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Die Positionierung des B-FMT der Vibrant Bonebridge kann aufgrund der anatomischen Verhältnisse des Mastoids und der Größe des Aktuators ohne eine vorherige Beurteilung der individuellen Computertomographie (CT) des Felsenbeins problematisch sein. Die Entwicklung eines einfach zu bedienenden Viewers, welcher eine Positionierung des B-FMT im Felsenbeinmodell ermöglicht und hier auf individuelle potenzielle anatomische Konflikte hinweist sowie Lösungsmöglichkeiten anbietet, kann ein hilfreiches Werkzeug zur präoperativen Positionierung sein.
Ziel der Arbeit war die Definition von Anforderungen und die Anfertigung eines Prototyps eines Vibrant-Bonebridge-Viewers.
Auf der Basis einer ZIBAmira-Software-Version und der Inklusion eines B-FMT-Modells unter Erstellung eines Felsenbeinmodells, welches die intuitive Beurteilung von Konflikten ermöglicht, erfolgte die Erstellung des Prototyps eines Vibrant-Bonebridge-Viewers.Ergebnisse. Die Segmentierungszeit der individuellen DICOM-Daten („digital imaging and communications in medicine“) beträgt etwa 5 min. Eine Positionierung im individuellen 3-D-Felsenbeinmodell ermöglicht die quantitative und qualitative Beurteilung von Konflikten (Sinus sigmoideus, mittlere Schädelgrube) und das Aufsuchen einer bevorzugten Position. Das Anheben des B-FMT mittels virtueller Unterlegscheiben kann simuliert werden.
Der erstellte Vibrant-Bonebridge-Viewer ermöglicht verlässlich eine Simulation der B-FMT-Positionierung. Die klinische Anwendbarkeit muss evaluiert werden.
Information about the temporal bone size and variations of anatomical structures are crucial for a safe positioning of the Vibrant Bonebridge B-FMT. A radiological based preoperative planning of the surgical procedure decreases the surgical time and minimizes the risk of complications.
We developed a software tool, which allows a catch up of foreign DICOM data based CT temporal bone scans. The individual CT scan is transmitted into a 3D reconstructed pattern of the temporal bone. In this 3D reconstruction the individually favored position of the B- FMT should be found.
The software allows a determination of a safe B-FMT position by identifying the individual relation of middle fossa, jugular bulb and external auditory canal. Skull thickness and screw length are contained parameters for the surgical planning.
An easy to handle software tool allows a radiologically data based safe and fast surgical positioning of the B-FMT.
Changes in knee shape and geometry resulting from total knee arthroplasty can affect patients in numerous important ways: pain, function, stability, range of motion, and kinematics. Quantitative data concerning these changes have not been previously available, to our knowledge, yet are essential to understand individual experiences of total knee arthroplasty and thereby improve outcomes for all patients. The limiting factor has been the challenge of accurately measuring these changes. Our study objective was to develop a conceptual framework and analysis method to investigate changes in knee shape and geometry, and prospectively apply it to a sample total knee arthroplasty population. Using clinically available computed tomography and radiography imaging systems, the three-dimensional knee shape and geometry of nine patients (eight varus and one valgus) were compared before and after total knee arthroplasty. All patients had largely good outcomes after their total knee arthroplasty. Knee shape changed both visually and numerically. On average, the distal condyles were slightly higher medially and lower laterally (range: +4.5 mm to −4.4 mm), the posterior condyles extended farther out medially but not laterally (range: +1.8 to −6.4 mm), patellofemoral distance increased throughout flexion by 1.8–3.5 mm, and patellar thickness alone increased by 2.9 mm (range: 0.7–5.2 mm). External femoral rotation differed preop and postop. Joint line distance, taking cartilage into account, changed by +0.7 to −1.5 mm on average throughout flexion. Important differences in shape and geometry were seen between pre-total knee arthroplasty and post-total knee arthroplasty knees. While this is qualitatively known, this is the first study to report it quantitatively, an important precursor to identifying the reasons for the poor outcome of some patients. Using the developed protocol and visualization techniques to compare patients with good versus poor clinical outcomes could lead to changes in implant design, implant selection, component positioning, and surgical technique. Recommendations based on this sample population are provided. Intraoperative and postoperative feedback could ultimately improve patient satisfaction.
Computed tomography analysis of knee pose and geometry before and after total knee arthroplasty
(2012)
Patientenspezifische Simulationsmodelle für die funktionelle Analyse von künstlichem Gelenkersatz
(2012)
Towards Robust Measurement Of Pelvic Parameters From AP Radiographs Using Articulated 3D Models
(2015)
Patient-specific parameters such as the orientation of the acetabulum or pelvic tilt are useful for custom planning for total hip arthroplasty (THA) and for evaluating the outcome of surgical interventions. The gold standard in obtaining pelvic parameters is from three-dimensional (3D) computed tomography (CT) imaging. However, this adds time and cost, exposes the patient to a substantial radiation dose, and does not allow for imaging under load (e.g. while the patient is standing). If pelvic parameters could be reliably derived from the standard anteroposterior (AP) radiograph, preoperative planning would be more widespread, and research analyses could be applied to retrospective data, after a postoperative issue is discovered.
The goal of this work is to enable robust measurement of two surgical parameters of interest: the tilt of the anterior pelvic plane (APP) and the orientation of the natural acetabulum. We present a computer-aided reconstruction method to determine the APP and natural acetabular orientation from a single, preoperative X-ray. It can easily be extended to obtain other important preoperative and postoperative parameters solely based on a single AP radiograph.
We present an automated method for extrapolating missing
regions in label data of the skull in an anatomically plausible manner. The ultimate goal is to design patient-specic cranial implants for correcting large, arbitrarily shaped defects of the skull that can, for example, result from trauma of the head. Our approach utilizes a 3D statistical shape model (SSM) of the skull and a 2D generative adversarial network (GAN) that is trained in an unsupervised fashion from samples of healthy patients alone. By tting the SSM to given input labels containing the skull defect, a First approximation of the healthy state of the patient is obtained. The GAN is then applied to further correct and smooth the output of the SSM in an anatomically plausible manner. Finally, the defect region is extracted using morphological operations and subtraction between the extrapolated healthy state of the patient and the defective input labels. The method is trained and evaluated based on data from the MICCAI 2020 AutoImplant challenge. It produces state-of-the art results on regularly
shaped cut-outs that were present in the training and testing data of the challenge. Furthermore, due to unsupervised nature of the approach, the method generalizes well to previously unseen defects of varying shapes that were only present in the hidden test dataset.
Acetabular bone defects are still challenging to quantify. Numerous classification schemes have been proposed to categorize the diverse kinds of defects. However, these classification schemes are mainly descriptive and hence it remains difficult to apply them in pre-clinical testing, implant development and pre-operative planning. By reconstructing the native situation of a defect pelvis using a Statistical Shape Model (SSM), a more quantitative analysis of the bone defects could be performed. The aim of this study is to develop such a SSM and to validate its accuracy using relevant clinical scenarios and parameters.
This study’s objective was the generation of a standardized geometry of the healthy nasal cavity.
An average geometry of the healthy nasal cavity was generated using a statistical shape model based on 25 symptom-free subjects. Airflow within the average geometry and these geometries was calculated using fluid simulations. Integral measures of the nasal resistance, wall shear stresses (WSS) and velocities were calculated as well as cross-sectional areas (CSA). Furthermore, individual WSS and static pressure distributions were mapped onto the average geometry.
The average geometry featured an overall more regular shape that resulted in less resistance, reduced wall shear stresses and velocities compared to the median of the 25 geometries. Spatial distributions of WSS and pressure of average geometry agreed well compared to the average distributions of all individual geometries. The minimal CSA of the average geometry was larger than the median of all individual geometries (83.4 vs. 74.7 mm²).
The airflow observed within the average geometry of the healthy nasal cavity did not equal the average airflow of the individual geometries. While differences observed for integral measures were notable, the calculated values for the average geometry lay within the distributions of the individual parameters. Spatially resolved parameters differed less prominently.
The aim of this paper is to provide a comprehensive overview of the MICCAI 2020 AutoImplant Challenge. The approaches and publications submitted and accepted within the challenge will be summarized and reported, highlighting common algorithmic trends and algorithmic diversity. Furthermore, the evaluation results will be presented, compared and discussed in regard to the challenge aim: seeking for low cost, fast and fully automated solutions for cranial implant design. Based on feedback from collaborating neurosurgeons, this paper concludes by stating open issues and post-challenge requirements for intra-operative use.
Vertebral labelling and segmentation are two fundamental tasks in an automated spine processing pipeline. Reliable and accurate processing of spine images is expected to benefit clinical decision support systems for diagnosis, surgery planning, and population-based analysis of spine and bone health. However, designing automated algorithms for spine processing is challenging predominantly due to considerable variations in anatomy and acquisition protocols and due to a severe shortage of publicly available data. Addressing these limitations, the Large Scale Vertebrae Segmentation Challenge (VerSe) was organised in conjunction with the International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) in 2019 and 2020, with a call for algorithms tackling the labelling and segmentation of vertebrae. Two datasets containing a total of 374 multi-detector CT scans from 355 patients were prepared and 4505 vertebrae have individually been annotated at voxel level by a human-machine hybrid algorithm (https://osf.io/nqjyw/, https://osf.io/t98fz/). A total of 25 algorithms were benchmarked on these datasets. In this work, we present the results of this evaluation and further investigate the performance variation at the vertebra level, scan level, and different fields of view. We also evaluate the generalisability of the approaches to an implicit domain shift in data by evaluating the top-performing algorithms of one challenge iteration on data from the other iteration. The principal takeaway from VerSe: the performance of an algorithm in labelling and segmenting a spine scan hinges on its ability to correctly identify vertebrae in cases of rare anatomical variations. The VerSe content and code can be accessed at: https://github.com/anjany/verse.