Validazione di un dispositivo indossabile basato sulla realta aumentata per il riposizionamento del mascellare superiore

Aim: We present a newly designed, localiser-free, head-mounted system featuring augmented reality (AR) as an aid to maxillofacial bone surgery, and assess the potential utility of the device by conducting a feasibility study and validation. Also, we implement a novel and ergonomic strategy designed to present AR information to the operating surgeon (hPnP). Methods: The head-mounted wearable system was developed as a stand- alone, video-based, see-through device in which the visual features were adapted to facilitate maxillofacial bone surgery. The system is designed to exhibit virtual planning overlaying the details of a real patient. We implemented a method allowing performance of waferless, AR-assisted maxillary repositioning. In vitro testing was conducted on a physical replica of a human skull. Surgical accuracy was measured. The outcomes were compared with those expected to be achievable in a three-dimensional environment. Data were derived using three levels of surgical planning, of increasing complexity, and for nine different operators with varying levels of surgical skill. Results: The mean linear error was 1.70±0.51mm. The axial errors were 0.89±0.54mm on the sagittal axis, 0.60±0.20mm on the frontal axis, and 1.06±0.40mm on the craniocaudal axis. Mean angular errors were also computed. Pitch: 3.13°±1.89°; Roll: 1.99°±0.95°; Yaw: 3.25°±2.26°. No significant difference in terms of error was noticed among operators, despite variations in surgical experience. Feedback from surgeons was acceptable; all tests were completed within 15 min and the tool was considered to be both comfortable and usable in practice. Conclusion: Our device appears to be accurate when used to assist in waferless maxillary repositioning. Our results suggest that the method can potentially be extended for use with many surgical procedures on the facial skeleton. Further, it would be appropriate to proceed to in vivo testing to assess surgical accuracy under real clinical conditions.Obiettivo: Presentare un nuovo sistema indossabile, privo di sistema di tracciamento esterno, che utilizzi la realtà aumentata come ausilio alla chirurgia ossea maxillo-facciale. Abbiamo validato il dispositivo. Inoltre, abbiamo implementato un nuovo metodo per presentare le informazioni aumentate al chirurgo (hPnP). Metodi: Le caratteristiche di visualizzazione del sistema, basato sul paradigma video see-through, sono state sviluppate specificamente per la chirurgia ossea maxillo-facciale. Il dispositivo è progettato per mostrare la pianificazione virtuale della chirurgia sovrapponendola all’anatomia del paziente. Abbiamo implementato un metodo che consente una tecnica senza splint, basata sulla realtà aumentata, per il riposizionamento del mascellare superiore. Il test in vitro è stato condotto su una replica di un cranio umano. La precisione chirurgica è stata misurata confrontando i risultati reali con quelli attesi. Il test è stato condotto utilizzando tre pianificazioni chirurgiche di crescente complessità, per nove operatori con diversi livelli di abilità chirurgica. Risultati: L'errore lineare medio è stato di 1,70±0,51mm. Gli errori assiali erano: 0,89±0,54mm sull'asse sagittale, 0,60±0,20mm sull'asse frontale, e 1,06±0,40mm sull'asse craniocaudale. Anche gli errori angolari medi sono stati calcolati. Beccheggio: 3.13°±1,89°; Rollio: 1,99°±0,95°; Imbardata: 3.25°±2,26°. Nessuna differenza significativa in termini di errore è stata rilevata tra gli operatori. Il feedback dei chirurghi è stato soddisfacente; tutti i test sono stati completati entro 15 minuti e lo strumento è stato considerato comodo e utilizzabile nella pratica. Conclusione: Il nostro dispositivo sembra essersi dimostrato preciso se utilizzato per eseguire il riposizionamento del mascellare superiore senza splint. I nostri risultati suggeriscono che il metodo può potenzialmente essere esteso ad altre procedure chirurgiche sullo scheletro facciale. Inoltre, appare utile procedere ai test in vivo per valutare la precisione chirurgica in condizioni cliniche reali

Brain-Computer Interfacing for Wheelchair Control by Detecting Voluntary Eye Blinks

The human brain is considered as one of the most powerful quantum computers and combining the human brain with technology can even outperform artificial intelligence. Using a Brain-Computer Interface (BCI) system, the brain signals can be analyzed and programmed for specific tasks. This research work employs BCI technology for a medical application that gives the unfortunate paralyzed individuals the capability to interact with their surroundings solely using voluntary eye blinks. This research contributes to the existing technology to be more feasible by introducing a modular design with three physically separated components: a headwear, a computer, and a wheelchair. As the signal-to-noise ratio (SNR) of the existing systems is too high to separate the eye blink artifacts from the regular EEG signal, a precise ThinkGear module is used which acquired the raw EEG signal through a single dry electrode. This chip offers an advanced filtering technology that has a high noise immunity along with an embedded Bluetooth module using which the acquired signal is transferred wirelessly to a computer. A MATLAB program captures voluntary eye blink artifacts from the brain waves and commands the movement of a miniature wheelchair via Bluetooth. To distinguish voluntary eye blinks from involuntary eye blinks, blink strength thresholds are determined. A Graphical User Interface (GUI) designed in MATLAB displays the EEG waves in real-time and enables the user to determine the movements of the wheelchair which is specially designed to take commands from the GUI.  The findings from the testing phase unveil the advantages of a modular design and the efficacy of using eye blink artifacts as the control element for brain-controlled wheelchairs. The work presented here gives a basic understanding of the functionality of a BCI system, and provides eye blink-controlled navigation of a wheelchair for patients suffering from severe paralysis

Anatomical and functional custom made restoration techniques with Direct Metal Laser Forming technology: systematic workflow and CAD-CAM

Introduction Bone defects are usually repaired by the body’s healing process itself. If severe fracture, tumor or infection occur on large bones, it poses a serious challenge to the regeneration ability of the bones. One of the latest advancement in medical science is the rapid prototyping technologies. Therefore, the aim of the present study was the developing and testing of a reliable workflow to fabricate custom-made grafts in the field craniofacial surgery. Material and Methods In this study 14 patients with different cranio-facial bone defects were enrolled. Two evaluation methods were associated to test the results of the workflow. Surveys were given to patients undergone surgery and their surgeons to have a subjective analysis of the workflow. For each patient the produced prosthesis was superimposed on the original prosthesis design, the displacement between was evaluated. Results Significant level of discomfort at 4 weeks after surgery compared to 2 days after surgery, aesthetic improvement significant improved 1 year after surgery compared to 4 weeks after surgery. Aesthetic improvement 1 year after surgery and aesthetic improvement according to expectations showed correlation, aesthetic improvement 1 year after surgery and aesthetic improvement according to expectations showed correlation. The mean distance of the printed model was significant smaller than the virtual model, with a mean difference of -0.075 mm. Conclusion According to the results of the present study custom made bone graft made with laser sintering technique represents a valid alternative to traditional bone grafts with high clinical accuracy and the advantage to avoid morbidity of the donor site or of the patient due to animal grafting

Variability of EEG electrode positions and their underlying brain regions: visualizing gel artifacts from a simultaneous EEG-fMRI dataset

Introduction We investigated the between-subject variability of EEG (electroencephalography) electrode placement from a simultaneously recorded EEG-fMRI (functional magnetic resonance imaging) dataset. Methods Neuro-navigation software was used to localize electrode positions, made possible by the gel artifacts present in the structural magnetic resonance images. To assess variation in the brain regions directly underneath electrodes we used MNI coordinates, their associated Brodmann areas, and labels from the Harvard-Oxford Cortical Atlas. We outline this relatively simple pipeline with accompanying analysis code. Results In a sample of 20 participants, the mean standard deviation of electrode placement was 3.94 mm in x, 5.55 mm in y, and 7.17 mm in z, with the largest variation in parietal and occipital electrodes. In addition, the brain regions covered by electrode pairs were not always consistent; for example, the mean location of electrode PO7 was mapped to BA18 (secondary visual cortex), whereas PO8 was closer to BA19 (visual association cortex). Further, electrode C1 was mapped to BA4 (primary motor cortex), whereas C2 was closer to BA6 (premotor cortex). Conclusions Overall, the results emphasize the variation in electrode positioning that can be found even in a fixed cap. This may be particularly important to consider when using EEG positioning systems to inform non-invasive neurostimulation

Intraoperative Navigation Systems for Image-Guided Surgery

Recent technological advancements in medical imaging equipment have resulted in a dramatic improvement of image accuracy, now capable of providing useful information previously not available to clinicians. In the surgical context, intraoperative imaging provides a crucial value for the success of the operation. Many nontrivial scientific and technical problems need to be addressed in order to efficiently exploit the different information sources nowadays available in advanced operating rooms. In particular, it is necessary to provide: (i) accurate tracking of surgical instruments, (ii) real-time matching of images from different modalities, and (iii) reliable guidance toward the surgical target. Satisfying all of these requisites is needed to realize effective intraoperative navigation systems for image-guided surgery. Various solutions have been proposed and successfully tested in the field of image navigation systems in the last ten years; nevertheless several problems still arise in most of the applications regarding precision, usability and capabilities of the existing systems. Identifying and solving these issues represents an urgent scientific challenge. This thesis investigates the current state of the art in the field of intraoperative navigation systems, focusing in particular on the challenges related to efficient and effective usage of ultrasound imaging during surgery. The main contribution of this thesis to the state of the art are related to: Techniques for automatic motion compensation and therapy monitoring applied to a novel ultrasound-guided surgical robotic platform in the context of abdominal tumor thermoablation. Novel image-fusion based navigation systems for ultrasound-guided neurosurgery in the context of brain tumor resection, highlighting their applicability as off-line surgical training instruments. The proposed systems, which were designed and developed in the framework of two international research projects, have been tested in real or simulated surgical scenarios, showing promising results toward their application in clinical practice

Developing preclinical devices for neuroscience research in the fields of animal tracking, fMRI acquisition, and 3D histology cutting

[ES] La neurociencia es un campo que abarca muchas especialidades. El objetivo de esta tesis es subsanar algunas carencias tecnológicas que existen en los métodos actuales de experimentación animal en neurociencia. En esta tesis, se presentan seis proyectos, que tendrán como objetivo mejorar el "Principio de las tres R", el cual fue enunciado por los biólogos ingleses W. M. S. Russell y R. L. Burch, durante la experimentación animal. El comportamiento es uno de los aspectos más importantes de la vida animal. Depende de los vínculos entre los animales, sus sistemas nerviosos y sus entornos. Para estudiar el comportamiento de los animales de laboratorio, se necesitan varias herramientas, pero una herramienta de seguimiento es esencial para llevar a cabo un estudio de comportamiento exhaustivo. Varias herramientas de seguimiento visual están actualmente disponibles. Sin embargo, todas tienen algunos inconvenientes. Por ejemplo, en una situación en la que un animal está dentro de una madriguera o cerca de otros animales, las cámaras de rastreo (tracking) no siempre pueden detectar la ubicación precisa o el movimiento del animal. Por esta razón, los entornos enriquecidos para intentar recrear el hábitat natural de los animales en experimentación no pueden utilizarse, ya que los datos recopilados son insuficientes/inexactos. Con la finalidad de mejorar los experimentos de tracking RFID Assisted Tracking Tile (RATT) es presentado en esta tesis. RATT es un sistema de seguimiento basado en tecnología de identificación pasiva de radiofrecuencia (RFID) y está compuesto por baldosas electrónicas con las que se puede construir una gran superficie, sobre la cual los animales pueden moverse libremente. Esto permite la identificación más precisa de los animales, así como el seguimiento de sus movimientos. Este sistema, que también se puede combinar con un sistema de seguimiento con cámaras, allana el camino para estudios completos de comportamiento en entornos enriquecidos. Dada la capacidad de rastrear animales y, por lo tanto, realizar experimentos de comportamiento exhaustivos, es posible observar cómo se comportan los sujetos desde un punto de vista externo. Sin embargo, si queremos comprender lo que sucede en el cerebro de estos sujetos, es necesario aplicar otras técnicas de análisis, por ejemplo, el estudio de señales dependientes del nivel de oxígeno en la sangre (BOLD, por sus siglas en inglés). Las señales BOLD se basan en las respuestas vasculares a la activación neuronal y se utilizan ampliamente en estudios de investigación clínicos y preclínicos. En entornos preclínicos, los animales suelen ser anestesiados. Sin embargo, los anestésicos causan cambios en la fisiología de los animales, p. Ej. hipotermia, y esto tiene el potencial de alterar las señales funcionales de MRI (fMRI). Para evitar la hipotermia en roedores anestesiados, se presenta TherMouseDuino. Este es un sistema de control automático de temperatura de código abierto, que reduce las fluctuaciones de la temperatura, lo que proporciona condiciones sólidas para realizar experimentos de resonancia magnética funcional. En los cursos de biología y neurociencia, la anatomía del cerebro se enseña generalmente utilizando imágenes de resonancia magnética (IRM) o secciones histológicas de diferentes planos. Estos muestran las áreas macroscópicas más importantes en el cerebro de un animal. Sin embargo, este método no es dinámico ni intuitivo. En esta tesis se presenta un cerebro de rata impreso en 3D con fines educativos. La manipulación manual de la estructura, facilitada por la ampliación de sus dimensiones, junto con la capacidad de desmontar el "cerebro" en algunas de sus partes principales, facilita la comprensión de la organización 3D del sistema nervioso. Este es un método alternativo y mejorado para enseñar a los estudiantes en general y a los biólogos, en particular, la anatomía del cerebro de rata.[CA] La neurociència és un camp que abasta moltes especialitats. L'objectiu d'aquesta tesi és esmenar algunes manques tecnològiques que existeixen en els mètodes actuals d'experimentació animal en neurociència. En aquesta tesi, es presenten sis projectes, que tindran com a objectiu millorar el "Principi de les tres R", el qual va ser enunciat pels biòlegs anglesos W. M. S. Russell i R. L. Burch, durant l'experimentació animal. El comportament és un dels aspectes m'és importants de la vida animal. Depèn dels vincles entre els animals, els seus sistemes nerviosos i els seus entorns. Per estudiar el comportament dels animals de laboratori, es necessiten diverses eines, però` una eina de seguiment és essencial per a dur a terme un estudi de comportament exhaustiu. Diverses eines de seguiment visual estan actualment disponibles. No obstant això, totes tenen alguns inconvenients. Per exemple, en una situació en la qual un animal esta` dins d'un cau o prop d'altres animals, les cambres de rastreig (tracking) no sempre poden detectar la ubicació precisa o el moviment de l'animal. Per aquesta raó, els entorns enriquits per a intentar recrear l'hàbitat natural dels animals en experimentació no poden utilitzar-se, ja que les dades recopilades són insuficients/inexactes. Amb la finalitat de millorar els experiments de tracking/seguiment RFID Assisted Tracking Tile (RATT) és presentat en aquesta tesi. RATT es un sistema de seguiment basat en tecnologia d'identificació passiva de radiofreqüència (RFID) i esta` compost per rajoles electròniques amb les quals es pot construir una gran superfície, sobre la qual els animals poden moures lliurement. Això permet la identificació més precisa dels animals, així com el seguiment dels seus moviments. Aquest sistema, que també es pot combinar amb un sistema de seguiment amb cambres, aplana el camí per a estudis complets de comportament en entorns enriquits. Donada la capacitat de rastrejar animals i, per tant, realitzar experiments de comportament exhaustius, és possible observar com es comporten els subjectes des d'un punt de vista extern. No obstant això, si volem comprendre el que succeeix en el cervell d'aquests subjectes, és necessari aplicar altres tècniques d'anàlisis, per exemple, l'estudi de senyals dependents del nivell d'oxigen en la sang (BOLD, per les seues sigles en anglès). Els senyals BOLD es basen en les respostes vasculars a l'activació neuronal i s'utilitzen àmpliament en estudis d'investigació clínics i preclínics. En entorns preclínics, els animals solen ser anestesiats. No obstant això, els anestèsics causen canvis en la fisiologia de els animals, per exemple hipotèrmia, i això te el potencial d'alterar els senyals funcionals de MRI (fMRI). Per a evitar la hipotèrmia en rosegadors anestesiats, es presenta TherMouseDuino. Aquest és un sistema de control automàtic de temperatura de codi obert, que redueix les fluctuacions de la temperatura, la qual cosa proporciona condicions solides per a realitzar experiments de ressonància magnètica funcional. En els cursos de biologia i neurociència, l'anatomia del cervell s'ensenya generalment utilitzant imatges de ressonància magnètica (IRM) o seccions histològiques de diferents plans. Aquests mostren les àrees macroscòpiques més importants en el cervell de un animal. No obstant això, aquest mètode no és dinàmic ni intuïtiu. En aquesta tesi es presenta un cervell de rata imprès en 3D amb finalitats educatius. La manipulació manual de l'estructura, facilitada per l'ampliació de les seues dimensions, juntament amb la capacitat de desmuntar el "cervell" en algunes de les seues parts principals, facilita la comprensió de l'organització 3D del sistema nerviós. Aquest és un mètode alternatiu i millorat per a ensenyar a els estudiants en general i als biòlegs, en particular, l'anatomia del cervell de rata.[EN] Neuroscience is a field that covers many specialties. The objective of this thesis is to correct some technological deficiencies that exist in current methods of animal experimentation in neuroscience. In this thesis, six projects are presented, which will aim to improve the "Principle of the three Rs" in animal experimentation enunciated by the English biologists W. M. S. Russell and R. L. Burch. In the present era of impressive progress in neuroscience, it is still not arguable that a complete understanding of the brain cannot be possible without a comparable understanding of animal behavior. In order to study the behavior of laboratory animals, various tools are needed, being a reliable tracking system one of the most important to follow large populations of individual subjects that interact in complex manners. Several visual tracking tools are currently available. However, they all have some drawbacks. For example, in a situation where an animal is inside a cave, or is in close proximity to other animals, tracking cameras cannot always detect the precise location or movement of the animal. For this reason, environments that have been enriched in order to attempt to recreate the natural habitat of the animals under experiment, cannot be used, as the data gathered is insufficient/inaccurate. In order to improve the current tracking systems , the RATT is presented. RATT is a tracking system based on passive RFID technology and it is composed of electronic tiles. Using several tiles, a large surface area, on which the animals can move freely, can be built. This enables the more accurate identification of the animals, as well as the tracking of their movements. This system, which can also be combined with a visual tracking system, paves the way for complete behavioral studies in enriched environments. Given the ability to track animals and thus conduct thorough behavioral experiments, it is possible to observe how the subjects behave from an external viewpoint. However, if we want to understand what is going on in the brains of these subjects, it is necessary to apply other analysis techniques, for example the study of BOLD signals. BOLD signals are based on vascular responses to neuronal activation and are used extensively in clinical and preclinical research studies. In preclinical settings, animals are usually anesthetized. However, anesthetics cause changes in the physiology of the animals, e.g. hypothermia, and this has the potential to disrupt fMRI signals. In order to avoid hypothermia in anesthetized rodents, TherMouseDuino is presented. This is an Open-Source automatic temperature control system, which reduces temperature fluctuations, thus providing robust conditions in which to perform fMRI experiments. In biology and neuroscience courses, brain anatomy is generally taught using MRI or histological sections of different planes. These show the most important macroscopic areas in an animals' brain. However, this method is neither dynamic nor intuitive. An anatomical 3D printed rat brain with educative purposes is presented in this thesis. Hand manipulation of the structure, facilitated by the scaling up of its dimensions, together with the ability to dismantle the "brain" into some of main its constituent parts, facilitates the understanding of the 3D organization of the nervous system. This is an alternative and improved method for teaching students in general and biologists, in particular, the rat brain anatomy.This work was supported in part by the Spanish Ministerio de Economía y Competitividad (MINECO) and FEDER funds under grants BFU2015-64380-C2-2-R (D.M.) and BFU2015-64380-C2-1-R, by EU Horizon 2020 Program 668863-SyBil-AA grant (S.C.). S.C. acknowledges financial support from the Spanish State Research Agency, through the “Severo Ochoa” Programme for Centres of Excellence in R&D (ref. SEV-2013-0317) and by a grant “Ayudas para la formación de personal investigador (FPI)” from the Vicerrectorado de Investigación, Innovación y Transferencia of the Universitat Politècnica de València.Quiñones Colomer, DR. (2019). Developing preclinical devices for neuroscience research in the fields of animal tracking, fMRI acquisition, and 3D histology cutting [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/118795TESI

Medical image registration and soft tissue deformation for image guided surgery system

In parallel with the developments in imaging modalities, image-guided surgery (IGS) can now provide the surgeon with high quality three-dimensional images depicting human anatomy. Although IGS is now in widely use in neurosurgery, there remain some limitations that must be overcome before it can be employed in more general minimally invasive procedures. In this thesis, we have developed several contributions to the field of medical image registration and brain tissue deformation modeling. From the methodology point of view, medical image registration algorithms can be classified into feature-based and intensity-based methods. One of the challenges faced by feature-based registration would be to determine which specific type of feature is desired for a given task and imaging type. For this reason, a point set registration using points and curves feature is proposed, which has the accuracy of registration based on points and the robustness of registration based on lines or curves. We have also tackled the problem on rigid registration of multimodal images using intensity-based similarity measures. Mutual information (MI) has emerged in recent years as a popular similarity metric and widely being recognized in the field of medical image registration. Unfortunately, it ignores the spatial information contained in the images such as edges and corners that might be useful in the image registration. We introduce a new similarity metric, called Adaptive Mutual Information (AMI) measure which incorporates the gradient spatial information. Salient pixels in the regions with high gradient value will contribute more in the estimation of mutual information of image pairs being registered. Experimental results showed that our proposed method improves registration accuracy and it is more robust to noise images which have large deviation from the reference image. Along with this direction, we further improve the technique to simultaneously use all information obtained from multiple features. Using multiple spatial features, the proposed algorithm is less sensitive to the effect of noise and some inherent variations, giving more accurate registration. Brain shift is a complex phenomenon and there are many different reasons causing brain deformation. We have investigated the pattern of brain deformation with respect to location and magnitude and to consider the implications of this pattern for correcting brain deformation in IGS systems. A computational finite element analysis was carried out to analyze the deformation and stress tensor experienced by the brain tissue during surgical operations. Finally, we have developed a prototype visualization display and navigation platform for interpretation of IGS. The system is based upon Qt (cross-platform GUI toolkit) and it integrates VTK (an object-oriented visualization library) as the rendering kernel. Based on the construction of a visualization software platform, we have laid a foundation on the future research to be extended to implement brain tissue deformation into the system

Modeling, Simulation, And Visualization Of 3d Lung Dynamics

Medical simulation has facilitated the understanding of complex biological phenomenon through its inherent explanatory power. It is a critical component for planning clinical interventions and analyzing its effect on a human subject. The success of medical simulation is evidenced by the fact that over one third of all medical schools in the United States augment their teaching curricula using patient simulators. Medical simulators present combat medics and emergency providers with video-based descriptions of patient symptoms along with step-by-step instructions on clinical procedures that alleviate the patient\u27s condition. Recent advances in clinical imaging technology have led to an effective medical visualization by coupling medical simulations with patient-specific anatomical models and their physically and physiologically realistic organ deformation. 3D physically-based deformable lung models obtained from a human subject are tools for representing regional lung structure and function analysis. Static imaging techniques such as Magnetic Resonance Imaging (MRI), Chest x-rays, and Computed Tomography (CT) are conventionally used to estimate the extent of pulmonary disease and to establish available courses for clinical intervention. The predictive accuracy and evaluative strength of the static imaging techniques may be augmented by improved computer technologies and graphical rendering techniques that can transform these static images into dynamic representations of subject specific organ deformations. By creating physically based 3D simulation and visualization, 3D deformable models obtained from subject-specific lung images will better represent lung structure and function. Variations in overall lung deformations may indicate tissue pathologies, thus 3D visualization of functioning lungs may also provide a visual tool to current diagnostic methods. The feasibility of medical visualization using static 3D lungs as an effective tool for endotracheal intubation was previously shown using Augmented Reality (AR) based techniques in one of the several research efforts at the Optical Diagnostics and Applications Laboratory (ODALAB). This research effort also shed light on the potential usage of coupling such medical visualization with dynamic 3D lungs. The purpose of this dissertation is to develop 3D deformable lung models, which are developed from subject-specific high resolution CT data and can be visualized using the AR based environment. A review of the literature illustrates that the techniques for modeling real-time 3D lung dynamics can be roughly grouped into two categories: Geometrically-based and Physically-based. Additional classifications would include considering a 3D lung model as either a volumetric or surface model, modeling the lungs as either a single-compartment or a multi-compartment, modeling either the air-blood interaction or the air-blood-tissue interaction, and considering either a normal or pathophysical behavior of lungs. Validating the simulated lung dynamics is a complex problem and has been previously approached by tracking a set of landmarks on the CT images. An area that needs to be explored is the relationship between the choice of the deformation method for the 3D lung dynamics and its visualization framework. Constraints on the choice of the deformation method and the 3D model resolution arise from the visualization framework. Such constraints of our interest are the real-time requirement and the level of interaction required with the 3D lung models. The work presented here discusses a framework that facilitates a physics-based and physiology-based deformation of a single-compartment surface lung model that maintains the frame-rate requirements of the visualization system. The framework presented here is part of several research efforts at ODALab for developing an AR based medical visualization framework. The framework consists of 3 components, (i) modeling the Pressure-Volume (PV) relation, (ii) modeling the lung deformation using a Green\u27s function based deformation operator, and (iii) optimizing the deformation using state-of-art Graphics Processing Units (GPU). The validation of the results obtained in the first two modeling steps is also discussed for normal human subjects. Disease states such as Pneumothorax and lung tumors are modeled using the proposed deformation method. Additionally, a method to synchronize the instantiations of the deformation across a network is also discussed