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Biomedical subjects

Francis E Kennedy

Publications and source records attributed to Francis E Kennedy.

13 recordsLinked to original sources

Elemental composition, morphology and mechanical properties of calcified deposits obtained from abdominal aortic aneurysms.

Calcified deposits exist in almost all abdominal aortic aneurysms (AAAs). The significant difference in stiffness between these hard deposits and the compliant arterial wall may result in local stress concentrations and increase the risk of aneurysm rupture. Calcium deposits may also complicate AAA repair by hindering the attachment of a graft or stent-graft to the arterial wall or cause vessel wall injury at the site of balloon dilation or vascular clamp placement. Knowledge of the composition and properties of calcified deposits helps in understanding the risks associated with their presence. This work presents results of elemental composition, microscopic morphology, and mechanical property measurements of human calcified deposits obtained from within AAAs. The elemental analyses indicate the deposits are composed primarily of calcium phosphate with other assorted constituents. Microscopy investigations show a variety of microstructures within the deposits. The mechanical property measurements indicate an average elastic modulus in the range of cortical bone and an average hardness similar to nickel and iron.

Aged↗

Elastic and rupture properties of porcine aortic tissue measured using inflation testing.

A new inflation test device was developed to study the mechanical properties of aortic tissue. The device was used to measure failure (rupture) strength and to determine the nonlinear, anisotropic elastic properties of porcine thoracic aorta. The tester was designed to stretch initially flat, circular tissue specimens to rupture under uniform biaxial loading. Water was chosen as the pressurizing fluid. Mechanical stretch and radius of curvature during inflation were measured optically in two orthogonal directions, and the Cauchy stress components were calculated from the deformation and the applied pressure. All porcine samples that ruptured successfully did so via a tear in the circumferential direction. Thus, the failure strength was taken to be the stress in the axial direction immediately prior to rupture. The mean failure strength was 1.75 MPa and mean axial stretch at failure was 1.52. These values agree well with published data for other arterial tissues. The nonlinearly elastic deformation behavior was modeled using a hyperelastic constitutive law of the type proposed by Holzapfel et al. [Holzapfel GA, Gasser TC, Ogden RW. J Elasticity 2000;61:1-48]. The results showed that the dominant directions of anisotropy in the porcine aortas were approximately 45 degrees to the axial and circumferential directions, and that the isotropic contribution to the constitutive model was insignificant.

Animals↗

Data-guided brain deformation modeling: evaluation of a 3-D adjoint inversion method in porcine studies.

Biomechanical models of brain deformation are useful tools for estimating parenchymal shift that results during open cranial procedures. Intraoperative data is likely to improve model estimates, but incorporation of such data into the model is not trivial. This study tests the adjoint equations method (AEM) for data assimilation as a viable approach for integrating displacement data into a brain deformation model. AEM was applied to two porcine experiments. AEM-based estimates were compared both to measured displacement data [from computed tomography (CT) scans] and to model solutions obtained without the guidance of sparse data, which we term the best prior estimate (BPE). Additionally, the sensitivity of the AEM solution to inverse parameter selection was investigated. The results suggest that it is most important to estimate the size of the variance in the measurement error correctly, make the correlation length long and estimate displacement (over stress) boundary conditions. Application of AEM shows an average 33% improvement over BPE. This paper represents the first evidence of successful use of the AEM technique in three dimensions with experimental data validation. The guidelines established for selection of model parameters are starting points for further optimization of the method under clinical conditions.

Algorithms↗

Assimilating intraoperative data with brain shift modeling using the adjoint equations.

Biomechanical models of brain deformation are increasingly being used to nonrigidly register preoperative MR (pMR) images of the brain to the surgical scene. These model estimates can potentially be improved by incorporating sparse displacement data available in the operating room (OR), but integrating the intraoperative information with model calculations is a nontrivial problem. We present an inverse method to estimate the unknown boundary and volumetric forces necessary to achieve a least-squares fit between the model and the data that is formulated in terms of the adjoint equations, which are solved directly by the method of representers. The scheme is illustrated in a 2D simulation and in a 2D approximation based on a patient case using actual OR data.

Algorithms↗

A three-parameter mechanical property reconstruction method for MR-based elastic property imaging.

A reconstruction process featuring full parameterization of the three dimensional, time-harmonic equations of linear elasticity is developed and reconstructed property images are presented from simulation-based investigation. While interesting in its own right through the potential for increased adaptability of these reconstructive elastic imaging techniques, this study also presents a set of analysis tools used to study the poor convergence behavior found in the case of tissue like conditions (i.e. nearly incompressible materials). The choice of elastic properties for imaging in elastography research remains an open question at this point; the use of the stability and sensitivity-based analytical methods described here will help to predict and understand the value and reliability of different parameterizations of elasticity imaging. Additionally, though results indicate significant work needs to be done to achieve effective multiparameter reconstructive imaging, the methods detailed here offer the promise of increased flexibility and sophistication in elastographic imaging techniques.

Algorithms↗

Automated methodology for determination of stress distribution in human abdominal aortic aneurysm.

Knowledge of impending abdominal aortic aneurysm (AAA) rupture can help in surgical planning. Typically, aneurysm diameter is used as the indicator of rupture, but recent studies have hypothesized that pressure-induced biomechanical stress may be a better predictor Verification of this hypothesis on a large study population with ruptured and unruptured AAA is vital if stress is to be reliably used as a clinical prognosticator for AAA rupture risk. We have developed an automated algorithm to calculate the peak stress in patient-specific AAA models. The algorithm contains a mesh refinement module, finite element analysis module, and a postprocessing visualization module. Several aspects of the methodology used are an improvement over past reported approaches. The entire analysis may be run from a single command and is completed in less than 1 h with the peak wall stress recorded for statistical analysis. We have used our algorithm for stress analysis of numerous ruptured and unruptured AAA models and report some of our results here. By current estimates, peak stress in the aortic wall appears to be a better predictor of rupture than AAA diameter. Further use of our algorithm is ongoing on larger study populations to convincingly verify these findings.

Algorithms↗

Initial in vivo experience with steady-state subzone-based MR elastography of the human breast.

PURPOSE: To describe initial in vivo experiences with a subzone-based, steady-state MR elastography (MRE) method. This sparse collection of in vivo results is intended to shed light on some of the strengths and weaknesses of existing clinical MRE approaches and to indicate important areas of future research. MATERIALS AND METHODS: Elastic property reconstruction results are compared with data compiled from the limited existing body of published studies in breast elasticity. Mechanical parameter distributions are also investigated in terms of their implications for the nature of biological soft tissue. Additionally, a derivation of the statistical variance of the elastic parameter reconstruction is given and the resulting confidence intervals (CIs) for different parameter solutions are examined. RESULTS: By comparison with existing estimates of the elastic properties of breast tissue, the subzone-based, steady-state MRE method is seen to produce reasonable estimates for the mechanical properties of in vivo tissue. CONCLUSION: MRE shows potential as an effective way to determine the elastic properties of breast tissue, and may be of significant clinical interest.

Adipose Tissue↗

Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter.

OBJECTIVES: We previously showed that peak abdominal aortic aneurysm (AAA) wall stress calculated for aneurysms in vivo is higher at rupture than at elective repair. The purpose of this study was to analyze rupture risk over time in patients under observation. METHODS: Computed tomography (CT) scans were analyzed for patients with AAA when observation was planned for at least 6 months. AAA wall stress distribution was computationally determined in vivo with CT data, three-dimensional computer modeling, finite element analysis (nonlinear hyperelastic model depicting aneurysm wall behavior), and blood pressure during observation. RESULTS: Analysis included 103 patients and 159 CT scans (mean follow-up, 14 +/- 2 months per CT). Forty-two patients were observed with no intervention for at least 1 year (mean follow-up, 28 +/- 3 months). Elective repair was performed within 1 year in 39 patients, and emergent repair was performed in 22 patients (mean, 6 +/- 1 month after CT) for rupture (n = 14) or acute severe pain. Significant differences were found for initial diameter (observation, 4.9 +/-.1 cm; elective repair, 5.9 +/-.1 cm; emergent repair, 6.1 +/-.2 cm; P <.0001) and initial peak wall stress (38 +/- 1 N/cm(2), 42 +/- 2 n/cm(2), 58 +/- 4 N/cm(2), respectively; P <.0001), but peak wall stress appeared to better differentiate patients who later required emergent repair (elective vs emergent repair: diameter, 3% difference, P =.5; stress, 38% difference, P <.0001). Receiver operating characteristic (ROC) curves for predicting rupture were better for peak wall stress (sensitivity, 94%; specificity,81%; accuracy, 85% [with 44 N/cm(2) threshold]) than for diameter (81%, 70%, 73%, respectively [with optimal 5.5 cm threshold). With proportional hazards analysis, peak wall stress (relative risk, 25x) and gender (relative risk, 3x) were the only significant independent predictors of rupture. CONCLUSIONS: For AAAs under observation, peak AAA wall stress seems superior to diameter in differentiating patients who will experience catastrophic outcome. Elevated wall stress associated with rupture is not simply an acute event near the time of rupture.

Aged↗

Comparison of cross-linked polyethylene materials for orthopaedic applications.

Cross-linked polyethylenes are being marketed by orthopaedic manufacturers to address the problem of osteolysis caused by polyethylene particulate wear debris. Wear testing of these cross-linked polyethylenes in hip simulators has shown dramatic reduction in wear rate compared with standard ultrahigh molecular weight polyethylene, either gamma irradiated in air or nitrogen - or ethylene oxide-sterilized. However, this reduction in wear rate is not without cost. The cross-linking processes can result in materials with lower mechanical properties than standard ultrahigh molecular weight polyethylene. To evaluate the effect of the various cross-linking processes on physical and mechanical properties of ultrahigh molecular weight polyethylene, commercially available cross-linked polyethylenes from six orthopaedic manufacturers were tested. This study was the culmination of collaboration with these manufacturers, who provided cross-linked polyethylene for this study, wear characteristics of the material they provided, and review of the physical and mechanical properties measure for their polyethylene. Cross-linked materials were evaluated as received and after an accelerated aging protocol. Free radical identity and concentration, oxidation, crystallinity, melt temperature, ultimate tensile strength, elongation at break, tensile stress at yield, and toughness are reported for each material. By comparing these physical and mechanical properties, surgeons can evaluate the trade-off that results from developing materials with substantially lower wear rates.

Magnetic Resonance Spectroscopy↗

Displacement estimation with co-registered ultrasound for image guided neurosurgery: a quantitative in vivo porcine study.

Brain shift during open cranial surgery presents a challenge for maintaining registration with image-guidance systems. Ultrasound (US) is a convenient intraoperative imaging modality that may be a useful tool in detecting tissue shift and updating preoperative images based on intraoperative measurements of brain deformation. We have quantitatively evaluated the ability of spatially tracked freehand US to detect displacement of implanted markers in a series of three in vivo porcine experiments, where both US and computed tomography (CT) image acquisitions were obtained before and after deforming the brain. Marker displacements ranged from 0.5 to 8.5 mm. Comparisons between CT and US measurements showed a mean target localization error of 1.5 mm, and a mean vector error for displacement of 1.1 mm. Mean error in the magnitude of displacement was 0.6 mm. For one of the animals studied, the US data was used in conjunction with a biomechanical model to nonrigidly re-register a baseline CT to the deformed brain. The mean error between the actual and deformed CT's was found to be on average 1.2 and 1.9 mm at the marker locations depending on the extent of the deformation induced. These findings indicate the potential accuracy in coregistered freehand US displacement tracking in brain tissue and suggest that the resulting information can be used to drive a modeling re-registration strategy to comparable levels of agreement.

Algorithms↗

Thresholds for detecting and characterizing focal lesions using steady-state MR elastography.

An objective contrast-detail analysis was performed in this study to assess the low contrast detectability of a clinical prototype harmonic magnetic resonance elastographic imaging system. Elastographic imaging was performed on gelatin phantoms containing spherical inclusions of varying size and modulus contrast. The results demonstrate that lesions as small as 5 mm can be detected with a minimum modulus contrast of 14 dB. However, the shear modulus of such small lesions was not accurately recovered. In general, the shear modulus of larger focal lesions was accurately (i.e., within 25% of the true value) recovered. The minimum modulus contrast needed to detect focal lesions was observed to decrease with increasing lesion size.

Algorithms↗

In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk.

OBJECTIVE: The purpose of this study was to calculate abdominal aortic aneurysm (AAA) wall stresses in vivo for ruptured, symptomatic, and electively repaired AAAs with three-dimensional computer modeling techniques, computed tomographic scan data, and blood pressure and to compare wall stress with current clinical indices related to rupture risk. METHODS: CT scans were analyzed for 48 patients with AAAs: 18 AAAs that ruptured (n = 10) or were urgently repaired for symptoms (n = 8) and 30 AAAs large enough to merit elective repair within 12 weeks of the CT scan. Three-dimensional computer models of AAAs were reconstructed from CT scan data. The stress distribution on the AAA as a result of geometry and blood pressure was computationally determined with finite element analysis with a hyperelastic nonlinear model that depicted the mechanical behavior of the AAA wall. RESULTS: Peak wall stress (maximal stress on the AAA surface) was significantly different between groups (ruptured, 47.7 +/- 6 N/cm(2); emergent symptomatic, 47.5 +/- 4 N/cm(2); elective repair, 36.9 +/- 2 N/cm(2); P =.03), with no significant difference in blood pressure (P =.2) or AAA diameter (P =.1). Because of trends toward differences in diameter, comparison was made only with diameter-matched subjects. Even with identical mean diameters, ruptured/symptomatic AAAs had a significantly higher peak wall stress (46.8 +/- 4.5 N/cm(2) versus 38.1 +/- 1.3 N/cm(2); P =.05). Maximal wall stress predicted risk of rupture better than the LaPlace equation (20.7 +/- 5.7 N/cm(2) versus 18.8 +/- 2.9 N/cm(2); P =.2) or other proposed indices of rupture risk. The smallest ruptured AAA was 4.8 cm, but this aneurysm had a stress equivalent to the average electively repaired 6.3-cm AAA. CONCLUSION: Peak wall stresses calculated in vivo for AAAs near the time of rupture were significantly higher than peak stresses for electively repaired AAAs, even when matched for maximal diameter. Calculation of wall stress with computer modeling of three-dimensional AAA geometry appears to assess rupture risk more accurately than AAA diameter or other previously proposed clinical indices. Stress analysis is practical and feasible and may become an important clinical tool for evaluation of AAA rupture risk.

Aged↗

In vivo quantification of retraction deformation modeling for updated image-guidance during neurosurgery.

The use of coregistered preoperative anatomical scans to provide navigational information in the operating room has greatly benefited the field of neurosurgery. Nonetheless, it has been widely acknowledged that significant errors between the operating field and the preoperative images are generated as surgery progresses. Quantification of tissue shift can be accomplished with volumetric intraoperative imaging; however, more functional, lower cost alternative solutions to this challenge are desirable. We are developing the strategy of exploiting a computational model driven by sparse data obtained from intraoperative ultrasound and cortical surface tracking to warp preoperative images to reflect the current state of the operating field. This paper presents an initial quantification of the predictive capability of the current model to computationally capture tissue deformation during retraction in the porcine brain. Performance validation is achieved through comparisons of displacement and pressure predictions to experimental measurements obtained from computed tomographic images and pressure sensor recordings. Group results are based upon a generalized set of boundary conditions for four subjects that, on average, account for at least 75% of tissue motion generated during interhemispheric retraction. Individualized boundary conditions can improve the degree of data-model match by 10% or more but warrant further study. Overall, the level of quantitative agreement achieved in these experiments is encouraging for updating preoperative images to reflect tissue deformation resulting from retraction, especially since model improvements are likely as a result of the intraoperative constraints that can be applied through sparse data collection.

Animals↗