Mr. Johannes Dirnberger Profile

Johannes Dirnberger

at RISC Software GmbH

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Proceedings Article | 18 March 2015 Paper

Real-time surgery simulation of intracranial aneurysm clipping with patient-specific geometries and haptic feedback

Wolfgang Fenz, Johannes Dirnberger

Proceedings Volume 9415, 94150H (2015) https://doi.org/10.1117/12.2082053

KEYWORDS: Computer simulations, Surgery, 3D modeling, Blood, Haptic technology, Finite element methods, Data modeling, Instrument modeling, Medical imaging, Silver

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Providing suitable training for aspiring neurosurgeons is becoming more and more problematic. The increasing popularity of the endovascular treatment of intracranial aneurysms leads to a lack of simple surgical situations for clipping operations, leaving mainly the complex cases, which present even experienced surgeons with a challenge. To alleviate this situation, we have developed a training simulator with haptic interaction allowing trainees to practice virtual clipping surgeries on real patient-specific vessel geometries. By using specialized finite element (FEM) algorithms (fast finite element method, matrix condensation) combined with GPU acceleration, we can achieve the necessary frame rate for smooth real-time interaction with the detailed models needed for a realistic simulation of the vessel wall deformation caused by the clamping with surgical clips. Vessel wall geometries for typical training scenarios were obtained from 3D-reconstructed medical image data, while for the instruments (clipping forceps, various types of clips, suction tubes) we use models provided by manufacturer Aesculap AG. Collisions between vessel and instruments have to be continuously detected and transformed into corresponding boundary conditions and feedback forces, calculated using a contact plane method. After a training, the achieved result can be assessed based on various criteria, including a simulation of the residual blood flow into the aneurysm. Rigid models of the surgical access and surrounding brain tissue, plus coupling a real forceps to the haptic input device further increase the realism of the simulation.

Proceedings Article | 2 March 2011 Paper

Patient-specific blood flow simulation to improve intracranial aneurysm diagnosis

Wolfgang Fenz, Johannes Dirnberger

Proceedings Volume 7964, 79642D (2011) https://doi.org/10.1117/12.877983

KEYWORDS: Blood circulation, Visualization, Blood, Finite element methods, Chemical elements, Computational fluid dynamics, Computer simulations, Fluid dynamics, 3D modeling, 3D image processing

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We present a novel simulation system of blood flow through intracranial aneurysms including the interaction between blood lumen and vessel tissue. It provides the means to estimate rupture risks by calculating the distribution of pressure and shear stresses in the aneurysm, in order to support the planning of clinical interventions. So far, this has only been possible with commercial simulation packages originally targeted at industrial applications, whereas our implementation focuses on the intuitive integration into clinical workflow. Due to the time-critical nature of the application, we exploit most efficient state-of-the-art numerical methods and technologies together with high performance computing infrastructures (Austrian Grid). Our system builds a three-dimensional virtual replica of the patient's cerebrovascular system from X-ray angiography, CT or MR images. The physician can then select a region of interest which is automatically transformed into a tetrahedral mesh. The differential equations for the blood flow and the wall elasticity are discretized via the finite element method (FEM), and the resulting linear equation systems are handled by an algebraic multigrid (AMG) solver. The wall displacement caused by the blood pressure is calculated using an iterative fluid-structure interaction (FSI) algorithm, and the fluid mesh is deformed accordingly. First simulation results on measured patient geometries show good medical relevance for diagnostic decision support.

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