Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), , Mekelweg 2, Delft 2628 CD, The Netherlands.
J R Soc Interface. 2014 Feb 12;11(93):20131146. doi: 10.1098/rsif.2013.1146. Print 2014 Apr 6.
Patient-specific biomechanical models including patient-specific finite-element (FE) models are considered potentially important tools for providing personalized healthcare to patients with musculoskeletal diseases. A multi-step procedure is often needed to generate a patient-specific FE model. As all involved steps are associated with certain levels of uncertainty, it is important to study how the uncertainties of individual components propagate to final simulation results. In this study, we considered a specific case of this problem where the uncertainties of the involved steps were known and the aim was to determine the uncertainty of the predicted strain distribution. The effects of uncertainties of three important components of patient-specific models, including bone density, musculoskeletal loads and the parameters of the material mapping relationship on the predicted strain distributions, were studied. It was found that the number of uncertain components and the level of their uncertainty determine the uncertainty of simulation results. The 'average' uncertainty values were found to be relatively small even for high levels of uncertainty in the components of the model. The 'maximum' uncertainty values were, however, quite high and occurred in the areas of the scapula that are of the greatest clinical relevance. In addition, the uncertainty of the simulation result was found to be dependent on the type of movement analysed, with abduction movements presenting consistently lower uncertainty values than flexion movements.
患者特异性生物力学模型，包括患者特异性有限元（FE）模型，被认为是为患有肌肉骨骼疾病的患者提供个性化医疗的潜在重要工具。生成患者特异性 FE 模型通常需要多步骤过程。由于所有涉及的步骤都与一定程度的不确定性相关，因此研究单个组件的不确定性如何传播到最终模拟结果非常重要。在这项研究中，我们考虑了这种情况下的一个具体问题，其中涉及步骤的不确定性是已知的，目的是确定预测应变分布的不确定性。研究了患者特异性模型的三个重要组件的不确定性，包括骨密度、肌肉骨骼负荷和材料映射关系参数对预测应变分布的影响。结果发现，不确定组件的数量及其不确定性水平决定了模拟结果的不确定性。即使模型组件的不确定性水平很高，“平均”不确定性值也相对较小。然而，“最大”不确定性值相当高，并且发生在肩胛骨的临床相关性最大的区域。此外，模拟结果的不确定性被发现取决于分析的运动类型，外展运动比屈曲运动呈现出一致较低的不确定性值。
