Development of a three-dimensional treatment planning system based on computed tomographic data
Development of a three-dimensional treatment planning system based on computed tomographic data
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DOI：
10.1054/ijom.2002.0278
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发表时间：
2002-08-01
影响因子：
2.4
通讯作者：
Kaban, LB
中科院分区：
文献类型：
--
作者：
Troulis, MJ;Everett, R;Kaban, LB
当前的手术治疗计划系统从二维（2d）数据预测三维（3D）校正，并且不足以进行复杂的运动。本文提出了一个基于CT数据的三维规划系统，颅面骨骼的三维CT扫描形成数据库。在哈佛外科计划实验室开发的软件被修改为颅面骨骼。识别可再现的骨骼标志用于叠加。一个“切割工具”被用来分割下颌骨和部分被移动到其预测的位置。一个“碰撞工具”，提醒操作员骨骼冲突。通过对所选扫描的分析来展示该系统，完成了面部骨骼的三维可视化、标志的选择、角度和距离的测量、截骨术的模拟、骨骼的重新定位、碰撞检测和扫描的叠加。在HeMifacial矮小症的说明性病例中，记录了整个下颌骨的预测和实际3D矫正运动。扫描分析表明，3D规划可以防止标准2D方法出现的颌骨延长不足或其他手术不准确性。这里展示的软件将允许外科医生准确地规划治疗并评估颅颌面手术结果。未来的应用可能包括手术导航。
Current surgical treatment planning systems predict three-dimensional (3D) corrections from two-dimensional (2d) data and are inadequate for complex movements. In this paper, we present a 3D planning system based on computed tomographic (CT) data.A three-dimensional CT scan of the craniofacial skeleton forms the database. Software developed in the Harvard Surgical Planning Laboratory was modified for the craniofacial skeleton. Reproducible skeletal landmarks are identified for superimposition. A 'cutting tool' is used to segment the mandible and segments are moved to their predicted positions. A 'collision tool', alerts the operator of skeletal interferences. An analysis of selected scans is used to demonstrate the system.Three-dimensional visualization of the facial skeleton, selection of landmarks, measurement of angles and distances, simulation of osteotomies, repositioning of bones, detection of collisions and super-imposition of scans were accomplished. In an illustrative case of HeMifacial Microsomia, predicted and actual 3D corrective movements of the entire mandible were documented. Analysis of scans indicated that 3D planning can prevent insufficient jaw lengthening or other surgical inaccuracies which occur with standard 2D methods.Software demonstrated here will allow the surgeon to accurately plan treatment and evaluate craniomaxillofacial surgery outcomes. Future applications may include surgical navigation.