Matthieu Poyade

Development of a Patient-Specific 3D-Printed Liver Model for Preoperative Planning

Introduction. Liver surgery is widely used as a treatment modality for various liver pathologies. Despite significant improvement in clinical care, operative strategies, and technology over the past few decades, liver surgery is still risky, and optimal preoperative planning and anatomical assessment are necessary to minimize risks of serious complications. 3D printing technology is rapidly expanding, and whilst appliactions in medicine are growing, but its applications in liver surgery are still limited. This article describes the development of models of hepatic structures specific to a patient diagnosed with an operable hepatic malignancy. Methods. Anatomy data were segmented and extracted from computed tomography and magnetic resonance imaging of the liver of a single patient with a resectable liver tumor. The digital data of the extracted anatomical surfaces was then edited and smoothed, resulting in a set of digital 3D models of the hepatic vein, portal vein with tumor, biliary tree with gallbladder, and hepatic artery. These were then 3D printed. Results. The final models of the liver structures and tumor provided good anatomical detail and representation of the spatial relationships between the liver tumor and adjacent hepatic structures and could be easily manipulated and explored from different angles. Conclusions. A graspable, patient-specific, 3D printed model of liver structures could provide an improved understanding of the complex liver anatomy and better navigation in difficult areas and allow surgeons to anticipate anatomical issues that might arise during the operation. Further research into adequate imaging, liver-specific volumetric software, and segmentation algorithms are worth considering to optimize this application.

A recommended workflow methodology in the creation of an educational and training application incorporating a digital reconstruction of the cerebral ventricular system and cerebrospinal fluid circulation to aid anatomical understanding

BackgroundThe use of computer-aided learning in education can be advantageous, especially when interactive three-dimensional (3D) models are used to aid learning of complex 3D structures. The anatomy of the ventricular system of the brain is difficult to fully understand as it is seldom seen in 3D, as is the flow of cerebrospinal fluid (CSF). This article outlines a workflow for the creation of an interactive training tool for the cerebral ventricular system, an educationally challenging area of anatomy. This outline is based on the use of widely available computer software packages.MethodsUsing MR images of the cerebral ventricular system and several widely available commercial and free software packages, the techniques of 3D modelling, texturing, sculpting, image editing and animations were combined to create a workflow in the creation of an interactive educational and training tool. This was focussed on cerebral ventricular system anatomy, and the flow of cerebrospinal fluid.ResultsWe have successfully created a robust methodology by using key software packages in the creation of an interactive education and training tool. This has resulted in an application being developed which details the anatomy of the ventricular system, and flow of cerebrospinal fluid using an anatomically accurate 3D model. In addition to this, our established workflow pattern presented here also shows how tutorials, animations and self-assessment tools can also be embedded into the training application.ConclusionsThrough our creation of an established workflow in the generation of educational and training material for demonstrating cerebral ventricular anatomy and flow of cerebrospinal fluid, it has enormous potential to be adopted into student training in this field. With the digital age advancing rapidly, this has the potential to be used as an innovative tool alongside other methodologies for the training of future healthcare practitioners and scientists. This workflow could be used in the creation of other tools, which could be developed for use not only on desktop and laptop computers but also smartphones, tablets and fully immersive stereoscopic environments. It also could form the basis on which to build surgical simulations enhanced with haptic interaction.

Canine neuroanatomy: Development of a 3D reconstruction and interactive application for undergraduate veterinary education

Current methods used to communicate and present the complex arrangement of vasculature related to the brain and spinal cord is limited in undergraduate veterinary neuroanatomy training. Traditionally it is taught with 2-dimensional (2D) diagrams, photographs and medical imaging scans which show a fixed viewpoint. 2D representations of 3-dimensional (3D) objects however lead to loss of spatial information, which can present problems when translating this to the patient. Computer-assisted learning packages with interactive 3D anatomical models have become established in medical training, yet equivalent resources are scarce in veterinary education. For this reason, we set out to develop a workflow methodology creating an interactive model depicting the vasculature of the canine brain that could be used in undergraduate education. Using MR images of a dog and several commonly available software programs, we set out to show how combining image editing, segmentation and surface generation, 3D modeling and texturing can result in the creation of a fully interactive application for veterinary training. In addition to clearly identifying a workflow methodology for the creation of this dataset, we have also demonstrated how an interactive tutorial and self-assessment tool can be incorporated into this. In conclusion, we present a workflow which has been successful in developing a 3D reconstruction of the canine brain and associated vasculature through segmentation, surface generation and post-processing of readily available medical imaging data. The reconstructed model was implemented into an interactive application for veterinary education that has been designed to target the problems associated with learning neuroanatomy, primarily the inability to visualise complex spatial arrangements from 2D resources. The lack of similar resources in this field suggests this workflow is original within a veterinary context. There is great potential to explore this method, and introduce a new dimension into veterinary education and training.

Toward the Development of an Accurate 3D Human Body Model Implemented in a Real-Time, Interactive Application to Enhance Anatomy Teaching

GABA and its synthesising enzyme, glutamate decarboxylase, have been detected in the rat kidney [1–2]. GABA has also been found in human plasma and urine [3–4] and most recently, a renoprotective role for GABA has been suggested [5]. We are systematically investigating functional roles for GABA and glutamate in the mammalian kidney. Contractile pericytes regulate vasa recta diameter in response to a number of endogenous vasoactive agents and in doing so regulate medullary blood flow (MBF) [6]. We have utilised the live kidney slice model [6] to demonstrate GABA-mediated constriction of vasa recta that was significantly greater at pericyte sites than at non-pericyte sites (p< 0.01). Conversely, the GABA substrate glutamate (100 ?M) caused a significantly greater vasodilation of vasa recta at pericyte sites compared to non-pericyte sites (p< 0.05). Data presented here identifies a novel role for GABA and glutamate in pericyte-mediated regulation of vasa recta diameter and thus MBF.Obesity frequently associates with chronic inflammatory diseases, including type 2 diabetes. In this study, a combination of a protein hydrolysate, LCPUFAs and a probiotic strain was investigated on the development of high fat diet -induced diabetic risk factors and complications in LDLr-/-.Leiden mice. Male LDLr-/-.Leiden mice at 12 wks of age received a high fat diet (HFD) for 21 wks with or without a combination of an extensive casein hydrolysate, docosahexaenoic acid (DHA), arachidonic acid (ARA), and Lactobacillus Rhamnosus GG (LGG). Both HFD and intervention diet were isocaloric and casein from HFD was replaced with casein hydrolysate in the test diets. The addition of DHA/ARA in the test diets was controlled for in the HFD. Moreover, a PBS gavage control group was included to control for potential effects of LGG gavage. There were significant beneficial effects of the hydrolysate/ARA/DHA/LGG composition versus the HFD control group including reduced body weight gain, lower plasma levels of insulin, cholesterol and triglycerides, lower systemic inflammation, improved adipose tissue quality and mass, and improved kidney and liver function. In a follow up study, evaluating the individual components of the test formulation, some of the outcomes were attributable to the hydrolysate or LGG. A combination of an extensive casein hydrolysate, ARA, DHA and LGG reduces the detrimental effects of HFD on the development of obesity and its metabolic complications. Main risk factors for the metabolic syndrome such as adipose tissue and chronic inflammation were markedly reduced which could provide a rationale for the beneficial effects observed.OBJECTIVETo evaluate the impact of a mobile phone SMS text message intervention on the exclusiveness of breastfeeding (EBF) in infants 0–6 months. METHODSA two-arm parallel randomized controlled tr...

Proof of concept of a workflow methodology for the creation of basic canine head anatomy veterinary education tool using augmented reality

Neuroanatomy can be challenging to both teach and learn within the undergraduate veterinary medicine and surgery curriculum. Traditional techniques have been used for many years, but there has now been a progression to move towards alternative digital models and interactive 3D models to engage the learner. However, digital innovations in the curriculum have typically involved the medical curriculum rather than the veterinary curriculum. Therefore, we aimed to create a simple workflow methodology to highlight the simplicity there is in creating a mobile augmented reality application of basic canine head anatomy. Using canine CT and MRI scans and widely available software programs, we demonstrate how to create an interactive model of head anatomy. This was applied to augmented reality for a popular Android mobile device to demonstrate the user-friendly interface. Here we present the processes, challenges and resolutions for the creation of a highly accurate, data based anatomical model that could potentially be used in the veterinary curriculum. This proof of concept study provides an excellent framework for the creation of augmented reality training products for veterinary education. The lack of similar resources within this field provides the ideal platform to extend this into other areas of veterinary education and beyond.

Using mobile virtual reality to empower people with hidden disabilities to overcome their barriers

This paper presents a proof of concept for an immersive and interactive mobile application which aims to help people with hidden disabilities to develop tolerance to the environmental stressors that are typically found in crowded public spaces, and more particularly in airports. The application initially proposes the user to rehearse a series of sensory attenuated experiences within digitally reconstructed environments of the Aberdeen International Airport. Throughout rehearsals, environmental stressors are gradually increased making the environments more sensory challenging for the user. Usability and pilot testing provided encouraging outcomes ahead of future developments.

Sinbad and the Magic Cure: A Serious Game for Children with ASD and Auditory Hypersensitivity

Serious games (SG) are part of a range of technologies that can be used for children with Autism Spectrum Disorder (ASD). Typically, these games target communication skills, social interaction and speech. There are, however, few SGs for autistic children which have the aim of helping to moderate sensory hypersensitivity. This paper presents an SG which aims to target this area. A set of critical sounds was heuristically determined, and implemented in an interactive SG for reducing auditory hypersensitivity (i.e. over-sensitivity to environmental sounds) in children with ASD. The game, Sinbad and the Magic Cure, is designed for Android devices, and is intended for children aged 8–11.

CREATION OF A DIGITAL TRAINING PACKAGE FOR CANINE NEUROANATOMY FOR THE UNDERGRADUATE VETERINARY CURRICULUM

The current methods used to communicate and present the complex arrangement of vasculature often falls short in undergraduate veterinary neuroanatomy training. The teaching resources currently available are primarily 2-Dimensional (2D) textbook diagrams, photographs and medical imaging scans showing a fixed viewpoint. 2D representations of 3-Dimensional (3D) objects unavoidably leads to the loss of certain spatial information, which can present problems when translating the knowledge acquired using these methods to the 3D patient. In recognition of these issues, the value of computer-assisted learning packages offering interactive 3D anatomical models has long since been realized in medical education. The ability to view and manipulate an object in 3D space has been shown to improve anatomical learning by allowing spatial relationships, which are all too often unclear in 2D materials, to be fully appreciated and understood. Despite the routine usage of such technology in medical education, equivalent resources are scarce in veterinary education. It was therefore the aim of this project to develop an interactive application for undergraduate veterinary education to target the leading problems associated with learning neuroanatomy, primarily the inability of students to visualize the complex spatial arrangements of the cerebral vasculature from 2D resources. This project presents a method that has been successful in developing a 3D reconstruction of the canine brain and associated vasculature through segmentation, surface generation and post-processing of readily available medical imaging data. This reconstructed 3D model has been implemented into an engaging interactive application, designed using Unity 3D, with features including 360o rotation, vessels highlighted and labeled on selection as well as the display of vessel-specific information. In addition to this, revision materials and opportunities for self-assessment were included based on content of the Bachelor of Veterinary Medicine and Surgery (BVMS) anatomy course at the University of Glasgow, School of Veterinary Medicine. The lack of similar resources in this field suggests this workflow is original within a veterinary context. There is therefore great potential to explore this method further, and introduce a new dimension into veterinary learning.

A Haptic-Based Virtual Reality Head and Neck Model for Dental Education

There have been numerous datasets, 3D models and simulations developed over the years however it is clear that there is a need to provide an anatomically accurate, flexible, user driven virtual training environment that can potentially offer significant advantages over traditional teaching methods, techniques and practices. The ability to virtually train dental trainees to navigate and interact in a repeatable format, before directly engaging with the patients can measurably reduce error rates while significantly enhancing the learner experience. Accurate dental simulation with force feedback allows dental students to familiarize with clinical procedures and master practical skills with realistic tactual sensation. In this chapter, we review the state of art of using haptics in dental training and present the development and construction of a medically validated high-definition interactive 3D head and neck anatomical dataset with a haptic interface to support and enhance dental teaching across multiple training sites for NHS Education Scotland. Data acquisition from cadaveric specimens and 3D laser scanning of precision dissection is discussed, including techniques employed to build digital models capable of real-time interaction and display. Digital anatomical model construction is briefly described, including the necessity to clinically validate each stage of development that would ensure a normalised human data set whilst removing anatomical variance arising from individual donor cadaveric material. This complex digital model was transformed into a real-time environment capable of large-scale 3D stereo display in medical teaching labs across Scotland, whilst also offering the support for single users with laptops and PC. The 3D viewer environment also supports haptic interaction through a force feedback probe device (Phantom Omni) offering the ability for users to repeatedly practise giving dental anaesthesia injections into the gum. Specific tools supported include guillotine tools, picking and selection tools capable of expanding specific local regions of anatomy. Zoom camera functions and freeform rotation allows thorough and meaningful investigation to take place of all major and minor anatomical structures and systems whilst providing the user with the means to record sessions and individual scenes for learning and training purposes.