Biomedical Engineering and Bioengineering Commons^™

Improving The Reliability And Accessibility Of Ct Perfusion Imaging In Acute Ischemic Stroke, Kevin J. Chung

Electronic Thesis and Dissertation Repository

CT perfusion (CTP) imaging is a validated treatment decision support tool in acute ischemic stroke. Automated analysis of CTP cerebral blood flow (CBF) and Tmax maps produces estimates of ischemic core and penumbra volumes used to determine target mismatch profiles for treatment. However, availability and utilization of CTP is low due to diagnostic variability between CTP software and technical, logistical, and radiation dose considerations that may limit its routine adoption. The objective of this doctoral research was to improve the reliability and accessibility of CTP by (1) improving diagnostic agreement between CTP software, (2) enabling perfusion imaging with standard acute …

4dct Analysis Of In-Vivo Carpal Kinematics During Fem, Manisha R. Mistry

Electronic Thesis and Dissertation Repository

A consensus, detailed understanding of carpal kinematics remains elusive. 4-dimensional CT (4DCT) is a validated modality capable of accurately studying in-vivokinematic motion. The objective of this work is to quantify normal, in-vivo kinematic motion of the carpus through a flexion-extension arc of motion using 4DCT. Ten healthy, un-injured volunteers underwent a 4DCT scanning protocol through a complete arc of flexion-extension motion. Kinematic changes in motion were quantified using helical axis motion data for each carpal bone. Helical axes were compared between bones and statistical analysis performed using repeated-measures ANOVA to identify difference in kinematic motion between bones (p<0.05). The carpus can be divided into four main kinematic blocks: the distal carpal block, the proximal carpal block and individual scaphoid and trapezial blocks. This work supports an additional segmentation of the trapezium from the distal carpal row, which suggests some modulation between the scaphoid and distal carpal row.

In Vitro Analyses Of The Contributions Of The Hip Capsule To Joint Biomechanics, Emma Donnelly

Electronic Thesis and Dissertation Repository

Optimal management of the hip capsule during arthroscopic surgery has not been established. The impact of incisions made to the capsule during minimally invasive procedures on joint biomechanics, and whether repair provides any benefit, continue to be debated. The effectiveness of capsular repair to restore native kinematics may be insufficient. Therefore, a better understanding of joint behavior during various capsule conditions is needed. A new robotic system was used to analyze the effect of progressive capsulotomy incision and repairs on the behavior of a normal hip within range of motion (ROM) limits with respect to the intact joint. Complete repairs …

Navigation And Patient Specific Instrumentation In Shoulder Arthroplasty, Joseph Cavanagh

Electronic Thesis and Dissertation Repository

The humeral head osteotomy influences shoulder arthroplasty component height, version and neck shaft angle and therefore outcomes. The purpose of this study is to develop and utilize navigation to execute the osteotomy.

3D printed models were used to develop a navigation technique, and then to execute planned osteotomies. Free hand, fixed angle guide, patient specific guides, and real time navigation osteotomies were completed. The height, neck shaft angle and version were recorded. Also collected, were the planes of the guides once they were placed.

Navigation had significantly less error from the planned osteotomy in neck shaft angle versus all other …

A Biomechanical Investigation Into The Effect Of Experimental Design On Wrist Biomechanics And Contact Mechanics, Clare E. Padmore

Electronic Thesis and Dissertation Repository

The wrist is one of the most commonly injured joints, and injury can have serious sequelae if pathological healing ensues. Strides have been made to understand normal and pathological wrist biomechanics using experimental approaches, which has contributed to improved patient care. The present work advances our understanding of the influence of experimental techniques and joint motion measurement techniques on in-vitro wrist biomechanical cadaveric studies, and applies the knowledge learned to a common clinical entity of scapholunate insufficiency.

First, the relative contributions of the carpal rows to wrist motion were assessed, in addition to the identification of limitations of current biomechanical …

The Of Application Of 3d-Printing To Lumbar Spine Surgery, Andrew J. Kanawati

Electronic Thesis and Dissertation Repository

Rapid prototyping refers to the manufacturing process in which a three-dimensional (3D) digital model can be transformed into a physical model by layering material in the shape of successive cross sections atop of previously layers. Rapid prototyping has been increasing in popularity in the field of medicine and surgery due to the ability to personalize various aspects of patient care. The thesis will explore the use of rapid prototyping in lumbar spine surgery, aim to quantify the accuracy of medical imaging when relating to imaged structures and their corresponding models produced by rapid prototyping, and determine if complex patient-specific guides …

Acromial Insufficiency Fractures In Reverse Total Shoulder Arthroplasty: A Biomechanical Study, Alicia Kerrigan

Electronic Thesis and Dissertation Repository

Reverse total shoulder arthroplasty (RTSA) is increasingly utilized in the aging population, with a growing list of surgical indications including rotator cuff tear arthropathy, proximal humerus fractures, and revision arthroplasty. Acromial insufficiency fractures following RTSA are poorly understood, difficult to diagnose, and associated with inferior clinical outcomes. There is limited knowledge in the literature regarding the etiology of post-operative acromial fractures. The purpose of this study is to evaluate the role of implant parameters on acromial strain following RTSA.

Using a cadaveric model, a custom designed modular RTSA system was implanted that allowed for evaluation of modifiable parameters including glenoid …

Tibiotalar Arthrodesis: Development Of A Novel Jig And Alignment Guide, Adam Mathew Ropchan

Electronic Thesis and Dissertation Repository

Tibiotalar arthrodesis is a surgical procedure, used for the treatment of end-stage ankle arthrosis and instability. There are dozens of described procedures in the literature, all with varying rates of success. Two of the most common reasons for reoperation in tibiotalar arthrodesis are nonunion and infection; few studies have established any associations between patient/surgical factors and reoperation for nonunion and infection.

The first part of this thesis focuses on determining the rate of reoperation to the ipsilateral lower limb and if any patient/surgical factors are associated with reoperation for nonunion and infection. The second part of this thesis turns attention …

The Development Of A Temporomandibular Force Simulator To Study Craniofacial Strain In-Vitro, Kenneth Kc Ip

Electronic Thesis and Dissertation Repository

An in-vitro musculoskeletal loading simulator was developed to replicate the internal forces of mastication, and then employed in a comparison of clinically relevant facial fracture repairs. Muscle forces are simulated by pneumatic pistons via 3D printed mounts that are reverse-engineered from CT scan to match muscle attachment sites, which are adhered to bone in order to simulate native stress distributions. Bite force and bone strain pattern of the craniofacial structure under load were measured using a force sensor and strain gauges respectively. In a series of five fresh-frozen cadaveric heads, it was found that strain patterns of the craniofacial structure …

Design Of Radio-Frequency Arrays For Ultra-High Field Mri, Ian R O Connell

Electronic Thesis and Dissertation Repository

Magnetic Resonance Imaging (MRI) is an indispensable, non-invasive diagnostic tool for the assessment of disease and function. As an investigational device, MRI has found routine use in both basic science research and medicine for both human and non-human subjects.

Due to the potential increase in spatial resolution, signal-to-noise ratio (SNR), and the ability to exploit novel tissue contrasts, the main magnetic field strength of human MRI scanners has steadily increased since inception. Beginning in the early 1980’s, 0.15 T human MRI scanners have steadily risen in main magnetic field strength with ultra-high field (UHF) 8 T MRI systems deemed to …

The Role Of Scapular Morphology In Reverse Shoulder Arthroplasty, Ashish Gupta

Electronic Thesis and Dissertation Repository

Baseplate fixation in a reverse shoulder arthroplasty depends on adequate bone stock. In cases of severe glenoid bone loss and revision shoulder arthroplasty, deficiency of the glenoid vault compels the surgeon to attain screw fixation in the three columns of the scapula. The relationship of these columns demonstrated that the coracoid is closer to the lateral scapular pillar in females than in males. Significant gender dimorphism exists between the orientations of the three columns. The gender dimorphism is further evaluated by anthropometric measurements of the scapular body and the glenoid. The clinical significance lies in the ability to reconstruct the …

Design Of Novel Sensors And Instruments For Minimally Invasive Lung Tumour Localization Via Palpation, Anish Srinivasan Naidu

Electronic Thesis and Dissertation Repository

Minimally Invasive Thoracoscopic Surgery (MITS) has become the treatment of choice for lung cancer. However, MITS prevents the surgeons from using manual palpation, thereby often making it challenging to reliably locate the tumours for resection. This thesis presents the design, analysis and validation of novel tactile sensors, a novel miniature force sensor, a robotic instrument, and a wireless hand-held instrument to address this limitation. The low-cost, disposable tactile sensors have been shown to easily detect a 5 mm tumour located 10 mm deep in soft tissue. The force sensor can measure six degrees of freedom forces and torques with temperature …

Magnetic Resonance Imaging Compatible Remote Catheter Navigation System, Mohammad Ali Tavallaei

Electronic Thesis and Dissertation Repository

Many vascular and cardiac diseases are diagnosed and treated using a medical technique known as percutaneous transluminal catheter intervention (PTC). In PTC, the interventionalist inserts a catheter into the vasculature, and using the vessel as the guiding passageway, the catheter is navigated to desired anatomical targets where it would be used for various purposes such as catheter ablation for the treatment/management of cardiac arrhythmias. The catheterization procedure is conventionally guided with x-ray fluoroscopic imaging and more recently, but rarely, with Magnetic Resonance Imaging (MRI). X-ray imaging irradiates the patient directly during the procedure, and the staff and interventionalists indirectly through …

Resting-State Functional Network Disruptions In A Rodent Model Of Mesial Temporal Lobe Epilepsy (Tle), Ravnoor Singh Gill

Electronic Thesis and Dissertation Repository

Mesial temporal lobe epilepsy (TLE) is the most common form of drug-refractory epilepsy. The clinical application of non-invasively mapped networks using resting-state functional magnetic resonance imaging (rsfMRI) in humans has been rather limited due to heterogeneous (varying etiology, drugs, onset, latent period, etc.) patient groups. We employed a pharmacological (kainic acid) rodent model of TLE to measure the extent of functional network disruptions using rsfMRI, and study selected behaviors and olfactory to hippocampus transmission. Graph theoretical network modelling and analysis revealed significant increase in functional connectivity connectivity to the temporal lobe (hippocampus) in epileptic-rats compared to controls in the limbic …

The Effect Of Fixation Plate Length On Spinal Instability Following Anterior Cervical Plate Fixation For The Repair Of In Vitro Flexion-Distraction Injuries, Abdulaziz J. Al-Kuwari

Electronic Thesis and Dissertation Repository

Abstract:

The Effect of Fixation Plate Length on Spinal Instability Following Anterior Cervical Plate Fixation for the Repair of in Vitro Flexion-Distraction Injuries

Introduction: Anterior cervical decompression and fusion with a plate (ACDFP) is a commonly performed treatment following a traumatic injury to the subaxial cervical spine. The purpose of the presented work was to determine the biomechanical effect of plate length on cervical spine kinematic stability following ACDFP stabilization for a simulated traumatic injury.

Methods: Eleven fresh-frozen cadaveric C5-C6 and C6-C7 motion segments were examined in this study. To assess kinematics, flexibility testing was performed on each specimen …

Image Fusion And Axial Labeling Of The Spine, Brandon Miles

Electronic Thesis and Dissertation Repository

In order to improve radiological diagnosis of back pain and spine disease, two new algorithms have been developed to aid the 75% of Canadians who will suffer from back pain in a given year. With the associated medical imaging required for many of these patients, there is a potential for improvement in both patient care and healthcare economics by increasing the accuracy and efficiency of spine diagnosis. A real-time spine image fusion system and an automatic vertebra/disc labeling system have been developed to address this. Both magnetic resonance (MR) images and computed tomography (CT) images are often acquired for patients. …

Development And Assessment Of An Impact Apparatus And High-Speed Camera Motion Tracking System To Quantify The Effect Of Static Muscle Loads On Fracture Threshold Measures In The Distal Radius, Jacob M. Reeves

Electronic Thesis and Dissertation Repository

Distal radius fractures are prevalent, debilitating, and costly. This thesis conducts an in vitro investigation of these injuries, examining the role of static muscle loading on fracture threshold measures (i.e., force, impulse, energy). Initially, an impact apparatus and custom LabVIEW colour-thresholding program were designed and assessed for repeatability and accuracy in quantifying fracture measures and impact kinematics. These tools were then used to test six pairs of cadaveric forearms, with static muscle loads simulated in one specimen from each pair. Distal radius fractures were achieved in 5 pairs, with perilunate dislocations in the remaining pair. None of the …

Design And Development Of A Novel Expanding Pedicle Screw For Use In The Osteoporotic Lumbar Spine, Parham Rasoulinejad

Electronic Thesis and Dissertation Repository

Pedicle screws are commonly utilized in spinal surgery; however, traditional designs often do not provide adequate fixation in osteoporotic spines. The objective of this thesis was to develop a novel expanding screw for use in osteoporotic lumbar pedicles. Helical screws capable of expanding post insertion were built on a rapid prototype machine. A materials testing machine performed axial load to failure tests in both Sawbones and cadaveric specimens comparing the new design to traditional screws (rate = 10mm/min to 20 mm). Output parameters included yield load, ultimate load, stiffness, energy to failure and total energy. The expanding screw showed a …

Augmented Image-Guidance For Transcatheter Aortic Valve Implantation, Pencilla Lang

Electronic Thesis and Dissertation Repository

The introduction of transcatheter aortic valve implantation (TAVI), an innovative stent-based technique for delivery of a bioprosthetic valve, has resulted in a paradigm shift in treatment options for elderly patients with aortic stenosis. While there have been major advancements in valve design and access routes, TAVI still relies largely on single-plane fluoroscopy for intraoperative navigation and guidance, which provides only gross imaging of anatomical structures. Inadequate imaging leading to suboptimal valve positioning contributes to many of the early complications experienced by TAVI patients, including valve embolism, coronary ostia obstruction, paravalvular leak, heart block, and secondary nephrotoxicity from contrast use.

A …

Mri-Based Attenuation Correction In Emission Computed Tomography, Harry R. Marshall

Electronic Thesis and Dissertation Repository

The hybridization of magnetic resonance imaging (MRI) with positron emission tomography (PET) or single photon emission computed tomography (SPECT) enables the collection of an assortment of biological data in spatial and temporal register. However, both PET and SPECT are subject to photon attenuation, a process that degrades image quality and precludes quantification. To correct for the effects of attenuation, the spatial distribution of linear attenuation coefficients (μ-coefficients) within and about the patient must be available. Unfortunately, extracting μ-coefficients from MRI is non-trivial. In this thesis, I explore the problem of MRI-based attenuation correction (AC) in emission tomography.

In particular, I …