@misc{ScheppachMendelProbstetal., author = {Scheppach, Markus W. and Mendel, Robert and Probst, Andreas and Meinikheim, Michael and Palm, Christoph and Messmann, Helmut and Ebigbo, Alanna}, title = {Artificial Intelligence (AI) - assisted vessel and tissue recognition during third space endoscopy (Smart ESD)}, series = {Zeitschrift f{\"u}r Gastroenterologie}, volume = {60}, journal = {Zeitschrift f{\"u}r Gastroenterologie}, number = {08}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/s-0042-1755110}, abstract = {Clinical setting Third space procedures such as endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are complex minimally invasive techniques with an elevated risk for operator-dependent adverse events such as bleeding and perforation. This risk arises from accidental dissection into the muscle layer or through submucosal blood vessels as the submucosal cutting plane within the expanding resection site is not always apparent. Deep learning algorithms have shown considerable potential for the detection and characterization of gastrointestinal lesions. So-called AI - clinical decision support solutions (AI-CDSS) are commercially available for polyp detection during colonoscopy. Until now, these computer programs have concentrated on diagnostics whereas an AI-CDSS for interventional endoscopy has not yet been introduced. We aimed to develop an AI-CDSS („Smart ESD") for real-time intra-procedural detection and delineation of blood vessels, tissue structures and endoscopic instruments during third-space endoscopic procedures. Characteristics of Smart ESD An AI-CDSS was invented that delineates blood vessels, tissue structures and endoscopic instruments during third-space endoscopy in real-time. The output can be displayed by an overlay over the endoscopic image with different modes of visualization, such as a color-coded semitransparent area overlay, or border tracing (demonstration video). Hereby the optimal layer for dissection can be visualized, which is close above or directly at the muscle layer, depending on the applied technique (ESD or POEM). Furthermore, relevant blood vessels (thickness> 1mm) are delineated. Spatial proximity between the electrosurgical knife and a blood vessel triggers a warning signal. By this guidance system, inadvertent dissection through blood vessels could be averted. Technical specifications A DeepLabv3+ neural network architecture with KSAC and a 101-layer ResNeSt backbone was used for the development of Smart ESD. It was trained and validated with 2565 annotated still images from 27 full length third-space endoscopic videos. The annotation classes were blood vessel, submucosal layer, muscle layer, electrosurgical knife and endoscopic instrument shaft. A test on a separate data set yielded an intersection over union (IoU) of 68\%, a Dice Score of 80\% and a pixel accuracy of 87\%, demonstrating a high overlap between expert and AI segmentation. Further experiments on standardized video clips showed a mean vessel detection rate (VDR) of 85\% with values of 92\%, 70\% and 95\% for POEM, rectal ESD and esophageal ESD respectively. False positive measurements occurred 0.75 times per minute. 7 out of 9 vessels which caused intraprocedural bleeding were caught by the algorithm, as well as both vessels which required hemostasis via hemostatic forceps. Future perspectives Smart ESD performed well for vessel and tissue detection and delineation on still images, as well as on video clips. During a live demonstration in the endoscopy suite, clinical applicability of the innovation was examined. The lag time for processing of the live endoscopic image was too short to be visually detectable for the interventionist. Even though the algorithm could not be applied during actual dissection by the interventionist, Smart ESD appeared readily deployable during visual assessment by ESD experts. Therefore, we plan to conduct a clinical trial in order to obtain CE-certification of the algorithm. This new technology may improve procedural safety and speed, as well as training of modern minimally invasive endoscopic resection techniques.}, subject = {Bildgebendes Verfahren}, language = {en} } @misc{GschossmannSuessDendorfer, author = {Gschoßmann, Lukas and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Impact of Model Parameters on Ground Reaction Force Predictions in Musculoskeletal Modelling}, series = {ISB 2025 - The XXX Congress of the International Society of Biomechanics, 27-31 July, Stockholm}, journal = {ISB 2025 - The XXX Congress of the International Society of Biomechanics, 27-31 July, Stockholm}, abstract = {This study evaluated how model parameters affect ground reaction force (GRF) predictions in musculoskeletal simulations. A parameter study varying contact height and velocity thresholds and marker weights was conducted. While height and velocity thresholds had minimal impact, marker weights impact prediction errors. These findings highlight the importance of carefully selecting model parameters.}, language = {en} } @misc{AdlerFoerstlČechovaetal., author = {Adler, Ina and F{\"o}rstl, Nikolas and Čechov{\´a}, Hana and Nov{\´a}ček, V{\´i}t and S{\"u}ß, Franz and Dendorfer, Sebastian}, title = {Mechanistic analysis of pelvic floor functionality using musculoskeletal simulation}, series = {ISB 2025 - The XXX Congress of the International Society of Biomechanics, 27-31 July 2025, Stockholm}, journal = {ISB 2025 - The XXX Congress of the International Society of Biomechanics, 27-31 July 2025, Stockholm}, doi = {10.35096/othr/pub-8729}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-87294}, pages = {1}, abstract = {There is consensus that knowledge about the fundamentals of the pelvic floor remains incomplete, particularly regarding the sensitivity of individual pelvic floor muscles to posture variations. This study aimed to investigate the effects of variations in pelvic tilt and the point of force application induced by changes in posture on pelvic floor activity using musculoskeletal simulation. A parameter study analysed various loading cases, highlighting the coherent response of individual pelvic floor muscles to loads. Muscle activities and forces were compared across different force application points and pelvic tilt angles. A key finding was identifying peak muscle activity conditions that could help better understand the causes of pelvic floor disorders.}, language = {en} } @misc{GschossmannSchedelSuessetal., author = {Gschoßmann, Lukas and Schedel, Valentin and S{\"u}ß, Franz and Weber, Markus and Pfingsten, Andrea and Dendorfer, Sebastian}, title = {Evaluating Knee Joint Loads Across Exercises and Activities of Daily Living to Personalize TKA Rehabilitation}, series = {ISB 2025 - The XXX Congress of the International Society of Biomechanics, 27.-31. July 2025, Stockholm}, journal = {ISB 2025 - The XXX Congress of the International Society of Biomechanics, 27.-31. July 2025, Stockholm}, doi = {10.35096/othr/pub-8725}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-87252}, pages = {1}, abstract = {This study assessed knee joint loading during various physiotherapy exercises and activities of daily living in 30 healthy subjects. Results showed that lunges and squats caused the highest joint forces, while gait and stair activities also imposed substantial loads. These findings support datadriven exercise selection for personalized rehabilitation after total knee arthroplasty.}, language = {en} } @misc{MichelKrenkel, author = {Michel, Johanna and Krenkel, Lars}, title = {Experimental Investigation of Shear-Induced Generation of Respiratory Aerosol: Simultaneous Measurements of Particle Quantities and Wave Topology}, series = {2nd European Fluid Dynamics Conference (EFDC2), 26-29 August 2025, Dublin, Ireland}, journal = {2nd European Fluid Dynamics Conference (EFDC2), 26-29 August 2025, Dublin, Ireland}, doi = {10.35096/othr/pub-8859}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-88593}, pages = {1}, abstract = {Despite the high level of attention on infectious respiratory aerosol during the Covid19 pandemic, little is known about the processes how these particles form inside the respiratory system. Understanding the underlying fluid mechanical processes and their influencing factors would enable the development of drugs to suppress the generation of infectious aerosol. In the proposed work, we focus on the shear-induced mechanism of aerosol generation, which is supposed to occur mostly in the larger airways during coughing. In this process, high air velocities trigger Kelvin-Helmholtz waves in the mucus film, which lines the air vessels. Through a series of instabilities, particles detach from the crest of these waves. In the proposed work, we investigate the process of shear-induced aerosol generation in idealized experiments where we vary the air-flow characteristics and the properties of the mucus fluid. Our central aim here is to deduct an empirical model of the quantity and size distribution of generated particles depending on the mucus rheology and the local shear flow. Further, we observe the wave topology to better understand the coupling between the air flow and the waves. In our experimental setup, we measure the quantity of created particles and the emerging waves simultaneously. To ensure controllable conditions, we simplify the complex flow conditions in the airways. We use a rectangular channel with the bottom wall covered in a mucus mimetic. The mucus mimetic fluid is a synthetic hydrogel developed to recreate the viscoelastic properties and low surface tensions of the mucus. Filtered pressurized air is guided through the channel to trigger shear-induced aerosol generation. After passing the mucus mimetic, the air enters into a collection chamber from where particles are sampled continuously by an aerosol spectrometer. To measure wave topology, we use planar laser induced fluorescence. For this, we stain the mucus mimetic with fluorescent dyes and illuminate a line on the surface of the fluid film with a 532 nm laser. A high-resolution camera captures the resulting fluorescent glow of the mucus mimetic. Figure 1 presents exemplary wave topology results from the experiments, employing varying air flow volume rates, mucus mimetic gel properties, and different configurations of the laser and camera. The resulting wave topologies exhibit significant variation. For the conference, we will conduct parameter studies of the particle quantities and wave topology while varying the mucus mimetic properties and the flow rate of the air. Additionally, we will present grid projection-based techniques to extend the single-line wave measurements and asses the entire surface of the mucus film.}, language = {en} } @misc{KranzPointnerLehleetal., author = {Kranz, Michael and Pointner, Daniel and Lehle, Karla and Lubnow, Matthias and Krenkel, Lars}, title = {High-resolution flow field investigations in membrane lungs, considering the complex blood rheology}, series = {1st European Fluid Dynamics Conference (EFDC1), 16-20.September 2024, Aachen}, journal = {1st European Fluid Dynamics Conference (EFDC1), 16-20.September 2024, Aachen}, doi = {10.35096/othr/pub-8921}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-89214}, pages = {2}, abstract = {Despite major improvements over the last years, coagulative disorders and clotting phenomena in membrane lungs (MLs) are still considerable complications in extracorporeal membrane oxygenation (ECMO). ECMO is an increasingly used treatment for patients with severe respiratory failure or cardiac arrest [1]. For both, evaluation of therapeutic decisions and fundamental research on patient specific intra-device clotting phenomena, the direct visualization and analysis of clot formation in combination with a detailed flow field correlation is highly desirable and therefore an intensively followed research topic. Modelling blood flow and shear induced coagulation in MLs is challenging. The relevant geometry of oxygenator fibers and chaining threads is complex and spans several length scales. In relevant scales and regimes, blood shows several significant non-Newtonian effects. Viscosity impacts shear rate, which is important in several coagulation mechanisms. Additionally, coagulation processes are influencing fluid properties and geometry significantly. Existing approaches of previous research work are only able to consider some, but not all relevant effects and geometrical details. Due to the enormous size of the discretized geometries, highly detailed viscosity and coagulations models are not applicable. Our goal is to develop a model for combined viscosity and coagulation properties of blood flow in MLs. In our work, we compare the influence of different levels of detail of the ML geometry as well as the influence of considering realistic blood flow behavior (viscosity change by considering the local hematocrit distribution within the F{\aa}hraeus-Lindqvist-Effect) on the resulting flow field in relevant subsections of a ML. High-resolution micro-CT geometry reconstructions [1] are compared to idealized generic fiber representations. For realistic blood flow modelling, Newtonian representation is compared to the established Carreau-Yasuda and a multiphase Euler-Euler approach. Results are presented for relevant subsections as well as for the complete ML.}, language = {en} } @misc{KranzWagnerPointneretal., author = {Kranz, Michael and Wagner, Maria Stella and Pointner, Daniel and Waldbauer, Selina and M{\"u}ller, Thomas and Lubnow, Matthias and Foltan, Maik and Krenkel, Lars and Lehle, Karla}, title = {Polymeric Embedding of Membrane Lungs: A Novel Method for Histological Investigations of Intra-Device Clot Formation}, series = {12th EuroELSO Congress, 24-27. April 2024, Krakow}, journal = {12th EuroELSO Congress, 24-27. April 2024, Krakow}, language = {en} } @misc{KranzWagnerKrenkeletal., author = {Kranz, Michael and Wagner, Maria Stella and Krenkel, Lars and M{\"u}ller, Thomas and Lubnow, Matthias and Philipp, Alois and Lehle, Karla}, title = {Clot Localization within Membrane Lungs using different Imaging Methods and Histological Clot Characterization as a way to prevent Thrombosis in Extracorporeal Membrane Oxygenation}, volume = {2023}, language = {en} } @misc{KoesterKranzWagneretal., author = {K{\"o}ster, Leonie and Kranz, Michael and Wagner, Maria Stella and Foltan, Maik and M{\"u}ller, Thomas and Lubnow, Matthias and Krenkel, Lars and Lehle, Karla}, title = {Histological Investigations of Intra-Device Clot Formation in ECMO Pumps}, series = {12th EuroELSO Congress, 24-27. April 2024, Krakow}, journal = {12th EuroELSO Congress, 24-27. April 2024, Krakow}, language = {en} } @misc{KlausmannRueckertRauberetal., author = {Klausmann, Leonard and Rueckert, Tobias and Rauber, David and Maerkl, Raphaela and Yildiran, Suemeyye R. and Gutbrod, Max and Palm, Christoph}, title = {Abstract: DIY Challenge Blueprint}, series = {Bildverarbeitung f{\"u}r die Medizin 2025: Proceedings, German Conference on Medical Image Computing, L{\"u}beck March 15-17, 2026}, journal = {Bildverarbeitung f{\"u}r die Medizin 2025: Proceedings, German Conference on Medical Image Computing, L{\"u}beck March 15-17, 2026}, editor = {Handels, Heinz and Breininger, Katharina and Deserno, Thomas M. and Maier, Andreas and Maier-Hein, Klaus H. and Palm, Christoph and Tolxdorff, Thomas}, publisher = {Springer Vieweg}, address = {Wiesbaden}, doi = {10.1007/978-3-658-51100-5_27}, pages = {131 -- 131}, abstract = {The high cost of challenge platforms prevents many people from organizing their own competitions. The do-it-yourself (DIY) challenge blueprint [1] allows you to host your own biomedical AI benchmark challenge. Our DIY approach circumvents the current constraints of commercial challenge platforms. A sovereign, extensible and cost-efficient deployment is provided via containerised, identity-managed and reproducible pipelines. Focus lies on GDPR-compliant hosting via infrastructure-as-code, automated evaluation, modular orchestration, and role-based identity and access management. The framework integrates Docker-based execution and standardised interfaces for task definitions, dataset curation and evaluation. All in all it is designed to be flexible and modular, as demonstrated in the MICCAI 2024 PhaKIR challenge [2, 3]. In this case study, different medical tasks on a multicentre laparoscopic dataset with framewise labels for phases and spatial annotations for instruments across fulllength videos were supported. This case study empirically validates the DIY challenge blueprint as a reproducible and customizable challenge-hosting infrastructure. The full code can be found at https://github.com/remic-othr/PhaKIR_DIY.}, subject = {Bildverarbeitung}, language = {en} }