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Patient-Specific Three-Dimensional Composite Bone Models for Teaching and Operation Planning
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Institution: |
Surgical Planning Laboratory, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA. |
Publisher: |
J Digit Imaging |
Publication Date: |
Oct-2009 |
Citation: |
J Digit Imaging. 2009 Oct;22(5):473-82. |
PubMed ID: |
17885790 |
Keywords: |
3D Imaging, fluoroscopy, tomography, orthopedic surgery, operation planning, composite bone model |
Appears in Collections: |
SPL |
Generated Citation: |
Matthews F, Messmer P, Raikov V, Wanner G, Jacob A, Regazzoni P, Egli A. Patient-Specific Three-Dimensional Composite Bone Models for Teaching and Operation Planning. J Digit Imaging. 2009 Oct;22(5):473-82. PMID: 17885790. |
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| Paper: | Download, View online |
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Orthopedic trauma care relies on two-dimensional radiograms both before and during the operation. Understanding the three-dimensional nature of complex fractures on plain radiograms is challenging. Modern fluoroscopes can acquire three-dimensional volume datasets even during an operation, but the device limitations constrain the acquired volume to a cube of only 12-cm edge. However, viewing the surrounding intact structures is important to comprehend the fracture in its context. We suggest merging a fluoroscope's volume scan into a generic bone model to form a composite full-length 3D bone model. Methods: Materials consisted of one cadaver bone and 20 three-dimensional surface models of human femora. Radiograms and computed tomography scans were taken before and after applying a controlled fracture to the bone. A 3D scan of the fracture was acquired using a mobile fluoroscope (Siemens Siremobil). The fracture was fitted into the generic bone models by rigid registration using a modified least-squares algorithm. Registration precision was determined and a clinical appraisal of the composite models obtained. Results: Twenty composite bone models were generated. Average registration precision was 2.0 mm (range 1.6 to 2.6). Average processing time on a laptop computer was 35 s (range 20 to 55). Comparing synthesized radiograms with the actual radiograms of the fractured bone yielded clinically satisfactory results. Conclusion: A three-dimensional full-length representation of a fractured bone can reliably be synthesized from a short scan of the patient's fracture and a generic bone model. This patient-specific model can subsequently be used for teaching, surgical operation planning, and intraoperative visualization purposes.
Additional Material
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Matthews-JDigitImaging2007-fig6.jpg (209.246kB)