Thorax Model Research Articles

Attenuation Tomography Using Low-Frequency Ultrasound for Thorax Imaging: Feasibility Study.

Low-frequency ultrasound can permeate human thorax and can be applied in functional imaging of the respiratory system. In this study, we investigate the transmission of low-frequency ultrasound through the human thorax and propose a waveform matching method to track the changes in the transmission signal during subject's respiration. The method's effectiveness is validated through experiments involving ten human subjects. Furthermore, the experimental findings indicate that the traveltime of the first-arrival signal remains consistent throughout the respiratory cycle. Leveraging this observation, we introduce an algorithm for ultrasound thorax attenuation factor differential imaging. By computing the paths and energy variation of the first-arrival signal from the received waveform, the algorithm reconstructs the distribution of attenuation factor differences between two different thorax states, providing insights into the functional status of the respiratory system. Numerical experiments, using both normal thorax and defective thorax models, confirm the algorithm's feasibility and its robustness against noise, variations in transducer position and orientation. These results highlight the potential of low-frequency ultrasound for bedside, continuous monitoring of human respiratory system through functional imaging.

Hypoxia in the pulmonary vein increases pulmonary vascular resistance independently of oxygen in the pulmonary artery.

Hypoxic pulmonary vasoconstriction (HPV) can be a challenging clinical problem. It is not fully elucidated where in the circulation the regulation of resistance takes place. It is often referred to as if it is in the arteries, but we hypothesized that it is in the venous side of the pulmonary circulation. In an open thorax model, pigs were treated with a veno-venous extra corporeal membrane oxygenator to either oxygenate or deoxygenate blood passing through the pulmonary vessels. At the same time the lungs were ventilated with extreme variations of inspired air from 5% to 100% oxygen, making it possible to make combinations of high and low oxygen content through the pulmonary circulation. A flow probe was inserted around the main pulmonary artery and catheters in the pulmonary artery and in the left atrium were used for pressure monitoring and blood tests. Under different combinations of oxygenation, pulmonary vascular resistance (PVR) was calculated. With unchanged level of oxygen in the pulmonary artery and reduced inspired oxygen fraction lowering oxygen tension from 29 to 6.7 kPa in the pulmonary vein, PVR was doubled. With more extreme hypoxia PVR suddenly decreased. Combinations with low oxygenation in the pulmonary artery did not systematic influence PVR if there was enough oxygen in the inspired air and in the pulmonary veins. The impact of hypoxia occurs from the alveolar level and forward with the blood flow. The experiments indicated that the regulation of PVR is mediated from the venous side.

Impact Location Dependence of Behind Armor Blunt Trauma Injury Assessed Using a Human Body Finite Element Model.

Behind armor blunt trauma (BABT), resulting from dynamic deformation of protective ballistic armor into the thorax, is currently assessed assuming a constant threshold of maximum backface deformation (BFDs) (44 mm). Although assessed for multiple impacts on the same armor, testing is focused on armor performance (shot-to-edge and shot-to-shot) without consideration of the underlying location on the thorax. Previous studies identified the importance of impacts on organs of animal surrogates wearing soft armor. However, the effect of impact location was not quantified outside the threshold of 44 mm. In the present study, a validated biofidelic advanced human thorax model (50th percentile male) was utilized to assess the BABT outcome from varying impact location. The thorax model was dynamically loaded using a method developed for recreating BABT impacts, and BABT events within the range of real-world impact severities and locations were simulated. It was found that thorax injury depended on impact location for the same BFDs. Generally, impacts over high compliance locations (anterolateral rib cage) yielded increased thoracic compression and loading on the lungs leading to pulmonary lung contusion (PLC). Impacts at low compliance locations (top of sternum) yielded hard tissue fractures. Injuries to the sternum, ribs, and lungs were predicted at BFDs lower than 44 mm for low compliance locations. Location-based injury risk curves demonstrated greater accuracy in injury prediction. This study quantifies the importance of impact location on BABT injury severity and demonstrates the need for consideration of location in future armor design and assessment.

Lung radiotherapy verification with a 3D printed thorax phantom and an ionisation chamber array

In this study, a 3D printing error inspired the development of a novel method for using a sagittally-sliced 3D printed thorax phantom to perform dosimetric verifications of lung radiotherapy treatment methods using a 2D ionization chamber array. A full-size thorax model was designed for 3D printing with multiple tissue densities including lung and bone and printed as a series of 2.4 cm sagittal slices using a Raise 3D Pro dual nozzle printer (Raise 3D Technologies Inc, Irvine, USA). An error introduced midway through printing resulted in one half of the phantom being printed at unrealistically high densities. A method was therefore devised whereby the entire phantom was used to plan two lung treatments, one conventionally fractionated and one hypo-fractionated, which were then verified via measurements using an Octavius 729 ionisation chamber array (PTW-Freiburg GmbH, Freiburg, Germany) in combination with several correctly-printed slices of the phantom. The measurements allowed dose distributions in planes through the target, adjacent to the target and at the location key of organs at risk to be verified, for both treatment plans. This method has the potential to be adapted for use with other phantoms and other dosimetry arrays to allow efficient evaluation of future treatment techniques.

Simulation and Experiment of Cardiopulmonary Resuscitation Robot

Aiming at the emergence of patients with outdoor cardiac arrest, to strive for more golden rescue time, a robot suitable for the rescue of patients with outdoor cardiac arrest is proposed. Combined with the medical research on the human thorax, the dynamic model of the human thorax is established, the kinematics and dynamics of the end effector mechanism are analyzed, and the robot is simulated for cardiopulmonary resuscitation in the human thorax with Adams software. The relationship between the stroke, speed, acceleration, driving torque, and time of the end effector is obtained. Second, the dynamic formula theory is simulated with Matlab software. The difference between the theoretical driving torque and the simulation driving torque is 5.2% and 2.3% respectively. Finally, the feasibility of the CPR operation of the robot is preliminarily verified through experiments.

Blue-Blood Pig Thorax Model Increases Residents' Confidence in Internal Mammary Dissection.

Preparation of the recipient vessels is a crucial step in autologous breast reconstruction, with limited opportunity for resident training intraoperatively. The Blue-Blood-infused porcine chest wall-a cadaveric pig thorax embedded in a mannequin shell, connected to a saline perfusion system-is a novel, cost-effective ($55) simulator of internal mammary artery (IMA) dissection and anastomosis intended to improve resident's comfort, safety, and expertise with all steps of this procedure. The purpose of this study was to assess the effect of the use of this chest wall model on resident's confidence in performing dissection and anastomosis of the IMA, as well as obtain resident's and faculty's perspectives on model realism and utility. Plastic surgery residents and microsurgery faculty at the University of Wisconsin were invited to participate. One expert microsurgeon led individual training sessions and performed as the microsurgical assistant. Participants anonymously completed surveys prior to and immediately following their training session to assess their change in confidence performing the procedure, as well as their perception of model realism and utility as a formal microsurgical training tool on a five-point scale. Every participant saw improvement in confidence after their training session in a minimum of one of seven key procedural steps identified. Of participants who had experience with this procedure in humans, the majority rated model anatomy and performance of key procedural steps as "very" or "extremely" realistic as compared with humans. 100% of participants believed practice with this model would improve residents' ability to perform this operation in the operating room and 100% of participants would recommend this model be incorporated into the microsurgical training curriculum. The Blue-Blood porcine chest wall simulator increases trainee confidence in performing key steps of IMA dissection and anastomosis and is perceived as valuable to residents and faculty alike.

A new biomechanical FE model for blunt thoracic impact.

In the field of biomechanics, numerical procedures can be used to understand complex phenomena that cannot be analyzed with experimental setups. The use of experimental data from human cadavers can present ethical issues that can be avoided by utilizing biofidelic models. Biofidelic models have been shown to have far-reaching benefits, particularly in evaluating the effectiveness of protective devices such as body armors. For instance, numerical twins coupled with a biomechanical model can be used to assess the efficacy of protective devices against intense external forces. Similarly, the use of human body surrogates in experimental studies has allowed for biomechanical studies, as demonstrated by the development of crash test dummies that are commonly used in automotive testing. This study proposes using numerical procedures and simplifying the structure of an existing biofidelic FE model of the human thorax as a preliminary step in building a physical surrogate. A reverse engineering method was used to ensure the use of manufacturable materials, which resulted in a FE model called SurHUByx FEM (Surrogate HUByx Finite Element Model, with HUByx being the original thorax FE model developed previously). This new simplified model was validated against existing experimental data on cadavers in the context of ballistic impact. SurHUByx FEM, with its new material properties of manufacturable materials, demonstrated consistent behavior with the corresponding biomechanical corridors derived from these experiments. The validation process of this new simplified FE model yielded satisfactory results and is the first step towards the development of its physical twin using manufacturable materials.

Probing Deep Lung Regions using a New 6-electrode Tetrapolar Impedance Method.

Probing deep regions of the lung using electrical impedance is very important considering the need for a low cost and simple technique, particularly for the low and medium income countries. Because of complexity and cost, Electrical Impedance Tomography is not suitable for this envisaged application. The simple Tetrapolar Impedance Measurement (TPIM) technique employing four electrodes is the age old technique for bioelectrical measurements. However, it has its limitations in respect of organ localisation and depth sensitivity using skin surface electrodes. Recently, a new 6-electrode TPIM with two current electrodes but two pairs of appropriately connected potential electrodes positioned on the front and back of the thorax, proposed by one of the authors, came with a promise. However, this work gave a qualitative proposal based on concepts of physics and lacked a quantitative evaluation. In order to evaluate the method quantitatively, the present work employed finite element method based COMSOL Multiphysics software and carried out simulation studies using this new 6-electrode TPIM and compared the results with those from 4-electrode TPIM, with electrodes applied either on the front or at the back of the thorax for the latter. Initially, it carried out a sensitivity distribution study using a simple rectangular volume conductor which showed that the 6-electrode TPIM gives better depth sensitivity throughout the lung region. Next it used a near life like thorax model developed by another of the authors earlier. Using this model, extensive studies were carried out to quantify the overall sensitivity over a target lung region, the contribution of the target lung to the total measured impedance, and several other parameters. Through these studies, the 6-electrode TPIM was established on a stronger footing for probing deep regions of the lungs.

Quantifying the Effect of Body Habitus on Cardiac Auscultation Via Computational Hemoacoustics.

The effect of body habitus on auscultation of heart murmurs is investigated via computational hemoacoustic modeling. The source of the heart murmur is first obtained from a hemodynamic simulation of blood flow through a stenosed aortic valve. This sound source is then placed at the aortic valve location in four distinct human thorax models, and the propagation of the murmur in each thorax model is simulated by solving the elastic wave equations in the time-domain. Placing the same sound source in different thorax models allows for the disambiguation of the effect of body habitus on cardiac auscultation. The surface acceleration resulting from the murmur on each subject's chest surface shows that subjects with higher body-mass index and thoracic cross-sectional area yield smaller acceleration values for the S1 sound. Moreover, the spectral analysis of the signal shows that slope from linear regression in the normal heart sound frequency range (10-150 Hz) is larger for children at the aortic, pulmonic, and mitral auscultation points compared to that for adults. The slope in the murmur frequency range (150-400 Hz) was larger for female subjects at the mitral point compared to that for male subjects. The trends from the results show the potential of the proposed computational method to provide quantitative insights regarding the effect of various anatomical factors on cardiac auscultation.

Image Human Thorax Using Ultrasound Traveltime Tomography with Supervised Descent Method

The change of acoustic velocity in the human thorax reflects the functional status of the respiratory system. Imaging the thorax’s acoustic velocity distribution can be used to monitor the respiratory system. In this paper, the feasibility of imaging the human thorax using ultrasound traveltime tomography with a supervised descent method (SDM) is studied. The forward modeling is computed using the shortest path ray tracing (SPR) method. The training model is composed of homogeneous acoustic velocity background and a high-velocity rectangular block moving in the domain of interest (DoI). The average descent direction is learned from the training set. Numerical experiments are conducted to verify the method’s feasibility. Normal thorax model experiment proves that SDM traveltime tomography can efficiently reconstruct thorax acoustic velocity distribution. Numerical experiments based on synthetic thorax model of pleural effusion and pneumothorax show that SDM traveltime tomography has good generalization ability and can detect the change of acoustic velocity in human thorax. This method might be helpful for the diagnosis and evaluation of respiratory diseases.

Assessment of in situ chest deflection of post mortem human subjects (PMHS) and personalized human body models (HBM) in nearside oblique impacts

Objective The present study has three objectives: First, to analyze the chest deflection measured in nearside oblique tests performed with three post mortem human subjects (PMHS). Second, to assess the capability of a HBM to predict the chest deflection sustained by the PMHS. Third to evaluate the influence on chest deflection prediction of subject-specific HBM. Methods Three dimensional chest deformation of five anterior chest landmarks was extracted from three PMHS (A-C) in three sled tests. The sled test configurations corresponded to a 30 degree nearside oblique impact at 35 km/h. Two different restraint system versions (RSv) were used. RSv1 was used for PMHS A and B while RSv2 was used for PMHS C. The capability of the SAFER HBM (called baseline model) to predict PMHS chest deflection was benchmarked by means of the PMHS test results. In a second step, the anthropometry, mass and pre-impact posture of the baseline HBM were modified to the PMHS-specific characteristics to develop a model to assess the influence of personalization techniques in the capability of the human body model to predict PMHS chest deflection. Results In the sled tests, the measured sternum compression relative to the eighth thoracic vertebra in the PMHS tests was 49, 54 and 55 millimeters respectively. The HBM baseline model predicted 48%, 43% and 34% of the deflections measured in the PMHS tests, while the personalized version predicted 38%, 34% and 28%. When chest deflection was analyzed in x-, y- and z-direction for the five chest landmarks it was found that neither the baseline HBM nor the personalized model predicted x, y and z axis deflections. Conclusions The PMHS in situ chest deflection was found to be sensitive to the variation in restraint system and the three PMHS exhibited greater values of lower right chest deflection compared to what was found in available literature. The baseline HBM underpredicted peak chest deflection obtained in the PMHS test. The personalized model was not capable of predicting the chest deflection sustained by the PMHS. Hence, further biofidelity investigations have to be carried out on the human body thorax model for oblique loading.

Effect of anisotropy in myocardial electrical conductivity on lesion characteristics during radiofrequency cardiac ablation: a numerical study

Background Traditional computer simulation studies of radiofrequency catheter ablation (RFCA) usually neglect the anisotropy in myocardial electrical conductivity (MEC), which is likely an essential factor in governing the ablation outcome. Here, a numerical study of lesion characteristics during RFCA based on an anatomy-based model incorporating fiber orientation was performed to investigate the anisotropy in MEC. Methods A three-dimensional thorax model including atria, blood, connective tissue, muscle, fat, and skin was constructed. The myocardial fiber was established through a rule-based method (RBM) based on the anatomical structure of the heart. The anisotropic MEC were 0.40 and 0.28 S m−1 in longitudinal and transverse directions, respectively. The ablation result was compared with the isotropic scenario where the isotropic MEC was the average of the anisotropic conductivities as 0.34 S m−1. Results The complexity of fiber architecture varied with that of the local anatomical structure. At RF power of 20 W for 30 s, the tissue temperature and lesion volume were reduced by 2.8 ± 0.1% and 6.9 ± 0.5%, respectively, under anisotropic MEC around the ostium of the pulmonary vein and left atrial appendage. Those for the posterior wall and roof of the left atrium, and the inside of the superior vena cava were 1.9 ± 0.3% and 5.6 ± 1.2%, respectively. Conclusions Anisotropy in MEC has a greater reduction effect on lesion volume than on tissue temperature during RFCA; this effect tends to be restrained at positions with more uniform fiber distributions and can be enhanced where significant variation in fiber architecture occurred.

Three-Dimensional Printed Models for Preoperative Planning and Surgical Treatment of Chest Wall Disease: A Systematic Review

Introduction: In chest wall reconstruction, the main objectives are the restoration of the chest wall integrity, function, and aesthetic, which is often achieved with the placement of implants. We aimed to evaluate whether 3D printed models can be useful for preoperative planning and surgical treatment in chest wall reconstruction to improve the outcome of the surgery and to reduce the rate of complications. Methods: We conducted a systematic review of literature using PubMed, Scopus, Embase, and Google Scholar databases until 8 November 2021 with the following keywords: (“3D printing” or “rapid prototyping” or “three-dimensional printing” or “bioprinting”) and (“chest wall” or “rib” or “sternum” or “ribcage” or “pectus excavatum”). Results were then manually screened by two independent authors to select studies relevant to 3D printing application in chest wall reconstruction. The primary outcome was morphological correction, and secondary outcomes were changes in operating time and procedure-related complication rate. Results: Eight articles were included in our review. Four studies were related to pectus excavatum correction, two studies were related to rib fracture stabilization, and two studies were related to chest wall tumor resection and reconstruction. Seven studies reported 3D printing of a thorax model or template implants for preoperative planning and implant modeling, and one study reported 3D printing of a PEEK prosthesis for direct implantation. Four studies reported comparison with a conventionally treated control group, and three of them detected a shorter operative time in the 3D printing model-assisted group. Satisfactory morphological correction was reported in all studies, and six studies reported a good implant fitting with minimal need for intraoperative adjustments. There were no major intraoperative or postoperative complications in any of the studies. Conclusions: The use of 3D printing models in chest wall reconstruction seems to be helpful for the production of personalized implants, reducing intraoperative adjustments. Results of morphological correction and postoperative recovery after the 3D printing-assisted surgery were satisfactory in all studies with a low rate of complication. Our literature review suggests good results regarding prosthesis fitting, accuracy of surgical planning, and reduction in operative time in 3D printing-assisted procedures, although more evidence is needed to prove this observation.

An Improved Equivalent Impact Model of Human Thorax for Human-Robot Collaboration

An Improved Equivalent Impact Model of Human Thorax for Human-Robot Collaboration

Evaluation and Validation of Thorax Model Responses: A Hierarchical Approach to Achieve High Biofidelity for Thoracic Musculoskeletal System.

As one of the most frequently occurring injuries, thoracic trauma is a significant public health burden occurring in road traffic crashes, sports accidents, and military events. The biomechanics of the human thorax under impact loading can be investigated by computational finite element (FE) models, which are capable of predicting complex thoracic responses and injury outcomes quantitatively. One of the key challenges for developing a biofidelic FE model involves model evaluation and validation. In this work, the biofidelity of a mid-sized male thorax model has been evaluated and enhanced by a multi-level, hierarchical strategy of validation, focusing on injury characteristics, and model improvement of the thoracic musculoskeletal system. At the component level, the biomechanical responses of several major thoracic load-bearing structures were validated against different relevant experimental cases in the literature, including the thoracic intervertebral joints, costovertebral joints, clavicle, sternum, and costal cartilages. As an example, the thoracic spine was improved by accurate representation of the components, material properties, and ligament failure features at tissue level then validated based on the quasi-static response at the segment level, flexion bending response at the functional spinal unit level, and extension angle of the whole thoracic spine. At ribcage and full thorax levels, the thorax model with validated bony components was evaluated by a series of experimental testing cases. The validation responses were rated above 0.76, as assessed by the CORA evaluation system, indicating the model exhibited overall good biofidelity. At both component and full thorax levels, the model showed good computational stability, and reasonable agreement with the experimental data both qualitatively and quantitatively. It is expected that our validated thorax model can predict thorax behavior with high biofidelity to assess injury risk and investigate injury mechanisms of the thoracic musculoskeletal system in various impact scenarios. The relevant validation cases established in this study shall be directly used for future evaluation of other thorax models, and the validation approach and process presented here may provide an insightful framework toward multi-level validating of human body models.

Development of a novel 3D-printed multifunctional thorax model simulator for the simulation-based training of tube thoracostomy.

Tube thoracostomy is a high-acuity, low-occurrence (HALO) procedure with significant morbidity when performed incorrectly; this is amendable through simulation. Commercially available trainers exist but often have limited realism or exorbitant cost. Three-dimensional (3D) printing produces realistic and cost-effective models suitable for simulation, but no simulator has been developed for tube thoracostomy. The aim of this paper is to describe the initial development of a multifunctional 3D-printed thorax trainer for the instruction of tube thoracostomy. The thorax model was developed in conjunction with a multi-disciplinary team using 3D-printing capable software. An existing ribcage model was modified and printed in separate elements, including bony portions (ribcage, sternum and clavicles), flexible joints, skin, heart and lungs and then assembled. The total printing cost was $180 CAD. Future research will focus on incorporating the model's ability to simulate other HALO procedures and evaluating it as a training adjunct.

A Feasibility Study of 2-D Microwave Thorax Imaging Based on the Supervised Descent Method

In this paper, the application of the supervised descent method (SDM) for 2-D microwave thorax imaging is studied. The forward modeling problem is solved by the finite element-boundary integral (FE-BI) method. According to the prior information of human thorax, a 3-ellipse training set is generated offline. Then, the average descent direction between an initial background model and the training models is calculated. Finally, the reconstruction of the testing thorax model is achieved based on the average descent directions online. The feasibility using One-Step SDM for thorax imaging is studied. Numerical results indicate that the structural information of thorax can be reconstructed. It has potential for real-time imaging in future clinical diagnosis.

Incomplete PET projection data reconstruction method and simulation experiment

In positron emission tomography (PET) imaging, the whole body reconstruction is not required if the region of interest (ROI) is only a part of the object. This paper researched a local image reconstruction algorithm based on the PI-lines, and proposed the derivative-backprojection-Hilbert (DBH) algorithm which can use the incomplete PET projection data to achieve accurate reconstruction of ROI. We designed simulation experiments to evaluate the performance of the DBH algorithm with thorax model as the object of PET image reconstruction, and compared root mean square error (RMSE) of DBH reconstruction and RMSE of filtered backprojection (FBP) reconstruction from simulations data sets with and without noise. The result shows that DBH algorithm has advantages over traditional FBP algorithm, the RMSE decreases by 49.07% and 51.19% with the coincidence events number of 20 million and 40 million, respectively. Compared with traditional maximum-likelihood expectation-maximization (ML-EM), the local iteration algorithm which uses DBH reconstruction as the initial image produces a better reconstructed image at fewer iterations with the coincidence events number of 60 million. DBH algorithm is expected to be applied to fast two-dimensional local image reconstruction and optimize the local iterative reconstruction algorithm in clinical diagnosis.

A Thorax Marker Set Model to Analyse the Kinematics of Walking Without the Need to Place Markers on the Back.

Previous thorax models have been proposed for gait analysis, however these require markers to be placed on the back. This presents a limitation in the kinematic analysis of the thorax under load carriage conditions. This study evaluated the validity and reliability of a thorax marker set that does not require markers to be placed on the back (HubemaLab model) when compared to 3 previously published marker set models. 17 young adults were evaluated while walking at their self-selected speed. A 12 camera motion capture system was used to acquire the marker position data which was then processed using the respective models using Visual-3D. The level of agreement for the flexion/extension peak, right/left lateral peak and right/left rotation peak of the thorax angle and angular velocity; together with the range of motion and thorax angular velocities in the three planes was found between each thorax marker set, while the reliability was measured using the intraclass correlation coefficient. The ICC results for the thorax angle ROM and the range of thorax angular velocity between the HubemaLab model and the other models showed excellent to good reliability in all three planes. While the ICCs for the peak flexion/extension, peak right/left lateral flexion and peak right/left rotation showed excellent to moderate reliability in all three planes. The new model could be potentially valuable for kinematic gait analysis under load carriage conditions which obscure markers placed on the back.

A finite element model of the human lower thorax to pelvis spinal segment: Validation and modal analysis.

Several finite element (FE) models have been developed to study the effects of vibration on human lumbar spine. However, the authors know of no published results so far that have proposed computed tomography-based FE models of whole lumbar spine including the pelvis to conduct dynamic analysis. To create and validate a three-dimensional ligamentous FE model of the human lower thorax to pelvis spinal segment (T12-Pelvis) and provide a detailed simulation environment to investigate the dynamic characteristics of the lumbar spine under whole body vibration (WBV). The T12-Pelvis model was generated based on volume reconstruction from computed tomography scans and validated against the published experimental data. FE modal analysis was implemented to predict dynamic characteristics associated with the first-order vertical resonant frequency and vibration mode of the model with upper body mass of 40kg under WBV. It was found that the current FE model was validated and corresponded closely with the published data. The obtained results from the modal analysis indicated that the first-order vertical resonant frequency of the T12-Pelvis model was 6.702Hz, and the lumbar spine mainly performed vertical motion with a small anteroposterior motion. It was also found that shifting the upper body mass centroid onwards or rearwards from the normal upright sitting posture reduced the vertical resonant frequency. These findings may be helpful to better understand vibration response of the human spine, and provide important information to minimize injury and discomfort for these WBV-exposed occupational groups.