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Annual Report 2019 : Personalized computer models help get pelvic cancer patients back on their feet
Personalized computer models help get pelvic cancer patients back on their feet
A new research collaboration is exploring personalized options for pelvic cancer surgery.
Physical therapist Alexander Penny is wired with motion capture technology that tracks his muscle activity while walking. Valerae Lewis, M.D., center, and B.J. Fregly, Ph.D., right, are using the technology to predict how patients will walk after bone cancer surgery. Photo by Jeff Fitlow
What is the best surgical option for patients with cancer of the pelvis, the ring-shaped bone that anchors the spine and the hips? A new research project will help doctors decide.
“Few cancer surgeries are as invasive or difficult to recover from as those involving the pelvis,” says Valerae Lewis, M.D., chair of Orthopaedic Oncology at MD Anderson.
“Removing parts of the pelvis can keep patients off their feet for more than a year.”
Now, Lewis and Benjamin Fregly, Ph.D., professor of Mechanical Engineering and CPRIT scholar in cancer research at Rice University, are working together to create personalized computer models for pelvic cancer patients waiting to undergo surgery for bone cancer of the pelvis. The models can predict which reconstruction option will last the longest and will get patients back up and walking in the shortest amount of time.
For pelvic cancer patients, those options include removing the cancerous portion of the bone with no reconstructive surgery, reconstructing the removed section using a combination of cadaver bone and metal implants, or a custom-designed, human-made pelvis.
“Each option has its advantages and disadvantages, and what’s best for one person may not be best for another,” says Lewis, one of the country's leading orthopaedic cancer surgeons.
“There’s no ‘one size fits all.’”
What’s best for one person may not be best for another.
Simulating recovery for pelvic cancer patients
Using motion capture technology similar to that used in the film industry, Fregly and his team are building customized computer models of Lewis’ patients to simulate how they will function after each possible treatment option.
Patients are outfitted with electrodes and reflective markers that measure muscle activity and track body motion as they walk across the floor of the Biomotion Lab, located on the nearby campus of The University of Texas Health Science Center. These data are used to create a personalized computer model of the patient, which the research team uses to predict how the patient will walk after different surgical or rehabilitation treatments.
Not only that, but the data can also allow the research team to print custom 3D prostheses that may potentially help patients get back on their feet sooner.
“Custom pelvic prostheses have great potential, but the ones that are currently available clinically are not reliable,” Fregly says. “That’s an engineering problem we’re in a good position to tackle.”
And the same 3D imaging data used to design a prosthetic pelvis can be used to make custom surgical cutting guides, which help surgeons map out prior to surgery where they will cut bone. This minimizes unnecessary removal of bone and muscle.
Fregly says this five-year research project, funded by the Cancer Prevention and Research Institute of Texas, couldn’t have happened without a collaborative team.
“Rice is handling the computational modelling and 3D printing, MD Anderson is providing us with patients and clinical problems to address, and The University of Texas Health Science Center is doing the pretreatment testing,” explains Fregly. “It takes all of us to make this project go.”
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