Medical simulations
Medical simulations utilize computer-generated models to replicate real-world medical scenarios for training and research purposes. Initially used in aviation and military contexts, their application has expanded significantly across various medical fields since the early 2000s. These simulations enable the modeling of complex clinical and surgical procedures, as well as the evaluation of medical devices, allowing for a safe environment for training healthcare professionals. A key advantage of medical simulations is the ability to conduct high-risk procedures without jeopardizing patient safety, offering repeated practice opportunities at lower costs, and potentially reducing the necessity for animal testing in medical experimentation.
Medical simulators often employ finite element methods to create accurate anatomical models, involving detailed mathematical descriptions of biological tissues and their interactions. The process requires collaboration across multiple disciplines, including computer science, clinical specialties, and engineering. Validation of these simulations is crucial; it involves comparing experimental outcomes with simulated results to ensure the accuracy of the models. Challenges remain, particularly in modeling the elastic properties of biological tissues, which can complicate the validation process. Overall, advancements in medical simulations continue to enhance medical education and improve patient care outcomes.
Medical simulations
- SUMMARY: Virtual simulations of medical procedures are used in medical training and are possible because of advanced numerical simulation techniques and software.
Initially, virtual simulations were used only by the aviation and military industries. In the twenty-first century, they have become important tools for teaching and research in almost all fields of medicine. It is now possible to model a physical system and to express it in the language of mathematics, enabling realistic simulations of several clinical and surgical procedures as well as the testing of medical implants. Thanks to advances in computer science, many simulations, once deemed impossible, have become routine. This progress is because of the continued advance of numerical simulation techniques and software packages that allow the creation of numerical models with sufficient detail and complexity. As the twenty-first century progresses, the use of computerized simulators is expected to develop considerably and to be incorporated into medical schools throughout the world. A computer simulation is nothing more than a computer program that runs a mathematical model of a physical situation. To do this, first, a geometrical model is created, and then a mathematic algorithm describes the behavior of the model under influences of external agents. A simulation is effective only if the physical situation is accurately modeled, providing a convincing user experience.
Benefits
Virtual medical simulation is an important tool for medical training in cases of high-risk, unusual, or difficult surgical procedures and for predicting the interaction of medical devices (such as implants or prostheses) with biological tissues. The main advantage of using these simulations is to provide a safe environment for both patients and students during training in risky procedures, as well as the opportunity to repeat several medical performances with lower costs. Furthermore, the number of animals used in medical experimentation can be reduced through the use of virtual simulations.
Applications
Medical simulators based on the finite element method are used in almost all fields of medicine. The creation of an accurate mathematical model of a given anatomical structure includes a three-dimensional reconstruction from medical images, a description of the material properties of the biological tissues that form this structure, and a description of the limits and interfaces between the adjacent structures, besides the external loading that actuates in the physical system.
The finite element method is a numerical procedure that reduces an anatomical structure, such as a kidney, to a mesh of nodes. During a simulation, a set of discretized partial differential equations defines the movements of the nodal points as a result of external force, for example, because of the contact of a medical instrument. Therefore, the deformation of this structure is a function of the acting forces applied at discrete points of the mesh as well as the elastic properties and geometry of the structure. Many arithmetic operations that require fast computer processing are necessary to find the solution for the system of equations to provide the detailed behavior of structures under particular conditions. Furthermore, the modeling process requires an interdisciplinary team of people from a wide range of disciplines, including computer science, electronics, mechanical engineering, clinical specialties, medical training, mathematics, and physics.
For example, there is a standard surgical procedure for the treatment of chronic sinusitis, an inflammation of the airspaces within facial bones. A robotic arm can be used to hold and guide the endoscope. This method can help the surgeon in the procedure and decrease the time to perform the surgery. A proper mathematical modeling of the inner nose structures followed by a realistic simulation of this surgical procedure can predict the risk of using the robotic arm in this surgery. It can be used to define the range of movement and forces used by the robotic arm close to vital structures, such as the optic nerve, the carotid arteries, and the brain. Moreover, it can be a virtual environment for surgical training, ensuring safe robotic endoscopic guidance for the patient.
Accuracy and Validation
Without an accurate model, it is not possible to obtain an accurate simulation. Therefore, a very important aspect of a medical simulation is validation to be sure that the model is correct and that the simulation corresponds to the reality. To validate a medical model and the respective simulation, some experiments are performed, and the results of these experiments are compared with the results of the simulations. A difference in this comparison can indicate that the numerical code is not accurate enough or that the theoretical predictions do not agree with the experiments, which means that the mathematical model is not satisfactory.
Significant research has been conducted to model the deformation behavior of biological tissues. Accurate simulation, in the sense that one can confidently control the numerical error compared to real subjects, is very difficult to obtain because of the difficulties in building mathematical models of real biological tissues. The development of appropriate mathematical models is dependent on the knowledge of the tissues’ elastic properties. In some cases, because of the limitations of measurement technology, some models have not been rigorously validated.
Emerging technologies, such as Artificial Intelligence, have significantly advanced medical simulations in the twenty-first century, allowing for realistic, real-time simulations. Because of this, medical simulations have become more widespread. Improved validation techniques have also advanced medical simulations.
Bibliography
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Preziosi, Luigi. Cancer Modeling and Simulation. CRC Press, 2003.
Riley, Richard H. A Manual of Simulation in Healthcare. Oxford University Press, 2008.