Computer-aided planning for zygomatic bone reconstruction in maxillofacial traumatology

An optimal planning procedure has been proposed to define the target position of the zygomatic bone following a fracture of the mid-face skeleton. The protocol has been successfully tested on healthy subjects, and ensures the global symmetry of the face could be obtained after the reconstruction surgery. Now that the planning procedure is available, the next step of this project will be to develop an intra-operative guiding system to help the surgeon to follow the planning. This procedure will mainly rely on the intra-operative registration of the zygomatic bone fragment, and the design of specific surgical ancillaries for cranio-maxillofacial surgery

MRI/TRUS data fusion for brachytherapy

BACKGROUND: Prostate brachytherapy consists in placing radioactive seeds for tumour destruction under transrectal ultrasound imaging (TRUS) control. It requires prostate delineation from the images for dose planning. Because ultrasound imaging is patient- and operator-dependent, we have proposed to fuse MRI data to TRUS data to make image processing more reliable. The technical accuracy of this approach has already been evaluated. METHODS: We present work in progress concerning the evaluation of the approach from the dosimetry viewpoint. The objective is to determine what impact this system may have on the treatment of the patient. Dose planning is performed from initial TRUS prostate contours and evaluated on contours modified by data fusion. RESULTS: For the eight patients included, we demonstrate that TRUS prostate volume is most often underestimated and that dose is overestimated in a correlated way. However, dose constraints are still verified for those eight patients. CONCLUSIONS: This confirms our initial hypothesis

Orbital and Maxillofacial Computer Aided Surgery: Patient-Specific Finite Element Models To Predict Surgical Outcomes

This paper addresses an important issue raised for the clinical relevance of Computer-Assisted Surgical applications, namely the methodology used to automatically build patient-specific Finite Element (FE) models of anatomical structures. From this perspective, a method is proposed, based on a technique called the Mesh-Matching method, followed by a process that corrects mesh irregularities. The Mesh-Matching algorithm generates patient-specific volume meshes from an existing generic model. The mesh regularization process is based on the Jacobian matrix transform related to the FE reference element and the current element. This method for generating patient-specific FE models is first applied to Computer-Assisted maxillofacial surgery, and more precisely to the FE elastic modelling of patient facial soft tissues. For each patient, the planned bone osteotomies (mandible, maxilla, chin) are used as boundary conditions to deform the FE face model, in order to predict the aesthetic outcome of the surgery. Seven FE patient-specific models were successfully generated by our method. For one patient, the prediction of the FE model is qualitatively compared with the patient's post-operative appearance, measured from a Computer Tomography scan. Then, our methodology is applied to Computer-Assisted orbital surgery. It is, therefore, evaluated for the generation of eleven patient-specific FE poroelastic models of the orbital soft tissues. These models are used to predict the consequences of the surgical decompression of the orbit. More precisely, an average law is extrapolated from the simulations carried out for each patient model. This law links the size of the osteotomy (i.e. the surgical gesture) and the backward displacement of the eyeball (the consequence of the surgical gesture)

Biomechanics applied to computer-aided diagnosis: examples of orbital and maxillofacial surgeries

This paper introduces the methodology proposed by our group to model the biological soft tissues deformations and to couple these models with Computer-Assisted Surgical (CAS) applications. After designing CAS protocols that mainly focused on bony structures, the Computer Aided Medical Imaging group of Laboratory TIMC (CNRS, France) now tries to take into account the behaviour of soft tissues in the CAS context. For this, a methodology, originally published under the name of the Mesh-Matching method, has been proposed to elaborate patient specific models. Starting from an elaborate manually-built "generic" Finite Element (FE) model of a given anatomical structure, models adapted to the geometries of each new patient ("patient specific" FE models) are automatically generated through a non-linear elastic registration algorithm. This paper presents the general methodology of the Mesh-Matching method and illustrates this process with two clinical applications, namely the orbital and the maxillofacial computer-assisted surgeries

Medical image computing and computer-aided medical interventions applied to soft tissues. Work in progress in urology

Until recently, Computer-Aided Medical Interventions (CAMI) and Medical Robotics have focused on rigid and non deformable anatomical structures. Nowadays, special attention is paid to soft tissues, raising complex issues due to their mobility and deformation. Mini-invasive digestive surgery was probably one of the first fields where soft tissues were handled through the development of simulators, tracking of anatomical structures and specific assistance robots. However, other clinical domains, for instance urology, are concerned. Indeed, laparoscopic surgery, new tumour destruction techniques (e.g. HIFU, radiofrequency, or cryoablation), increasingly early detection of cancer, and use of interventional and diagnostic imaging modalities, recently opened new challenges to the urologist and scientists involved in CAMI. This resulted in the last five years in a very significant increase of research and developments of computer-aided urology systems. In this paper, we propose a description of the main problems related to computer-aided diagnostic and therapy of soft tissues and give a survey of the different types of assistance offered to the urologist: robotization, image fusion, surgical navigation. Both research projects and operational industrial systems are discussed

An efficient algorithm for non-rigid object registration

An efficient algorithm for registration of two non-rigid objects based on geometrical transformation of the template object to target object is proposed. The transformation is considered as warping of the template onto the target. To choose the most suitable transformation from all possible warps, a registration algorithm should satisfy deformation constraints referred to as regularization of non-rigid objects. In this work, we use variational functionals for affine transformations. With the help of computer simulation, the proposed method for searching the optimal geometrical transformation is compared with that of common algorithms

Blending liquids

We present a method for smoothly blending between existing liquid animations. We introduce a semi-automatic method for matching two existing liquid animations, which we use to create new fluid motion that plausibly interpolates the input. Our contributions include a new space-time non-rigid iterative closest point algorithm that incorporates user guidance, a subsampling technique for efficient registration of meshes with millions of vertices, and a fast surface extraction algorithm that produces 3D triangle meshes from a 4D space-time surface. Our technique can be used to instantly create hundreds of new simulations, or to interactively explore complex parameter spaces. Our method is guaranteed to produce output that does not deviate from the input animations, and it generalizes to multiple dimensions. Because our method runs at interactive rates after the initial precomputation step, it has potential applications in games and training simulations