Craniomaxillofacial surgery planning based on 3D models derived from Cone-Beam CT data
Craniomaxillofacial surgery planning based on 3D models derived from Cone-Beam CT data
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DOI：
10.3109/10929088.2013.796002
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Hoffmeister, Bodo
中科院分区：
文献类型：
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作者：
Adolphs, Nicolai;Liu, Weichen;Hoffmeister, Bodo
简介：复杂颌面矫正的个体规划可能需要可基于 DICOM 数据集制造的 3D 模型。图像采集的黄金标准仍然是高分辨率多层计算机断层扫描 (MSCT)。然而，可以通过专为颌面成像开发的现代锥形束 CT (CBCT) 设备获取用于模型制作的适当数据集。评估了基于 CBCT 数据集制作的个体模型的临床实用性。方法：对 5 名患有不同颌面部骨骼缺陷的患者进行术前 ILUMA CBCT 成像。通过阈值手动进行硬组织分割。创建相应的 STL 数据集并将其导出到专门从事快速原型制作的工业服务提供商（德国慕尼黑 Alphaform），并通过选择性激光烧结 (SLS) 技术制造 3D 模型。对于方差分析，在虚拟模型和 3D 模型上进行了标志性测量。随后，根据基于模型的规划进行颌面手术。结果：所有基于CBCT的DICOM数据集都可以用于个体模型制作。实现了个体解剖结构的详细再现，并且地形测量显示虚拟模型和真实模型之间没有相关异常。因此，基于 CBCT 的 3D 模型可用于不同颌面手术的规划和转移。结论：如果设置正确的阈值，基于 CBCT 的数据集可用于制作手术 3D 模型。通过使用这种“内部”成像技术，术前工作流程和患者舒适度在快速通道概念方面得到了改善。
Introduction: Individual planning of complex maxillofacial corrections may require 3D models which can be manufactured based on DICOM datasets. The gold standard for image acquisition is still high-resolution multi-slice computed tomography (MSCT). However, appropriate datasets for model fabrication can be acquired by modern Cone-Beam CT (CBCT) devices that have been developed specifically for maxillofacial imaging. The clinical utility of individual models fabricated on the basis of CBCT datasets was assessed.Methods: In five patients affected by different deficiencies of the maxillofacial skeleton, preoperative imaging was performed with ILUMA CBCT. Segmentation of hard tissues was performed manually by thresholding. Corresponding STL datasets were created and exported to an industrial service provider (Alphaform, Munich, Germany) specializing in rapid prototyping, and 3D models were fabricated by the selective laser sintering (SLS) technique. For variance analysis, landmark measurements were performed on both virtual and 3D models. Subsequently, maxillofacial surgery was performed according to the model-based planning.Results: All CBCT-based DICOM datasets could be used for individual model fabrication. Detailed reproduction of individual anatomy was achieved and a topographic survey showed no relevant aberrance between the virtual and real models. The CBCT-based 3D models were therefore used for planning and transfer of different maxillofacial procedures.Conclusions: CBCT-based datasets can be used for the fabrication of surgical 3D models if the correct threshold is set. Preoperative workflow and patient comfort is improved in terms of the fast-track concept by using this " in-house'' imaging technique.