Image-guided planning system for skull correction in children with craniosynostos

描述（由申请人提供）：颅缝闭合症是颅缝合线过早融合，大约每2000例活产婴儿中发生一例。它会导致颅内畸形，从而导致颅内压升高、脑生长障碍和发育缺陷。颅缝闭锁最常见的治疗选择是手术。目前颅缝闭锁的手术治疗方案大多是定性的、主观的、不可复制的，主要由外科医生的经验指导。虽然虚拟规划已经成功地应用于颅面外科的小众领域，如颌矫正手术的应用，但目前还不存在能够提供准确和可重复的颅形态评估来指导颅穹窿重塑的临床工具。为了弥补目前临床实践中的这一空白，我们将为颅缝闭合的婴儿制定个性化的术前计划，以减少手术时间和出血量，从而减少围手术期的发病率，同时也促进优化和更持久的长期结果。在这个第一阶段的STTR项目中，我们的目标是设计、开发和验证一个虚拟手术系统，以实现颅骨重塑的最佳治疗计划。该计划包括创建一个规范的多图谱数据库，以捕获颅骨形状和患者年龄的广泛正常变化，开发图像处理和统计形状分析算法，以确定理想的术后颅骨形状，并分析颅骨的生物力学特性以评估截骨计划。外科医生将获得患者颅骨畸形的视觉和定量图，治疗后所需的颅骨形状，以及如何以最小的侵入方式改变颅骨形状以最准确地接近正常头部形状的个性化计划。我们的技术的影响是减少围手术期的发病率和降低治疗费用。该技术还可以对颅拱顶重建前后的测量结果进行精确、定量的比较，以确定特定重建技术的有效性和耐久性。

DESCRIPTION (provided by applicant): Craniosynostosis is the premature fusion of cranial sutures and occurs in approximately one in 2000 live births. It results in cranial malformation that can lead to elevated intra-cranial pressure, brain growth impairment, and developmental deficiency. The most common treatment option for craniosynostosis is surgery. Currently, surgical treatment planning of craniosynostosis is mostly qualitative, subjective and irreproducible guided mainly by the surgeon's experience. While virtual planning has been successfully introduced in niche areas of craniofacial surgery, such as corrective jaw surgery applications, clinical tools that provide accurate and reproducible evaluation of cranial morphology to guide cranial vault remodeling do not yet exist. To cover this gap in current clinical practice, we will develop personalized preoperative planning for infants with craniosynostosis that allows for decreased operative time and blood loss, thereby reducing perioperative morbidity, but also facilitates an optimized and more durable long-term outcome. In this Phase I STTR project, our goal is to design, develop and validate a virtual surgery system for optimal treatment planning for cranial remodeling. The plan includes creating a normative multi-atlas database to capture a wide breadth of normal variations on cranial shape and patient ages, developing image processing and statistical shape analysis algorithms to identify desirable post-operative skull shapes, and analyzing biomechanical properties of cranial bones to evaluate osteotomy plans. The surgeon will be presented with a visual and quantitative map of the patient's cranial malformations, the desired post-treatment cranial shape, and a personalized plan of how cranial shape should be altered in the least invasive fashion to most accurately approach the normal head shape. The impact of our technology is reduced perioperative morbidity and lower treatment costs. The technology will also enable the precise, quantitative comparison of measurements before and after cranial vault reconstruction to determine the efficacy and durability of specific reconstructive techniques.