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Publisher: Springer-Verlag (Total: 2348 journals)

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Showing 1 - 200 of 2348 Journals sorted alphabetically
3D Printing in Medicine     Open Access   (Followers: 1)
3D Research     Hybrid Journal   (Followers: 21, SJR: 0.222, CiteScore: 1)
4OR: A Quarterly J. of Operations Research     Hybrid Journal   (Followers: 10, SJR: 0.825, CiteScore: 1)
AAPS J.     Hybrid Journal   (Followers: 22, SJR: 1.118, CiteScore: 4)
AAPS PharmSciTech     Hybrid Journal   (Followers: 7, SJR: 0.752, CiteScore: 3)
Abdominal Imaging     Hybrid Journal   (Followers: 15, SJR: 0.866, CiteScore: 2)
Abhandlungen aus dem Mathematischen Seminar der Universitat Hamburg     Hybrid Journal   (Followers: 4, SJR: 0.439, CiteScore: 0)
Academic Psychiatry     Full-text available via subscription   (Followers: 24, SJR: 0.53, CiteScore: 1)
Academic Questions     Hybrid Journal   (Followers: 8, SJR: 0.106, CiteScore: 0)
Accreditation and Quality Assurance: J. for Quality, Comparability and Reliability in Chemical Measurement     Hybrid Journal   (Followers: 26, SJR: 0.316, CiteScore: 1)
Acoustical Physics     Hybrid Journal   (Followers: 11, SJR: 0.359, CiteScore: 1)
Acoustics Australia     Hybrid Journal   (SJR: 0.232, CiteScore: 1)
Acta Analytica     Hybrid Journal   (Followers: 7, SJR: 0.367, CiteScore: 0)
Acta Applicandae Mathematicae     Hybrid Journal   (Followers: 1, SJR: 0.675, CiteScore: 1)
Acta Biotheoretica     Hybrid Journal   (Followers: 4, SJR: 0.284, CiteScore: 1)
Acta Diabetologica     Hybrid Journal   (Followers: 18, SJR: 1.587, CiteScore: 3)
Acta Endoscopica     Hybrid Journal   (Followers: 1)
acta ethologica     Hybrid Journal   (Followers: 4, SJR: 0.769, CiteScore: 1)
Acta Geochimica     Hybrid Journal   (Followers: 7, SJR: 0.24, CiteScore: 1)
Acta Geodaetica et Geophysica     Hybrid Journal   (Followers: 2, SJR: 0.305, CiteScore: 1)
Acta Geophysica     Hybrid Journal   (Followers: 10, SJR: 0.312, CiteScore: 1)
Acta Geotechnica     Hybrid Journal   (Followers: 7, SJR: 1.588, CiteScore: 3)
Acta Informatica     Hybrid Journal   (Followers: 5, SJR: 0.517, CiteScore: 1)
Acta Mathematica     Hybrid Journal   (Followers: 12, SJR: 7.066, CiteScore: 3)
Acta Mathematica Hungarica     Hybrid Journal   (Followers: 2, SJR: 0.452, CiteScore: 1)
Acta Mathematica Sinica, English Series     Hybrid Journal   (Followers: 6, SJR: 0.379, CiteScore: 1)
Acta Mathematica Vietnamica     Hybrid Journal   (SJR: 0.27, CiteScore: 0)
Acta Mathematicae Applicatae Sinica, English Series     Hybrid Journal   (SJR: 0.208, CiteScore: 0)
Acta Mechanica     Hybrid Journal   (Followers: 21, SJR: 1.04, CiteScore: 2)
Acta Mechanica Sinica     Hybrid Journal   (Followers: 5, SJR: 0.607, CiteScore: 2)
Acta Metallurgica Sinica (English Letters)     Hybrid Journal   (Followers: 7, SJR: 0.576, CiteScore: 2)
Acta Meteorologica Sinica     Hybrid Journal   (Followers: 3, SJR: 0.638, CiteScore: 1)
Acta Neurochirurgica     Hybrid Journal   (Followers: 6, SJR: 0.822, CiteScore: 2)
Acta Neurologica Belgica     Hybrid Journal   (Followers: 1, SJR: 0.376, CiteScore: 1)
Acta Neuropathologica     Hybrid Journal   (Followers: 5, SJR: 7.589, CiteScore: 12)
Acta Oceanologica Sinica     Hybrid Journal   (Followers: 3, SJR: 0.334, CiteScore: 1)
Acta Physiologiae Plantarum     Hybrid Journal   (Followers: 2, SJR: 0.574, CiteScore: 2)
Acta Politica     Hybrid Journal   (Followers: 14, SJR: 0.605, CiteScore: 1)
Activitas Nervosa Superior     Hybrid Journal   (SJR: 0.147, CiteScore: 0)
adhäsion KLEBEN & DICHTEN     Hybrid Journal   (Followers: 7, SJR: 0.103, CiteScore: 0)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 23, SJR: 0.72, CiteScore: 2)
Adhesion Adhesives & Sealants     Hybrid Journal   (Followers: 9)
Administration and Policy in Mental Health and Mental Health Services Research     Partially Free   (Followers: 16, SJR: 1.005, CiteScore: 2)
Adsorption     Hybrid Journal   (Followers: 4, SJR: 0.703, CiteScore: 2)
Advances in Applied Clifford Algebras     Hybrid Journal   (Followers: 4, SJR: 0.698, CiteScore: 1)
Advances in Atmospheric Sciences     Hybrid Journal   (Followers: 37, SJR: 0.956, CiteScore: 2)
Advances in Computational Mathematics     Hybrid Journal   (Followers: 19, SJR: 0.812, CiteScore: 1)
Advances in Contraception     Hybrid Journal   (Followers: 3)
Advances in Data Analysis and Classification     Hybrid Journal   (Followers: 52, SJR: 1.09, CiteScore: 1)
Advances in Gerontology     Partially Free   (Followers: 8, SJR: 0.144, CiteScore: 0)
Advances in Health Sciences Education     Hybrid Journal   (Followers: 28, SJR: 1.64, CiteScore: 2)
Advances in Manufacturing     Hybrid Journal   (Followers: 3, SJR: 0.475, CiteScore: 2)
Advances in Polymer Science     Hybrid Journal   (Followers: 44, SJR: 1.04, CiteScore: 3)
Advances in Therapy     Hybrid Journal   (Followers: 5, SJR: 1.075, CiteScore: 3)
Aegean Review of the Law of the Sea and Maritime Law     Hybrid Journal   (Followers: 6)
Aequationes Mathematicae     Hybrid Journal   (Followers: 2, SJR: 0.517, CiteScore: 1)
Aerobiologia     Hybrid Journal   (Followers: 3, SJR: 0.673, CiteScore: 2)
Aesthetic Plastic Surgery     Hybrid Journal   (Followers: 9, SJR: 0.825, CiteScore: 1)
African Archaeological Review     Hybrid Journal   (Followers: 16, SJR: 0.862, CiteScore: 1)
Afrika Matematika     Hybrid Journal   (Followers: 1, SJR: 0.235, CiteScore: 0)
AGE     Hybrid Journal   (Followers: 7)
Ageing Intl.     Hybrid Journal   (Followers: 7, SJR: 0.39, CiteScore: 1)
Aggiornamenti CIO     Hybrid Journal   (Followers: 1)
Aging Clinical and Experimental Research     Hybrid Journal   (Followers: 3, SJR: 0.67, CiteScore: 2)
Agricultural Research     Hybrid Journal   (Followers: 5, SJR: 0.276, CiteScore: 1)
Agriculture and Human Values     Hybrid Journal   (Followers: 14, SJR: 1.173, CiteScore: 3)
Agroforestry Systems     Hybrid Journal   (Followers: 20, SJR: 0.663, CiteScore: 1)
Agronomy for Sustainable Development     Hybrid Journal   (Followers: 12, SJR: 1.864, CiteScore: 6)
AI & Society     Hybrid Journal   (Followers: 8, SJR: 0.227, CiteScore: 1)
AIDS and Behavior     Hybrid Journal   (Followers: 14, SJR: 1.792, CiteScore: 3)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4, SJR: 0.862, CiteScore: 3)
Akupunktur & Aurikulomedizin     Full-text available via subscription   (Followers: 1)
Algebra and Logic     Hybrid Journal   (Followers: 6, SJR: 0.531, CiteScore: 0)
Algebra Universalis     Hybrid Journal   (Followers: 2, SJR: 0.583, CiteScore: 1)
Algebras and Representation Theory     Hybrid Journal   (Followers: 1, SJR: 1.095, CiteScore: 1)
Algorithmica     Hybrid Journal   (Followers: 9, SJR: 0.56, CiteScore: 1)
Allergo J.     Full-text available via subscription   (Followers: 1, SJR: 0.234, CiteScore: 0)
Allergo J. Intl.     Hybrid Journal   (Followers: 2)
Alpine Botany     Hybrid Journal   (Followers: 5, SJR: 1.11, CiteScore: 3)
ALTEX : Alternatives to Animal Experimentation     Open Access   (Followers: 3)
AMBIO     Hybrid Journal   (Followers: 10, SJR: 1.569, CiteScore: 4)
American J. of Cardiovascular Drugs     Hybrid Journal   (Followers: 16, SJR: 0.951, CiteScore: 3)
American J. of Community Psychology     Hybrid Journal   (Followers: 28, SJR: 1.329, CiteScore: 2)
American J. of Criminal Justice     Hybrid Journal   (Followers: 7, SJR: 0.772, CiteScore: 1)
American J. of Cultural Sociology     Hybrid Journal   (Followers: 16, SJR: 0.46, CiteScore: 1)
American J. of Dance Therapy     Hybrid Journal   (Followers: 4, SJR: 0.181, CiteScore: 0)
American J. of Potato Research     Hybrid Journal   (Followers: 2, SJR: 0.611, CiteScore: 1)
American J. of Psychoanalysis     Hybrid Journal   (Followers: 21, SJR: 0.314, CiteScore: 0)
American Sociologist     Hybrid Journal   (Followers: 12, SJR: 0.35, CiteScore: 0)
Amino Acids     Hybrid Journal   (Followers: 8, SJR: 1.135, CiteScore: 3)
AMS Review     Partially Free   (Followers: 4)
Analog Integrated Circuits and Signal Processing     Hybrid Journal   (Followers: 7, SJR: 0.211, CiteScore: 1)
Analysis and Mathematical Physics     Hybrid Journal   (Followers: 5, SJR: 0.536, CiteScore: 1)
Analysis in Theory and Applications     Hybrid Journal   (Followers: 1)
Analysis of Verbal Behavior     Hybrid Journal   (Followers: 5)
Analytical and Bioanalytical Chemistry     Hybrid Journal   (Followers: 32, SJR: 0.978, CiteScore: 3)
Anatomical Science Intl.     Hybrid Journal   (Followers: 2, SJR: 0.367, CiteScore: 1)
Angewandte Schmerztherapie und Palliativmedizin     Hybrid Journal  
Angiogenesis     Hybrid Journal   (Followers: 3, SJR: 2.177, CiteScore: 5)
Animal Cognition     Hybrid Journal   (Followers: 19, SJR: 1.389, CiteScore: 3)
Annales françaises de médecine d'urgence     Hybrid Journal   (Followers: 1, SJR: 0.192, CiteScore: 0)
Annales Henri Poincaré     Hybrid Journal   (Followers: 3, SJR: 1.097, CiteScore: 2)
Annales mathématiques du Québec     Hybrid Journal   (Followers: 4, SJR: 0.438, CiteScore: 0)
Annali dell'Universita di Ferrara     Hybrid Journal   (SJR: 0.429, CiteScore: 0)
Annali di Matematica Pura ed Applicata     Hybrid Journal   (Followers: 1, SJR: 1.197, CiteScore: 1)
Annals of Biomedical Engineering     Hybrid Journal   (Followers: 18, SJR: 1.042, CiteScore: 3)
Annals of Combinatorics     Hybrid Journal   (Followers: 4, SJR: 0.932, CiteScore: 1)
Annals of Data Science     Hybrid Journal   (Followers: 12)
Annals of Dyslexia     Hybrid Journal   (Followers: 10, SJR: 0.85, CiteScore: 2)
Annals of Finance     Hybrid Journal   (Followers: 30, SJR: 0.579, CiteScore: 1)
Annals of Forest Science     Hybrid Journal   (Followers: 7, SJR: 0.986, CiteScore: 2)
Annals of Global Analysis and Geometry     Hybrid Journal   (Followers: 1, SJR: 1.228, CiteScore: 1)
Annals of Hematology     Hybrid Journal   (Followers: 15, SJR: 1.043, CiteScore: 2)
Annals of Mathematics and Artificial Intelligence     Hybrid Journal   (Followers: 12, SJR: 0.413, CiteScore: 1)
Annals of Microbiology     Hybrid Journal   (Followers: 11, SJR: 0.479, CiteScore: 2)
Annals of Nuclear Medicine     Hybrid Journal   (Followers: 4, SJR: 0.687, CiteScore: 2)
Annals of Operations Research     Hybrid Journal   (Followers: 10, SJR: 0.943, CiteScore: 2)
Annals of Ophthalmology     Hybrid Journal   (Followers: 11)
Annals of Regional Science     Hybrid Journal   (Followers: 7, SJR: 0.614, CiteScore: 1)
Annals of Software Engineering     Hybrid Journal   (Followers: 13)
Annals of Solid and Structural Mechanics     Hybrid Journal   (Followers: 9, SJR: 0.239, CiteScore: 1)
Annals of Surgical Oncology     Hybrid Journal   (Followers: 13, SJR: 1.986, CiteScore: 4)
Annals of Telecommunications     Hybrid Journal   (Followers: 9, SJR: 0.223, CiteScore: 1)
Annals of the Institute of Statistical Mathematics     Hybrid Journal   (Followers: 1, SJR: 1.495, CiteScore: 1)
Antonie van Leeuwenhoek     Hybrid Journal   (Followers: 5, SJR: 0.834, CiteScore: 2)
Apidologie     Hybrid Journal   (Followers: 4, SJR: 1.22, CiteScore: 3)
APOPTOSIS     Hybrid Journal   (Followers: 8, SJR: 1.424, CiteScore: 4)
Applicable Algebra in Engineering, Communication and Computing     Hybrid Journal   (Followers: 2, SJR: 0.294, CiteScore: 1)
Applications of Mathematics     Hybrid Journal   (Followers: 2, SJR: 0.602, CiteScore: 1)
Applied Biochemistry and Biotechnology     Hybrid Journal   (Followers: 43, SJR: 0.571, CiteScore: 2)
Applied Biochemistry and Microbiology     Hybrid Journal   (Followers: 17, SJR: 0.21, CiteScore: 1)
Applied Cancer Research     Open Access  
Applied Categorical Structures     Hybrid Journal   (Followers: 2, SJR: 0.49, CiteScore: 0)
Applied Composite Materials     Hybrid Journal   (Followers: 49, SJR: 0.58, CiteScore: 2)
Applied Entomology and Zoology     Partially Free   (Followers: 4, SJR: 0.422, CiteScore: 1)
Applied Geomatics     Hybrid Journal   (Followers: 3, SJR: 0.733, CiteScore: 3)
Applied Geophysics     Hybrid Journal   (Followers: 8, SJR: 0.488, CiteScore: 1)
Applied Intelligence     Hybrid Journal   (Followers: 12, SJR: 0.6, CiteScore: 2)
Applied Magnetic Resonance     Hybrid Journal   (Followers: 4, SJR: 0.319, CiteScore: 1)
Applied Mathematics & Optimization     Hybrid Journal   (Followers: 6, SJR: 0.886, CiteScore: 1)
Applied Mathematics - A J. of Chinese Universities     Hybrid Journal   (SJR: 0.17, CiteScore: 0)
Applied Mathematics and Mechanics     Hybrid Journal   (Followers: 5, SJR: 0.461, CiteScore: 1)
Applied Microbiology and Biotechnology     Hybrid Journal   (Followers: 64, SJR: 1.182, CiteScore: 4)
Applied Physics A     Hybrid Journal   (Followers: 9, SJR: 0.481, CiteScore: 2)
Applied Physics B: Lasers and Optics     Hybrid Journal   (Followers: 24, SJR: 0.74, CiteScore: 2)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 8, SJR: 0.519, CiteScore: 2)
Applied Research in Quality of Life     Hybrid Journal   (Followers: 12, SJR: 0.316, CiteScore: 1)
Applied Solar Energy     Hybrid Journal   (Followers: 18, SJR: 0.225, CiteScore: 0)
Applied Spatial Analysis and Policy     Hybrid Journal   (Followers: 5, SJR: 0.542, CiteScore: 1)
Aquaculture Intl.     Hybrid Journal   (Followers: 23, SJR: 0.591, CiteScore: 2)
Aquarium Sciences and Conservation     Hybrid Journal   (Followers: 1)
Aquatic Ecology     Hybrid Journal   (Followers: 34, SJR: 0.656, CiteScore: 2)
Aquatic Geochemistry     Hybrid Journal   (Followers: 4, SJR: 0.591, CiteScore: 1)
Aquatic Sciences     Hybrid Journal   (Followers: 13, SJR: 1.109, CiteScore: 3)
Arabian J. for Science and Engineering     Hybrid Journal   (Followers: 5, SJR: 0.303, CiteScore: 1)
Arabian J. of Geosciences     Hybrid Journal   (Followers: 2, SJR: 0.319, CiteScore: 1)
Archaeological and Anthropological Sciences     Hybrid Journal   (Followers: 20, SJR: 1.052, CiteScore: 2)
Archaeologies     Hybrid Journal   (Followers: 12, SJR: 0.224, CiteScore: 0)
Archiv der Mathematik     Hybrid Journal   (Followers: 1, SJR: 0.725, CiteScore: 1)
Archival Science     Hybrid Journal   (Followers: 60, SJR: 0.745, CiteScore: 2)
Archive for History of Exact Sciences     Hybrid Journal   (Followers: 7, SJR: 0.186, CiteScore: 1)
Archive for Mathematical Logic     Hybrid Journal   (Followers: 3, SJR: 0.909, CiteScore: 1)
Archive for Rational Mechanics and Analysis     Hybrid Journal   (SJR: 3.93, CiteScore: 3)
Archive of Applied Mechanics     Hybrid Journal   (Followers: 5, SJR: 0.79, CiteScore: 2)
Archives and Museum Informatics     Hybrid Journal   (Followers: 142, SJR: 0.101, CiteScore: 0)
Archives of Computational Methods in Engineering     Hybrid Journal   (Followers: 5, SJR: 1.41, CiteScore: 5)
Archives of Dermatological Research     Hybrid Journal   (Followers: 7, SJR: 1.006, CiteScore: 2)
Archives of Environmental Contamination and Toxicology     Hybrid Journal   (Followers: 14, SJR: 0.773, CiteScore: 2)
Archives of Gynecology and Obstetrics     Hybrid Journal   (Followers: 16, SJR: 0.956, CiteScore: 2)
Archives of Microbiology     Hybrid Journal   (Followers: 8, SJR: 0.644, CiteScore: 2)
Archives of Orthopaedic and Trauma Surgery     Hybrid Journal   (Followers: 8, SJR: 1.146, CiteScore: 2)
Archives of Osteoporosis     Hybrid Journal   (Followers: 2, SJR: 0.71, CiteScore: 2)
Archives of Sexual Behavior     Hybrid Journal   (Followers: 10, SJR: 1.493, CiteScore: 3)
Archives of Toxicology     Hybrid Journal   (Followers: 17, SJR: 1.541, CiteScore: 5)
Archives of Virology     Hybrid Journal   (Followers: 5, SJR: 0.973, CiteScore: 2)
Archives of Women's Mental Health     Hybrid Journal   (Followers: 14, SJR: 1.274, CiteScore: 3)
Archivio di Ortopedia e Reumatologia     Hybrid Journal  
Archivum Immunologiae et Therapiae Experimentalis     Hybrid Journal   (Followers: 2, SJR: 0.946, CiteScore: 3)
ArgoSpine News & J.     Hybrid Journal  
Argumentation     Hybrid Journal   (Followers: 5, SJR: 0.349, CiteScore: 1)
Arid Ecosystems     Hybrid Journal   (Followers: 2, SJR: 0.2, CiteScore: 0)
Arkiv för Matematik     Hybrid Journal   (Followers: 1, SJR: 0.766, CiteScore: 1)
Arnold Mathematical J.     Hybrid Journal   (Followers: 1, SJR: 0.355, CiteScore: 0)
Arthropod-Plant Interactions     Hybrid Journal   (Followers: 2, SJR: 0.839, CiteScore: 2)
Arthroskopie     Hybrid Journal   (Followers: 1, SJR: 0.131, CiteScore: 0)
Artificial Intelligence and Law     Hybrid Journal   (Followers: 11, SJR: 0.937, CiteScore: 2)
Artificial Intelligence Review     Hybrid Journal   (Followers: 15, SJR: 0.833, CiteScore: 4)
Artificial Life and Robotics     Hybrid Journal   (Followers: 9, SJR: 0.226, CiteScore: 0)
Asia Europe J.     Hybrid Journal   (Followers: 5, SJR: 0.504, CiteScore: 1)
Asia Pacific Education Review     Hybrid Journal   (Followers: 12, SJR: 0.479, CiteScore: 1)
Asia Pacific J. of Management     Hybrid Journal   (Followers: 16, SJR: 1.185, CiteScore: 2)
Asia-Pacific Education Researcher     Hybrid Journal   (Followers: 12, SJR: 0.353, CiteScore: 1)
Asia-Pacific Financial Markets     Hybrid Journal   (Followers: 2, SJR: 0.187, CiteScore: 0)
Asia-Pacific J. of Atmospheric Sciences     Hybrid Journal   (Followers: 19, SJR: 0.855, CiteScore: 1)
Asian Business & Management     Hybrid Journal   (Followers: 9, SJR: 0.378, CiteScore: 1)
Asian J. of Business Ethics     Hybrid Journal   (Followers: 9)
Asian J. of Criminology     Hybrid Journal   (Followers: 5, SJR: 0.543, CiteScore: 1)
AStA Advances in Statistical Analysis     Hybrid Journal   (Followers: 3, SJR: 0.548, CiteScore: 1)
AStA Wirtschafts- und Sozialstatistisches Archiv     Hybrid Journal   (Followers: 5, SJR: 0.183, CiteScore: 0)
ästhetische dermatologie & kosmetologie     Full-text available via subscription  

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Journal Cover
Annals of Biomedical Engineering
Journal Prestige (SJR): 1.042
Citation Impact (citeScore): 3
Number of Followers: 18  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1573-9686 - ISSN (Online) 0090-6964
Published by Springer-Verlag Homepage  [2348 journals]
  • The Development of a Four-Electrode Bio-Impedance Sensor for
           Identification and Localization of Deep Pulmonary Nodules
    • Authors: Rasool Baghbani; Mohammad Hassan Moradi; Mohammad Behgam Shadmehr
      Pages: 1079 - 1090
      Abstract: Identifying and localizing of deep pulmonary nodules are among the main challenges that thoracic surgeons face during operations, particularly in thoracoscopic procedures. To facilitate this, we have tried to introduce a non-invasive and safe method by measuring the lung electrical bio-impedance spectrum with a four-electrode array sensor. To study the feasibility of this method, since any change in the depth or diameter of the nodule in the lung tissue is not practical, we used the finite element modeling of the lung tissue and pulmonary nodule to allow changes in the depth and diameter of the nodule, as well as the distance in between the injection electrodes. Accordingly, a bio-impedance sensor was designed and fabricated. By measuring the electrical impedance spectrum of pulmonary tissues in four different specimens with a frequency band of 50 kHz to 5 MHz, 4 pulmonary nodules at four different depths were identified. The obtained bio-impedance spectrum from the lung surface showed that the magnitude and phase of electrical bio-impedance of the tumoral tissue at each frequency is smaller than that of the healthy tissue. In addition, the frequency characteristic varies in the Nyquist curves for tumoral and healthy lung tissues.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2032-8
      Issue No: Vol. 46, No. 8 (2018)
       
  • Tissue Identification in a Porcine Model by Differential Ion Mobility
           Spectrometry Analysis of Surgical Smoke
    • Authors: Anton Kontunen; Markus Karjalainen; Jukka Lekkala; Antti Roine; Niku Oksala
      Pages: 1091 - 1100
      Abstract: Electrosurgery is widely used in various surgical operations. When tissue is cut with high-frequency current, the cell contents at the incision area evaporate and together with water and possible soot particles, form surgical smoke. The smoke contains cell metabolites, and therefore, possible biomarkers for cancer or bacterial infection. Thus, the analysis of surgical smoke could be used in intraoperative medical diagnostics. We present a method that can be used to detect the characteristics of various tissue types by means of differential ion mobility spectrometry (DMS) analysis of surgical smoke. We used our method to test tissue identification with ten different porcine tissues. We classified the DMS responses with cross-validated linear discriminant analysis models. The classification accuracy in a measurement set with ten tissue types was 95%. The presented tissue identification by DMS analysis of surgical smoke is a proof-of-concept, which opens the possibility to research the method in diagnosing human tissues and diseases in the future.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2035-5
      Issue No: Vol. 46, No. 8 (2018)
       
  • The Effect of Heated CO 2 Insufflation in Minimising Surgical Wound
           Contamination During Open Surgery
    • Authors: Monika Baumann; John E. Cater
      Pages: 1101 - 1111
      Abstract: The primary source of infections in open surgeries has been found to be bacteria and viruses carried into the surgical wound on the surfaces of skin particles shed by patients and surgical staff. In open cardiac surgeries, insufflation of the wound with carbon dioxide is used to limit the quantity of air able to enter into the heart, avoiding air embolisms when the heart is restarted. This surgical technique has been evaluated as a method of limiting the number of skin particles able to enter into the wound, using computational fluid dynamics (CFD) simulations and experimental testing. Spherical particles of 5.0 and 13.5 μm in diameter were used to simulate skin particles falling above a wound, travelling in air ventilation velocities of either 0.2 or 0.4 m/s, and with or without CO2 insufflation. The CFD simulations with CO2 included a diffuser placed in the wound and supplied with CO2 at a rate of 10 L/min. Experimental testing was completed under similar conditions. The results of CFD simulations and experimental testing showed CO2 insufflation can significantly limit the number of particles able to enter into the wound.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2034-6
      Issue No: Vol. 46, No. 8 (2018)
       
  • Finite Element Analysis of Tricuspid Valve Deformation from Multi-slice
           Computed Tomography Images
    • Authors: Fanwei Kong; Thuy Pham; Caitlin Martin; Raymond McKay; Charles Primiano; Sabet Hashim; Susheel Kodali; Wei Sun
      Pages: 1112 - 1127
      Abstract: Despite the growing clinical interest in the tricuspid valve (TV), there is an incomplete understanding of TV biomechanics which is important in normal TV function and successful TV repair techniques. Computational models with patient-specific human TV geometries can provide a quantitative understanding of TV biomechanic. Therefore, this study aimed to develop finite element (FE) models of human TVs from multi-slice computed tomography (MSCT) images to investigate chordal forces and leaflet stresses and strains. Three FE models were constructed for human subjects with healthy TVs from MSCT images and incorporated detailed leaflet geometries, realistic nonlinear anisotropic hyperelastic material properties of human TV, and physiological boundary conditions tracked from MSCT images. TV closure from diastole to systole was simulated. Chordal lengths were iteratively adjusted until the simulated TV geometries were in good agreement with the “true” geometries reconstructed from MSCT images at systole. Larger chordal forces were found on the strut (or basal) chords than on the rough zone chords and the total forces applied on the anterior papillary muscles by the strut chords were higher than those on the posterior or septal papillary muscles. At peak systolic pressure, the average maximum stress on the middle sections of the leaflets ranged from 30 to 90 kPa, while the average maximum principal strain values ranged from 0.16 to 0.30. The results from healthy TVs can serve as baseline biomechanical metrics of TV mechanics and may be used to inform TV repair device design. The computational approach developed could be one step towards developing computational models that may support pre-operative planning in complex TV repair procedures in the future.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2024-8
      Issue No: Vol. 46, No. 8 (2018)
       
  • The Role of Circle of Willis Anatomy Variations in Cardio-embolic Stroke:
           A Patient-Specific Simulation Based Study
    • Authors: Debanjan Mukherjee; Neel D. Jani; Jared Narvid; Shawn C. Shadden
      Pages: 1128 - 1145
      Abstract: We describe a patient-specific simulation based investigation on the role of Circle of Willis anatomy in cardioembolic stroke. Our simulation framework consists of medical image-driven modeling of patient anatomy including the Circle, 3D blood flow simulation through patient vasculature, embolus transport modeling using a discrete particle dynamics technique, and a sampling based approach to incorporate parametric variations. A total of 24 (four patients and six Circle anatomies including the complete Circle) models were considered, with cardiogenic emboli of varying sizes and compositions released virtually and tracked to compute distribution to the brain. The results establish that Circle anatomical variations significantly influence embolus distribution to the six major cerebral arteries. Embolus distribution to MCA territory is found to be least sensitive to the influence of anatomical variations. For varying Circle topologies, differences in flow through cervical vasculature are observed. This incoming flow is recruited differently across the communicating arteries of the Circle for varying anastomoses. Emboli interact with the routed flow, and can undergo significant traversal across the Circle arterial segments, depending upon their inertia and density ratio with respect to blood. This interaction drives the underlying biomechanics of embolus transport across the Circle, explaining how Circle anatomy influences embolism risk.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2027-5
      Issue No: Vol. 46, No. 8 (2018)
       
  • Cell Mimicking Microparticles Influence the Organization, Growth, and
           Mechanophenotype of Stem Cell Spheroids
    • Authors: Nicholas R. Labriola; Jessica S. Sadick; Jeffrey R. Morgan; Edith Mathiowitz; Eric M. Darling
      Pages: 1146 - 1159
      Abstract: Substrate stiffness is known to alter cell behavior and drive stem cell differentiation, though most research in this area has been restricted to traditional, two-dimensional culture systems rather than more physiologically relevant, three-dimensional (3D) platforms. In this study, we utilized polymer-based, cell mimicking microparticles (CMMPs) to deliver distinct, stable mechanical cues to human adipose derived stem cells in 3D spheroid culture to examine changes in adipogenic differentiation response and mechanophenotype. After 21 days of adipogenic induction, spheroids containing CMMPs (composite spheroids) stiffened in accordance with CMMP elasticity such that spheroids containing the stiffest, ~ 10 kPa, CMMPs were over 27% stiffer than those incorporating the most compliant, ~ 0.25 kPa CMMPs. Adipogenically induced, cell-only spheroids were over 180% larger and 50% more compliant than matched controls. Interestingly, composite spheroids cultured without chemical induction factors dissociated when presented with CMMPs stiffer than ~ 1 kPa, while adipogenic induction factors mitigated this behavior. Gene expression for PPARG and FABP4 were upregulated more than 45-fold in adipogenically induced samples compared to controls but were unaffected by CMMP elasticity, attributed to insufficient cell-CMMP contacts throughout the composite spheroid. In summary, mechanically tuned CMMPs influenced whole-spheroid mechanophenotype and stability but minimally affected differentiation response.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2028-4
      Issue No: Vol. 46, No. 8 (2018)
       
  • Novel Method for Superposing 3D Digital Models for Monitoring Orthodontic
           Tooth Movement
    • Authors: Falko Schmidt; Fatih Kilic; Neltje Emma Piro; Martin Eberhard Geiger; Bernd Georg Lapatki
      Pages: 1160 - 1172
      Abstract: Quantitative three-dimensional analysis of orthodontic tooth movement (OTM) is possible by superposition of digital jaw models made at different times during treatment. Conventional methods rely on surface alignment at palatal soft-tissue areas, which is applicable to the maxilla only. We introduce two novel numerical methods applicable to both maxilla and mandible. The OTM from the initial phase of multi-bracket appliance treatment of ten pairs of maxillary models were evaluated and compared with four conventional methods. The median range of deviation of OTM for three users was 13–72% smaller for the novel methods than for the conventional methods, indicating greater inter-observer agreement. Total tooth translation and rotation were significantly different (ANOVA, p < 0.01) for OTM determined by use of the two numerical and four conventional methods. Directional decomposition of OTM from the novel methods showed clinically acceptable agreement with reference results except for vertical translations (deviations of medians greater than 0.6 mm). The difference in vertical translational OTM can be explained by maxillary vertical growth during the observation period, which is additionally recorded by conventional methods. The novel approaches are, thus, particularly suitable for evaluation of pure treatment effects, because growth-related changes are ignored.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2029-3
      Issue No: Vol. 46, No. 8 (2018)
       
  • Computational Model for Hyperfibrinolytic Onset of Acute Traumatic
           Coagulopathy
    • Authors: Tie Bo Wu; Sheng Wu; Matthew Buoni; Thomas Orfeo; Kathleen Brummel-Ziedins; Mitchell Cohen; Linda Petzold
      Pages: 1173 - 1182
      Abstract: The onset of acute traumatic coagulopathy in trauma patients exacerbates hemorrhaging and dramatically increases mortality. The disease is characterized by increased localized bleeding, and the mechanism for its onset is not yet known. We propose that the fibrinolytic response, specifically the release of tissue-plasminogen activator (t-PA), within vessels of different sizes leads to a variable susceptibility to local coagulopathy through hyperfibrinolysis which can explain many of the clinical observations in the early stages from severely injured coagulopathic patients. We use a partial differential equation model to examine the consequences of vessel geometry and extent of injury on fibrinolysis profiles. In addition, we simulate the efficacy of tranexamic acid treatment on coagulopathy initiated through endothelial t-PA release, and are able to reproduce the time-sensitive nature of the efficacy of this treatment as observed in clinical studies.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2031-9
      Issue No: Vol. 46, No. 8 (2018)
       
  • Torso-Tank Validation of High-Resolution Electrogastrography (EGG):
           Forward Modelling, Methodology and Results
    • Authors: Stefan Calder; Greg O’Grady; Leo K. Cheng; Peng Du
      Pages: 1183 - 1193
      Abstract: Electrogastrography (EGG) is a non-invasive method for measuring gastric electrical activity. Recent simulation studies have attempted to extend the current clinical utility of the EGG, in particular by providing a theoretical framework for distinguishing specific gastric slow wave dysrhythmias. In this paper we implement an experimental setup called a ‘torso-tank’ with the aim of expanding and experimentally validating these previous simulations. The torso-tank was developed using an adult male torso phantom with 190 electrodes embedded throughout the torso. The gastric slow waves were reproduced using an artificial current source capable of producing 3D electrical fields. Multiple gastric dysrhythmias were reproduced based on high-resolution mapping data from cases of human gastric dysfunction (gastric re-entry, conduction blocks and ectopic pacemakers) in addition to normal test data. Each case was recorded and compared to the previously-presented simulated results. Qualitative and quantitative analyses were performed to define the accuracy showing \(\sim \)  1.8% difference, \(\sim \)  0.99 correlation, and \(\sim \)  0.04 normalised RMS error between experimental and simulated findings. These results reaffirm previous findings and these methods in unison therefore present a promising morphological-based methodology for advancing the understanding and clinical applications of EGG.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2030-x
      Issue No: Vol. 46, No. 8 (2018)
       
  • Mechanical and Clinical Evaluation of a Shape Memory Alloy and
           Conventional Struts in a Flexible Scoliotic Brace
    • Authors: Wing-Yu Chan; Joanne Yip; Kit-Lun Yick; Sun-Pui Ng; Lu Lu; Kenneth Man-Chee Cheung; Kenny Yat-Hong Kwan; Jason Pui-Yin Cheung; Kelvin Wai-Kwok Yeung; Chi-Yung Tse
      Pages: 1194 - 1205
      Abstract: Smart materials have attracted considerable attention in the medical field. In particular, shape memory alloys (SMAs) are most commonly utilized for their superelasticity (SE) in orthopaedic treatment. In this study, the resin struts of a flexible brace for adolescent idiopathic scoliosis (AIS) are replaced with different conventional materials and an SMA. The corrective mechanism mainly depends on the compressive force applied by the brace at the desired location. Therefore, the mechanical properties of the materials used and the interface pressure are both critical factors that influence the treatment effectiveness. The results indicate that titanium is the most rigid among the five types of materials, whereas the brace with SMA struts presents the best recovery properties and the most stable interface pressure. A radiographic examination of two patients with AIS is then conducted to validate the results, which shows that the SMA struts can provide better correction of thoracic curvature. These findings suggest that SMAs can be applied in orthoses because their SE allows for continuous and controllable corrective forces.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2016-8
      Issue No: Vol. 46, No. 8 (2018)
       
  • 3D Reconstruction of Scoliotic Spines from Stereoradiography and Depth
           Imaging
    • Authors: Benjamin Groisser; Ron Kimmel; Guy Feldman; Nimrod Rozen; Alon Wolf
      Pages: 1206 - 1215
      Abstract: Spine shape can be reconstructed from stereoradiography, but often requires specialized infrastructure or fails to account for subject posture. In this paper a protocol is presented for stereo reconstructions that integrates surface recordings with radiography and naturally accounts for variations in patient posture. Low cost depth cameras are added to an existing radiographic system to capture patient pose. A statistical model of human body shape is learned from public datasets and registered to depth scans, providing 3D correspondence across images for stereo reconstruction of radiographic landmarks. A radiographic phantom was used to validate these methods in vitro with RMS 3D landmark reconstruction error of 2.0 mm. Surfaces were automatically and reliably registered, with SD 12 mm translation disparity and SD .5° rotation. The proposed method is suitable for 3D radiographic reconstructions and may be beneficial in compensating for involuntary patient motion.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2033-7
      Issue No: Vol. 46, No. 8 (2018)
       
  • Predictive Simulations of Neuromuscular Coordination and Joint-Contact
           Loading in Human Gait
    • Authors: Yi-Chung Lin; Jonathan P. Walter; Marcus G. Pandy
      Pages: 1216 - 1227
      Abstract: ABSTRACT We implemented direct collocation on a full-body neuromusculoskeletal model to calculate muscle forces, ground reaction forces and knee contact loading simultaneously for one cycle of human gait. A data-tracking collocation problem was solved for walking at the normal speed to establish the practicality of incorporating a 3D model of articular contact and a model of foot–ground interaction explicitly in a dynamic optimization simulation. The data-tracking solution then was used as an initial guess to solve predictive collocation problems, where novel patterns of movement were generated for walking at slow and fast speeds, independent of experimental data. The data-tracking solutions accurately reproduced joint motion, ground forces and knee contact loads measured for two total knee arthroplasty patients walking at their preferred speeds. RMS errors in joint kinematics were < 2.0° for rotations and < 0.3 cm for translations while errors in the model-computed ground-reaction and knee-contact forces were < 0.07 BW and < 0.4 BW, respectively. The predictive solutions were also consistent with joint kinematics, ground forces, knee contact loads and muscle activation patterns measured for slow and fast walking. The results demonstrate the feasibility of performing computationally-efficient, predictive, dynamic optimization simulations of movement using full-body, muscle-actuated models with realistic representations of joint function.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2026-6
      Issue No: Vol. 46, No. 8 (2018)
       
  • Correction to: Predictive Simulations of Neuromuscular Coordination and
           Joint-Contact Loading in Human Gait
    • Authors: Yi-Chung Lin; Jonathan P. Walter; Marcus G. Pandy
      Pages: 1228 - 1228
      Abstract: In the “Materials and Methods” section, the link provided at the bottom of the second paragraph should be https://simtk.org/home/dcwithjtcontact/.
      PubDate: 2018-08-01
      DOI: 10.1007/s10439-018-2045-3
      Issue No: Vol. 46, No. 8 (2018)
       
  • A Combined Approach for the Analysis of Ocular Fluid Dynamics in the
           Presence of Saccadic Movements
    • Authors: Marco Ferroni; Matteo Giuseppe Cereda; Federica Boschetti
      Abstract: One of the main ocular diseases is age-related macular degeneration, actually treated with antibodies injections into the eye. This problem has been faced by computational approaches, taking into account either the influence of the tissues surrounding the vitreous, or the saccades. The aim of this work is to propose a combined fluid dynamic model of the vitreous chamber that analyses the impact of the saccades on the fluid dynamic mechanisms. The ocular vitreous humor was modeled considering liquefaction occurring in presence of age-related macular degeneration. We identified two kinds of boundary conditions, one related to the physiological environment outside the chamber, and one related to the saccades. The scleral hydraulic conductivity was evaluated by means of experimental permeability tests. An exponential decay was used to describe the trend of the scleral hydraulic conductivity with the acting pressure drop. The streamline analysis shows two main stagnant regions on the equatorial plane and peculiar fluid dynamics in absence of saccades. This study demonstrates the major role played by the saccades in determining the fluid dynamic mechanisms inside the vitreous chamber of the eye and represents a powerful tool to investigate vitreous dynamics and its relation to clinical issues.
      PubDate: 2018-08-07
      DOI: 10.1007/s10439-018-02110-2
       
  • A Wearable Magnet-Based System to Assess Activity and Joint Flexion in
           Humans and Large Animals
    • Authors: Feini Qu; Brendan D. Stoeckl; Peter M. Gebhard; Todd J. Hullfish; Josh R. Baxter; Robert L. Mauck
      Abstract: Functional outcomes, such as joint flexion and gait, are important indicators of efficacy in musculoskeletal research. Current technologies that objectively assess these parameters, including visual tracking systems and force plates, are challenging to deploy in long-term translational and clinical studies. To that end, we developed a wearable device that measures both physical activity and joint flexion using a single integrated sensor and magnet system, and hypothesized that it could evaluate post-operative functional recovery in an unsupervised setting. To demonstrate the feasibility of measuring joint flexion, we first compared knee motion from the wearable device to that acquired from a motion capture system to confirm that knee flexion measurements during normal human gait, predicted via changes in magnetic field strength, closely correlated with data acquired by motion capture. Using this system, we then monitored a porcine cohort after bilateral stifle arthrotomy to investigate longitudinal changes in physical activity and joint flexion. We found that unsupervised activity declined immediately after surgery, with a return to pre-operative activity occurring over a period of 2 weeks. By providing objective, individualized data on locomotion and joint function, this magnet-based system will facilitate the in vivo assessment of novel therapeutics in translational orthopaedic research.
      PubDate: 2018-08-06
      DOI: 10.1007/s10439-018-2105-8
       
  • Improving the Subcutaneous Mouse Tumor Model by Effective Manipulation of
           Magnetic Nanoparticles-Treated Implanted Cancer Cells
    • Authors: Katerina Spyridopoulou; Georgios Aindelis; Evangeli Lampri; Maria Giorgalli; Eleftheria Lamprianidou; Ioannis Kotsianidis; Anastasia Tsingotjidou; Aglaia Pappa; Orestis Kalogirou; Katerina Chlichlia
      Abstract: Murine tumor models have played a fundamental role in the development of novel therapeutic interventions and are currently widely used in translational research. Specifically, strategies that aim at reducing inter-animal variability of tumor size in transplantable mouse tumor models are of particular importance. In our approach, we used magnetic nanoparticles to label and manipulate colon cancer cells for the improvement of the standard syngeneic subcutaneous mouse tumor model. Following subcutaneous injection on the scruff of the neck, magnetically-tagged implanted cancer cells were manipulated by applying an external magnetic field towards localized tumor formation. Our data provide evidence that this approach can facilitate the formation of localized tumors of similar shape, reducing thereby the tumor size’s variability. For validating the proof-of-principle, a low-dose of 5-FU was administered in small animal groups as a representative anticancer therapy. Under these experimental conditions, the 5-FU-induced tumor growth inhibition was statistically significant only after the implementation of the proposed method. The presented approach is a promising strategy for studying accurately therapeutic interventions in subcutaneous experimental solid tumor models allowing for the detection of statistically significant differences between smaller experimental groups.
      PubDate: 2018-08-03
      DOI: 10.1007/s10439-018-2107-6
       
  • Comparison of Flow Estimators for Rotary Blood Pumps: An In Vitro and In
           Vivo Study
    • Authors: Anastasios Petrou; Daniel Kuster; Jongseok Lee; Mirko Meboldt; Marianne Schmid Daners
      Abstract: Various approaches for estimating the flow rate of a rotary blood pump have been proposed for monitoring and control purposes. They have been evaluated under different test conditions and, therefore, a direct comparison among them is difficult. Furthermore, a limited performance has been reported for the areas where the pump flow and motor current present a non-monotonic relationship. In this regard, we selected most approaches that have been presented in literature and added a modified one, resulting in four estimators, which are either non-invasive or invasive, i.e., inlet and outlet pump pressure sensors are used. Data from in vitro and in vivo studies with the Deltastream pump DP2 were used to compare the estimators under the same test conditions. These data included both constant and varying pre- and afterload, contractility, viscosity, as well as pump speed settings. Bland–Altman plots were used to evaluate the performance of the estimators. The mean error of the overall estimated flow in vitro ranged from 0.002 to 0.38 L/min and the limits of agreement (LoA) between ± 2 L/min. During negative flows the mean error decreased by about 25% when the pump inlet pressure was added as an input. In vivo, the mean errors increased, while the LoA remained in the same range. An estimator based on pump pressure difference improves the reliability in areas where flow and current relationship is not monotonic. A trade-off between estimation accuracy and number of sensors was identified. The estimation objective and the potential errors should be considered when selecting an estimation approach and designing the pump systems.
      PubDate: 2018-07-27
      DOI: 10.1007/s10439-018-2106-7
       
  • Optimal Design of Needle Array for Effective Drug Delivery
    • Authors: Hanwook Park; Hyejeong Kim; Sang Joon Lee
      Abstract: Recently, the multi-needle drug injection has been adopted to overcome the shortcomes of conventional single-needle injection, enhancing the efficiency of drug delivery. However, the effect of needle array on the efficacy of drug delivery has not been fully elucidated. In this study, the interactions of drug analogous solution injected from a pair of needles were analyzed to examine the design criteria of effective multi-needle devices for drug delivery. Temporal and spatial variations of relative contents of the solution in the tissues were compared according to the distance between two adjacent needles (DN). As the DN increases from 5 to 20 D, where D is the needle diameter, the solution from each needle encounters 3.5 times faster, and 4.22 times more solution was accumulated. At the same time, the effective spreading area was continuously increased from 54.2 to 177.8 mm2 and RCS gradient decreases from 0.087 to 0.037, due to the overlapping effect of the spreading solution from neighboring needles. Finally, based on the experimental results, an optimal design criterion of needle array for effective drug delivery was proposed. The present results would be helpful in the design of multi-needle injection devices and eventually offer advantage to patients with effective drug delivery.
      PubDate: 2018-07-26
      DOI: 10.1007/s10439-018-2100-0
       
  • Clinical Translation of the LevelCheck Decision Support Algorithm for
           Target Localization in Spine Surgery
    • Authors: Amir Manbachi; Tharindu De Silva; Ali Uneri; Matthew Jacobson; Joseph Goerres; Michael Ketcha; Runze Han; Nafi Aygun; David Thompson; Xiaobu Ye; Sebastian Vogt; Gerhard Kleinszig; Camilo Molina; Rajiv Iyer; Tomas Garzon-Muvdi; Michael R. Raber; Mari Groves; Jean-Paul Wolinsky; Jeffrey H. Siewerdsen
      Abstract: Recent work has yielded a method for automatic labeling of vertebrae in intraoperative radiographs as an assistant to manual level counting. The method, called LevelCheck, previously demonstrated promise in phantom studies and retrospective studies. This study aims to: (#1) Analyze the effect of LevelCheck on accuracy and confidence of localization in two modes: (a) Independent Check (labels displayed after the surgeon’s decision) and (b) Active Assistant (labels presented before the surgeon’s decision). (#2) Assess the feasibility and utility of LevelCheck in the operating room. Two studies were conducted: a laboratory study investigating these two workflow implementations in a simulated operating environment with 5 surgeons, reviewing 62 cases selected from a dataset of radiographs exhibiting a challenge to vertebral localization; and a clinical study involving 20 patients undergoing spine surgery. In Study #1, the median localization error without assistance was 30.4% (IQR = 5.2%) due to the challenging nature of the cases. LevelCheck reduced the median error to 2.4% for both the Independent Check and Active Assistant modes (p < 0.01). Surgeons found LevelCheck to increase confidence in 91% of cases. Study #2 demonstrated accuracy in all cases. The algorithm runtime varied from 17 to 72 s in its current implementation. The algorithm was shown to be feasible, accurate, and to improve confidence during surgery.
      PubDate: 2018-07-26
      DOI: 10.1007/s10439-018-2099-2
       
  • Neuromonitoring During Robotic Cochlear Implantation: Initial Clinical
           Experience
    • Authors: Juan Ansó; Olivier Scheidegger; Wilhelm Wimmer; Kate Gavaghan; Nicolas Gerber; Daniel Schneider; Jan Hermann; Christoph Rathgeb; Cilgia Dür; Kai Michael Rösler; Georgios Mantokoudis; Marco Caversaccio; Stefan Weber
      Abstract: During robotic cochlear implantation a drill trajectory often passes at submillimeter distances from the facial nerve due to close lying critical anatomy of the temporal bone. Additional intraoperative safety mechanisms are thus required to ensure preservation of this vital structure in case of unexpected navigation system error. Electromyography based nerve monitoring is widely used to aid surgeons in localizing vital nerve structures at risk of injury during surgery. However, state of the art neuromonitoring systems, are unable to discriminate facial nerve proximity within submillimeter ranges. Previous work demonstrated the feasibility of utilizing combinations of monopolar and bipolar stimulation threshold measurements to discretize facial nerve proximity with greater sensitivity and specificity, enabling discrimination between safe (> 0.4 mm) and unsafe (< 0.1 mm) trajectories during robotic cochlear implantation (in vivo animal model). Herein, initial clinical validation of the determined stimulation protocol and nerve proximity analysis integrated into an image guided system for safety measurement is presented. Stimulation thresholds and corresponding nerve proximity values previously determined from an animal model have been validated in a first-in-man clinical trial of robotic cochlear implantation. Measurements performed automatically at preoperatively defined distances from the facial nerve were used to determine safety of the drill trajectory intraoperatively. The presented system and automated analysis correctly determined sufficient safety distance margins (> 0.4 mm) to the facial nerve in all cases.
      PubDate: 2018-07-26
      DOI: 10.1007/s10439-018-2094-7
       
 
 
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