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

Analyse des mutations des domaines ISDR et V3 de la protéine NS5A du virus de l'hépatite C avant le traitement par l'interféron avec ou sans ribavirine

Aim of the study. – The hepatitis C virus (HCV) non-structural NS5A protein has been controversially implicated in the resistance of HCV to interferon therapy in clinical studies. In Japan, mutations in the interferon sensitivity-determining region (ISDR) in the NS5A gene were associated with response to interferon therapy in patients infected with genotype 1b. In contrast, studies from Europe did not confirm such association. More recently, it has been suggested that the V3 domain outside the putative ISDR might also have amino acids changes that may be involved in the resistance to IFN. In this study, the relationship between NS5A mutations in ISDR and V3 domains and virological response to therapy were investigated. Materials and methods. – The NS5A gene was sequenced from 35 HCV genotype 1b infected patients at D0 of a prospective clinical trial of interferon therapy and interferon plus Ribavirin combination therapy. Results. – In the ISDR domain, we did not observe any significant differences in amino acids changes between responders (1.7 ± 1.8, n = 19, range 0–6) and non-responders (1.1 ± 0.8, n = 14, range: 0–3), (P = 0.483), to therapy before the beginning of treatment. In the V3 domain, we found more mutations in responders (6.5 ± 1.9, range: 2–11) than in non-responders (4.7 ± 1.2, range: 3–8) (P = 0.0013), before the beginning of treatment. Conclusion. – Our results confirm that, in Europe, the ISDR domain is not predictive for treatment success but suggest that the V3 domain have greater variability in responders than non-responders

Quasispecies evolution in NS5A region of hepatitis C virus genotype 1b during interferon or combined interferon-ribavirin therapy

AIM: To evaluate the implication of substitutions in the hepatitis C virus (HCV) non-structural 5A (NS5A) protein in the resistance of HCV during mono-interferon (IFN) or combined IFN-ribavirin (IFN-R) therapy. Although NS5A has been reported to interact with the HCV RNA-dependent RNA polymerase, NS5B, as well as with many cellular proteins, the function of NS5A in the life cycle of HCV remains unclear. METHODS: HCV quasispecies were studied by cloning and sequencing of sequential isolates from patients infected by HCV genotype 1b. Patients were treated by IFN-alpha2b for 3 mo followed by IFN-alpha2b alone or combined IFN-R therapy for 9 additional months. Patients were categorized into two groups based on their response to the treatments: 7 with sustained virological response (SVR) (quasispecies = 150) and 3 non-responders (NR) to IFN-R (quasispecies = 106). RESULTS: Prior to treatment, SVR patients displayed a lower complexity of quasispecies than NR patients. Most patients had a decrease in the complexity of quasispecies during therapy. Analysis of amino acids substitutions showed that the degree of the complexity of the interferon sensitivity-determining region (ISDR) and the V3 domain of NS5A protein was able to discriminate the two groups of patients. Moreover, SVR patients displayed more variability in the NS5A region than NR patients. CONCLUSION: These results suggest that detailed molecular analysis of the NS5A region may be important for understanding its function in IFN response during HCV 1b infection

Intensity-Based Registration of Freehand 3D Ultrasound and CT-scan Images of the Kidney

This paper presents a method to register a pre-operative Computed-Tomography (CT) volume to a sparse set of intra-operative Ultra-Sound (US) slices. In the context of percutaneous renal puncture, the aim is to transfer planning information to an intra-operative coordinate system. The spatial position of the US slices is measured by optically localizing a calibrated probe. Assuming the reproducibility of kidney motion during breathing, and no deformation of the organ, the method consists in optimizing a rigid 6 Degree Of Freedom (DOF) transform by evaluating at each step the similarity between the set of US images and the CT volume. The correlation between CT and US images being naturally rather poor, the images have been preprocessed in order to increase their similarity. Among the similarity measures formerly studied in the context of medical image registration, Correlation Ratio (CR) turned out to be one of the most accurate and appropriate, particularly with the chosen non-derivative minimization scheme, namely Powell-Brent's. The resulting matching transforms are compared to a standard rigid surface registration involving segmentation, regarding both accuracy and repeatability. The obtained results are presented and discussed

Probing material nonlinearity at various depths by time reversal mirrors

International audienceIn this letter, the time reversal mirror is used to focus elastic energy at a prescribed location and to analyze the amplitude dependence of the focus signal, thus providing the nonlinearity of the medium. By varying the frequency content of the focused waveforms, the technique can be used to probe the surface, by penetrating to a depth defined by the wavelength of the focused waves. The validity of this concept is shown in the presence of gradual and distributed damage in concrete by comparing actual results with a reference nonlinear measurement and X ray tomography images

How a plantar pressure-based, tongue-placed tactile biofeedback modifies postural control mechanisms during quiet standing

The purpose of the present study was to determine the effects of a plantar pressure-based, tongue-placed tactile biofeedback on postural control mechanisms during quiet standing. To this aim, sixteen young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements, recorded using a force platform, were used to compute the horizontal displacements of the vertical projection the centre of gravity (CoGh) and those of the difference between the CoP and the vertical projection of the CoG (CoP-CoGv). Altogether, the present findings suggest that the main way the plantar pressure-based, tongue-placed tactile biofeedback improves postural control during quiet standing is via both a reduction of the correction thresholds and an increased efficiency of the corrective mechanism involving the CoGh displacements

Haptic guidance improves the visuo-manual tracking of trajectories

BACKGROUND: Learning to perform new movements is usually achieved by following visual demonstrations. Haptic guidance by a force feedback device is a recent and original technology which provides additional proprioceptive cues during visuo-motor learning tasks. The effects of two types of haptic guidances-control in position (HGP) or in force (HGF)-on visuo-manual tracking ("following") of trajectories are still under debate. METHODOLOGY/PRINCIPALS FINDINGS: Three training techniques of haptic guidance (HGP, HGF or control condition, NHG, without haptic guidance) were evaluated in two experiments. Movements produced by adults were assessed in terms of shapes (dynamic time warping) and kinematics criteria (number of velocity peaks and mean velocity) before and after the training sessions. CONCLUSION/SIGNIFICANCE: These results show that the addition of haptic information, probably encoded in force coordinates, play a crucial role on the visuo-manual tracking of new trajectories