Research on real-time physics-based deformation for haptic-enabled medical simulation

This study developed a multiple effective visuo-haptic surgical engine to handle a variety of surgical manipulations in real-time. Soft tissue models are based on biomechanical experiment and continuum mechanics for greater accuracy. Such models will increase the realism of future training systems and the VR/AR/MR implementations for the operating room

Soft volume simulation using a deformable surface model

The aim of the research is to contribute to the modelling of deformable objects, such as soft tissues in medical simulation. Interactive simulation for medical training is a concept undergoing rapid growth as the underlying technologies support the increasingly more realstic and functional training environments. The prominent issues in the deployment of such environments centre on a fine balance between the accuracy of the deformable model and real-time interactivity. Acknowledging the importance of interacting with non-rigid materials such as the palpation of a breast for breast assessment, this thesis has explored the physics-based modelling techniques for both volume and surface approach. This thesis identified that the surface approach based on the mass spring system (MSS) has the benefits of rapid prototyping, reduced mesh complexity, computational efficiency and the support for large material deformation compared to the continuum approach. However, accuracy relative to real material properties is often over looked in the configuration of the resulting model. This thesis has investigated the potential and the feasibility of surface modelling for simulating soft objects regardless of the design of the mesh topology and the non-existence of internal volume discretisation. The assumptions of the material parameters such as elasticity, homogeneity and incompressibility allow a reduced set of material values to be implemented in order to establish the association with the surface configuration. A framework for a deformable surface model was generated in accordance with the issues of the estimation of properties and volume behaviour corresponding to the material parameters. The novel extension to the surface MSS enables the tensile properties of the material to be integrated into an enhanced configuration despite its lack of volume information. The benefits of the reduced complexity of a surface model are now correlated with the improved accuracy in the estimation of properties and volume behaviour. Despite the irregularity of the underlying mesh topology and the absence of volume, the model reflected the original material values and preserved volume with minimal deviations. Global deformation effect which is essential to emulate the run time behaviour of a real soft material upon interaction, such as the palpation of a generic breast, was also demonstrated, thus indicating the potential of this novel technique in the application of soft tissue simulation

Design and development of a VR system for exploration of medical data using haptic rendering and high quality visualization

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TrauMAP - Integrating Anatomical and Physiological Simulation (Dissertation Proposal)

In trauma, many injuries impact anatomical structures, which may in turn affect physiological processes - not only those processes within the structure, but also ones occurring in physical proximity to them. Our goal with this research is to model mechanical interactions of different body systems and their impingement on underlying physiological processes. We are particularly concerned with pathological situations in which body system functions that normally do not interact become dependent as a result of mechanical behavior. Towards that end, the proposed TRAUMAP system (Trauma Modeling of Anatomy and Physiology) consists of three modules: (1) a hypothesis generator for suggesting possible structural changes that result from the direct injuries sustained; (2) an information source for responding to operator querying about anatomical structures, physiological processes, and pathophysiological processes; and (3) a continuous system simulator for simulating and illustrating anatomical and physiological changes in three dimensions. Models that can capture such changes may serve as an infrastructure for more detailed modeling and benefit surgical planning, surgical training, and general medical education, enabling students to visualize better, in an interactive environment, certain basic anatomical and physiological dependencies

Mixed Reality system to study deformable objects: Breast Cancer application

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2020-2021. Directors: Eduardo Soudah i Óscar de Coss. Tutor: Aida NiñerolaA significant amount of women who go through a breast cancer conservative surgery to treat early stage breast cancer undergo a repeat surgery due to concerns that residual tumor was left behind. To avoid this, tumor localization is needed to assist the surgeon in order to determine tumor extent and also, it is critical to account for tissue deformations. For these reasons, new navigation systems, like the one proposed on this project, are emerging to cover those needs. This project focuses on the use of a Mixed Reality system to improve the accuracy in placing the static hologram of the tumor and, to implement a dynamical hologram when deformation takes place. In order to do so, two different molds with objects inside have been manufactured. Next, two different approaches were considered, a mathematical approach to create a 3D CAD model of the molds and a medical approach, which consisted in performing a CT and then, segment the images. The models were post-processed and imported to the HoloLens head-mounted display. The system was tested on the molds and on a breast phantom provided by the Hospital Clinic. The results obtained were encouraging and although some things need to be improved, this exciting new use for Augmented Reality has the potential to improve the lives of many patients

Virtual environments for medical training : graphic and haptic simulation of tool-tissue interactions

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 2004.Includes bibliographical references (leaves 122-127).For more than 2,500 years, surgical teaching has been based on the so called "see one, do one, teach one" paradigm, in which the surgical trainee learns by operating on patients under close supervision of peers and superiors. However, higher demands on the quality of patient care and rising malpractice costs have made it increasingly risky to train on patients. Minimally invasive surgery, in particular, has made it more difficult for an instructor to demonstrate the required manual skills. It has been recognized that, similar to flight simulators for pilots, virtual reality (VR) based surgical simulators promise a safer and more comprehensive way to train manual skills of medical personnel in general and surgeons in particular. One of the major challenges in the development of VR-based surgical trainers is the real-time and realistic simulation of interactions between surgical instruments and biological tissues. It involves multi-disciplinary research areas including soft tissue mechanical behavior, tool-tissue contact mechanics, computer haptics, computer graphics and robotics integrated into VR-based training systems. The research described in this thesis addresses many of the problems of simulating tool-tissue interactions in medical virtual environments. First, two kinds of physically based real time soft tissue models - the local deformation and the hybrid deformation model - were developed to compute interaction forces and visual deformation fields that provide real-time feed back to the user. Second, a system to measure in vivo mechanical properties of soft tissues was designed, and eleven sets of animal experiments were performed to measure in vivo and in vitro biomechanical properties of porcine intra-abdominal organs. Viscoelastic tissue(cont.) parameters were then extracted by matching finite element model predictions with the empirical data. Finally, the tissue parameters were combined with geometric organ models segmented from the Visible Human Dataset and integrated into a minimally invasive surgical simulation system consisting of haptic interface devices inside a mannequin and a graphic display. This system was used to demonstrate deformation and cutting of the esophagus, where the user can haptically interact with the virtual soft tissues and see the corresponding organ deformation on the visual display at the same time.by Jung Kim.Ph.D

SOFA: A Multi-Model Framework for Interactive Physical Simulation

International audienceSOFA (Simulation Open Framework Architecture) is an open-source C++ library primarily targeted at interactive computational medical simulation. SOFA facilitates collaborations between specialists from various domains, by decomposing complex simulators into components designed independently and organized in a scenegraph data structure. Each component encapsulates one of the aspects of a simulation, such as the degrees of freedom, the forces and constraints, the differential equations, the main loop algorithms, the linear solvers, the collision detection algorithms or the interaction devices. The simulated objects can be represented using several models, each of them optimized for a different task such as the computation of internal forces, collision detection, haptics or visual display. These models are synchronized during the simulation using a mapping mechanism. CPU and GPU implementations can be transparently combined to exploit the computational power of modern hardware architectures. Thanks to this flexible yet efficient architecture, \sofa{} can be used as a test-bed to compare models and algorithms, or as a basis for the development of complex, high-performance simulators

Soft volume simulation using a deformable surface model

The aim of the research is to contribute to the modelling of deformable objects, such as soft tissues in medical simulation. Interactive simulation for medical training is a concept undergoing rapid growth as the underlying technologies support the increasingly more realstic and functional training environments. The prominent issues in the deployment of such environments centre on a fine balance between the accuracy of the deformable model and real-time interactivity. Acknowledging the importance of interacting with non-rigid materials such as the palpation of a breast for breast assessment, this thesis has explored the physics-based modelling techniques for both volume and surface approach. This thesis identified that the surface approach based on the mass spring system (MSS) has the benefits of rapid prototyping, reduced mesh complexity, computational efficiency and the support for large material deformation compared to the continuum approach. However, accuracy relative to real material properties is often over looked in the configuration of the resulting model. This thesis has investigated the potential and the feasibility of surface modelling for simulating soft objects regardless of the design of the mesh topology and the non-existence of internal volume discretisation. The assumptions of the material parameters such as elasticity, homogeneity and incompressibility allow a reduced set of material values to be implemented in order to establish the association with the surface configuration. A framework for a deformable surface model was generated in accordance with the issues of the estimation of properties and volume behaviour corresponding to the material parameters. The novel extension to the surface MSS enables the tensile properties of the material to be integrated into an enhanced configuration despite its lack of volume information. The benefits of the reduced complexity of a surface model are now correlated with the improved accuracy in the estimation of properties and volume behaviour. Despite the irregularity of the underlying mesh topology and the absence of volume, the model reflected the original material values and preserved volume with minimal deviations. Global deformation effect which is essential to emulate the run time behaviour of a real soft material upon interaction, such as the palpation of a generic breast, was also demonstrated, thus indicating the potential of this novel technique in the application of soft tissue simulation.EThOS - Electronic Theses Online ServiceUniversiti Malaysia Sarawak (UMS)Malaysia. Jabatan Perkhidmatan Awam (JPA)Malaysia. Kementerian Pengajian Tinggi (KPT)GBUnited Kingdo

General Dynamic Surface Reconstruction: Application to the 3D Segmentation of the Left Ventricle

Aquesta tesi descriu la nostra contribució a la reconstrucció tridimensional de les superfícies interna i externa del ventricle esquerre humà. La reconstrucció és un primer procés dins d'una aplicació global de Realitat Virtual dissenyada com una important eina de diagnòstic per a hospitals. L'aplicació parteix de la reconstrucció de les superfícies i proveeix a l'expert de manipulació interactiva del model en temps real, a més de càlculs de volums i de altres paràmetres d'interès. El procés de recuperació de les superfícies es caracteritza per la seva velocitat de convergència, la suavitat a les malles finals i la precisió respecte de les dades recuperades. Donat que el diagnòstic de patologies cardíaques requereix d'experiència, temps i molt coneixement professional, la simulació és un procés clau que millora la eficiència.Els nostres algorismes i implementacions han estat aplicats a dades sintètiques i reals amb diferències relatives a la quantitat de dades inexistents, casuístiques presents a casos patològics i anormals. Els conjunts de dades inclouen adquisicions d'instants concrets i de cicles cardíacs complets. La bondat del sistema de reconstrucció ha estat avaluada mitjançant paràmetres mèdics per a poder comparar els nostres resultats finals amb aquells derivats a partir de programari típic utilitzat pels professionals de la medicina.A més de l'aplicació directa al diagnòstic mèdic, la nostra metodologia permet reconstruccions de tipus genèric en el camp dels Gràfics 3D per ordinador. Les nostres reconstruccions permeten generar models tridimensionals amb un baix cost en quant a la interacció manual necessària i a la càrrega computacional associada. Altrament, el nostre mètode pot entendre's com un robust algorisme de triangularització que construeix superfícies partint de núvols de punts que poden obtenir-se d'escàners làser o sensors magnètics, per exemple.Esta tesis describe nuestra contribución a la reconstrucción tridimensional de las superficies interna y externa del ventrículo izquierdo humano. La reconstrucción es un primer proceso que forma parte de una aplicación global de Realidad Virtual diseñada como una importante herramienta de diagnóstico para hospitales. La aplicación parte de la reconstrucción de las superficies y provee al experto de manipulación interactiva del modelo en tiempo real, además de cálculos de volúmenes y de otros parámetros de interés. El proceso de recuperación de las superficies se caracteriza por su velocidad de convergencia, la suavidad en las mallas finales y la precisión respecto de los datos recuperados. Dado que el diagnóstico de patologías cardíacas requiere experiencia, tiempo y mucho conocimiento profesional, la simulación es un proceso clave que mejora la eficiencia.Nuestros algoritmos e implementaciones han sido aplicados a datos sintéticos y reales con diferencias en cuanto a la cantidad de datos inexistentes, casuística presente en casos patológicos y anormales. Los conjuntos de datos incluyen adquisiciones de instantes concretos y de ciclos cardíacos completos. La bondad del sistema de reconstrucción ha sido evaluada mediante parámetros médicos para poder comparar nuestros resultados finales con aquellos derivados a partir de programario típico utilizado por los profesionales de la medicina.Además de la aplicación directa al diagnóstico médico, nuestra metodología permite reconstrucciones de tipo genérico en el campo de los Gráficos 3D por ordenador. Nuestras reconstrucciones permiten generar modelos tridimensionales con un bajo coste en cuanto a la interacción manual necesaria y a la carga computacional asociada. Por otra parte, nuestro método puede entenderse como un robusto algoritmo de triangularización que construye superficies a partir de nubes de puntos que pueden obtenerse a partir de escáneres láser o sensores magnéticos, por ejemplo.This thesis describes a contribution to the three-dimensional reconstruction of the internal and external surfaces of the human's left ventricle. The reconstruction is a first process fitting in a complete VR application that will serve as an important diagnosis tool for hospitals. Beginning with the surfaces reconstruction, the application will provide volume and interactive real-time manipulation to the model. We focus on speed, precision and smoothness for the final surfaces. As long as heart diseases diagnosis requires experience, time and professional knowledge, simulation is a key-process that enlarges efficiency.The algorithms and implementations have been applied to both synthetic and real datasets with differences regarding missing data, present in cases where pathologies and abnormalities arise. The datasets include single acquisitions and complete cardiac cycles. The goodness of the reconstructions has been evaluated with medical parameters in order to compare our results with those retrieved by typical software used by physicians.Besides the direct application to medicine diagnosis, our methodology is suitable for generic reconstructions in the field of computer graphics. Our reconstructions can serve for getting 3D models at low cost, in terms of manual interaction and CPU computation overhead. Furthermore, our method is a robust tessellation algorithm that builds surfaces from clouds of points that can be retrieved from laser scanners or magnetic sensors, among other available hardware

Non-Rigid Liver Registration for Laparoscopy using Data-Driven Biomechanical Models

During laparoscopic liver resection, the limited access to the organ, the small field of view and lack of palpation can obstruct a surgeon’s workflow. Automatic navigation systems could use the images from preoperative volumetric organ scans to help the surgeons find their target (tumors) and risk-structures (vessels) more efficiently. This requires the preoperative data to be fused (or registered) with the intraoperative scene in order to display information at the correct intraoperative position. One key challenge in this setting is the automatic estimation of the organ’s current intra-operative deformation, which is required in order to predict the position of internal structures. Parameterizing the many patient-specific unknowns (tissue properties, boundary conditions, interactions with other tissues, direction of gravity) is very difficult. Instead, this work explores how to employ deep neural networks to solve the registration problem in a data-driven manner. To this end, convolutional neural networks are trained on synthetic data to estimate an organ’s intraoperative displacement field and thus its current deformation. To drive this estimation, visible surface cues from the intraoperative camera view must be supplied to the networks. Since reliable surface features are very difficult to find, the networks are adapted to also find correspondences between the pre- and intraoperative liver geometry automatically. This combines the search for correspondences with the biomechanical behavior estimation and allows the networks to tackle the full non-rigid registration problem in one single step. The result is a model which can quickly predict the volume deformation of a liver, given only sparse surface information. The model combines the advantages of a physically accurate biomechanical simulation with the speed and powerful feature extraction capabilities of deep neural networks. To test the method intraoperatively, a registration pipeline is developed which constructs a map of the liver and its surroundings from the laparoscopic video and then uses the neural networks to fuse the preoperative volume data into this map. The deformed organ volume can then be rendered as an overlay directly onto the laparoscopic video stream. The focus of this pipeline is to be applicable to real surgery, where everything should be quick and non-intrusive. To meet these requirements, a SLAM system is used to localize the laparoscopic camera (avoiding setup of an external tracking system), various neural networks are used to quickly interpret the scene and semi-automatic tools let the surgeons guide the system. Beyond the concrete advantages of the data-driven approach for intraoperative registration, this work also demonstrates general benefits of training a registration system preoperatively on synthetic data. The method lets the engineer decide which values need to be known explicitly and which should be estimated implicitly by the networks, which opens the door to many new possibilities.:1 Introduction 1.1 Motivation 1.1.1 Navigated Liver Surgery 1.1.2 Laparoscopic Liver Registration 1.2 Challenges in Laparoscopic Liver Registration 1.2.1 Preoperative Model 1.2.2 Intraoperative Data 1.2.3 Fusion/Registration 1.2.4 Data 1.3 Scope and Goals of this Work 1.3.1 Data-Driven, Biomechanical Model 1.3.2 Data-Driven Non-Rigid Registration 1.3.3 Building a Working Prototype 2 State of the Art 2.1 Rigid Registration 2.2 Non-Rigid Liver Registration 2.3 Neural Networks for Simulation and Registration 3 Theoretical Background 3.1 Liver 3.2 Laparoscopic Liver Resection 3.2.1 Staging Procedure 3.3 Biomechanical Simulation 3.3.1 Physical Balance Principles 3.3.2 Material Models 3.3.3 Numerical Solver: The Finite Element Method (FEM) 3.3.4 The Lagrangian Specification 3.4 Variables and Data in Liver Registration 3.4.1 Observable 3.4.2 Unknowns 4 Generating Simulations of Deforming Organs 4.1 Organ Volume 4.2 Forces and Boundary Conditions 4.2.1 Surface Forces 4.2.2 Zero-Displacement Boundary Conditions 4.2.3 Surrounding Tissues and Ligaments 4.2.4 Gravity 4.2.5 Pressure 4.3 Simulation 4.3.1 Static Simulation 4.3.2 Dynamic Simulation 4.4 Surface Extraction 4.4.1 Partial Surface Extraction 4.4.2 Surface Noise 4.4.3 Partial Surface Displacement 4.5 Voxelization 4.5.1 Voxelizing the Liver Geometry 4.5.2 Voxelizing the Displacement Field 4.5.3 Voxelizing Boundary Conditions 4.6 Pruning Dataset - Removing Unwanted Results 4.7 Data Augmentation 5 Deep Neural Networks for Biomechanical Simulation 5.1 Training Data 5.2 Network Architecture 5.3 Loss Functions and Training 6 Deep Neural Networks for Non-Rigid Registration 6.1 Training Data 6.2 Architecture 6.3 Loss 6.4 Training 6.5 Mesh Deformation 6.6 Example Application 7 Intraoperative Prototype 7.1 Image Acquisition 7.2 Stereo Calibration 7.3 Image Rectification, Disparity- and Depth- estimation 7.4 Liver Segmentation 7.4.1 Synthetic Image Generation 7.4.2 Automatic Segmentation 7.4.3 Manual Segmentation Modifier 7.5 SLAM 7.6 Dense Reconstruction 7.7 Rigid Registration 7.8 Non-Rigid Registration 7.9 Rendering 7.10 Robotic Operating System 8 Evaluation 8.1 Evaluation Datasets 8.1.1 In-Silico 8.1.2 Phantom Torso and Liver 8.1.3 In-Vivo, Human, Breathing Motion 8.1.4 In-Vivo, Human, Laparoscopy 8.2 Metrics 8.2.1 Mean Displacement Error 8.2.2 Target Registration Error (TRE) 8.2.3 Champfer Distance 8.2.4 Volumetric Change 8.3 Evaluation of the Synthetic Training Data 8.4 Data-Driven Biomechanical Model (DDBM) 8.4.1 Amount of Intraoperative Surface 8.4.2 Dynamic Simulation 8.5 Volume to Surface Registration Network (V2S-Net) 8.5.1 Amount of Intraoperative Surface 8.5.2 Dependency on Initial Rigid Alignment 8.5.3 Registration Accuracy in Comparison to Surface Noise 8.5.4 Registration Accuracy in Comparison to Material Stiffness 8.5.5 Champfer-Distance vs. Mean Displacement Error 8.5.6 In-vivo, Human Breathing Motion 8.6 Full Intraoperative Pipeline 8.6.1 Intraoperative Reconstruction: SLAM and Intraoperative Map 8.6.2 Full Pipeline on Laparoscopic Human Data 8.7 Timing 9 Discussion 9.1 Intraoperative Model 9.2 Physical Accuracy 9.3 Limitations in Training Data 9.4 Limitations Caused by Difference in Pre- and Intraoperative Modalities 9.5 Ambiguity 9.6 Intraoperative Prototype 10 Conclusion 11 List of Publications List of Figures Bibliograph