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Case-Based Simulation to Support Complex Active Catheterization: Preliminary Results
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-04-10 DOI: 10.1016/j.irbm.2025.100890
Arif Badrou , Aurélien de Turenne , Nathan Lescanne , Jérôme Szewczyk , Raphaël Blanc , Nahiène Hamila , Nicolas Tardif , Aline Bel-Brunon , Pascal Haigron

Objective

Active catheters are intended to support endovascular navigation in complex anatomies. Nevertheless, their configuration and utilization are challenging. Finite element (FE) modeling representing the navigation of active guidewires alongside catheters can be considered at an early stage to identify the best parameters and support physicians in their planning and procedure. However, FE simulations require significant computation time. We introduce the concept of case-based simulation (CBS) to quickly find adequate configuration parameters for complex catheterization scenarios.

Method

Combining case-based reasoning and FE simulation, CBS approach is considered to reuse design and navigation parameters from previous simulations. A case base is made of successful catheterization simulations performed on reference aorta geometries. For a new patient, a distance metric based on a statistical shape model is used to determine appropriate catheterization parameters from previously simulated cases. The proof-of-concept of this method is performed in the case of the navigation from the aortic arch to the left carotid artery. Among 11 patient-specific aortic arches, three were selected for the reference FE simulations of the left carotid artery hooking to constitute the case base and three others were selected for evaluation.

Results

The retrieved parameters allowed a successful simulated navigation in 100% of the test cases. This demonstrates that the proposed approach can effectively and instantaneously determine appropriate design and navigation parameters for complex catheterization scenarios.
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引用次数: 0
Patchwise Trabecular Bone Reconstruction of a 2D Proximal Femur Using Deep Learning and Seamless Quilting Algorithm
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-04-08 DOI: 10.1016/j.irbm.2025.100889
Bong Ju Chun , Sang Min Sin , Hyukjin Koh , Jung Jin Kim , In Gwun Jang

Background and Objective

Current in vivo imaging modalities such as CT and MRI provide low-resolution (LR) skeletal images of a limited resolution (400 to 600 μm), which is insufficient to precisely evaluate bone strength. Similarly, recent deep learning technologies show a limitation in terms of upscale ratio and image size. They also require a large number of high-resolution (HR) reference images for training, which are unavailable to acquire in clinical practice. Although topology optimization shows the potential to reconstruct HR skeletal images from CT scan data, it requires extreme computing cost for a limited region of interest (ROI). The goal of this study is to acquire a 2D HR full proximal femur image by reconstructing HR patch images via a deep neural network and merging them seamlessly.

Methods

Topology optimization was conducted to generate synthetic proximal femur images. After these HR images were downscaled 10 times, finite element analysis was conducted to evaluate the structural behavior of the downscaled LR images. By dividing the proximal femur images into a set of patches which share their cut boundary, we could generate a total of 52,000 pairs of the HR and LR image patches and the LR structural behavior (nodal displacement in this study). Then, these patch-wise data were used to train three different deep neural networks: ResNet, U-Net, and SRGAN. Finally, after the HR patch images were upscaled 10 times by the trained networks, they were seamlessly merged by minimizing a structural discontinuity on the patch boundary.

Results

The reconstructed HR proximal femur images were evaluated at three different ROIs in terms of image quality, apparent stiffness, and trabecular morphometric indices. They showed characteristic trabecular patterns with no visible structural discontinuity between the patches in all ROIs. Among three networks, ResNet showed the best performance in all quantitative measures.

Conclusion

This study proposes a novel framework that incorporates deep learning-based patchwise reconstruction and seamless quilting algorithm. Because the proposed method requires a very small number of reference HR images (only 11 synthetic full proximal femur images in total), it could be expanded to reconstruct trabecular bone from 3D clinical CT scan data for more reliable bone strength assessment in clinical practice.
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引用次数: 0
An Approach to Compute Fetal Cardiac Biomarkers from the Abdominal Electrocardiogram
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-14 DOI: 10.1016/j.irbm.2025.100886
Paula Romina Soria , Pablo Daniel Cruces , César Federico Caiafa , Pedro David Arini
Objective: The fetal electrocardiogram (FECG) can be recorded from the 20th week of gestation. The aim of this work is to determine fetal cardiac biomarkers from non-invasive cardiac signals that may be useful in the assessment of fetal health. Methods: We have developed an algorithm to obtain FECG fiducial points. It started by discriminating fetal heartbeats based on the relative location between fetal and maternal QRS complexes. An average beat is derived from the abdominal electrocardiogram (AECG) using 20 beats with a correlation greater than 0.95 and stable RR-interval, based on data from 12 fetuses (38th - 42nd weeks). We have implemented a combination between quaternion algebra and principal component analysis (Q-PCA method) to determine the onset and end of FECG waves by analyzing the angular velocity of the heart electrical vector. To validate our findings, we compared them with measurements obtained from the direct fetal electrocardiogram (DFECG), as a benchmark. Results: The values calculated by the Q-PCA method, as well as their correlation and the p-value in relation to the DFECG, were as follows: PR interval: 125.1±19.8 ms (ρ=0.97, p<2.39e7), QRS complex: 73.0±4.4 ms (ρ=0.67, p<1.74e2), QT interval: 261.1±28.5 ms (ρ=0.84, p<7.05e4) and QTc interval: 388.3±35.9 ms (ρ=0.79, p<2.27e3). Conclusion: Given its importance and the measurement performance achieved, the methodology presented represents a significant potential tool for improving the diagnosis of fetal health.
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引用次数: 0
Objective Assessment of Pull Test Scores in Parkinson's Disease Under Dynamic Conditions
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-05 DOI: 10.1016/j.irbm.2025.100884
Marta Cardoso , Cristiana Pinheiro , Helena R. Gonçalves , Ana Margarida Rodrigues , Cristina P. Santos

Background

Postural instability is considered one of the most incapacitating motor symptoms and a primary cause of falls in Parkinson's disease (PD), compromising patients' autonomy and well-being. The traditional clinical examination used to evaluate this symptom designed by pull test is difficult to standardize and is not sensitive to subtle but significant postural changes. Inertial measurement units have emerged as a portable and cost-effective solution to measure on-body patients' postural sway allowing them to obtain more sensitive metrics able to capture postural instability. However, further studies are required to monitor patients' postural conditions under dynamic conditions.

Methods

The proposed research focused on investigating the hypothesis of whether it is possible to differentiate between all the scores of the pull test through postural and gait metrics extracted from raw acceleration and angular velocity signals from the centre of mass of patients with PD acquired while performing basic daily tasks. A new cross-sectional study was conducted with 23 patients to determine which gait and postural-associated metrics are considered significant to distinguish between the different levels of pull test, and which metrics are more correlated with the pull test score.

Results

Achieved results showed that most of the estimated metrics can differentiate the pull test scores (ρ-value0.048, R20.513). The duration of the activity, root-mean-square and range of motion of vertical and mediolateral angular velocity, as also most of the gait-associated metrics, presented the most significant differences in all trials which involved motion tasks, such as sitting, lying, walking and turning.

Conclusions:

Overall, promising results were achieved as the statistical analysis revealed that gait and postural metrics estimated under dynamic conditions were considered relevant to distinguish between the scores of the pull test.
背景姿势不稳定被认为是最令人丧失能力的运动症状之一,也是帕金森病(PD)患者跌倒的主要原因,损害了患者的自主性和幸福感。传统的临床检查通过拉力测试来评估这一症状,但这种方法很难标准化,而且对细微但显著的姿势变化不敏感。惯性测量装置作为一种便携式、经济高效的解决方案出现,可用于测量患者的体位摇摆,从而获得更灵敏的指标,捕捉体位不稳定性。该研究的假设是,是否有可能通过从帕金森病患者在执行基本日常任务时从质心获得的原始加速度和角速度信号中提取的姿势和步态指标来区分拉力测试的所有得分。对 23 名患者进行了一项新的横断面研究,以确定哪些步态和姿势相关指标被认为对区分不同级别的牵拉试验具有重要意义,以及哪些指标与牵拉试验得分的相关性更高。活动持续时间、垂直和内外侧角速度的均方根和运动范围,以及大多数与步态相关的指标,在所有涉及运动任务(如坐、卧、行走和转身)的试验中都显示出最显著的差异。
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引用次数: 0
Unlocking Cognitive Potential: Exploring a Virtual Environment for Cognitive Training in Healthy Aging and Mild Cognitive Impairment
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-03-05 DOI: 10.1016/j.irbm.2025.100885
Pierre-Alexandre Andrieu-Devilly , Marc Gandit , Didier Schwab , Lisa Quillion-Dupré , Emmanuel Monfort

Objective

This study aims to investigate how cognitive impairment and social presence influence goal attainment in an ecological virtual environment. It also examines the role of interactive features in improving computer-assisted cognitive training for older adults, both with and without mild cognitive impairment (MCI).

Materials and Methods

A virtual supermarket was used to simulate a realistic exploration task, incorporating social interactions and adaptive assistance strategies. Error analysis was conducted to identify performance patterns linked to cognitive profiles.

Results

Participants with MCI exhibited a significantly higher frequency of wandering and uncorrected orientation errors, compared to cognitively healthy older adults. While verbal support was beneficial in facilitating virtual task progress, it did not fully mitigate performance deficits in those with MCI. Additionally, all older participants, regardless of cognitive status, reported significantly lower perceptions of social presence compared to younger participants.

Conclusion

Virtual environments constitute a promising tool for the assessment and enhancement of functional abilities in older adults with neurocognitive impairments. The integration of tailored cognitive training protocols and adaptive support strategies holds potential to optimize cognitive stimulation and task performance.
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引用次数: 0
Facial Palsy Characterization Using Dual Regression Trees
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-02-20 DOI: 10.1016/j.irbm.2025.100882
Soualmi Ameur , Mohd Saquib Khan , Régis Fournier , Marina Guihard , Laurent Chatelain , Marjolaine Baude , Amine Nait-ali
1) Objectives: The current facial recognition tools are inefficient in predicting landmarks for facial palsy patients. Noticeable asymmetry in the face results in inaccurate results as the prediction models are trained on symmetrical faces. In this study, a method is proposed which takes advantage of the existing powerful machine learning tools which are trained on datasets of healthy subjects with symmetric facial movements to create a system that can analyze and localize facial landmarks on both healthy as well as facial palsy subjects.
2) Methods: The task is accomplished by a simple image processing algorithm where two symmetric faces are generated from a non-symmetric face image representing the left and right sides of the original image. This method was tested against two other methods. One, which uses the cascade of regression trees (CRT) algorithm and the other which is a retrained version of the CRT algorithm on a dataset of facial palsy cases called Massachusetts Eye and Ear database and model (MEE).
3) Results: The methods were compared on 3 different types of test datasets containing a total 125 images. The proposed method outperforms other two methods in cases of asymmetrical faces from healthy people and palsy patients with approximately 7% lesser error compared to the CRT method and 39% lesser error than the MEE method.
4) Conclusion: The proposed method had a considerably better performance compared to the other two methods, which opens new perspectives to address the problem of face landmarks localization problem on facial palsy cases.
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引用次数: 0
Complementary Split-Ring Resonator for Non-Invasive Diagnosis of Carotid Artery Atherosclerosis: Towards Future in-Vivo Measurements
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-02-14 DOI: 10.1016/j.irbm.2025.100883
Joséphine Dupeyron Masini , Frédérique Deshours , Georges Alquie , Rania Shahbaz , Sylvain Feruglio , Olivier Meyer , Dimitri Galayko , Hamid Kokabi , Jean-Michel Davaine

Objectives

The limited penetration depth of electromagnetic (EM) waves into biological tissues is a significant challenge for the use of microwave sensors in medical diagnostics. This study proposes a sensor based on a complementary split-ring resonator (CSRR) for the non-invasive detection of carotid atherosclerotic plaques, designed to be placed on the patient's neck.

Material and methods

The sensor employs a widened feed line and an optimized sensing area to concentrate the electric field and store a significant amount of energy within the biological tissue. Validation includes EM simulations and ex-vivo measurements on fresh animal tissues using monolayer and multilayer configurations to simulate human neck anatomy. A three-dimensional carotid artery model is also introduced to extend the analysis to deeper tissue layers and simulate different degrees of stenosis between 25% and 75%.

Results

The sensor demonstrates a sensitivity of 0.72% and a detection resolution of 14 MHz for a dielectric constant range from 1 to 52 in material measurements, which has contributed to enhancing the EM penetration depth in neck tissues. Simulation results for atherosclerotic plaques in the carotid artery revealed a frequency shift difference induced by stable and vulnerable plaques of around 1 to 2 MHz.

Conclusion

These findings highlight the sensor's potential for future use in the in- vivo diagnosis of carotid artery atherosclerosis.
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引用次数: 0
Comparison of Different Sensor Locations on Freezing-of-Gait Ratio Results
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-02-14 DOI: 10.1016/j.irbm.2025.100881
Slavka Netukova , Lucie Horakova , Evžen Růžička , Petr Dusek , Zoltan Szabo , Radim Krupička

Background

Freezing of gait (FoG) is a walking disturbance in the Parkinson's disease (PD). The freezing ratio (FoG-ratio) is a parameter used to quantify overall freezing severity rather than to assess single freezing episodes. Originally the FoG-ratio was designed to be computed from lower limb acceleration. However, some available measurement systems get their data from a single sensor located elsewhere, e.g. on the lower back.

Purpose

The objective of our paper is to analyse whether acceleration signals measured on different body locations result in a consistent FoG-ratio.

Methods

Eighty-four people with PD and 65 people without neurological disorders completed an instrumented Timed Up&Go Test (iTUG) twice. The FoG-ratios from inertial units placed on the chest, lower back, left and right lower limbs were calculated.

Findings

There were significant differences between the tested FoG-ratios in the control group as well as in the PD group for both segments. Four significant, but not consistent, correlations were revealed for the turn segment in the PD group. Eight correlations were revealed in the control group. The inter-trial reliability of all the tested cases for gait was good (rho>0.75) but only in one case for turning.

Conclusion

In conclusion, the placement of sensors affected the FoG-ratio parameter output. The different FoG-ratios reflect different amounts of power in the locomotion band of body segments. This could result in inconclusive validity and incomparability of freezing severity presented in studies when the sensor is placed somewhere other than on the lower limbs.
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引用次数: 0
IMU Calibration Effect on Lower Limbs Kinematics Against Optical Motion Capture in Post-Stroke Gait
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-02-01 DOI: 10.1016/j.irbm.2024.100873
Ariane P. Lallès , Geoffroy Moucheboeuf , Emilie Doat , Hélène Pillet , Xavier Bonnet

Background

Stroke is the most common cause of disabilities worldwide. Rehabilitation is central to restore functions. Inertial measurement units (IMU) can be used to ease goal settings and monitor progression. Contrary to optical motion capture (OMC), IMU are less expensive, portable, and allow large scale data collections in ambulatory settings. Although Xsens MVN system validity has been demonstrated in healthy participants, its validity among post-stroke (PS) patients is yet to be proven.

Research question

Computation methods being affected by the calibration type; the goal of this study is to compare lower limbs kinematics from Xsens system, after two calibrations against OMC in slow PS walkers exhibiting reduced ranges of movements.

Methods

Data was collected for six PS patients. They were equipped with 29 reflective markers and seven IMU. A minimum of two walks with a dynamic calibration and four walks with a static calibration were performed. All trials were accomplished at a self-selected walking speed and PS used their usual walking aids.

Results

Few interactions between the calibration type and side were found for the ankle abduction/adduction (A/A) bias, root mean square error (RMSE), and range of motion difference (ROMd) (p = 0.011, p = 0.048, p = 0.039). Few effects of the side on errors' values were found. We noticed some effects of the calibration type on errors' values, the dynamic calibration showing better results. In the sagittal plane, we reported RMSE values from 3.6 to 4.8°, 5.2 to 6.5°, and 5.0 to 5.9° for the hip, knee, and ankle dynamic calibration.

Significance

The calibration type, reduced range of movement, and slow walking speed does not seem to impact Xsens' accuracy to a great extent. Nevertheless, dynamic calibration provides slightly better results. Considering the patient's walking ability, we recommend using this calibration.
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引用次数: 0
Acknowledging our reviewers
IF 5.6 4区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2025-02-01 DOI: 10.1016/S1959-0318(25)00003-X
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引用次数: 0
期刊
Irbm
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