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Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs

State-of-the-art preoperative biomechanical analysis for the planning of spinal surgery not only requires the generation of three-dimensional patient-specific models but also the accurate biomechanical representation of vertebral joints. The benefits offered by computational models suitable for such...

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Autores principales: Caprara, Sebastiano, Carrillo, Fabio, Snedeker, Jess G., Farshad, Mazda, Senteler, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876284/
https://www.ncbi.nlm.nih.gov/pubmed/33585436
http://dx.doi.org/10.3389/fbioe.2021.636953
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author Caprara, Sebastiano
Carrillo, Fabio
Snedeker, Jess G.
Farshad, Mazda
Senteler, Marco
author_facet Caprara, Sebastiano
Carrillo, Fabio
Snedeker, Jess G.
Farshad, Mazda
Senteler, Marco
author_sort Caprara, Sebastiano
collection PubMed
description State-of-the-art preoperative biomechanical analysis for the planning of spinal surgery not only requires the generation of three-dimensional patient-specific models but also the accurate biomechanical representation of vertebral joints. The benefits offered by computational models suitable for such purposes are still outweighed by the time and effort required for their generation, thus compromising their applicability in a clinical environment. In this work, we aim to ease the integration of computerized methods into patient-specific planning of spinal surgery. We present the first pipeline combining deep learning and finite element methods that allows a completely automated model generation of functional spine units (FSUs) of the lumbar spine for patient-specific FE simulations (FEBio). The pipeline consists of three steps: (a) multiclass segmentation of cropped 3D CT images containing lumbar vertebrae using the DenseVNet network, (b) automatic landmark-based mesh fitting of statistical shape models onto 3D semantic segmented meshes of the vertebral models, and (c) automatic generation of patient-specific FE models of lumbar segments for the simulation of flexion-extension, lateral bending, and axial rotation movements. The automatic segmentation of FSUs was evaluated against the gold standard (manual segmentation) using 10-fold cross-validation. The obtained Dice coefficient was 93.7% on average, with a mean surface distance of 0.88 mm and a mean Hausdorff distance of 11.16 mm (N = 150). Automatic generation of finite element models to simulate the range of motion (ROM) was successfully performed for five healthy and five pathological FSUs. The results of the simulations were evaluated against the literature and showed comparable ROMs in both healthy and pathological cases, including the alteration of ROM typically observed in severely degenerated FSUs. The major intent of this work is to automate the creation of anatomically accurate patient-specific models by a single pipeline allowing functional modeling of spinal motion in healthy and pathological FSUs. Our approach reduces manual efforts to a minimum and the execution of the entire pipeline including simulations takes approximately 2 h. The automation, time-efficiency and robustness level of the pipeline represents a first step toward its clinical integration.
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spelling pubmed-78762842021-02-12 Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs Caprara, Sebastiano Carrillo, Fabio Snedeker, Jess G. Farshad, Mazda Senteler, Marco Front Bioeng Biotechnol Bioengineering and Biotechnology State-of-the-art preoperative biomechanical analysis for the planning of spinal surgery not only requires the generation of three-dimensional patient-specific models but also the accurate biomechanical representation of vertebral joints. The benefits offered by computational models suitable for such purposes are still outweighed by the time and effort required for their generation, thus compromising their applicability in a clinical environment. In this work, we aim to ease the integration of computerized methods into patient-specific planning of spinal surgery. We present the first pipeline combining deep learning and finite element methods that allows a completely automated model generation of functional spine units (FSUs) of the lumbar spine for patient-specific FE simulations (FEBio). The pipeline consists of three steps: (a) multiclass segmentation of cropped 3D CT images containing lumbar vertebrae using the DenseVNet network, (b) automatic landmark-based mesh fitting of statistical shape models onto 3D semantic segmented meshes of the vertebral models, and (c) automatic generation of patient-specific FE models of lumbar segments for the simulation of flexion-extension, lateral bending, and axial rotation movements. The automatic segmentation of FSUs was evaluated against the gold standard (manual segmentation) using 10-fold cross-validation. The obtained Dice coefficient was 93.7% on average, with a mean surface distance of 0.88 mm and a mean Hausdorff distance of 11.16 mm (N = 150). Automatic generation of finite element models to simulate the range of motion (ROM) was successfully performed for five healthy and five pathological FSUs. The results of the simulations were evaluated against the literature and showed comparable ROMs in both healthy and pathological cases, including the alteration of ROM typically observed in severely degenerated FSUs. The major intent of this work is to automate the creation of anatomically accurate patient-specific models by a single pipeline allowing functional modeling of spinal motion in healthy and pathological FSUs. Our approach reduces manual efforts to a minimum and the execution of the entire pipeline including simulations takes approximately 2 h. The automation, time-efficiency and robustness level of the pipeline represents a first step toward its clinical integration. Frontiers Media S.A. 2021-01-28 /pmc/articles/PMC7876284/ /pubmed/33585436 http://dx.doi.org/10.3389/fbioe.2021.636953 Text en Copyright © 2021 Caprara, Carrillo, Snedeker, Farshad and Senteler. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Bioengineering and Biotechnology
Caprara, Sebastiano
Carrillo, Fabio
Snedeker, Jess G.
Farshad, Mazda
Senteler, Marco
Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs
title Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs
title_full Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs
title_fullStr Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs
title_full_unstemmed Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs
title_short Automated Pipeline to Generate Anatomically Accurate Patient-Specific Biomechanical Models of Healthy and Pathological FSUs
title_sort automated pipeline to generate anatomically accurate patient-specific biomechanical models of healthy and pathological fsus
topic Bioengineering and Biotechnology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7876284/
https://www.ncbi.nlm.nih.gov/pubmed/33585436
http://dx.doi.org/10.3389/fbioe.2021.636953
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