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Biomedical subjects

Cinzia Zannoni

Publications and source records attributed to Cinzia Zannoni.

8 recordsLinked to original sources

The multimod application framework: a rapid application development tool for computer aided medicine.

This paper describes a new application framework (OpenMAF) for rapid development of multimodal applications in computer-aided medicine. MAF applications are multimodal in data, in representation, and in interaction. The framework supports almost any type of biomedical data, including DICOM datasets, motion-capture recordings, or data from computer simulations (e.g. finite element modeling). The interactive visualization approach (multimodal display) helps the user interpret complex datasets, providing multiple representations of the same data. In addition, the framework allows multimodal interaction by supporting the simultaneous use of different input-output devices like 3D trackers, stereoscopic displays, haptics hardware and speech recognition/synthesis systems. The Framework has been designed to run smoothly even on limited power computers, but it can take advantage of all hardware capabilities. The Framework is based on a collection of portable libraries and it can be compiled on any platform that supports OpenGL, including Windows, MacOS X and any flavor of Unix/linux.

Humans↗

Efficacy of stereoscopic visualization and six degrees of freedom interaction in preoperative planning of total hip replacement.

The aim of this study was to assess the accuracy of a six-degrees-of-freedom application for pre-operative planning of total hip replacement in a virtual reality (VR) environment. A test was performed estimating the system inherent accuracy. The users can move objects in the VR environment with an intrinsic accuracy almost four orders of magnitude greater than the object dimension. A second unambiguous and relevant task was defined to assess the accuracy achievable with the interface in a specific planning task. The results were compared with those obtained with 2D interfaces for both the stem and the cup component. The RMSE was assumed as an indicator of the achievable accuracy. The accuracy of the immersive interface was comparable with that achievable with a standard mouse - monitor interface. The users were consistent using the VR interface, confirming the high usability of the new interface and the steep learning curve of users unfamiliar with the new environment. This study has demonstrated that the application of VR environment for pre-operative planning of total hip replacement may help to shorten the duration of the positioning and to yield consistent results even with first-time users.

Arthroplasty, Replacement, Hip↗

JIDE: a new software for computer-aided design of hip prosthesis.

This work is aimed at developing an innovative simulation environment supporting and improving the design of standard joint implants (JPD integrated design environment (JIDE)). The conceptual workflow starts from the design of a new implant, by using conventional CAD programmes and completes with the generation of a report that summarises the goodness for a new implant against a database of human bone anatomies. For each dataset in the database, the JPD application calculates a set of quantitative indicators that will support the designer in the evaluation of its design on a statistical basis. The resulting system is thus directed to prostheses manufacturers and addresses a market segment that appears to have a steady growth in the future.

Computer Simulation↗

Specialised CT scan protocols for 3-D pre-operative planning of total hip replacement.

X-ray computer tomography (CT) provides an accurate source of information in orthopaedics. Many computer aided orthopaedic surgery systems are based on CT images; thus, obtaining high resolution images is important. However, this may result in an excessive radiation dose for the patient. This study is aimed at developing a special CT scanning protocol for the hip region that can be adopted in clinical practise for 3-D pre-operative planning of total hip replacement surgery. Optimisation of CT acquisition parameters is investigated for both axial and spiral CT and the two resulting protocols are compared in terms of effective radiation dose to the patient. Results show that spiral CT with D=3 and P=1.5 in regions with higher morphological and density gradients and D=5 and P=1.5 in regions where the morphology is more regular degrades the image quality slightly but allows acquisition of a higher number of images at comparable costs, increasing the longitudinal resolution of the acquired data set. The effective dose is comparable to that of a standard pelvic CT exam. Adjusting the axial CT scan parameters the effective dose can be reduced, however lowering the accuracy of 3-D bone geometry reconstruction.

Arthroplasty, Replacement, Hip↗

Validation of two algorithms to evaluate the interface between bone and orthopaedic implants.

The level of fit and fill of the prosthetic stem in the femoral canal is an important parameter when planning a cementless total hip arthroplasty. However, the standard templates used in combination with radiographs are not always effective in the pre-operative evaluation of the level of fitting. For this reason, two algorithms were developed able to provide clinically relevant three-dimensional indicators of the implant fit and fill in the host femur, based on the CT data of each specific patient as collected in vivo. In this study the computational methods were described and validated using digital phantom datasets. Then the algorithms were applied for in vivo datasets and the sensitivity of each indicator was evaluated. The validation showed that the two algorithms are accurate from a computational point of view. Moreover, the in vivo testing demonstrated that the developed methods provide reasonable quantitative indicators of the stem positioning in the femoral CT dataset.

Algorithms↗

An automated method to position prosthetic components within multiple anatomical spaces.

The level of fit and fill of a stem in the host femur is the most critical factor for the mechanical stability and success of the prosthesis. It would be useful to have a simulation tool able to investigate the anatomical compatibility of a new implant in a large library of femoral anatomies in the early phases of the design process. In order to realise this tool, it is necessary to develop an automatic method for the positioning of the stem in a database of anatomies. The aim of this study was to develop and evaluate a method for the automatic positioning of the stem geometry in the anatomical CT dataset. Two different strategies were considered: a completely automatic registration technique and a semi-automatic method based on an anatomical referencing. The two procedures were compared to the manual positioning obtained by an expert surgeon in a set of nine CT datasets. For both methods in each femur the positioning and the orientation of the stem were good. The results showed a better level of fitting for the automatic method, while the shift of the hip joint centre was lower for the anatomical referencing technique. However, the anatomical referencing method requires a higher computational effort without being significantly better than the automatic method. For this reason, the automatic method should be chosen to develop the automatic positioning of a stem in a database of anatomies.

Arthroplasty, Replacement, Hip↗

Effect of display modality on spatial accuracy of orthopaedic surgery pre-operative planning applications.

Graphical representation of a patient's anatomy is fairly similar in the majority of orthopaedic surgery planning programs. The position of implantable devices is usually established using a three-pane window showing 2D cross sections of the CT data set taken on three user-selectable orthogonal planes. In some cases this orthogonal-plane representation is replaced or extended by interactive 3D visualization, obtained using surface rendering techniques. These ways to represent the CT data come naturally and easily to the programmer. However, the efficacy of these display strategies is questionable. The present study aims to assess if the display modality used to visualize CT data affects the inherent spatial accuracy achievable in a surgical planning application. A group of users was asked to perform repeatedly a specific planning task using various display interfaces to the same underlying software application. The planning task was designed to allow an assessment of the accuracy with which each user was able to position the prosthetic component. A specialized interface, called multimodal display, presented a peak error of 0.45 mm and 0.95 deg, significantly lower than the 2.4 mm and 4 deg for the othogonal slices interface, and the 3.8 mm and 16.7 deg for the 3D-rendering interface. The results of this study indicate an important effect of the type of visualization modality used to represent CT data on final accuracy of the planning operation.

Computer Graphics↗

Hip-Op: an innovative software to plan total hip replacement surgery.

This paper describes an innovative surgical simulation software environment for the pre-operative planning of total hip replacement surgery. The software is a CT-based three-dimensional planning environment, with a user-friendly graphic user interface based on the multimodal display visualization paradigm. Although it relies on a fully three dimensional internal representation, this approach represents the relevant anatomical objects by means of multiple views, each simulating a different medical imaging modality familiar to the medical professional. In the Hip-Op program the multimodal display interface integrates four different display modalities: orthogonal radiographs, Blended slices, CT slices, and arbitrary slices. A conventional surface rendering view is also available. The user 'navigates' the prosthetic components, which are dynamically selected from a library of available parts, within the CT volume while the implant and the patient anatomy are simultaneously rendered in each specialized view. Beside a consideration of anatomical compatibility, the surgeon may evaluate the planned implant type, size and position, also on the basis of two analysis modules that compute the achieved level of implant fitting and filling. After being evaluated in an internal clinical trial, the software is currently made available as freeware at http:// www.ior.it/hipop/.

Algorithms↗