A Novel Imaging Informatics Platform for Craniomaxillofacial Surgery

描述(申请人提供)：该项目的最终目标是开发一个开源的新型影像信息学平台--AntopicAligner，以改进颅颌面(CMF)手术的手术规划方法，并随后改善CMF畸形患者的治疗结果。CMF手术包括矫正颅骨和面部的先天性和获得性畸形。由于CMF骨骼的复杂性，它需要广泛的术前计划。不幸的是，传统的规划方法，如预测跟踪和对结石模型的模拟手术在过去的50年里没有变化。许多不想要的手术结果是这些有缺陷的方法的结果。为了解决这些问题，我们开发了一个计算机辅助手术模拟(CASS)系统。虽然CASS方法还需要改进，但它的使用已经消除了传统方法的大部分局限性。不幸的是，这也带来了一个新的问题，即牙齿咬合的数字化建立变得更加困难。在矫正先前存在的错牙合或通过手术重建新的咬合的计划过程中，牙科关节是一个重要的步骤。目前的黄金标准是利用石牙模型，并在牙合架上手工咬合它们。不幸的是，在虚拟世界中情况并非如此。这些牙弓是3D图像。当数字牙齿相互移动时，它们不会因碰撞而停止，并继续通过彼此移动，这在现实世界中是不会发生的。为了彻底解决这些问题，开发一种新的系统至关重要，该系统将整合牙齿咬合的全自动化过程，并显著改进我们的CASS技术。我们的假设是，可以在计算机规划系统中以数字方式自动建立咬合关系，计算机生成的咬合关系与通过手动连接一组石头模型建立的咬合关系一样精确(目前的黄金标准)。为了证明我们的假设，我们提出了三个具体目标，以开发和验证一个用于CMF手术的新型成像信息学平台--解剖学Aligner。该系统是创新的，因为医生将第一次能够在计算机中高效而准确地计划整个手术，包括自动建立牙齿咬合。新的技术贡献包括：1)一种稳健的基于3D分割的方法来实现初始数字牙模型对齐；以及2)自动最终数字发音的新方法。这个项目的意义在于，AntopicAligner系统将在CMF规划中产生范式转换。外科医生将能够完全放弃有问题的传统方法，转而采用更准确、更快、更具成本效益的方法。AntopicAligner的成功将为CMF手术带来一类新的影像信息学平台。这个平台还可以转型为骨科等医学专业。一旦完成，该软件(包括源代码和可执行文件)将由研究团体从互联网上免费下载。

DESCRIPTION (provided by applicant): The ultimate goal of this project is to develop an open source novel imaging informatics platform, the AnatomicAligner, to improve the surgical planning method for craniomaxillofacial (CMF) surgery and subsequently to improve the treatment outcome of the patients with CMF deformities. CMF surgery involves the correction of congenital and acquired deformities of the skull and face. Due to the complex nature of the CMF skeleton, it requires extensive presurgical planning. Unfortunately, the traditional planning methods, e.g. prediction tracings and simulating surgery on stone models have remained unchanged over the last 50 years. Many unwanted surgical outcomes are the result of these deficient methods. To solve these problems, we have developed a Computer-Aided Surgical Simulation (CASS) system. Although it still needs significant improvements, the use of CASS has eliminated most of the limitations of the traditional methods. Unfortunately, it also creates a new problem that the digital establishment of dental occlusion becomes significantly more difficult. The dental articulation is an important step during the planning process to correct preexisting malocclusions or to surgically reestablish a new occlusion. The current gold standard is to utilize stone dental models and hand-articulate them on an articulator. Unfortunately, the same is not true in virtual world. These dental arches are 3D images. When the digital teeth are moved towards each other, they are not stopped by collision and continue to move through each other, which do not occur in real world. In order to completely solve these problems, it is critical to develop a new system that will integrate fully automated process of dental articulation and significantly improved our CASS technologies. Our hypotheses are that the occlusion can be digitally and automatically established in a computer planning system, and the computer-generated occlusion is as precise as the occlusion established by hand-articulating a set of stone models (the current gold standard). In order to prove our hypotheses, we are proposing three Specific Aims to develop and validate a novel imaging informatics platform, the AnatomicAligner, for CMF surgery. The system is innovative because for the first time, doctors will be able to efficiently and accurately plan the entire surgery in the computer, including automated establishment of dental occlusion. The new technical contributions include: 1) a robust 3D segmentation-based approach to achieve the initial digital dental model alignment; and 2) novel approaches for automated final digital articulation. The significance of this project is that the AnatomicAligner system will produce a paradigm shift in CMF planning. Surgeons will be able to completely abandon the problematic traditional methods for a more accurate, faster and cost effective method. The success of AnatomicAligner will lead to a new class of imaging informatics platform for CMF surgery. This platform can also be transformed to orthopedic surgery and other medical specialties. Once completed, the software (both source codes and executables) will be freely downloaded from internet by research community.