Measurement of the width of thin structures such as the cortical shell of the vertebral body or femoral neck with computed tomography (CT) is limited by the spatial resolution of the CT system. Limited spatial resolution exists both within the CT image plane and perpendicular to it and can be described by the in-plane point spread function (PSF) and the across-plane slice sensitivity profile (SSP), respectively. The goal of this study was to confirm that errors of thickness measurement of thin structures critically depend on the spatial positioning of the object and the spatial resolution limitations of CT in all three dimensions, and to assess the size of the errors themselves. We compared computer models that incorporated both effects to experimentally assessed cortical thicknesses of the European Spine Phantom. Analysis included varying CT slice width, the orientation of measurement and angle beta of misalignment of longitudinal scanner and phantom axes. Agreement of models with measurements was good in all configurations with an overall error of 0.17 mm. This showed that PSF and SSP are adequate system characteristics to predict deviation of measured values from true widths. Errors between measurements and true cortical thickness values delta(true) averaged to 1.5 mm were strongly positively correlated with slice width d and beta. When the across-plane partial volume effect was eliminated, limited in-plane resolution still accounted for overestimation of delta(true) by 0.68 (137%), 0.27 (27%), and 0.06 mm (4%) for delta(true)=0.5, 1.0, and 1.5 mm, respectively. For delta(true) of 1.0 mm and above, it was shown that although the absolute cortical thickness values might not be accurately measurable, relative differences between two values are reflected in measurement. Implications for cortical thickness measurement are that the spinal cortical shell is too thin, whereas accurate assessment at locations of the femoral neck exhibiting a thicker cortical shell of both difference and absolute values should be possible with CT even for larger misalignment angles, especially when a smaller CT slice width is chosen.
Trabecular bone is a highly porous orthotropic cellular solid material present inside human bones such as the femur (hip bone) and vertebra (spine). In this study, an infinitesimal plasticity-like model with isotropic/kinematic hard- A. ening is developed to describe yielding of trabecular bone at the continuum level. One of the unique features of this formulation is the development of the plasticity-like model in strain space for a yield envelope expressed in terms of principal strains having asymmetric yield behavior. An implicit return-mapping approach is adopted to obtain a symmetric algorithmic tangent modulus and a step-by-step procedure of algorithmic implementation is derived. To investigate the performance of this approach in a full-scale finite element simulation, the model is implemented in a non-linear finite element analysis program and several test problems including the simulation of loading of the human femur structures are analyzed. The results show good agreement with the experimental data.
Bioresorbable scaffolds (BRS) combine attributes of the preceding generations of percutaneous coronary intervention (PCI) devices with new technologies to result in a novel therapy promoted as being the fourth generation of PCI. By providing mechanical support and drug elution to suppress restenosis, BRS initially function similarly to drug eluting stents. Thereafter, through their degradation, BRS undergo a decline in radial strength, allowing a gradual transition of mechanical function from the scaffold back to the artery in order to provide long term effectiveness similar to balloon angioplasty. The principles of operation of BRS, whether of polymeric or metallic composition, follow three phases of functionality reflective of differing physiological requirements over time: revascularization, restoration, and resorption. In this review, these three fundamental performance phases and the metrics for the nonclinical evaluation of BRS, including both bench and preclinical testing, are discussed. V C 2016 Wiley Periodicals, Inc.
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