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Fougeron N, Oddes Z, Ashkenazi A, Solav D. Identification of constitutive materials of bi-layer soft tissues from multimodal indentations. J Mech Behav Biomed Mater 2024; 155:106572. [PMID: 38754153 DOI: 10.1016/j.jmbbm.2024.106572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/19/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
The personalisation of finite element models is an important problem in the biomechanical fields where subject-specific analyses are fundamental, particularly in studying soft tissue mechanics. The personalisation includes the choice of the constitutive law of the model's material, as well as the choice of the material parameters. In vivo identification of the material properties of soft tissues is challenging considering the complex behaviour of soft tissues that are, among other things, non-linear hyperelastic and heterogeneous. Hybrid experimental-numerical methods combining in vivo indentations and inverse finite element analyses are common to identify these material parameters. Yet, the uniqueness and the uncertainty of the multi-material hyperelastic model have not been evaluated. This study presents a sensitivity analysis performed on synthetic indentation data to investigate the identification uncertainties of the material parameters in a bi-material thigh phantom. Synthetic numerical data, used to replace experimental measurements, considered several measurement modalities: indenter force and displacement, stereo-camera 3D digital image correlation of the indented surface, and ultrasound B-mode images. A finite element model of the indentation was designed with either Ogden-Moerman or Mooney-Rivlin constitutive laws for both materials. The parameters' identifiability (i.e. the possibility of converging to a unique parameter set within an acceptable margin of error) was assessed with various cost functions formulated using the different synthetic data sets. The results underline the need for multiple experimental modalities to reduce the uncertainty of the identified parameters. Additionally, the experimental error can impede the identification of a unique parameter set, and the cost function depends on the constitutive law. This study highlights the need for sensitivity analyses before the design of the experimental protocol. Such studies can also be used to define the acceptable range of errors in the experimental measurement. Eventually, the impact of the evaluated uncertainty of the identified parameters should be further investigated according to the purpose of the finite element modelling.
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Affiliation(s)
- Nolwenn Fougeron
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel.
| | - Zohar Oddes
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel
| | - Amit Ashkenazi
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel
| | - Dana Solav
- Faculty of Mechanical Engineering, Technion Institute of Technology, Haifa, Israel
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Sahrmann AS, Handsfield GG, Gizzi L, Gerlach J, Verl A, Besier TF, Rohrle O. A System for Reproducible 3D Ultrasound Measurements of Skeletal Muscles. IEEE Trans Biomed Eng 2024; 71:2022-2032. [PMID: 38285583 DOI: 10.1109/tbme.2024.3359854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
In 3D freehand ultrasound imaging, operator dependent variations in applied forces and movements can lead to errors in the reconstructed images. In this paper, we introduce an automated 3D ultrasound system, which enables acquisitions with controlled movement trajectories by using motors, which electrically move the probe. Due to integrated encoders there is no need of position sensors. An included force control mechanism ensures a constant contact force to the skin. We conducted 8 trials with the automated 3D ultrasound system on 2 different phantoms with 3 force settings and 10 trials on a human tibialis anterior muscle with 2 force settings. For comparison, we also conducted 8 freehand 3D ultrasound scans from 2 operators (4 force settings) on one phantom and 10 with one operator on the tibialis anterior muscle. Both freehand and automated trials showed small errors in volume and length computations of the reconstructions, however the freehand trials showed larger standard deviations. We also computed the thickness of the phantom and the tibialis anterior muscle. We found significant differences in force settings for the operators and higher coefficients of variation for the freehand trials. Overall, the automated 3D ultrasound system shows a high accuracy in reconstruction. Due to the smaller coefficients of variation, the automated 3D ultrasound system enables more reproducible ultrasound examinations than the freehand scanning. Therefore, the automated 3D ultrasound system is a reliable tool for 3D investigations of skeletal muscle.
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Sai H, Xu Z, Xia C, Wang L, Zhang J. Lightweight Force-Controlled Device for Freehand Ultrasound Acquisition. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:944-960. [PMID: 37028093 DOI: 10.1109/tuffc.2023.3252015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study investigates a force-controlled auxiliary device for freehand ultrasound (US) examinations. The designed device allows sonographers to maintain a steady target pressure on the US probe, thereby improving the US image quality and reproducibility. The use of a screw motor to power the device and a Raspberry Pi as the system controller results in a lightweight and portable device, while a screen enhances user-interactivity. Using gravity compensation, error compensation, an adaptive proportional-integral-derivative algorithm, and low-pass signal filtering, the designed device provides highly accurate force control. Several experiments using the developed device, including clinical trials relating to the jugular and superficial femoral veins, validate its utility in ensuring the desired pressure in response to varying environments and prolonged US examinations, enabling low or high pressures to be maintained and lowering the threshold of clinical experience. Moreover, the experimental results show that the designed device effectively relieves the stress on the sonographer's hand joints during US examinations and enables rapid assessment of the tissue elasticity characteristics. With automatic pressure tracking between probe and patient, the proposed device offers potentially significant benefits for the reproducibility and stability of US images and the health of sonographers.
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Sai H, Wang L, Zhang J, Xia C, Xu Z. Portable Device to Assist With Force Control in Ultrasound Acquisition. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:930-943. [PMID: 35675230 DOI: 10.1109/tuffc.2022.3181287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study presents a portable device that ensures precise contact force between a subject and a probe to improve the stability and reproducibility of ultrasound (US) acquisition. The mechanical portion of the device includes a servo motor, gears, and a ball screw linear actuator; two photoelectric switches are used to limit the stroke. A combined force and position control system is developed, and a pressure threshold is introduced to reduce the chattering of the system so that it can be applied to US examinations of tissues of different stiffness levels. Force control experiments were conducted on the device, and the results showed that the device can overcome the chattering of a physician's hand and movement caused by a subject's respiration. Additionally, the stability of the US acquisition was substantially improved. Based on clinical trials on humans, this device was observed to improve the consistency of ultrasonic results and the repeatability of images, and it assisted sonographers with maintaining suitable contact force and improving imaging quality. The device can either be handheld by a physician or easily integrated with a manipulator as an autonomous robotic US acquisition device, thereby validating its potential for US applications.
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Neumann EE, Doherty S, Bena J, Erdemir A. Role of multi-layer tissue composition of musculoskeletal extremities for prediction of in vivo surface indentation response and layer deformations. PLoS One 2023; 18:e0284721. [PMID: 37083580 PMCID: PMC10121013 DOI: 10.1371/journal.pone.0284721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023] Open
Abstract
Emergent mechanics of musculoskeletal extremities (surface indentation stiffness and tissue deformation characteristics) depend on the underlying composition and mechanics of each soft tissue layer (i.e. skin, fat, and muscle). Limited experimental studies have been performed to explore the layer specific relationships that contribute to the surface indentation response. The goal of this study was to examine through statistical modeling how the soft tissue architecture contributed to the aggregate mechanical surface response across 8 different sites of the upper and lower extremities. A publicly available dataset was used to examine the relationship of soft tissue thickness (fat and muscle) to bulk tissue surface compliance. Models required only initial tissue layer thicknesses, making them usable in the future with only a static ultrasound image. Two physics inspired models (series of linear springs), which allowed reduced statistical representations (combined locations and location specific), were explored to determine the best predictability of surface compliance and later individual layer deformations. When considering the predictability of the experimental surface compliance, the physics inspired combined locations model showed an improvement over the location specific model (percent difference of 25.4 +/- 27.9% and 29.7 +/- 31.8% for the combined locations and location specific models, respectively). While the statistical models presented in this study show that tissue compliance relies on the individual layer thicknesses, it is clear that there are other variables that need to be accounted for to improve the model. In addition, the individual layer deformations of fat and muscle tissues can be predicted reasonably well with the physics inspired models, however additional parameters may improve the robustness of the model outcomes, specifically in regard to capturing subject specificity.
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Affiliation(s)
- Erica E Neumann
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - Sean Doherty
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
| | - James Bena
- Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States of America
| | - Ahmet Erdemir
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States of America
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Doherty S, Landis B, Owings TM, Erdemir A. Template models for simulation of surface manipulation of musculoskeletal extremities. PLoS One 2022; 17:e0272051. [PMID: 35969593 PMCID: PMC9377586 DOI: 10.1371/journal.pone.0272051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/12/2022] [Indexed: 11/18/2022] Open
Abstract
Capturing the surface mechanics of musculoskeletal extremities would enhance the realism of life-like mechanics imposed on the limbs within surgical simulations haptics. Other fields that rely on surface manipulation, such as garment or prosthetic design, would also benefit from characterization of tissue surface mechanics. Eight homogeneous tissue models were developed for the upper and lower legs and arms of two donors. Ultrasound indentation data was used to drive an inverse finite element analysis for individualized determination of region-specific material coefficients for the lumped tissue. A novel calibration strategy was implemented by using a ratio based adjustment of tissue properties from linear regression of model predicted and experimental responses. This strategy reduced requirement of simulations to an average of under four iterations. These free and open-source specimen-specific models can serve as templates for simulations focused on mechanical manipulations of limb surfaces.
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Affiliation(s)
- Sean Doherty
- Department of Biomedical Engineering and Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Ben Landis
- Department of Biomedical Engineering and Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Tammy M. Owings
- Department of Biomedical Engineering and Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Ahmet Erdemir
- Department of Biomedical Engineering and Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
- * E-mail:
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Chen X, Chen H, Peng Y, Tao D. Probe Sector Matching for Freehand 3D Ultrasound Reconstruction. SENSORS (BASEL, SWITZERLAND) 2020; 20:E3146. [PMID: 32498321 PMCID: PMC7308927 DOI: 10.3390/s20113146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/26/2020] [Accepted: 05/28/2020] [Indexed: 11/16/2022]
Abstract
A 3D ultrasound image reconstruction technique, named probe sector matching (PSM), is proposed in this paper for a freehand linear array ultrasound probe equipped with multiple sensors, providing the position and attitude of the transducer and the pressure between the transducer and the target surface. The proposed PSM method includes three main steps. First, the imaging target and the working range of the probe are set to be the center and the radius of the imaging field of view, respectively. To reconstruct a 3D volume, the positions of all necessary probe sectors are pre-calculated inversely to form a sector database. Second, 2D cross-section probe sectors with the corresponding optical positioning, attitude and pressure information are collected when the ultrasound probe is moving around the imaging target. Last, an improved 3D Hough transform is used to match the plane of the current probe sector to the existing sector images in the sector database. After all pre-calculated probe sectors are acquired and matched into the 3D space defined by the sector database, a 3D ultrasound reconstruction is completed. The PSM is validated through two experiments: a virtual simulation using a numerical model and a lab experiment using a real physical model. The experimental results show that the PSM effectively reduces the errors caused by changes in the target position due to the uneven surface pressure or the inhomogeneity of the transmission media. We conclude that the PSM proposed in this study may help to design a lightweight, inexpensive and flexible ultrasound device with accurate 3D imaging capacity.
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Affiliation(s)
- Xin Chen
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing 100044, China; (H.C.); (Y.P.); (D.T.)
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Rosen D, Jiang J. Modeling Uncertainty of Strain Ratio Measurements in Ultrasound Breast Strain Elastography: A Factorial Experiment. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:258-268. [PMID: 31545719 PMCID: PMC8011866 DOI: 10.1109/tuffc.2019.2942821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Strain elastography (SE) is a technique in which images of localized tissue strains are used to detect the relative stiffness of tissues. The application of SE in differentiating malignant breast lesions from benign ones has been broadly investigated. The strain ratio (SR) between the background and the breast tumor has been used and its results have been mixed. Due to the complex nature of tissue elasticity and how it relates to the strain fields measured in SE, the exact reason is not known. In this study, we apply a novel design-of-experiments-based metamodeling approach to mechanical simulation of SE in the human breast. To our knowledge, such a study has not been reported in the ultrasound SE literature. More specifically, we first conduct a screening study to identify the biomechanical factors/simulation inputs that most strongly determine SR. We then apply a response surface experimental design to these factors to produce a metamodel of SR as a function of said factors. Results from the screening study suggest that the SR measurements are primarily influenced by three factors: the initial shear modulus of the lesion, the elastic nonlinearity of the lesion, and the precompression applied during acquisition. In order to investigate the implications of these results, stochastic inputs for these three factors associated with the malignant and benign cases were applied to the resulting response surface. The resulting optimal cutoffs, sensitivity, and specificity were generally in line with a majority (>60%) of 19 clinical trials in the literature.
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Schimmoeller T, Neumann EE, Owings TM, Nagle TF, Colbrunn RW, Landis B, Jelovsek JE, Hing T, Ku JP, Erdemir A. Reference data on in vitro anatomy and indentation response of tissue layers of musculoskeletal extremities. Sci Data 2020; 7:20. [PMID: 31941894 PMCID: PMC6962198 DOI: 10.1038/s41597-020-0358-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/20/2019] [Indexed: 12/05/2022] Open
Abstract
The skin, fat, and muscle of the musculoskeletal system provide essential support and protection to the human body. The interaction between individual layers and their composite structure dictate the body's response during mechanical loading of extremity surfaces. Quantifying such interactions may improve surgical outcomes by enhancing surgical simulations with lifelike tissue characteristics. Recently, a comprehensive tissue thickness and anthropometric database of in vivo extremities was acquired using a load sensing instrumented ultrasound to enhance the fidelity of advancing surgical simulations. However detailed anatomy of tissue layers of musculoskeletal extremities was not captured. This study aims to supplement that database with an enhanced dataset of in vitro specimens that includes ultrasound imaging supported by motion tracking of the ultrasound probe and two additional full field imaging modalities (magnetic resonance and computed tomography). The additional imaging datasets can be used in conjunction with the ultrasound/force data for more comprehensive modeling of soft tissue mechanics. Researchers can also use the image modalities in isolation if anatomy of legs and arms is needed.
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Affiliation(s)
- Tyler Schimmoeller
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Erica E Neumann
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tammy M Owings
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
| | - Tara F Nagle
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- BioRobotics and Mechanical Testing Core, Medical Device Solutions, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Robb W Colbrunn
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- BioRobotics and Mechanical Testing Core, Medical Device Solutions, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Benjamin Landis
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - J Eric Jelovsek
- Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Tod Hing
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Joy P Ku
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Ahmet Erdemir
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA.
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
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Schimmoeller T, Neumann EE, Nagle TF, Erdemir A. Reference tool kinematics-kinetics and tissue surface strain data during fundamental surgical acts. Sci Data 2020; 7:21. [PMID: 31941889 PMCID: PMC6962378 DOI: 10.1038/s41597-020-0359-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/04/2019] [Indexed: 12/03/2022] Open
Abstract
Haptic based surgical simulations are popular training aids in medicine. Previously, surgical tool loads and motion were measured during cutting and needle insertion on non-human tissue and several haptic based simulations were developed to enhance surgical training. However, there was a lack of realistic foundational data regarding the mechanical responses of human tissue and tools during fundamental acts of surgery, i.e., cutting, suturing, retracting, pinching and indenting. This study used four recently developed surgical tools in a variety of procedures on a diverse set of cadaver leg specimens from human donors. The kinematics and kinetics of surgical tools were recorded along with topical three-dimensional strain during commonly performed surgical procedures. Full motion and load signatures of foundational surgical acts can also be used beyond the development of authentic visual and haptic simulations of surgery, i.e., they provide mechanical specifications for the development of autonomous surgical systems.
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Affiliation(s)
- Tyler Schimmoeller
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Erica E Neumann
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tara F Nagle
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA
- BioRobotics and Mechanical Testing Core, Medical Device Solutions, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmet Erdemir
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA.
- Computational Biomodeling (CoBi) Core, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
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Regional variations of in vivo surface stiffness of soft tissue layers of musculoskeletal extremities. J Biomech 2019; 95:109307. [DOI: 10.1016/j.jbiomech.2019.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 07/23/2019] [Accepted: 08/01/2019] [Indexed: 12/23/2022]
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