Approach-specific, multi-GPU, multi-tool, high-realism neurosurgery simulation

描述(由申请人提供)：模拟在神经外科中取得的进展有限，尽管验证研究证明了它比传统培训的优势。它强调了针头插入，而没有解决未来大多数病例数量上的实习外科医生的要求。现有的模拟器显示，大脑网状结构缺乏关于裂缝的分离性，不够稀疏，不足以交互地解决大的位移，并且没有考虑关键组织。这些模拟器也只模拟了简单的仪器。我们的长期目标是一种交互式模拟器，可以复制大多数未来年轻外科医生的病例，使面临紧凑实习日程的医院能够在患者结果与手术经验相关的情况下加快培训并提高技能。这一目标将通过集成多分辨率大脑网格来实现，该网格在粗略水平上是稀疏的和沟槽可分离的，在精细水平上是描述性的，基于交互式非线性多网格有限元的生物力学，通过灵活的触觉实现的多工具交互，以及通过手术本体指定的临床要求。我们的假设是，为了使交互式神经外科模拟具有相关性和技术可行性，解剖学建模必须充分描述手术中的运动和组织形态，生物力学必须忠于组织响应，触觉必须能够提供多工具交互，并且系统必须满足反映特定手术入路和病理的临床要求。 与公共健康相关：现有的神经外科模拟器无法满足实习外科医生的需求，因为合成生物力学组织反应所需的脑网模型以及用户向计算机输入手势所需的触觉设备不够描述性，也因为模拟的临床规范不够严格。我们的长期目标是一种交互式模拟器，可以复制未来大多数年轻外科医生的病例。这一目标将通过集成1)在粗略水平上稀疏和可在脑裂隙处分离并在精细水平上描述相关组织的多分辨率脑网格，2)基于交互式非线性有限元的生物力学，3)通过灵活的触觉实现的多工具交互，以及4)基于特定的入路和病理通过外科本体指定的临床要求来实现。

DESCRIPTION (provided by applicant): Simulation has made limited inroads in neurosurgery, despite validation studies demonstrating its advantages over traditional training. It has emphasized needle insertion and failed to address requirements of surgeons-in-training on most future caseloads. Existing simulators exhibit brain mesh that lacks separability about fissures, is insufficiently sparse to resolve large displacements interactively, and does not account for critical tissues. These simulators also have only modeled simple instruments. Our long-term objective is an interactive simulator that replicates most future cases of young surgeons, enabling hospitals faced with compressed internship schedules to accelerate training and improve skills where patient outcome correlates with surgical experience. This objective will be met by integrating a multi-resolution brain mesh that is sparse and sulcal-separable at the coarse level and descriptive at the fine level, biomechanics based on interactive nonlinear multi-grid finite elements, multi-tool interaction achieved through flexible haptics, and clinical requirements specified through surgical ontologies. Our hypothesis is that for interactive neurosurgery simulation to be relevant and technically feasible, anatomical modeling must be sufficiently descriptive in intra-surgical motion and tissue morphology, biomechanics must be faithful to tissue response, haptics must afford multi-tool interaction, and the system must meet clinical requirements reflecting the specific surgical approach and pathology. PUBLIC HEALTH RELEVANCE: Existing neurosurgery simulators fail to meet the needs of surgeons-in-training because the brain mesh model, needed for synthesizing biomechanical tissue response, as well as the haptic device, manipulated by the user to enter a gesture to the computer, are not descriptive enough, and because clinical specifications for simulation are insufficiently rigorous. Our long-term objective is an interactive simulator that replicates most future caseloads of young surgeons. This objective will be met by integrating 1) a multi-resolution brain mesh that is sparse and separable at brain fissures at the coarse level and descriptive of relevant tissues at the fine level, 2) biomechanics based on interactive nonlinear finite elements, 3) multi-tool interaction achieved through flexible haptics, and 4) clinical requirements specified through surgical ontologies based on the specific approach and pathology.