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  <front>
    <journal-meta>
      <journal-title-group>
        <journal-title>Robomech Journal 2 (2015) 1-16.
[11] K. Sase</journal-title>
      </journal-title-group>
    </journal-meta>
    <article-meta>
      <article-id pub-id-type="doi">10.3389/fmed.2024.1380046</article-id>
      <title-group>
        <article-title>XR-oriented Medical Elastodynamics: Developing a Versatile 2D Energy-based FEM Framework and Its Applications⋆</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Xu Wang</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Atsushi Konno</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Hokkaido University</institution>
          ,
          <addr-line>Sapporo, Hokkaido, 060-0814</addr-line>
          ,
          <country country="JP">Japan</country>
        </aff>
      </contrib-group>
      <pub-date>
        <year>2016</year>
      </pub-date>
      <volume>25</volume>
      <fpage>291</fpage>
      <lpage>294</lpage>
      <abstract>
        <p>Real-time elastodynamic simulations in Extended Reality (XR) environments show promise for supporting remote emergency medical procedures during disasters. However, determining the optimal combination of energy models and computational frameworks for real-time 3D elastodynamic simulations is complex due to the multitude of existing methods and their potential combinations. This paper introduces a 2D energy-based Finite Element Method (FEM) prototyping framework designed to facilitate comparative analysis of various energy models across diferent computational frameworks. To enable the reproduction of disaster scenarios in 2D space, we propose an algorithm for semi-automatic conversion of arbitrary geometries into 2D FEM-compatible meshes. Using this framework, we simulated a leg trapped under collapsed building debris, computing and visualizing stress distributions to aid medical decision-making. Our framework facilitates the implementation of common energy models and enables eficient comparison of their combinations with various real-time computation frameworks, aiding the selection of optimal approaches for XR-oriented medical elastodynamics simulations.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Extended Reality</kwd>
        <kwd>Medical Elastodynamics</kwd>
        <kwd>Finite Element Method</kwd>
        <kwd>Energy-based Models</kwd>
        <kwd>Disaster Medicine</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>To demonstrate the practical applicability of our
framework, we modeled a case study of a leg trapped under
In recent years, multiple applications of XR technologies collapsed building debris. This simulation computed and
in medical practices have led to notable advancements visualized Von Mises stress distributions, providing
critin remote disaster healthcare [1, 2]. During major dis- ical data that could inform medical decision-making in
asters, physical barriers may substantially impact the real-world disaster response situations. The
contribuprovision of professional medical treatment for victims. tions of this paper are:
One solution is combining elastodynamic simulations
with XR technology, which has multiple benefits for med- • A versatile 2D energy-based FEM prototyping
ical treatment and medical education training [1]. One framework
challenge is that there are several existing energy models • An algorithm for semi-automatic conversion of
and solvers, each of which has its own strengths and lim- arbitrary geometries into 2D FEM-compatible
itations. Determining the optimal combination of these meshes
elements for a specific medical scenario is a non-trivial • A comparative analysis of common energy
modtask, requiring thorough comparative analysis and perfor- els and their combinations with various real-time
mance evaluation. To address this challenge, we propose computation frameworks
a 2D energy-based FEM prototyping framework. This • A case study demonstrating the application of the
framework is designed to compare various energy mod- framework in simulating a disaster scenario with
els (e.g., Saint Venant-Kirchhof (StVK), Co-rotational, potential medical implications
and Neo-Hookean) across diferent computational
frameworks (e.g., Explicit FEM, Position-Based Dynamics (PBD) This paper is organized as follows: Section 2 reviews
[3], and Extended Position-Based Dynamics (XPBD) [4]). related work in the fields of medical elastodynamics.
SecIt serves as a stepping stone towards more complex 3D tion 3 describes the methodology behind our 2D
energysimulations. By focusing on 2D representations, we can based FEM framework and the semi-automatic mesh
conreduce computational complexity while still capturing es- version algorithm. Section 4 presents the results of our
sential physical behaviors, allowing for rapid prototyping case study and comparative analysis. Finally, Section 5
and evaluation of diferent approaches. discusses the limitations of our framework and
summarizes future works.</p>
    </sec>
    <sec id="sec-2">
      <title>2. Related Works</title>
      <sec id="sec-2-1">
        <title>2.1. Finite Element Based Method</title>
        <p>The finite element method has a broad range of
applications across various fields, including but not limited to
engineering, physics, and biomedical sciences [5, 6]. Due
to its ability to accurately simulate the characteristics
of deformable objects and represent multiple complex
materials and structures, it has been widely used in 3D
elastodynamics to simulate brittle and ductile fracture of
materials [7, 8, 9].</p>
        <p>In the field of medical elastodynamics, FEM has found
numerous applications. For example, Sase et al. [10]
proposed a GPU-accelerated FEM-based approach for
simulating brain fissure opening in surgical procedures.
They also introduced a volume embedding method [11]
to preserve complex topological structures during
surgical simulations, and a penalty based method for
rigiddeformable objects coupling [12]. In these cases, all of
their methods employed the Corotational FEM [13] for
rapid computation of organ deformation simulations.
Our study extends this line of research by comparing
the performance of the Corotational energy model with
St. Venant-Kirchhof (StVK) and Neo-Hookean energy
models. Unlike previous studies, we utilize explicit FEM
rather than implicit solvers. This approach allows us
to simply evaluate the eficacy of diferent energy
models in the context of real-time medical elastodynamics
simulations.</p>
      </sec>
      <sec id="sec-2-2">
        <title>2.2. Position Based Method</title>
        <p>Position-Based Dynamics (PBD) is a real-time
physicsoriented simulation framework initially proposed by
Müller et al. in the computer graphics community [3].
Unlike other physics-based simulation methods, PBD
primarily focuses on converting physics models into
constraint forms and solving them. Although this framework
has proven capable of achieving accuracy comparable to
physics-based models through multiple iterations of
computation, developers primarily use in real-time physical
simulations with fewer iterations to achieve satisfactory
visual efects. Macklin et al. [ 4] identified limitations
in the PBD framework when simulating elastic objects,
as the stifness of materials depends on the timestep. In
response, they introduced an approximate implicit Euler
method called extended PBD (XPBD).</p>
        <p>Given the stability and ease of parallelization of the
PBD framework, numerous applications have emerged
for medical elastodynamics simulations. For instance, Tai
et al. [14] developed a virtual surgical training system
in Augmented Reality (AR), using XPBD for soft tissue
elastodynamic simulations. Camara et al. [15] utilized the
PBD-based library NVIDIA FleX to develop a simulation
platform for exploring optimal material properties and
other parameters. Moreover, Yu et al. [16] employed
PBD methods in a Virtual Reality (VR) environment to
develop a real-time medical education training system.
While these studies demonstrate the direct application
of PBD/XPBD in medical simulations, our framework
develops energy model-based PBD and XPBD approaches,
building upon the FEM-PBD method proposed by Bender
et al. [17].</p>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>3. Energy-based FEM Prototyping</title>
    </sec>
    <sec id="sec-4">
      <title>Framework</title>
      <p>This section will describe the implementation of our
developed 2D energy-based FEM prototyping framework.
First, we will describe the computation of various energy
models when employing explicit FEM methods.
Subsequently, we will detail the calculation of diferent energy
models within the position-based approach. Finally, we
will introduce the semi-automatic mesh conversion
algorithm for 2D scenarios.</p>
      <sec id="sec-4-1">
        <title>3.1. Energy Model in Explicit FEM</title>
        <sec id="sec-4-1-1">
          <title>Deformation Map</title>
          <p>In continuum mechanics, the
deformation of a material can be conceptualized as an afine
mapping (· ) from the material space to the deformed
world space [5]. This mapping allows us to describe
the position of any point in the deformed world space.
Specifically, for a material point ¯ in the material space,
its position  in the world space is given by:
 =(¯) =  ¯ + 
 =
=</p>
          <p>( ¯ +  )
(¯)
¯

¯
(1)
where  is the deformation gradient and  is a
translation matrix.</p>
          <p>This formulation provides a fundamental basis for
analyzing material deformation in our 2D energy-based
FEM framework. It enables us to track the movement
and deformation of each point in the material over time,
which is crucial for computing various energy models
and simulating elastodynamic behavior.</p>
        </sec>
        <sec id="sec-4-1-2">
          <title>Elastic Energy</title>
          <p>The energy models Ψ used in
elastodynamics calculations can be viewed as evaluation
functions that measure the degree of material deformation.
These can be expressed as [13, 18, 19, 20, 21]:
Ψ StVK = ‖‖2F +</p>
          <p>(tr())2

2
Ψ Co-rotational = ‖ − ‖2F +
(tr(  − ))2
Ψ Neo-Hookean =
(tr(  )− 3)−  log(det(  ))

2
log2(det(   ))
(2)

2
1
2
+

2

 = (   − )
 =
 =
2(1 +  )</p>
          <p>(1 +  )(1 − 2 )
Frobenius norm.
where  is a matrix representing the pure rotational part
of  , which must satisfy   = .  denotes Green’s
strain tensor. tr(· ) represents the trace of a matrix. The
Lamé parameters, denoted as  and  , characterize the
elastic properties of the material. These coeficients are
directly related to two fundamental material constants:
Young’s modulus  and Poisson’s ratio  . det(· ) denotes
the determinant of a matrix. ‖ · ‖ 2F represents the squared</p>
        </sec>
        <sec id="sec-4-1-3">
          <title>Explicit FEM</title>
          <p>In the explicit FEM framework, we can
derive the nodal forces  for each independent element
based on various energy models Ψ (i.e., elastic potential
function ( + ∆ ) is minimized to zero. For an
individual constraint, the position adjustment ∆  is derived
by resolving the linearized equation. This process can be
(3) represented as follows:
energy) as follows:
 = − 
Ψ Ψ 
 = −   
= −  ( )


Where  represents the area of the element in its
undeformed configuration.  is an energy-independent
matrix that can be derived directly from the defined
element.  ( ) denotes the first Piola-Kirchhof stress
tensor, which can be derived from Equation 2.</p>
          <p>Based on the derivation of the aforementioned energy
models, we can eficiently decompose the calculation of
nodal forces for each element in the explicit FEM method
into energy-independent and energy-dependent
components. This decomposition facilitates the seamless
substitution of various energy models within the explicit
FEM framework, enabling straightforward validation of
their performance and behavior. The algorithm for the
2D explicit FEM is presented in Algorithm I.</p>
        </sec>
      </sec>
      <sec id="sec-4-2">
        <title>3.2. Energy Model in PBD</title>
        <p>To integrate the FEM method into the PBD
framework, we primarily developed our framework using the
position-based energy reduction method proposed by
Bender et al. [17] Additionally, we attempted to
implement the energy constraints within the XPBD method
[4] and conducted comparative experiments.</p>
        <p>The position-based energy reduction method aims to
determine position adjustments ∆  such that the energy
( + ∆ ) ≈ () + ∇  ()∆  = 0
∇ =
∫︁ Ψ</p>
        <p>=
∫︁
 ( )
d¯ =


d¯
∫︁ Ψ 
 
d¯</p>
        <p>To constrain ∆  to align with the direction of ∇,
a Lagrange multiplier  is introduced, which is defined
such that:
()
 = − ∑︀  |∇ ()|2
Algorithm I 2D Explicit FEM Algorithm
1: for each finite element  do
2: compute 
3: compute  ( )
4: compute  (Equation (3))
5: accumulate forces  for each vertex in 
6: end for
7:  ←  − 1( +  ext)
8: +1  + ∆ 
9: +1 ←←  + ∆ 
10: damp velocities +1
(4)
(5)</p>
        <p>1 represents the inverse of the particle
where  = 
mass, and the position correction for each particle is
determined by:
∆  =  ∇()</p>
        <sec id="sec-4-2-1">
          <title>Project 3D Geometries to 2D Points To project 3D</title>
          <p>geometries onto a 2D plane, we first establish a camera
coordinate system using three vectors: camera position ,
focal point  , and up vector . From these, we derive the
(6) orthonormal basis: ˆ = |−− | , ˆ = |×× | , ˆ = ˆ × ˆ</p>
          <p>We then construct the camera-to-world transformation
matrix  :</p>
          <p>In contrast to the energy-based FEM framework, the
energy-based PBD framework requires a priori
conversion of all vertices of each element into a particle-based ⎡x x − x x⎤
ddeaptaenstdreuncttumraes,se,nvseuloricnitgy,thaantdepaocshitvioenrtienxfopromssaetsiosens. Ains-  = ⎢⎢⎣yz yz −− yz yz ⎥⎦⎥ (8)
for XPBD method can be conceptualized as a solver that 0 0 0 1
approximates an implicit Euler solution. It difers from
the PBD framework in its computation of position cor- For a point  = [  ] in world coordinates, we convert
rections, as illustrated below: it to camera coordinates ′ using:
∆  = − 1∇() ∆ 
∆  =</p>
          <p>− () − 
∇ − 1∇ + 
′ = [x   1] ·  − 1
(9)
(7)</p>
          <p>Finally, we project ′ = (′, ′, ′, ′) onto the 2D plane
as proj = (′, ′).
where  is a compliance coeficient. The algorithm for
the energy-based XPBD is presented in Algorithm II.</p>
        </sec>
        <sec id="sec-4-2-2">
          <title>Polygon Reconstruction from 2D Point Clouds Af</title>
          <p>ter projecting the 3D geometry to 2D, we obtain a large
set of 2D point data that needs to be processed. Our next
3.3. Mesh Conversion task is to reconstruct the polygon shape information
To facilitate the simulation of complex and irregular geo- based on these 2D point data. While the most
straightmetric shapes in elastodynamics within our developed forward approach typically involves using a convex hull
framework, we propose a computational pipeline capa- algorithm to obtain the contour information of these
ble of transforming arbitrary geometries into 2D FEM- points, this method struggles to handle concave
polycompatible meshes. The following sections elucidate the gon shapes. Therefore, we opted to employ the alpha
step-by-step implementation process of this computa- shapes algorithm [22] for 2D polygon shape
reconstructional pipeline. tion. An experimental result of applying the alpha shape
algorithm can be found in Figure 1.
Generation of FEM-Compatible Meshes from 2D evaluate computational performance. The following
exPolygon Directly converting the polygons into FEM- perimental parameters were used: a Young’s modulus of
compatible meshes is challenging due to the massive 1000 Pa, a Poisson’s ratio of 0.3, a mass of 1 kg, and a time
number of vertices in polygons. This is because numer- step of 0.001 s. As illustrated in Figure 2, the simulation
ous vertices allow for accurate representation of the orig- results show that there are no significant diferences in
viinal geometric object shape, while they complicate the sual efects across the diferent models for the cantilever
Delaunay triangulation process, which is essential for beam deformation. Furthermore, to precisely capture the
producing FEM-computable meshes. As an example of similarities and diferences among these energy models,
complex polygon shapes, Delaunay triangulation often we recorded the variations in the vertical displacement
generates numerous small-area triangles. These small of the cantilever beam tip node, as presented in Table
triangles can impact both the stability and computational 1. The statistical results indicate that the displacement
eficiency of FEM solvers. To overcome this challenge, amounts generated through deformation are relatively
we implement a polygon simplification step before ap- similar for the Co-rotational and Neo-Hookean models.
plying Delaunay triangulation. The Douglas-Peucker As for the computational performance, the StVK model
algorithm primarily forms the basis of the polygon sim- and the Neo-Hookean model require approximately 14
plification process; we choose it for its eficiency in re- seconds to compute 2000 steps, whereas the corotational
ducing the number of vertices while preserving essential method necessitates nearly 20 seconds. Additionally, we
shape characteristics. For Delaunay triangulation, we conducted an experiment to test the stability of diferent
additionally incorporate maximum area and minimum energy models by increasing the Young’s modulus and
angle constraints to produce FEM-compatible meshes. reducing the time step. The results of this experiment
The complete mesh conversion process is illustrated in demonstrated that all of the energy models can achieve
Figure 1. stable simulation for the cantilever beam.</p>
          <p>Given these results, the StVK model emerges as the
optimal choice for this cantilever beam case study. It not
4. Experimental Results only ensures simulation stability across diferent
parameter settings but also demonstrates the highest
computational eficiency.</p>
          <p>Case A In this case study, we simulate a cantilever
beam (5 m long, 1 m high), which is fixed at its left end,
and utilize explicit FEM frameworks with diferent
energy models to test its deformation under gravity and
Algorithm II 2D Energy Based XPBD Algorithm
1: +1  + ∆  − 1 ext
2: +1 ←←  + ∆ +1
3:  ← 0
4: for iter := 1 to maxIterations do
5: for each energy constraint () do
6: compute ∆ 
7: compute ∆ 
8:  ←  + ∆ 
9:  ←  + ∆ 
10: end for
11: end for
12: +1 ← Δ1 (+1 − )
13: damp velocities +1
Case B In this case study, we initially fix both ends
of the bar-shaped elastic body. Subsequently, we apply
a stretching operation to the nodes on the right side of
the elastic body. The fundamental experimental
parameters remain consistent with those in Case A. The final
experimental results are presented in Figure 3.
Examining the longitudinal contraction of the elastic body
post-stretching, we observe that the StVK model exhibits
more pronounced contraction compared to the
corotational and Neo-Hookean models. However, when we
attempted to test the stability of various energy models
by increasing the Young’s modulus and reducing the time
step, the StVK model required a smaller time step than
the corotational and Neo-Hookean models to achieve
stable simulations. From these observations, we can
conclude that the StVK energy model is the optimal choice
when simulating elastic bodies with lower Young’s
module in 2D scenarios. However, when simulating objects</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>5. Conclusion</title>
      <p>with higher Young’s module and prioritizing
computational performance and stability, the corotational and
Neo-Hookean models prove more suitable.</p>
      <p>In this paper, we develop an energy model-based 2D FEM
framework for XR-oriented medical elastodynamics. The
Case C In this case study, we adopt the same exper- main goal of developing this framework is to assist in
imental setup as in Case A. However, we will evaluate determining the optimal combination of energy models
and compare the performance of the StVK model imple- and computational frameworks for real-time 3D
elastomented within three diferent computational frameworks: dynamic simulations. Through comparative experiments
explicit FEM, PBD, and XPBD. The simulation results in conducted in 2D space across 4 case studies, we analyze
Figure 4 show that even when using the same energy the performance of various energy models and
elastomodel, elastic bodies exhibit diferent behaviors under dynamic frameworks, subsequently identifying their
apPBD and XPBD frameworks. It should be noted here plicable simulation scenarios. Furthermore, to enable
that the deformation under the PBD framework is not our proposed framework to simulate elastodynamics of
significant. This is because the material stifness in the more complex geometries, we introduce an algorithm for
PBD framework depends on the time step. From this ob- semi-automatic conversion of arbitrary geometries into
servation, we should be cautious when using PBD-based 2D FEM-compatible meshes. We successfully employ the
frameworks in medical dynamics simulations, especially resulting meshes in dynamic simulations. However, it
when simulation accuracy is required. should be noted that our framework does not include
parallel versions of the PBD and XPBD approaches, which
Case D In this case study, we utilized the mesh con- laidmviatsntoaugreasbiinlitoyutrocdoemmpoanrasttirvaeteepxopteerni
mtiaelnptse.rfIonrmthaenfcueversion method described in Section 3.3 to project a 3D ture, we would like to implement parallel algorithms for
human body model onto a 2D plane. This projection en- each approach and incorporate an implicit FEM solver
abled us to conduct an elastodynamic experiment simu- for comparing the stability of existing methods.
lating a simplified scenario where a human leg is trapped Recently, deep learning-based FEM approaches [23, 24,
under building debris. For this study, we used the follow- 25, 26] have emerged and demonstrated superior
accuing parameters: Young’s modulus of 1.85 MPa, Poisson’s racy and performance compared to classical FEM
methratio of 0.3, total mass of 70 kg, and time step of 0.0001 ods, with some implementations achieving real-time
pers. We employed the Neo-Hookean energy model and formance. However, our literature review reveals that
Explicit FEM framework as our solver. Through visual- these approaches have primarily been validated in
lowerization techniques, we were able to illustrate the stress dimensional spaces, with most demonstrations limited
distribution on the leg when compressed by the debris. to 1D and a few in 2D scenarios. While authors suggest
This approach demonstrates the practical application of that their methods can be extended to 3D applications,
our framework in simulating medical scenarios relevant the performance and interactive capabilities in such
sceto disaster response. narios remain unverified. In contrast, all energy-based</p>
    </sec>
    <sec id="sec-6">
      <title>Acknowledgments</title>
      <p>This work was supported by Innovative Science and
Technology Initiative for Security Grant Number JPJ004596,
ATLA, Japan.
methods examined in our comparative study have been
proven efective and stable in 3D implementations, which
is not yet the case for deep learning-based approaches.
This observation partly motivates our choice of methods
for comparison. As future work, we plan to investigate
the stability of deep learning-based FEM methods and
evaluate their efectiveness in 3D scenarios, particularly
for XR-oriented medical dynamics applications.
mentation and production practicalities, in: ACM
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[23] J. Jung, K. Yoon, P.-S. Lee, Deep learned
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//doi.org/10.1016/j.cma.2020.113401.
[24] R. Phellan, B. Hachem, J. Clin, J.-M. Mac-Thiong,
L. Duong, Real-time biomechanics using the finite
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[25] R. E. Meethal, A. Kodakkal, M. Khalil, A.
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