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Tantisatirapong S, Khunakornpattanakarn S, Suesatsakul T, Boonpratatong A, Benjamin I, Tongmeesee S, Kangkorn T, Chanwimalueang T. The simplified tailor-made workflows for a 3D slicer-based craniofacial implant design. Sci Rep 2023; 13:2850. [PMID: 36801943 PMCID: PMC9938178 DOI: 10.1038/s41598-023-30117-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
A specific design of craniofacial implant model is vital and urgent for patients with traumatic head injury. The mirror technique is commonly used for modeling these implants, but it requires the presence of a healthy skull region opposite to the defect. To address this limitation, we propose three processing workflows for modeling craniofacial implants: the mirror method, the baffle planner, and the baffle-based mirror guideline. These workflows are based on extension modules on the 3D Slicer platform and were developed to simplify the modeling process for a variety of craniofacial scenarios. To evaluate the effectiveness of these proposed workflows, we investigated craniofacial CT datasets collected from four accidental cases. The designed implant models were created using the three proposed workflows and compared to reference models created by an experienced neurosurgeon. The spatial properties of the models were evaluated using performance metrics. Our results show that the mirror method is suitable for cases where a healthy skull region can be completely reflected to the defect region. The baffle planner module offers a flexible prototype model that can be fit independently to any defect location, but it requires customized refinement of contour and thickness to fill the missing region seamlessly and relies on the user's experience and expertise. The proposed baffle-based mirror guideline method strengthens the baffle planner method by tracing the mirrored surface. Overall, our study suggests that the three proposed workflows for craniofacial implant modeling simplify the process and can be practically applied to a variety of craniofacial scenarios. These findings have the potential to improve the care of patients with traumatic head injuries and could be used by neurosurgeons and other medical professionals.
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Affiliation(s)
- Suchada Tantisatirapong
- grid.412739.a0000 0000 9006 7188Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, 26120 Thailand
| | - Sarunyapong Khunakornpattanakarn
- grid.412739.a0000 0000 9006 7188Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, 26120 Thailand
| | - Thanyakarn Suesatsakul
- grid.412739.a0000 0000 9006 7188Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, 26120 Thailand
| | - Amaraporn Boonpratatong
- grid.412739.a0000 0000 9006 7188Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, 26120 Thailand
| | - Itsara Benjamin
- grid.414283.80000 0001 0580 0910Division of Plastic and Reconstructive Surgery, Department of Surgery, Chonburi Hospital, Chonburi, 20000 Thailand
| | - Somprasong Tongmeesee
- grid.414283.80000 0001 0580 0910Division of Plastic and Reconstructive Surgery, Department of Surgery, Chonburi Hospital, Chonburi, 20000 Thailand
| | - Tanasit Kangkorn
- grid.414283.80000 0001 0580 0910Division of Plastic and Reconstructive Surgery, Department of Surgery, Chonburi Hospital, Chonburi, 20000 Thailand
| | - Theerasak Chanwimalueang
- Department of Biomedical Engineering, Faculty of Engineering, Srinakharinwirot University, Nakhon Nayok, 26120, Thailand.
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Chen YW, Shih CT, Cheng CY, Lin YC. Solving the Prosthesis Modeling for Skull Repair Through Differential Evolution Algorithm. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cranial defects can result in compromised physical protection for the brain and a how risky the brain infection is. Cranioplasty is commonly performed by doing the bone graft onto the deficient area or areas and/or using the metal to support them for restoring the cranial cavity integrity
and maintain the physiological intracranial pressure stability. Nowadays, the suitable shape of skull prosthesis can be created and operated precisely and efficiently during cranioplasty process, because the technological development of additive manufacturing or 3D printing. Additive manufacturing
has great potential in regard to addressing irregular cranial defects because it can be used to create customized shapes rapidly. However, an unsuitable cranial prosthesis that made from synthetic polymer or a metal implantation will cause a serious infections, and required additional surgery.
This paper proposes a geometric model of skull defects by using the superellipse and Differential Evolution (DE). The defects of skill bones in each tomography slice can be modeled by superellipse. The DE optimizes the parameters of superellipse to emulate and compensate the suitable curvature.
In a rapid 2D image process and 3D cranial model construction system, the clinical surgeons’ ability is determining, processing, and implanting a customized prosthesis for patients just in a short time in surgery and with maximum surgical quality, especially in emergency cases.
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Affiliation(s)
- Yi-Wen Chen
- X-Dimension Center for Medical Research and Translation, China Medical University Hospital, Taichung, Taiwan, 40402, R.O.C; Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, 40402, R.O.C; 3D Printing Medical
Research Institute, Asia University, Taichung, Taiwan, 40402, R.O.C
| | - Cheng-Ting Shih
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, 40402, Taiwan, R.O.C
| | - Chen-Yang Cheng
- Department of Industrial Engineering & Management, National Taipei University of Technology, Taipei, Taiwan, 10608, R.O.C
| | - Yu-Cheng Lin
- Department of Industrial Engineering & Management, National Taipei University of Technology, Taipei, Taiwan, 10608, R.O.C
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Li J, Gsaxner C, Pepe A, Morais A, Alves V, von Campe G, Wallner J, Egger J. Synthetic skull bone defects for automatic patient-specific craniofacial implant design. Sci Data 2021; 8:36. [PMID: 33514740 PMCID: PMC7846796 DOI: 10.1038/s41597-021-00806-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 12/03/2020] [Indexed: 11/09/2022] Open
Abstract
Patient-specific craniofacial implants are used to repair skull bone defects after trauma or surgery. Currently, cranial implants are designed and produced by third-party suppliers, which is usually time-consuming and expensive. Recent advances in additive manufacturing made the in-hospital or in-operation-room fabrication of personalized implants feasible. However, the implants are still manufactured by external companies. To facilitate an optimized workflow, fast and automatic implant manufacturing is highly desirable. Data-driven approaches, such as deep learning, show currently great potential towards automatic implant design. However, a considerable amount of data is needed to train such algorithms, which is, especially in the medical domain, often a bottleneck. Therefore, we present CT-imaging data of the craniofacial complex from 24 patients, in which we injected various artificial cranial defects, resulting in 240 data pairs and 240 corresponding implants. Based on this work, automatic implant design and manufacturing processes can be trained. Additionally, the data of this work build a solid base for researchers to work on automatic cranial implant designs. Measurement(s) | Image Acquisition Matrix Size • Image Slice Thickness • craniofacial region | Technology Type(s) | imaging technique • computed tomography | Sample Characteristic - Organism | Homo sapiens |
Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.13265225
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Affiliation(s)
- Jianning Li
- Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16c/II, 8010, Graz, Austria.,Computer Algorithms for Medicine Laboratory, Graz, Austria
| | - Christina Gsaxner
- Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16c/II, 8010, Graz, Austria.,Computer Algorithms for Medicine Laboratory, Graz, Austria.,Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 6/1, 8036, Graz, Austria
| | - Antonio Pepe
- Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16c/II, 8010, Graz, Austria.,Computer Algorithms for Medicine Laboratory, Graz, Austria
| | - Ana Morais
- Department of Informatics, School of Engineering, University of Minho, Braga, Portugal.,Algoritmi Centre, University of Minho, Braga, Portugal
| | - Victor Alves
- Algoritmi Centre, University of Minho, Braga, Portugal
| | - Gord von Campe
- Department of Neurosurgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria
| | - Jürgen Wallner
- Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 6/1, 8036, Graz, Austria.
| | - Jan Egger
- Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16c/II, 8010, Graz, Austria. .,Computer Algorithms for Medicine Laboratory, Graz, Austria. .,Department of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 6/1, 8036, Graz, Austria.
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4
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Wu CT, Lu TC, Chan CS, Lin TC. Patient-Specific Three-Dimensional Printing Guide for Single-Stage Skull Bone Tumor Surgery: Novel Software Workflow with Manufacturing of Prefabricated Jigs for Bone Resection and Reconstruction. World Neurosurg 2020; 147:e416-e427. [PMID: 33359737 DOI: 10.1016/j.wneu.2020.12.072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To describe a novel system workflow to design and manufacture patient-specific three-dimensional (3D) printing jigs for single-stage skull bone tumor excision and reconstruction and to present surgical outcomes of 14 patients. METHODS A specific computer-aided design/computer-aided manufacturing software and hardware system was set up, including a virtual surgical planning subsystem and a 3D printing-associated manufacturing subsystem. Computed tomography data of the patient's skull were used for 3D rendering of the skull and tumor. The output of patient-specific designing included a 3D printing guide for tumor resection and a 3D printing model of the bone defect after tumor excision. A polymethyl methacrylate implant was fabricated preoperatively and used for repair. RESULTS The specific 3D printing guide was used to design intraoperative jigs and implants for 14 patients (age range, 1-72 years) with skull bone tumors. In all cases, the cutting jig allowed precise excision of tumor and bone, and implants were exact fits for the defects created. All operative results were successful, without intraoperative or postoperative complications. Postoperative computed tomography scans were obtained for analysis. Postoperative 3D measurement of the skull symmetry index (cranial vault asymmetry index) showed significant improvement of head contour after surgery. CONCLUSIONS The computer-aided design/computer-aided manufacturing system described allows definitive preoperative planning and fabrication for treatment of skull bone tumors. Apparent benefits of the method include more accurate determination of surgical margins and better oncological outcomes.
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Affiliation(s)
- Chieh-Tsai Wu
- Department of Neurosurgery, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
| | - Ting-Chen Lu
- Department of Plastic and Reconstructive Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chun-Sheng Chan
- Medical Augmented Reality Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Chin Lin
- Department of Neurosurgery, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
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The first step of patient-specific design calvarial implant: A quantitative analysis of fresh parietal bones. EUROPEAN JOURNAL OF PLASTIC SURGERY 2018. [DOI: 10.1007/s00238-018-1411-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Peel S, Eggbeer D, Burton H, Hanson H, Evans PL. Additively manufactured versus conventionally pressed cranioplasty implants: An accuracy comparison. Proc Inst Mech Eng H 2018; 232:949-961. [DOI: 10.1177/0954411918794718] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This article compared the accuracy of producing patient-specific cranioplasty implants using four different approaches. Benchmark geometry was designed to represent a cranium and a defect added simulating a craniectomy. An ‘ideal’ contour reconstruction was calculated and compared against reconstructions resulting from the four approaches –‘conventional’, ‘semi-digital’, ‘digital – non-automated’ and ‘digital – semi-automated’. The ‘conventional’ approach relied on hand carving a reconstruction, turning this into a press tool, and pressing titanium sheet. This approach is common in the UK National Health Service. The ‘semi-digital’ approach removed the hand-carving element. Both of the ‘digital’ approaches utilised additive manufacturing to produce the end-use implant. The geometries were designed using a non-specialised computer-aided design software and a semi-automated cranioplasty implant-specific computer-aided design software. It was found that all plates were clinically acceptable and that the digitally designed and additive manufacturing plates were as accurate as the conventional implants. There were no significant differences between the additive manufacturing plates designed using non-specialised computer-aided design software and those designed using the semi-automated tool. The semi-automated software and additive manufacturing production process were capable of producing cranioplasty implants of similar accuracy to multi-purpose software and additive manufacturing, and both were more accurate than handmade implants. The difference was not of clinical significance, demonstrating that the accuracy of additive manufacturing cranioplasty implants meets current best practice.
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Affiliation(s)
- Sean Peel
- PDR – International Centre for Design & Research, Cardiff Metropolitan University, Cardiff, UK
| | - Dominic Eggbeer
- PDR – International Centre for Design & Research, Cardiff Metropolitan University, Cardiff, UK
| | - Hanna Burton
- PDR – International Centre for Design & Research, Cardiff Metropolitan University, Cardiff, UK
| | - Hayley Hanson
- PDR – International Centre for Design & Research, Cardiff Metropolitan University, Cardiff, UK
| | - Peter L Evans
- Morriston Hospital, Abertawe Bro Morgannwg University Health Board, Swansea, UK
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7
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Custom implant design for large cranial defects. Int J Comput Assist Radiol Surg 2016; 11:2217-2230. [DOI: 10.1007/s11548-016-1454-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 06/18/2016] [Indexed: 11/26/2022]
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Abstract
Cranioplasty is a medical technique to correct cranial bone defects. Depending on the size and location of the defect, a bone substitute can be used to replace the missing bone. Frontal bone defects are important to patients in terms of cosmetics because they are visible. Advances in computer design allow the production of customized implants with improved cosmetic and functional results. This report describes hybrid optimization of three-dimensional technological methods along with traditional methods toward the manufacture of deep-buried titanium implants, restoring frontal skull defects for 4 patients. A three-dimensional model was produced from the computed tomographic scan data of 3 patients using an in-house three-dimensional printer. A new approach was followed in treating the fourth patient. The defect was restored using preoperative scan before cranioplasty. These data were transported digitally into the defect skull to recreate the bone contour required, and a three-dimensional model was produced from the "new" digital model using the three-dimensional printer. Defect areas of the patients were large and measured 101.21 × 123.35 (vertical × horizontal) in average (mm). Conventional wax-up of the defect was carried to restore normal conformity. A titanium sheet (0.5 mm) was swaged into the desired shape; however, convexity of the defect area makes titanium swaging challenging, especially at the deep lateral undercuts. Making side flanges at reasonable lengths made it easy to swage without creasing. Three-dimensional models aided to produce accurately fitting plates. Finally, the sequential method of using both digital and manual procedures is a low-cost, reliable, accurate, and reproducible method.
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9
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Mylona EA, Savelonas MA, Maroulis D. Self-parameterized active contours based on regional edge structure for medical image segmentation. SPRINGERPLUS 2014; 3:424. [PMID: 25152851 PMCID: PMC4141071 DOI: 10.1186/2193-1801-3-424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 07/24/2014] [Indexed: 11/17/2022]
Abstract
This work introduces a novel framework for unsupervised parameterization of region-based active contour regularization and data fidelity terms, which is applied for medical image segmentation. The work aims to relieve MDs from the laborious, time-consuming task of empirical parameterization and bolster the objectivity of the segmentation results. The proposed framework is inspired by an observed isomorphism between the eigenvalues of structure tensors and active contour parameters. Both may act as descriptors of the orientation coherence in regions containing edges. The experimental results demonstrate that the proposed framework maintains a high segmentation quality without the need of trial-and-error parameter adjustment.
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Affiliation(s)
- Eleftheria A Mylona
- Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, 15703 Panepistimiopolis, Athens Greece
| | - Michalis A Savelonas
- Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, 15703 Panepistimiopolis, Athens Greece
| | - Dimitris Maroulis
- Department of Informatics and Telecommunications, National and Kapodistrian University of Athens, 15703 Panepistimiopolis, Athens Greece
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Burnham RMC, McMillian K, Williams R, Sharp I. A new role for stereolithic models in the management of complex mandibular fractures. Int J Oral Maxillofac Surg 2013; 43:194-6. [PMID: 23932578 DOI: 10.1016/j.ijom.2012.10.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 09/06/2012] [Accepted: 10/25/2012] [Indexed: 11/16/2022]
Abstract
The author discusses a new role for stereolithic models in the management of complex mandibular fractures with reference to two case studies.
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Affiliation(s)
- R M C Burnham
- Speciality Trainee Oral and Maxillofacial Surgery, University Hospitals of Birmingham Queen Elizabeth Hospital, Birmingham, West Midlands, B15 2TH.
| | - K McMillian
- Speciality Trainee Oral and Maxillofacial Surgery, University Hospitals of Birmingham Queen Elizabeth Hospital, Birmingham, West Midlands, B15 2TH
| | - R Williams
- Consultant in Oral and Maxillofacial Surgery University Hospitals of Birmingham Queen Elizabeth Hospital, Birmingham, West Midlands, B15 2TH
| | - I Sharp
- Consultant in Oral and Maxillofacial Surgery University Hospitals of Birmingham Queen Elizabeth Hospital, Birmingham, West Midlands, B15 2TH
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Lee L, Ker J, Quah BL, Chou N, Choy D, Yeo TT. A retrospective analysis and review of an institution's experience with the complications of cranioplasty. Br J Neurosurg 2013; 27:629-35. [DOI: 10.3109/02688697.2013.815313] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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van der Meer WJ, Bos RR, Vissink A, Visser A. Digital planning of cranial implants. Br J Oral Maxillofac Surg 2013; 51:450-2. [DOI: 10.1016/j.bjoms.2012.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 11/19/2012] [Indexed: 12/01/2022]
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13
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Using three-dimensional multigrid-based snake and multiresolution image registration for reconstruction of cranial defect. Med Biol Eng Comput 2012; 51:89-101. [DOI: 10.1007/s11517-012-0972-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 09/27/2012] [Indexed: 11/27/2022]
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