Javier Pascau

University Carlos III de Madrid | UC3M · Department of Bioengineering and Aeroespace Engineering

Background and purpose: The association between dose to selected bladder and rectum symptom-related sub-regions (SRS) and late toxicity after prostate cancer radiotherapy has been evidenced by voxel-wise analyses. The aim of the current study was to explore the feasibility of combining knowledge-based (KB) and multi-criteria optimization (MCO) to...

Purpose: Up to date, there has been a lack of software infrastructure to connect 3D Slicer to any augmented reality (AR) device. This work describes a novel connection approach using Microsoft HoloLens 2 and OpenIGTLink, with a demonstration in pedicle screw placement planning. Methods: We developed an AR application in Unity that is wirelessly...

Background and purpose: The intraprostatic urethra is an organ at risk in prostate cancer radiotherapy, but its segmentation in computed tomography (CT) is challenging. This work sought to: i) propose an automatic pipeline for intraprostatic urethra segmentation in CT, ii) analyze the dose to the urethra, iii) compare the predictions to magnetic r...

[This corrects the article DOI: 10.3389/fonc.2022.1037262.].

Background Oligo-recurrent disease has a consolidated evidence of long-term surviving patients due to the use of intense local cancer therapy. The latter combines real-time surgical exploration/resection with high-energy electron beam single dose of irradiation. This results in a very precise radiation dose deposit, which is an essential element of...

Magnetic Resonance Imaging (MRI) has been used as an effective tool for breast cancer evaluation due to its high sensitiveness to detect breast tumors. However, these MRIs are performed with the patient lying prone, while the tumor resection surgery is performed with the patient lying in supine position. The breast undergoes large deformations due...

Background: Local cancer therapy by combining real-time surgical exploration and resection with delivery of a single dose of high-energy electron irradiation entails a very precise and effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron...

Introduction: The clinical practice and outcome results of intraoperative electron radiation therapy (IOeRT) in cancer patients have been extensively reported over 4 decades. Electron beams can be delivered in the promising FLASH dose rate. Methods and materials: Several cancer models were approached by two alternative radiobiological strategies...

Purpose Augmented Reality (AR) has the potential to simplify ultrasound (US) examinations which usually require a skilled and experienced sonographer to mentally align narrow 2D cross-sectional US images in the 3D anatomy of the patient. This work describes and evaluates a novel approach to track retroreflective spheres attached to the US probe usi...

This work analyzed the use of Microsoft HoloLens 2 in orthopedic oncological surgeries and compares it to its predecessor (Microsoft HoloLens 1). Specifically, we developed two equivalent applications, one for each device, and evaluated the augmented reality (AR) projection accuracy in an experimental scenario using phantoms based on two patients....

Background and Objective Sacral nerve stimulation (SNS) is a minimally invasive procedure where an electrode lead is implanted through the sacral foramina to stimulate the nerve modulating colonic and urinary functions. One of the most crucial steps in SNS procedures is the placement of the tined lead close to the sacral nerve. However, needle inse...

Image-guided surgery, prosthetic-based virtual planning, 3D printing, and CAD/CAM technology are changing head and neck ablative and reconstructive surgical oncology. Due to quality-of-life improvement, dental implant rehabilitation could be considered in every patient treated with curative intent. Accurate implant placement is mandatory for prosth...

Adenoid Cystic Carcinoma is a rare and aggressive tumor representing less than 1% of head and neck cancers. This malignancy often arises from the minor salivary glands, being the palate its most common location. Surgical en-bloc resection with clear margins is the primary treatment. However, this location presents a limited line of sight and a high...

Patient-specific instruments (PSIs) have become a valuable tool for osteotomy guidance in complex surgical scenarios such as pelvic tumor resection. They provide similar accuracy to surgical navigation systems but are generally more convenient and faster. However, their correct placement can become challenging in some anatomical regions, and it can...

Background: The surgical correction of metopic craniosynostosis usually relies on the subjective judgment of surgeons to determine the configuration of the cranial bone fragments and the degree of overcorrection. This study evaluates the effectiveness of a new approach for automatic planning of fronto-orbital advancement based on statistical shape...

Surgical interventions for musculoskeletal tumor resection are particularly challenging in the pelvic region due to their anatomical complexity and proximity to vital structures. Several techniques, such as surgical navigation or patient-specific instruments (PSIs), have been introduced to ensure accurate resection margins. However, their inclusion...

Deep learning is a recent technology that has shown excellent capabilities for recognition and identification tasks. This study applies these techniques in open cranial vault remodeling surgeries performed to correct craniosynostosis. The objective was to automatically recognize surgical tools in real-time and estimate the surgical phase based on t...

Background The integration of 3D printing technology in hospitals is evolving toward production models such as point-of-care manufacturing. This study aims to present the results of the integration of 3D printing technology in a manufacturing university hospital. Methods Observational, descriptive, retrospective, and monocentric study of 907 insta...

Background 3D printing technology in hospitals facilitates production models such as point-of-care manufacturing. Orthopedic Surgery and Traumatology is the specialty that can most benefit from the advantages of these tools. The purpose of this study is to present the results of the integration of 3D printing technology in a Department of Orthopedi...

Purpose3D-printed patient-specific instruments have become a useful tool to improve accuracy in pelvic tumour resections. However, their correct placement can be challenging in some regions due to the morphology of the bone, so it is essential to be aware of the possible placement errors in each region. In this study, we characterize these errors i...

During the last decade, orthopedic oncology has experienced the benefits of computerized medical imaging to reduce human dependency, improving accuracy and clinical outcomes. However, traditional surgical navigation systems do not always adapt properly to this kind of interventions. Augmented reality (AR) and three-dimensional (3D) printing are tec...

PurposeSurgical correction of metopic craniosynostosis typically involves open cranial vault remodeling. Accurate translation of the virtual surgical plan into the operating room is challenging due to the lack of tools for intraoperative analysis of the surgical outcome. This study aimed to evaluate the feasibility of using a hand-held 3D photograp...

Surgical navigation techniques have shown potential benefits in orthopedic oncologic surgery. However, the translation of these results to acral tumor resection surgeries is challenging due to the large number of joints with complex movements of the affected areas (located in distal extremities). This study proposes a surgical workflow that combine...

Background and purpose Few tools are available to predict tumor response to treatment. This retrospective study assesses visual and automatic heterogeneity from ¹⁸ F-FDG PET images as predictors of response in locally advanced rectal cancer. Methods This study included 37 LARC patients who underwent an ¹⁸ F-FDG PET before their neoadjuvant therapy...

Current approaches for the surgical correction of craniosynostosis are highly dependent on surgeon experience. Therefore, outcomes are often inadequate, causing suboptimal esthetic results. Novel methods for cranial shape analysis based on statistical shape models enable accurate and objective diagnosis from preoperative 3D photographs or computed...

Current approaches for surgical correction of craniosynostosis are highly dependent on the experience of the surgeon and inaccuracies during cranial vault remodelling can compromise the surgical outcome. The objective of this study is the evaluation of a novel augmented reality system to guide surgeons during fronto-orbital advancement procedures....

The real degree of constriction of rotating hinge knee (RHK) and condylar constrained prostheses (CCK) is a matter of discussion in revision knee arthroplasty. The objectives of this study are to compare the tibial rotation of both implants and validate the use of inertial sensors with optical tracking system as movement measurement tools. A total...

A new workflow is proposed to update the intraoperative electron radiotherapy (IOERT) planning refreshing the position and orientation (pose) of a virtual applicator with respect to the preoperative computed tomography (CT) with the actual pose during surgery. The workflow proposed relies on a robust registration of the preoperative CT and intraope...

Evaluation of an automatic workflow for the intraoperative assessment of the surgical outcome during craniosynostosis reconstruction surgery. Our framework is based on the automatic registration of intraoperative 3D photographs using 3D printed color markers attached to the bone surface. 3D photographs are acquired using a hand-held structured ligh...

In intraoperative electron radiation therapy (IOERT) the energy of the electron beam is selected under the conventional assumption of water-equivalent tissues at the applicator end. However, the treatment field can deviate from the theoretic flat irradiation surface, thus altering dose profiles. This patient-based study explored the feasibility of...

Augmented reality (AR) has great potential in education, training, and surgical guidance in the medical field. Its combination with three-dimensional (3D) printing (3DP) opens new possibilities in clinical applications. Although these technologies have grown exponentially in recent years, their adoption by physicians is still limited, since they re...

Craniosynostosis must often be corrected using surgery, by which the affected bone tissue is remodeled. Nowadays, surgical reconstruction relies mostly on the subjective judgement of the surgeon to best restore normal skull shape, since remodeled bone is manually placed and fixed. Slight variations can compromise the cosmetic outcome. The objective...

Evaluation of intraoperative 3D photography for outcome quantification in craniosynostosis reconstruction surgery.

Background: Dose calculations in intraoperative electron radiation therapy (IOERT) rely on the conventional assumption of water-equivalent tissues at the applicator end, which defines a flat irradiation surface. However, the shape of the irradiation surface modifies the dose distribution. Our study explores, for the first time, the use of surface...

Image-guided interventions enable the surgeon to display the position of instruments and devices with respect to the patient’s imaging studies during surgery by means of a tracker device. Optical trackers are commonly chosen for many surgical applications when high accuracy and robustness are required. OptiTrack is a multicamera optical tracker who...

The World Health Organization recommends a rate of cesareans inferior than 15%. However, the actual rates in the US double this value, while the use of obstetrical instruments, a recommended alternative to cesareans but which requires high skill and experience, has significantly decreased in the latest years. In this context there is a clear demand...

Purpose The nucleus accumbens (NAcc) has been suggested as a possible target for deep brain stimulation (DBS) in the treatment of obesity. Our hypothesis was that NAcc-DBS would modulate brain regions related to reward and food intake regulation, consequently reducing the food intake and, finally, the weight gain. Therefore, we examined changes in...

Augmented reality (AR) can be an interesting technology for clinical scenarios as an alternative to conventional surgical navigation. However, the registration between augmented data and real-world spaces is a limiting factor. In this study, the authors propose a method based on desktop three-dimensional (3D) printing to create patient-specific too...

In this work, we present the development and validation of a novel system for knee joint goniometry based on two low-cost inertial sensors and open-source software.

In this work, we present the development and validation of a novel system for knee joint goniometry based on two low-cost inertial sensors and open-source software.

In this work, we present and evaluate a workflow combining surgical navigation and 3D printed anatomical models and templates for orbital floor fracture reconstruction.

In this work, we present and evaluate a workflow combining surgical navigation and 3D printed anatomical models and templates for orbital floor fracture reconstruction.

Emphysema quantification techniques rely on the use of CT scans, but they are rarely used in the diagnosis and management of patients with COPD; X-ray films are the preferred method to do this. However, this diagnosis method is very controversial, as there are not established guidelines to define the disease, sensitivity is low, and quantification...

Purpose: Intraoperative electron radiation therapy (IOERT) involves the delivery of a high radiation dose during tumor resection in a shorter time than other radiation techniques, thus improving local control of tumors. However, a linear accelerator device is needed to produce the beam safely. Mobile linear accelerators have been designed as dedic...

The notion that schizophrenia is a neurodevelopmental disorder in which neuropathologies evolve gradually over the developmental course indicates a potential therapeutic window during which pathophysiological processes may be modified to halt disease progression or reduce its severity. Here we used a neurodevelopmental maternal immune stimulation (...

This work presents development of an integrated ultrasound (US) – cone-beam CT (CBCT) system for image-guided needle interventions, combining a low-cost ultrasound system (Interson VC 7.5 MHz, Pleasanton CA) with a mobile C-arm for fluoroscopy and CBCT via use of a surgical tracker. Imaging performance of the ultrasound system was characterized in...

Objective To investigate metabolic changes in brain networks by deep brain stimulation (DBS) of the medial prefrontal cortex (mPFC), nucleus accumbens (NAcc) and dorsomedial thalamus (DM) using positron emission tomography (PET) in naïve rats. Methods 43 male Wistar rats underwent stereotactic surgery and concentric bipolar platinum-iridium electr...

Background: A difficulty in computer-assisted interventions is acquiring the patient's anatomy intraoperatively. Standard modalities have several limitations: low image quality (ultrasound), radiation exposure (computed tomography) or high costs (magnetic resonance imaging). An alternative approach uses a tracked pointer; however, the pointer caus...

Background A growing body of evidence suggests that schizophrenia (scz) is a neurodevelopmental disorder in which some brain alterations already occur during early brain development and others progress along the developmental course. This progressive nature of scz raises interest in the development of preventive avenues, i.e. therapeutic interventi...

Intraoperative electron radiation therapy (IOERT) involves irradiation of an unresected tumour or a post-resection tumour bed. The dose distribution is calculated from a preoperative computed tomography (CT) study acquired using a CT simulator. However, differences between the actual IOERT field and that calculated from the preoperative study arise...

Schizophrenia is a debilitating psychiatric disorder with a significant number of patients not adequately responding to treatment. Deep brain stimulation (DBS) is a surgical technique currently investigated for medically-refractory psychiatric disorders. Here, we use the poly I:C rat model of schizophrenia to study the effects of medial prefrontal...

Low-dose protocols for respiratory gating in cardiothoracic small-animal imaging lead to streak artifacts in the images reconstructed with a Feldkamp-Davis-Kress (FDK) method. We propose a novel prior- and motion-based reconstruction (PRIMOR) method, which improves prior-based reconstruction (PBR) by adding a penalty function that includes a model...

This repository contains a demo that shows how to use a novel prior- and motion-based reconstruction (PRIMOR) method for respiratory gated CT, as presented in the paper A novel prior- and motion-based compressed sensing methods for small-animal respiratory gated CT. JFPJ Abascal, M Abella, E Marinetto, J Pascau, and M Desco. PLOS ONE 9;11(3):e01498...

The purpose of this study was to develop a multi-platform automatic software tool for full processing of fMRI rodent studies. Existing tools require the usage of several different plug-ins, a significant user interaction and/or programming skills. Based on a user-friendly interface, the tool provides statistical parametric brain maps (t and Z) and...

A growing body of evidence sheds light on the neurodevelopmental nature of schizophrenia with symptoms typically emerging during late adolescence or young adulthood. We compared the pre-symptomatic adolescence period with the full symptomatic period of adulthood at the behavioral and neurobiological level in the poly I:C maternal immune stimulation...

This work analysed the feasibility of using a fast, customized Monte Carlo (MC) method to perform accurate computation of dose distributions during pre- and intraplanning of intraoperative electron radiation therapy (IOERT) procedures. The MC method that was implemented, which has been integrated into a specific innovative simulation and planning t...