Wolfgang Recheis

Differential Growth and Development of the Upper and Lower Human Thorax

The difficulties in quantifying the 3D form and spatial relationships of the skeletal components of the ribcage present a barrier to studies of the growth of the thoracic skeleton. Thus, most studies to date have relied on traditional measurements such as distances and indices from single or few ribs. It is currently known that adult-like thoracic shape is achieved early, by the end of the second postnatal year, with the circular cross-section of the newborn thorax transforming into the ovoid shape of adults; and that the ribs become inclined such that their anterior borders come to lie inferior to their posterior. Here we present a study that revisits growth changes using geometric morphometrics applied to extensive landmark data taken from the ribcage. We digitized 402 (semi) landmarks on 3D reconstructions to assess growth changes in 27 computed tomography-scanned modern humans representing newborns to adults of both sexes. Our analyses show a curved ontogenetic trajectory, resulting from different ontogenetic growth allometries of upper and lower thoracic units. Adult thoracic morphology is achieved later than predicted, by diverse modifications in different anatomical regions during different ontogenetic stages. Besides a marked increase in antero-posterior dimensions, there is an increase in medio-lateral dimensions of the upper thorax, relative to the lower thorax. This transforms the pyramidal infant thorax into the barrel-shaped one of adults. Rib descent is produced by complex changes in 3D curvature. Developmental differences between upper and lower thoracic regions relate to differential timings and rates of maturation of the respiratory and digestive systems, the spine and the locomotor system. Our findings are relevant to understanding how changes in the relative rates of growth of these systems and structures impacted on the development and evolution of modern human body shape.

An Intra-Individual Comparison of MRI, [18F]-FET and [18F]-FLT PET in Patients with High-Grade Gliomas

Objectives Intra-individual spatial overlap analysis of tumor volumes assessed by MRI, the amino acid PET tracer [18F]-FET and the nucleoside PET tracer [18F]-FLT in high-grade gliomas (HGG). Methods MRI, [18F]-FET and [18F]-FLT PET data sets were retrospectively analyzed in 23 HGG patients. Morphologic tumor volumes on MRI (post-contrast T1 (cT1) and T2 images) were calculated using a semi-automatic image segmentation method. Metabolic tumor volumes for [18F]-FET and [18F]-FLT PETs were determined by image segmentation using a threshold-based volume of interest analysis. After co-registration with MRI the morphologic and metabolic tumor volumes were compared on an intra-individual basis in order to estimate spatial overlaps using the Spearmans rank correlation coefficient and the Mann-Whitney U test. Results [18F]-FLT uptake was negative in tumors with no or only moderate contrast enhancement on MRI, detecting only 21 of 23 (91%) HGG. In addition, [18F]-FLT uptake was mainly restricted to cT1 tumor areas on MRI and [18F]-FLT volumes strongly correlated with cT1 volumes (r = 0.841, p<0.001). In contrast, [18F]-FET PET detected 22 of 23 (96%) HGG. [18F]-FET uptake beyond areas of cT1 was found in 61% of cases and [18F]-FET volumes showed only a moderate correlation with cT1 volumes (r = 0.573, p<0.001). Metabolic tumor volumes beyond cT1 tumor areas were significantly larger for [18F]-FET compared to [18F]-FLT tracer uptake (8.3 vs. 2.7 cm3, p<0.001). Conclusion In HGG [18F]-FET but not [18F]-FLT PET was able to detect metabolic active tumor tissue beyond contrast enhancing tumor on MRI. In contrast to [18F]-FET, blood-brain barrier breakdown seems to be a prerequisite for [18F]-FLT tracer uptake.

Sheep as a Large Animal Model for Middle and Inner Ear Implantable Hearing Devices: A Feasibility Study in Cadavers

Objective Currently, no large animal model exists for surgical-experimental exploratory analysis of implantable hearing devices. In a histomorphometric study, we sought to investigate whether sheep or pig cochleae are suitable for this purpose and whether device implantation is feasible. Methods Skulls of pig and sheep cadavers were examined using high-resolution 128-slice computed tomography (CT) to study anatomic relationships. A cochlear implant and an active middle ear implant could be successfully implanted into the sheep’s inner and middle ear, respectively. Correct device placement was verified by CT and histology. The cochlear anatomy of the sheep was further studied by micro-CT and histology. Results Our investigations indicate that the sheep is a suitable animal model for implantation of implantable hearing devices. The implantation of the devices was successfully performed by access through a mastoidectomy. The histologic, morphologic, and micro-CT study of the sheep cochlea showed that it is highly similar to the human cochlea. The temporal bone of the pig was not suitable for these microsurgical procedures because the middle and inner ear were not accessible owing to distinct soft and fatty tissue coverage of the mastoid. Conclusion The sheep is an appropriate large animal model for experimental studies with implantable hearing devices, whereas the pig is not.

Geometric modeling and motion analysis of the epicardial surface of the heart

Pathological processes cause abnormal regional motions of the heart. Regional wall motion analyses are important to evaluate the success of therapy, especially of cell therapy, since the recovery of the heart in cell therapy proceeds slowly and results in only small changes of ventricular wall motility. The usual ultrasound imaging of heart motion is too inaccurate to be considered as an appropriate method. MRI studies are more accurate, but insufficient to reliably detect small changes in regional ventricular wall motility. We thus aim at a more accurate method of motion analysis. Our approach is based on two imaging modalities, viz. cardiac CT and biplane cineangiography. The epicardial surface represented in the CT data set at the end of the diastole is registered to the three-dimensionally reconstructed epicardial artery tree from the angiograms in end-diastolic position. The motion tracking procedures are carried out by applying thin-plate spline transformations between the epicardial artery trees belonging to consecutive frames of our cineangiographic imagery.

Post-mortem interval estimation of human skeletal remains by micro-computed tomography, mid-infrared microscopic imaging and energy dispersive X-ray mapping

In this study different state-of-the-art visualization methods were evaluated to study human skeletal remains for the determination of the post-mortem interval (PMI).

Radial Basis Functions and Splines for Landmark‐Based Registration of Medical Images

We propose the use of a class of spline functions, called Lobachevsky splines, for landmark‐based registration. We recall the analytic expressions of the Lobachevsky splines and some of their properties, reasoning in the context of probability theory. These functions have simple analytic expressions and compact support. Numerical tests appear to be promising.

Visualization Aspects of Motion Tracking and Analysis of the Outer Surface of the Left Ventricle

The quantitative assessment of the motion and deformation of the heart is instrumental to diagnosis. We developed an accurate method for tracking and analysing the regional motion and deformation of the heart. To be of clinical value, the results must be visualized, and we paid much attention to all relevant visualization aspects.

Reconstruction of large cranial defects with poly-methyl-methacrylate (PMMA) using a rapid prototyping model and a new technique for intraoperative implant modeling

BACKGROUND Reconstruction of large cranial defects after craniectomy can be accomplished by free-hand poly-methyl-methacrylate (PMMA) or industrially manufactured implants. The free-hand technique often does not achieve satisfactory cosmetic results but is inexpensive. In an attempt to combine the accuracy of specifically manufactured implants with low cost of PMMA. METHODS Forty-six consecutive patients with large skull defects after trauma or infection were retrospectively analyzed. The defects were reconstructed using computer-aided design/computer-aided manufacturing (CAD/CAM) techniques. The computer file was imported into a rapid prototyping (RP) machine to produce an acrylonitrile-butadiene-styrene model (ABS) of the patients bony head. The gas-sterilized model was used as a template for the intraoperative modeling of the PMMA cranioplasty. Thus, not the PMMA implant was generated by CAD/CAM technique but the model of the patients head to easily form a well-fitting implant. Cosmetic outcome was rated on a six-tiered scale by the patients after a minimum follow-up of three months. RESULTS The mean size of the defect was 74.36cm2. The implants fitted well in all patients. Seven patients had a postoperative complication and underwent reoperation. Mean follow-up period was 41 months (range 2-91 months). Results were excellent in 42, good in three and not satisfactory in one patient. Costs per implant were approximately 550 Euros. CONCLUSION PMMA implants fabricated in-house by direct molding using a bio-model of the patients bony head are easily produced, fit properly and are inexpensive compared to cranial implants fabricated with other RP or milling techniques.

Development of an accurate method for motion analyses of the heart wall based on medical imagery

In the field of diagnosis and therapy of coronary artery disease, it is highly important to acquire a fair knowledge of the heart wall motion and its regional variations. Unfortunately, the accuracy of all currently applied methods for the acquisition and analysis of the regional heart wall motion is rather limited. We developed a sufficiently accurate technique for tracking and analysing the regional motion of the epicardium throughout the cardiac cycle which is based on cardiac CT and biplane angiography. In the end-diastolic position, the epicardial surface in the 3D CT data is segmented and registered to the skeleton representation of the coronary artery tree obtained from the end-diastolic frame of a biplane cineangiogram. In doing so, a landmark-based approach based on TPS transformations has been chosen. The motion tracking is accomplished by carrying out further landmark-based TPS transformations of the surface to the successive frames of the cineangiogram.

Computing Topology Preservation of RBF Transformations for Landmark-Based Image Registration

In image registration, a proper transformation should be topology preserving. Especially for landmark-based image registration, if the displacement of one landmark is larger enough than those of neighbourhood landmarks, topology violation will be occurred. This paper aims to analyse the topology preservation of some Radial Basis Functions (RBFs) which are used to model deformations in image registration. Matern functions are quite common in the statistic literature (see, e.g. [9, 13]). In this paper, we use them to solve the landmark-based image registration problem. We present the topology preservation properties of RBFs in one landmark and four landmarks model respectively. Numerical results of three kinds of Matern transformations are compared with results of Gaussian, Wendland’s, and Wu’s functions.