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Feature-adaptive motion tracking of ultrasound image sequences using a deformable mesh.

By exploiting the correlation of ultrasound speckle patterns that result from scattering by underlying tissue elements, two-dimensional tissue motion theoretically can be recovered by tracking the apparent movement of the associated speckle patterns. Speckle tracking, however, is an ill-posed inverse problem because of temporal decorrelation of the speckle patterns and the inherent low signal-to-noise ratio of medical ultrasonic images. This paper investigates the use of an adaptive deformable mesh for nonrigid tissue motion recovery from ultrasound images. The nodes connecting the mesh elements are allocated adaptively to stable speckle patterns that are less susceptible to temporal decorrelation. We use the approach of finite element analysis in manipulating the irregular mesh elements. A novel deformable block matching algorithm, making use of a Lagrange element for higher-order description of local motion, is proposed to estimate a nonrigid motion vector at each node. In order to ensure that the motion estimates are admissible to a physically plausible solution, the nodal displacements are regularized by minimizing the strain energy associated with the mesh deformations. Experiments based on ultrasound images of a tissue-mimicking phantom and a muscle undergoing contraction, and on computer simulations, have shown that the proposed algorithm can successfully track nonrigid displacement fields.

Algorithms↗

Finite element modelling of a residual lower-limb in a prosthetic socket: a survey of the development in the first decade.

A review is presented of the existing finite element models developed from 1987 to 1996 for the biomechanics of lower-limb prostheses. Finite element analysis can be a useful tool in investigating the mechanical interaction between the residual limb and its prosthetic socket, and in computer-aided design and computer-aided manufacturing of prosthetic sockets. Various assumptions and simplifications are made in these models to simplify the actual problem with complex geometry, material properties, boundary and interfacial conditions, as well as loading situations. The analyses can provide the information on the stress distribution at the stump/socket interface and within the residual limb tissues. More recently, nonlinear models have been developed taking into consideration the process of socket rectifications, the slip/friction conditions and material large deformation. The models so far developed have provided some basic understanding of the biomechanics. Comparison of the predictions of these models with experimental measurements indicated that the predicted stresses were within the ranges measured, although one-to-one correspondence was difficult to achieve. Further research is still required in order to improve these models to obtain higher precision in the results taking into account nonlinear and dynamic effects.

Artificial Limbs↗

Material properties of the human calcaneal fat pad in compression: experiment and theory.

The structural behaviour of the human heel pad has been studied extensively due to its ability to absorb shock, protect against excessive local stress, and reduce plantar pressures. However, the material properties of the tissue have not been adequately measured. These must be known in order to perform a finite element analysis of the effect of factors such as foot geometry and shoe/surface construction on heel pad function. Therefore, the purposes of this study were to (a). measure the viscoelastic behaviour of the fat pad in compression, and (b). to determine an appropriate constitutive equation to model the tissue. A series of unconfined compression tests were performed on 8mm diameter cylinders of fat pad tissue, consisting of quasi-static, 175, 350 mm/s and stress-relaxation tests to approximately 50% deformation. The tissue exhibited nonlinear, viscoelastic behaviour. No significant difference was found in the quasi-static behaviour between samples from different locations and orientations in the heel. The stress-relaxation tests were used to determine the time constant (tau(1)=0.5s), the 175 mm/s test to determine the relaxation coefficient (g(1)=28), and the 350 mm/s compression test to determine the material constants (C(100)=C(010)=0.01, C(200)=C(020)=0.1 Pa) of a single-phase, hyperelastic, linear viscoelastic strain energy function (r(2)=0.98).

Adipose Tissue↗

The role of cuspal flexure in the development of abfraction lesions: a finite element study.

A tooth flexure mechanism has been proposed over the past 15 yr to explain non-carious cervical tooth loss. It is well established that cavity preparation weakens a tooth, resulting in more cuspal movement under occlusal load. The aim of this study was to investigate the effect that an occlusal restoration would have on the stress profile in the cervical region of a lower second premolar using two-dimensional finite element stress analysis. Under an eccentric 100 N occlusal load, a premolar with an occlusal amalgam restoration showed peak tensile and shear stresses in the buccal cervical region that were in excess of the known failure stress for enamel. Increases in the cavity depth of the occlusal amalgam restoration were found to increase cervical stress more than increases in cavity width. It was concluded that the weakening effect of cavity preparation may contribute to the development of non-carious cervical tooth loss.

Bicuspid↗

Modeling the heat transfer problem for the novel combined cryosurgery and hyperthermia system.

A multidimensional, finite element analysis (FEA) for the freezing, holding, rewarming and heating processes of biological tissues during the cryosurgery process of the new Combined Cryosurgery/Hyperthermia System is presented to theoretically test its validity. The tissues are treated as nonideal materials freezing over a temperature range, and the thermophysical properties of which are temperature dependent. The enthalpy method is applied to solve the highly nonlinear problem. It was found that when the same boundary condition and the same target tissue presented, the novel Cryosurgery/Hyperthermia System could supply the target tissue an approximative cooling rate, a much lower minimal temperature, a much greater warming rate, and a much greater thermal gradients compared with that of the simplified Endocare system. The numerical simulation indicates that the novel combined cryosurgery and hyperthermia system can provide an excellent curative effect in the corresponding cryotherapy. And the most attractive feature of this FEA framework is that it can be easily mastered by the surgeon without in-depth theory of heat transfer to analyze the cryosurgery process beforehand due to the friendly GUI (graphical user interface) of Ansys software.

Body Temperature↗

Surgical variables affect the mechanics of a hip resurfacing system.

Recent clinical studies have linked failure to surgical variables of stemmed hip resurfacing systems. We used finite element analysis to investigate the effects of implant position, stem orientation, and extent of fixation both on the local stresses and strains associated with implant loosening, neck fracture, and stem fracture, as well as on the load transfer distribution in the bone-implant system. The range of peak stress in the cement was reduced from 11 to 13 MPa for the varus stem to 3.2 to 4.2 MPa for the valgus stem. The range of peak strain in the bone was also reduced from -0.35% to -0.45% strain for the varus stem to -0.19% to -0.27% strain for the valgus stem, but only when reamed cancellous bone remained exposed. Peak stresses in the stem were low for all cases. Additionally, the implant's load transfer distribution was generally insensitive to all variables examined and the femoral head was substantially unloaded. Our data indicate the local stresses and strains associated with implant loosening and neck fracture were reduced by placing the implant in a valgus orientation and covering reamed cancellous bone, but unloading of the femoral head, found for all variables examined, may lead to adverse bone remodeling.

Arthroplasty, Replacement, Hip↗

The influence of different core material on the FEA-determined stress distribution in dental crowns.

OBJECTIVES: All ceramic restorations without metal have great advantages in their biocompatibility and aesthetic aspects. With the introduction of new core materials, the cores are sufficiently strong to produce long lasting all-ceramic restorations; however, the stresses in the veneering porcelain could still determine the longevity. The objective of this study was to evaluate, by finite element analysis (FEA), the influence of different core materials on the stress distribution in dental crowns. METHODS: The model of a multi-layer all-ceramic crown for posterior tooth 46 produced with CAD-CAM-technology was translated into a three-dimensional FEA program. This crown model was made with gold, zirconia, and alumina-based porcelain core and their matching veneering porcelains. The stress distribution due to the combined influences of bite forces, residual stresses caused by the difference in expansion coefficient of the core material and the veneering porcelain, and the influence of shrinkage of the cement was investigated. RESULTS: Stiffer core material does not always for various reasons result in lower stresses in the veneering porcelain. SIGNIFICANCE: This study indicates that the actual distribution of the tensile stresses and the design of restorations must be taken into account; otherwise, the significant contribution of stronger and tougher core materials to the performance of all-ceramic restorations may be offset by the weaker veneering porcelain.

Aluminum Oxide↗

The transfer of occlusal forces through the maxillary molars: a finite element study.

The morphology of the skeleton is known to reflect functional demand. A change in the intramaxillary position of molars can be expected to influence the transfer of occlusal forces to the facial skeleton. A finite element analysis allows us to simulate the displacement of a molar in relation to the well-defined morphology of the maxilla. Three 3-dimensional unilateral models of a maxilla from a skull with skeletal Class I and neutral molar relationships were produced based on CT-scan data. The maxillary first molar was localized so that the contour of the mesial root continued into the infrazygomatic crest. When the molar was loaded with occlusal forces, the stresses were transferred predominantly through the infrazygomatic crest. This changed when mesial and distal displacements of the molars were simulated. In the model with mesial molar displacement, a larger part of the bite forces were transferred through the anterior part of the maxilla, resulting in the buccal bone being loaded in compression. In the model with distal molar displacement, the posterior part of the maxilla was deformed through compression; this resulted in higher compensatory tensile stresses in the anterior part of the maxilla and at the zygomatic arch. This distribution of the occlusal forces might contribute to the posterior rotation often described as the orthopedic effect of extraoral traction.

Alveolar Process↗

Patient specific finite element model of the face soft tissues for computer-assisted maxillofacial surgery.

This paper addresses the prediction of face soft tissue deformations resulting from bone repositioning in maxillofacial surgery. A generic 3D Finite Element model of the face soft tissues was developed. Face muscles are defined in the mesh as embedded structures, with different mechanical properties (transverse isotropy, stiffness depending on muscle contraction). Simulations of face deformations under muscle actions can thus be performed. In the context of maxillofacial surgery, this generic soft-tissue model is automatically conformed to patient morphology by elastic registration, using skin and skull surfaces segmented from a CT scan. Some elements of the patient mesh could be geometrically distorted during the registration, which disables Finite Element analysis. Irregular elements are thus detected and automatically regularized. This semi-automatic patient model generation is robust, fast and easy to use. Therefore it seems compatible with clinical use. Six patient models were successfully built, and simulations of soft tissue deformations resulting from bone displacements performed on two patient models. Both the adequation of the models to the patient morphologies and the simulations of post-operative aspects were qualitatively validated by five surgeons. Their conclusions are that the models fit the morphologies of the patients, and that the predicted soft tissue modifications are coherent with what they would expect.

Biomechanical Phenomena↗

Modelling the elastic properties of the anterior eye and their contribution to maintenance of image quality: the role of the limbus.

PURPOSE: The elastic moduli of the cornea, sclera, and limbus for different corneal eccentricities (e) and varying levels of intraocular pressure (IOP) were modelled in order to determine how the rheological properties, especially those of the limbus, need to alter to maintain optical image quality when the eye is subjected to small variations in IOP. METHODS: Finite element analysis (FEA) was used to construct eyeball models with four different corneal eccentricities (e=0, 0.33, 0.5, 0.65). Three values for Young's modulus of the cornea were tested in all models (0.2 megapascal (MPa), 1.2 and 10 MPa). For each corneal modulus, scleral moduli of 3, 4, 5, 7, and 10 times that of the corneal modulus were selected. The limbal modulus was varied to optimise image quality of the eye model subjected to IOP variations of +/-0.8 mmHg for three different levels of IOP (8, 16, and 32 mmHg). RESULTS: The elastic modulus of the limbal ring increases with an increase in corneal modulus and rises to a peak when the ratio of scleral to corneal moduli is between 5 and 7 depending on corneal eccentricity. Different levels of IOP produce only slight differences in the relative moduli required to maintain optical image quality. CONCLUSIONS: The significance of a peak in the value of Young's modulus of the limbus is not clear but suggests that there may be an optimal limbal modulus that must be balanced with the moduli of cornea and sclera for preservation of image quality.

Biomechanical Phenomena↗

2D-finite element analyses and histomorphology of lag screws with and without a biconcave washer.

For osteosynthesis and for bone transplant fixation in particular, a lag screw with a biconcave washer, the so called "Anchor Screw" (AS) has been introduced in maxillo-facial surgery. Using 2D-finite element analysis (FEA), the v. Mises and the circumferential stresses induced in underlying bone by this AS are analysed and compared to those under a conventional lag screw. The stress distributions below the biconcave washer of the AS were correlated with histomorphological bone reactions after AS osteosynthesis in two tumor patients, retrieved 12 weeks and 19 months after tumor surgery, respectively. Depending on the thickness of cortical bone, the v. Mises stress concentrations below the biconcave washer were lower than under the head of the conventional lag screw (CLS), but with a higher stress maximum concentrated around the rim of the washer. The circumferential stresses were only half as high around the AS, and thus the deformation of bone was reduced. As predicted by FEA, histology showed microcrack formation, but then after minimal resorption, remodelling of bone below the biconcave washer. Stable osteosynthesis could be demonstrated by bony union already after 12 weeks, and, while bone remodelling continued in the healed osteotomy, it had decreased around the screws after 19 months. It can be concluded from the biomechanical principles and the histomorphological findings that the AS appears superior to the CLS.

Bone Remodeling↗

Predictions of cement microfracture under crowns using 3D-FEA.

PURPOSE: The objective of this research study was to test the effects of (1) crown margin type, (2) cement type, (3) cement thickness, (4) loading direction, and (5) loading magnitude on stress levels and distributions within luting cement that might lead to cement microfracture using three-dimensional Finite Element Analysis techniques. MATERIALS AND METHODS: Thirty-two three-dimensional computer models, as well as models for standards, were generated for a mandibular first premolar. Crown preparations exhibited shoulder or chamfer margin configurations, and zinc phosphate, zinc polycarboxylate, glass ionomer, and resin cements were used in thicknesses of 25 or 100 microm. Modeled crowns were loaded axially or obliquely at 10 and 100 MPa. Areas and levels of stress concentrations within the cement were determined. RESULTS: Stresses in the cement were low for all situations except 100 MPa oblique stressing. Stresses at the margins of crowns with chamfer marginal configuration were higher than those with shoulder margins. Stresses under oblique stressing were 10 to 150 times higher than under axial stressing. Except for Zn phosphate cement, cement thickness minimally affected stress levels and distributions. Greater stresses were found in cements with the greater Young's modulus. CONCLUSIONS: Although the chamfer margin design could lead to greater stresses near the margins that places the cement at risk for microfracture and possible crown failure, glass-ionomer and composite resin cements have more favorable mechanical properties for resisting microfracture.

Bicuspid↗

Stem surface roughness alters creep induced subsidence and 'taper-lock' in a cemented femoral hip prosthesis.

The clinical success of polished tapered stems has been widely reported in numerous long term studies. The mechanical environment that exists for polished tapered stems, however, is not fully understood. In this investigation, a collarless, tapered femoral total hip stem with an unsupported distal tip was evaluated using a 'physiological' three-dimensional (3D) finite element analysis. It was hypothesized that stem-cement interface friction, which alters the magnitude and orientation of the cement mantle stress, would subsequently influence stem 'taper-lock' and viscoelastic relaxation of bone cement stresses. The hypothesis that creep-induced subsidence would result in increases to stem-cement normal (radial) interface stresses was also examined. Utilizing a viscoelastic material model for the bone cement in the analysis, three different stem-cement interface conditions were considered: debonded stem with zero friction coefficient (mu=0) (frictionless), debonded stem with stem-cement interface friction (mu=0.22) ('smooth' or polished) and a completely bonded stem ('rough'). Stem roughness had a profound influence on cement mantle stress, stem subsidence and cement mantle stress relaxation over the 24-h test period. The frictionless and smooth tapered stems generated compressive normal stress at the stem-cement interface creating a mechanical environment indicative of 'taper-lock'. The normal stress increased with decreasing stem-cement interface friction but decreased proximally with time and stem subsidence. Stem subsidence also increased with decreasing stem-cement interface friction. We conclude that polished stems have a greater potential to develop 'taper-lock' fixation than do rough stems. However, subsidence is not an important determinant of the maintenance of 'taper-lock'. Rather subsidence is a function of stem-cement interface friction and bone cement creep.

Aged↗

[Influence of cartilage cap modelling on FEM simulation of femoral head stress].

The present study reports on the finite element analysis (FEA) of the femoral head in a process of preparation for a program for the realistic simulation of correctional osteotomies of the proximal femur. While the material properties have been studied extensively, only few publications consider the influence of the cartilage layer geometry on FE stimulation of the hip joint. Various models of the femoral head with and without the cartilage layer are generated and analysed. On looking at the maximum surface stresses, we found a strong influence of the cartilage layer and the subchondral osseous layer on the magnitude of the von Mises equivalent stress. The model with an anatomically realistic cartilage layer and compact bone shows stresses of between 4 and 5.5 MPa, depending on the position of the joint, while the model with a concentric cartilage layer has a maximum von Mises stress of 0.8 MPa. Only on simulation of a "realistic" cartilage layer, with a maximum thickness at the "pole" and minimum thickness at the "equator" do the changes in stress distribution--determined by changes in the position of the femoral head--become visible. Owing to major artefacts and the inability to create a realistic cartilage layer, voxel-based models of the femur are not suitable for the simulation of the femoral head surface.

Cartilage, Articular↗

A shell finite element model of the pelvic floor muscles.

The pelvic floor gives support to the organs in the abdominal cavity. Using the dataset made public in (Janda et al. J. Biomech. (2003) 36(6), pp. 749-757), we have reconstructed the geometry of one of the most important parts of the pelvic floor, the levator ani, using NURB surfaces. Once the surface is triangulated, the corresponding mesh is used in a finite element analysis with shell elements. Based on the 3D behavior of the muscle we have constructed a shell that takes into account the direction of the muscle fibers and the incompressibility of the tissue. The constitutive model for the isotropic strain energy and the passive strain energy stored in the fibers is adapted from Humphrey's model for cardiac muscles. To this the active behavior of the skeletal muscle is added. We present preliminary results of a simulation of the levator ani muscle under pressure and with active contraction. This research aims at helping simulate the damages to the pelvic floor that can occur after childbirth.

Computer Simulation↗

The role of an effective isotropic tissue modulus in the elastic properties of cancellous bone.

Conceptually, the elastic characteristics of cancellous bone could be predicted directly from the trabecular morphology--or architecture--and by the elastic properties of the tissue itself. Although hardly any experimental evidence exists, it is often implicitly assumed that tissue anisotropy has a negligible effect on the apparent elastic properties of cancellous bone. The question addressed in this paper is whether this is actually true. If it is, then micromechanical finite element analysis (micro-FEA) models, representing trabecular architecture, using an 'effective isotropic tissue modulus' should be able to predict apparent elastic properties of cancellous bone. To test this, accurate multi-axial compressive mechanical tests of 29 whale bone specimens were simulated with specimen-specific micro-FEA computer models built from true three-dimensional reconstructions. By scaling the micro-FEA predictions by a constant tissue modulus, 92% of the variation of Young's moduli determined experimentally could be explained. The correlation even increased to 95% when the micro-FEA moduli were scaled to the isotropic tissue moduli of individual specimens. Excellent agreement was also found in the elastic symmetry axes and anisotropy ratios. The prediction of Poisson's ratios was somewhat less precise at 85% correlation. The results support the hypothesis; for practical purposes, the concept of an 'effective isotropic tissue modulus' concept is a viable one. They also suggest that the value of such a modulus for individual cases might be inferred from the average tissue density, hence the degree of mineralization. Future studies must clarify how specific the tissue modulus should be for different types of bone if adequate predictions of elastic behavior are to be made in this way.

Animals↗

Finite element study of a novel intervertebral disc substitute.

STUDY DESIGN: A new type of composite device with a similar structure to a natural lumbar intervertebral disc was modeled, and its mechanical interaction with a L3-L5 lumbar spine segment was studied by a finite element analysis. OBJECTIVE: To identify the influence of the prosthesis on the biomechanical changes induced in a L3-L4 lumbar spine segment model after having substituted the physiologic L4-L5 intervertebral disc by the implant. SUMMARY OF BACKGROUND DATA: In our societies, the large number of back pain cases highly motivates the investigation of intervertebral disc prostheses. Postoperative complications induced by spinal fusion showed that the mechanical properties of the novel components and its interactivity with the rest of the spine are a critical point. METHODS: The prosthesis replaced the L4-L5 intervertebral disc within a previously developed L3-L5 lumbar spine segment physiologic model. The effect of loads in compression, flexion, extension, and axial rotation was simulated, and two types of vertebrae-implant contact were compared to the physiologic model. RESULTS: Models with disc substitute are much stiffer than the physiologic model. In case of perfect contact with the adjacent vertebrae, the implant behaves like a physiologic intervertebral disc and respects the surrounding motion segment biomechanics. Although no traumatic loads were calculated within the adjacent vertebrae, bone remodeling would be expected in the trabecular bone. CONCLUSION: By using numerical methods, this study allows prediction of the static mechanical behavior of a new device within a lumbar spine structure, which appears very useful for preclinical study.

Biomechanical Phenomena↗

Deformable structure registration of bladder through surface mapping.

Cumulative dose distributions in fractionated radiation therapy depict the dose to normal tissues and therefore may permit an estimation of the risk of normal tissue complications. However, calculation of these distributions is highly challenging because of interfractional changes in the geometry of patient anatomy. This work presents an algorithm for deformable structure registration of the bladder and the verification of the accuracy of the algorithm using phantom and patient data. In this algorithm, the registration process involves conformal mapping of genus zero surfaces using finite element analysis, and guided by three control landmarks. The registration produces a correspondence between fractions of the triangular meshes used to describe the bladder surface. For validation of the algorithm, two types of balloons were inflated gradually to three times their original size, and several computerized tomography (CT) scans were taken during the process. The registration algorithm yielded a local accuracy of 4 mm along the balloon surface. The algorithm was then applied to CT data of patients receiving fractionated high-dose-rate brachytherapy to the vaginal cuff, with the vaginal cylinder in situ. The patients' bladder filling status was intentionally different for each fraction. The three required control landmark points were identified for the bladder based on anatomy. Out of an Institutional Review Board (IRB) approved study of 20 patients, 3 had radiographically identifiable points near the bladder surface that were used for verification of the accuracy of the registration. The verification point as seen in each fraction was compared with its predicted location based on affine as well as deformable registration. Despite the variation in bladder shape and volume, the deformable registration was accurate to 5 mm, consistently outperforming the affine registration. We conclude that the structure registration algorithm presented works with reasonable accuracy and provides a means of calculating cumulative dose distributions.

Algorithms↗