3,377 research outputs found
Evaluation of User Performance in Simulation-Based Diagnostic Cerebral Angiography Training
Simulation of anatomically complex procedures, such as angiography, is becoming more practical, however, computer-based modules require extensive research to assess their effectiveness. We organized two training schemas – alternating cases and consistent cases – and hypothesized that the alternating practice cases would be beneficial to test performance. Eight residents (4 radiology/4 neurosurgery) and 8 anatomy graduate students were trained on the Simbionix™ simulator in order to assess skill acquisition in diagnostic cerebral angiography over 8 sessions. We found that participants improve on total procedure time and total fluoroscopy time (p\u3c0.05), but not on contrast injected or roadmaps created. There were no significant differences between alternating and consistent training types. Additional work needs to be done with higher sample numbers and visuospatial scores as criteria
Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions:an iliac angioplasty exemplar case study
Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages’ durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education
Aerospace Medicine and Biology: A continuing bibliography with indexes (supplement 153)
This bibliography lists 175 reports, articles, and other documents introduced into the NASA scientific and technical information system in March 1976
Medical imaging analysis with artificial neural networks
Given that neural networks have been widely reported in the research community of medical imaging, we provide a focused literature survey on recent neural network developments in computer-aided diagnosis, medical image segmentation and edge detection towards visual content analysis, and medical image registration for its pre-processing and post-processing, with the aims of increasing awareness of how neural networks can be applied to these areas and to provide a foundation for further research and practical development. Representative techniques and algorithms are explained in detail to provide inspiring examples illustrating: (i) how a known neural network with fixed structure and training procedure could be applied to resolve a medical imaging problem; (ii) how medical images could be analysed, processed, and characterised by neural networks; and (iii) how neural networks could be expanded further to resolve problems relevant to medical imaging. In the concluding section, a highlight of comparisons among many neural network applications is included to provide a global view on computational intelligence with neural networks in medical imaging
The Role of Computational Fluid Dynamics in the Management of Unruptured Intracranial Aneurysms: A Clinicians' View
Objective. The
importance of hemodynamics in the
etiopathogenesis of intracranial aneurysms (IAs)
is widely accepted. Computational fluid dynamics
(CFD) is being used increasingly for hemodynamic
predictions. However, alogn with the continuing
development and validation of these
tools, it is imperative to collect
the opinion of the clinicians.
Methods. A workshop on CFD was
conducted during the European Society of
Minimally Invasive Neurological Therapy (ESMINT)
Teaching Course, Lisbon, Portugal.
36 delegates, mostly clinicians,
performed supervised CFD analysis for an IA, using the
@neuFuse software developed within the European
project @neurIST. Feedback on the workshop was
collected and analyzed. The
performance was assessed on a scale of 1 to 4
and, compared with experts' performance.
Results. Current dilemmas in
the management of unruptured IAs remained the
most important motivating factor to attend the
workshop and majority of participants showed interest in participating in a
multicentric trial. The participants achieved
an average score of 2.52 (range 0–4) which was 63% (range 0–100%) of an expert user. Conclusions.
Although participants showed a manifest interest
in CFD, there was a clear
lack of awareness concerning the role of
hemodynamics in the etiopathogenesis of IAs and
the use of CFD in this context. More efforts
therefore are required to enhance understanding of the
clinicians in the subject
Cerebrovascular modelling for the management of aneurysm embolization using an intrasaccular flow diverter made by 3D printing
Purpose: Using 3-dimensional (3D) printers, the creation of patient-specific models is possible before and after a therapeutic intervention. There are many articles about replicas for training and simulation of aneurysm clipping. However, no paper has focused on 3D replicas obtained from 3-tesla 3D time of flight (3D-TOF) MR angiography for intrasaccular flow diverter (WEB device) embolization of the cerebral aneurysms. In this paper, we aimed to investigate the feasibility of 3D printing models obtained from 3-tesla 3D-TOF data in the management and training of WEB-assisted embolization procedures. Case presentation: We presented a longitudinal case report with several 3D-TOF MRA prints over time. Three-tesla 3D-TOF data were converted into STL and G-code files using an open-source (3D-Slicer) program. We built patient-specific realistic 3D models of a patient with a middle cerebral artery trifurcation aneurysm, which were able to demonstrate the entire WEB device treatment procedure in the pre-intervention and post-intervention periods. The aneurysmatic segment was well displayed on the STL files and the 3D replicas. They allowed visualization of the aneurysmatic segment and changes within a 6-year follow-up period. We successfully showed the possibility of fast, cheap, and easy production of replicas for demonstration of the aneurysm, the parent vessels, and post-intervention changes in a simple way using an affordable 3D printer. Conclusions: 3D printing is useful for training the endovascular team and the patients, understanding the aneurysm/parent vessels, and choosing the optimal embolization technique/device. 3D printing will potentially lead to greater interventionalist confidence, decreased radiation dose, and improvements in patient safety
Accurate geometry reconstruction of vascular structures using implicit splines
3-D visualization of blood vessel from standard medical datasets (e.g. CT or MRI) play an important role in many clinical situations, including the diagnosis of vessel stenosis, virtual angioscopy, vascular surgery planning and computer aided vascular surgery. However, unlike other human organs, the vasculature system is a very complex network of vessel, which makes it a very challenging task to perform its 3-D visualization. Conventional techniques of medical volume data visualization are in general not well-suited for the above-mentioned tasks. This problem can be solved by reconstructing vascular geometry. Although various methods have been proposed for reconstructing vascular structures, most of these approaches are model-based, and are usually too ideal to correctly represent the actual variation presented by the cross-sections of a vascular structure. In addition, the underlying shape is usually expressed as polygonal meshes or in parametric forms, which is very inconvenient for implementing ramification of branching. As a result, the reconstructed geometries are not suitable for computer aided diagnosis and computer guided minimally invasive vascular surgery. In this research, we develop a set of techniques associated with the geometry reconstruction of vasculatures, including segmentation, modelling, reconstruction, exploration and rendering of vascular structures. The reconstructed geometry can not only help to greatly enhance the visual quality of 3-D vascular structures, but also provide an actual geometric representation of vasculatures, which can provide various benefits. The key findings of this research are as follows: 1. A localized hybrid level-set method of segmentation has been developed to extract the vascular structures from 3-D medical datasets. 2. A skeleton-based implicit modelling technique has been proposed and applied to the reconstruction of vasculatures, which can achieve an accurate geometric reconstruction of the vascular structures as implicit surfaces in an analytical form. 3. An accelerating technique using modern GPU (Graphics Processing Unit) is devised and applied to rendering the implicitly represented vasculatures. 4. The implicitly modelled vasculature is investigated for the application of virtual angioscopy
Focal Spot, Winter 2005/2006
https://digitalcommons.wustl.edu/focal_spot_archives/1101/thumbnail.jp
Focal Spot, Fall/Winter 2002/2003
https://digitalcommons.wustl.edu/focal_spot_archives/1092/thumbnail.jp
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