The main program includes lectures by various researchers and industry leaders regarding the multiple uses of Mimics software.

An extensive range of topics will be discussed in two parallel sessions.

Click the presentation title to read the abstract.

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Session 1 - moderated by Prof. Dr. Jos Vander Sloten, KULeuven, Belgium

Session 2 - moderated by Dr. Panayotis Diamantopoulos, University of Athens, Greece

Abstracts

Prof. Dr. Andreas Linninger, University of Illinois, US
Medical imaging for targeted delivery of macro-molecules to the human brain

Recent advances in imaging techniques such as MRI, functional MRI, Diffusion Tensor Imaging, Computer Tomography, Positron Emission Tomography, have enabled a quantum leap in medical diagnosis. However, remaining challenges in targeted delivery of drugs to the brain or image-guided brain surgery call for a more accurate quantification of imaging data and their integration into customized patient-specific treatment protocols. We will present novel scientific methods to quantify the patient-specific biometrics as well as its anisotropic physiological properties of the human brain with state-of-the-art image reconstruction techniques.
Several treatment modalities for neuro-degenerative diseases or tumors of the central nervous system involve invasive delivery of large molecular weight drugs to the brain. Despite ample experimental efforts, accurate drug targeting for the human brain remains a challenge. Our interdisciplinary research aims at a systematic design process for the targeted delivery of therapeutic agents into specific regions of brain based on first principles mathematical equations of drug transport and pharmaco-kinetics in porous tissue. The proposed mathematical framework predicts achievable treatment volumes in the desired regions as a function of target anatomy and infusion catheter positioning.
We also tackle the three-dimensional optimal catheter placement problem to determine optimal infusion and catheter design parameters that maximize drug penetration and volumes of distribution in the target area, while minimizing toxicity in non-targeted regions. A novel computational approach for determining unknown transport properties of therapeutic agents from in-vivo imaging data will also be introduced.
We expect for the near future that rigorous computational approaches like ours will enable physicians and scientists to design and optimize drug administration in a systematic fashion.

Prof. Dr. Karl Entacher, Salzburg University of Applied Sciences, Austria

Finite element analysis for total shoulder joint replacement

The application of Mimics for the generation of accurate 3D Finite Element (FE) shoulder models based on computed tomography (CT) data is demonstrated. The patient’s individual anatomy is taken into account when producing 3D models for five patients (two women aged 84 years and three men aged 27, 57 and 66 years, respectively). Virtual surgery is performed in order to insert a HAS (Howmedica Osteonics, Ireland) glenoid implant at various angles to the ventral surface of the scapula. The whole modeling process from CT-data to accurate FE-models will be demonstrated and challenges will be discussed.

The aim of the presented study is to analyze different positions of the sockets of the glenoid shoulder prosthesis. The normal angle between the ventral surface and the articular surface of the scapula is 65°; in atrophic shoulder joints this angle could be reduced down to 45°. Stresses in the scapula are explored by insertions of the socket from 65° to 45°. Therefore, a FE analysis is used, where different load distributions and shear stresses at the interfaces prosthesis / cement-cement / scapula and their impact to the shoulder blade are calculated, analyzed and compared.

Dr. Ting Jiao, Shanghai No.9 People's Hospital, China
Design and fabrication of auricular prostheses by CAD/CAM system

Material and Methods: Spiral CT was given to a patient who had his right ear defect resulting from an accident. Though Mimics software，3-dimension image was reconstructed with the CT data. By image ware, the image of the normal ear was extracted, mirrored and Boolean Operated with the image of the deformed side of the face. It was well modified and smoothened in Freeform model system so that it could precisely adapt to the deficient side of the face. A paper model ear was manufactured by rapid prototyping manufacturing from the digitized data. Finally, silicone was poured into a silicone mold from the paper ear to create a silicone auricular prosthesis.
Results: The dimension, shape and anatomic contour of the auricular prosthesis were really similar to the normal ear and precisely matched the deformed area.
Conclusion: The CAD/CAM system created auricular prostheses appears to be a practical technique.

Dr. Philipp Juergens, University Hospital Basel, Switzerland
3D- planning and navigation in the clinical routine for the correction of craniofacial deformities

Sophisticated pre-operative planning of corrective surgery of deformities in the facial skeleton becomes more and more important.
Virtual 3D- models of the facial soft tissue and the underlying bony structures generated from CT- Scans are used to perform relocation planning and soft tissue prediction. To achieve optimal transfer from planning to patient, obtained planning data were transferred into a prototype system for intraoperative navigation.
In more than 20 patients suffering from congenital or acquired (trauma or tumor) skeletal deformities corrective surgical interventions were planned using the Mimics or the Surgicase software package. In all Patients CT- datasets of midface and mandible, acquired in clinical routine, were used to perform the surgical planning procedure. For intraoperative navigation the planning data were transferred into stl format and imported into our prototype system. The components of this tracking and navigation system include navigation hardware like the system control unit, position sensor, and different dynamic reference bases (DRB). This system allows a real- time navigation with 3D- display of the bone- fragment repositioning.
The surgical procedures supported by the navigation system have been fully successful. Linking industrial planning software with a research prototype navigation system allows reliable standardized planning and the implementation of innovative scientific approaches for intraoperative navigation into the clinical routine. The high quality of the preoperative planning has a crucial influence on the quality of the navigation and by this optimizes the surgical outcome. The planning procedure and the subsequent intraoperative navigation will be exemplarily presented on clinical cases.

Prof. Tim McGloughlin, University of Limerick, Ireland
Realistic model development for biomedical engineering research

An abdominal aortic aneurysm (AAA) which is a localized swelling of the aortic artery is indicated when the size reaches at least 1.5 times greater than the normal diameter of the infrarenal aorta. AAAs have a high risk of rupture if left untreated and AAA rupture results in more than 15,000 deaths per annum in the USA. Currently, surgical intervention is decided on the basis of maximum diameter of the aneurysm, with most surgeons intervening when AAA diameter exceeds 50-60mm. We have conducted studies aimed at improving the clinical methods of rupture prediction and at evaluating flow and force behaviour of grafts and stent-grafts following surgical treatment
In order to asses the behaviour of a range of realistic patient specific aneurysms we have developed computational and experimental modelling methods at our laboratories.
Computed topography (CT) scan data was obtained from patients who were awaiting AAA repair and this CT data was then reconstructed using Mimics v10.0 (Materialise, Belgium). These reconstructions allowed stress analysis and experimental studies of a range of aneurysms models to be conducted. The stress analysis has been conducted using Finite Element Analysis (Abaqus) and the results have enabled us to identify magnitudes and locations of peak stresses in the models and we have compared the results with experimental findings. Flow behavior has also been investigated and the aneurysm models have been analysed using fluid structure interaction models. Our experimental modeling methods and the associated flow and stress studies will be presented and additional findings from analyses of a range of other vascular applications will be described.

Ir. Matthieu De Beule, University of Ghent, Belgium

The role of microCT in finite element stent research

Balloon expandable stents are small laser cut metallic structures used in medical percutaneous interventions to prop open narrowed arteries. After laser cutting and electropolishing, these stents are crimped on a balloon catheter to an external diameter often smaller than 1 mm. During the medical intervention, the balloon catheter with crimped stent is guided through the stenotic lesion that causes the narrowing of the artery. Subsequently the balloon is successively inflated and deflated leaving the expanded stent to strut the reopened blood vessel. The Finite Element Method (FEM) offers the possibility to optimize the design of these miniature devices without costly and time-consuming trial-and-error processes. The FEM also procures valuable quantitative information (forces, stresses, …) that one is almost unable to obtain in other ways. One important prerequisite for using the FEM is the availability of and detailed models. High resolution X-ray tomography has revealed to be very suited to study stent expansion in combination with the FEM. Scans taken at the centre for X-ray Tomography of Ghent University (UGCT) provide detailed 3D information that is readily importable into FE solvers.
In this study, different balloon mounted stent geometries were scanned with 5 µm resolution prior to expansion. These initial geometries were transformed into numerical models either by directly converting them to input files with Mimics or by creating a redrawn meshed geometrical model with the in-house developed software pyFormex. In combination with very realistic balloon models, the expansion was simulated with the FE solver ABAQUS. Subsequently, the stents were expanded experimentally under the scanner in order to compare successfully with the numerical results. Overall, an excellent qualitative and quantitative agreement was found between the stent deployment pattern obtained from the numerical simulations and found in the experiments.

Ir. Wim Vos, FluidDA, Belgium
The use of Mimics and functional imaging to guide and evaluate the placement of intrabronchial stents and valves

Modern imaging techniques such as MR and CT turn out to be an excellent starting point to obtain functional data about the human body. Combining the segmentation and 3D model generation tools within Mimics with flow simulations, we were able to come up with a workflow that provides the clinician with a detailed insight of the local status of pathological lungs. We believe that these insights can assist the clinician in his decision making considering local therapies, i.e. stent or valve placement, lung volume reduction surgery, …
We will show examples on how (local) deformations of the airway tree and deterioration of the lung tissue do interfere with the general mechanics of the respiratory system. Using functional imaging techniques the exact origin of these problems could be mapped and a patient specific solution was proposed. After therapeutic intervention both the short-term and long-term effects of the proposed solutions were analyzed for their (local) influences on the dynamics of the respiratory system.
Since functional imaging is the only non-invasive technique to obtain local characteristics on the dynamic properties of the lungs we believe that this technique has a great future in the field of pulmonology.

Prof. Wei Sun, Drexel University, US
Mimics in computer aided tissue engineering

Computer-aided tissue engineering (CATE) is an evolving interdisciplinary field that utilizes tools of medical image processing, computer-aided design (CAD), computational and multi-scale modeling, and novel biomanufacturing process to model, design, and fabricate biological tissue and organ substitutes. Application of MIMICS for imaging data manipulation and three- dimensional reconstruction for biomodeling has facilitated the design of biomaterials to complex tissue scaffolds. This presentation will summarize our recent research and education on interdisciplinary field of CATE, particular on utilization of MIMICS software for computer-aided tissue modeling, biomaterial design of 3D tissue scaffold, scaffold characterization, and the application of the modelling database for bio-manufacturing of tissue constructs. Examples of using MIMICS for bioCAD modelling and biomimetic design of load bearing scaffold for orthopaedic applications will be presented. An educational experience of implementing MIMICS in an interdisciplinary course “Computer-Aided Tissue Engineering” will also be shared.

Erik Boelen, Phd., Mimics Product Specialist, Materialise, Belgium
Mimics - Past, Present, Future

Originally Mimics software was developed to convert Computed Tomography (CT) scans into physical medical models using additive technology. Over time, many image processing tools and export possibilities were added, which opened up a wide variety of application domains in which Mimics is used nowadays. Due to Mimics’ diversity it is challenging to develop the software in such a way that everyone benefits from the newest tools. New tools should satisfy our broad audience. Our current improvements do just that. For the future we foresee an increased use of CAE in the biomedical field. Another field that holds much promise for the future of medicine is tissue engineering. By adding tools to Mimics that help researchers in this field, we hope to contribute to a better and healthier world.

Bernardo Innocenti, PhD, Smith&Nephew Knee Research Centre, Belgium
The use of Mimics to define anatomical landmarks for the kinematic analysis of the knee

 In recent years, the kinematics of the human knee has been studied in quite some detail using cadaver specimens mounted on simulators as well as techniques to make measurements in vivo. The results of these studies have shown that the classical four bar linkage model of the knee is not adequate. This obviously has repercussions for the design of knee implants. They should at least permit normal kinematic behavior to prevent abnormal loads on the soft tissues and on other joints of the leg. Studies where implant kinematics can be compared to kinematics of the natural knee of the same specimen are very rare, though.
In the project that will be presented, we measured the kinematics of six fresh frozen human cadaver knees in the natural state and after replacement of the joint with a bi-cruciate stabilizing implant. Before testing, frames with reflective markers were mounted on femur and tibia. Then, a CT scan was made and the images were processed using Mimics 11.02 to identify anatomical landmarks and their position with respect to the reflective markers. Thus, an anatomically relevant coordinate system could be defined for each bone. During testing, the motion of the markers was continuously measured. The data obtained with Mimics enabled us to calculate the motion of the femur and tibia with respect to each other and present that in clinically relevant terms. After testing a second CT scan was made to check the position of the implant with respect to the original articular surfaces and also for a control of the position of the marker frames. Mimics was also used to process these images. Finally, a study was performed to assess the inter-observer and intra-observer variability of the identification of the anatomical landmarks. The results of this study will be presented too.

Dr.med.vet. Renate Weller, Royal Veterinary College, UK
Three-dimensional anatomy of the equine check teeth

Background: Infundibular caries and tooth root infections are common dental disorders in the horse. These present a challenge to the clinician both with regards to diagnosis and treatment due to the complex structure of the equine check teeth. To date the detailed three-dimensional anatomy of these teeth has not been described, which is essential to understand the aetiopathogenesis of dental disease, to improve the diagnostic process and optimise treatment.
Aims: To describe the three-dimensional anatomy of normal and diseased equine cheek teeth.
Methods: Computed tomography was performed in 126 normal and pathological mandibular and maxillary check teeth with eruption ages of between 0.5 and 19 years. Detailed 3D reconstructions (Mimics, Materialise, Belgium) were created illustrating the infundibula, the pulp configuration, the dentin and enamel layers and compared to anatomical sections.
Results: For the first time the complex anatomy of equine check teeth with its intricate pulp configurations was demonstrated in three dimensions. The pulpar configurations of the maxillary cheek teeth were observed to be of far greater variety compared to those of the mandibular cheek teeth. Both mandibular and maxillary cheek teeth showed consistent patterns in their pulpar and enamel morphology, however did show variation with age. Conclusions and clinical significance: The detailed description of the normal and abnormal 3D anatomy of equine cheek teeth provides a reference tool for diagnosis and treatment of dental disorders in the horse.

Dr. Simon Collins, Animal Health Trust and Loughborough University, UK 
Foot hoof and fancy FEA - The development of a finite element model of the horse's foot using Materialise software

This presentation outlines the biomechanical modelling work currently in progress, as part of the FWF Project V56-N14, to explicate the functional biomechanics of the equine digit. In particular, the presentation highlights the direct application of Mimics and 3-matic software functionality within the modelling process.

The equine digit represents the dynamic platform for athletic performance, and is the major site of musculoskeletal injury. Despite these facts, relatively little is known of the pathomechanics associated with locomotor dysfunction, and this severely limits our ability to treat. The Finite Element (FE) modelling technique uniquely provides a non-invasive method of investigation, that can give new information vital for the development of improved strategies for preventative and therapeutic management of foot dysfunction.

In order to simulate biomechanical function, anatomical models must first be generated. Advanced imaging modalities including MRI/CT and SPECT/PET have revolutionised our ability to image the anatomy and physiology of the body. However, traditional 'reverse' engineering techniques have placed limitations on utilising this information to develop sophisticated FE models with the required anatomical 'detail' and 'quality' to perform accurate biomechanical simulations. A novel 'digital', 'forward' engineering approach has been developed and optimised using Mimics and 3-matic software to generate a 32 component model from CT and MRI data. Issues relating to image acquisition, anatomical rationalisation, component segmentation, contact surfaces generation, and remeshing will be discussed. This novel approach enables FE model generation of complex anatomical assemblages.

Dipl.-Ing Paulo Antunes, University of Minho, Portugal
From CT scan to finite element model of the human foot – a study on the foot biomechanical behaviour

Detailed anatomic virtual models are increasing their importance in the process of designing new products with interaction with the human body. The combination of growing computer power with new modelling tools makes possible the development of Computer Aided Engineering (CAE) methodologies for geometrical or material formulation optimisation of orthotic devices. In this work, a 3D anatomically detailed non-linear finite element human foot model was built from density segmentation 3D reconstruction techniques applied to Computed Tomography (CT) scan images in conjunction with 3D Computer Aided Design (CAD) operations. The geometrical complexity of the foot structure implied the use of reverse engineering tools in order to obtain a model that could accurately simulate the biomechanical behaviour of the human foot. Some geometrical simplifications were considered in the definition of plantar fascia and Achilles tendon that were included in the FEA model through the definition of truss and axial connectors elements, respectively. Linear and non-linear material constitutive laws were used in the definition of biological materials present in the foot-ankle complex FEA model. Foot plantar contact pressure values for a rigid contact (barefoot/soil) were experimentally verified for a balanced standing loading case and compared with FEA results. For studying the dependence on contact pressure generated at the foot with changes in the contact stiffness at the insole/foot interface, simple flat insoles were geometrically defined and implemented in the FEA model. This study allowed the quantification of the variations in the foot plantar contact pressure and contact area values for different non-linear elastic material formulations and insole thicknesses.

Dr. Stephen Wroe,University of New South Wales, Australia
Building and using high-resolution heterogeneous finite element models to examine cranial mechanics and feeding behaviour in hominids and other vertebrates, living and extinct

In recent years Finite Element (FE) analysis has emerged as a powerful tool in the examination and prediction of mechanical behaviour in biological structures. The FE approach delivers the advantage of being nondestructive, while facilitating collection of far more detailed information than can be achieved using traditional methods. These features lend great promise for investigators concerned with areas ranging from the evolution of feeding behaviour to the optimization of surgical techniques and design of prosthetics. However, a number of limitations have constrained the application of FE in such roles. Problematic areas include: the time consuming nature of model generation, the assignment of multiple properties for bone of varying densities, and the simulation of joint articulation and musculature. Here I discuss recent advances made by the Computational Biomechanics Research Group (Universities of UNSW and Newcastle, Australia) that have at least partly overcome each of these constraints (Wroe 2007; Wroe et al. 2007). Our protocols facilitate the generation of heterogeneous FE models comprising up to 3 million ‘brick’ elements within 2-4 hrs inclusive of articulating crania and mandibles. Complete assembly of models simulating musculature in which point loading is minimized can be achieved within days. Results of FE modeling using these techniques on a variety of species will be considered.

Prof. Dr. Niels Lynnerup, University of Copenhagen, Denmark

Back to the future: using Mimics to study the dead (the very dead)

The advent of powerful computers and high resolution CT-scanners has profoundly changed the nature of medical imaging. Very detailed visualisations of internal anatomical structures can now be produced. In terms of analyses of bog bodies and mummies this has opened up for new ways to document, investigate and “recreate” such finds.

While documentation may seem a trivial use of the techniques, this may well be one of the most important aspects of the technology: the ability to literally visualize the internal structures of a mummy, millimetre by millimetre and inside -out, as well as easy archival and retrieval of the information, will be invaluable for future curatorial work.

The techniques also enable non-invasive and non-destructive, paleopathological and biological anthropological analyses. Finally, the techniques allow for reconstructive efforts.

However, especially concerning bog bodies, the effects of the thousands of years in the bog has had a detrimental effect to the tissue conservation. We have found it necessary to pursue detailed post-processing of the CT-images. To this end, we have used Mimics as our standard segmentation software. Furthermore, Mimics allows us to build RPT files rapidly.

A recent published case, the Danish bog body the Grauballe Man, is now published, and we demonstrate how the use of Mimics was essential to many of the investigations.