated from x-ray computed tomography data of five fresh asymptomatic cadaver knees using AutoCAD (AutoDesk, Sausalito, CA), a computer-aided design and drafting software. Each femur model was graphically repositioned to a standardized orientation using a series of alignment templates and scaled to a nominal size of 85 mm in mediolateral and 73 mm in anteroposterior dimensions. An average generic shape of the distal femur was synthesized by combining these pseudosolid models and reslicing the composite structure at different elevations using clipping and smoothing techniques in interactive computer graphics. The resulting distal femoral geometry was imported into a computer-aided manufacturing system, and anatomic prototypes of the distal femur were produced. Quantitative geometric analyses of the generic femur in the coronal and transverse planes revealed definite condylar camber (3 degrees-6 degrees) and toe-in (8 degrees-10 degrees) with an oblique patellofemoral groove (15 degrees) with respect to the mechanical axis of the femur. In the sagittal plane, each condyle could be approximated by three concatenated circular arcs (anterior, distal, and posterior) with slope continuity and a single arc for the patellofemoral groove. The results of this study may have important implications in future femoral prosthesis design and clinical applications.

Image-guided ex-vivo targeting accuracy using a laparoscopic tissue localization system

NASA Astrophysics Data System (ADS)

Bieszczad, Jerry; Friets, Eric; Knaus, Darin; Rauth, Thomas; Herline, Alan; Miga, Michael; Galloway, Robert; Kynor, David

2007-03-01

In image-guided surgery, discrete fiducials are used to determine a spatial registration between the location of surgical tools in the operating theater and the location of targeted subsurface lesions and critical anatomic features depicted in preoperative tomographic image data. However, the lack of readily localized anatomic landmarks has greatly hindered the use of image-guided surgery in minimally invasive abdominal procedures. To address these needs, we have previously described a laser-based system for localization of internal surface anatomy using conventional laparoscopes. During a procedure, this system generates a digitized, three-dimensional representation of visible anatomic surfaces in the abdominal cavity. This paper presents the results of an experiment utilizing an ex-vivo bovine liver to assess subsurface targeting accuracy achieved using our system. During the experiment, several radiopaque targets were inserted into the liver parenchyma. The location of each target was recorded using an optically-tracked insertion probe. The liver surface was digitized using our system, and registered with the liver surface extracted from post-procedure CT images. This surface-based registration was then used to transform the position of the inserted targets into the CT image volume. The target registration error (TRE) achieved using our surface-based registration (given a suitable registration algorithm initialization) was 2.4 mm +/- 1.0 mm. A comparable TRE (2.6 mm +/- 1.7 mm) was obtained using a registration based on traditional fiducial markers placed on the surface of the same liver. These results indicate the potential of fiducial-free, surface-to-surface registration for image-guided lesion targeting in minimally invasive abdominal surgery.

BeatBox-HPC simulation environment for biophysically and anatomically realistic cardiac electrophysiology.

PubMed

Antonioletti, Mario; Biktashev, Vadim N; Jackson, Adrian; Kharche, Sanjay R; Stary, Tomas; Biktasheva, Irina V

2017-01-01

The BeatBox simulation environment combines flexible script language user interface with the robust computational tools, in order to setup cardiac electrophysiology in-silico experiments without re-coding at low-level, so that cell excitation, tissue/anatomy models, stimulation protocols may be included into a BeatBox script, and simulation run either sequentially or in parallel (MPI) without re-compilation. BeatBox is a free software written in C language to be run on a Unix-based platform. It provides the whole spectrum of multi scale tissue modelling from 0-dimensional individual cell simulation, 1-dimensional fibre, 2-dimensional sheet and 3-dimensional slab of tissue, up to anatomically realistic whole heart simulations, with run time measurements including cardiac re-entry tip/filament tracing, ECG, local/global samples of any variables, etc. BeatBox solvers, cell, and tissue/anatomy models repositories are extended via robust and flexible interfaces, thus providing an open framework for new developments in the field. In this paper we give an overview of the BeatBox current state, together with a description of the main computational methods and MPI parallelisation approaches.

Improved automatic optic nerve radius estimation from high resolution MRI

NASA Astrophysics Data System (ADS)

Harrigan, Robert L.; Smith, Alex K.; Mawn, Louise A.; Smith, Seth A.; Landman, Bennett A.

2017-02-01

The optic nerve (ON) is a vital structure in the human visual system and transports all visual information from the retina to the cortex for higher order processing. Due to the lack of redundancy in the visual pathway, measures of ON damage have been shown to correlate well with visual deficits. These measures are typically taken at an arbitrary anatomically defined point along the nerve and do not characterize changes along the length of the ON. We propose a fully automated, three-dimensionally consistent technique building upon a previous independent slice-wise technique to estimate the radius of the ON and surrounding cerebrospinal fluid (CSF) on high-resolution heavily T2-weighted isotropic MRI. We show that by constraining results to be three-dimensionally consistent this technique produces more anatomically viable results. We compare this technique with the previously published slice-wise technique using a short-term reproducibility data set, 10 subjects, follow-up <1 month, and show that the new method is more reproducible in the center of the ON. The center of the ON contains the most accurate imaging because it lacks confounders such as motion and frontal lobe interference. Long-term reproducibility, 5 subjects, follow-up of approximately 11 months, is also investigated with this new technique and shown to be similar to short-term reproducibility, indicating that the ON does not change substantially within 11 months. The increased accuracy of this new technique provides increased power when searching for anatomical changes in ON size amongst patient populations.

Improved Automatic Optic Nerve Radius Estimation from High Resolution MRI.

PubMed

Harrigan, Robert L; Smith, Alex K; Mawn, Louise A; Smith, Seth A; Landman, Bennett A

2017-02-11

The optic nerve (ON) is a vital structure in the human visual system and transports all visual information from the retina to the cortex for higher order processing. Due to the lack of redundancy in the visual pathway, measures of ON damage have been shown to correlate well with visual deficits. These measures are typically taken at an arbitrary anatomically defined point along the nerve and do not characterize changes along the length of the ON. We propose a fully automated, three-dimensionally consistent technique building upon a previous independent slice-wise technique to estimate the radius of the ON and surrounding cerebrospinal fluid (CSF) on high-resolution heavily T2-weighted isotropic MRI. We show that by constraining results to be three-dimensionally consistent this technique produces more anatomically viable results. We compare this technique with the previously published slice-wise technique using a short-term reproducibility data set, 10 subjects, follow-up <1 month, and show that the new method is more reproducible in the center of the ON. The center of the ON contains the most accurate imaging because it lacks confounders such as motion and frontal lobe interference. Long-term reproducibility, 5 subjects, follow-up of approximately 11 months, is also investigated with this new technique and shown to be similar to short-term reproducibility, indicating that the ON does not change substantially within 11 months. The increased accuracy of this new technique provides increased power when searching for anatomical changes in ON size amongst patient populations.

Prospective feasibility trial of radiotherapy target definition for head and neck cancer using 3-dimensional PET and CT imaging.

PubMed

Scarfone, Christopher; Lavely, William C; Cmelak, Anthony J; Delbeke, Dominique; Martin, William H; Billheimer, Dean; Hallahan, Dennis E

2004-04-01

The aim of this investigation was to evaluate the influence and accuracy of (18)F-FDG PET in target volume definition as a complementary modality to CT for patients with head and neck cancer (HNC) using dedicated PET and CT scanners. Six HNC patients were custom fitted with head and neck and upper body immobilization devices, and conventional radiotherapy CT simulation was performed together with (18)F-FDG PET imaging. Gross target volume (GTV) and pathologic nodal volumes were first defined in the conventional manner based on CT. A segmentation and surface-rendering registration technique was then used to coregister the (18)F-FDG PET and CT planning image datasets. (18)F-FDG PET GTVs were determined and displayed simultaneously with the CT contours. CT GTVs were then modified based on the PET data to form final PET/CT treatment volumes. Five-field intensity-modulated radiation therapy (IMRT) was then used to demonstrate dose targeting to the CT GTV or the PET/CT GTV. One patient was PET-negative after induction chemotherapy. The CT GTV was modified in all remaining patients based on (18)F-FDG PET data. The resulting PET/CT GTV was larger than the original CT volume by an average of 15%. In 5 cases, (18)F-FDG PET identified active lymph nodes that corresponded to lymph nodes contoured on CT. The pathologically enlarged CT lymph nodes were modified to create final lymph node volumes in 3 of 5 cases. In 1 of 6 patients, (18)F-FDG-avid lymph nodes were not identified as pathologic on CT. In 2 of 6 patients, registration of the independently acquired PET and CT data using segmentation and surface rendering resulted in a suboptimal alignment and, therefore, had to be repeated. Radiotherapy planning using IMRT demonstrated the capability of this technique to target anatomic or anatomic/physiologic target volumes. In this manner, metabolically active sites can be intensified to greater daily doses. Inclusion of (18)F-FDG PET data resulted in modified target volumes in radiotherapy planning for HNC. PET and CT data acquired on separate, dedicated scanners may be coregistered for therapy planning; however, dual-acquisition PET/CT systems may be considered to reduce the need for reregistrations. It is possible to use IMRT to target dose to metabolically active sites based on coregistered PET/CT data.

A Dynamic Finite Element Analysis of Human Foot Complex in the Sagittal Plane during Level Walking

PubMed Central

Qian, Zhihui; Ren, Lei; Ding, Yun; Hutchinson, John R.; Ren, Luquan

2013-01-01

The objective of this study is to develop a computational framework for investigating the dynamic behavior and the internal loading conditions of the human foot complex during locomotion. A subject-specific dynamic finite element model in the sagittal plane was constructed based on anatomical structures segmented from medical CT scan images. Three-dimensional gait measurements were conducted to support and validate the model. Ankle joint forces and moment derived from gait measurements were used to drive the model. Explicit finite element simulations were conducted, covering the entire stance phase from heel-strike impact to toe-off. The predicted ground reaction forces, center of pressure, foot bone motions and plantar surface pressure showed reasonably good agreement with the gait measurement data over most of the stance phase. The prediction discrepancies can be explained by the assumptions and limitations of the model. Our analysis showed that a dynamic FE simulation can improve the prediction accuracy in the peak plantar pressures at some parts of the foot complex by 10%–33% compared to a quasi-static FE simulation. However, to simplify the costly explicit FE simulation, the proposed model is confined only to the sagittal plane and has a simplified representation of foot structure. The dynamic finite element foot model proposed in this study would provide a useful tool for future extension to a fully muscle-driven dynamic three-dimensional model with detailed representation of all major anatomical structures, in order to investigate the structural dynamics of the human foot musculoskeletal system during normal or even pathological functioning. PMID:24244500

A dynamic finite element analysis of human foot complex in the sagittal plane during level walking.

PubMed

Qian, Zhihui; Ren, Lei; Ding, Yun; Hutchinson, John R; Ren, Luquan

2013-01-01

The objective of this study is to develop a computational framework for investigating the dynamic behavior and the internal loading conditions of the human foot complex during locomotion. A subject-specific dynamic finite element model in the sagittal plane was constructed based on anatomical structures segmented from medical CT scan images. Three-dimensional gait measurements were conducted to support and validate the model. Ankle joint forces and moment derived from gait measurements were used to drive the model. Explicit finite element simulations were conducted, covering the entire stance phase from heel-strike impact to toe-off. The predicted ground reaction forces, center of pressure, foot bone motions and plantar surface pressure showed reasonably good agreement with the gait measurement data over most of the stance phase. The prediction discrepancies can be explained by the assumptions and limitations of the model. Our analysis showed that a dynamic FE simulation can improve the prediction accuracy in the peak plantar pressures at some parts of the foot complex by 10%-33% compared to a quasi-static FE simulation. However, to simplify the costly explicit FE simulation, the proposed model is confined only to the sagittal plane and has a simplified representation of foot structure. The dynamic finite element foot model proposed in this study would provide a useful tool for future extension to a fully muscle-driven dynamic three-dimensional model with detailed representation of all major anatomical structures, in order to investigate the structural dynamics of the human foot musculoskeletal system during normal or even pathological functioning.

Three-dimensional printed ultrasound and photoacoustic training phantoms for vasculature access (Conference Presentation)

NASA Astrophysics Data System (ADS)

Nikitichev, Daniil I.; Xia, Wenfeng; West, Simeon J.; Desjardins, Adrien E.; Ourselin, Sebastien; Vercauteren, Tom

2017-03-01

Ultrasound (US) imaging is widely used to guide vascular access procedures such as arterial and venous cannulation. As needle visualisation with US imaging can be very challenging, it is easy to misplace the needle in the patient and it can be life threating. Photoacoustic (PA) imaging is well suited to image medical needles and catheters that are commonly used for vascular access. To improve the success rate, a certain level of proficiency is required that can be gained through extensive practice on phantoms. Unfortunately, commercial training phantoms are expensive and custom-made phantoms usually do not replicate the anatomy very well. Thus, there is a great demand for more realistic and affordable ultrasound and photoacoustic imaging phantoms for vasculature access procedures training. Three-dimensional (3D) printing can help create models that replicate complex anatomical geometries. However, the available 3D printed materials do not possess realistic tissue properties. Alternatively, tissue-mimicking materials can be employed using casting and 3D printed moulds but this approach is limited to the creation of realistic outer shapes with no replication of complex internal structures. In this study, we developed a realistic vasculature access phantom using a combination of mineral oil based materials as background tissue and a non-toxic, water dissolvable filament material to create complex vascular structure using 3D printing. US and PA images of the phantoms comprising the complex vasculature network were acquired. The results show that 3D printing can facilitate the fabrication of anatomically realistic training phantoms, with designs that can be customized and shared electronically.

Feasibility of remote sensing for detecting thermal pollution. Part 1: Feasibility study. Part 2: Implementation plan. [coastal ecology

NASA Technical Reports Server (NTRS)

Veziroglu, T. N.; Lee, S. S.

1973-01-01

A feasibility study for the development of a three-dimensional generalized, predictive, analytical model involving remote sensing, in-situ measurements, and an active system to remotely measure turbidity is presented. An implementation plan for the development of the three-dimensional model and for the application of remote sensing of temperature and turbidity measurements is outlined.

Three-dimensional sinus imaging as an adjunct to two-dimensional imaging to accelerate education and improve spatial orientation.

PubMed

Yao, William C; Regone, Rachel M; Huyhn, Nancy; Butler, E Brian; Takashima, Masayoshi

2014-03-01

Develop a novel three-dimensional (3-D) anatomical model to assist in improving spatial knowledge of the skull base, paranasal sinuses, and adjacent structures, and validate the utilization of 3-D reconstruction to augment two-dimensional (2-D) computed tomography (CT) for the training of medical students and otolaryngology-head and neck surgery residents. Prospective study. A study of 18 subjects studying sinus anatomy was conducted at a tertiary academic center during the 2011 to 2012 academic year. An image processing and 3-D modeling program was used to create a color coded 3-D scalable/layerable/rotatable model of key paranasal and skull base structures from a 2-D high-resolution sinus CT scan. Subjects received instruction of the sinus anatomy in two sessions, first through review of a 2-D CT sinus scan, followed by an educational module of the 3-D reconstruction. After each session, subjects rated their knowledge of the sinus and adjacent structures on a self-assessment questionnaire. Significant improvement in the perceived understanding of the anatomy was noted after the 3-D educational module session when compared to the 2-D CT session alone (P < .01). Every subject believed the addition of 3-D imaging accelerated their education of sinus anatomy and recommended its use to others. The impression of the learners was that a 3-D educational module, highlighting key structures, is a highly effective tool to enhance the education of medical students and otolaryngology residents in sinus and skull base anatomy and its adjacent structures, specifically in conceptualizing the spatial orientation of these structures. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Arthroscopy or ultrasound in undergraduate anatomy education: a randomized cross-over controlled trial.

PubMed

Knobe, Matthias; Carow, John Bennet; Ruesseler, Miriam; Leu, Benjamin Moritz; Simon, Melanie; Beckers, Stefan K; Ghassemi, Alireza; Sönmez, Tolga T; Pape, Hans-Christoph

2012-09-09

The exponential growth of image-based diagnostic and minimally invasive interventions requires a detailed three-dimensional anatomical knowledge and increases the demand towards the undergraduate anatomical curriculum. This randomized controlled trial investigates whether musculoskeletal ultrasound (MSUS) or arthroscopic methods can increase the anatomical knowledge uptake. Second-year medical students were randomly allocated to three groups. In addition to the compulsory dissection course, the ultrasound group (MSUS) was taught by eight, didactically and professionally trained, experienced student-teachers and the arthroscopy group (ASK) was taught by eight experienced physicians. The control group (CON) acquired the anatomical knowledge only via the dissection course. Exposure (MSUS and ASK) took place in two separate lessons (75 minutes each, shoulder and knee joint) and introduced standard scan planes using a 10-MHz ultrasound system as well as arthroscopy tutorials at a simulator combined with video tutorials. The theoretical anatomic learning outcomes were tested using a multiple-choice questionnaire (MCQ), and after cross-over an objective structured clinical examination (OSCE). Differences in student's perceptions were evaluated using Likert scale-based items. The ASK-group (n = 70, age 23.4 (20-36) yrs.) performed moderately better in the anatomical MC exam in comparison to the MSUS-group (n = 84, age 24.2 (20-53) yrs.) and the CON-group (n = 88, 22.8 (20-33) yrs.; p = 0.019). After an additional arthroscopy teaching 1% of students failed the MC exam, in contrast to 10% in the MSUS- or CON-group, respectively. The benefit of the ASK module was limited to the shoulder area (p < 0.001). The final examination (OSCE) showed no significant differences between any of the groups with good overall performances. In the evaluation, the students certified the arthroscopic tutorial a greater advantage concerning anatomical skills with higher spatial imagination in comparison to the ultrasound tutorial (p = 0.002; p < 0.001). The additional implementation of arthroscopy tutorials to the dissection course during the undergraduate anatomy training is profitable and attractive to students with respect to complex joint anatomy. Simultaneous teaching of basic-skills in musculoskeletal ultrasound should be performed by medical experts, but seems to be inferior to the arthroscopic 2D-3D-transformation, and is regarded by students as more difficult to learn. Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery.

Arthroscopy or ultrasound in undergraduate anatomy education: a randomized cross-over controlled trial

PubMed Central

2012-01-01

Background The exponential growth of image-based diagnostic and minimally invasive interventions requires a detailed three-dimensional anatomical knowledge and increases the demand towards the undergraduate anatomical curriculum. This randomized controlled trial investigates whether musculoskeletal ultrasound (MSUS) or arthroscopic methods can increase the anatomical knowledge uptake. Methods Second-year medical students were randomly allocated to three groups. In addition to the compulsory dissection course, the ultrasound group (MSUS) was taught by eight, didactically and professionally trained, experienced student-teachers and the arthroscopy group (ASK) was taught by eight experienced physicians. The control group (CON) acquired the anatomical knowledge only via the dissection course. Exposure (MSUS and ASK) took place in two separate lessons (75 minutes each, shoulder and knee joint) and introduced standard scan planes using a 10-MHz ultrasound system as well as arthroscopy tutorials at a simulator combined with video tutorials. The theoretical anatomic learning outcomes were tested using a multiple-choice questionnaire (MCQ), and after cross-over an objective structured clinical examination (OSCE). Differences in student’s perceptions were evaluated using Likert scale-based items. Results The ASK-group (n = 70, age 23.4 (20–36) yrs.) performed moderately better in the anatomical MC exam in comparison to the MSUS-group (n = 84, age 24.2 (20–53) yrs.) and the CON-group (n = 88, 22.8 (20–33) yrs.; p = 0.019). After an additional arthroscopy teaching 1% of students failed the MC exam, in contrast to 10% in the MSUS- or CON-group, respectively. The benefit of the ASK module was limited to the shoulder area (p < 0.001). The final examination (OSCE) showed no significant differences between any of the groups with good overall performances. In the evaluation, the students certified the arthroscopic tutorial a greater advantage concerning anatomical skills with higher spatial imagination in comparison to the ultrasound tutorial (p = 0.002; p < 0.001). Conclusions The additional implementation of arthroscopy tutorials to the dissection course during the undergraduate anatomy training is profitable and attractive to students with respect to complex joint anatomy. Simultaneous teaching of basic-skills in musculoskeletal ultrasound should be performed by medical experts, but seems to be inferior to the arthroscopic 2D-3D-transformation, and is regarded by students as more difficult to learn. Although arthroscopy and ultrasound teaching do not have a major effect on learning joint anatomy, they have the potency to raise the interest in surgery. PMID:22958784

A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment.

PubMed

Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm; Nielsen, Michael Bachmann; Jensen, Jorgen Arendt

2017-01-01

This paper discusses the methods for the assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology is valuable in the continuing process of method optimization and guided development of new imaging methods. It includes a three phased study plan covering from initial prototype development to clinical assessment. Recommendations to the clinical assessment protocol, software, and statistical analysis are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer to properly reveal the clinical value. This paper exemplifies the methodology using recent studies of synthetic aperture sequential beamforming tissue harmonic imaging.

Pre-operative simulation of pediatric mastoid surgery with 3D-printed temporal bone models.

PubMed

Rose, Austin S; Webster, Caroline E; Harrysson, Ola L A; Formeister, Eric J; Rawal, Rounak B; Iseli, Claire E

2015-05-01

As the process of additive manufacturing, or three-dimensional (3D) printing, has become more practical and affordable, a number of applications for the technology in the field of pediatric otolaryngology have been considered. One area of promise is temporal bone surgical simulation. Having previously developed a model for temporal bone surgical training using 3D printing, we sought to produce a patient-specific model for pre-operative simulation in pediatric otologic surgery. Our hypothesis was that the creation and pre-operative dissection of such a model was possible, and would demonstrate potential benefits in cases of abnormal temporal bone anatomy. In the case presented, an 11-year-old boy underwent a planned canal-wall-down (CWD) tympano-mastoidectomy for recurrent cholesteatoma preceded by a pre-operative surgical simulation using 3D-printed models of the temporal bone. The models were based on the child's pre-operative clinical CT scan and printed using multiple materials to simulate both bone and soft tissue structures. To help confirm the models as accurate representations of the child's anatomy, distances between various anatomic landmarks were measured and compared to the temporal bone CT scan and the 3D model. The simulation allowed the surgical team to appreciate the child's unusual temporal bone anatomy as well as any challenges that might arise in the safety of the temporal bone laboratory, prior to actual surgery in the operating room (OR). There was minimal variability, in terms of absolute distance (mm) and relative distance (%), in measurements between anatomic landmarks obtained from the patient intra-operatively, the pre-operative CT scan and the 3D-printed models. Accurate 3D temporal bone models can be rapidly produced based on clinical CT scans for pre-operative simulation of specific challenging otologic cases in children, potentially reducing medical errors and improving patient safety. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra provides reduced effect of scanner for cortex volumetry with atlas-based method in healthy subjects.

PubMed

Goto, Masami; Abe, Osamu; Aoki, Shigeki; Hayashi, Naoto; Miyati, Tosiaki; Takao, Hidemasa; Iwatsubo, Takeshi; Yamashita, Fumio; Matsuda, Hiroshi; Mori, Harushi; Kunimatsu, Akira; Ino, Kenji; Yano, Keiichi; Ohtomo, Kuni

2013-07-01

This study aimed to investigate whether the effect of scanner for cortex volumetry with atlas-based method is reduced using Diffeomorphic Anatomical Registration Through Exponentiated Lie Algebra (DARTEL) normalization compared with standard normalization. Three-dimensional T1-weighted magnetic resonance images (3D-T1WIs) of 21 healthy subjects were obtained and evaluated for effect of scanner in cortex volumetry. 3D-T1WIs of the 21 subjects were obtained with five MRI systems. Imaging of each subject was performed on each of five different MRI scanners. We used the Voxel-Based Morphometry 8 tool implemented in Statistical Parametric Mapping 8 and WFU PickAtlas software (Talairach brain atlas theory). The following software default settings were used as bilateral region-of-interest labels: "Frontal Lobe," "Hippocampus," "Occipital Lobe," "Orbital Gyrus," "Parietal Lobe," "Putamen," and "Temporal Lobe." Effect of scanner for cortex volumetry using the atlas-based method was reduced with DARTEL normalization compared with standard normalization in Frontal Lobe, Occipital Lobe, Orbital Gyrus, Putamen, and Temporal Lobe; was the same in Hippocampus and Parietal Lobe; and showed no increase with DARTEL normalization for any region of interest (ROI). DARTEL normalization reduces the effect of scanner, which is a major problem in multicenter studies.

Computer-assisted surgical planning and automation of laser delivery systems

NASA Astrophysics Data System (ADS)

Zamorano, Lucia J.; Dujovny, Manuel; Dong, Ada; Kadi, A. Majeed

1991-05-01

This paper describes a 'real time' surgical treatment planning interactive workstation, utilizing multimodality imaging (computer tomography, magnetic resonance imaging, digital angiography) that has been developed to provide the neurosurgeon with two-dimensional multiplanar and three-dimensional 'display' of a patient's lesion.

Comparison of femur tunnel aperture location in patients undergoing transtibial and anatomical single-bundle anterior cruciate ligament reconstruction.

PubMed

Lee, Dae-Hee; Kim, Hyun-Jung; Ahn, Hyeong-Sik; Bin, Seong-Il

2016-12-01

Although three-dimensional computed tomography (3D-CT) has been used to compare femoral tunnel position following transtibial and anatomical anterior cruciate ligament (ACL) reconstruction, no consensus has been reached on which technique results in a more anatomical position because methods of quantifying femoral tunnel position on 3D-CT have not been consistent. This meta-analysis was therefore performed to compare femoral tunnel location following transtibial and anatomical ACL reconstruction, in both the low-to-high and deep-to-shallow directions. This meta-analysis included all studies that used 3D-CT to compare femoral tunnel location, using quadrant or anatomical coordinate axis methods, following transtibial and anatomical (AM portal or OI) single-bundle ACL reconstruction. Six studies were included in the meta-analysis. Femoral tunnel location was 18 % higher in the low-to-high direction, but was not significant in the deep-to-shallow direction, using the transtibial technique than the anatomical methods, when measured using the anatomical coordinate axis method. When measured using the quadrant method, however, femoral tunnel positions were significantly higher (21 %) and shallower (6 %) with transtibial than anatomical methods of ACL reconstruction. The anatomical ACL reconstruction techniques led to a lower femoral tunnel aperture location than the transtibial technique, suggesting the superiority of anatomical techniques for creating new femoral tunnels during revision ACL reconstruction in femoral tunnel aperture location in the low-to-high direction. However, the mean difference in the deep-to-shallow direction differed by method of measurement. Meta-analysis, Level II.

Muscle-driven finite element simulation of human foot movements.

PubMed

Spyrou, L A; Aravas, N

2012-01-01

This paper describes a finite element scheme for realistic muscle-driven simulation of human foot movements. The scheme is used to simulate human ankle plantar flexion. A three-dimensional anatomically detailed finite element model of human foot and lower leg is developed and the idea of generating natural foot movement based entirely on the contraction of the plantar flexor muscles is used. The bones, ligaments, articular cartilage, muscles, tendons, as well as the rest soft tissues of human foot and lower leg are included in the model. A realistic three-dimensional continuum constitutive model that describes the biomechanical behaviour of muscles and tendons is used. Both the active and passive properties of muscle tissue are accounted for. The materials for bones and ligaments are considered as homogeneous, isotropic and linearly elastic, whereas the articular cartilage and the rest soft tissues (mainly fat) are defined as hyperelastic materials. The model is used to estimate muscle tissue deformations as well as stresses and strains that develop in the lower leg muscles during plantar flexion of the ankle. Stresses and strains that develop in Achilles tendon during such a movement are also investigated.

A method for automatic feature points extraction of human vertebrae three-dimensional model

NASA Astrophysics Data System (ADS)

Wu, Zhen; Wu, Junsheng

2017-05-01

A method for automatic extraction of the feature points of the human vertebrae three-dimensional model is presented. Firstly, the statistical model of vertebrae feature points is established based on the results of manual vertebrae feature points extraction. Then anatomical axial analysis of the vertebrae model is performed according to the physiological and morphological characteristics of the vertebrae. Using the axial information obtained from the analysis, a projection relationship between the statistical model and the vertebrae model to be extracted is established. According to the projection relationship, the statistical model is matched with the vertebrae model to get the estimated position of the feature point. Finally, by analyzing the curvature in the spherical neighborhood with the estimated position of feature points, the final position of the feature points is obtained. According to the benchmark result on multiple test models, the mean relative errors of feature point positions are less than 5.98%. At more than half of the positions, the error rate is less than 3% and the minimum mean relative error is 0.19%, which verifies the effectiveness of the method.

3D printing functional materials and devices (Conference Presentation)

NASA Astrophysics Data System (ADS)

McAlpine, Michael C.

2017-05-01

The development of methods for interfacing high performance functional devices with biology could impact regenerative medicine, smart prosthetics, and human-machine interfaces. Indeed, the ability to three-dimensionally interweave biological and functional materials could enable the creation of devices possessing unique geometries, properties, and functionalities. Yet, most high quality functional materials are two dimensional, hard and brittle, and require high crystallization temperatures for maximal performance. These properties render the corresponding devices incompatible with biology, which is three-dimensional, soft, stretchable, and temperature sensitive. We overcome these dichotomies by: 1) using 3D printing and scanning for customized, interwoven, anatomically accurate device architectures; 2) employing nanotechnology as an enabling route for overcoming mechanical discrepancies while retaining high performance; and 3) 3D printing a range of soft and nanoscale materials to enable the integration of a diverse palette of high quality functional nanomaterials with biology. 3D printing is a multi-scale platform, allowing for the incorporation of functional nanoscale inks, the printing of microscale features, and ultimately the creation of macroscale devices. This three-dimensional blending of functional materials and `living' platforms may enable next-generation 3D printed devices.

Cardiovascular causes of airway compression.

PubMed

Kussman, Barry D; Geva, Tal; McGowan, Francis X

2004-01-01

Compression of the paediatric airway is a relatively common and often unrecognized complication of congenital cardiac and aortic arch anomalies. Airway obstruction may be the result of an anomalous relationship between the tracheobronchial tree and vascular structures (producing a vascular ring) or the result of extrinsic compression caused by dilated pulmonary arteries, left atrial enlargement, massive cardiomegaly, or intraluminal bronchial obstruction. A high index of suspicion of mechanical airway compression should be maintained in infants and children with recurrent respiratory difficulties, stridor, wheezing, dysphagia, or apnoea unexplained by other causes. Prompt diagnosis is required to avoid death and minimize airway damage. In addition to plain chest radiography and echocardiography, diagnostic investigations may consist of barium oesophagography, magnetic resonance imaging (MRI), computed tomography, cardiac catheterization and bronchoscopy. The most important recent advance is MRI, which can produce high quality three-dimensional reconstruction of all anatomic elements allowing for precise anatomic delineation and improved surgical planning. Anaesthetic technique will depend on the type of vascular ring and the presence of any congenital heart disease or intrinsic lesions of the tracheobronchial tree. Vascular rings may be repaired through a conventional posterolateral thoracotomy, or utilizing video-assisted thoracoscopic surgery (VATS) or robotic endoscopic surgery. Persistent airway obstruction following surgical repair may be due to residual compression, secondary airway wall instability (malacia), or intrinsic lesions of the airway. Simultaneous repair of cardiac defects and vascular tracheobronchial compression carries a higher risk of morbidity and mortality.

Take Away Body Parts! An Investigation into the Use of 3D-Printed Anatomical Models in Undergraduate Anatomy Education

ERIC Educational Resources Information Center

Smith, Claire F.; Tollemache, Nicholas; Covill, Derek; Johnston, Malcolm

2018-01-01

Understanding the three-dimensional (3D) nature of the human form is imperative for effective medical practice and the emergence of 3D printing creates numerous opportunities to enhance aspects of medical and healthcare training. A recently deceased, un-embalmed donor was scanned through high-resolution computed tomography. The scan data underwent…

[An interactive three-dimensional model of the human body].

PubMed

Liem, S L

2009-01-01

Driven by advanced computer technology, it is now possible to show the human anatomy on a computer. On the internet, the Visible Body programme makes it possible to navigate in all directions through the anatomical structures of the human body, using mouse and keyboard. Visible Body is a wonderful tool to give insight in the human structures, body functions and organs.

Predicting Student Performance in Sonographic Scanning Using Spatial Ability as an Ability Determinent of Skill Acquisition

ERIC Educational Resources Information Center

Clem, Douglas Wayne

2012-01-01

Spatial ability refers to an individual's capacity to visualize and mentally manipulate three dimensional objects. Since sonographers manually manipulate 2D and 3D sonographic images to generate multi-viewed, logical, sequential renderings of an anatomical structure, it can be assumed that spatial ability is central to the perception and…

Three-Dimensional Photoacoustic Endoscopic Imaging of the Rabbit Esophagus

PubMed Central

Yao, Junjie; Chen, Ruimin; Zhou, Qifa; Shung, K. Kirk; Wang, Lihong V.

2015-01-01

We report photoacoustic and ultrasonic endoscopic images of two intact rabbit esophagi. To investigate the esophageal lumen structure and microvasculature, we performed in vivo and ex vivo imaging studies using a 3.8-mm diameter photoacoustic endoscope and correlated the images with histology. Several interesting anatomic structures were newly found in both the in vivo and ex vivo images, which demonstrates the potential clinical utility of this endoscopic imaging modality. In the ex vivo imaging experiment, we acquired high-resolution motion-artifact-free three-dimensional photoacoustic images of the vasculatures distributed in the walls of the esophagi and extending to the neighboring mediastinal regions. Blood vessels with apparent diameters as small as 190 μm were resolved. Moreover, by taking advantage of the dual-mode high-resolution photoacoustic and ultrasound endoscopy, we could better identify and characterize the anatomic structures of the esophageal lumen, such as the mucosal and submucosal layers in the esophageal wall, and an esophageal branch of the thoracic aorta. In this paper, we present the first photoacoustic images showing the vasculature of a vertebrate esophagus and discuss the potential clinical applications and future development of photoacoustic endoscopy. PMID:25874640

Three-dimensional photoacoustic endoscopic imaging of the rabbit esophagus.

PubMed

Yang, Joon Mo; Favazza, Christopher; Yao, Junjie; Chen, Ruimin; Zhou, Qifa; Shung, K Kirk; Wang, Lihong V

2015-01-01

We report photoacoustic and ultrasonic endoscopic images of two intact rabbit esophagi. To investigate the esophageal lumen structure and microvasculature, we performed in vivo and ex vivo imaging studies using a 3.8-mm diameter photoacoustic endoscope and correlated the images with histology. Several interesting anatomic structures were newly found in both the in vivo and ex vivo images, which demonstrates the potential clinical utility of this endoscopic imaging modality. In the ex vivo imaging experiment, we acquired high-resolution motion-artifact-free three-dimensional photoacoustic images of the vasculatures distributed in the walls of the esophagi and extending to the neighboring mediastinal regions. Blood vessels with apparent diameters as small as 190 μm were resolved. Moreover, by taking advantage of the dual-mode high-resolution photoacoustic and ultrasound endoscopy, we could better identify and characterize the anatomic structures of the esophageal lumen, such as the mucosal and submucosal layers in the esophageal wall, and an esophageal branch of the thoracic aorta. In this paper, we present the first photoacoustic images showing the vasculature of a vertebrate esophagus and discuss the potential clinical applications and future development of photoacoustic endoscopy.

Three-dimensional facial architecture in normodivergent class I Caucasian subjects.

PubMed

Ghoubril, J V; Abou Obeid, F M

2013-06-01

The aims of this study were to (1) define facial architecture in Caucasian patients with normodivergent, skeletal and dental class I using Treil's cephalometric analysis, which is based on computed tomography (CT), and (2) develop a scheme to determine individual balance or normality in relation to linear, angular and volumetric parameters. The CT data of 60 adult subjects were equally divided between both genders. Based on anatomical points located along the trigeminal neuro-matricial facial growth axes, a three-dimensional maxillo-facial architecture was constructed. Volumetric and linear parameters were greater in males (0.000 < p < 0.044) except for the anterior and posterior mandibular width. Sexual dimorphism was not observed with angular parameters. There was no correlation between volumetric and angular parameters. The correlation tests showed that the total volume of the frame increases with infraorbital depth, supraorbital depth, posterior mandibular width and facial height (0.526 < r < 0.777), while it was not associated with the maxillo-orbital width (0.252 < r < 0.389). Total and orbital volumes were more correlated with posterior than with anterior mandibular width. Maxillo-mandibular volume of the frame was more cor-related with orbital depth (0.591 < r < 0.742) than the orbital volume (0.482 < r < 0.589). The results allowed us to establish three-dimensional cephalometric standards, and to replace the tenet of normality, which is a mean value of calculated parameters, by the concept of individual balance among volumetric entities. While sagittal and vertical dimensions affect volumetric changes of the frame, the transverse dimension does not.

Virtual reality in neurosurgical education: part-task ventriculostomy simulation with dynamic visual and haptic feedback.

PubMed

Lemole, G Michael; Banerjee, P Pat; Luciano, Cristian; Neckrysh, Sergey; Charbel, Fady T

2007-07-01

Mastery of the neurosurgical skill set involves many hours of supervised intraoperative training. Convergence of political, economic, and social forces has limited neurosurgical resident operative exposure. There is need to develop realistic neurosurgical simulations that reproduce the operative experience, unrestricted by time and patient safety constraints. Computer-based, virtual reality platforms offer just such a possibility. The combination of virtual reality with dynamic, three-dimensional stereoscopic visualization, and haptic feedback technologies makes realistic procedural simulation possible. Most neurosurgical procedures can be conceptualized and segmented into critical task components, which can be simulated independently or in conjunction with other modules to recreate the experience of a complex neurosurgical procedure. We use the ImmersiveTouch (ImmersiveTouch, Inc., Chicago, IL) virtual reality platform, developed at the University of Illinois at Chicago, to simulate the task of ventriculostomy catheter placement as a proof-of-concept. Computed tomographic data are used to create a virtual anatomic volume. Haptic feedback offers simulated resistance and relaxation with passage of a virtual three-dimensional ventriculostomy catheter through the brain parenchyma into the ventricle. A dynamic three-dimensional graphical interface renders changing visual perspective as the user's head moves. The simulation platform was found to have realistic visual, tactile, and handling characteristics, as assessed by neurosurgical faculty, residents, and medical students. We have developed a realistic, haptics-based virtual reality simulator for neurosurgical education. Our first module recreates a critical component of the ventriculostomy placement task. This approach to task simulation can be assembled in a modular manner to reproduce entire neurosurgical procedures.

Preoperative brain shift: study of three surgical cases

NASA Astrophysics Data System (ADS)

El Ganaoui, O.; Morandi, X.; Duchesne, S.; Jannin, P.

2008-03-01

In successful brain tumor surgery, the neurosurgeon's objectives are threefold: (1) reach the target, (2) remove it and (3) preserve eloquent tissue surrounding it. Surgical Planning (SP) consists in identifying optimal access route(s) to the target based on anatomical references and constrained by functional areas. Preoperative images are essential input in Multi-modal Image Guided NeuroSurgery systems (MIGNS) and update of these images, with precision and accuracy, is crucial to approach the anatomical reality in the Operating Room (OR). Intraoperative brain deformation has been previously identified by many research groups and related update of preoperative images has also been studied. We present a study of three surgical cases with tumors accompanied with edema and where corticosteroids were administered and monitored during a preoperative stage [t 0, t I = t 0 + 10 days]. In each case we observed a significant change in the Region Of Interest (ROI) and in anatomical references around it. This preoperative brain shift could induce error for localization during intervention (time t S) if the SP is based on the t 0 preoperative images. We computed volume variation, distance maps based on closest point (CP) for different components of the ROI, and displacement of center of mass (CM) of the ROI. The matching between sets of homologous landmarks from t 0 to t I was performed by an expert. The estimation of the landmarks displacement showed significant deformations around the ROI (landmarks shifted with mean of 3.90 +/- 0.92 mm and maximum of 5.45 mm for one case resection). The CM of the ROI moved about 6.92 mm for one biopsy. Accordingly, there was a sizable difference between SP based at t 0 vs SP based at t I, up to 7.95 mm for localization of reference access in one resection case. When compared to the typical MIGNS system accuracy (2 mm), it is recommended that preoperative images be updated within the interval time [t I,t S] in order to minimize the error correspondence between the anatomical reality and the preoperative data. This should help maximize the accuracy of registration between the preoperative images and the patient in the OR.

Anatomic partial nephrectomy: technique evolution.

PubMed

Azhar, Raed A; Metcalfe, Charles; Gill, Inderbir S

2015-03-01

Partial nephrectomy provides equivalent long-term oncologic and superior functional outcomes as radical nephrectomy for T1a renal masses. Herein, we review the various vascular clamping techniques employed during minimally invasive partial nephrectomy, describe the evolution of our partial nephrectomy technique and provide an update on contemporary thinking about the impact of ischemia on renal function. Recently, partial nephrectomy surgical technique has shifted away from main artery clamping and towards minimizing/eliminating global renal ischemia during partial nephrectomy. Supported by high-fidelity three-dimensional imaging, novel anatomic-based partial nephrectomy techniques have recently been developed, wherein partial nephrectomy can now be performed with segmental, minimal or zero global ischemia to the renal remnant. Sequential innovations have included early unclamping, segmental clamping, super-selective clamping and now culminating in anatomic zero-ischemia surgery. By eliminating 'under-the-gun' time pressure of ischemia for the surgeon, these techniques allow an unhurried, tightly contoured tumour excision with point-specific sutured haemostasis. Recent data indicate that zero-ischemia partial nephrectomy may provide better functional outcomes by minimizing/eliminating global ischemia and preserving greater vascularized kidney volume. Contemporary partial nephrectomy includes a spectrum of surgical techniques ranging from conventional-clamped to novel zero-ischemia approaches. Technique selection should be tailored to each individual case on the basis of tumour characteristics, surgical feasibility, surgeon experience, patient demographics and baseline renal function.

Application of Mathematical and Three-Dimensional Computer Modeling Tools in the Planning of Processes of Fuel and Energy Complexes

NASA Astrophysics Data System (ADS)

Aksenova, Olesya; Nikolaeva, Evgenia; Cehlár, Michal

2017-11-01

This work aims to investigate the effectiveness of mathematical and three-dimensional computer modeling tools in the planning of processes of fuel and energy complexes at the planning and design phase of a thermal power plant (TPP). A solution for purification of gas emissions at the design development phase of waste treatment systems is proposed employing mathematical and three-dimensional computer modeling - using the E-nets apparatus and the development of a 3D model of the future gas emission purification system. Which allows to visualize the designed result, to select and scientifically prove economically feasible technology, as well as to ensure the high environmental and social effect of the developed waste treatment system. The authors present results of a treatment of planned technological processes and the system for purifying gas emissions in terms of E-nets. using mathematical modeling in the Simulink application. What allowed to create a model of a device from the library of standard blocks and to perform calculations. A three-dimensional model of a system for purifying gas emissions has been constructed. It allows to visualize technological processes and compare them with the theoretical calculations at the design phase of a TPP and. if necessary, make adjustments.

Superimposition of 3-dimensional cone-beam computed tomography models of growing patients

PubMed Central

Cevidanes, Lucia H. C.; Heymann, Gavin; Cornelis, Marie A.; DeClerck, Hugo J.; Tulloch, J. F. Camilla

2009-01-01

Introduction The objective of this study was to evaluate a new method for superimposition of 3-dimensional (3D) models of growing subjects. Methods Cone-beam computed tomography scans were taken before and after Class III malocclusion orthopedic treatment with miniplates. Three observers independently constructed 18 3D virtual surface models from cone-beam computed tomography scans of 3 patients. Separate 3D models were constructed for soft-tissue, cranial base, maxillary, and mandibular surfaces. The anterior cranial fossa was used to register the 3D models of before and after treatment (about 1 year of follow-up). Results Three-dimensional overlays of superimposed models and 3D color-coded displacement maps allowed visual and quantitative assessment of growth and treatment changes. The range of interobserver errors for each anatomic region was 0.4 mm for the zygomatic process of maxilla, chin, condyles, posterior border of the rami, and lower border of the mandible, and 0.5 mm for the anterior maxilla soft-tissue upper lip. Conclusions Our results suggest that this method is a valid and reproducible assessment of treatment outcomes for growing subjects. This technique can be used to identify maxillary and mandibular positional changes and bone remodeling relative to the anterior cranial fossa. PMID:19577154

A web-based instruction module for interpretation of craniofacial cone beam CT anatomy.

PubMed

Hassan, B A; Jacobs, R; Scarfe, W C; Al-Rawi, W T

2007-09-01

To develop a web-based module for learner instruction in the interpretation and recognition of osseous anatomy on craniofacial cone-beam CT (CBCT) images. Volumetric datasets from three CBCT systems were acquired (i-CAT, NewTom 3G and AccuiTomo FPD) for various subjects using equipment-specific scanning protocols. The datasets were processed using multiple software to provide two-dimensional (2D) multiplanar reformatted (MPR) images (e.g. sagittal, coronal and axial) and three-dimensional (3D) visual representations (e.g. maximum intensity projection, minimum intensity projection, ray sum, surface and volume rendering). Distinct didactic modules which illustrate the principles of CBCT systems, guided navigation of the volumetric dataset, and anatomic correlation of 3D models and 2D MPR graphics were developed using a hybrid combination of web authoring and image analysis techniques. Interactive web multimedia instruction was facilitated by the use of dynamic highlighting and labelling, and rendered video illustrations, supplemented with didactic textual material. HTML coding and Java scripting were heavily implemented for the blending of the educational modules. An interactive, multimedia educational tool for visualizing the morphology and interrelationships of osseous craniofacial anatomy, as depicted on CBCT MPR and 3D images, was designed and implemented. The present design of a web-based instruction module may assist radiologists and clinicians in learning how to recognize and interpret the craniofacial anatomy of CBCT based images more efficiently.

Atlas instrumentation guided by the medial edge of the posterior arch: An anatomic and radiologic study.

PubMed

Al-Habib, Amro F; Al-Rabie, Abdulkarim; Aleissa, Sami; Albakr, Abdulrahman; Abobotain, Abdulaziz

2017-01-01

This was an interventional human cadaver study and radiological study. Atlas instrumentation is frequently involved in fusion procedures involving the craniocervical junction area. Identification of the entry point at the center of atlas lateral mass (ALM) is challenging because of its rounded posterior surface and the surrounding venous plexus. This report examines using the medial edge of atlas posterior arch (MEC1) as a fixed and reliable anatomic reference to guide the entry point of ALM screws. Fifty, normal, cervical spine computed tomography studies were reviewed. ALM screw trajectories were planned at one point along MEC1 and another point 2 mm lateral to MEC1. Free-hand ALM instrumentation was performed in ten fresh human cadavers using the 2 mm entry point, with a sagittal trajectory parallel to atlas inferior arch (IAC1); three-dimensional imaging was then performed to confirm instrumentation accuracy. The average ALM diameter was 12.35 mm. Inserting a screw using the entry point 2 mm lateral to MEC1 was closer to ALM midpoint than using the entry point along MEC1 ( P < 0.0001). Twenty ALM screws were successfully inserted in the ten cadavers. No encroachments into the spinal canal or foramen transversarium occurred. However, two screws were superiorly directed and violated the occipitocervical joint; they were not parallel to IAC1. MEC1 provides a fixed and reliable landmark for ALM instrumentation. An entry point 2 mm point lateral to MEC1 is close to ALM midpoint. IAC1 also provides a guide for the sagittal trajectory. Attention to anatomic landmarks may help reduce complications associated with atlas instrumentation but should be verified in future clinical studies.

Motion representation of the long fingers: a proposal for the definitions of new anatomical frames.

PubMed

Coupier, Jérôme; Moiseev, Fédor; Feipel, Véronique; Rooze, Marcel; Van Sint Jan, Serge

2014-04-11

Despite the availability of the International Society of Biomechanics (ISB) recommendations for the orientation of anatomical frames, no consensus exists about motion representations related to finger kinematics. This paper proposes novel anatomical frames for motion representation of the phalangeal segments of the long fingers. A three-dimensional model of a human forefinger was acquired from a non-pathological fresh-frozen hand. Medical imaging was used to collect phalangeal discrete positions. Data processing was performed using a customized software interface ("lhpFusionBox") to create a specimen-specific model and to reconstruct the discrete motion path. Five examiners virtually palpated two sets of landmarks. These markers were then used to build anatomical frames following two methods: a reference method following ISB recommendations and a newly-developed method based on the mean helical axis (HA). Motion representations were obtained and compared between examiners. Virtual palpation precision was around 1mm, which is comparable to results from the literature. The comparison of the two methods showed that the helical axis method seemed more reproducible between examiners especially for secondary, or accessory, motions. Computed Root Mean Square distances comparing methods showed that the ISB method displayed a variability 10 times higher than the HA method. The HA method seems to be suitable for finger motion representation using discrete positions from medical imaging. Further investigations are required before being able to use the methodology with continuous tracking of markers set on the subject's hand. Copyright © 2014 Elsevier Ltd. All rights reserved.

Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review.

PubMed

Martelli, Nicolas; Serrano, Carole; van den Brink, Hélène; Pineau, Judith; Prognon, Patrice; Borget, Isabelle; El Batti, Salma

2016-06-01

Three-dimensional (3D) printing is becoming increasingly important in medicine and especially in surgery. The aim of the present work was to identify the advantages and disadvantages of 3D printing applied in surgery. We conducted a systematic review of articles on 3D printing applications in surgery published between 2005 and 2015 and identified using a PubMed and EMBASE search. Studies dealing with bioprinting, dentistry, and limb prosthesis or those not conducted in a hospital setting were excluded. A total of 158 studies met the inclusion criteria. Three-dimensional printing was used to produce anatomic models (n = 113, 71.5%), surgical guides and templates (n = 40, 25.3%), implants (n = 15, 9.5%) and molds (n = 10, 6.3%), and primarily in maxillofacial (n = 79, 50.0%) and orthopedic (n = 39, 24.7%) operations. The main advantages reported were the possibilities for preoperative planning (n = 77, 48.7%), the accuracy of the process used (n = 53, 33.5%), and the time saved in the operating room (n = 52, 32.9%); 34 studies (21.5%) stressed that the accuracy was not satisfactory. The time needed to prepare the object (n = 31, 19.6%) and the additional costs (n = 30, 19.0%) were also seen as important limitations for routine use of 3D printing. The additional cost and the time needed to produce devices by current 3D technology still limit its widespread use in hospitals. The development of guidelines to improve the reporting of experience with 3D printing in surgery is highly desirable. Copyright © 2016 Elsevier Inc. All rights reserved.

[Application and prospect of digital technology in the field of orthodontics].

PubMed

Zhou, Y H

2016-06-01

The three-dimensional(3D)digital technology has brought a revolutionary change in diagnostic planning and treatment strategy of orthodontics. Acquisition of 3D image data of the hard and soft tissues of the patients, diagnostic analysis and treatment prediction, and ultimately the individualized orthodontic appliance, will become the development trend and workflow of the 3D orthodontics. With the development of 3D digital technology, the traditional plaster model has been gradually replacing by 3D digital models. Meanwhile, 3D facial soft tissue scan and cone-beam CT scan have been gradually applied to clinical orthodontics, making it possible to get 3D virtual anatomical structure for patients. With the help of digital technology, the diagnostic process is much easier for orthodontist. However how to command the whole digital workflow and put it into practice in the daily work is still a long way to go. The purpose of this article is to enlighten the orthodontists interested in digital technology and discuss the future of digital orthodontics in China.

3D printing in neurosurgery: A systematic review

PubMed Central

Randazzo, Michael; Pisapia, Jared M.; Singh, Nickpreet; Thawani, Jayesh P.

2016-01-01

Background: The recent expansion of three-dimensional (3D) printing technology into the field of neurosurgery has prompted a widespread investigation of its utility. In this article, we review the current body of literature describing rapid prototyping techniques with applications to the practice of neurosurgery. Methods: An extensive and systematic search of the Compendex, Scopus, and PubMed medical databases was conducted using keywords relating to 3D printing and neurosurgery. Results were manually screened for relevance to applications within the field. Results: Of the search results, 36 articles were identified and included in this review. The articles spanned the various subspecialties of the field including cerebrovascular, neuro-oncologic, spinal, functional, and endoscopic neurosurgery. Conclusions: We conclude that 3D printing techniques are practical and anatomically accurate methods of producing patient-specific models for surgical planning, simulation and training, tissue-engineered implants, and secondary devices. Expansion of this technology may, therefore, contribute to advancing the neurosurgical field from several standpoints. PMID:27920940

A novel medical image data-based multi-physics simulation platform for computational life sciences.

PubMed

Neufeld, Esra; Szczerba, Dominik; Chavannes, Nicolas; Kuster, Niels

2013-04-06

Simulating and modelling complex biological systems in computational life sciences requires specialized software tools that can perform medical image data-based modelling, jointly visualize the data and computational results, and handle large, complex, realistic and often noisy anatomical models. The required novel solvers must provide the power to model the physics, biology and physiology of living tissue within the full complexity of the human anatomy (e.g. neuronal activity, perfusion and ultrasound propagation). A multi-physics simulation platform satisfying these requirements has been developed for applications including device development and optimization, safety assessment, basic research, and treatment planning. This simulation platform consists of detailed, parametrized anatomical models, a segmentation and meshing tool, a wide range of solvers and optimizers, a framework for the rapid development of specialized and parallelized finite element method solvers, a visualization toolkit-based visualization engine, a Python scripting interface for customized applications, a coupling framework, and more. Core components are cross-platform compatible and use open formats. Several examples of applications are presented: hyperthermia cancer treatment planning, tumour growth modelling, evaluating the magneto-haemodynamic effect as a biomarker and physics-based morphing of anatomical models.

Concept and development of an orthotropic FE model of the proximal femur.

PubMed

Wirtz, Dieter Christian; Pandorf, Thomas; Portheine, Frank; Radermacher, Klaus; Schiffers, Norbert; Prescher, Andreas; Weichert, Dieter; Niethard, Fritz Uwe

2003-02-01

In contrast to many isotropic finite-element (FE) models of the femur in literature, it was the object of our study to develop an orthotropic FE "model femur" to realistically simulate three-dimensional bone remodelling. The three-dimensional geometry of the proximal femur was reconstructed by CT scans of a pair of cadaveric femurs at equal distances of 2mm. These three-dimensional CT models were implemented into an FE simulation tool. Well-known "density-determined" bony material properties (Young's modulus; Poisson's ratio; ultimate strength in pressure, tension and torsion; shear modulus) were assigned to each FE of the same "CT-density-characterized" volumetric group. In order to fix the principal directions of stiffness in FE areas with the same "density characterization", the cadaveric femurs were cut in 2mm slices in frontal (left femur) and sagittal plane (right femur). Each femoral slice was scanned into a computer-based image processing system. On these images, the principal directions of stiffness of cancellous and cortical bone were determined manually using the orientation of the trabecular structures and the Haversian system. Finally, these geometric data were matched with the "CT-density characterized" three-dimensional femur model. In addition, the time and density-dependent adaptive behaviour of bone remodelling was taken into account by implementation of Carter's criterion. In the constructed "model femur", each FE is characterized by the principal directions of the stiffness and the "CT-density-determined" material properties of cortical and cancellous bone. Thus, on the basis of anatomic data a three-dimensional FE simulation reference model of the proximal femur was realized considering orthotropic conditions of bone behaviour. With the orthotropic "model femur", the fundamental basis has been formed to realize realistic simulations of the dynamical processes of bone remodelling under different loading conditions or operative procedures (osteotomies, total hip replacements, etc).

Bionic Nanosystems

NASA Astrophysics Data System (ADS)

Sebastian Mannoor, Manu

Direct multidimensional integration of functional electronics and mechanical elements with viable biological systems could allow for the creation of bionic systems and devices possessing unique and advanced capabilities. For example, the ability to three dimensionally integrate functional electronic and mechanical components with biological cells and tissue could enable the creation of bionic systems that can have tremendous impact in regenerative medicine, prosthetics, and human-machine interfaces. However, as a consequence of the inherent dichotomy in material properties and limitations of conventional fabrication methods, the attainment of truly seamless integration of electronic and/or mechanical components with biological systems has been challenging. Nanomaterials engineering offers a general route for overcoming these dichotomies, primarily due to the existence of a dimensional compatibility between fundamental biological functional units and abiotic nanomaterial building blocks. One area of compelling interest for bionic systems is in the field of biomedical sensing, where the direct interfacing of nanosensors onto biological tissue or the human body could stimulate exciting opportunities such as on-body health quality monitoring and adaptive threat detection. Further, interfacing of antimicrobial peptide based bioselective probes onto the bionic nanosensors could offer abilities to detect pathogenic bacteria with bio-inspired selectivity. Most compellingly, when paired with additive manufacturing techniques such as 3D printing, these characteristics enable three dimensional integration and merging of a variety of functional materials including electronic, structural and biomaterials with viable biological cells, in the precise anatomic geometries of human organs, to form three dimensionally integrated, multi-functional bionic hybrids and cyborg devices with unique capabilities. In this thesis, we illustrate these approaches using three representative bionic systems: 1) Bionic Nanosensors: featuring bio-integrated graphene nanosensors for ubiquitous sensing, 2) Bionic Organs: featuring 3D printed bionic ears with three dimensionally integrated electronics and 3) Bionic Leaves: describing ongoing work in the direction of the creation of a bionic leaf enabled by the integration of plant derived photosynthetic functional units with electronic materials and components into a leaf-shaped hierarchical structure for harvesting photosynthetic bioelectricity.

Investigation and evaluation of a computer program to minimize three-dimensional flight time tracks

NASA Technical Reports Server (NTRS)

Parke, F. I.

1981-01-01

The program for the DC 8-D3 flight planning was slightly modified for the three dimensional flight planning for DC 10 aircrafts. Several test runs of the modified program over the North Atlantic and North America were made for verifying the program. While geopotential height and temperature were used in a previous program as meteorological data, the modified program uses wind direction and speed and temperature received from the National Weather Service. A scanning program was written to collect required weather information from the raw data received in a packed decimal format. Two sets of weather data, the 12-hour forecast and 24-hour forecast based on 0000 GMT, are used for dynamic processes in testruns. In order to save computing time only the weather data of the North Atlantic and North America is previously stored in a PCF file and then scanned one by one.

Traditional surgical planning of liver surgery is modified by 3D interactive quantitative surgical planning approach: a single-center experience with 305 patients.

PubMed

Wang, Xue-Dong; Wang, Hong-Guang; Shi, Jun; Duan, Wei-Dong; Luo, Ying; Ji, Wen-Bin; Zhang, Ning; Dong, Jia-Hong

2017-06-01

Decision making and surgical planning are to achieve the precise balance of maximal removal of target lesion, maximal sparing of functional liver remnant volume, and minimal surgical invasiveness and therefore, crucial in liver surgery. The aim of this prospective study was to validate the accuracy and predictability of 3D interactive quantitative surgical planning approach (IQSP), and to evaluate the impact of IQSP on traditional surgical plans based on 2D images. A total of 305 consecutive patients undergoing hepatectomy were included in this study. Surgical plans were created by traditional 2D approach using picture archiving and communication system (PACS) and 3D approach using IQSP respectively by two groups of physicians who did not know the surgical plans of the other group. The two surgical plans were submitted to the chief surgeon for selection before operation. The specimens were weighed. The two surgical plans were compared and analyzed retrospectively based on the operation results. The two surgical plans were successfully developed in all 305 patients and all the 3D IQSP surgical plans were selected as the final decision. Total 278 patients successfully underwent surgery, including 147 uncomplex hepatectomy and 131 complex hepatectomy. Twenty-seven patients were withdrawn from hepatectomy. In the uncomplex group, the two surgical plans were the same in all 147 patients and no statistically significant difference was found among 2D calculated resection volume (2D-RV), 3D IQSP calculated resection volume (IQSP-RV) and the specimen volume. In the complex group, the two surgical plans were different in 49 patients (49/131, 37.4%). According to the significance of differences, the 49 different patients were classified into three grades. No statistically significant difference was found between IQSP-RV and specimen volume. The coincidence rate of territory analysis of IQSP with operation was 92.1% (93/101) for 101 patients of anatomic hepatectomy. The accuracy and predictability of 3D IQSP were validated. Compared with traditional surgical planning, 3D IQSP can provide more quantitative information of anatomic structure. With the assistance of 3D IQSP, traditional surgical plans were modified to be more radical and safe.

Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy.

PubMed

Wang, Jiazhou; Jin, Xiance; Zhao, Kuaike; Peng, Jiayuan; Xie, Jiang; Chen, Junchao; Zhang, Zhen; Studenski, Matthew; Hu, Weigang

2015-02-01

To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient's anatomic and dosimetric parameters for esophageal cancer patients. Eighty esophagus patients in the authors' institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlap volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman's rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. It is feasible to use patients' anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.

TU-C-17A-10: Patient Features Based Dosimetric Pareto Front Prediction In Esophagus Cancer Radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, J; Zhao, K; Peng, J

2014-06-15

Purpose: The purpose of this study is to study the feasibility of the dosimetric pareto front (PF) prediction based on patient anatomic and dosimetric parameters for esophagus cancer patients. Methods: Sixty esophagus patients in our institution were enrolled in this study. A total 2920 IMRT plans were created to generated PF for each patient. On average, each patient had 48 plans. The anatomic and dosimetric features were extracted from those plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose and PTV homogeneous index (PTVHI) were recorded for each plan. The principal component analysis (PCA) wasmore » used to extract overlap volume histogram (OVH) features between PTV and other critical organs. The full dataset was separated into two parts include the training dataset and the validation dataset. The prediction outcomes were the MHD and MLD for the current study. The spearman rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The PF was fit by the the stepwise multiple regression method. The cross-validation method was used to evaluation the model. Results: The mean prediction error of the MHD was 465 cGy with 100 repetitions. The most correlated factors were the first principal components of the OVH between heart and PTV, and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 195 cGy. The most correlated factors were the first principal components of the OVH between lung and PTV, and the overlap between lung and PTV in Z-axis. Conclusion: It is feasible to use patients anatomic and dosimetric features to generate a predicted PF. Additional samples and further studies were required to get a better prediction model.« less

Patient feature based dosimetric Pareto front prediction in esophageal cancer radiotherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Jiazhou; Zhao, Kuaike; Peng, Jiayuan

2015-02-15

Purpose: To investigate the feasibility of the dosimetric Pareto front (PF) prediction based on patient’s anatomic and dosimetric parameters for esophageal cancer patients. Methods: Eighty esophagus patients in the authors’ institution were enrolled in this study. A total of 2928 intensity-modulated radiotherapy plans were obtained and used to generate PF for each patient. On average, each patient had 36.6 plans. The anatomic and dosimetric features were extracted from these plans. The mean lung dose (MLD), mean heart dose (MHD), spinal cord max dose, and PTV homogeneity index were recorded for each plan. Principal component analysis was used to extract overlapmore » volume histogram (OVH) features between PTV and other organs at risk. The full dataset was separated into two parts; a training dataset and a validation dataset. The prediction outcomes were the MHD and MLD. The spearman’s rank correlation coefficient was used to evaluate the correlation between the anatomical features and dosimetric features. The stepwise multiple regression method was used to fit the PF. The cross validation method was used to evaluate the model. Results: With 1000 repetitions, the mean prediction error of the MHD was 469 cGy. The most correlated factor was the first principal components of the OVH between heart and PTV and the overlap between heart and PTV in Z-axis. The mean prediction error of the MLD was 284 cGy. The most correlated factors were the first principal components of the OVH between heart and PTV and the overlap between lung and PTV in Z-axis. Conclusions: It is feasible to use patients’ anatomic and dosimetric features to generate a predicted Pareto front. Additional samples and further studies are required improve the prediction model.« less

Data representation for joint kinematics simulation of the lower limb within an educational context.

PubMed

Van Sint Jan, Serge; Hilal, Isam; Salvia, Patrick; Sholukha, Victor; Poulet, Pascal; Kirokoya, Ibrahim; Rooze, Marcel

2003-04-01

Three-dimensional (3D) visualization is becoming increasingly frequent in both qualitative and quantitative biomechanical studies of anatomical structures involving multiple data sources (e.g. morphological data and kinematics data). For many years, this kind of experiment was limited to the use of bi-dimensional images due to a lack of accurate 3D data. However, recent progress in medical imaging and computer graphics has forged new perspectives. Indeed, new techniques allow the development of an interactive interface for the simulation of human motions combining data from both medical imaging (i.e., morphology) and biomechanical studies (i.e., kinematics). Fields of application include medical education, biomechanical research and clinical research. This paper presents an experimental protocol for the development of anatomically realistic joint simulation within a pedagogical context. Results are shown for the lower limb. Extension to other joints is straightforward. This work is part of the Virtual Animation of the Kinematics of the Human project (VAKHUM) (http://www.ulb.ac.be/project/vakhum).

3D visualization of Thoraco-Lumbar Spinal Lesions in German Shepherd Dog

DOE Office of Scientific and Technical Information (OSTI.GOV)

Azpiroz, J.; Krafft, J.; Cadena, M.

2006-09-08

Computed tomography (CT) has been found to be an excellent imaging modality due to its sensitivity to characterize the morphology of the spine in dogs. This technique is considered to be particularly helpful for diagnosing spinal cord atrophy and spinal stenosis. The three-dimensional visualization of organs and bones can significantly improve the diagnosis of certain diseases in dogs. CT images were acquired of a German shepherd's dog spinal cord to generate stacks and digitally process them to arrange them in a volume image. All imaging experiments were acquired using standard clinical protocols on a clinical CT scanner. The three-dimensional visualizationmore » allowed us to observe anatomical structures that otherwise are not possible to observe with two-dimensional images. The combination of an imaging modality like CT together with imaging processing techniques can be a powerful tool for the diagnosis of a number of animal diseases.« less

From tissue to silicon to plastic: three-dimensional printing in comparative anatomy and physiology

PubMed Central

Lauridsen, Henrik; Hansen, Kasper; Nørgård, Mathias Ørum; Wang, Tobias; Pedersen, Michael

2016-01-01

Comparative anatomy and physiology are disciplines related to structures and mechanisms in three-dimensional (3D) space. For the past centuries, scientific reports in these fields have relied on written descriptions and two-dimensional (2D) illustrations, but in recent years 3D virtual modelling has entered the scene. However, comprehending complex anatomical structures is hampered by reproduction on flat inherently 2D screens. One way to circumvent this problem is in the production of 3D-printed scale models. We have applied computed tomography and magnetic resonance imaging to produce digital models of animal anatomy well suited to be printed on low-cost 3D printers. In this communication, we report how to apply such technology in comparative anatomy and physiology to aid discovery, description, comprehension and communication, and we seek to inspire fellow researchers in these fields to embrace this emerging technology. PMID:27069653

3D visualization of Thoraco-Lumbar Spinal Lesions in German Shepherd Dog

NASA Astrophysics Data System (ADS)

Azpiroz, J.; Krafft, J.; Cadena, M.; Rodríguez, A. O.

2006-09-01

Computed tomography (CT) has been found to be an excellent imaging modality due to its sensitivity to characterize the morphology of the spine in dogs. This technique is considered to be particularly helpful for diagnosing spinal cord atrophy and spinal stenosis. The three-dimensional visualization of organs and bones can significantly improve the diagnosis of certain diseases in dogs. CT images were acquired of a German shepherd's dog spinal cord to generate stacks and digitally process them to arrange them in a volume image. All imaging experiments were acquired using standard clinical protocols on a clinical CT scanner. The three-dimensional visualization allowed us to observe anatomical structures that otherwise are not possible to observe with two-dimensional images. The combination of an imaging modality like CT together with imaging processing techniques can be a powerful tool for the diagnosis of a number of animal diseases.

Colposcopic imaging using visible-light optical coherence tomography.

PubMed

Duan, Lian; McRaven, Michael D; Liu, Wenzhong; Shu, Xiao; Hu, Jianmin; Sun, Cheng; Veazey, Ronald S; Hope, Thomas J; Zhang, Hao F

2017-05-01

High-resolution colposcopic optical coherence tomography (OCT) provides key anatomical measures, such as thickness and minor traumatic injury of vaginal epithelium, of the female reproductive tract noninvasively. This information can be helpful in both fundamental investigations in animal models and disease screenings in humans. We present a fiber-based visible-light OCT and two probe designs for colposcopic application. One probe conducts circular scanning using a DC motor, and the other probe is capable of three-dimensional imaging over a 4.6 × 4.6 - mm 2 area using a pair of galvo scanners. Using this colposcopic vis-OCT with both probes, we acquired high-resolution images from whole isolated macaque vaginal samples and identified biopsy lesions.

Colposcopic imaging using visible-light optical coherence tomography

NASA Astrophysics Data System (ADS)

Duan, Lian; McRaven, Michael D.; Liu, Wenzhong; Shu, Xiao; Hu, Jianmin; Sun, Cheng; Veazey, Ronald S.; Hope, Thomas J.; Zhang, Hao F.

2017-05-01

High-resolution colposcopic optical coherence tomography (OCT) provides key anatomical measures, such as thickness and minor traumatic injury of vaginal epithelium, of the female reproductive tract noninvasively. This information can be helpful in both fundamental investigations in animal models and disease screenings in humans. We present a fiber-based visible-light OCT and two probe designs for colposcopic application. One probe conducts circular scanning using a DC motor, and the other probe is capable of three-dimensional imaging over a 4.6×4.6-mm2 area using a pair of galvo scanners. Using this colposcopic vis-OCT with both probes, we acquired high-resolution images from whole isolated macaque vaginal samples and identified biopsy lesions.

Correlations with operative anatomy of real time three-dimensional echocardiographic imaging of congenital aortic valvar stenosis.

PubMed

Sadagopan, Shankar N; Veldtman, Gruschen R; Sivaprakasam, Muthukumaran C; Keeton, Barry R; Gnanapragasam, James P; Salmon, Anthony P; Haw, Marcus P; Vettukattil, Joseph J

2006-10-01

To define the anatomic characteristics of the congenitally malformed and severely stenotic aortic valve using trans-thoracic real time three-dimensional echocardiography, and to compare and contrast this with the valvar morphology as seen at surgery. Prospective cross-sectional observational study. Tertiary centre for paediatric cardiology. All patients requiring aortic valvotomy between December 2003 and July 2004 were evaluated prior to surgery with three-dimensional echocardiography. Full volume loop images were acquired using the Phillips Sonos 7500 system. A single observer analysed the images using "Q lab 4.1" software. The details were then compared with operative findings. We identified 8 consecutive patients, with a median age of 16 weeks, ranging from 1 day to 11 years, with median weight of 7.22 kilograms, ranging from 2.78 to 22 kilograms. The measured diameter of the valvar orifice, and the number of leaflets identified, corresponded closely with surgical assessment. The sites of fusion of the leaflets were correctly identified by the echocardiographic imaging in all cases. Fusion between the right and non-coronary leaflets was identified in half the patients. Dysplasia was observed in 3 patients, with 1 patient having nodules and 2 shown to have excrescences. At surgery, nodules were excised, and excrescences were trimmed. The dysplastic changes correlated well with operative findings, though statistically not significant. We recommend trans-thoracic real time three-dimensional echocardiography for the assessment of the congenitally malformed aortic valve, particularly to identify sites of fusion between leaflets and to measure the orificial diameter. The definition of nodularity, and the prognosis of nodules based on the mode of intervention, will need a comparative study of patients submitted to balloon dilation as well as those undergoing surgical valvotomy.

The size of the supraspinatus outlet during elevation of the arm in the frontal and sagittal plane: a 3-D model study.

PubMed

Meskers, Carel G M; van der Helm, Frans C T; Rozing, Piet M

2002-05-01

To quantify the size of the supraspinatus outlet as it is dictated by both the three-dimensional geometry of the shoulder and the relative orientation of the humerus with respect to the scapula during motions of the arm. Previously obtained data of shoulder kinematics were brought into a geometrical model of the shoulder, derived from a cadaver study. Knowledge of the parameters dictating the size of the supraspinatus outlet is essential for a better understanding of the impingement syndrome of the shoulder. A geometrical model, based on fitting spheres to various anatomical items of the shoulder was derived from three-dimensional position data of the gleno-humeral joint and coraco-acromial arch of 32 cadaver shoulders. Kinematical data were collected from 10 healthy volunteers. The geometrical and kinematical data were combined to study the supraspinatus outlet during elevation of the humerus in the frontal and sagittal plane. No single geometry parameter correlated significantly with the initial size of the outlet. During arm elevation, the greater tuberosity was moved away from the coraco-acromial arch quite effectively resulting in narrowing of the outlet during elevation in the frontal plane from 60 degrees to 120 degrees only. Deviations from the average were quite substantial. This was caused by kinematical and especially geometrical variability. The size of the outlet is dictated by both the geometry and kinematics of the gleno-humeral joint. Assessment of the individual susceptibility to impingement requires three-dimensional viewing techniques including three-dimensional movements of both the scapula and humerus. Little is known about etiology and pathogenesis of various shoulder disorders such as the impingement syndrome. The supraspinatus outlet plays probably a key role. More knowledge on the architecture of the outlet is required for a better understanding.

A collaborative virtual reality environment for neurosurgical planning and training.

PubMed

Kockro, Ralf A; Stadie, Axel; Schwandt, Eike; Reisch, Robert; Charalampaki, Cleopatra; Ng, Ivan; Yeo, Tseng Tsai; Hwang, Peter; Serra, Luis; Perneczky, Axel

2007-11-01

We have developed a highly interactive virtual environment that enables collaborative examination of stereoscopic three-dimensional (3-D) medical imaging data for planning, discussing, or teaching neurosurgical approaches and strategies. The system consists of an interactive console with which the user manipulates 3-D data using hand-held and tracked devices within a 3-D virtual workspace and a stereoscopic projection system. The projection system displays the 3-D data on a large screen while the user is working with it. This setup allows users to interact intuitively with complex 3-D data while sharing this information with a larger audience. We have been using this system on a routine clinical basis and during neurosurgical training courses to collaboratively plan and discuss neurosurgical procedures with 3-D reconstructions of patient-specific magnetic resonance and computed tomographic imaging data or with a virtual model of the temporal bone. Working collaboratively with the 3-D information of a large, interactive, stereoscopic projection provides an unambiguous way to analyze and understand the anatomic spatial relationships of different surgical corridors. In our experience, the system creates a unique forum for open and precise discussion of neurosurgical approaches. We believe the system provides a highly effective way to work with 3-D data in a group, and it significantly enhances teaching of neurosurgical anatomy and operative strategies.

Feasibility study on dosimetry verification of volumetric-modulated arc therapy-based total marrow irradiation.

PubMed

Liang, Yun; Kim, Gwe-Ya; Pawlicki, Todd; Mundt, Arno J; Mell, Loren K

2013-03-04

The purpose of this study was to develop dosimetry verification procedures for volumetric-modulated arc therapy (VMAT)-based total marrow irradiation (TMI). The VMAT based TMI plans were generated for three patients: one child and two adults. The planning target volume (PTV) was defined as bony skeleton, from head to mid-femur, with a 3 mm margin. The plan strategy similar to published studies was adopted. The PTV was divided into head and neck, chest, and pelvic regions, with separate plans each of which is composed of 2-3 arcs/fields. Multiple isocenters were evenly distributed along the patient's axial direction. The focus of this study is to establish a dosimetry quality assurance procedure involving both two-dimensional (2D) and three-dimensional (3D) volumetric verifications, which is desirable for a large PTV treated with multiple isocenters. The 2D dose verification was performed with film for gamma evaluation and absolute point dose was measured with ion chamber, with attention to the junction between neighboring plans regarding hot/cold spots. The 3D volumetric dose verification used commercial dose reconstruction software to reconstruct dose from electronic portal imaging devices (EPID) images. The gamma evaluation criteria in both 2D and 3D verification were 5% absolute point dose difference and 3 mm of distance to agreement. With film dosimetry, the overall average gamma passing rate was 98.2% and absolute dose difference was 3.9% in junction areas among the test patients; with volumetric portal dosimetry, the corresponding numbers were 90.7% and 2.4%. A dosimetry verification procedure involving both 2D and 3D was developed for VMAT-based TMI. The initial results are encouraging and warrant further investigation in clinical trials.

Marginal hepatectomy in the rat: from anatomy to surgery.

PubMed

Madrahimov, Nodir; Dirsch, Olaf; Broelsch, Christoph; Dahmen, Uta

2006-07-01

Based on the 3-dimensional visualization of vascular supply and drainage, a vessel-oriented resection technique was optimized. The new surgical technique was used to determine the maximal reduction in liver mass enabling a 50% 1-week survival rate. Determination of the minimal liver mass is necessary in clinical as well as in experimental liver surgery. In rats, survival seems to depend on the surgical technique applied. Extended hepatectomy with removal of 90% of the liver mass was long regarded as a lethal model. Introduction of a vessel-oriented approach enabled long-term survival in this model. The lobar and vascular anatomy of rat livers was visualized by plastination of the whole organ, respectively, by corrosion casts of the portal vein, hepatic artery and liver veins. The three-dimensional models were used to extract the underlying anatomic structure. In 90% partial hepatectomy, the liver parenchyma was clamped close to the base of the respective liver lobes (left lateral, median and right, liver lobe). Piercing sutures were placed through the liver parenchyma, so that the stem of portal vein and the accompanying hepatic artery but also the hepatic vein were included. A 1-week survival rate of 100% was achieved after 90% hepatectomy. Extending the procedure to 95% resection by additional removal of the upper caudate lobe led to a 1-week survival rate of 66%; 97% partial hepatectomy, accomplished by additional resection of the lower caudate lobe only leaving the paracaval parts of the liver behind, resulted in 100% lethality within 4 days. Using a anatomically based, vessel-oriented, parenchyma-preserving surgical technique in 95% liver resections led to long-term survival. This represents the maximal reduction of liver mass compatible with survival.

Development of a linearized unsteady Euler analysis for turbomachinery blade rows

NASA Technical Reports Server (NTRS)

Verdon, Joseph M.; Montgomery, Matthew D.; Kousen, Kenneth A.

1995-01-01

A linearized unsteady aerodynamic analysis for axial-flow turbomachinery blading is described in this report. The linearization is based on the Euler equations of fluid motion and is motivated by the need for an efficient aerodynamic analysis that can be used in predicting the aeroelastic and aeroacoustic responses of blade rows. The field equations and surface conditions required for inviscid, nonlinear and linearized, unsteady aerodynamic analyses of three-dimensional flow through a single, blade row operating within a cylindrical duct, are derived. An existing numerical algorithm for determining time-accurate solutions of the nonlinear unsteady flow problem is described, and a numerical model, based upon this nonlinear flow solver, is formulated for the first-harmonic linear unsteady problem. The linearized aerodynamic and numerical models have been implemented into a first-harmonic unsteady flow code, called LINFLUX. At present this code applies only to two-dimensional flows, but an extension to three-dimensions is planned as future work. The three-dimensional aerodynamic and numerical formulations are described in this report. Numerical results for two-dimensional unsteady cascade flows, excited by prescribed blade motions and prescribed aerodynamic disturbances at inlet and exit, are also provided to illustrate the present capabilities of the LINFLUX analysis.

Development of a patient-specific anatomical foot model from structured light scan data.

PubMed

Lochner, Samuel J; Huissoon, Jan P; Bedi, Sanjeev S

2014-01-01

The use of anatomically accurate finite element (FE) models of the human foot in research studies has increased rapidly in recent years. Uses for FE foot models include advancing knowledge of orthotic design, shoe design, ankle-foot orthoses, pathomechanics, locomotion, plantar pressure, tissue mechanics, plantar fasciitis, joint stress and surgical interventions. Similar applications but for clinical use on a per-patient basis would also be on the rise if it were not for the high costs associated with developing patient-specific anatomical foot models. High costs arise primarily from the expense and challenges of acquiring anatomical data via magnetic resonance imaging (MRI) or computed tomography (CT) and reconstructing the three-dimensional models. The proposed solution morphs detailed anatomy from skin surface geometry and anatomical landmarks of a generic foot model (developed from CT or MRI) to surface geometry and anatomical landmarks acquired from an inexpensive structured light scan of a foot. The method yields a patient-specific anatomical foot model at a fraction of the cost of standard methods. Average error for bone surfaces was 2.53 mm for the six experiments completed. Highest accuracy occurred in the mid-foot and lowest in the forefoot due to the small, irregular bones of the toes. The method must be validated in the intended application to determine if the resulting errors are acceptable.

ARBOOK: Development and Assessment of a Tool Based on Augmented Reality for Anatomy

NASA Astrophysics Data System (ADS)

Ferrer-Torregrosa, J.; Torralba, J.; Jimenez, M. A.; García, S.; Barcia, J. M.

2015-02-01

The evolution of technologies and the development of new tools with educational purposes are growing up. This work presents the experience of a new tool based on augmented reality (AR) focusing on the anatomy of the lower limb. ARBOOK was constructed and developed based on TC and MRN images, dissections and drawings. For ARBOOK evaluation, a specific questionnaire of three blocks was performed and validated according to the Delphi method. The questionnaire included motivation and attention tasks, autonomous work and three-dimensional interpretation tasks. A total of 211 students from 7 public and private Spanish universities were divided in two groups. Control group received standard teaching sessions supported by books, and video. The ARBOOK group received the same standard sessions but additionally used the ARBOOK tool. At the end of the training, a written test on lower limb anatomy was done by students. Statistically significant better scorings for the ARBOOK group were found on attention-motivation, autonomous work and three-dimensional comprehension tasks. Additionally, significantly better scoring was obtained by the ARBOOK group in the written test. The results strongly suggest that the use of AR is suitable for anatomical purposes. Concretely, the results indicate how this technology is helpful for student motivation, autonomous work or spatial interpretation. The use of this type of technologies must be taken into account even more at the present moment, when new technologies are naturally incorporated to our current lives.

Scaled Anatomical Model Creation of Biomedical Tomographic Imaging Data and Associated Labels for Subsequent Sub-surface Laser Engraving (SSLE) of Glass Crystals.

PubMed

Betts, Aislinn M; McGoldrick, Matthew T; Dethlefs, Christopher R; Piotrowicz, Justin; Van Avermaete, Tony; Maki, Jeff; Gerstler, Steve; Leevy, W M

2017-04-25

Biomedical imaging modalities like computed tomography (CT) and magnetic resonance (MR) provide excellent platforms for collecting three-dimensional data sets of patient or specimen anatomy in clinical or preclinical settings. However, the use of a virtual, on-screen display limits the ability of these tomographic images to fully convey the anatomical information embedded within. One solution is to interface a biomedical imaging data set with 3D printing technology to generate a physical replica. Here we detail a complementary method to visualize tomographic imaging data with a hand-held model: Sub Surface Laser Engraving (SSLE) of crystal glass. SSLE offers several unique benefits including: the facile ability to include anatomical labels, as well as a scale bar; streamlined multipart assembly of complex structures in one medium; high resolution in the X, Y, and Z planes; and semi-transparent shells for visualization of internal anatomical substructures. Here we demonstrate the process of SSLE with CT data sets derived from pre-clinical and clinical sources. This protocol will serve as a powerful and inexpensive new tool with which to visualize complex anatomical structures for scientists and students in a number of educational and research settings.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Manem, V; Paganetti, H

Purpose: Evaluate the excess relative risk (ERR) induced by photons and protons in each voxel of the lung, and display it as a three-dimensional map, known as the ERRM (i.e. excess relative risk map) along with the dose distribution map. In addition, we also study the effect of variations in the linear energy transfer (LET) distribution on ERRM for a given proton plan. Methods: The excess relative risk due to radiation is estimated using the initiation-inactivation-proliferation formalism. This framework accounts for three biological phenomenon: mutation induction, cell kill and proliferation. Cell kill and mutation induction are taken as a functionmore » of LET using experimental data. LET distributions are calculated using a Monte Carlo algorithm. ERR is then estimated for each voxel in the organ, and displayed as a three dimensional carcinogenic map. Results: The differences in the ERR’s between photons and protons is seen from the three-dimensional ERR map. In addition, we also varied the LET of a proton plan and observed the differences in the corresponding ERR maps demonstrating variations in the ERR maps depend on features of a proton plan. Additionally, our results suggest that any two proton plans that have the same integral dose does not necessarily imply identical ERR maps, and these changes are due to the variations in the LET distribution map. Conclusion: Clinically, it is important to have a three dimensional display of biological end points. This study is an effort to introduce 3D ERR maps into the treatment planning workflow for certain sites such as pediatric head and neck tumors.« less

Automatic MRI 2D brain segmentation using graph searching technique.

PubMed

Pedoia, Valentina; Binaghi, Elisabetta

2013-09-01

Accurate and efficient segmentation of the whole brain in magnetic resonance (MR) images is a key task in many neuroscience and medical studies either because the whole brain is the final anatomical structure of interest or because the automatic extraction facilitates further analysis. The problem of segmenting brain MRI images has been extensively addressed by many researchers. Despite the relevant achievements obtained, automated segmentation of brain MRI imagery is still a challenging problem whose solution has to cope with critical aspects such as anatomical variability and pathological deformation. In the present paper, we describe and experimentally evaluate a method for segmenting brain from MRI images basing on two-dimensional graph searching principles for border detection. The segmentation of the whole brain over the entire volume is accomplished slice by slice, automatically detecting frames including eyes. The method is fully automatic and easily reproducible by computing the internal main parameters directly from the image data. The segmentation procedure is conceived as a tool of general applicability, although design requirements are especially commensurate with the accuracy required in clinical tasks such as surgical planning and post-surgical assessment. Several experiments were performed to assess the performance of the algorithm on a varied set of MRI images obtaining good results in terms of accuracy and stability. Copyright © 2012 John Wiley & Sons, Ltd.

Implementation of IMRT and VMAT using Delta4 phantom and portal dosimetry as dosimetry verification tools

DOE Office of Scientific and Technical Information (OSTI.GOV)

Daci, Lulzime, E-mail: lulzime.daci@nodlandssykehuset.no; Malkaj, Partizan, E-mail: malkaj-p@hotmail.com

2016-03-25

In this study we analyzed and compared the dose distribution of different IMRT and VMAT plans with the intent to provide pre-treatment quality assurance using two different tools. Materials/Methods: We have used the electronic portal imaging device EPID after calibration to dose and correction for the background offset signal and also the Delta4 phantom after en evaluation of angular sensitivity. The Delta4 phantom has a two-dimensional array with ionization chambers. We analyzed three plans for each anatomical site calculated by Eclipse treatment planning system. The measurements were analyzed using γ-evaluation method with passing criteria 3% absolute dose and 3 mm distancemore » to agreement (DTA). For all the plans the range of score has been from 97% to 99% for gantry fixed at 0° while for rotational planes there was a slightly decreased pass rates and above 95%. Point measurement with a ionization chamber were done in additional to see the accuracy of portal dosimetry and to evaluate the Delta4 device to various dose rates. Conclusions: Both Delt4 and Portal dosimetry shows good results between the measured and calculated doses. While Delta4 is more accurate in measurements EPID is more time efficient. We have decided to use both methods in the first steps of IMRT and VMAT implementation and later on to decide which of the tools to use depending on the complexity of plans, how much accurate we want to be and the time we have on the machine.« less

Fabrication and assessment of 3D printed anatomical models of the lower limb for anatomical teaching and femoral vessel access training in medicine.

PubMed

O'Reilly, Michael K; Reese, Sven; Herlihy, Therese; Geoghegan, Tony; Cantwell, Colin P; Feeney, Robin N M; Jones, James F X

2016-01-01

For centuries, cadaveric dissection has been the touchstone of anatomy education. It offers a medical student intimate access to his or her first patient. In contrast to idealized artisan anatomical models, it presents the natural variation of anatomy in fine detail. However, a new teaching construct has appeared recently in which artificial cadavers are manufactured through three-dimensional (3D) printing of patient specific radiological data sets. In this article, a simple powder based printer is made more versatile to manufacture hard bones, silicone muscles and perfusable blood vessels. The approach involves blending modern approaches (3D printing) with more ancient ones (casting and lost-wax techniques). These anatomically accurate models can augment the approach to anatomy teaching from dissection to synthesis of 3D-printed parts held together with embedded rare earth magnets. Vascular simulation is possible through application of pumps and artificial blood. The resulting arteries and veins can be cannulated and imaged with Doppler ultrasound. In some respects, 3D-printed anatomy is superior to older teaching methods because the parts are cheap, scalable, they can cover the entire age span, they can be both dissected and reassembled and the data files can be printed anywhere in the world and mass produced. Anatomical diversity can be collated as a digital repository and reprinted rather than waiting for the rare variant to appear in the dissection room. It is predicted that 3D printing will revolutionize anatomy when poly-material printing is perfected in the early 21st century. © 2015 American Association of Anatomists.

Three-dimensional analysis of the anatomical growth response of European conifers to mechanical disturbance.

PubMed

Schneuwly, Dominique M; Stoffel, Markus; Dorren, Luuk K A; Berger, Frédéric

2009-10-01

Studies on tree reaction after wounding were so far based on artificial wounding or chemical treatment. For the first time, type, spread and intensity of anatomical responses were analyzed and quantified in naturally disturbed Larix decidua Mill., Picea abies (L.) Karst. and Abies alba Mill. trees. The consequences of rockfall impacts on increment growth were assessed at the height of the wounds, as well as above and below the injuries. A total of 16 trees were selected on rockfall slopes, and growth responses following 54 wounding events were analyzed on 820 cross-sections. Anatomical analysis focused on the occurrence of tangential rows of traumatic resin ducts (TRD) and on the formation of reaction wood. Following mechanical disturbance, TRD production was observed in 100% of L. decidua and P. abies wounds. The radial extension of TRD was largest at wound height, and they occurred more commonly above, rather than below, the wounds. For all species, an intra-annual radial shift of TRD was observed with increasing axial distance from wounds. Reaction wood was formed in 87.5% of A. alba following wounding, but such cases occurred only in 7.7% of L. decidua. The results demonstrate that anatomical growth responses following natural mechanical disturbance differ significantly from the reactions induced by artificial stimuli or by decapitation. While the types of reactions remain comparable between the species, their intensity, spread and persistence disagree considerably. We also illustrate that the external appearance of wounds does not reflect an internal response intensity. This study reveals that disturbance induced under natural conditions triggers more intense and more widespread anatomical responses than that induced under artificial stimuli, and that experimental laboratory tests considerably underestimate tree response.

Vascular corrosion casting technique steps.

PubMed

Verli, Flaviana Dornela; Rossi-Schneider, Tissiana Raquel; Schneider, Felipe Luís; Yurgel, Liliane Soares; de Souza, Maria Antonieta Lopes

2007-01-01

The vascular corrosion casting technique produces a replica of vascular beds of normal or pathological tissues. Once associated with scanning electron microscopy (SEM), this technique provides details of the three-dimensional anatomic arrangement of the vascular replica, which is the main advantage of this method. The present study is intended to describe the steps of the vascular corrosion casting technique and the different ways to perform them. them.

Coupled Physical and Digital Cadaver Dissection Followed by a Visual Test Protocol Provides Insights into the Nature of Anatomical Knowledge and Its Evaluation

ERIC Educational Resources Information Center

Hisley, Kenneth C.; Anderson, Larry D.; Smith, Stacy E.; Kavic, Stephen M.; Tracy, J. Kathleen

2008-01-01

This research effort compared and contrasted two conceptually different methods for the exploration of human anatomy in the first-year dissection laboratory by accomplished students: "physical" dissection using an embalmed cadaver and "digital" dissection using three-dimensional volume modeling of whole-body CT and MRI image sets acquired using…

Use of 3D Printed Models in Medical Education: A Randomized Control Trial Comparing 3D Prints versus Cadaveric Materials for Learning External Cardiac Anatomy

ERIC Educational Resources Information Center

Lim, Kah Heng Alexander; Loo, Zhou Yaw; Goldie, Stephen J.; Adams, Justin W.; McMenamin, Paul G.

2016-01-01

Three-dimensional (3D) printing is an emerging technology capable of readily producing accurate anatomical models, however, evidence for the use of 3D prints in medical education remains limited. A study was performed to assess their effectiveness against cadaveric materials for learning external cardiac anatomy. A double blind randomized…

A spatiotemporal-based scheme for efficient registration-based segmentation of thoracic 4-D MRI.

PubMed

Yang, Y; Van Reeth, E; Poh, C L; Tan, C H; Tham, I W K

2014-05-01

Dynamic three-dimensional (3-D) (four-dimensional, 4-D) magnetic resonance (MR) imaging is gaining importance in the study of pulmonary motion for respiratory diseases and pulmonary tumor motion for radiotherapy. To perform quantitative analysis using 4-D MR images, segmentation of anatomical structures such as the lung and pulmonary tumor is required. Manual segmentation of entire thoracic 4-D MRI data that typically contains many 3-D volumes acquired over several breathing cycles is extremely tedious, time consuming, and suffers high user variability. This requires the development of new automated segmentation schemes for 4-D MRI data segmentation. Registration-based segmentation technique that uses automatic registration methods for segmentation has been shown to be an accurate method to segment structures for 4-D data series. However, directly applying registration-based segmentation to segment 4-D MRI series lacks efficiency. Here we propose an automated 4-D registration-based segmentation scheme that is based on spatiotemporal information for the segmentation of thoracic 4-D MR lung images. The proposed scheme saved up to 95% of computation amount while achieving comparable accurate segmentations compared to directly applying registration-based segmentation to 4-D dataset. The scheme facilitates rapid 3-D/4-D visualization of the lung and tumor motion and potentially the tracking of tumor during radiation delivery.

Three-Dimensional Printing of Complex Structures by Freeform Reversible Embedding of Suspended Hydrogels (FRESH)

NASA Astrophysics Data System (ADS)

Feinberg, Adam

We demonstrate the additive manufacturing of complex three-dimensional (3D) structures using soft protein and polysaccharide hydrogels that are challenging or impossible to create using traditional fabrication approaches. These structures are built by embedding the printed hydrogel within a secondary hydrogel that serves as a temporary, thermoreversible, and biocompatible support. This process, termed freeform reversible embedding of suspended hydrogels (FRESH), enables 3D printing of hydrated materials with an elastic modulus less than 500 kPa including alginate, collagen, hyaluronic acid and fibrin. A range of crosslinking mechanisms can be used depending on the polymer being printed, including ionic, enzymatic, pH, thermal and light based approaches. CAD models of 3D optical, computed tomography, and magnetic resonance imaging data can be 3D printed at a resolution of 100 μm and at low cost by leveraging open-source hardware and software tools. Proof-of-concept structures based on femurs, branched coronary arteries, trabeculated embryonic hearts, and human brains are mechanically robust and recreate complex 3D internal and external anatomical architectures. Recent advances have improved the resolution and broadened the range of materials that can be FRESH 3D printed. This work was supported in part by the NIH Director's New Innovator Award (DP2HL117750) and the NSF CAREER Award (1454248).

Structural and congenital heart disease interventions: the role of three-dimensional printing.

PubMed

Meier, L M; Meineri, M; Qua Hiansen, J; Horlick, E M

2017-02-01

Advances in catheter-based interventions in structural and congenital heart disease have mandated an increased demand for three-dimensional (3D) visualisation of complex cardiac anatomy. Despite progress in 3D imaging modalities, the pre- and periprocedural visualisation of spatial anatomy is relegated to two-dimensional flat screen representations. 3D printing is an evolving technology based on the concept of additive manufacturing, where computerised digital surface renders are converted into physical models. Printed models replicate complex structures in tangible forms that cardiovascular physicians and surgeons can use for education, preprocedural planning and device testing. In this review we discuss the different steps of the 3D printing process, which include image acquisition, segmentation, printing methods and materials. We also examine the expanded applications of 3D printing in the catheter-based treatment of adult patients with structural and congenital heart disease while highlighting the current limitations of this technology in terms of segmentation, model accuracy and dynamic capabilities. Furthermore, we provide information on the resources needed to establish a hospital-based 3D printing laboratory.

Finite-element-based matching of pre- and intraoperative data for image-guided endovascular aneurysm repair

PubMed Central

Dumenil, Aurélien; Kaladji, Adrien; Castro, Miguel; Esneault, Simon; Lucas, Antoine; Rochette, Michel; Goksu, Cemil; Haigron, Pascal

2013-01-01

Endovascular repair of abdominal aortic aneurysms is a well-established technique throughout the medical and surgical communities. Although increasingly indicated, this technique does have some limitations. Because intervention is commonly performed under fluoroscopic control, two-dimensional (2D) visualization of the aneurysm requires the injection of a contrast agent. The projective nature of this imaging modality inevitably leads to topographic errors, and does not give information on arterial wall quality at the time of deployment. A specially-adapted intraoperative navigation interface could increase deployment accuracy and reveal such information, which preoperative three-dimensional (3D) imaging might otherwise provide. One difficulty is the precise matching of preoperative data (images and models) and intraoperative observations affected by anatomical deformations due to tool-tissue interactions. Our proposed solution involves a finite element-based preoperative simulation of tool/tissue interactions, its adaptive tuning regarding patient specific data, and the matching with intra-operative data. The biomechanical model was first tuned on a group of 10 patients and assessed on a second group of 8 patients. PMID:23269745