The musculoskeletal system is one of the most promising targets for the application of simulation methods in the clinical practice. The VPHOP session inside ICT-BIO 2008 provided an overview on some of the most exciting research developments related to musculoskeletal multiscale modelling in the world. A summary of the current state of the art in this field, but also a definition of the current research challenges, and a vision of the future in this research area were addressed in the session.

The session was introduced by Marco Viceconti, coordinator of the VPHOP project, who stressed as muscusloskeletal diseases are considered less important than others, in spite of the fact that most elders face significant reductions in their quality of life mostly because of musculoskeletal diseases, and the healthcare costs associated to these diseases are always listed in the largest in all national statistics of EU member states.

Among the large integrated projects recently funded by the European Commission, VPHOP is the only one focusing on the musculoskeletal system.  This large endeavour, which aims to develop the next-generation technology to fight osteoporosis, were summarised in two presentations given by representatives of the VPHOP consortium. 

Fulvia Taddei, head of the computational biomechanics group at the Rizzoli Orthopaedic Institute, reported about the generation of patient-specific probabilistic predictive models at the body-organ level capable of predicting the loading spectrum the patient applies on her bone during daily life. Dr. Taddei showed how by transforming the images of the patient skeleton obtained from a Computer Tomography examination into an accurate computer model capable of predicting the strength of the bones of each patient with an accuracy of 90% or better it is already possible today solve important clinical problems in orthopaedic surgery, paediatric skeletal oncology, and osteoporosis.  Current research within the VPHOP project opens up a whole new scenario, where the prediction of the skeletal strength will be combined with the prediction of the overloading that each patient produces during daily activities because of neuromuscular deficits related to aging. 

Ralph Müller, Professor of Bioengineering at ETH Zurich, showed how multiscale modelling can be used to link the organ-tissue clinical observations with the cell-molecule laboratory observations.  Prof. Müller showed some recent results of his group at ETH where computer models of bone tissue-cell interaction were used to predict the optimal time for the beginning of the pharmacological treatment with anti-osteoporosis drugs.

SIMBIOS is the American National Institute of Health Center for physics-based Simulation of Biological Structures. SIMBIOS provides infrastructure, software, and training to help biomedical researchers understand biological form and function as they create novel drugs, synthetic tissues, medical devices, and surgical interventions. Musculoskeletal research is a fundamental focus of SIMBIOS research activities; Antonie van den Bogert, associate staff at the Cleveland Clinic Lerner Research Institute and leader of the Simbios associate project “Efficient Methods for Multi-Domain Biomechanical Simulations” provided an overview of the important achievements that this large project has and will produce in the next few years in the context of musculoskeletal modelling.  Dr. van den Bogert showed how whole body neuromuscular models can be used to explore the changes in physical activity in altered gravity conditions, leading the exploration of the biological effects of long-term permanence in low-gravity planets like Mars.

RIKEN is one of the largest Japanese research institutions with its over 3000 researchers, spread on seven campuses across Japan. RIKEN carries out high level experimental and research work in a wide range of fields, including physics, chemistry, medical science, biology, and engineering, covering the entire range from basic research to practical application. Ryutaro Himeno, as director of the Computational Biomechanics Lab at the RIKEN Discovery Research Institute, as well as director of the Research and Development Group at the RIKEN Next-Generation Supercomputer R&D Center in charge of the Japanese Petaflop Initiative was in the ideal position to show how the traditional Japanese excellence in technology is being leveraged to solve the grand challenge of going form the medical images directly to the patient-specific simulation.  The use of a computer capable of making 1000 billion operations every second opens up totally new scenario in the use of computer models in biomedical research and practice.

Useful links

-          The Virtual Physiological Human: http://en.wikipedia.org/wiki/Virtual_Physiological_Human 

-          Unit “ICT for Health”: http://ec.europa.eu/information_society/activities/health/index_en.htm