Generación de modelos físicos personalizados y segmentación de la pared arterial y el trombo intraluminal en imágenes de aneurismas aórticos abdominales

Esta tesis doctoral está encuadrada dentro del marco general de la ingeniería biomédica aplicada al tratamiento de las enfermedades cardiovasculares, enfermedades que provocan alrededor de 1.9 millones (40%) de muertes al año en la Unión Europea. En este contexto surge el proyecto europeo SCATh-Smart Catheterization, cuyo objetivo principal es mejorar los procedimientos de cateterismo aórtico introduciendo nuevas tecnologías de planificación y navegación quirúrgica y minimizando el uso de fluoroscopía. En particular, esta tesis aborda el modelado y diagnóstico de aneurismas aórticos abdominales (AAA) y del trombo intraluminal (TIL), allí donde esté presente, así como la segmentación de estas estructuras en imágenes preoperatorias de RM. Los modelos físicos específicos del paciente, construidos a partir de imágenes médicas preoperatorias, tienen múltiples usos, que van desde la evaluación preoperatoria de estructuras anatómicas a la planificación quirúrgica para el guiado de catéteres. En el diagnóstico y tratamiento de AAA, los modelos físicos son útiles a la hora de evaluar diversas variables biomecánicas y fisiológicas de las estructuras vasculares. Existen múltiples técnicas que requieren de la generación de modelos físicos que representen la anatomía vascular. Una de las principales aplicaciones de los modelos físicos es el análisis de elementos finitos (FE). Las simulaciones de FE para AAA pueden ser específicas para el paciente y permiten modelar estados de estrés complejos, incluyendo los efectos provocados por el TIL. La aplicación de métodos numéricos de análisis tiene como requisito previo la generación de una malla computacional que representa la geometría de interés mediante un conjunto de elementos poliédricos, siendo los hexaédricos los que presentan mejores resultados. En las estructuras vasculares, generar mallas hexaédricas es un proceso especialmente exigente debido a la compleja anatomía 3D ramificada. La mayoría de los AAA se encuentran situados en la bifurcación de la arteria aorta en las arterias iliacas y es necesario modelar de manera fiel dicha bifurcación. En el caso de que la sangre se estanque en el aneurisma provocando un TIL, éste forma una estructura adyacente a la pared aórtica. De este modo, el contorno externo del TIL es el mismo que el contorno interno de la pared, por lo que las mallas resultantes deben reflejar esta particularidad, lo que se denomina como "mallas conformadas". El fin último de este trabajo es modelar las estructuras vasculares de modo que proporcionen nuevas herramientas para un mejor diagnóstico clínico, facilitando medidas de riesgo de rotura de la arteria, presión sistólica o diastólica, etc. Por tanto, el primer objetivo de esta tesis es diseñar un método novedoso y robusto para generar mallas hexaédricas tanto de la pared aórtica como del trombo. Para la identificación de estas estructuras se utilizan imágenes de resonancia magnética (RM). Deben mantenerse sus propiedades de adyacencia utilizando elementos de alta calidad, prestando especial atención al modelado de la bifurcación y a que sean adecuadas para el análisis de FE. El método tiene en cuenta la evolución de la línea central del vaso en el espacio tridimensional y genera la malla directamente a partir de las imágenes segmentadas, sin necesidad de reconstruir superficies triangulares. Con el fin de reducir la intervención del usuario en el proceso de generación de las mallas, es también objetivo de esta tesis desarrollar un método de segmentación semiautomática de las distintas estructuras de interés. Las principales contribuciones de esta tesis doctoral son: 1. El diseño, implementación y evaluación de un algoritmo de generación de mallas hexaédricas conformadas de la pared y el TIL a partir de los contornos segmentados en imágenes de RM. Se ha llevado a cabo una evaluación de calidad que determine su aplicabilidad a métodos de FE. Los resultados demuestran que el algoritmo desarrollado genera mallas conformadas de alta calidad incluso en la región de la bifurcación, que son adecuadas para su uso en métodos de análisis de FE. 2. El diseño, implementación y evaluación de un método de segmentación automático de las estructuras de interés. La luz arterial se segmenta de manera semiautomática utilizando un software disponible a partir de imágenes de RM con contraste. Los resultados de este proceso sirven de inicialización para la segmentación automática de las caras interna y externa de la pared aórtica utilizando métodos basado en modelos de textura y forma a partir de imágenes de RM sin contraste. Los resultados demuestran que el algoritmo desarrollado proporciona segmentaciones fieles de las distintas estructuras de interés. En conclusión, el trabajo realizado en esta tesis doctoral corrobora las hipótesis de investigación postuladas, y pretende servir como aportación para futuros avances en la generación de modelos físicos de geometrías biológicas. ABSTRACT The frame of this PhD Thesis is the biomedical engineering applied to the treatment of cardiovascular diseases, which cause around 1.9 million deaths per year in the European Union and suppose about 40% of deaths per year. In this context appears the European project SCATh-Smart Catheterization. The main objective of this project is creating a platform which improves the navigation of catheters in aortic catheterization minimizing the use of fluoroscopy. In the framework of this project, the specific field of this PhD Thesis is the diagnosis and modeling of abdominal aortic aneurysm (AAAs) and the intraluminal thrombus (ILT) whenever it is present. Patient-specific physical models built from preoperative imaging are becoming increasingly important in the area of minimally invasive surgery. These models can be employed for different purposes, such as the preoperatory evaluation of anatomic structures or the surgical planning for catheter guidance. In the specific case of AAA diagnosis and treatment, physical models are especially useful for evaluating pressures over vascular structures. There are multiple techniques that require the generation of physical models which represent the target anatomy. Finite element (FE) analysis is one the principal applications for physical models. FE simulations for AAA may be patient-specific and allow modeling biomechanical and physiological variables including those produced by ILT, and also the segmentation of those anatomical structures in preoperative MR images. Applying numeric methods requires the generation of a proper computational mesh. These meshes represent the patient anatomy using a set of polyhedral elements, with hexahedral elements providing better results. In the specific case of vascular structures, generating hexahedral meshes is a challenging task due to the complex 3D branching anatomy. Each patient’s aneurysm is unique, characterized by its location and shape, and must be accurately represented for subsequent analyses to be meaningful. Most AAAs are located in the region where the aorta bifurcates into the iliac arteries and it is necessary to model this bifurcation precisely and reliably. If blood stagnates in the aneurysm and forms an ILT, it exists as a conforming structure with the aortic wall, i.e. the ILT’s outer contour is the same as the wall’s inner contour. Therefore, resulting meshes must also be conforming. The main objective of this PhD Thesis is designing a novel and robust method for generating conforming hexahedral meshes for the aortic wall and the thrombus. These meshes are built using largely high-quality elements, especially at the bifurcation, that are suitable for FE analysis of tissue stresses. The method accounts for the evolution of the vessel’s centerline which may develop outside a single plane, and generates the mesh directly from segmented images without the requirement to reconstruct triangular surfaces. In order to reduce the user intervention in the mesh generation process is also a goal of this PhD. Thesis to develop a semiautomatic segmentation method for the structures of interest. The segmentation is performed from magnetic resonance image (MRI) sequences that have tuned to provide high contrast for the arterial tissue against the surrounding soft tissue, so that we determine the required information reliably. The main contributions of this PhD Thesis are: 1. The design, implementation and evaluation of an algorithm for generating hexahedral conforming meshes of the arterial wall and the ILT from the segmented contours. A quality inspection has been applied to the meshes in order to determine their suitability for FE methods. Results show that the developed algorithm generates high quality conforming hexahedral meshes even at the bifurcation region. Thus, these meshes are suitable for FE analysis. 2. The design, implementation and evaluation of a semiautomatic segmentation method for the structures of interest. The lumen is segmented in a semiautomatic way from contrast filled MRI using an available software. The results obtained from this process are used to initialize the automatic segmentation of the internal and external faces of the aortic wall. These segmentations are performed by methods based on texture and shape models from MRI with no contrast. The results show that the algorithm provides faithful segmentations of the structures of interest requiring minimal user intervention. In conclusion, the work undertaken in this PhD. Thesis verifies the investigation hypotheses. It intends to serve as basis for future physical model generation of proper biological anatomies used by numerical methods.

Auscultación de presas de hormigón con láser escáner terrestre y modelización de las deformaciones del paramento

Se está produciendo en la geodesia un cambio de paradigma en la concepción de los modelos digitales del terreno, pasando de diseñar el modelo con el menor número de puntos posibles a hacerlo con cientos de miles o millones de puntos. Este cambio ha sido consecuencia de la introducción de nuevas tecnologías como el escáner láser, la interferometría radar y el tratamiento de imágenes. La rápida aceptación de estas nuevas tecnologías se debe principalmente a la gran velocidad en la toma de datos, a la accesibilidad por no precisar de prisma y al alto grado de detalle de los modelos. Los métodos topográficos clásicos se basan en medidas discretas de puntos que considerados en su conjunto forman un modelo; su precisión se deriva de la precisión en la toma singular de estos puntos. La tecnología láser escáner terrestre (TLS) supone una aproximación diferente para la generación del modelo del objeto observado. Las nubes de puntos, producto del escaneo con TLS, pasan a ser tratadas en su conjunto mediante análisis de áreas, de forma que ahora el modelo final no es el resultado de una agregación de puntos sino la de la mejor superficie que se adapta a las nubes de puntos. Al comparar precisiones en la captura de puntos singulares realizados con métodos taquimétricos y equipos TLS la inferioridad de estos últimos es clara; sin embargo es en el tratamiento de las nubes de puntos, con los métodos de análisis basados en áreas, se han obtenido precisiones aceptables y se ha podido considerar plenamente la incorporación de esta tecnología en estudios de deformaciones y movimientos de estructuras. Entre las aplicaciones del TLS destacan las de registro del patrimonio, registro de las fases en la construcción de plantas industriales y estructuras, atestados de accidentes y monitorización de movimientos del terreno y deformaciones de estructuras. En la auscultación de presas, comparado con la monitorización de puntos concretos dentro, en coronación o en el paramento de la presa, disponer de un modelo continuo del paramento aguas abajo de la presa abre la posibilidad de introducir los métodos de análisis de deformaciones de superficies y la creación de modelos de comportamiento que mejoren la comprensión y previsión de sus movimientos. No obstante, la aplicación de la tecnología TLS en la auscultación de presas debe considerarse como un método complementario a los existentes. Mientras que los péndulos y la reciente técnica basada en el sistema de posicionamiento global diferencial (DGPS) dan una información continua de los movimientos de determinados puntos de la presa, el TLS permite ver la evolución estacional y detectar posibles zonas problemáticas en todo el paramento. En este trabajo se analizan las características de la tecnología TLS y los parámetros que intervienen en la precisión final de los escaneos. Se constata la necesidad de utilizar equipos basados en la medida directa del tiempo de vuelo, también llamados pulsados, para distancias entre 100 m y 300 m Se estudia la aplicación del TLS a la modelización de estructuras y paramentos verticales. Se analizan los factores que influyen en la precisión final, como el registro de nubes, tipo de dianas y el efecto conjunto del ángulo y la distancia de escaneo. Finalmente, se hace una comparación de los movimientos dados por los péndulos directos de una presa con los obtenidos del análisis de las nubes de puntos correspondientes a varias campañas de escaneos de la misma presa. Se propone y valida el empleo de gráficos patrón para relacionar las variables precisión o exactitud con los factores distancia y ángulo de escaneo en el diseño de trabajos de campo. Se expone su aplicación en la preparación del trabajo de campo para la realización de una campaña de escaneos dirigida al control de movimientos de una presa y se realizan recomendaciones para la aplicación de la técnica TLS a grandes estructuras. Se ha elaborado el gráfico patrón de un equipo TLS concreto de alcance medio. Para ello se hicieron dos ensayos de campo en condiciones reales de trabajo, realizando escaneos en todo el rango de distancias y ángulos de escaneo del equipo. Se analizan dos métodos para obtener la precisión en la modelización de paramentos y la detección de movimientos de estos: el método del “plano de mejor ajuste” y el método de la “deformación simulada”. Por último, se presentan los resultados de la comparación de los movimientos estacionales de una presa arco-gravedad entre los registrados con los péndulos directos y los obtenidos a partir de los escaneos realizados con un TLS. Los resultados muestran diferencias de milímetros, siendo el mejor de ellos del orden de un milímetro. Se explica la metodología utilizada y se hacen consideraciones respecto a la densidad de puntos de las nubes y al tamaño de las mallas de triángulos. A shift of paradigm in the conception of the survey digital models is taking place in geodesy, moving from designing a model with the fewer possible number of points to models of hundreds of thousand or million points. This change has happened because of the introduction of new technologies like the laser scanner, the interferometry radar and the processing of images. The fast acceptance of these new technologies has been due mainly to the great speed getting the data, to the accessibility as reflectorless technique, and to the high degree of detail of the models. Classic survey methods are based on discreet measures of points that, considered them as a whole, form a model; the precision of the model is then derived from the precision measuring the single points. The terrestrial laser scanner (TLS) technology supposes a different approach to the model generation of the observed object. Point cloud, the result of a TLS scan, must be treated as a whole, by means of area-based analysis; so, the final model is not an aggregation of points but the one resulting from the best surface that fits with the point cloud. Comparing precisions between the one resulting from the capture of singular points made with tachometric measurement methods and with TLS equipment, the inferiority of this last one is clear; but it is in the treatment of the point clouds, using area-based analysis methods, when acceptable precisions have been obtained and it has been possible to consider the incorporation of this technology for monitoring structures deformations. Among TLS applications it have to be emphasized those of registry of the cultural heritage, stages registry during construction of industrial plants and structures, police statement of accidents and monitorization of land movements and structures deformations. Compared with the classical dam monitoring, approach based on the registry of a set of points, the fact having a continuous model of the downstream face allows the possibility of introducing deformation analysis methods and behavior models that would improve the understanding and forecast of dam movements. However, the application of TLS technology for dam monitoring must be considered like a complementary method with the existing ones. Pendulums and recently the differential global positioning system (DGPS) give a continuous information of the movements of certain points of the dam, whereas TLS allows following its seasonal evolution and to detect damaged zones of the dam. A review of the TLS technology characteristics and the factors affecting the final precision of the scanning data is done. It is stated the need of selecting TLS based on the direct time of flight method, also called pulsed, for scanning distances between 100m and 300m. Modelling of structures and vertical walls is studied. Factors that influence in the final precision, like the registry of point clouds, target types, and the combined effect of scanning distance and angle of incidence are analyzed. Finally, a comparison among the movements given by the direct pendulums of a dam and the ones obtained from the analysis of point clouds is done. A new approach to obtain a complete map-type plot of the precisions of TLS equipment based on the direct measurement of time of flight method at midrange distances is presented. Test were developed in field-like conditions, similar to dam monitoring and other civil engineering works. Taking advantage of graphic semiological techniques, a “distance - angle of incidence” map based was designed and evaluated for field-like conditions. A map-type plot was designed combining isolines with sized and grey scale points, proportional to the precision values they represent. Precisions under different field conditions were compared with specifications. For this purpose, point clouds were evaluated under two approaches: the standar "plane-of-best-fit" and the proposed "simulated deformation”, that showed improved performance. These results lead to a discussion and recommendations about optimal TLS operation in civil engineering works. Finally, results of the comparison of seasonal movements of an arc-gravity dam between the registered by the direct pendulums ant the obtained from the TLS scans, are shown. The results show differences of millimeters, being the best around one millimeter. The used methodology is explained and considerations with respect to the point cloud density and to the size of triangular meshes are done.

A two-dimensional finite element model of front surface current flow in cells under non-uniform, concentrated illumination

A two-dimensional finite element model of current flow in the front surface of a PV cell is presented. In order to validate this model we perform an experimental test. Later, particular attention is paid to the effects of non-uniform illumination in the finger direction which is typical in a linear concentrator system. Fill factor, open circuit voltage and efficiency are shown to decrease with increasing degree of non-uniform illumination. It is shown that these detrimental effects can be mitigated significantly by reoptimization of the number of front surface metallization fingers to suit the degree of non-uniformity. The behavior of current flow in the front surface of a cell operating at open circuit voltage under non-uniform illumination is discussed in detail.

A simplified energy consumption model for fiber-based Next Generation Access Networks

ICTs account nowadays for 2% of total carbon emissions. However, in a time when strict measures to reduce energyconsumption in all the industrial and services sectors are required, the ICT sector faces an increase in services and bandwidth demand. The deployment of NextGenerationNetworks (NGN) will be the answer to this new demand and specifically, the NextGenerationAccessNetworks (NGANs) will provide higher bandwidth access to users. Several policy and cost analysis are being carried out to understand the risks and opportunities of new deployments, though the question of which is the role of energyconsumption in NGANs seems off the table. Thus, this paper proposes amodel to analyze the energyconsumption of the main fiber-based NGAN architectures, i.e. Fiber To The House (FTTH) in both Passive Optical Network (PON) and Point-to-Point (PtP) variations, and FTTx/VDSL. The aim of this analysis is to provide deeper insight on the impact of new deployments on the energyconsumption of the ICT sector and the effects of energyconsumption on the life-cycle cost of NGANs. The paper presents also an energyconsumption comparison of the presented architectures, particularized in the specific geographic and demographic distribution of users of Spain, but easily extendable to other countries.

Column Generation Algorithms for Nonlinear Optimization II: Numerical Investigations

García et al. present a class of column generation (CG) algorithms for nonlinear programs. Its main motivation from a theoretical viewpoint is that under some circumstances, finite convergence can be achieved, in much the same way as for the classic simplicial decomposition method; the main practical motivation is that within the class there are certain nonlinear column generation problems that can accelerate the convergence of a solution approach which generates a sequence of feasible points. This algorithm can, for example, accelerate simplicial decomposition schemes by making the subproblems nonlinear. This paper complements the theoretical study on the asymptotic and finite convergence of these methods given in [1] with an experimental study focused on their computational efficiency. Three types of numerical experiments are conducted. The first group of test problems has been designed to study the parameters involved in these methods. The second group has been designed to investigate the role and the computation of the prolongation of the generated columns to the relative boundary. The last one has been designed to carry out a more complete investigation of the difference in computational efficiency between linear and nonlinear column generation approaches. In order to carry out this investigation, we consider two types of test problems: the first one is the nonlinear, capacitated single-commodity network flow problem of which several large-scale instances with varied degrees of nonlinearity and total capacity are constructed and investigated, and the second one is a combined traffic assignment model

A Simplified Energy Consumption Model for Fibre-Based Next Generation Access Networks

Presentación realizada en el PhD Seminar del ITS 2011 en Budapest. ICTs (Information and Communication Technologies) currently account for 2% of total carbon emissions. However, although modern standards require strict measures to reduce energy consumption across all industrial and services sectors, the ICT sector also faces an increase in services and bandwidth demand. The deployment of Next Generation Networks (NGN) will be the answer to this new demand; more specifically, Next Generation Access Networks (NGANs) will provide higher bandwidth access to users. Several policy and cost analyses are being carried out to understand the risks and opportunities of new deployments, but the question of what role energy consumption plays in NGANs seems off the table. Thus, this paper proposes a model to analyse the energy consumption of the main fibre-based NGAN architectures: Fibre To The House (FTTH), in both Passive Optical Network (PON) and Point-to-Point (PtP) variations, and FTTx/VDSL. The aim of this analysis is to provide deeper insight on the impact of new deployments on the energy consumption of the ICT sector and the effects of energy consumption on the life-cycle cost of NGANs. The paper also presents an energy consumption comparison of the presented architectures, particularised to the specific geographic and demographic distribution of users of Spain but easily extendable to other countries.

Automatic generation of real-time deformable parametric model of the aorta for a VR-based catheterism guidance system

The purpose of this work is twofold: first, to develop a process to automatically create parametric models of the aorta that can adapt to any possible intraoperative deformation of the vessel. Second, it intends to provide the tools needed to perform this deformation in real time, by means of a non-rigid registration method. This dynamically deformable model will later be used in a VR-based surgery guidance system for aortic catheterism procedures, showing the vessel changes in real time.

Finite Element Analysis Model of a Contactless Transformer for Battery Chargers in Electric Vehicles

A contactless transformer model is proposed in this paper using Finite Element Analysis (FEA). This model can be used to simulate Inductive Coupling Power Transfer (ICPT) systems with good accuracy of the transformer and reduce the fabrication time of these systems. The model not only takes into account the geometry of the windings but also the frequency effects in them. As the transformer does not have a magnetic core, it is complicated to model because the flux is expanded in the area around the windings. In order to obtain a very accurate model, it is necessary to use a 2D/3D field solver.

How much energy will your NGN consume? A model for energy consumption in next generation access networks: The case of Spain

The contribution to global energy consumption of the information and communications technology (ICT) sector has increased considerably in the last decade, along with its growing relevance to the overall economy. This trend will continue due to the seemingly ever greater use of these technologies, with broadband data traffic generated by the usage of telecommunication networks as a primary component. In fact, in response to user demand, the telecommunications industry is initiating the deployment of next generation networks (NGNs). However, energy consumption is mostly absent from the debate on these deployments, in spite of the potential impact on both expenses and sustainability. In addition, consumers are unaware of the energy impact of their choices in ultra-broadband services. This paper focuses on forecasting energy consumption in the access part of NGNs by modelling the combined effect of the deployment of two different ultra-broadband technologies (FTTH-GPON and LTE), the evolution of traffic per user, and the energy consumption in each of the networks and user devices. Conclusions are presented on the levels of energy consumption, their cost and the impact of different network design parameters. The effect of technological developments, techno-economic and policy decisions on energy consumption is highlighted. On the consumer side, practical figures and comparisons across technologies are provided. Although the paper focuses on Spain, the analysis can be extended to similar countries.

An embedded cohesive crack model for finite element analysis of quasi-brittle materials

This paper presents a numerical implementation of the cohesive crack model for the anal-ysis of quasibrittle materials based on the strong discontinuity approach in the framework of the finite element method. A simple central force model is used for the stress versus crack opening curve. The additional degrees of freedom defining the crack opening are determined at the crack level, thus avoiding the need for performing a static condensation at the element level. The need for a tracking algorithm is avoided by using a consistent pro-cedure for the selection of the separated nodes. Such a model is then implemented into a commercial program by means of a user subroutine, consequently being contrasted with the experimental results. The model takes into account the anisotropy of the material. Numerical simulations of well-known experiments are presented to show the ability of the proposed model to simulate the fracture of quasibrittle materials such as mortar, concrete and masonry.

AALUMO: a user model ontology for ambient assisted living services supported in next-generation networks

Ambient Assisted Living (AAL) services are emerging as context-awareness solutions to support elderly people?s autonomy. The context-aware paradigm makes applications more user-adaptive. In this way, context and user models expressed in ontologies are employed by applications to describe user and environment characteristics. The rapid advance of technology allows creating context server to relieve applications of context reasoning techniques. Specifically, the Next Generation Networks (NGN) provides by means of the presence service a framework to manage the current user's state as well as the user's profile information extracted from Internet and mobile context. This paper propose a user modeling ontology for AAL services which can be deployed in a NGN environment with the aim at adapting their functionalities to the elderly's context information and state.

A dynamic factor model for mid-term forecasting of wind power generation

The main objective of this paper is the development and application of multivariate time series models for forecasting aggregated wind power production in a country or region. Nowadays, in Spain, Denmark or Germany there is an increasing penetration of this kind of renewable energy, somehow to reduce energy dependence on the exterior, but always linked with the increaseand uncertainty affecting the prices of fossil fuels. The disposal of accurate predictions of wind power generation is a crucial task both for the System Operator as well as for all the agents of the Market. However, the vast majority of works rarely onsider forecasting horizons longer than 48 hours, although they are of interest for the system planning and operation. In this paper we use Dynamic Factor Analysis, adapting and modifying it conveniently, to reach our aim: the computation of accurate forecasts for the aggregated wind power production in a country for a forecasting horizon as long as possible, particularly up to 60 days (2 months). We illustrate this methodology and the results obtained for real data in the leading country in wind power production: Denmark

A gradient-enhanced continuum damage model with application to fibre-reinforced tissues at finite strains

A non-local gradient-based damage formulation within a geometrically non-linear set- ting is presented. The hyperelastic constitutive response at local material point level is governed by a strain energy function which is additively composed by an isotropic neo-Hookean matrix and by an anisotropic fibre-reinforced material based on the model proposed by T. Gasser, R. Ogden, and G. Holzapfel.

Finite Element Model of the Innovation Diffusion: An Application to Photovoltaic Systems

This paper presents a Finite Element Model, which has been used for forecasting the diffusion of innovations in time and space. Unlike conventional models used in diffusion literature, the model considers the spatial heterogeneity. The implementation steps of the model are explained by applying it to the case of diffusion of photovoltaic systems in a local region in southern Germany. The applied model is based on a parabolic partial differential equation that describes the diffusion ratio of photovoltaic systems in a given region over time. The results of the application show that the Finite Element Model constitutes a powerful tool to better understand the diffusion of an innovation as a simultaneous space-time process. For future research, model limitations and possible extensions are also discussed.