The virtual human face – superimposing the simultaneously captured 3D photorealistic skin surface of the face on the untextured skin image of the CBCT Scan

The aim of this study was to evaluate the impact of simultaneous capture of the three-dimensional (3D) surface of the face and cone beam computed tomography (CBCT) scan of the skull on the accuracy of their registration and superimposition. 3D facial images were acquired in 14 patients using the Di3d (Dimensional Imaging, UK) imaging system and i-CAT CBCT scanner. One stereophotogrammetry image was captured at the same time as the CBCT and another one hour later. The two stereophotographs were then individually superimposed over the CBCT using VRmesh. Seven patches were isolated on the final merged surfaces. For the whole face and each individual patch; maximum and minimum range of deviation between surfaces, absolute average distance between surfaces, and standard deviation for the 90th percentile of the distance errors were calculated. The superimposition errors of the whole face for both captures revealed statistically significant differences (P=0.00081). The absolute average distances in both separate and simultaneous captures were 0.47mm and 0.27mm, respectively. The level of superimposition accuracy in patches from separate captures ranged between 0.3 and 0.9mm, while that of simultaneous captures was 0.4mm. Simultaneous capture of Di3d and CBCT images significantly improved the accuracy of superimposition of these image modalities

Real-time Error Control for Surgical Simulation

Objective: To present the first real-time a posteriori error-driven adaptive finite element approach for real-time simulation and to demonstrate the method on a needle insertion problem. Methods: We use corotational elasticity and a frictional needle/tissue interaction model. The problem is solved using finite elements within SOFA. The refinement strategy relies upon a hexahedron-based finite element method, combined with a posteriori error estimation driven local $h$-refinement, for simulating soft tissue deformation. Results: We control the local and global error level in the mechanical fields (e.g. displacement or stresses) during the simulation. We show the convergence of the algorithm on academic examples, and demonstrate its practical usability on a percutaneous procedure involving needle insertion in a liver. For the latter case, we compare the force displacement curves obtained from the proposed adaptive algorithm with that obtained from a uniform refinement approach. Conclusions: Error control guarantees that a tolerable error level is not exceeded during the simulations. Local mesh refinement accelerates simulations. Significance: Our work provides a first step to discriminate between discretization error and modeling error by providing a robust quantification of discretization error during simulations.Comment: 12 pages, 16 figures, change of the title, submitted to IEEE TBM

Radiological Society of North America (RSNA) 3D printing Special Interest Group (SIG): Guidelines for medical 3D printing and appropriateness for clinical scenarios

Este número da revista Cadernos de Estudos Sociais estava em organização quando fomos colhidos pela morte do sociólogo Ernesto Laclau. Seu falecimento em 13 de abril de 2014 surpreendeu a todos, e particularmente ao editor Joanildo Burity, que foi seu orientando de doutorado na University of Essex, Inglaterra, e que recentemente o trouxe à Fundação Joaquim Nabuco para uma palestra, permitindo que muitos pudessem dialogar com um dos grandes intelectuais latinoamericanos contemporâneos. Assim, buscamos fazer uma homenagem ao sociólogo argentino publicando uma entrevista inédita concedida durante a sua passagem pelo Recife, em 2013, encerrando essa revista com uma sessão especial sobre a sua trajetória

Evaluation of 3D Printed Immobilisation Shells for Head and Neck IMRT

This paper presents the preclinical evaluation of a novel immobilization system for patients undergoing external beam radiation treatment of head and neck tumors. An immobilization mask is manufactured directly from a 3-D model, built using the CT data routinely acquired for treatment planning so there is no need to take plaster of Paris moulds. Research suggests that many patients find the mould room visit distressing and so rapid prototyping could potentially improve the overall patient experience. Evaluation of a computer model of the immobilization system using an anthropomorphic phantom shows that >99% of vertices are within a tolerance of ±0.2 mm. Hausdorff distance was used to analyze CT slices obtained by rescanning the phantom with a printed mask in position. These results show that for >80% of the slices the median “worse-case” tolerance is approximately 4 mm. These measurements suggest that printed masks can achieve similar levels of immobilization to those of systems currently in clinical use

A Computational Tool for Pre-operative Breast Augmentation Planning in Aesthetic Plastic Surgery

Abstract—Breast augmentation was the most commonly performed cosmetic surgery procedure in 2011 in the United States. Although aesthetically pleasing surgical results can only be achieved if the correct breast implant is selected from a large variety of different prosthesis sizes and shapes available on the market, surgeons still rely on visual assessment and other subjective approaches for operative planning because of lacking objective evaluation tools. In this paper we present the development of a software prototype for augmentation mammaplasty simulation solely based on 3D surface scans, from which patient-specific finite element models are generated in a semi-automatic process. The finite element model is used to pre-operatively simulate the expected breast shapes using physical soft tissue mechanics. Our approach uses a novel mechanism based on so-called displacement templates, which, for a specific implant shape and position, describe the respective internal body forces. Due to a highly efficient numerical solver we can provide immediate visual feedback of the simulation results, and thus the software prototype can be integrated smoothly into the medical workflow. The clinical value of the developed 3D computational tool for aesthetic breast augmentation surgery planning is demonstrated in patientspecific use cases

Finite element modeling of soft tissue deformation.

Computer-aided minimally invasive surgery (MIS) has progressed significantly in the last decade and it has great potential in surgical planning and operations. To limit the damage to nearby healthy tissue, accurate modeling is required of the mechanical behavior of a target soft tissue subject to surgical manipulations. Therefore, the study of soft tissue deformations is important for computer-aided (MIS) in surgical planning and operation, or in developing surgical simulation tools or systems. The image acquisition facilities are also important for prediction accuracy. This dissertation addresses partial differential and integral equations (PDIE) based biomechanical modeling of soft tissue deformations incorporating the specific material properties to characterize the soft tissue responses for certain human interface behaviors. To achieve accurate simulation of real tissue deformations, several biomechanical finite element (FE) models are proposed to characterize liver tissue. The contribution of this work is in theoretical and practical aspects of tissue modeling. High resolution imaging techniques of Micro Computed Tomography (Micro-CT) and Cone Beam Computed Tomography (CBCT) imaging are first proposed to study soft tissue deformation in this dissertation. These high resolution imaging techniques can detect the tissue deformation details in the contact region between the tissue and the probe for small force loads which would be applied to a surgical probe used. Traditional imaging techniques in clinics can only achieve low image resolutions. Very small force loads seen in these procedures can only yield tissue deformation on the few millimeters to submillimeter scale. Small variations are hardly to detect. Furthermore, if a model is validated using high resolution images, it implies that the model is true in using the same model for low resolution imaging facilities. The reverse cannot be true since the small variations at the sub-millimeter level cannot be detected. In this dissertation, liver tissue deformations, surface morphological changes, and volume variations are explored and compared from simulations and experiments. The contributions of the dissertation are as follows. For liver tissue, for small force loads (5 grams to tens of grams), the linear elastic model and the neo-Hooke\u27s hyperelastic model are applied and shown to yield some discrepancies among them in simulations and discrepancies between simulations and experiments. The proposed finite element models are verified for liver tissue. A general FE modeling validation system is proposed to verify the applicability of FE models to the soft tissue deformation study. The validation of some FE models is performed visually and quantitatively in several ways in comparison with the actual experimental results. Comparisons among these models are also performed to show their advantages and disadvantages. The method or verification system can be applied for other soft tissues for the finite element analysis of the soft tissue deformation. For brain tissue, an elasticity based model was proposed previously employing local elasticity and Poisson\u27s ratio. It is validated by intraoperative images to show more accurate prediction of brain deformation than the linear elastic model. FE analysis of brain ventricle shape changes was also performed to capture the dynamic variation of the ventricles in author\u27s other works. There, for the safety reasons, the images for brain deformation modeling were from Magnetic Resonance Imaging (MRI) scanning which have been used for brain scanning. The measurement process of material properties involves the tissue desiccation, machine limits, human operation errors, and time factors. The acquired material parameters from measurement devices may have some difference from the tissue used in real state of experiments. Therefore, an experimental and simulation based method to inversely evaluate the material parameters is proposed and compare

Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

Virtual reality training and assessment in laparoscopic rectum surgery

Background: Virtual-reality (VR) based simulation techniques offer an efficient and low cost alternative to conventional surgery training. This article describes a VR training and assessment system in laparoscopic rectum surgery. Methods: To give a realistic visual performance of interaction between membrane tissue and surgery tools, a generalized cylinder based collision detection and a multi-layer mass-spring model are presented. A dynamic assessment model is also designed for hierarchy training evaluation. Results: With this simulator, trainees can operate on the virtual rectum with both visual and haptic sensation feedback simultaneously. The system also offers surgeons instructions in real time when improper manipulation happens. The simulator has been tested and evaluated by ten subjects. Conclusions: This prototype system has been verified by colorectal surgeons through a pilot study. They believe the visual performance and the tactile feedback are realistic. It exhibits the potential to effectively improve the surgical skills of trainee surgeons and significantly shorten their learning curve. © 2014 John Wiley & Sons, Ltd