Clinical indicators of heart function are often limited in their ability to accurately evaluate the current mechanical state of the myocardium. Biomechanical modeling has been shown to be a promising tool in addition to clinical indicators. By providing a patient-specific measure of myocardial active stress (contractility), biomechanical modeling can enhance the precision of the description of patient's pathophysiology at any given point in time. In this work we aim to explore the ability of biomechanical modeling to predict the response of ventricular mechanics to the progressively decreasing afterload in repaired tetralogy of Fallot (rTOF) patients undergoing pulmonary valve replacement (PVR) for significant residual right ventricular outflow tract obstruction (RVOTO). We used 19 patient-specific models of patients with rTOF prior to pulmonary valve replacement (PVR), denoted as PSMpre, and patient-specific models of the same patients created post-PVR (PSMpost)-both created in our previous published work. Using the PSMpre and assuming cessation of the pulmonary regurgitation and a progressive decrease of RVOT resistance, we built relationships between the contractility and RVOT resistance post-PVR. The predictive value of such in silico obtained relationships were tested against the PSMpost, i.e. the models created from the actual post-PVR datasets. Our results show a linear 1-dimensional relationship between the in silico predicted contractility post-PVR and the RVOT resistance. The predicted contractility was close to the contractility in the PSMpost model with a mean (± SD) difference of 6.5 (± 3.0)%. The relationships between the contractility predicted by in silico PVR vs. RVOT resistance have a potential to inform clinicians about hypothetical mechanical response of the ventricle based on the degree of pre-operative RVOTO.
- MeSH
- biomechanika MeSH
- chirurgická náhrada chlopně MeSH
- Fallotova tetralogie chirurgie MeSH
- individualizovaná medicína * MeSH
- lidé MeSH
- modely kardiovaskulární MeSH
- obstrukce výtoku ze srdeční komory patofyziologie chirurgie MeSH
- plicní chlopeň chirurgie MeSH
- pooperační komplikace patofyziologie chirurgie MeSH
- prediktivní hodnota testů MeSH
- remodelace komor MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The geometrical representation of muscles in computational models of the musculoskeletal system typically consists of a series of line segments. These muscle anatomies are based on measurements from a limited number of cadaveric studies that recently have been used as atlases for creating subject-specific models from medical images, so potentially restricting the options for personalisation and assessment of muscle geometrical models. To overcome this methodological limitation, we propose a novel, completely automated technique that, from a surface geometry of a skeletal muscle and its attachment areas, can generate an arbitrary number of lines of action (fibres) composed by a user-defined number of straight-line segments. These fibres can be included in standard musculoskeletal models and used in biomechanical simulations. This methodology was applied to the surfaces of four muscles surrounding the hip joint (iliacus, psoas, gluteus maximus and gluteus medius), segmented on magnetic resonance imaging scans from a cadaveric dataset, for which highly discretised muscle representations were created and used to simulate functional tasks. The fibres' moment arms were validated against measurements and models of the same muscles from the literature with promising outcomes. The proposed approach is expected to improve the anatomical representation of skeletal muscles in personalised biomechanical models and finite element applications.
- MeSH
- biologické modely * MeSH
- biomechanika MeSH
- kosterní svaly * diagnostické zobrazování fyziologie MeSH
- kyčelní kloub * diagnostické zobrazování fyziologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mrtvola MeSH
- počítačová rentgenová tomografie MeSH
- počítačové modelování podle konkrétního pacienta * MeSH
- senioři nad 80 let MeSH
- Check Tag
- lidé MeSH
- senioři nad 80 let MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The balanced initial fixation of an implant makes up a crucial condition for its long-term survival. However, the quantification of initial fixation is no easy task and, to date, only qualitative assessments can be made. Although the concept of measuring fixation by means of vibration analysis is already widely used in dental implantology, the rigorous application of this method for the assessment of the fixation of femoral and acetabular components remains a challenge. Moreover, most studies on this subject have tended to focus solely on the femoral stem even though acetabular cup fixation is also important and even more difficult with respect to qualitative measurement. This study describes a comprehensive experiment aimed at assessing acetabular cup fixation. Fixation is expressed in terms of the impact force and polar gap variables, which are correlated with the modal properties of the acetabular implant during the various insertion stages. The predictive capabilities of modal frequencies and frequency functions were investigated by means of surrogate models based on the Gaussian process and functional principal component analysis. The prediction accuracy of the proposed models was in the range 82-94%. The results indicate that natural frequencies, reduced frequency, impact force and polar gap features provide great potential in terms of the prediction of implant fixation.
During the minimally-invasive liver surgery, only the partial surface view of the liver is usually provided to the surgeon via the laparoscopic camera. Therefore, it is necessary to estimate the actual position of the internal structures such as tumors and vessels from the pre-operative images. Nevertheless, such task can be highly challenging since during the intervention, the abdominal organs undergo important deformations due to the pneumoperitoneum, respiratory and cardiac motion and the interaction with the surgical tools. Therefore, a reliable automatic system for intra-operative guidance requires fast and reliable registration of the pre- and intra-operative data. In this paper we present a complete pipeline for the registration of pre-operative patient-specific image data to the sparse and incomplete intra-operative data. While the intra-operative data is represented by a point cloud extracted from the stereo-endoscopic images, the pre-operative data is used to reconstruct a biomechanical model which is necessary for accurate estimation of the position of the internal structures, considering the actual deformations. This model takes into account the patient-specific liver anatomy composed of parenchyma, vascularization and capsule, and is enriched with anatomical boundary conditions transferred from an atlas. The registration process employs the iterative closest point technique together with a penalty-based method. We perform a quantitative assessment based on the evaluation of the target registration error on synthetic data as well as a qualitative assessment on real patient data. We demonstrate that the proposed registration method provides good results in terms of both accuracy and robustness w.r.t. the quality of the intra-operative data.
- MeSH
- biologické modely * MeSH
- individualizovaná medicína metody MeSH
- játra chirurgie MeSH
- lidé MeSH
- miniinvazivní chirurgické výkony metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Wall stress analysis of abdominal aortic aneurysm (AAA) is a promising method of identifying AAAs at high risk of rupture. However, neglecting residual strains (RS) in the load-free configuration of patient-specific finite element analysis models is a sever limitation that strongly affects the computed wall stresses. Although several methods for including RS have been proposed, they cannot be directly applied to patient-specific AAA simulations. RS in the AAA wall are predicted through volumetric tissue growth that aims at satisfying the homogeneous stress hypothesis at mean arterial pressure load. Tissue growth is interpolated linearly across the wall thickness and aneurysm tissues are described by isotropic constitutive formulations. The total deformation is multiplicatively split into elastic and growth contributions, and a staggered schema is used to solve the field variables. The algorithm is validated qualitatively at a cylindrical artery model and then applied to patient-specific AAAs (n = 5). The induced RS state is fully three-dimensional and in qualitative agreement with experimental observations, i.e., wall strips that were excised from the load-free wall showed stress-releasing-deformations that are typically seen in laboratory experiments. Compared to RS-free simulations, the proposed algorithm reduced the von Mises stress gradient across the wall by a tenfold. Accounting for RS leads to homogenized wall stresses, which apart from reducing the peak wall stress (PWS) also shifted its location in some cases. The present study demonstrated that the homogeneous stress hypothesis can be effectively used to predict RS in the load-free configuration of the vascular wall. The proposed algorithm leads to a fast and robust prediction of RS, which is fully capable for a patient-specific AAA rupture risk assessment. Neglecting RS leads to non-realistic wall stress values that severely overestimate the PWS.
- MeSH
- algoritmy MeSH
- aneurysma břišní aorty patofyziologie radiografie MeSH
- angiografie MeSH
- aorta abdominalis patofyziologie radiografie MeSH
- biologické modely * MeSH
- biomechanika MeSH
- lidé MeSH
- mechanický stres MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
