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Models and tissue mimics for brain shift simulations.

ABSTRACT: Capturing the deformation of human brain during neurosurgical operations is an extremely important task to improve the accuracy or surgical procedure and minimize permanent damage in patients. This study focuses on the development of an accurate numerical model for the prediction of brain shift during surgical procedures and employs a tissue mimic recently developed to capture the complexity of the human tissue. The phantom, made of a composite hydrogel, was designed to reproduce the dynamic mechanical behaviour of the brain tissue in a range of strain rates suitable for surgical procedures. The use of a well-controlled, accessible and MRI compatible alternative to real brain tissue allows us to rule out spurious effects due to patient geometry and tissue properties variability, CSF amount uncertainties, and head orientation. The performance of different constitutive descriptions is evaluated using a brain-skull mimic, which enables 3D deformation measurements by means of MRI scans. Our combined experimental and numerical investigation demonstrates the importance of using accurate constitutive laws when approaching the modelling of this complex organic tissue and supports the proposal of a hybrid poro-hyper-viscoelastic material formulation for the simulation of brain shift.

SUBMITTER: Forte AE

PROVIDER: S-EPMC5807478 | biostudies-other | 2018 Feb

REPOSITORIES: biostudies-other

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Models and tissue mimics for brain shift simulations.

Forte Antonio E AE Galvan Stefano S Dini Daniele D

Biomechanics and modeling in mechanobiology 20170906 1

Capturing the deformation of human brain during neurosurgical operations is an extremely important task to improve the accuracy or surgical procedure and minimize permanent damage in patients. This study focuses on the development of an accurate numerical model for the prediction of brain shift during surgical procedures and employs a tissue mimic recently developed to capture the complexity of the human tissue. The phantom, made of a composite hydrogel, was designed to reproduce the dynamic mec ...[more]

PMID: 28879577

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Project description:Computational modeling and simulation have become essential tools in the quest to better understand the brain's makeup and to decipher the causal interrelations of its components. The breadth of biochemical and biophysical processes and structures in the brain has led to the development of a large variety of model abstractions and specialized tools, often times requiring high performance computing resources for their timely execution. What has been missing so far was an in-depth analysis of the complexity of the computational kernels, hindering a systematic approach to identifying bottlenecks of algorithms and hardware. If whole brain models are to be achieved on emerging computer generations, models and simulation engines will have to be carefully co-designed for the intrinsic hardware tradeoffs. For the first time, we present a systematic exploration based on analytic performance modeling. We base our analysis on three in silico models, chosen as representative examples of the most widely employed modeling abstractions: current-based point neurons, conductance-based point neurons and conductance-based detailed neurons. We identify that the synaptic modeling formalism, i.e. current or conductance-based representation, and not the level of morphological detail, is the most significant factor in determining the properties of memory bandwidth saturation and shared-memory scaling of in silico models. Even though general purpose computing has, until now, largely been able to deliver high performance, we find that for all types of abstractions, network latency and memory bandwidth will become severe bottlenecks as the number of neurons to be simulated grows. By adapting and extending a performance modeling approach, we deliver a first characterization of the performance landscape of brain tissue simulations, allowing us to pinpoint current bottlenecks for state-of-the-art in silico models, and make projections for future hardware and software requirements.

Project description:BACKGROUND:The necessity for rapid evaluation and treatment of acute ischemic stroke with intravenous tPA (tissue-type plasminogen activator) may increase the risk of administrating tPA to patients presenting with noncerebrovascular conditions that closely resemble stroke (stroke mimics). However, there are limited data on thrombolysis safety in stroke mimics. METHODS AND RESULTS:Using data from the Get With The Guidelines-Stroke Registry, we identified 72?582 patients with suspected ischemic stroke treated with tPA from 485 US hospitals between January 2010 and December 2017. We documented the use of tPA in stroke mimics, defined as patients who present with stroke-like symptoms, but after workup are determined not to have suffered from a stroke or transient ischemic attack, and compared characteristics and outcomes in stroke mimics versus those with ischemic stroke. Overall, 3.5% of tPA treatments were given to stroke mimics. Among them, 38.2% had a final nonstroke diagnoses of migraine, functional disorder, seizure, and electrolyte or metabolic imbalance. Compared with tPA-treated true ischemic strokes, tPA-treated mimics were younger (median 54 versus 71 years), had a less severe National Institute of Health Stroke Scale (median 6 versus 8), and a lower prevalence of cardiovascular risk factors, except for a higher prevalence of prior stroke/transient ischemic attack (31.3% versus 26.1%, all P<0.001). The rate of symptomatic intracranial hemorrhage was lower in stroke mimics (0.4%) as compared with 3.5% in ischemic strokes (adjusted odds ratio, 0.29; 95% CI, 0.17-0.50). In-hospital mortality rate was significantly lower in stroke mimics (0.8% versus 6.2%, adjusted odds ratio, 0.31; 95% CI, 0.20-0.49). Patients with stroke mimics were more likely to be discharged to home (83.8% versus 49.3%, adjusted odds ratio, 2.97; 95% CI, 2.59-3.42) and to ambulate independently at discharge (78.6% versus 50.6%, adjusted odds ratio, 1.86; 95% CI, 1.61-2.14). CONCLUSIONS:In this large cohort of patients treated with tPA, relatively few patients who received tPA for presumed stroke were ultimately not diagnosed with a stroke or transient ischemic attack. The complication rates associated with tPA in stroke mimics were low. Despite the potential risk of administering tPA to stroke mimics, opportunity remains for continued improvement in the rapid and accurate diagnosis and treatment of ischemic stroke.

Project description:Human voxel models incorporating detailed anatomical features are vital tools for the computational evaluation of electromagnetic (EM) fields within the body. Besides whole-body human voxel models, phantoms representing smaller heterogeneous anatomical features are often employed; for example, localized breast voxel models incorporating fatty and fibroglandular tissues have been developed for a variety of EM applications including mammography simulation and dosimetry, magnetic resonance imaging (MRI), and ultra-wideband microwave imaging. However, considering wavelength effects, electromagnetic modeling of the breast at sub-microwave frequencies necessitates detailed breast phantoms in conjunction with whole-body voxel models.Heterogeneous breast phantoms are sized to fit within radiofrequency coil hardware, modified by voxel-wise extrusion, and fused to whole-body models using voxel-wise, tissue-dependent logical operators. To illustrate the utility of this method, finite-difference time-domain simulations are performed using a whole-body model integrated with a variety of available breast phantoms spanning the standard four tissue density classifications representing the majority of the population.The software library uses a combination of voxel operations to seamlessly size, modify, and fuse eleven breast phantoms to whole-body voxel models. The software is publicly available on GitHub and is linked to the file exchange at MATLAB® Central. Simulations confirm the proportions of fatty and fibroglandular tissues in breast phantoms have significant yet predictable implications on projected power deposition in tissue.Breast phantoms may be modified and fused to whole-body voxel models using the software presented in this work; user considerations for the open-source software and resultant phantoms are discussed. Furthermore, results indicate simulating breast models as predominantly fatty tissue can considerably underestimate the potential for tissue heating in women with substantial fibroglandular tissue.

Project description:BackgroundDeep brain stimulation (DBS) of the subcallosal cingulate (SCC) is an emerging experimental therapy for treatment-resistant depression. New developments in SCC DBS surgical targeting are focused on identifying specific axonal pathways for stimulation that are estimated from preoperatively collected diffusion-weighted imaging (DWI) data. However, brain shift induced by opening burr holes in the skull may alter the position of the target pathways.ObjectivesQuantify the effect of electrode location deviations on tractographic representations for stimulating the target pathways using longitudinal clinical imaging datasets.MethodsPreoperative MRI and DWI data (planned) were coregistered with postoperative MRI (1 day, near-term) and CT (3 weeks, long-term) data. Brain shift was measured with anatomical control points. Electrode models corresponding to the planned, near-term, and long-term locations were defined in each hemisphere of 15 patients. Tractography analyses were performed using estimated stimulation volumes as seeds centered on the different electrode positions.ResultsMean brain shift of 2.2 mm was observed in the near-term for the frontal pole, which resolved in the long-term. However, electrode displacements from the planned stereotactic target location were observed in the anterior-superior direction in both the near-term (mean left electrode shift: 0.43 mm, mean right electrode shift: 0.99 mm) and long-term (mean left electrode shift: 1.02 mm, mean right electrode shift: 1.47 mm). DBS electrodes implanted in the right hemisphere (second-side operated) were more displaced from the plan than those in the left hemisphere. These displacements resulted in 3.6% decrease in pathway activation between the electrode and the ventral striatum, but 2.7% increase in the frontal pole connection, compared to the plan. Remitters from six-month chronic stimulation had less variance in pathway activation patterns than the non-remitters.ConclusionsBrain shift is an important concern for SCC DBS surgical targeting and can impact connectomic analyses.

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Models and tissue mimics for brain shift simulations.

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Models and tissue mimics for brain shift simulations.

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