Knowledge of patient-specific liver anatomy is key to patient safety during major hepatobiliary surgery. Three-dimensional (3D) models of patient-specific liver anatomy based on diagnostic MRI... Show moreKnowledge of patient-specific liver anatomy is key to patient safety during major hepatobiliary surgery. Three-dimensional (3D) models of patient-specific liver anatomy based on diagnostic MRI images can provide essential vascular and biliary anatomical insight during surgery. However, a method for generating these is not yet publicly available. This paper describes how these 3D models of the liver can be generated using open source software, and then subsequently integrated into a sterile surgical environment. The most common image quality aspects that degrade the quality of the 3D models as well possible ways of eliminating these are also discussed. Per patient, a single diagnostic multiphase MRI scan with hepatospecific contrast agent was used for automated segmentation of liver contour, arterial, portal, and venous anatomy, and the biliary tree. Subsequently, lesions were delineated manually. The resulting interactive 3D model could be accessed during surgery on a sterile covered tablet. Up to now, such models have been used in 335 surgical procedures. Their use simplified the surgical treatment of patients with a high number of liver metastases and contributed to the localization of vanished lesions in cases of a radiological complete response to neoadjuvant treatment. They facilitated perioperative verification of the relationship of tumors and the surrounding vascular and biliary anatomy, and eased decision-making before and during surgery. Show less
The late stages of evolution of stars like our Sun are dominated by several episodes of violent mass loss. Space based observations of the resulting objects, known as Planetary Nebulae, show a... Show moreThe late stages of evolution of stars like our Sun are dominated by several episodes of violent mass loss. Space based observations of the resulting objects, known as Planetary Nebulae, show a bewildering array of highly symmetric shapes. The interplay between gasdynamics and radiative processes determines the morphological outcome of these objects, and numerical models for astrophysical gasdynamics have to incorporate these effects. This thesis presents new numerical techniques for carrying out high-resolution three-dimensional radiation hydrodynamical simulations. Such calculations require parallelization of computer codes, and the use of state-of-the-art supercomputer technology. Numerical models in the context of the shaping of Planetary Nebulae are presented, providing insight into their origin and fate. Show less
