Catálogo de publicaciones - libros

A low-cost, sterilizable and unobtrusive instrumentation device was developed to quantify and study the loss-of-resistance technique in epidural anesthesia. In the porcine study, the rapid fall of the applied force, plunger displacement and fluid pressure, and the oral indication of the anesthesiologists were shown to be consistent with the loss-of-resistance. A model based on fluid leakage was developed to estimate the pressure from the force and displacement measurements, so that the pressure sensor could be omitted in human studies. In both human (in vivo) and porcine (in vitro) subjects, we observed that the ligamentum flavum is less amenable to saline injection than the interspinous ligament.

In cancer research, well characterized small animal models of human cancer, such as transgenic mice, have greatly accelerated the pace of development of cancer treatments. The goal of the Small Animal Radiation Research Platform (SARRP) is to make those same models available for the development and evaluation of novel radiation therapies. In combination with advanced imaging methods, small animal research allows detailed study of biological processes, disease progression, and response to therapy, with the potential to provide a natural bridge to the clinical environment. The SARRP will realistically model human radiation treatment methods in standard animal models. In this paper, we describe the mechanical and control structure of the system. This system requires accurate calibration of the x-ray beam for both imaging and radiation treatment, which is presented in detail in the paper.

We propose a computer-assisted technique for correcting bone deformities using the Ilizarov method. Our technique is an improvement over prior art in that it does not require a tracking system, navigation hardware and software, or intraoperative registration. Instead, we rely on a postoperative CT scan to obtain all of the information necessary to plan the correction and compute a correction schedule for the patient. Our laboratory experiments using plastic phantoms produced deformity corrections accurate to within 3.0° of rotation and 1 mm of lengthening.

An algorithm to globally register multiple 3D data sets (point sets) within a general reference frame is proposed. The algorithm uses the Unscented Kalman Filter algorithm to simultaneously compute the registration transformations that map the data sets together, and to calculate the variances of the registration parameters. The data sets are either randomly generated, or collected from a set of fractured bone phantoms using Computed Tomography (CT) images. The algorithm robustly converges for isotropic Gaussian noise that could have perturbed the point coordinates in the data sets. It is also computationally efficient, and enables real-time global registration of multiple data sets, with applications in computer-assisted orthopaedic trauma surgery.

This paper addresses the problem of estimating postoperative cup alignment from single standard X-ray radiograph with gonadal shielding. The widely used procedure of evaluation of cup orientation following total hip arthroplasty using single standard anteroposterior radiograph is known inaccurate, largely due to the wide variability in individual pelvic position relative to X-ray plate. 2D-3D image registration methods have been introduced to estimate the rigid transformation between a preoperative CT volume and postoperative radiograph(s) for an accurate estimation of the postoperative cup alignment relative to an anatomical reference extracted from the CT data. However, these methods require either multiple radiographs or a radiograph-specific calibration, both of which are not avaiable for most retrospective studies. Furthermore, these methods were only evaluated on X-ray radiograph(s) without gonadal shielding. In this paper, we propose to use a hybrid 2D-3D registration scheme combining an iterative landmark-to-ray registration with a 2D-3D intensity-based registration to estimate the rigid transfromation for a precise estimation of cup alignment. Quantitative and qualitative results evaluated on clinical and cadaveric datasets are given which indicate the validity of our approach.

Automated detection of amyloid plaques (AP) in brain sections of patients with Alzheimer disease (AD) or in mouse models of the disease is a major issue to improve quantitative, standardized and accurate assessment of neuropathological lesions as well as of their modulation by treatment. We propose a new segmentation method to automatically detect amyloid plaques in Congo Red stained sections based on adaptive thresholds and a dedicated amyloid plaque/tissue modelling. A set of histological sections focusing on anatomical structures was used to validate the method in comparison to expert segmentation. Original information concerning global amyloid load have been derived from 6 mouse brains which opens new perspectives for the extensive analysis of such a data in 3-D and the possibility to integrate information for diagnosis purposes.

In the United States, unenhanced CT is currently the most common imaging modality used to guide percutaneous biopsy and tumor ablation. The majority of liver tumors such as hepatocellular carcinomas are visible on contrast-enhanced CT or MRI obtained prior to the procedure. Yet, these tumors may not be visible or may have poor margin conspicuity on unenhanced CT images acquired during the procedure. Non-rigid registration has been used to align images accurately, even in the presence of organ motion. However, to date, it has not been used clinically for radiofrequency ablation (RFA), since it requires significant computational infrastructure and often these methods are not sufficient robust. We have already introduced a novel finite element based method (FEM) that is demonstrated to achieve good accuracy and robustness for the problem of brain shift in neurosurgery. In this current study, we adapt it to fuse pre-procedural MRI with intra-procedural CT of liver. We also compare its performance with conventional rigid registration and two non-rigid registration methods: b-spline and demons on 13 retrospective datasets from patients that underwent RFA at our institution. FEM non-rigid registration technique was significantly better than rigid (p<10-5), non-rigid b-spline (p<10-4) and demons (p<10-4) registration techniques. The results of our study indicate that this novel technology may be used to optimize placement of RF applicator during CT-guided ablations.