Surgical Planning and Patient-Specific Biomechanical Simulation for Tracheal Endoprostheses Interventions

We have developed a system for computer-assisted surgical planning of tracheal surgeries. The system allows to plan the intervention based on CT images of the patient, and includes a virtual database of commercially available prostheses. Automatic segmentation of the trachea and apparent pathological structures is obtained using a modified region growing algorithm. A method for automatic adaptation of a finite element mesh allows to build a patient-specific biomechanical model for simulation of the expected performance of the implant under physiological movement (swallowing, sneezing). Laboratory experiments were performed to characterise the tissues present in the trachea, and movement models were obtained from fluoroscopic images of a patient. Results are reported on the planning and biomechanical simulation of two patients that underwent surgery at our hospital.

[1]  Yehudah Roth,et al.  A brief history of tracheostomy and tracheal intubation, from the Bronze Age to the Space Age , 2008, Intensive Care Medicine.

[2]  Jitendra Malik,et al.  Scale-Space and Edge Detection Using Anisotropic Diffusion , 1990, IEEE Trans. Pattern Anal. Mach. Intell..

[3]  J. A. Bea,et al.  Theoretical and experimental studies on the nonlinear mechanical property of tracheal cartilage , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[4]  Nicholas Ayache,et al.  Medical Image Computing and Computer-Assisted Intervention - MICCAI 2007, 10th International Conference, Brisbane, Australia, October 29 - November 2, 2007, Proceedings, Part I , 2007, MICCAI.

[5]  R. Ogden,et al.  A New Constitutive Framework for Arterial Wall Mechanics and a Comparative Study of Material Models , 2000 .

[6]  Xiaobo Li,et al.  Adaptive image region-growing , 1994, IEEE Trans. Image Process..

[7]  M. Noppen,et al.  Removal of covered self-expandable metallic airway stents in benign disorders: indications, technique, and outcomes. , 2005, Chest.

[8]  J. A. Bea,et al.  Nonlinear mechanical property of tracheal cartilage: a theoretical and experimental study. , 2008, Journal of biomechanics.

[9]  Wiro J. Niessen,et al.  Level set based cerebral vasculature segmentation and diameter quantification in CT angiography , 2006, Medical Image Anal..

[10]  Philippe C. Cattin,et al.  Inter-subject Modelling of Liver Deformation During Radiation Therapy , 2007, MICCAI.