Novel Approaches to the Representation and Analysis of 3D Segmented Anatomical Districts

Nowadays, image processing and 3D shape analysis are an integral part of clinical practice and have the potentiality to support clinicians with advanced analysis and visualization techniques. Both approaches provide visual and quantitative information to medical practitioners, even if from different points of view. Indeed, shape analysis is aimed at studying the morphology of anatomical structures, while image processing is focused more on the tissue or functional information provided by the pixels/voxels intensities levels. Despite the progress obtained by research in both fields, a junction between these two complementary worlds is missing. When working with 3D models analyzing shape features, the information of the volume surrounding the structure is lost, since a segmentation process is needed to obtain the 3D shape model; however, the 3D nature of the anatomical structure is represented explicitly. With volume images, instead, the tissue information related to the imaged volume is the core of the analysis, while the shape and morphology of the structure are just implicitly represented, thus not clear enough. The aim of this Thesis work is the integration of these two approaches in order to increase the amount of information available for physicians, allowing a more accurate analysis of each patient. An augmented visualization tool able to provide information on both the anatomical structure shape and the surrounding volume through a hybrid representation, could reduce the gap between the two approaches and provide a more complete anatomical rendering of the subject. To this end, given a segmented anatomical district, we propose a novel mapping of volumetric data onto the segmented surface. The grey-levels of the image voxels are mapped through a volume-surface correspondence map, which defines a grey-level texture on the segmented surface. The resulting texture mapping is coherent to the local morphology of the segmented anatomical structure and provides an enhanced visual representation of the anatomical district. The integration of volume-based and surface-based information in a unique 3D representation also supports the identification and characterization of morphological landmarks and pathology evaluations. The main research contributions of the Ph.D. activities and Thesis are: \u2022 the development of a novel integration algorithm that combines surface-based (segmented 3D anatomical structure meshes) and volume-based (MRI volumes) information. The integration supports different criteria for the grey-levels mapping onto the segmented surface; \u2022 the development of methodological approaches for using the grey-levels mapping together with morphological analysis. The final goal is to solve problems in real clinical tasks, such as the identification of (patient-specific) ligament insertion sites on bones from segmented MR images, the characterization of the local morphology of bones/tissues, the early diagnosis, classification, and monitoring of muscle-skeletal pathologies; \u2022 the analysis of segmentation procedures, with a focus on the tissue classification process, in order to reduce operator dependency and to overcome the absence of a real gold standard for the evaluation of automatic segmentations; \u2022 the evaluation and comparison of (unsupervised) segmentation methods, finalized to define a novel segmentation method for low-field MR images, and for the local correction/improvement of a given segmentation. The proposed method is simple but effectively integrates information derived from medical image analysis and 3D shape analysis. Moreover, the algorithm is general enough to be applied to different anatomical districts independently of the segmentation method, imaging techniques (such as CT), or image resolution. The volume information can be integrated easily in different shape analysis applications, taking into consideration not only the morphology of the input shape but also the real context in which it is inserted, to solve clinical tasks. The results obtained by this combined analysis have been evaluated through statistical analysis

Validation of Radiocarpal Joint Contact Models Based On Images from a Clinical MRI Scanner

Due to the severity and continuing escalation in occurrences of degenerative joint diseases, it is vital to establish a means of detection and prevention that could lead to an improvement in quality of life. One such means is MRI-based modeling for joint contact analysis of in vivo functional loading. The purpose of this study was to validate models generated from a clinical MR scanner for future in vivo joint contact analyses. Models were tested using 3 cadaver forearm specimens and compared with experimental data. It was found that models were validated based on contact area. Direct contact area measurements were observed to be very close to experimental data. Model force measurements were reasonable, but did not agree with experimental data as well as contact area. Peak pressure data from the models were less consistent in correspondence with experimental data. Also, radiocarpal mechanics were investigated to determine the effect of inserting a sensor into the joint space. Magnitudes of bone motions were found to be greater with film inserted than without film. Model results showed contact areas to be higher with film than without film

Finite element model creation and stability considerations of complex biological articulation : the human wrist joint

The finite element method has been used with considerable success to simulate the behaviour of various joints such as the hip, knee and shoulder. It has had less impact on more complicated joints such as the wrist and the ankle. Previously published finite element studies on these multi bone joints have needed to introduce un-physiological boundary conditions in order to establish numerical convergence of the model simulation. That is necessary since the stabilising soft tissue mechanism of these joints is usually too elaborate in order to be fully included both anatomically and with regards to material properties. This paper looks at the methodology of creating a finite element model of such a joint focussing on the wrist and the effects additional constraining has on the solution of the model. The study shows that by investigating the effects each of the constraints, a better understanding on the nature of the stabilizing mechanisms of these joints can be achieved

IN VIVO CONTACT MECHANICS OF THE DISTAL RADIOULNAR JOINT WITH AND WITHOUT SCAPHOLUNATE DISSOCIATION

The distal radioulnar joint (DRUJ) is a joint of the wrist which allows force transmission and forearm rotation in the upper limb while preserving the stability of the forearm independent of elbow and wrist flexion and extension. DRUJ is a commonly injured part of the body. Conditions affecting the joint could be positive ulnar variance or negative ulnar variance, the length of the ulna relative to radius. It is also adversely affected by nearby injuries such as distal radial fractures. In fact, a significant correlation was found between negative ulnar variance and scapholunate dissociation (SLD), a ligament injury of the wrist. This leads to the question of whether or not SLD causes changes in the radioulnar joint mechanics. Altered joint mechanics are associated with the onset of osteoarthritis (OA). An understanding of the of the normal and pathological wrist in vivo DRUJ contact mechanics should help physicians make better clinical recommendations and improve treatment for the primary injury. Proper treatment of the DRUJ could help prevent the onset of OA. Image registration is used in our modeling to determine the kinematic transformations for carpal bones from the unloaded to the loaded configuration. A perturbation study was done to evaluate the effect of varying initial manual registrations and the relative image plane orientations on the final registration kinematics. The results of the study showed that Subject II (with different imaging plane orientations) was found to have greater translation errors compared to subject I (consistent imaging planes). This result emphasizes the need to be consistent with forearm position and/or image plane orientation to minimize the errors of translation and attitude vectors. In a separate study, five additional subjects with unilateral SLD participated in another study in which MRI based contact modeling was used to analyze the contact mechanics parameters of the injured wrist compared to the normal wrist. The contact forces, peak contact pressures, average pressures and contact areas generally trended to be higher in injured wrists compared to the normal and surgically repaired wrists. Model contact areas were found to be consistent with the directly measured areas from the grasp MR images. A repeatability test was done on a single subject and the absolute differences between the contact parameters for both the trials were close. These findings suggest that SLD injury of the wrist may have an effect on the DRUJ mechanics

Biomechanics

Biomechanics is a vast discipline within the field of Biomedical Engineering. It explores the underlying mechanics of how biological and physiological systems move. It encompasses important clinical applications to address questions related to medicine using engineering mechanics principles. Biomechanics includes interdisciplinary concepts from engineers, physicians, therapists, biologists, physicists, and mathematicians. Through their collaborative efforts, biomechanics research is ever changing and expanding, explaining new mechanisms and principles for dynamic human systems. Biomechanics is used to describe how the human body moves, walks, and breathes, in addition to how it responds to injury and rehabilitation. Advanced biomechanical modeling methods, such as inverse dynamics, finite element analysis, and musculoskeletal modeling are used to simulate and investigate human situations in regard to movement and injury. Biomechanical technologies are progressing to answer contemporary medical questions. The future of biomechanics is dependent on interdisciplinary research efforts and the education of tomorrow’s scientists

Effects of Surgical Repair or Reconstruction on Radiocarpal Mechanics from Wrists with Scapholunate Ligament Injury

Osteoarthritis as a result of injury/trauma is a significant problem, and there is still a need to develop tools for evaluating joint injuries and the effectiveness of surgical treatments. For the wrist in particular, injury to the scapholunate ligament from impact loading, can lead to scapholunate joint instability. Without treatment, this can lead to progressive development of wrist osteoarthritis. Joint contact pressures are important mechanical factors in the etiology of osteoarthritis, and these can be determined non-invasively through computer modeling. Hence, the goal of this work was to investigate the effects of scapholunate ligament injury and surgical repair on radioscapholunate contact mechanics, through surface contact modeling (SCM) and finite element modeling (FEM). The modeling process required geometries, boundary conditions and a contact relationship. Magnetic resonance imaging (MRI) was used to acquire images of the normal, injured and post-operative wrists, while relaxed and during active grasp loading. Surface and volumetric models were generated from the relaxed images, while kinematic boundary conditions were determined from image registration between the relaxed and loaded images. To improve the automatic image registration process, the effects of initial manual registration on the outcome of final registration accuracy, were investigated. Results showed that kinematic accuracy and subsequent contact mechanics were improved by performing a manual registration to align the image volumes as close as possible, before auto-registration. Looking at the effects of scapholunate ligament injury, results showed that contact forces, contact areas, peak and mean contact pressures significantly increased in the radioscaphoid joint. The locations of contact also shifted with injury. This novel data showed that contact mechanics was altered for the worse after injury. Novel contact mechanics data on the effects of surgical repair were also obtained. Results showed that radiolunate peak and mean contact pressures decreased significantly compared to injured, which indicated the possibility of restoring normal mechanics post surgery. SCM results were compared to FEM results to demonstrate the feasibility of the surface contact modeling approach for clinical applications. Contact parameters compared well between the two techniques. This work demonstrated the potential of MRI-based SCM as a tool to evaluate joint injuries and subsequent treatments, for clinical applications

Bone in vivo: Surface mapping technique

Bone surface mapping technique is proposed on the bases of two kinds of uniqueness of bone in vivo, (i) magnitude of the principal moments of inertia, (ii) the direction cosines of principal axes of inertia relative to inertia reference frame. We choose the principal axes of inertia as the bone coordinate system axes. The geographical marks such as the prime meridian of the bone in vivo are defined and methods such as tomographic reconstruction and boundary development are employed so that the surface of bone in vivo can be mapped. Experimental results show that the surface mapping technique can both reflect the shape and help study the surface changes of bone in vivo. The prospect of such research into the surface shape and changing laws of organ, tissue or cell will be promising.Comment: 9 pages, 6 figure