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Fusion Imagine for Craniofacial Transplantation
Darren M. Smith MD, Vijay S. Gorantla MD, PhD, Joseph E. Losee MD
University of Pittsburgh
2013-03-15
Presenter: Darren M. Smith, MD
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. Please make a statement as to how much of the above work represents the original work of the resident.
Director Name: Joseph E. Losee, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
INTRODUCTION
Increasingly complex composite craniofacial defects are being addressed as craniofacial transplantation is performed more frequently. Skeletal, soft tissue, and neurovascular structures can be imaged via sophisticated modalities ranging from MRI to 3DCT to tractography to stereophotogrammetry. Here, a method is presented to integrate data from multiple imaging sources into a single 3D representation of donor or recipient anatomy that supports real-time user interaction and modification.
METHODS
The craniofacial skeleton is represented as a polygonal model generated from CT scans. A skin model is generated by stereophotogrammetry. Muscles are extracted from the same dicom dataset as the bone data, or from MRI. Blood vessels are modeled by thresholding dicoms from a CT angiogram. Nerves are modeled as non-uniform rational basis splines based on tractography data. The data from all imaging modalities are imported into a commercially available 3D software package to enable real-time user interaction and modification.
RESULTS
CT, stereophotogrammetry, MRI, tractography, and CTA data have been integrated to develop detailed 3D anatomical polygonal meshes compatible with real-time end-user manipulation and modification.
CONCLUSIONS
Craniofacial transplantation is visually complex in three dimensions. Critical insight into relevant patient anatomy is afforded by powerful imaging techniques. Here, we advance a workflow to integrate classically disparate data into a single interactive 3D representation of donor or recipient anatomy compatible with real-time user interaction and modification. Procedural planning may be enhanced by allowing simultaneous preoperative virtual interaction with patient skeletal, soft tissue, and neurovascular anatomy.
