scholarly journals Liver 3D modeling and hepatectomy simulation for the residents’ preoperative education

2015 ◽  
Author(s):  
Apollon Zygomalas ◽  
Vasileios Megalooikonomou ◽  
Dimitrios Koutsouris ◽  
Dimitrios Karavias ◽  
Ioannis Karagiannidis ◽  
...  
Keyword(s):  
Liver Resection ◽  
3D Modeling ◽  
Preoperative Planning ◽  
Medical Images ◽  
Patient Specific ◽  
Computer Assisted ◽  
Liver Imaging ◽  
Liver Segmentation ◽  
Preoperative Education ◽  
Liver Remnant

Background. Liver segmentation from medical images produces high quality patient specific 3D liver models which are used for preoperative planning and intraoperative guidance. These 3D models can be manipulated and visualized in various ways and can be useful for residents’ education. Objective. The aim of this study was to evaluate the implementation of a novel liver segmentation and hepatectomy simulation application as a tool for the residents’ preoperative education. Method. We developed in MATLAB® 2013a a liver segmentation and preoperative planning application. Ten liver imaging datasets of a prospectively selected random sample of patients undergoing elective hepatectomies at our institution were used for liver segmentation and 3D modeling. Residents were asked to identify anatomical and pathological structures and propose liver resection plans. Intraoperatively, they could consult the computer models in real time. Their surgical scenarios were evaluated and discussed with specialized liver surgeons. Learning objectives were defined and their accomplishment was evaluated using the Kirkpatrick’s four levels model. Results. The residents learned to 1) identify anatomical and pathological structures 2) calculate future liver remnant volume (FLR) from segmented liver images 3) propose liver resection plans based on FLR and liver vascular tree and tumor relations 4) consult liver medical images (CT and MRI) 5) understand the role of computer assisted surgery. They evaluated in-vivo their preoperative planning decisions and understood better the surgical operations. Conclusions. Our proposed liver segmentation and hepatectomy simulation application appears to be appropriate for the preoperative education of resident surgeons.

scholarly journals Liver 3D modeling and hepatectomy simulation for the residents’ preoperative education

2015 ◽  
Author(s):  
Apollon Zygomalas ◽  
Vasileios Megalooikonomou ◽  
Dimitrios Koutsouris ◽  
Dimitrios Karavias ◽  
Ioannis Karagiannidis ◽  
...  
Keyword(s):  
Liver Resection ◽  
3D Modeling ◽  
Preoperative Planning ◽  
Medical Images ◽  
Patient Specific ◽  
Computer Assisted ◽  
Liver Imaging ◽  
Liver Segmentation ◽  
Preoperative Education ◽  
Liver Remnant

Background. Liver segmentation from medical images produces high quality patient specific 3D liver models which are used for preoperative planning and intraoperative guidance. These 3D models can be manipulated and visualized in various ways and can be useful for residents’ education. Objective. The aim of this study was to evaluate the implementation of a novel liver segmentation and hepatectomy simulation application as a tool for the residents’ preoperative education. Method. We developed in MATLAB® 2013a a liver segmentation and preoperative planning application. Ten liver imaging datasets of a prospectively selected random sample of patients undergoing elective hepatectomies at our institution were used for liver segmentation and 3D modeling. Residents were asked to identify anatomical and pathological structures and propose liver resection plans. Intraoperatively, they could consult the computer models in real time. Their surgical scenarios were evaluated and discussed with specialized liver surgeons. Learning objectives were defined and their accomplishment was evaluated using the Kirkpatrick’s four levels model. Results. The residents learned to 1) identify anatomical and pathological structures 2) calculate future liver remnant volume (FLR) from segmented liver images 3) propose liver resection plans based on FLR and liver vascular tree and tumor relations 4) consult liver medical images (CT and MRI) 5) understand the role of computer assisted surgery. They evaluated in-vivo their preoperative planning decisions and understood better the surgical operations. Conclusions. Our proposed liver segmentation and hepatectomy simulation application appears to be appropriate for the preoperative education of resident surgeons.

scholarly journals Virtual hepatic surgery scenarios using manipulated real liver models

2015 ◽  
Author(s):  
Apollon Zygomalas ◽  
Vasileios Megalooikonomou ◽  
Dimitrios Koutsouris ◽  
Dimitrios Karavias ◽  
Ioannis Karagiannidis ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Clinical Information ◽  
Patient Specific ◽  
Image Editing ◽  
Liver Imaging ◽  
Liver Segmentation ◽  
Hepatic Surgery ◽  
Liver Injuries ◽  
Segmentation Algorithms ◽  
Four Levels

Background. High quality patient specific 3D liver models can be nowadays exported using computer liver segmentation algorithms. Specific 3D image editing tools can be used to manipulate the liver models and create virtual surgical cases. Objective. The aim of our study was to create virtual hepatic surgery scenarios using a novel liver segmentation and preoperative planning application and evaluating it as an educational tool. Method. A liver segmentation and preoperative planning application was developed on MATLAB® 2013a. Special image editing tools were designed to allow manipulation of the exported 3D liver models. Three pathological and two liver imaging datasets from healthy patients were used for the validation. The 3D liver models which have been created after liver segmentation were then manipulated by; 1) changing tumors’ volumes, 2) adding tumors and 3) designing liver injuries. Addition fictitious clinical information were implemented. Residents were asked to study the virtual cases and propose resection plans. Their scenarios were evaluated and discussed with specialized liver surgeons. The Kirkpatrick’s four levels model of learning evaluation was used. Results. Up to 30 different virtual liver surgical cases were created. The number of virtual scenarios that could be designed is theoretically unlimited. The residents quickly and effectively learned to evaluate critical anatomical and pathological structures and propose liver resection plans considering liver surgery principles. Conclusions. Virtual hepatic surgery scenarios allowed for a rapid education without the need to wait for similar real cases. The proposed liver segmentation and hepatectomy simulation application can be used for educational purposes.

scholarly journals Virtual hepatic surgery scenarios using manipulated real liver models

2015 ◽  
Author(s):  
Apollon Zygomalas ◽  
Vasileios Megalooikonomou ◽  
Dimitrios Koutsouris ◽  
Dimitrios Karavias ◽  
Ioannis Karagiannidis ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Clinical Information ◽  
Patient Specific ◽  
Image Editing ◽  
Liver Imaging ◽  
Liver Segmentation ◽  
Hepatic Surgery ◽  
Liver Injuries ◽  
Segmentation Algorithms ◽  
Four Levels

Background. High quality patient specific 3D liver models can be nowadays exported using computer liver segmentation algorithms. Specific 3D image editing tools can be used to manipulate the liver models and create virtual surgical cases. Objective. The aim of our study was to create virtual hepatic surgery scenarios using a novel liver segmentation and preoperative planning application and evaluating it as an educational tool. Method. A liver segmentation and preoperative planning application was developed on MATLAB® 2013a. Special image editing tools were designed to allow manipulation of the exported 3D liver models. Three pathological and two liver imaging datasets from healthy patients were used for the validation. The 3D liver models which have been created after liver segmentation were then manipulated by; 1) changing tumors’ volumes, 2) adding tumors and 3) designing liver injuries. Addition fictitious clinical information were implemented. Residents were asked to study the virtual cases and propose resection plans. Their scenarios were evaluated and discussed with specialized liver surgeons. The Kirkpatrick’s four levels model of learning evaluation was used. Results. Up to 30 different virtual liver surgical cases were created. The number of virtual scenarios that could be designed is theoretically unlimited. The residents quickly and effectively learned to evaluate critical anatomical and pathological structures and propose liver resection plans considering liver surgery principles. Conclusions. Virtual hepatic surgery scenarios allowed for a rapid education without the need to wait for similar real cases. The proposed liver segmentation and hepatectomy simulation application can be used for educational purposes.

scholarly journals Computer-Assisted Planning and Three-Dimensional-Printed Patient-Specific Instrumental Guide for Corrective Osteotomy in Post-Traumatic Femur Deformity: A Case Report and Literature Review

2018 ◽  
Vol 24 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Lau Chi-Kay ◽  
Chui King-him ◽  
Lee Kin-bong ◽  
Li Wilson
Keyword(s):  
Lower Limb ◽  
New Technologies ◽  
Preoperative Planning ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Patient Specific ◽  
Computer Assisted ◽  
Limb Deformity ◽  
Satisfactory Outcome ◽  
Post Traumatic

Post-traumatic limb deformity is often multiplanar and thus is a difficult pathology to deal with surgically. Precise preoperative planning and accurate intraoperative execution are two main important steps that lead to satisfactory outcome. Computer-assisted planning and three-dimensional-printed patient-specific instrumental guides provide excellent aid to the two steps, respectively. We report a case of posttraumatic lower limb deformity in a patient who underwent closing wedge corrective osteotomy with the aid of the aforementioned new technologies.

scholarly journals Automatic Liver Segmentation on Volumetric CT Images Using Supervoxel-Based Graph Cuts

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Weiwei Wu ◽  
Zhuhuang Zhou ◽  
Shuicai Wu ◽  
Yanhua Zhang
Keyword(s):  
Liver Volume ◽  
Maximum Intensity Projection ◽  
Liver Slice ◽  
Graph Cuts ◽  
Ct Images ◽  
Patient Specific ◽  
Computer Assisted ◽  
Morphological Operations ◽  
Liver Segmentation ◽  
Abdominal Ct

Accurate segmentation of liver from abdominal CT scans is critical for computer-assisted diagnosis and therapy. Despite many years of research, automatic liver segmentation remains a challenging task. In this paper, a novel method was proposed for automatic delineation of liver on CT volume images using supervoxel-based graph cuts. To extract the liver volume of interest (VOI), the region of abdomen was firstly determined based on maximum intensity projection (MIP) and thresholding methods. Then, the patient-specific liver VOI was extracted from the region of abdomen by using a histogram-based adaptive thresholding method and morphological operations. The supervoxels of the liver VOI were generated using the simple linear iterative clustering (SLIC) method. The foreground/background seeds for graph cuts were generated on the largest liver slice, and the graph cuts algorithm was applied to the VOI supervoxels. Thirty abdominal CT images were used to evaluate the accuracy and efficiency of the proposed algorithm. Experimental results show that the proposed method can detect the liver accurately with significant reduction of processing time, especially when dealing with diseased liver cases.

Haptic computer-assisted patient-specific preoperative planning for orthopedic fractures surgery

2015 ◽  
Vol 10 (10) ◽  
pp. 1535-1546 ◽  
Author(s):  
I. Kovler ◽  
L. Joskowicz ◽  
Y. A. Weil ◽  
A. Khoury ◽  
A. Kronman ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Patient Specific ◽  
Computer Assisted

scholarly journals Automatic planning of paediatric craniofacial deformities: new virtual facial-symmetry operative detection

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Giuditta Mannelli ◽  
Antonio Marzola ◽  
Francesco Buonamici ◽  
Yari Volpe ◽  
Francesca Uccheddu ◽  
...  
Keyword(s):  
Preoperative Planning ◽  
Maxillofacial Surgery ◽  
Central Element ◽  
Patient Specific ◽  
Surgical Approaches ◽  
Computer Assisted ◽  
Case Presentation ◽  
Non Invasive ◽  
Automatic Planning ◽  
Orbital Region

Background: The correction of craniofacial deformities is an ongoing challenge in maxillofacial surgery. However, conventional measurement methods for treatment planning are not appropriate for craniofacial surgery. Computer-assisted approaches can improve surgical outcomes. A new, non-invasive, patient-specific automatic method, proposed here, has been tested for assisting the surgeon in preoperative planning. Case Presentation: In the case reported, the described method allows effective surgery planning that led to a significant decrease in asymmetries in the orbital region. Conclusion: The multidisciplinary collaborative approach is a central element for the construction of effective personalized procedures and for the conception of new surgical approaches. The here proposed technology offers a good level of feasibility and has an achievable potential for breakthroughs in the improvement of facial deformities surgical treatment, thus representing an overwhelmingly useful tool in a clinical setting.

Full tractography for detecting the position of cranial nerves in preoperative planning for skull base surgery: technical note

2020 ◽  
Vol 132 (5) ◽  
pp. 1642-1652 ◽  
Author(s):  
Timothee Jacquesson ◽  
Fang-Chang Yeh ◽  
Sandip Panesar ◽  
Jessica Barrios ◽  
Arnaud Attyé ◽  
...  
Keyword(s):  
Skull Base ◽  
Preoperative Planning ◽  
Skull Base Surgery ◽  
Cranial Nerves ◽  
Patient Specific ◽  
Small Scale ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Brain White Matter ◽  
Human Connectome Project

OBJECTIVEDiffusion imaging tractography has allowed the in vivo description of brain white matter. One of its applications is preoperative planning for brain tumor resection. Due to a limited spatial and angular resolution, it is difficult for fiber tracking to delineate fiber crossing areas and small-scale structures, in particular brainstem tracts and cranial nerves. New methods are being developed but these involve extensive multistep tractography pipelines including the patient-specific design of multiple regions of interest (ROIs). The authors propose a new practical full tractography method that could be implemented in routine presurgical planning for skull base surgery.METHODSA Philips MRI machine provided diffusion-weighted and anatomical sequences for 2 healthy volunteers and 2 skull base tumor patients. Tractography of the full brainstem, the cerebellum, and cranial nerves was performed using the software DSI Studio, generalized-q-sampling reconstruction, orientation distribution function (ODF) of fibers, and a quantitative anisotropy–based generalized deterministic algorithm. No ROI or extensive manual filtering of spurious fibers was used. Tractography rendering was displayed in a tridimensional space with directional color code. This approach was also tested on diffusion data from the Human Connectome Project (HCP) database.RESULTSThe brainstem, the cerebellum, and the cisternal segments of most cranial nerves were depicted in all participants. In cases of skull base tumors, the tridimensional rendering permitted the visualization of the whole anatomical environment and cranial nerve displacement, thus helping the surgical strategy.CONCLUSIONSAs opposed to classical ROI-based methods, this novel full tractography approach could enable routine enhanced surgical planning or brain imaging for skull base tumors.

Cervical 1-2 Posterior Instrumented Fusion Utilizing Computer-Assisted Navigation With Harvest of Rib Strut Autograft: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Timothy J Yee ◽  
Michael J Strong ◽  
Matthew S Willsey ◽  
Mark E Oppenlander
Keyword(s):  
Surface Area ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Patient Specific ◽  
Computer Assisted ◽  
Type Ii ◽  
Instrumented Fusion ◽  
Assisted Navigation ◽  
Patient Consent ◽  
Posterior Instrumented Fusion

Abstract Nonunion of a type II odontoid fracture after the placement of an anterior odontoid screw can occur despite careful patient selection. Countervailing factors to successful fusion include the vascular watershed zone between the odontoid process and body of C2 as well as the relatively low surface area available for fusion. Patient-specific factors include osteoporosis, advanced age, and poor fracture fragment apposition. Cervical 1-2 posterior instrumented fusion is indicated for symptomatic nonunion. The technique leverages the larger posterolateral surface area for fusion and does not rely on bony growth in a watershed zone. Although loss of up to half of cervical rotation is expected after C1-2 arthrodesis, this may be better tolerated in the elderly, who may have lower physical demands than younger patients. In this video, we discuss the case of a 75-yr-old woman presenting with intractable mechanical cervicalgia 7 mo after sustaining a type II odontoid fracture and undergoing anterior odontoid screw placement at an outside institution. Cervical radiography and computed tomography exhibited haloing around the screw and nonunion across the fracture. We demonstrate C1-2 posterior instrumented fusion with Goel-Harms technique (C1 lateral mass and C2 pedicle screws), utilizing computer-assisted navigation, and modified Sonntag technique with rib strut autograft.  Posterior C1-2-instrumented fusion with rib strut autograft is an essential technique in the spine surgeon's armamentarium for the management of C1-2 instability, which can be a sequela of type II dens fracture. Detailed video demonstration has not been published to date.  Appropriate patient consent was obtained.

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