Towards Interactive Planning of Coil Embolization in Brain Aneurysms

The original publication is available at www.springerlink.comInternational audienceMany vascular pathologies can now be treated in a minimally invasive way thanks to interventional radiology. Instead of open surgery, it allows to reach the lesion of the arteries with therapeutic devices through a catheter. As a particular case, intracranial aneurysms are treated by filling the localized widening of the artery with a set of coils to prevent a rupture due to the weakened arterial wall. Considering the location of the lesion, close to the brain, and its very small size, the procedure requires a combination of careful planning and excellent technical skills. An interactive and reliable simulation, adapted to the patient anatomy, would be an interesting tool for helping the interventional neuroradiologist plan and rehearse a coil embolization procedure. This paper describes an original method to perform interactive simulations of coil embolization and proposes a clinical metric to quantitatively measure how the first coil fills the aneurysm. The simulation relies on an accurate reconstruction of the aneurysm anatomy and a real-time model of the coil for which sliding and friction contacts are taken into account. Simulation results are compared to real embolization procedure and exhibit good adequacy

Applications of Conformal Geometric Algebra in Computer Vision and Graphics

Abstract. This paper introduces the mathematical framework of con-formal geometric algebra (CGA) as a language for computer graphics and computer vision. Specifically it discusses a new method for pose and position interpolation based on CGA which firstly allows for existing interpolation methods to be cleanly extended to pose and position in-terpolation, but also allows for this to be extended to higher-dimension spaces and all conformal transforms (including dilations). In addition, we discuss a method of dealing with conics in CGA and the intersection and reflections of rays with such conic surfaces. Possible applications for these algorithms are also discussed.

Retracting and seeking movements during laparoscopic goal-oriented movements. Is the shortest path length optimal?

Aims- Minimally invasive surgery (MIS) requires a high degree of eye–hand coordination from the surgeon. To facilitate the learning process, objective assessment systems based on analysis of the instruments’ motion are being developed. To investigate the influence of performance on motion characteristics, we examined goaloriented movements in a box trainer. In general, goal-oriented movements consist of a retracting and a seeking phase, and are, however, not performed via the shortest path length. Therefore, we hypothesized that the shortest path is not an optimal concept in MIS. Methods-Participants were divided into three groups (experts, residents, and novices). Each participant performed a number of one-hand positioning tasks in a box trainer. Movements of the instrument were recorded with the TrEndo tracking system. The movement from point A to B was divided into two phases: A-M (retracting) and M-B (seeking). Normalized path lengths (given in %) of the two phases were compared. Results- Thirty eight participants contributed. For the retracting phase, we found no significant difference between experts [median (range) %: 152 (129–178)], residents [164 (126–250)], and novices [168 (136–268)]. In the seeking phase, we find a significant difference (<0.001) between experts [180 (172–247)], residents [201 (163–287)], and novices [290 (244–469)]. Moreover, within each group, a significant difference between retracting and seeking phases was observed. Conclusions- Goal-oriented movements in MIS can be split into two phases: retracting and seeking. Novices are less effective than experts and residents in the seeking phase. Therefore, the seeking phase is characteristic of performance differences. Furthermore, the retracting phase is essential, because it improves safety by avoiding intermediate tissue contact. Therefore, the shortest path length, as presently used during the assessment of basic MIS skills, may be not a proper concept for analyzing optimal movements and, therefore, needs to be revised.Biomechanical EngineeringMechanical, Maritime and Materials Engineerin

Robust Augmented Reality registration method for Localization of Solid Organs’ Tumors Using CT-derived Virtual Biomechanical Model and Fluorescent Fiducials

Presented at the SAGES 2016 Annual Meeting, March 16–19, 2016, Boston, MAInternational audienceAccurate localization of solid organs tumors is crucial to ensure both radicality and organ function preservation. Augmented Reality (AR) is the fusion of computer-generated and real-time images. AR can be used in surgery as a navigation tool, by creating a patient-specific virtual model through 3D software manipulation of DICOM imaging (e.g. CT-scan). The virtual model can be superimposed to the real-time images to obtain the enhanced real-time localization. However, the 3D virtual model is rigid, and does not take into account inner structures’ deformations. We present a concept of automated navigation system, enabling transparency visualization of internal anatomy and tumor’s margins, while the organs undergo deformation during breathing or surgical manipulation

NiftySim: A GPU-based nonlinear finite element package for simulation of soft tissue biomechanics

Purpose NiftySim, an open-source finite element toolkit, has been designed to allow incorporation of high-performance soft tissue simulation capabilities into biomedical applications. The toolkit provides the option of execution on fast graphics processing unit (GPU) hardware, numerous constitutive models and solid-element options, membrane and shell elements, and contact modelling facilities, in a simple to use library. Methods The toolkit is founded on the total Lagrangian explicit dynamics (TLEDs) algorithm, which has been shown to be efficient and accurate for simulation of soft tissues. The base code is written in C ++++ , and GPU execution is achieved using the nVidia CUDA framework. In most cases, interaction with the underlying solvers can be achieved through a single Simulator class, which may be embedded directly in third-party applications such as, surgical guidance systems. Advanced capabilities such as contact modelling and nonlinear constitutive models are also provided, as are more experimental technologies like reduced order modelling. A consistent description of the underlying solution algorithm, its implementation with a focus on GPU execution, and examples of the toolkit’s usage in biomedical applications are provided. Results Efficient mapping of the TLED algorithm to parallel hardware results in very high computational performance, far exceeding that available in commercial packages. Conclusion The NiftySim toolkit provides high-performance soft tissue simulation capabilities using GPU technology for biomechanical simulation research applications in medical image computing, surgical simulation, and surgical guidance applications

Deformation Aware Augmented Reality for Craniotomy using 3D/2D Non-rigid Registration of Cortical Vessels

International audienceIntra-operative brain shift is a well-known phenomenon that describes non-rigid deformation of brain tissues due to gravity and loss of cerebrospinal fluid among other phenomena. This has a negative influence on surgical outcome that is often based on pre-operative planning where the brain shift is not considered. We present a novel brain-shift aware Augmented Reality method to align pre-operative 3D data onto the deformed brain surface viewed through a surgical microscope. We formulate our non-rigid registration as a Shape-from-Template problem. A pre-operative 3D wire-like deformable model is registered onto a single 2D image of the cortical vessels, which is automatically segmented. This 3D/2D registration drives the underlying brain structures, such as tumors, and compensates for the brain shift in sub-cortical regions. We evaluated our approach on simulated and real data composed of 6 patients. It achieved good quantitative and qualitative results making it suitable for neurosurgical guidance

Calibration and performance of the ISO Long-Wavelength Spectrometer

The wavelength and flux calibration, and the in-orbit performance of the Infrared Space Observatory Long-Wavelength Spectrometer (LWS) are described. The LWS calibration is mostly complete and the instrument's performance in orbit is largely as expected before launch. The effects of ionising radiation on the detectors, and the techniques used to minimise them are outlined. The overall sensitivity figures achieved in practice are summarised. The standard processing of LWS data is described

Calibration and performance of the ISO Long-Wavelength Spectrometer

The wavelength and flux calibration, and the in-orbit performance of the Infrared Space Observatory Long-Wavelength Spectrometer (LWS) are described. The LWS calibration is mostly complete and the instrument's performance in orbit is largely as expected before launch. The effects of ionising radiation on the detectors, and the techniques used to minimise them are outlined. The overall sensitivity figures achieved in practice are summarised. The standard processing of LWS data is described