Comparison of linear and non-linear soft tissue models with postoperative ct scan in maxillofacial surgery

Abstract. A Finite Element model of the face soft tissue is proposed to simulate the morphological outcomes of maxillofacial surgery. Three modelling options are implemented: a linear elastic model with small and large deformation hypothesis, and an hyperelastic Mooney-Rivlin model. An evaluation procedure based on a qualitative and quantitative comparison of the simulations with a post-operative CT scan is detailed. It is then applied to one clinical case to evaluate the differences between the three models, and with the actual patient morphology. First results shows in particular that for a "simple" clinical procedure where stress is less than 20%, a linear model seams sufficient for a correct modelling

A fast and robust patient specific Finite Element mesh registration technique: application to 60 clinical cases

Finite Element mesh generation remains an important issue for patient specific biomechanical modeling. While some techniques make automatic mesh generation possible, in most cases, manual mesh generation is preferred for better control over the sub-domain representation, element type, layout and refinement that it provides. Yet, this option is time consuming and not suited for intraoperative situations where model generation and computation time is critical. To overcome this problem we propose a fast and automatic mesh generation technique based on the elastic registration of a generic mesh to the specific target organ in conjunction with element regularity and quality correction. This Mesh-Match-and-Repair (MMRep) approach combines control over the mesh structure along with fast and robust meshing capabilities, even in situations where only partial organ geometry is available. The technique was successfully tested on a database of 5 pre-operatively acquired complete femora CT scans, 5 femoral heads partially digitized at intraoperative stage, and 50 CT volumes of patients' heads. The MMRep algorithm succeeded in all 60 cases, yielding for each patient a hex-dominant, Atlas based, Finite Element mesh with submillimetric surface representation accuracy, directly exploitable within a commercial FE software

Environnement générique pour la validation de simulations médicales

Dans le cadre des simulations pour l'entrainement, le planning, ou l'aide per-opératoire aux gestes médicaux-chirurgicaux, de nombreux modèles ont été développés pour décrire le comportement mécanique des tissus mous. La vérification, la validation et l'évaluation sont des étapes cruciales en vue de l'acceptation clinique des résultats de simulation. Ces tâches, souvent basées sur des comparaisons avec des données expérimentales ou d'autres simulations, sont rendues difficiles par le nombre de techniques de modélisation existantes, le nombre d'hypothèses à considérer et la difficulté de réaliser des expériences réelles utilisables. Nous proposons un environnement de comparaison basé sur une analyse du processus de modélisation et une description générique des éléments constitutifs d'une simulation (e.g. géométrie, chargements, critère de stabilité) ainsi que des résultats (expérimentaux ou provenant d'une simulation). La description générique des simulations permet d'effectuer des comparaisons avec diverses techniques de modélisation (e.g. masse-ressorts, éléments finis) implémentées sur diverses plateformes de simulation. Les comparaisons peuvent être faites avec des expériences réelles, d'autres résultats de simulation ou d'anciennes versions du modèle grâce à la description commune des résultats, et s'appuient sur un ensemble de métriques pour quantifier la précision et la vitesse de calcul. La description des résultats permet également de faciliter l'échange d'expériences de validation. La pertinence de la méthode est montrée sur différentes expériences de validation et de comparaison de modèles. L'environnement et ensuite utilisé pour étudier l'influence des hypothèses de modélisations et des paramètres d'un modèle d'aspiration de tissu utilisé par un dispositif de caractérisation des lois de comportement. Cette étude permet de donner des pistes pour l'amélioration des prédictions du dispositif.Numerous models have been developed to describe the mechanical behavior of soft tissues for medical simulation. Verification, validation and evaluation are crucial steps towards the acceptance of simulation results by clinicians. These tasks, often based on comparisons between simulation results and experimental data or other simulations, are difficult because of the wide range of available modeling techniques, the number of possible assumptions, and the difficulty to perform validation experiments. A comparison framework is proposed based on the analysis of the modelisation process and on a generic description of both constitutive elements of a simulation (e.g. geometry, loads, stability criterion) and results (from simulations or experiments). Generic description allows comparisons between different modeling techniques implemented in various simulation platforms. Comparisons can be performed against real experiments, other simulation results or previous versions of a model thanks to the generic description of results and use a set of metrics to quantify both accuracy and computational efficiency. This description also facilitates validation experiments sharing. The usability of the method is shown on several validation and comparison experiments. The framework is then used to investigate the influence of modeling assumptions and parameters in a biomechanical finite element model of an in-vivo tissue aspiration device. This study gives clues towards the improvement of the predictions of the characterization device.SAVOIE-SCD - Bib.électronique (730659901) / SudocGRENOBLE1/INP-Bib.électronique (384210012) / SudocGRENOBLE2/3-Bib.électronique (384219901) / SudocSudocFranceF

Soft tissue modelling and facial movement simulation using the finite element method

This thesis presents a framework for soft tissue modelling, facial surgery simulation, and facial movement synthesis based on the volumetric finite element method. Assessment of facial appearance pre- and post-surgery is of major concern for both patients and clinicians. Pre-surgical planning is a prerequisite for successful surgical procedures and outcomes. Early computer-assisted facial models have been geometrically based. They are computationally efficient, but cannot give an accurate prediction for facial surgery simulation. Therefore, in this thesis, the emphasis is placed on physically-based methods, especially the finite element technique. To achieve realistic surgery simulation, soft tissue modelling is of crucial importance. Thus, in this thesis, considerable effort has been directed to develop constitutive equations for facial skeletal muscles. The skeletal muscle model subsequently developed is able to capture the complex mechanical properties of skeletal muscle, which are active, quasi-incompressible, fibre-reinforced and hyperelastic. In addition, to improve the characterisation of in-vivo muscle behaviour, a technique has been developed to visualise the internal fibre arrangement of skeletal muscle using the FEM-NURBS method, which is the combination of the finite element method and the non-uniform rational B-spline solid mathematical representation. Another principal contribution made in this thesis is the three-dimensional finite element facial model, which can be used for the simulations of facial surgery and facial movement. The procedure of one cranio-facial surgery is simulated by using this facial model and the numerical predictions show a good agreement with the patient post-surgical data. In addition, it would be very helpful to also simulate the facial movement and facial expressions. In this thesis, two facial expressions (smile and disgust) and the mouth opening are simulated to assess the post-surgical appearance and test the muscle-driven facial movement simulation method

Models for Planning and Simulation in Computer Assisted Orthognatic Surgery

Two aspects required to establish a planning in orthognatic surgery are addressed in this paper. First, a 3D cephalometric analysis, which is clini-cally essential for the therapeutic decision. Then, an original method to build a biomechanical model of patient face soft tissue, which provides evaluation of the aesthetic outcomes of an intervention. Both points are developed within a clinical application context for computer aided maxillofacial surgery