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Visual Data Integration in Computer Graphics-Based Planning for Facial Transplantation

Darren M Smith MD, Vijay S Gorantla MD PhD, Gerald Brandacher MD, Stefan Schneeberger MD, W P Andrew Lee MD, Joseph E Losee MD
University of Pittsburgh Medical Center
2010-04-01

Presenter: Darren M Smith MD

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Author Category: Resident/Fellow
Presentation Category: Basic Science Research
Abstract Category: Craniomaxillofacial

INTRODUCTION
Progressively complex composite craniofacial defects are being addressed by composite tissue allotransplantation. Functional and aesthetic outcomes are difficult to optimize. Imaging modalities ranging from MRI to 3D CT to tractography offer powerful visualization of skeletal, soft tissue, and neurovascular structures. Here, we present a method for the integration of data from classically isolated 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 the framework for the anatomical model. A mesh of the craniofacial skeleton is generated from "stacked" dicom images. To obviate concerns regarding registering multiple data sets, basic muscle morphology data is thresholded from the original dicom data. Blood vessels are modeled by an analogous process from CT angiogram dicoms. Finally, nerves are modeled and imported based on tractography data.

RESULTS
Data from once disparate and unwieldy CT, CT angiogram and surface scans have been integrated to develop detailed 3D polygonal anatomical models compatible with real-time end-user manipulation and modification. Integration of MRI and tractography data into these 3D models is underway.

CONCLUSIONS
Facial transplantation is visually complex in three dimensions. Powerful imaging techniques offer critical insight into relevant patient anatomy. In this study, we advance a workflow designed to integrate classically disparate and inaccessible data into a single interactive 3D representation of donor or recipient anatomy. Such data integration may enhance procedural planning by allowing preoperative virtual interaction with patient skeletal, soft tissue, and neurovascular anatomy.

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