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  <doc>
    <id>3205</id>
    <completedYear/>
    <publishedYear>2016</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>687</pageFirst>
    <pageLast>695</pageLast>
    <pageNumber/>
    <edition/>
    <issue>10</issue>
    <volume>192</volume>
    <type>article</type>
    <publisherName>Springer Nature</publisherName>
    <publisherPlace>Heidelberg</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Second Cancer Risk after simultaneous integrated boost radiation therapy of right sided breast cancer with and without flattening filter</title>
    <abstract language="eng">Background &#13;
The aim of this study was to investigate if the flattening filter free mode (FFF) of a linear accelerator reduces the excess absolute risk (EAR) for second cancer as compared to the flat beam mode (FF) in simultaneous integrated boost (SIB) radiation therapy of right-sided breast cancer.&#13;
&#13;
Patients and methods &#13;
Six plans were generated treating the whole breast to 50.4 Gy and a SIB volume to 63 Gy on CT data of 10 patients: intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), and a tangential arc VMAT (tVMAT), each with flattening filter and without. The EAR was calculated for the contralateral breast and the lungs from dose-volume histograms (DVH) based on the linear-exponential, the plateau, and the full mechanistic dose-response model. Peripheral low-dose measurements were performed to compare the EAR in more distant regions as the thyroids and the uterus.&#13;
&#13;
Results &#13;
FFF reduces the EAR significantly in the contralateral and peripheral organs for tVMAT and in the peripheral organs for VMAT. No reduction was found for IMRT. The lowest EAR for the contralateral breast and lung was achieved with tVMAT FFF, reducing the EAR by 25 % and 29 % as compared to tVMAT FF, and by 44 % to 58 % as compared to VMAT and IMRT in both irradiation modes. tVMAT FFF showed also the lowest peripheral dose corresponding to the lowest EAR in the thyroids and the uterus.&#13;
&#13;
Conclusion &#13;
The use of FFF mode allows reducing the EAR significantly when tVMAT is used as the treatment technique. When second cancer risk is a major concern, tVMAT FFF is considered the preferred treatment option in SIB irradiation of right-sided breast cancer.</abstract>
    <parentTitle language="eng">Strahlentherapie und Onkologie</parentTitle>
    <additionalTitle language="deu">Sekundärmalignom-Risiko nach simultan integrierter Boost-Bestrahlung des rechtsseitigen Mamma-Karzinoms mit und ohne Ausgleichskörper</additionalTitle>
    <identifier type="doi">10.1007/s00066-016-1025-5</identifier>
    <enrichment key="opus.import.date">2022-03-17T07:14:43+00:00</enrichment>
    <enrichment key="opus.source">sword</enrichment>
    <enrichment key="opus.import.user">importuser</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <enrichment key="opus.doi.autoCreate">false</enrichment>
    <enrichment key="opus.urn.autoCreate">false</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Barbara Dobler</author>
    <author>Johannes Maier</author>
    <author>Bernadette Knott</author>
    <author>Manuel Maerz</author>
    <author>Rainer Löschel</author>
    <author>Oliver Kölbl</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>3D-CRT</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Breast Cancer</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>CONTRALATERAL BREAST</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>DOSES RELEVANT</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>flattening filter free</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>HODGKIN COHORTS</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>IMRT</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>INDUCTION</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>JAPANESE A-BOMB</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Peripheral Dose</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>PREDICTED RISK</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Radiotherapy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Second Cancer Risk</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>VMAT</value>
    </subject>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
  </doc>
  <doc>
    <id>3209</id>
    <completedYear/>
    <publishedYear>2016</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume>11</volume>
    <type>article</type>
    <publisherName>BMC, Part of Springer Nature</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Simultaneous integrated boost (SIB) radiation therapy of right sided breast cancer with and without flattening filter - A treatment planning study</title>
    <abstract language="eng">Background: &#13;
The aim of the study was to compare the two irradiation modes with (FF) and without flattening filter (FFF) for three different treatment techniques for simultaneous integrated boost radiation therapy of patients with right sided breast cancer.&#13;
&#13;
Methods: &#13;
An Elekta Synergy linac with Agility collimating device is used to simulate the treatment of 10 patients. Six plans were generated in Monaco 5.0 for each patient treating the whole breast and a simultaneous integrated boost (SIB) volume: intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and a tangential arc VMAT (tVMAT), each with and without flattening filter. Plan quality was assessed considering target coverage, sparing of the contralateral breast, the lungs, the heart and the normal tissue. All plans were verified by a 2D-ionisation-chamber-array and delivery times were measured and compared. The Wilcoxon test was used for statistical analysis with a significance level of 0.05.&#13;
&#13;
Results: &#13;
Significantly best target coverage and homogeneity was achieved using VMAT FFF with V95% = (98.7 +/- 0.8) % and HI = (8.2 +/- 0.9) % for the SIB and V95% = (98.3 +/- 0.7) % for the PTV, whereas tVMAT showed significantly lowest doses to the contralateral organs at risk with a D-mean of (0.7 +/- 0.1) Gy for the contralateral lung, (1.0 +/- 0.2) Gy for the contralateral breast and (1.4 +/- 0.2) Gy for the heart. All plans passed the gamma evaluation with a mean passing rate of (99.2 +/- 0.8) %. Delivery times were significantly reduced for VMAT and tVMAT but increased for IMRT, when FFF was used. Lowest delivery times were observed for tVMAT FFF with (1:20 +/- 0:07) min.&#13;
&#13;
Conclusion: &#13;
Balancing target coverage, OAR sparing and delivery time, VMAT FFF and tVMAT FFF are considered the preferable of the investigated treatment options in simultaneous integrated boost irradiation of right sided breast cancer for the combination of an Elekta Synergy linac with Agility and the treatment planning system Monaco 5.0.</abstract>
    <parentTitle language="eng">Radiation oncology</parentTitle>
    <identifier type="doi">10.1186/s13014-016-0687-6</identifier>
    <enrichment key="opus.import.date">2022-03-17T07:14:43+00:00</enrichment>
    <enrichment key="opus.source">sword</enrichment>
    <enrichment key="opus.import.user">importuser</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Creative Commons - CC BY - Namensnennung 4.0 International</licence>
    <author>Johannes Maier</author>
    <author>Bernadette Knott</author>
    <author>Manuel März</author>
    <author>Rainer Löschel</author>
    <author>Oliver Kölbl</author>
    <author>Barbara Dobler</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>3D-CRT</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>CONSERVING THERAPY</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>FIELD</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>IMRT</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Radiotherapy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>VMAT</value>
    </subject>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="oaweg" number="">Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
  </doc>
  <doc>
    <id>1384</id>
    <completedYear/>
    <publishedYear>2016</publishedYear>
    <thesisYearAccepted/>
    <language>deu</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume/>
    <type>periodicalpart</type>
    <publisherName/>
    <publisherPlace>Regensburg</publisherPlace>
    <creatingCorporation>Ostbayerische Technische Hochschule Regensburg</creatingCorporation>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="deu">Forschungsbericht 2016</title>
    <identifier type="doi">10.35096/othr/pub-1384</identifier>
    <identifier type="urn">urn:nbn:de:bvb:898-opus4-13840</identifier>
    <author>Wolfgang Mauerer</author>
    <author>Tanja Rexhepaj</author>
    <author>Gareth J. Monkman</author>
    <author>Dirk Sindersberger</author>
    <author>Andreas Diermeier</author>
    <author>Thomas Neidhart</author>
    <author>Dominik Wolfrum</author>
    <author>Michael Sterner</author>
    <author>Michael Heberl</author>
    <author>Robert Nusko</author>
    <author>Georg Maier</author>
    <author>Klaus Nagl</author>
    <author>Monika Reuter</author>
    <author>Andreas Hofrichter</author>
    <author>Thomas Lex</author>
    <author>Florian Lesch</author>
    <author>Bärbel Kieninger</author>
    <author>Alexander Eduard Szalo</author>
    <author>Alexander Zehner</author>
    <author>Christoph Palm</author>
    <author>Mitchell Joblin</author>
    <author>Sven Apel</author>
    <author>Ralf Ramsauer</author>
    <author>Daniel Lohmann</author>
    <author>Markus Westner</author>
    <author>Artur Strasser</author>
    <author>Maximilian Munndi</author>
    <author>Lena Ebner</author>
    <author>Michael Elsner</author>
    <author>Nils Weiß</author>
    <author>Matthias Segerer</author>
    <author>Rudolf Hackenberg</author>
    <author>Sebastian Steger</author>
    <author>Anton Schmailzl</author>
    <author>Michael Dostalek</author>
    <author>Dominik Armbruster</author>
    <author>Fabian Koch</author>
    <author>Stefan Hierl</author>
    <author>Philipp Thumann</author>
    <author>Krzysztof Swidergal</author>
    <author>Marcus Wagner</author>
    <author>Ulrich Briem</author>
    <author>Andreas Diermeier</author>
    <author>Stefan Spreitzer</author>
    <author>Sabrina Beiderbeck</author>
    <author>Christian Hook</author>
    <author>Martin Zobel</author>
    <author>Tim Weber</author>
    <author>Simon Groß</author>
    <author>Rainer Penzkofer</author>
    <author>Sebastian Dendorfer</author>
    <author>Ingo Schillitz</author>
    <author>Thomas Bauer</author>
    <author>Clarissa Rudolph</author>
    <author>Katja Schmidt</author>
    <author>Thomas Liebetruth</author>
    <author>Markus Hamer</author>
    <author>Sonja Haug</author>
    <author>Matthias Vernim</author>
    <author>Karsten Weber</author>
    <author>Sean Patrick Saßmannshausen</author>
    <author>Sebastian Books</author>
    <author>Nikolaus Neuleitner</author>
    <author>Christian Rechenauer</author>
    <author>Oliver Steffens</author>
    <author>Wolfgang Kusterle</author>
    <author>Roland Gömmel</author>
    <author>Felix Wellnitz</author>
    <author>Johannes Stierstorfer</author>
    <author>Dominik Stadler</author>
    <author>Matthias J. Hofmann</author>
    <author>Hubert Motschmann</author>
    <author>Mikhail Shamonin (Chamonine)</author>
    <author>Veronika Bleicher</author>
    <author>Sebastian Fischer</author>
    <author>Rudolf Hackenberg</author>
    <author>Anton Horn</author>
    <author>Raphael Kawasch</author>
    <author>Michael Petzenhauser</author>
    <author>Tobias Probst</author>
    <author>Anton Udalzow</author>
    <author>Florian Dams</author>
    <author>Rupert Schreiner</author>
    <author>Christoph Langer</author>
    <author>Christian Prommesberger</author>
    <author>Robert Damian Ławrowski</author>
    <series>
      <title>Forschungsberichte der OTH Regensburg</title>
      <number>2016</number>
    </series>
    <collection role="institutes" number="HL">Hochschulleitung/Hochschulverwaltung</collection>
    <collection role="othpublikationsherkunft" number="">Von der OTH Regensburg herausgegeben</collection>
    <collection role="persons" number="weberlate">Weber, Karsten (Prof. Dr.) - Labor für Technikfolgenabschätzung und Angewandte Ethik</collection>
    <collection role="institutes" number="IAFW">Zentrum für Forschung und Transfer (ZFT ab 2024; vorher: IAFW)</collection>
    <collection role="persons" number="sternerfenes">Sterner, Michael (Prof. Dr.) - FENES / Forschungsgruppe Energiespeicher</collection>
    <collection role="persons" number="hauglasofo">Haug, Sonja (Prof. Dr.) - Labor Empirische Sozialforschung</collection>
    <thesisPublisher>Ostbayerische Technische Hochschule Regensburg</thesisPublisher>
    <file>https://opus4.kobv.de/opus4-oth-regensburg/files/1384/Forschungsbericht_OTHR_2016.pdf</file>
  </doc>
  <doc>
    <id>1383</id>
    <completedYear/>
    <publishedYear>2017</publishedYear>
    <thesisYearAccepted/>
    <language>deu</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume/>
    <type>periodicalpart</type>
    <publisherName/>
    <publisherPlace>Regensburg</publisherPlace>
    <creatingCorporation>Ostbayerische Technische Hochschule Regensburg</creatingCorporation>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="deu">Forschungsbericht 2017</title>
    <identifier type="isbn">978-3-9818209-3-5</identifier>
    <identifier type="urn">urn:nbn:de:bvb:898-opus4-13835</identifier>
    <identifier type="doi">10.35096/othr/pub-1383</identifier>
    <author>Karsten Weber</author>
    <author>Sebastian Dendorfer</author>
    <author>Franz Süß</author>
    <author>Simone Kubowitsch</author>
    <author>Thomas Schratzenstaller</author>
    <author>Sonja Haug</author>
    <author>Christa Mohr</author>
    <author>Hans Kiesl</author>
    <author>Jörg Drechsler</author>
    <author>Markus Westner</author>
    <author>Jörn Kobus</author>
    <author>Martin J. W. Schubert</author>
    <author>Stefan Zenger</author>
    <author>Alexander Pietsch</author>
    <author>Josef Weiß</author>
    <author>Sebastian Hinterseer</author>
    <author>Roland Schieck</author>
    <author>Stefanie Scherzinger</author>
    <author>Meike Klettke</author>
    <author>Andreas Ringlstetter</author>
    <author>Uta Störl</author>
    <author>Tegawendé F. Bissyandé</author>
    <author>Achim Seeburger</author>
    <author>Timo Schindler</author>
    <author>Ralf Ramsauer</author>
    <author>Jan Kiszka</author>
    <author>Andreas Kölbl</author>
    <author>Daniel Lohmann</author>
    <author>Wolfgang Mauerer</author>
    <author>Johannes Maier</author>
    <author>Ulrike Scorna</author>
    <author>Christoph Palm</author>
    <author>Alexander Soska</author>
    <author>Jürgen Mottok</author>
    <author>Andreas Ellermeier</author>
    <author>Daniel Vögele</author>
    <author>Stefan Hierl</author>
    <author>Ulrich Briem</author>
    <author>Knut Buschmann</author>
    <author>Ingo Ehrlich</author>
    <author>Christian Pongratz</author>
    <author>Benjamin Pielmeier</author>
    <author>Quirin Tyroller</author>
    <author>Gareth J. Monkman</author>
    <author>Franz Gut</author>
    <author>Carina Roth</author>
    <author>Peter Hausler</author>
    <author>Rudolf Bierl</author>
    <author>Christian Prommesberger</author>
    <author>Robert Damian Ławrowski</author>
    <author>Christoph Langer</author>
    <author>Rupert Schreiner</author>
    <author>Yifeng Huang</author>
    <author>Juncong She</author>
    <author>Andreas Ottl</author>
    <author>Walter Rieger</author>
    <author>Agnes Kraml</author>
    <author>Thomas Poxleitner</author>
    <author>Simon Hofer</author>
    <author>Benjamin Heisterkamp</author>
    <author>Maximilian Lerch</author>
    <author>Nike Sammer</author>
    <author>Olivia Golde</author>
    <author>Felix Wellnitz</author>
    <author>Sandra Schmid</author>
    <author>Claudia Muntschick</author>
    <author>Wolfgang Kusterle</author>
    <author>Ivan Paric</author>
    <author>Oliver Brückl</author>
    <author>Matthias Haslbeck</author>
    <author>Ottfried Schmidt</author>
    <author>Peter Schwanzer</author>
    <author>Hans-Peter Rabl</author>
    <author>Michael Sterner</author>
    <author>Franz Bauer</author>
    <author>Sven Steinmann</author>
    <author>Fabian Eckert</author>
    <author>Andreas Hofrichter</author>
    <series>
      <title>Forschungsberichte der OTH Regensburg</title>
      <number>2017</number>
    </series>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Forschung</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Forschungsbericht</value>
    </subject>
    <collection role="institutes" number="HL">Hochschulleitung/Hochschulverwaltung</collection>
    <collection role="othpublikationsherkunft" number="">Von der OTH Regensburg herausgegeben</collection>
    <collection role="persons" number="weberlate">Weber, Karsten (Prof. Dr.) - Labor für Technikfolgenabschätzung und Angewandte Ethik</collection>
    <collection role="institutes" number="IAFW">Zentrum für Forschung und Transfer (ZFT ab 2024; vorher: IAFW)</collection>
    <collection role="persons" number="sternerfenes">Sterner, Michael (Prof. Dr.) - FENES / Forschungsgruppe Energiespeicher</collection>
    <collection role="persons" number="bruecklfenes">Brückl, Oliver (Prof. Dr.) - FENES / Forschungsgruppe Energienetze</collection>
    <collection role="persons" number="hauglasofo">Haug, Sonja (Prof. Dr.) - Labor Empirische Sozialforschung</collection>
    <thesisPublisher>Ostbayerische Technische Hochschule Regensburg</thesisPublisher>
    <file>https://opus4.kobv.de/opus4-oth-regensburg/files/1383/Forschungsbericht_OTHR_2017.pdf</file>
  </doc>
  <doc>
    <id>96</id>
    <completedYear/>
    <publishedYear>2019</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>1</pageFirst>
    <pageLast>10</pageLast>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume>114</volume>
    <type>article</type>
    <publisherName>Elsevier</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2019-12-17</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Force-feedback assisted and virtual fixtures based K-wire drilling simulation</title>
    <abstract language="eng">One common method to fix fractures of the human hand after an accident is an osteosynthesis with Kirschner wires (K-wires) to stabilize the bone fragments. The insertion of K-wires is a delicate minimally invasive surgery, because surgeons operate almost without a sight. Since realistic training methods are time consuming, costly and insufficient, a virtual-reality (VR) based training system for the placement of K-wires was developed. As part of this, the current work deals with the real-time bone drilling simulation using a haptic force-feedback device.&#13;
&#13;
To simulate the drilling, we introduce a virtual fixture based force-feedback drilling approach. By decomposition of the drilling task into individual phases, each phase can be handled individually to perfectly control the drilling procedure. We report about the related finite state machine (FSM), describe the haptic feedback of each state and explain, how to avoid jerking of the haptic force-feedback during state transition.&#13;
&#13;
The usage of the virtual fixture approach results in a good haptic performance and a stable drilling behavior. This was confirmed by 26 expert surgeons, who evaluated the virtual drilling on the simulator and rated it as very realistic. To make the system even more convincing, we determined real drilling feed rates through experimental pig bone drilling and transferred them to our system. Due to a constant simulation thread we can guarantee a precise drilling motion.&#13;
&#13;
Virtual fixtures based force-feedback calculation is able to simulate force-feedback assisted bone drilling with high quality and, thus, will have a great potential in developing medical applications.</abstract>
    <parentTitle language="eng">Computers in Biology and Medicine</parentTitle>
    <identifier type="doi">10.1016/j.compbiomed.2019.103473</identifier>
    <note>Corresponding author: Christoph Palm</note>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International</licence>
    <author>Johannes Maier</author>
    <author>Jerome Perret</author>
    <author>Martina Simon</author>
    <author>Stephanie Schmitt-Rüth</author>
    <author>Thomas Wittenberg</author>
    <author>Christoph Palm</author>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Handchirurgie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Osteosynthese</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Operationstechnik</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Lernprogramm</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Virtuelle Realität</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Medical training system</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Virtual fixtures</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Virtual reality</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Force-feedback haptic</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Minimally invasive hand surgery</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>K-wire drilling</value>
    </subject>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmhaptivist">Palm, Christoph (Prof. Dr.) - Projekt HaptiVisT</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="oaweg" number="">Hybrid Open Access - OA-Veröffentlichung in einer Subskriptionszeitschrift/-medium</collection>
    <collection role="oaweg" number="">Corresponding author der OTH Regensburg</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>2565</id>
    <completedYear/>
    <publishedYear>2020</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>1</pageFirst>
    <pageLast>8</pageLast>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume/>
    <type>article</type>
    <publisherName>HINDAWI</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Quantitative Analysis of Surface Contouring with Pulsed Bipolar Radiofrequency on Thin Chondromalacic Cartilage</title>
    <abstract language="eng">The purpose of this study was to evaluate the quality of surface contouring of chondromalacic cartilage by bipolar radio frequency energy using different treatment patterns in an animal model, as well as examining the impact of the treatment onto chondrocyte viability by two different methods. Our experiments were conducted on 36 fresh osteochondral sections from the tibia plateau of slaughtered 6-month-old pigs, where the thickness of the cartilage is similar to that of human wrist cartilage. An area of 1 cm(2) was first treated with emery paper to simulate the chondromalacic cartilage. Then, the treatment with RFE followed in 6 different patterns. The osteochondral sections were assessed for cellular viability (live/dead assay, caspase (cell apoptosis marker) staining, and quantitative analysed images obtained by fluorescent microscopy). For a quantitative characterization of none or treated cartilage surfaces, various roughness parameters were measured using confocal laser scanning microscopy (Olympus LEXT OLS 4000 3D). To describe the roughness, the Root-Mean-Square parameter (Sq) was calculated. A smoothing effect of the cartilage surface was detectable upon each pattern of RFE treatment. The Sq for native cartilage was Sq=3.8 +/- 1.1 mu m. The best smoothing pattern was seen for two RFE passes and a 2-second pulsed mode (B2p2) with an Sq=27.3 +/- 4.9 mu m. However, with increased smoothing, an augmentation in chondrocyte death up to 95% was detected. Using bipolar RFE treatment in arthroscopy for small joints like the wrist or MCP joints should be used with caution. In the case of chondroplasty, there is a high chance to destroy the joint cartilage.</abstract>
    <parentTitle language="eng">BioMed Research International</parentTitle>
    <identifier type="doi">10.1155/2020/1242086</identifier>
    <enrichment key="opus.import.date">2022-01-27T15:19:14+00:00</enrichment>
    <enrichment key="opus.source">sword</enrichment>
    <enrichment key="opus.import.user">importuser</enrichment>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Creative Commons - CC BY - Namensnennung 4.0 International</licence>
    <author>Michaela Huber</author>
    <author>Daniela Schlosser</author>
    <author>Susanne Stenzel</author>
    <author>Johannes Maier</author>
    <author>Girish Pattappa</author>
    <author>Richard Kujat</author>
    <author>Birgit Striegl</author>
    <author>Denitsa Docheva</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>CHONDROCYTE DEATH</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>energy</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>HUMAN ARTICULAR-CARTILAGE</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>MONOPOLAR</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>THERMAL CHONDROPLASTY</value>
    </subject>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="oaweg" number="">Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>351</id>
    <completedYear/>
    <publishedYear>2019</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>218</pageFirst>
    <pageLast/>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume/>
    <type>conferencepresentation</type>
    <publisherName>Springer Vieweg</publisherName>
    <publisherPlace>Wiesbaden</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2020-04-22</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Abstract: Imitating Human Soft Tissue with Dual-Material 3D Printing</title>
    <abstract language="eng">Currently, it is common practice to use three-dimensional (3D) printers not only for rapid prototyping in the industry, but also in the medical area to create medical applications for training inexperienced surgeons. In a clinical training simulator for minimally invasive bone drilling to fix hand fractures with Kirschner-wires (K-wires), a 3D printed hand phantom must not only be geometrically but also haptically correct. Due to a limited view during an operation, surgeons need to perfectly localize underlying risk structures only by feeling of specific bony protrusions of the human hand.</abstract>
    <parentTitle language="eng">Bildverarbeitung für die Medizin 2019, Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 17. bis 19. März 2019 in Lübeck</parentTitle>
    <identifier type="isbn">978-3-658-25325-7</identifier>
    <identifier type="doi">10.1007/978-3-658-25326-4_48</identifier>
    <author>Johannes Maier</author>
    <author>Maximilian Weiherer</author>
    <author>Michaela Huber</author>
    <author>Christoph Palm</author>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Handchirurgie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>3D-Druck</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Lernprogramm</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>HaptiVisT</value>
    </subject>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>97</id>
    <completedYear/>
    <publishedYear>2019</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>30</pageFirst>
    <pageLast>42</pageLast>
    <pageNumber/>
    <edition/>
    <issue>1</issue>
    <volume>9</volume>
    <type>article</type>
    <publisherName>AME Publishing Company</publisherName>
    <publisherPlace/>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Imitating human soft tissue on basis of a dual-material 3D print using a support-filled metamaterial to provide bimanual haptic for a hand surgery training system</title>
    <abstract language="eng">Background: Currently, it is common practice to use three-dimensional (3D) printers not only for rapid prototyping in the industry, but also in the medical area to create medical applications for training inexperienced surgeons. In a clinical training simulator for minimally invasive bone drilling to fix hand fractures with Kirschner-wires (K-wires), a 3D-printed hand phantom must not only be geometrically but also haptically correct. Due to a limited view during an operation, surgeons need to perfectly localize underlying risk structures only by feeling of specific bony protrusions of the human hand.&#13;
Methods: The goal of this experiment is to imitate human soft tissue with its haptic and elasticity for a realistic hand phantom fabrication, using only a dual-material 3D printer and support-material-filled metamaterial between skin and bone. We present our workflow to generate lattice structures between hard bone and soft skin with iterative cube edge (CE) or cube face (CF) unit cells. Cuboid and finger shaped sample prints with and without inner hard bone in different lattice thickness are constructed and 3D printed.&#13;
Results: The most elastic available rubber-like material is too firm to imitate soft tissue. By reducing the amount of rubber in the inner volume through support material (SUP), objects become significantly softer. Without metamaterial, after disintegration, the SUP can be shifted through the volume and thus the body loses its original shape. Although the CE design increases the elasticity, it cannot restore the fabric form. In contrast to CE, the CF design increases not only the elasticity but also guarantees a local limitation of the SUP. Therefore, the body retains its shape and internal bones remain in its intended place. Various unit cell sizes, lattice thickening and skin thickness regulate the rubber material and SUP ratio. Test prints with higher SUP and lower rubber material percentage appear softer and vice versa. This was confirmed by an expert surgeon evaluation. Subjects adjudged pure rubber-like material as too firm and samples only filled with SUP or lattice structure in CE design as not suitable for imitating tissue. 3D-printed finger samples in CF design were rated as realistic compared to the haptic of human tissue with a good palpable bone structure.&#13;
Conclusions: We developed a new dual-material 3D print technique to imitate soft tissue of the human hand with its haptic properties. Blowy SUP is trapped within a lattice structure to soften rubber-like 3D print material, which makes it possible to reproduce a realistic replica of human hand soft tissue.</abstract>
    <parentTitle language="eng">Quantitative Imaging in Medicine and Surgery</parentTitle>
    <identifier type="doi">10.21037/qims.2018.09.17</identifier>
    <identifier type="urn">urn:nbn:de:bvb:898-opus4-979</identifier>
    <note>Corresponding author: Christoph Palm</note>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International</licence>
    <author>Johannes Maier</author>
    <author>Maximilian Weiherer</author>
    <author>Michaela Huber</author>
    <author>Christoph Palm</author>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Dual-material 3D printing</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Hand surgery training</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Metamaterial</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Support material</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Tissue-imitating hand phantom</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Handchirurgie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>3D-Druck</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Biomaterial</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Lernprogramm</value>
    </subject>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="oaweg" number="">Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium</collection>
    <collection role="persons" number="palmhaptivist">Palm, Christoph (Prof. Dr.) - Projekt HaptiVisT</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="oaweg" number="">Corresponding author der OTH Regensburg</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>346</id>
    <completedYear/>
    <publishedYear>2020</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>340</pageFirst>
    <pageLast>455</pageLast>
    <pageNumber/>
    <edition/>
    <issue>02</issue>
    <volume>10</volume>
    <type>article</type>
    <publisherName>AME Publishing Company</publisherName>
    <publisherPlace>Hong Kong, China</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2020-04-22</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Optically tracked and 3D printed haptic phantom hand for surgical training system</title>
    <abstract language="eng">Background: For surgical fixation of bone fractures of the human hand, so-called Kirschner-wires (K-wires) are drilled through bone fragments. Due to the minimally invasive drilling procedures without a view of risk structures like vessels and nerves, a thorough training of young surgeons is necessary. For the development of a virtual reality (VR) based training system, a three-dimensional (3D) printed phantom hand is required. To ensure an intuitive operation, this phantom hand has to be realistic in both, its position relative to the driller as well as in its haptic features. The softest 3D printing material available on the market, however, is too hard to imitate human soft tissue. Therefore, a support-material (SUP) filled metamaterial is used to soften the raw material. Realistic haptic features are important to palpate protrusions of the bone to determine the drilling starting point and angle. An optical real-time tracking is used to transfer position and rotation to the training system.&#13;
Methods: A metamaterial already developed in previous work is further improved by use of a new unit cell. Thus, the amount of SUP within the volume can be increased and the tissue is softened further. In addition, the human anatomy is transferred to the entire hand model. A subcutaneous fat layer and penetration of air through pores into the volume simulate shiftability of skin layers. For optical tracking, a rotationally symmetrical marker attached to the phantom hand with corresponding reference marker is developed. In order to ensure trouble-free position transmission, various types of marker point applications are tested.&#13;
&#13;
Results: Several cuboid and forearm sample prints lead to a final 30 centimeter long hand model. The whole haptic phantom could be printed faultless within about 17 hours. The metamaterial consisting of the new unit cell results in an increased SUP share of 4.32%. Validated by an expert surgeon study, this allows in combination with a displacement of the uppermost skin layer a good palpability of the bones. Tracking of the hand marker in dodecahedron design works trouble-free in conjunction with a reference marker attached to the worktop of the training system.&#13;
&#13;
Conclusions: In this work, an optically tracked and haptically correct phantom hand was developed using dual-material 3D printing, which can be easily integrated into a surgical training system.</abstract>
    <parentTitle language="eng">Quantitative Imaging in Medicine and Surgery</parentTitle>
    <identifier type="doi">10.21037/qims.2019.12.03</identifier>
    <note>Corresponding author: Christoph Palm</note>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International</licence>
    <author>Johannes Maier</author>
    <author>Maximilian Weiherer</author>
    <author>Michaela Huber</author>
    <author>Christoph Palm</author>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Handchirurgie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>3D-Druck</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Lernprogramm</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Zielverfolgung</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>HaptiVisT</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Dual-material 3D printing</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>hand surgery training</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>metamaterial</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>tissue imitating phantom hand</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="ddc" number="617">Chirurgie und verwandte medizinische Fachrichtungen</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="oaweg" number="">Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium</collection>
    <collection role="persons" number="palmhaptivist">Palm, Christoph (Prof. Dr.) - Projekt HaptiVisT</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="oaweg" number="">Corresponding author der OTH Regensburg</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>103</id>
    <completedYear/>
    <publishedYear>2018</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>291</pageFirst>
    <pageLast>296</pageLast>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume/>
    <type>conferenceobject</type>
    <publisherName>Springer</publisherName>
    <publisherPlace>Berlin</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>--</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="eng">Force-Feedback-assisted Bone Drilling Simulation Based on CT Data</title>
    <abstract language="eng">In order to fix a fracture using minimally invasive surgery approaches, surgeons are drilling complex and tiny bones with a 2 dimensional X-ray as single imaging modality in the operating room. Our novel haptic force-feedback and visual assisted training system will potentially help hand surgeons to learn the drilling procedure in a realistic visual environment. Within the simulation, the collision detection as well as the interaction between virtual drill, bone voxels and surfaces are important. In this work, the chai3d collision detection and force calculation algorithms are combined with a physics engine to simulate the bone drilling process. The chosen Bullet-Physics-Engine provides a stable simulation of rigid bodies, if the collision model of the drill and the tool holder is generated as a compound shape. Three haptic points are added to the K-wire tip for removing single voxels from the bone. For the drilling process three modes are proposed to emulate the different phases of drilling in restricting the movement of a haptic device.</abstract>
    <parentTitle language="deu">Bildverarbeitung für die Medizin 2018; Algorithmen - Systeme - Anwendungen; Proceedings des Workshops vom 11. bis 13. März 2018 in Erlangen</parentTitle>
    <identifier type="doi">10.1007/978-3-662-56537-7_78</identifier>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Johannes Maier</author>
    <author>Michaela Huber</author>
    <author>Uwe Katzky</author>
    <author>Jerome Perret</author>
    <author>Thomas Wittenberg</author>
    <author>Christoph Palm</author>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Handchirurgie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Osteosynthese</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Simulation</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Lernprogramm</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmhaptivist">Palm, Christoph (Prof. Dr.) - Projekt HaptiVisT</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>2939</id>
    <completedYear/>
    <publishedYear>2020</publishedYear>
    <thesisYearAccepted/>
    <language>deu</language>
    <pageFirst/>
    <pageLast/>
    <pageNumber>236</pageNumber>
    <edition/>
    <issue/>
    <volume/>
    <type>doctoralthesis</type>
    <publisherName>Shaker</publisherName>
    <publisherPlace>Düren</publisherPlace>
    <creatingCorporation/>
    <contributingCorporation/>
    <belongsToBibliography>0</belongsToBibliography>
    <completedDate>2022-02-16</completedDate>
    <publishedDate>--</publishedDate>
    <thesisDateAccepted>--</thesisDateAccepted>
    <title language="deu">Entwicklung eines Haptisch und Visuell unterstützten Trainingssystems (HaptiVisT) für komplexe Knochenbohrungen in der minimalinvasiven Handchirurgie</title>
    <abstract language="deu">Eine gängige Operationsmethode, um Frakturen der menschlichen Hand nach einem Unfall zu korrigieren, ist eine Osteosynthese mit sogenannten Kirschnerdrähten (K-Drähten) zur Stabilisierung von Knochenfragmenten. Die Einführung dieser langen, dünnen und scharfen Drähte durch manuelles Bohren ist eine komplexe minimalinvasive Operation, bei der ein Chirurg nahezu ohne visuelle Orientierung und nur durch eine kleine Öffnung der Haut des Patienten arbeitet. Als Orientierungshilfe für die optimale Lage der K-Drähte bleibt dem Chirurgen lediglich eine zweidimensionale (2D)-Röntgendarstellung und das Ertasten von knöchernen Vorsprüngen auf der menschlichen Hand, um Verletzungen an Risikostrukturen (Nerven, Gefäße usw.), die im Weichteilgewebe der Hand eingebettet sind, zu vermeiden. Für eine sichere und fehlerfreie Durchführung einer K-Draht-Osteosynthese ist deswegen eine gründliche theoretische und praktische Ausbildung junger Chirurgen notwendig.&#13;
&#13;
Da traditionelle Trainingsmethoden zeitaufwendig, kostspielig, ethisch nicht korrekt und unzureichend realistisch sind, wird in dieser Arbeit ein innovativer, auf virtueller Realität (VR) basierender, Haptisch und Visuell unterstützter Trainingssimulator (HaptiVisT) für die Platzierung von K-Drähten entwickelt, der vor allem Handchirurgen mit Übungs- und Perfektionierungsbedarf dabei unterstützt, das Bohrverfahren in einer realistischen aber virtuellen Umgebung zu erlernen. Beim HaptiVisT-Prototypenaufbau werden reale Patientendaten segmentierter Volumendaten aus einer Computertomographie (CT) und einer Magnetresonanztomographie (MRT) im virtuellen, dreidimensionalen (3D) Raum auf einem 3D-Monitor visualisiert und für eine intuitive bimanuelle Haptik sowohl mit einem Kraftfeedback-Gerät für den Bohrprozess und einer 3D-gedruckten und optisch getrackten Phantomhand kombiniert.&#13;
&#13;
Die vorliegende Arbeit beschreibt zunächst alle verwendeten Hardwaregeräte, die C++-Softwareumgebung, aufgebaut auf Multithreading (gleichzeitige Ausführung mehrerer Anweisungsfolgen in einem Prozess), und die auf Oberﬂächen- und Volumenrendering basierte Visualisierung. Die Kollisionsdetektion zwischen Bohrer und Knochen im virtuellen Raum wird in zwei separate Ereignisse unterteilt: Kollisionen zwischen Objekten als Gesamtes (Simulation der Kollision über die gesamte Objektoberﬂäche) und Kollisionen zwischen einer K-Draht-Spitze und dem Knochenvolumen für die Entfernung kleiner Volumenelemente (Voxel). Das Herzstück des Trainingssystems bildet eine echtzeitfähige Bohrsimulation, die den gesamten Bohrprozess in eine endliche Anzahl logischer Unterprozesse gliedert und diese Zustände in einen endlichen Zustandsautomaten (FSM, engl.: Finite State Machine) zusammenfasst. Das Kraftfeedback während einer Bohrung wird mit sogenannten „Virtual Fixtures“ (abstrakten sensorischen Informationen) berechnet und über einen Haptikarm auf den Benutzer übertragen. Damit die Simulation der Realität entspricht, wird unter Zuhilfenahme eines experimentellen Aufbaus die reale Bohrgeschwindigkeit durch kortikale Knochen ermittelt. Anschließend werden ein Levelkonzept und alle im System verfügbaren Bohrunterstützungswerkzeuge, wie haptische Korridore als Goldstandard oder eine Röntgenbildsimulation, vorgestellt. Mit ihnen ist es möglich, ausgesuchte Operationsfälle in Level unterschiedlicher Schwierigkeit zu unterteilen und den Operationsvorgang qualitativ zu bewerten. Der 3D-Druck einer Phantomhand (realitätsnahe Nachbildung einer Patientenhand) mit realistischen haptischen Eigenschaften zum Ertasten von Knochenvorsprüngen wird über einen metamaterialbasierten Ansatz (Neuanordnung des Grundmaterials durch eine künstlich angelegte, sich wiederholende Struktur) realisiert, da das aktuell am Markt verfügbare 3D-Druckmaterial für den Druck menschlichen Weichteilgewebes zu hart ist. Die Echtzeitverfolgung der Phantomhand beruht auf einem mit einer Stereokamera optisch getrackten Marker in Form eines Dodekaeders (Körper mit zwölf Flächen). Abschließend wird das HaptiVisT-Gesamtsystem in drei und der 3D-Druck einer Phantomhand in zwei Expertenevaluationen ausführlich untersucht und ausgewertet.&#13;
&#13;
Das HaptiVisT-System versteht sich als notwendiges Komplement für den ersten und weltweit einzigen funktionsfähigen, kompakten Prototypen für virtuelle K-DrahtOsteosynthesen mit haptischen Kraftfeedback, der in Zukunft Chirurgen in Aus- und Weiterbildung an Kliniken oder Trainingszentren ein risikofreies, zeit- und ortsunabhängiges Training ermöglicht. Die Kernelemente dieser Arbeit sind:&#13;
&#13;
• Stereoskopische 3D-Darstellung von realen Patientendaten.&#13;
&#13;
• Bimanuelle Haptik aus haptischen Kraftfeedback des Bohrens verbunden mit einer optisch getrackten, haptisch korrekten und 3D-gedruckten Phantomhand.&#13;
&#13;
• Zuverlässige Kollisionsdetektion zwischen virtuellen Objekten als Grundlage für das Kraftfeedback und die Abtragung von Knochen.&#13;
&#13;
• Echtzeitfähige Bohrsimulation durch Reduzierung des Bohrprozesses auf logische Bohr-Teilprozesse kombiniert mit einer Virtual Fixtures basierten Kraftberechnung.&#13;
&#13;
Haptisch korrekte Phantome sind vor allem im medizinischen Training von hoher Relevanz und die Berechnung des Kraftfeedbacks beruht erstmals auf der performanten und stabilen Simulation von Bohr-Teilprozessen unter Verwendung von Virtual Fixtures. Der Prototyp wird von Experten durchgehend positiv bewertet und bietet nach deren Einschätzung einen hohen Mehrwert für das chirurgische Training.&#13;
&#13;
Zukünftige Arbeiten könnten den Lerneffekt durch das HaptiVisT-Trainingssystem in stichhaltigen Evaluationen mit jungen Medizinstudenten unter Vorhandensein einer Kontrollgruppe statistisch validieren. Bei Bestätigung dieses Lerneffekts ist eine Ausgründung als eigenständiges Unternehmen und Weiterentwicklung des Prototyps mit Ausweitung auf weitere chirurgische Bereiche wie Knie- oder Hüftchirurgie denkbar. Unter Zuhilfenahme von automatischer Segmentierung könnten in Zukunft akut zu behandelnde Brüche abgebildet, vorab einer tatsächlichen Operation geübt und anschließend komplikationslos unter reduzierter Operationszeit durchgeführt werden.</abstract>
    <identifier type="isbn">978-3-8440-7547-2</identifier>
    <note>Titel verleihende Institution: Universität Regensburg</note>
    <enrichment key="opus.source">publish</enrichment>
    <enrichment key="OtherSeries">Schriftenreihe der OTH Regensburg</enrichment>
    <licence>Keine Lizenz - Es gilt das deutsche Urheberrecht: § 53 UrhG</licence>
    <author>Johannes Maier</author>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Medizinisches Trainingssystem</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Virtual Reality</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>uncontrolled</type>
      <value>Minimalinvasive Handchirurgie</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="ddc" number="6">Technik, Medizin, angewandte Wissenschaften</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmhaptivist">Palm, Christoph (Prof. Dr.) - Projekt HaptiVisT</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
    <collection role="othpublikationsherkunft" number="">Dissertation in Kooperation</collection>
  </doc>
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    <completedYear/>
    <publishedYear>2018</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
    <pageFirst>1</pageFirst>
    <pageLast>8</pageLast>
    <pageNumber/>
    <edition/>
    <issue/>
    <volume>19</volume>
    <type>article</type>
    <publisherName>Springer Nature</publisherName>
    <publisherPlace/>
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    <title language="eng">3D Analysis of Osteosyntheses Material using semi-automated CT Segmentation</title>
    <abstract language="eng">Backround&#13;
Scaphoidectomy and midcarpal fusion can be performed using traditional fixation methods like K-wires, staples, screws or different dorsal (non)locking arthrodesis systems. The aim of this study is to test the Aptus four corner locking plate and to compare the clinical findings to the data revealed by CT scans and semi-automated segmentation.&#13;
Methods:&#13;
This is a retrospective review of eleven patients suffering from scapholunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist, who received a four corner fusion between August 2011 and July 2014. The clinical evaluation consisted of measuring the range of motion (ROM), strength and pain on a visual analogue scale (VAS). Additionally, the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and the Mayo Wrist Score were assessed. A computerized tomography (CT) of the wrist was obtained six weeks postoperatively. After semi-automated segmentation of the CT scans, the models were post processed and surveyed.&#13;
Results&#13;
During the six-month follow-up mean range of motion (ROM) of the operated wrist was 60°, consisting of 30° extension and 30° flexion. While pain levels decreased significantly, 54% of grip strength and 89% of pinch strength were preserved compared to the contralateral healthy wrist. Union could be detected in all CT scans of the wrist. While X-ray pictures obtained postoperatively revealed no pathology, two user related technical complications were found through the 3D analysis, which correlated to the clinical outcome.&#13;
Conclusion&#13;
Due to semi-automated segmentation and 3D analysis it has been proved that the plate design can keep up to the manufacturers’ promises. Over all, this case series confirmed that the plate can compete with the coexisting techniques concerning clinical outcome, union and complication rate.</abstract>
    <parentTitle language="eng">BMC Musculoskeletal Disorders</parentTitle>
    <subTitle language="eng">a case series of a 4 corner fusion plate</subTitle>
    <identifier type="doi">10.1186/s12891-018-1975-0</identifier>
    <enrichment key="BegutachtungStatus">peer-reviewed</enrichment>
    <licence>Creative Commons - CC BY - Namensnennung 4.0 International</licence>
    <author>Rebecca Wöhl</author>
    <author>Johannes Maier</author>
    <author>Sebastian Gehmert</author>
    <author>Christoph Palm</author>
    <author>Birgit Riebschläger</author>
    <author>Michael Nerlich</author>
    <author>Michaela Huber</author>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Handchirurgie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Osteosynthese</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Arthrodese</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>4FC</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>SLAC wrist</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>SNAC wrist</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>Semi-automated segmentation</value>
    </subject>
    <subject>
      <language>eng</language>
      <type>uncontrolled</type>
      <value>3D analysis</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Computertomographie</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Bildsegmentierung</value>
    </subject>
    <subject>
      <language>deu</language>
      <type>swd</type>
      <value>Dreidimensionale Bildverarbeitung</value>
    </subject>
    <collection role="ddc" number="0">Informatik, Informationswissenschaft, allgemeine Werke</collection>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
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    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="oaweg" number="">Gold Open Access- Erstveröffentlichung in einem/als Open-Access-Medium</collection>
    <collection role="othforschungsschwerpunkt" number="16314">Lebenswissenschaften und Ethik</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
  </doc>
  <doc>
    <id>2257</id>
    <completedYear/>
    <publishedYear>2017</publishedYear>
    <thesisYearAccepted/>
    <language>eng</language>
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    <pageLast/>
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    <title language="eng">Development of a haptic and visual assisted training simulation concept for complex bone drilling in minimally invasive hand surgery</title>
    <parentTitle language="eng">CARS Conference, 5.10.-7.10.2017</parentTitle>
    <author>Johannes Maier</author>
    <author>Sonja Haug</author>
    <author>Michaela Huber</author>
    <author>Uwe Katzky</author>
    <author>Sabine Neumann</author>
    <author>Jérôme Perret</author>
    <author>Martin Prinzen</author>
    <author>Karsten Weber</author>
    <author>Thomas Wittenberg</author>
    <author>Rebecca Wöhl</author>
    <author>Ulrike Scorna</author>
    <author>Christoph Palm</author>
    <collection role="institutes" number="FakIM">Fakultät Informatik und Mathematik</collection>
    <collection role="institutes" number="FakSoz">Fakultät Sozial- und Gesundheitswissenschaften</collection>
    <collection role="institutes" number="RCBE">Regensburg Center of Biomedical Engineering - RCBE</collection>
    <collection role="persons" number="palmremic">Palm, Christoph (Prof. Dr.) - ReMIC</collection>
    <collection role="persons" number="palmhaptivist">Palm, Christoph (Prof. Dr.) - Projekt HaptiVisT</collection>
    <collection role="persons" number="weberlate">Weber, Karsten (Prof. Dr.) - Labor für Technikfolgenabschätzung und Angewandte Ethik</collection>
    <collection role="othforschungsschwerpunkt" number="16311">Digitalisierung</collection>
    <collection role="institutes" number="">Institut für Sozialforschung und Technikfolgenabschätzung (IST)</collection>
    <collection role="institutes" number="">Labor Empirische Sozialforschung</collection>
    <collection role="institutes" number="">Labor Regensburg Medical Image Computing (ReMIC)</collection>
    <collection role="institutes" number="">Labor für Technikfolgenabschätzung und Angewandte Ethik (LaTe)</collection>
    <collection role="persons" number="hauglasofo">Haug, Sonja (Prof. Dr.) - Labor Empirische Sozialforschung</collection>
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