Autonomous Finite Elements (AFE) are Used by Orthopedic Oncologists in Decisions About Prophylactic Surgery for Patients with Metastatic Tumors

  • Yosibash, Zohar (Tel Aviv University)
  • Myers, Kent (PerSimiO)
  • Sternheim, Amir (Sourasky Medical Center)
  • Trabelsi, Nir (Shamoon College of Engineering)

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The novel autonomous FEA in [1] for patient-specific analysis of human femurs is presented and its use by the orthopedic oncology department at the Tel-Aviv Sourasky Medical Center is demonstrated by clinical examples. We present the autonomous FE (AFE) workflow, starting by pulling the necessary CT scans from the hospital’s database, segmenting the femur by an accurate U-net algorithm, assigning proper material properties and physiological boundary conditions, meshing the femur by high-order finite element analysis and post-processing the results. The AFE system introduces a paradigm shift in the use of FEA. We present clinical applications of the AFE for the determination of the risk of a pathological fracture for patients with tumors of the femur and prophylactic surgeries performed when needed [2,3]. The specificity and sensitivity of the new AFE compared to the gold standard (the Mirels score) are highlighted following two clinical trials. REFERENCE [1] Yosibash Z, Myers K, Trabelsi N. and Sternheim A, “Autonomous FEs (AFE) - A stride toward personalized medicine”. Computers & Mathematics with Applications, 2020. 80(11): p. 2417-2432. [2] Sternheim A, Giladi O, Gortzak Y, Drexler M, Salai M, Trabelsi N, Milgrom C and Yosibash Z, “Pathological fracture risk assessment in patients with femoral metastases using CT-based finite element methods. A retrospective clinical study”, Bone, 110, pp. 215-220, 2018. [3] Sternheim A, Traub F, Trabelsi N, Gortzak Y, Dadia S, Snir N, Gorfine M and Yosibash Z., “When and where do patients with bone metastases actually break their femur? A CT-based finite element analysis of patients”, Bone & Joint Jour., 102-B, No. 5, pp. 638-645, 2020.