Real Time Simulation of Organ Motions Induced by Breathing: First Evaluation on Patient Data. In: Harders M, Székely G, editors. Biomedical Simulation. Berlin: Springer Berlin Heidelberg; 2006. pp. 9-18. [DOI: 10.1007/11790273_2]

A novel machine learning based computational framework for homogenization of heterogeneous soft materials: application to liver tissue

Real-time simulation of organs increases comfort and safety for patients during the surgery. Proper generalized decomposition (PGD) is an efficient numerical method with coordinate errors below 1 mm and response time below 0.1 s that can be used for simulated surgery. For input of this approach, nonlinear mechanical properties of each segment of the liver need to be calculated based on the geometries of the patient's liver extracted using medical imaging techniques. In this research work, a map of the mechanical properties of the liver tissue has been estimated with a novel combined method of the finite element (FE) optimization. Due to the existence of major-size vessels in the liver that makes the surrounding tissue anisotropic, the simulation of hyperelastic material with two different sections is computationally expensive. Thus, a homogenized, anisotropic, and hyperelastic model with the nearest response to the real heterogeneous model was developed and presented. Because of various possibilities of the vessel orientation, position, and size, homogenization has been carried out for adequate samples of heterogeneous models to train artificial neural networks (ANNs) as machine learning tools. Then, an unknown sample of heterogeneous material was categorized and mapped to its homogenized material parameters with the trained networks for the fast and low-cost generalization of our combined FE optimization method. The results showed the efficiency of the proposed novel machine learning based technique for the prediction of effective material properties of unknown heterogeneous tissues.

Real time 3D visualization of intraoperative organ deformations using structured dictionary

Restricted visualization of the surgical field is one of the most critical challenges for minimally invasive surgery (MIS). Current intraoperative visualization systems are promising. However, they can hardly meet the requirements of high resolution and real time 3D visualization of the surgical scene to support the recognition of anatomic structures for safe MIS procedures. In this paper, we present a new approach for real time 3D visualization of organ deformations based on optical imaging patches with limited field-of-view and a single preoperative scan of magnetic resonance imaging (MRI) or computed tomography (CT). The idea for reconstruction is motivated by our empirical observation that the spherical harmonic coefficients corresponding to distorted surfaces of a given organ lie in lower dimensional subspaces in a structured dictionary that can be learned from a set of representative training surfaces. We provide both theoretical and practical designs for achieving these goals. Specifically, we discuss details about the selection of limited optical views and the registration of partial optical images with a single preoperative MRI/CT scan. The design proposed in this paper is evaluated with both finite element modeling data and ex vivo experiments. The ex vivo test is conducted on fresh porcine kidneys using 3D MRI scans with 1.2 mm resolution and a portable laser scanner with an accuracy of 0.13 mm. Results show that the proposed method achieves a sub-3 mm spatial resolution in terms of Hausdorff distance when using only one preoperative MRI scan and the optical patch from the single-sided view of the kidney. The reconstruction frame rate is between 10 frames/s and 39 frames/s depending on the complexity of the test model.

Bulk modulus and volume variation measurement of the liver and the kidneys in vivo using abdominal kinetics during free breathing

This article presents a method of predictive simulation, patient-dependant, in real time of the abdominal organ positions during free breathing. The method, that considers both influence of the abdominal breathing and thoracic breathing, needs a tracking of the patient skin and a model of the patient-specific modification of the diaphragm shape. From a measurement of the abdomen viscera kinematic during free breathing, we evaluate through a finite element analysis, the stress field sustained by the organs for a hyperelastic mechanical behaviour using large strain theory. From this analysis, we deduce an in vivo Poisson's ratio and a homogeneous bulk modulus of the liver and kidneys, and compare it to the ones in vitro available in the literature.

Clinical evaluation of a respiratory gated guidance system for liver punctures

We have previously proposed a computer guidance system for liver punctures designed for intubated (free breathing) patients. The lack of accuracy reported (1 cm) was mostly due to the breathing motion that was not taken into account. In this paper we modify our system to synchronise the guidance information on the expiratory phases of the patient and present an evaluation on 6 patients of our respiratory gated system. Firstly, we show how a specific choice of patient allows us to rigorously and passively evaluate the system accuracy. Secondly, we demonstrate that our system can provide a guidance information with an error below 5 mm during expiratory phases.