1. The approach to obtain the anatomical and FE model of the rib cage Presented by Krzysztof Rechowicz on 05/07/2008

2. Krzysztof Rechowicz2 Pectus Excavatum Congenital chest wall deformity; Displacement of the sternum toward the spine; Different types of deformity;

3. Krzysztof Rechowicz3 The Nuss procedure

4. Krzysztof Rechowicz4 3D scanner Wand Styllus Tracker PU

5. Krzysztof Rechowicz5 3D Printing

6. Krzysztof Rechowicz6 Goals and Objectives: Finding the proper way to create the 3D virtual and then FE model of a the rib cage; Methodology of segmenting the rib cage with the cartilage; The registration between the cartilage and the skin surface in order to locate points to apply loads; Application of 3D scanning; Application of rapid prototyping; Discussion about requirements for FEM; Related work; Future work;

7. Krzysztof Rechowicz7 Motivation A stage in the Pectus Excavatum project; Little literature about the rib cage segmentation; Investigation of the mechanical properties of the PE cartilage; Results will be used to create a guide for the optimization of the Nuss procedure; Eventually, the surgery simulator is planned to be developed;

8. Krzysztof Rechowicz8 General description of the procedure CT rib cage model with manually identified DCPs CT skin surface model with DCPs (from extruded rib cage) Actual DCP data Laser skin surface scan Merged DCP data and CT skin surface Corrected FEA Model Merged DCP data and CT rib cage Compare 123 4 6 7 5

9. Krzysztof Rechowicz9 The rib cage segmentation w/out the cartlige

10. Krzysztof Rechowicz10 The rib cage segmentation with cartlige using Chebyshev’s Rule

11. Krzysztof Rechowicz11 Registration between the rib cage and the skin surface

12. Krzysztof Rechowicz12 Surface skin scan

13. Krzysztof Rechowicz13 3D Physical Models

14. Krzysztof Rechowicz14 3D CAD Model of the PE rib cage

15. Krzysztof Rechowicz15 3D CAD Model of the cartlige

16. Krzysztof Rechowicz16 Assumptions and requirements for the FEM Geometric modeling of the other tissue that is connected to the sternum, costal cartilage, and ribs would be more problematic than modeling of than the rib cage itself; Using constraints and boundaries to represent other organs; 3D FEM is to complicated; 2-1/2 FEM might be a good start - a single set of costal cartilages and a corresponding section of the sternum in the axial plane;

17. Krzysztof Rechowicz17 Related work Awrejewicz and Luczak; Simplified model based on an anatomy atlas; Impacts due to accidents; Frontal impacts to the chest after the Nuss procedure; Not deformed;

18. Krzysztof Rechowicz18 Related work Dr. Kelly; FEA of the sternum; Correlation of stress patterns within the sternum with bone growth centers;

19. Krzysztof Rechowicz19 Future work Obtaining input data to FEM; Use pre and postoperative surface scans in a shape analysis for objective improvement of chest symmetry and displacement/replacement; Use pre and post surface scans in a shape analysis of aesthetic improvement which will obtain an objective measurement of closeness to a norm; Develop a methodology for automatic classification into cup vs saucer, Haller index range, length (long vs short), torsion, symmetry, and slope; Parameterized 3D CAD model; A guide for the Nuss procedure optimization; Using 3D physical models to train doctors;