Optimized Solutions for Treating Bone Fractures Will Soon Be Reality

Hologram glasses in use: a physician uses Disior software to optimize the care of a patient coming in for jaw bone surgery. Copyright: Disior Ltd.

Mathematical modeling has been a standard tool for engineers for decades, but in clinical medicine, it is still a newcomer. The Finnish start-up software company Disior Ltd. develops computational software for treating bone fractures. The purpose is to bring mathematical modeling, known for its benefits in research and industry, available for physicians.

“We wish to provide physicians with software that corresponds to the powerful software used by mechanical engineers for computing mechanics, momentum and structural strength. The benefits and usability of the software must meet the doctors” needs, says CEO of Disior Ltd., Anna-Maria Henell.

From the very start of its establishment in 2016, Disior has collaborated with the Hospital District of Helsinki and Uusimaa (HUS) in product development. Disior’s development team is multidisciplinary, ranging from software developers to surgeons.

Quick optimization is essential
Disior is one of the six European companies that were granted resources in the European high-performance computing infrastructure PRACE (Partnership for Advanced Computing in Europe) in its latest call for applications under the SHAPE program (SME HPC Adoption Programme for Europe). The SHAPE call for applications is intended for European SMEs (Small and Medium Enterprises) that use high-performance computing in their operations, and can use it to improve their competitiveness. The purpose of the SHAPE program is to increase the opportunities for innovation in European SMEs and to lower the threshold for utilizing high-performance computing in product development.
Thanks to the resources obtained from PRACE, Disior gets support from SHAPE for developing their software code. The computing is performed with Elmer, an open-source simulation software developed by CSC for multi-physical simulations, including e.g. finite element analysis.
Currently, Disior’s most advanced solution algorithms apply to the reconstruction of jaw bone, but the same principles can also be applied to other parts of the body.
Optimization of the jaw reconstruction involves calculation of the correct size and location of an implant to be installed in the joint, minimization of the loads between bone and the implant screws, and the amount of metal used in the implant. Furthermore, the implant can be optimized to withstand the load caused by the mastication cycle.

he individual computations are not demanding per se, but since there is a huge number of computations to be optimized, the need for computing cores rises up to several thousands. The optimization must be fast, since the patient is waiting with a fractured jaw.

Sakari Soini, Director of Technology at Disior.

Thanks to help from SHAPE, the optimization of the jaw bone reconstruction is now approximately ten times faster than what it initially was.

“Parallelization of code with Elmer is beyond comparison” says Soini.

Disior and PRACE have collaborated in developing algorithms for optimizing loads on the jaw bone with the Elmer software suite developed by CSC. Copyright: Disior Ltd.

Personalized solutions for patient care
Let’s see how this works in practice. We are now in Disior’s office in Meilahti, Helsinki. I put on holographic glasses and play doctor for a moment. The patient has a fractured jawbone, needing an implant to mend the fracture. 3D X-ray images generated by a CT scan have been imported into Disior’s software that displays the patient’s skull as a hologram in front of my eyes.
I give the hologram a few commands, and the software starts to generate mathematical models for solutions best suited for the patient. The solution algorithm runs in a cloud service, and only takes a moment give optimized answers about the implant and other treatment-related factors that are best suited for this particular patient. The surgery can then begin.

This will soon be an everyday tool for all doctors, and hopes are that the maxillofacial surgery unit at HUS will adopt it within a year. In addition to optimizing implant-related parameters, mathematical modeling can also assist in making a diagnosis, selecting a care pathway, planning for surgical operations and optimizing patient rehabilitation.

Spare parts for humans
Disior aims to create separate versions of their software for various other purposes, from maxillofacial surgery to wrist fractures. This increases the usability of the software in the everyday clinical use: the physician only sees the essential information needed in the task at hand.
At present, most of the implants used in the treatment of bone fractures are made of titanium, but 3D-printed biomaterials for making “spare parts for humans” are becoming more common. These bio-manufactured parts might, for example, contain cells and nutrients.

“Nothing prevents Disior from modeling even personalized implants in the future” says Arto Poutala, Principal Developer responsible for optimization at Disior. In addition, optimization creates vast amounts of data, which could be utilized by artificial intelligence in the future. Disior is a pioneer in medical modeling.

“A few years from now, all physicians will use this kind of technology. We hope to see our solution deployed in the HUS already next year” concludes Poutala.

The next PRACE SHAPE call for applications for SMEs starts in April 2018. For more information about the PRACE SHAPE call for applications, see www.prace-ri.eu/hpc-access/shape-programme/

This article was first published on www.prace-ri.eu on 8 February 2018

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