Non-photorealistic rendering of virtual implant models for computer-assisted fluoroscopy-based surgical procedures

Surgical navigation systems visualize the positions and orientations of surgical instruments and implants as graphical overlays onto a medical image of the operated anatomy on a computer monitor. The orthopaedic surgical navigation systems could be categorized according to the image modalities that are used for the visualization of surgical action. In the so-called CT-based systems or 'surgeon-defined anatomy' based systems, where a 3D volume or surface representation of the operated anatomy could be constructed from the preoperatively acquired tomographic data or through intraoperatively digitized anatomy landmarks, a photorealistic rendering of the surgical action has been identified to greatly improve usability of these navigation systems. However, this may not hold true when the virtual representation of surgical instruments and implants is superimposed onto 2D projection images in a fluoroscopy-based navigation system due to the so-called image occlusion problem. Image occlusion occurs when the field of view of the fluoroscopic image is occupied by the virtual representation of surgical implants or instruments. In these situations, the surgeon may miss part of the image details, even if transparency and/or wire-frame rendering is used. In this paper, we propose to use non-photorealistic rendering to overcome this difficulty. Laboratory testing results on foamed plastic bones during various computer-assisted fluoroscopybased surgical procedures including total hip arthroplasty and long bone fracture reduction and osteosynthesis are shown.

Testing isotherm models and recovering empirical relationships for adsorption in microporous carbons using virtual carbon models and grand canonical Monte Carlo simulations

Using the plausible model of activated carbon proposed by Harris and co-workers and grand canonical Monte Carlo simulations, we study the applicability of standard methods for describing adsorption data on microporous carbons widely used in adsorption science. Two carbon structures are studied, one with a small distribution of micropores in the range up to 1 nm, and the other with micropores covering a wide range of porosity. For both structures, adsorption isotherms of noble gases (from Ne to Xe), carbon tetrachloride and benzene are simulated. The data obtained are considered in terms of Dubinin-Radushkevich plots. Moreover, for benzene and carbon tetrachloride the temperature invariance of the characteristic curve is also studied. We show that using simulated data some empirical relationships obtained from experiment can be successfully recovered. Next we test the applicability of Dubinin's related models including the Dubinin-Izotova, Dubinin-Radushkevich-Stoeckli, and Jaroniec-Choma equations. The results obtained demonstrate the limits and applications of the models studied in the field of carbon porosity characterization.

Validity of an automatic measure protocol in distal femur for allograft selection from a three-dimensional virtual bone bank system

Osteoarticular allograft is one possible treatment in wide surgical resections with large defects. Performing best osteoarticular allograft selection is of great relevance for optimal exploitation of the bone databank, good surgery outcome and patient’s recovery. Current approaches are, however, very time consuming hindering these points in practice. We present a validation study of a software able to perform automatic bone measurements used to automatically assess the distal femur sizes across a databank. 170 distal femur surfaces were reconstructed from CT data and measured manually using a size measure protocol taking into account the transepicondyler distance (A), anterior-posterior distance in medial condyle (B) and anterior-posterior distance in lateral condyle (C). Intra- and inter-observer studies were conducted and regarded as ground truth measurements. Manual and automatic measures were compared. For the automatic measurements, the correlation coefficients between observer one and automatic method, were of 0.99 for A measure and 0.96 for B and C measures. The average time needed to perform the measurements was of 16 h for both manual measurements, and of 3 min for the automatic method. Results demonstrate the high reliability and, most importantly, high repeatability of the proposed approach, and considerable speed-up on the planning.

Pathomorphologic alterations predict presence or absence of hip osteoarthrosis

Abnormal morphology of the hip has been associated with primary osteoarthrosis. We evaluated the morphology of 464 consecutive hips contralateral to hips treated by THA. We excluded all hips with known diagnoses leading to secondary osteoarthritis and all hips with advanced arthrosis to eliminate the effect of arthritic remodeling on the morphologic measurements. Of the remaining 119 hips, 25 were in patients aged 60 years or older who had no or mild arthrosis (Tönnis Grade 0 or 1) and 94 hips had Tönnis Grade 2 osteoarthrosis. We quantified morphologic parameters on plain radiographs and CT images and simulated range of motion using virtual bone models from the CT data. The nonarthritic hips had fewer pathomorphologic findings. High alpha angles and high lateral center edge angles were strongly associated with the presence of arthritis; decreased internal and external rotation in 90 degrees flexion showed lesser correlation. The data confirm previous observations that abnormal hip morphology predates arthrosis and is not secondary to the osteoarthritic process. Hips at risk for developing arthrosis resulting from pathomorphologic changes may potentially be identified at the cessation of growth, long before the development of osteoarthrosis.

Evidence Based Development of a Novel Lateral Fibula Plate (VariAx Fibula) Using a Real CT Bone Data Based Optimization Process During Device Development

Development of novel implants in orthopaedic trauma surgery is based on limited datasets of cadaver trials or artificial bone models. A method has been developed whereby implants can be constructed in an evidence based method founded on a large anatomic database consisting of more than 2.000 datasets of bones extracted from CT scans. The aim of this study was the development and clinical application of an anatomically pre-contoured plate for the treatment of distal fibular fractures based on the anatomical database. 48 Caucasian and Asian bone models (left and right) from the database were used for the preliminary optimization process and validation of the fibula plate. The implant was constructed to fit bilaterally in a lateral position of the fibula. Then a biomechanical comparison of the designed implant to the current gold standard in the treatment of distal fibular fractures (locking 1/3 tubular plate) was conducted. Finally, a clinical surveillance study to evaluate the grade of implant fit achieved was performed. The results showed that with a virtual anatomic database it was possible to design a fibula plate with an optimized fit for a large proportion of the population. Biomechanical testing showed the novel fibula plate to be superior to 1/3 tubular plates in 4-point bending tests. The clinical application showed a very high degree of primary implant fit. Only in a small minority of cases further intra-operative implant bending was necessary. Therefore, the goal to develop an implant for the treatment of distal fibular fractures based on the evidence of a large anatomical database could be attained. Biomechanical testing showed good results regarding the stability and the clinical application confirmed the high grade of anatomical fit.

Reconstrução e geração de malhas em estruturas biomecânicas tridimensionais para análise por elemento finitos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

3D facial merging for virtual human reconstruction

There is an increasing need of easy and affordable technologies to automatically generate virtual 3D models from their real counterparts. In particular, 3D human reconstruction has driven the creation of many clever techniques, most of them based on the visual hull (VH) concept. Such techniques do not require expensive hardware; however, they tend to yield 3D humanoids with realistic bodies but mediocre faces, since VH cannot handle concavities. On the other hand, structured light projectors allow to capture very accurate depth data, and thus to reconstruct realistic faces, but they are too expensive to use several of them. We have developed a technique to merge a VH-based 3D mesh of a reconstructed humanoid and the depth data of its face, captured by a single structured light projector. By combining the advantages of both systems in a simple setting, we are able to reconstruct realistic 3D human models with believable faces.

Augmented and Virtual Reality techniques for footwear

The use of 3D imaging techniques has been early adopted in the footwear industry. In particular, 3D imaging could be used to aid commerce and improve the quality and sales of shoes. Footwear customization is an added value aimed not only to improve product quality, but also consumer comfort. Moreover, customisation implies a new business model that avoids the competition of mass production coming from new manufacturers settled mainly in Asian countries. However, footwear customisation implies a significant effort at different levels. In manufacturing, rapid and virtual prototyping is required; indeed the prototype is intended to become the final product. The whole design procedure must be validated using exclusively virtual techniques to ensure the feasibility of this process, since physical prototypes should be avoided. With regard to commerce, it would be desirable for the consumer to choose any model of shoes from a large 3D database and be able to try them on looking at a magic mirror. This would probably reduce costs and increase sales, since shops would not require storing every shoe model and the process of trying several models on would be easier and faster for the consumer. In this paper, new advances in 3D techniques coming from experience in cinema, TV and games are successfully applied to footwear. Firstly, the characteristics of a high-quality stereoscopic vision system for footwear are presented. Secondly, a system for the interaction with virtual footwear models based on 3D gloves is detailed. Finally, an augmented reality system (magic mirror) is presented, which is implemented with low-cost computational elements that allow a hypothetical customer to check in real time the goodness of a given virtual footwear model from an aesthetical point of view.

When the virtual influences reality. The conservation project of the toledo gate in ciudad real (Spain)

The Toledo Gate of Ciudad Real, Spain, constructed between the late 13th and early 14th centuries, is the last remaining portion of a once complete medieval city wall. It represents the long history of the city and constitutes its main heritage symbol, dividing the historic city centre from the later 19th and 20th century expansions. In October 2012, the Town Hall and the Montemadrid Foundation started the conservation works to preserve this important monument. The preliminary phase of this project included an in-depth series of scientific studies which were carried out by a multidisciplinary team focusing on archival research, historic investigations, archaeological excavations as well as material composition analysis and main treatment application tests. As a result of these studies a series of virtual 3D models were created to inform, discuss and study the monument. A first digital model permitted visualization of the gate in the 19th century and how the main entrance to the city was integrated as a fundamental part of the city walls. This virtual reconstruction also became an important part of the campaign to raise awareness among the citizens towards a monument that had remained in the shadows for the last century, isolated in a roundabout after the systematic demolition of the city walls in the late 19th century. Over the last three years and as a result of these archaeological and historic investigations and subsequent virtual models, surprisingly new and interesting data were brought to light thus permitting the establishment and corroboration of a new and updated hypothesis of the Toledo Gate that goes beyond the previous ideas. As a result of these studies a new architectural typology with construction techniques of has been suggested. This paper describes how the results of this continuous and interdisciplinary documentation process have benefitted from a computer graphic reconstruction of the gate. It highlights how virtual reconstruction can be a powerful tool for conservation decision making and awareness raising. Furthermore, the interesting results of the final reconstruction hypothesis convinced the technical team responsible for the conservation to alter some aspects of the final project physical interventions in order to focus on some of the features and conclusions discovered through the virtual model study.

3D Printing and bioprinting of osteomimetic materials for 3D in vitro models and tissue repair applications

Bone disorders have severe impact on body functions and quality life, and no satisfying therapies exist yet. The current models for bone disease study are scarcely predictive and the options existing for therapy fail for complex systems. To mimic and/or restore bone, 3D printing/bioprinting allows the creation of 3D structures with different materials compositions, properties, and designs. In this study, 3D printing/bioprinting has been explored for (i) 3D in vitro tumor models and (ii) regenerative medicine. Tumor models have been developed by investigating different bioinks (i.e., alginate, modified gelatin) enriched by hydroxyapatite nanoparticles to increase printing fidelity and increase biomimicry level, thus mimicking the organic and inorganic phase of bone. High Saos-2 cell viability was obtained, and the promotion of spheroids clusters as occurring in vivo was observed. To develop new syntethic bone grafts, two approaches have been explored. In the first, novel magnesium-phosphate scaffolds have been investigated by extrusion-based 3D printing for spinal fusion. 3D printing process and parameters have been optimized to obtain custom-shaped structures, with competent mechanical properties. The 3D printed structures have been combined to alginate porous structures created by a novel ice-templating technique, to be loaded by antibiotic drug to address infection prevention. Promising results in terms of planktonic growth inhibition was obtained. In the second strategy, marine waste precursors have been considered for the conversion in biogenic HA by using a mild-wet conversion method with different parameters. The HA/carbonate ratio conversion efficacy was analysed for each precursor (by FTIR and SEM), and the best conditions were combined to alginate to develop a composite structure. The composite paste was successfully employed in custom-modified 3D printer for the obtainment of 3D printed stable scaffolds. In conclusion, the osteomimetic materials developed in this study for bone models and synthetic grafts are promising in bone field.

A 3D computer assisted Orthopedic Surgery Planning approach based on planar radiography

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Informática Médica)

Aspects on Process Engineering in the Finnish Pulp and Paper Industry : Thesis for the Degree of Licentiate in Science of Technology

Process development will be largely driven by the main equipment suppliers. The reason for this development is their ambition to supply complete plants or process systems instead of single pieces of equipment. The pulp and paper companies' interest lies in product development, as their main goal is to create winning brands and effective brand management. Design engineering companies will find their niche in detail engineering based on approved process solutions. Their development work will focus on increasing the efficiency of engineering work. Process design is a content-producing profession, which requires certain special characteristics: creativity, carefulness, the ability to work as a member of a design team according to time schedules and fluency in oral as well as written presentation. In the future, process engineers will increasingly need knowledge of chemistry as well as information and automation technology. Process engineering tools are developing rapidly. At the moment, these tools are good enough for static sizing and balancing, but dynamic simulation tools are not yet good enough for the complicated chemical reactions of pulp and paper chemistry. Dynamic simulation and virtual mill models are used as tools for training the operators. Computational fluid dynamics will certainlygain ground in process design.

Rapid prototyping and inclined plane technique in the treatment of maxillofacial malformations in a fox

An approximately 9-month-old fox (Pseudalopex ventulus) was presented With malocclusion and deviation of the lower jaw to the right side. Orthodontic treatment was performed using the inclined plane technique. Virtual 3D models and prototypes of the head were based on computed tomography (CT) image data to assist in diagnosis and treatment.

Rapid Prototyping applied to surgical planning for correcting craniofacial malformations in wild animals. A case study of a brazilian fox

Veterinary surgery for treatment of wild animals is becoming an increasingly demanding task because it involves animals of different anatomy, many of them are already stressed and treatment must be performed to the highest standard in the minimum period of time. Craniofacial alterations may occur for three main reasons: genetic, functional or a combination of both. It is possible to modify the functional cause using intraoral devices like inclined plane. The treatment planning can be made based on virtual 3D models and rapid prototyping. An approximately 9 months old, 3.7 kg male Brazilian fox (Lycalopex vetulus) was referred to the Veterinary Hospital. Physical examination showed malocclusion with a deviation of the mandible to the right side. The virtual 3D model of the head was generated based on CT image data. The 3D models and rapid prototyping opened up new possibilities for the surgical planning and treatment of wild animals.