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In this paper, a new constraint-based biomechanical simulation method is proposed to compensate for craniotomy-induced brain-shift. While being efficient to correct this deformation, the method is fully integrable in a clinical process.

The development of imaging modalities and computer technology provides a new approach in acetabular surgery. Areas covered: This review describes the role of computer-assisted surgery (CAS) in understanding of the fracture patterns, in the virtual preoperative planning of the surgery and in the use of custom-made plates in acetabular fractures with or without 3D printing technologies. A Pubmed internet research of the English literature of the last 20 years was carried out about studies concerning computer-assisted surgery in acetabular fractures. The several steps for CAS in acetabular fracture surgery are presented and commented by the main author regarding to his personal experience. Expert commentary: Computer-assisted surgery in acetabular fractures is still initial experiences with promising results. Patient-specific biomechanical models considering soft tissues should be developed to allow a more realistic planning.

This paper presents a biomechanical model of the face to simulate orofacial movements in speech and non-verbal communication. A 3D finite element model, based on medical images of a subject, is presented. A hyperelastic Mooney-Rivlin constitutive law accounts for the non-linear behaviour of facial tissue. Muscle fibres are represented by piece-wise uniaxial tensile element that generate force. The stress stiffening effect, an increase in the stiffness of the muscles when activated, is modelled by varying the constitutive law of the tissue with the level of activation of the muscle. A large number of facial movements occurring during speech and facial mimics are simulated. Results show that our modelling approach provides a realistic account of facial mimics. The differences between dynamic vs. quasi-static simulations are also discussed, proving that dynamic trajectories better fit experimental data.

In brain tumor surgery, the quality and safety of the procedure can be impacted by intra-operative tissue deformation, called brain shift. Brain shift can move the surgical targets and other vital structures such as blood vessels, thus invalidating the presurgical plan. Intra-operative ultrasound (iUS) is a convenient and cost-effective imaging tool to track brain shift and tumor resection. Accurate image registration techniques that update pre-surgical MRI based on iUS are crucial but challenging. The MICCAI Challenge 2018 for Correction of Brain shift with Intra-Operative UltraSound (CuRIOUS2018) provided a public platform to benchmark MRI-iUS registration algorithms on newly released clinical datasets. In this work, we present the data, setup, evaluation, and results of CuRIOUS 2018, which received 6 fully automated algorithms from leading academic and industrial research groups. All algorithms were first trained with the public RESECT database, and then ranked based on a test dataset of 10 additional cases with identical data curation and annotation protocols as the RESECT database. The article compares the results of all participating teams and discusses the insights gained from the challenge, as well as future work.

A Finite Element model of the face soft tissue is proposed to simulate the morphological outcomes of maxillofacial surgery. Three modelling options are implemented: a linear elastic model with small and large deformation hypothesis, and an hyperelastic Mooney-Rivlin model. An evaluation procedure based on a qualitative and quantitative comparison of the simulations with a post-operative CT scan is detailed. It is then applied to one clinical case to evaluate the differences between the three models, and with the actual patient morphology. First results shows in particular that for a "simple" clinical procedure where stress is less than 20%, a linear model seams sufficient for a correct modelling.

On the basis of simulations carried out with a finite element biomechanical model of the face, the influence of the muscle stress stiffening effect was studied for the protrusion/rounding of the lips produced with the Orbicularis Oris (OO). It is shown that the stress stiffening effect influences lip shape. When stress stiffening is modeled, the variation in the crucial geometrical characteristics of the lips shows a clear saturation effect as the OO activation level increases. Similarly, for a sufficient amount of OO activation, a saturation effect is observed when stiffening increases. In both cases, differences in lip shaping associated with the absence or presence of stiffening have consequences for the spectral characteristics of the speech signal obtained for the French vowel /u/. These results are interpreted in terms of their consequences for the motor control strategies underlying the protrusion/rounding gesture in speech production.

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