Recurring Meeting of Cleveland Clinic Core Team

Date: March 11, 2014

Time: 10:30 AM EST

Means: In person meeting

Attendees:

1. Ahmet Erdemir
2. Jason Halloran
3. Craig Bennetts
4. Snehal Chokhandre
5. Robb Colbrunn

Agenda:

1. Discuss immediate action items from the last meeting.
2. Update on anatomical imaging.
3. Evaluation of readiness for mechanical joint testing.
4. Update on data management approach.
5. Decide immediate action items for the next meeting.
6. Other.

Immediate Action Items:

• Robb
  • Summarize pressure sensor calibration/equilibration on specifications page of pressure measurement.
• Snehal
  • Provide initial labeling convention in editable form in the data management specifications wiki.
  • Put information for next trial imaging session on the imaging specifications page.
• Ahmet and Craig
  • Setup next trial imaging session.
• Jason and Robb
  • Receive patella marker assembly.
  • Receive relative coordinates of divots and centers of spheres of the patella marker assembly as designed.
  • Measure divots of patella marker assembly using a digitizer.
  • Measure sphere centers of patella marker assembly using MRI.
• Jason, Ahmet and Snehal
  • Update specimen preparation to reflect discussions in the meeting.

Notes:

1. Discuss immediate action items from the last meeting.
   • The pressure sensor calibration/equilibration procedure has not been updated. Jason and Robb will summarize the current work, much like the imaging specifications.
   • Jason needs to verify the accuracy of the patella registration marker. The divots will be measured with the Optotrak (or Microsribe) and the inter-divot distances and repeatability of the probing will be evaluated.
   • Tara has not made any changes to the tissue preparation page.
   • Snehal and Ahmet reviewed the specimen preparation page. It "mostly" looks fine though the workflow needs to be discussed (see the discussion on evaluation of joint testing readiness below).
   • Snehal summarized the three acquired specimens using the oks00# convention. Current specimens will be considered "candidates" until the screening qualifies their use for the specific population that specimen, i.e. an elderly knee specimen which may be anticipated as healthy may be classified as osteoarthritic once the knee is dissected. The specimen number, e.g., oks00#, will not change if the specimen does not qualify for a specific criteria or the experimentation fails. The reason for any exclusion or for discard of the specimen will be summarized on the specimen page.
     • Regarding summarizing the specimen/sampling labeling convention, Snehal and Craig summarized the minimum number of tissue samples to help establish the labelling convention. The summary was uploaded as a text document to the specifications page for data management. The information will be moved to the wiki page for editing purposes. Ahmet summarized his feedback where the team might consider separating the tissue type and location identifier. The "test type" may need to be associated with the data and not the sample. The discussion led to using a framework similar to what Snehal proposed, likely minus the testing condition. The "test type" will be associated with the data itself and will be populated in the wiki so the users know the specimen history.
2. Update on anatomical imaging.

   • The evaluation of the trial session from March 4, 2014 was completed. Another knee (previously tested by the BioRobotics Core) was imaged and the summary of imaging results were provided on the specifications page of anatomical imaging. The final imaging sequences need to be decided upon. Another candidate imaging session will potentially be setup to fine tune imaging protocols.

   • After much discussion, the team agreed upon the following to focus in the next trial imaging session:
     • Iteration of MESE settings (slice thickness and different planes) to decide if the ligaments can be reconstructed from multi-planar scans.
       • MESE, 0.35 by 0.35 by 3.0 mm in sagittal
       • MESE, 0.35 by 0.35 by 3.0 mm in coronal
       • MESE, 0.35 by 0.35 by 3.0 mm in axial
       • MESE, 0.35 by 0.35 by 1.0 mm with a 2.0 mm gap in sagittal
       • MESE, same resolution as previous but with number of excitations set to 3 (to increase the signal to noise ratio).
     • Iteration of T1-weighted 3D with fat suppression at a higher resolution of 0.35 by 0.35 by 0.7 mm to evaluate cartilage reconstruction (and as an alternative to DESS-type or T1 Vibe imaging).
     • Evaluation of the patella registration marker assembly by directly securing it to the patella with a base plug or by taping it.
3. Evaluation of readiness for mechanical joint testing.
   • There is some discrepancy about the order of operations for specimen preparation. The information at that wiki page does not seem to align with the specifications for joint testing. The actual flow of work that needs to be conducted for specimen preparation was discussed and the wiki page will be updated to reflect this discussions. Order of specimen dissection and recording of anatomical landmarks (for initialization of the JCS) needs to be accounted for. A meeting will be set up between Jason, Ahmet and Snehal to fix the current workflow and Tara will be asked to verify this information.
   • Robb summarized the progress on the robot set-up. The loads on the holder need to be verified after digitization. Related, the cross-talk in the mechanical system will be evaluated as a function of the flexion axis position and movement of the plate.
4. Update on data management approach.
   • See the notes above in discussion of immediate action items from the last meeting.
5. Decide immediate action items for the next meeting.
   • Immediate action items were assigned and agreed upon. See details above.
6. Other.
   • Ahmet created a wiki page to describe efforts and plans made to promote the project. He also added the information provided by Cara for development of an introductory promotional video.