A Novel Imaging Informatics Platform for Craniomaxillofacial Surgery

描述（由申请人提供）：该项目的最终目标是开发一种开源的新型成像信息学平台AnatomicAligner，以改善颅颌面（CMF）手术的手术计划方法，并随后改善CMF畸形患者的治疗结果。CMF手术涉及颅骨和面部先天性和后天畸形的矫正。由于CMF骨骼的复杂性，它需要广泛的术前计划。不幸的是，传统的计划方法，例如预测跟踪和模拟手术的石头模型在过去的50年里一直保持不变。许多不必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（卡斯）系统。虽然它仍然需要显着的改进，卡斯的使用已经消除了传统方法的大部分局限性。不幸的是，它也产生了一个新的问题，即牙咬合的数字建立变得更加困难。在计划过程中，牙关节是一个重要的步骤，以纠正先前存在的错牙合或手术重建一个新的咬合。目前的黄金标准是利用石牙模型，并在咬合架上手动连接它们。但在虚拟世界中，情况并非如此。这些牙弓是3D图像。当数字牙齿朝向彼此移动时，它们不会因碰撞而停止，而是继续移动穿过彼此，这在真实的世界中不会发生。 为了彻底解决这些问题，关键是要开发一种新的系统，它将集成全自动化的牙齿连接过程，并显着改善我们的卡斯技术。我们的假设是，闭塞可以数字化和自动建立在计算机规划系统中，和计算机生成的闭塞是一样精确的闭塞建立了一套石头模型（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，以开发和验证一种新的成像信息学平台，解剖对准，CMF手术。该系统具有创新性，因为医生将首次能够在计算机中高效准确地规划整个手术，包括自动建立牙齿咬合。新的技术贡献包括：1）一个强大的基于3D分割的方法，以实现初始数字牙模型对齐;和2）自动化最终数字关节的新方法。该项目的意义在于AnatomicAligner系统将在CMF计划中产生范式转变。外科医生将能够完全放弃有问题的传统方法，以获得更准确，更快速和更具成本效益的方法。AnatomicAligner的成功将为CMF手术带来一类新的成像信息学平台。该平台还可以转化为骨科手术和其他医疗专业。完成后，研究团体将从互联网上免费下载该软件（包括源代码和可执行文件）。

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.