Advanced Methods and Applications in Translational Myology and Surgical Planning

Computational and Mathematical Modeling of Medical Images: Advanced Methods and Applications in Translational Myology and Surgical Planning Kyle Edmunds Doctor of Philosophy June 2017 Biomedical Engineering Reykjavík University Ph.D. Dissertation ii Computational and Mathematical Modeling of Medical Images: Advanced Methods and Applications in Translational Myology and Surgical Planning Dissertation submitted to the School of Science and Engineering at Reykjavík University in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Ph.D.) in Biomedical Engineering June 2017 Thesis Committee: Paolo Gargiulo, Supervisor and Associate Professor Reykjavík University, Reykjavík, Iceland Þórður Helgason, Associate Professor Reykjavík University, Reykjavík, Iceland Hannes Petersen, Head of the Dept. of Anatomy and Professor University of Iceland, Reykjavík, Iceland Sigurður Brynjólfsson, Professor University of Iceland, Reykjavík, Iceland Thesis Examiner: Antonio Fratini, Lecturer and Biomedical Engineering Program Coordinator Aston University, Birmingham, United Kingdom iv Copyright Kyle Edmunds June 2017 vi Computational and Mathematical Modeling of Medical Images: Advanced Methods and Applications in Translational Myology and Surgical Planning Kyle Edmunds June 2017 Abstract The growing field of translational myology continually seeks to define and promote the generalizability of muscle research to clinical practice via optimizing the transition of a wide variety of investigative muscle assessment modalities. There are distinct challenges in all facets of this research, but understanding the physiological importance of mobility currently presents a strategic priority. The severe physiological consequences from the loss of mobility are experienced by all of us: whether induced by normative ambulatory challenges as we age or as sequela of lower extremity pathology. Indeed, a growing wealth of literature clearly implicates mobility loss with a plethora of comorbidities, leading to an increasingly deleterious quality of life and ultimately resulting in early mortality. The loss of mobility is concomitantly evidenced by the progressive decline of skeletal muscle size and quality – phenomena which altogether define muscle degeneration. Nonetheless, complete etiological definitions and methodological comparisons for the precise, non-invasive quantification of muscle degeneration remains disparately described in literature. This thesis focuses on the development, application, and assessment of novel methods in computational and mathematical modeling of medical images to quantify muscle degeneration and optimize our understanding of two mobility- restorative procedures: Functional Electrical Stimulation and Total Hip Arthroplasty. Additional impacts of these methods are further explored in defining multimodal metrics for mobility analysis, characterizing the utility of 3D printing for surgical planning, modeling craniofacial electromyography, and computing pre-surgical periprosthetic fracture risk. Results from these investigations altogether present the efficacies and limitations of available image processing modalities, and introduce novel methodologies, such as nonlinear trimodal regression analysis of radiodensitometric distributions and computational interference fitting for periprosthetic femoral fracture analysis. Such analyses and perspectives are herein presented in both a theoretical and practical context. Standardizing computational modeling methodologies for medical image assessment in these contexts would allow for the generalizability of such research to the indication of respective compensatory targets for clinical intervention. viii Tölfræði og Stærðfræðileg Líkanagerð Byggð á Læknisfræðilegum Upplýsingum, Framsækinni Nýtingu á Famförum í Vöðvafræði Nýting Þessa við Undirbúning Skurðaðgerða Kyle Edmunds Júní 2017 Útdráttur Vöðvafræði er vaxandi svið sem sækist að því að skilgreina og upphefja rannsóknir á vöðvakerfinu svo hægt sè að nýta þekkinguna í klínísku umhverfi. Þessu er náð fram með því að nýta þær rannsóknaraðferðir við höfum nú þegar, til hins ýtrasta. Það eru fjölbreytilegar áskoranir og erfiðleikar framundan en það má ekki aftra okkur. Mikilvægi þess að skilja þörf líkamans fyrir hreyfingu er mikið forgangsatriði. Við höfum öll orðið vitni að því hvað gerist við fólk þegar hreyfigetan hverfur, hvort sem það er ellin sem kippir undan okkur eða afleiðingar sjúkdóma, þá benda rannsóknir til þess að takmarkanir á hreyfigetu dragi verulega úr lífsgæðum fólks og stuðlað að hærri dánartíðni. Minnkuð hreyfigeta er bókfærð með mælingum á stærð og gæðum beinagrindarvöðva - Hlutir sem skilgreina vöðvarýrnun. Engu að síður eru læknisfræðilegar skilgreiningar og óáreitandi aðferðum við öflun gagna ekki einhvað sem er vanalega lýst í greinargerðum Þessi ritgerð einblínir á þróun, nýtingu og mat á nýjum aðferðum sem hægt er að nota við öflun gagna og nýtingu þeirra við þær tvær aðferðir sem við höfum til að hjálpa fólki með minnkaða hreyfigetu: rafstuðsmeðferð og gerfiliðaraðgerð á mjöðm. Áframhaldandi afleiðingar þessara aðferða er kannað enn frekar í: skilgreiningar á fjölþátta tölfræði greiningu á hreyfanleika, skilgreiningar á nýtingu þrívíddarprentunar við undirbúning skurðaðgerða, modeling craniofacial electromyography og tölfræðilegir útreikningar á brotlíkum beinstoðtækja fyrir aðgerð. Niðurstöður þessara aðgerða hafa leitt í ljós möguleika og hindranir tækninnar sem nú er notuð og hjálpað til við að auðga flóruna m.a. með nýstárlegum leiðum til að greina brotlíkur þegar beinagrindarstoðtækjum er komið fyrir við lærlegg sem er brotinn eða í brothættu. Að koma upp staðli fyrir aðferðir sem beitt er við módelgerð myndi flýta mikið fyrir því að þessar aðferðir finni praktísk hlutverk innan heilbrigðisstofnana. x The undersigned hereby certify that they recommend to the School of Science and Engi- neering at Reykjavík University for acceptance this Dissertation entitled Computational and Mathematical Modeling of Medical Images: Advanced Methods and Applications in Translational Myology and Surgical Planning submitted by Kyle Edmunds in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Ph.D.) in Biomedical Engineering 7.6.2017 Paolo Gargiulo, Supervisor and Associate Professor Reykjavík University, Reykjavík, Iceland Þórður Helgason, Associate Professor Reykjavík University, Reykjavík, Iceland Hannes Petersen, Head of the Dept. of Anatomy and Professor University of Iceland, Reykjavík, Iceland Sigurður Brynjólfsson, Professor University of Iceland, Reykjavík, Iceland Antonio Fratini, Lecturer and Biomedical Engineering Program Coordinator xii The undersigned hereby grants permission to the Reykjavík University Library to reproduce single copies of this Dissertation entitled Computational and Mathematical Modeling of Medical Images: Advanced Methods and Applications in Translational Myology and Surgical Planning and to lend or sell such copies for private, scholarly or scientific research purposes only. The author reserves all other publication and other rights in association with the copyright in the Dissertation, and except as herein before provided, neither the Dissertation nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author’s prior written permission. 7.6.2017 7.6.2017 Kyle Edmunds Doctor of Philosophy xiv I dedicate this to my family, for all the years of support, patience, and inspiration – I truly can never thank you enough. xvi Acknowledgements It is impossible to fully describe my gratitude for Dr. Paolo Gargiulo, my doctoral advisor. Over the last three years, since I moved from Boston to Iceland, he has shown me nothing but the sincerest support with his genuine positive energy and contagious passion for research, mentorship, and education. His perspective on biomedical engineering as a field (and life, in- general) has been truly inspirational – perhaps the greatest lesson he has taught me over the years was how to “keep one foot in the future, and one foot in the present, with a respect for what’s behind you”. His ability to keep his focus on what needs to be done now, in the context of planning for a growing department at Háskólinn í Reykjavík, has inspired me to continue my own personal pursuit of establishing myself as a professor whose focus revolves around the clinical translational applications of biomedical engineering. My personal transition to a new life as an immigrant in Iceland was always full of challenges, but as I felt from my first moments in the country, no matter where you go in this world, you will always find love and friendship to guide you through life. However, it is equally important for me to recognize all of my dearest friends back in the States who I truly can never thank enough for inspiring me to become who I am today: Dan, Layne, Rob, Harrison, Ben, Aaron, Sean, Morgan, Becky, Adam, Patrick, P-Ham, Steve, Tara, Nish, and so many others – I cannot express the depth of my personal gratitude enough, and I can’t wait for our paths to cross again. For my friends and colleagues I have had the distinct pleasure of getting to know here, I would also like to express my deepest thanks: Raggi, Christian, Laura, Sölvi, Siggi, Orri, Villi, Fribbi, Óli, Jósef, Þórolfur, and so many other amazing people – and last, but certainly not least, my amazing, beautiful, and inspirational girlfriend, Sarah. All of the love and support that you all have provided me when I

Load more