Recurring Meeting of Cleveland Clinic Core Team

Date: March 25, 2014

Time: 10:30 AM EST

Means: In person meeting

Attendees:

1. Ahmet Erdemir
2. Jason Halloran
3. Craig Bennetts
4. Snehal Chokhandre
5. Cara Sullivan

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 specifications.
5. Decide immediate action items for the next meeting.
6. Other.

Immediate Action Items:

• Craig
  • Provide sample images from last imaging trial on imaging specifications page.
• Ahmet
  • Summarize results of last imaging trial along with candidate imaging specifications for first Open Knee(s) specimen.
• Cara
  • Provide possible video clip ideas to incorporate into promotional video.

• Snehal & Jason

  • Follow up with BioRobotics Testing Core to complete unfinished action items.

• Snehal and Craig
  • Provide an illustration for sample tissue type and location labeling.

• Robb, Dylan, Snehal & Ahmet

  • Finalize testing chamber design including temperature control.

Notes:

1. Discuss immediate action items from the last meeting.
   • Ahmet updated the workflow illustration in the imaging specifications wiki .
   • Update on the gravity compensation issue during robotic testing is unknown. Tara will be sent an email in that regard.
   • No updates on measurement of patella marker assembly to characterize divot and sphere locations.
   • No updates on joint testing coordinate system registration task.
   • Jason needs to update the pressure calibration routine on the Wiki.
   • Craig and Snehal edited the data labeling and management protocol. This is to be discussed.
   • Ahmet and Snehal met to discuss the tissue testing plan.
     • The protocols, plans for tissue testing with Elvis Danso (visiting student), and the secondary and primary tissues were decided on.
     • Once Elvis arrives he can start testing the knees that Snehal ordered. It is anticipated Elvis will acquire material behavior for multiple tissue types and can help with the tissue testing protocols, including development of cartilage tension samples.
     • The patella ligament will be tested as a primary structure.
     • The quadriceps will be a "secondary tissue".
     • The cartilage will be tested both under confined and unconfined compression.
     • Snehal wondered testing of the cartilage in tension, i.e. using a tension sample from the superficial layer along the split lines. The initial thought is to keep this test as "secondary". Preliminary tests can be conducted once Elvis arrives.
     • Regarding tissue testing fixtures, Snehal and Robb thought the available fixtures can be utilized though the tank (testing chamber) needs to be modified. This includes temperature control of the bath.
     • Snehal will update the wiki to reflect their conversation.
   • Please refer to relevant agenda item below for updates on imaging specifications.
   • Please refer to relevant agenda item below for updates on sample labeling in regard to data management specifications.
2. Update on anatomical imaging.
   • The progression of imaging test sessions was discussed. The isotropic (0.5mm) T1 without fat suppression is thought of as a good overall image setting, especially for registration. The MESE protocol appears to highlight tissues (ACL, PCL) quite well.
   • Regarding the last imaging session, the desired MESE scans, including multiple planes and with varying imaging settings, were acquired, i.e. a proton density with 0.35x0.35x1.4 mm slice thickness (+1.4 mm gap) was acquired. T1 weighted image sets without fat suppression and with fat suppression (for cartilage) with high sagittal plane resolution (0.35x0.35x0.7 mm) were tested in order to explore highlighting the cartilage for segmentation.
   • To summarize, the group essentially converged to acquiring:
     1. 3D-T1 weighted imaging without fat suppression with isotropic voxel size,
     2. 3D-T1 weighted imaging with fat suppression with higher sagittal plane resolution (0.35x0.35x0.7 mm), and
     3. Three plane imaging of MESE scans at 0.35x0.35x1.4mm resolution.
   • Craig will provide sample images to help justify these choices. Ahmet will summarize the results of the last imaging trial along with candidate imaging specifications.
   • Filling in the segmentation specifications was also discussed as this is being developed for other projects (specifically Jason and Craig).
3. Evaluation of readiness for mechanical joint testing.
   • Robb talked with Ahmet and it seems that the mechanical issue is related to the "brakes" (locking mechanism) in the robot. It is anticipated that fixing this issue will require retrofitting of the motors and could take up to a month.
   • Ahmet proposed to utilize one of specimens acquired for the visiting student for a dry run before Open Knee(s) are tested.
   • Final scheduling of the joint testing will be put on hold until the robotic issues are worked out.
   • Additional scheduling and testing constraints were discussed in relation to scheduling of the imaging facility and the surgeon(s). We may be performing the tibio-femoral and patello-femoral testing in one day (a long day) to accommodate these constraints.
4. Update on data management approach.
   • Snehal and Craig's summary of the specimen labeling was discussed. We may change to a three letter tissue type followed by a four letter indicator of sample location.
   • Illustrations or images in the wiki will help describe the naming approach and also provide the description for each of the tissue types and the samples acquired. Craig and Snehal were assigned this as an immediate action item.
5. Decide immediate action items for the next meeting.
   • The team agreed on their assigned immediate action items (see above).
6. Other.
   • Cara summarized her findings related to the marketing video specifications. The accepted length for promotional videos was found to be 1-3 minutes in length. The summary of a proposed script was discussed (summarized on the wiki). A list of potential snippets (video or stills) will be populated on the wiki. That way, we can start editing the script and can go from there. Cara has a related immediate action item.