Locally Affine Diffeomorphic Surface Registration and Its Application to Surgical Planning of Fronto-Orbital Advancement.
Locally Affine Diffeomorphic Surface Registration and Its Application to Surgical Planning of Fronto-Orbital Advancement.
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DOI：
10.1109/tmi.2018.2816402
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发表时间：
2018-07
影响因子：
10.6
通讯作者：
Linguraru MG
中科院分区：
文献类型：
--
作者：
Porras AR;Paniagua B;Ensel S;Keating R;Rogers GF;Enquobahrie A;Linguraru MG
异位颅缝闭闭是由异位颅缝线过早融合引起的一种疾病。如果不及时治疗，会导致大脑发育受限、颅内压升高、视力受损和认知迟缓。额眶进路是一种被广泛接受的手术方法，用于纠正异位颅缝闭闭患者的颅形状异常，但由于在干预过程中缺乏客观和个性化的颅形状指标，手术的结果仍然非常依赖于外科医生的专业知识。本文提出了一个局部仿射微分面配准框架，以创建适合每位患者的最佳介入方案。我们的方法通过最小化颅骨形状异常来计算最佳手术计划，该方法使用基于198例健康病例建立的颅骨形状规范模型的客观指标进行量化。它以临床截骨模板为指导进行额眶前进，并自动计算每个骨块需要平移、旋转和/或弯曲的程度和方向。我们的局部仿射框架在保证全局转换一致性的同时，对每个骨块的转换分别建模。我们使用我们的方法计算了23例患者的最佳手术方案，在使用不同截骨模板的手术模拟结果中，畸形发生率显著降低（p < 0.001），在40.38%至50.85%之间。畸形值均在健康范围内（p < 0.01）。
Metopic craniosynostosis is a condition caused by the premature fusion of the metopic cranial suture. If untreated, it can result into brain growth restriction, increased intracranial pressure, visual impairment, and cognitive delay. Frontoorbital advancement is the widely accepted surgical approach to correct cranial shape abnormalities in patients with metopic craniosynostosis, but the outcome of the surgery remains very dependent on the expertise of the surgeon because of the lack of objective and personalized cranial shape metrics to target during the intervention. We propose in this paper a locally affine diffeomorphic surface registration framework to create an optimal interventional plan personalized to each patient. Our method calculates the optimal surgical plan by minimizing cranial shape abnormalities, which are quantified using objective metrics based on a normative model of cranial shapes built from 198 healthy cases. It is guided by clinical osteotomy templates for fronto-orbital advancement, and it automatically calculates how much and in which direction each bone piece needs to be translated, rotated and/or bent. Our locally affine framework models separately the transformation of each bone piece while ensuring the consistency of the global transformation. We used our method to calculate the optimal surgical plan for 23 patients, obtaining a significant reduction of malformations (p < 0.001) between 40.38% and 50.85% in the simulated outcome of the surgery using different osteotomy templates. In addition, malformation values were within healthy ranges (p > 0.01).