Meshless Mechanics and Point-Based Visualization Methods for Surgical Simulations

Computer-based modeling and simulation practices have become an integral part of the medical education field. For surgical simulation applications, realistic constitutive modeling of soft tissue is considered to be one of the most challenging aspects of the problem, because biomechanical soft-tissue models need to reflect the correct elastic response, have to be efficient in order to run at interactive simulation rates, and be able to support operations such as cuts and sutures. Mesh-based solutions, where the connections between the individual degrees of freedom (DoF) are defined explicitly, have been the traditional choice to approach these problems. However, when the problem under investigation contains a discontinuity that disrupts the connectivity between the DoFs, the underlying mesh structure has to be reconfigured in order to handle the newly introduced discontinuity correctly. This reconfiguration for mesh-based techniques is typically called dynamic remeshing, and most of the time it causes the performance bottleneck in the simulation. In this dissertation, the efficiency of point-based meshless methods is investigated for both constitutive modeling of elastic soft tissues and visualization of simulation objects, where arbitrary discontinuities/cuts are applied to the objects in the context of surgical simulation. The point-based deformable object modeling problem is examined in three functional aspects: modeling continuous elastic deformations with, handling discontinuities in, and visualizing a point-based object. Algorithmic and implementation details of the presented techniques are discussed in the dissertation. The presented point-based techniques are implemented as separate components and integrated into the open-source software framework SOFA. The presented meshless continuum mechanics model of elastic tissue were verified by comparing it to the Hertzian non-adhesive frictionless contact theory. Virtual experiments were setup with a point-based deformable block and a rigid indenter, and force-displacement curves obtained from the virtual experiments were compared to the theoretical solutions. The meshless mechanics model of soft tissue and the integrated novel discontinuity treatment technique discussed in this dissertation allows handling cuts of arbitrary shape. The implemented enrichment technique not only modifies the internal mechanics of the soft tissue model, but also updates the point-based visual representation in an efficient way preventing the use of costly dynamic remeshing operations

Assessing Tsunami Vulnerabilities of Geographies with Shallow Water Equations

Tsunami preparedness is crucial for saving human lives in case of disasters that involve massive water movement. In this work, we develop a framework for visual assessment of tsunami preparedness of geographies. Shallow water equations (also called Saint Venant equations) are a set of hyperbolic partial differential equations that are derived by depth-integrating the Navier-Stokes equations and provide a great abstraction of water masses that have lower depths compared to their free surface area. Our specific contribution in this study is to use Microsoft's XNA Game Studio to import underwater and shore line geographies, create different tsunami scenarios, and visualize the propagation of the waves and their impact on the shore line geography. Most importantly, we utilized the computational power of graphical processing units (GPUs) as HLSL based shader files and delegated all of the heavy computations to the GPU. Finally, we also conducted a validation study, in which we have tested our model against a controlled shallow water experiment. We believe that such a framework with an easy to use interface that is based on readily available software libraries, which are widely available and easily distributable, would encourage not only researchers, but also educators to showcase ideas

GPU Accelerated Vector Median Filter

Noise reduction is an important step for most image processing tasks. For three channel color images, a widely used technique is vector median filter in which color values of pixels are treated as 3-component vectors. Vector median filters are computationally expensive; for a window size of n x n, each of the n(sup 2) vectors has to be compared with other n(sup 2) - 1 vectors in distances. General purpose computation on graphics processing units (GPUs) is the paradigm of utilizing high-performance many-core GPU architectures for computation tasks that are normally handled by CPUs. In this work. NVIDIA's Compute Unified Device Architecture (CUDA) paradigm is used to accelerate vector median filtering. which has to the best of our knowledge never been done before. The performance of GPU accelerated vector median filter is compared to that of the CPU and MPI-based versions for different image and window sizes, Initial findings of the study showed 100x improvement of performance of vector median filter implementation on GPUs over CPU implementations and further speed-up is expected after more extensive optimizations of the GPU algorithm

Procedural Wound Geometry and Blood Flow Generation for Medical Training Simulators

Efficient application of wound treatment procedures is vital in both emergency room and battle zone scenes. In order to train first responders for such situations, physical casualty simulation kits, which are composed of tens of individual items, are commonly used. Similar to any other training scenarios, computer simulations can be effective means for wound treatment training purposes. For immersive and high fidelity virtual reality applications, realistic 3D models are key components. However, creation of such models is a labor intensive process. In this paper, we propose a procedural wound geometry generation technique that parameterizes key simulation inputs to establish the variability of the training scenarios without the need of labor intensive remodeling of the 3D geometry. The procedural techniques described in this work are entirely handled by the graphics processing unit (GPU) to enable interactive real-time operation of the simulation and to relieve the CPU for other computational tasks. The visible human dataset is processed and used as a volumetric texture for the internal visualization of the wound geometry. To further enhance the fidelity of the simulation, we also employ a surface flow model for blood visualization. This model is realized as a dynamic texture that is composed of a height field and a normal map and animated at each simulation step on the GPU. The procedural wound geometry and the blood flow model are applied to a thigh model and the efficiency of the technique is demonstrated in a virtual surgery scene

Meshless Elasticity Model and Contact Mechanics-based Verification Technique

Mesh-based techniques are well studied and established methods for solving continuum biomechanics problems. When the problem at hand involves extreme deformations or artificial discontinuities, meshless methods provide sev-eral advantages over the mesh-based methods. This work discusses the Moving Least Square approximation-based meshless collocation method for simulating de-formable objects and presents a verification technique that is based on the Hertzian theory of non-adhesive elastic contact. The effectiveness of the Hertzian contact theory as a means for verification was first tested and proven through a well-established FEM code, FEBio. The meshless method was implemented as a reusable component for the SOFA framework, an open source software library for real-time simulations. Through experimentation, the Hertzian theory has been tested against SOFA hexahedral FEM and the meshless models within the SOFA framework. Convergence studies and L2 error curves are provided for both mod-els. Experimental results demonstrated the effectiveness of the implementation of the meshless method

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes