3D pediatric cranial bone imaging using high-resolution MRI for visualizing cranial sutures: a pilot study

Patel, Kamlesh B.; Eldeniz, Cihat; Skolnick, Gary B.; Jammalamadaka, Udayabhanu; Commean, Paul K.; Goyal, Manu; Smyth, Matthew D.; An, Hongyu

doi:10.3171/2020.4.peds20131

Cited by 18 publications

(11 citation statements)

References 40 publications

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“…Saariko et al compared BB-MR imaging using a T1 VIBE sequence and CT in nine pediatric patients and concluded that BB-MR imaging is a valid alternative to 3D-CT in the preoperative evaluation of patients with craniosynostosis [23]. In a further study, Patel et al concluded that BB imaging using a GA-VIBE sequence on a 3 T MRI is a promising method to achieve CT-like 3D cranial bone images in 11 pediatric patients [14].…”

Section: Discussionmentioning

confidence: 99%

“…In 2018, Kuusela et al used the variant of BB imaging derived from a T1 VIBE sequence, which was acquired using two echo times (in phase and out of phase), and applied this sequence to a study group of 15 pediatric patients [13]. Moreover, a fast low-angle shot goldenangle 3D stack-of-stars radial VIBE-(GA-VIBE-) based sequence on a 3 T MRI, with similar TR/TE and a flip angle of 3°was applied and evaluated in 11 pediatric patients [14]; however, 3D reconstruction and post-processing of the BB sequences are fairly extensive and time consuming, which still limits the application in the clinical routine. This problem was approached by automated segmentation techniques; however, these techniques were applied to BB-MR images of the skull of adults.…”

Section: Introductionmentioning

confidence: 99%

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CT-like MR-derived Images for the Assessment of Craniosynostosis and other Pathologies of the Pediatric Skull

et al. 2022

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Purpose To evaluate the diagnostic value of CT-like images based on a 3D T1-weighted spoiled gradient echo-based sequence (T1SGRE) for the visualization of the pediatric skull and the identification of pathologies, such as craniosynostosis or fractures. Methods In this prospective study, 20 patients with suspected craniosynostosis (mean age 1.26 ± 1.38 years, 10 females) underwent MR imaging including the T1SGRE sequence and 2 more patients were included who presented with skull fractures (0.5 and 6.3 years, both male). Additionally, the skull of all patients was assessed using radiography or CT in combination with ultrasound. Two radiologists, blinded to the clinical information, evaluated the CT-like images. The results were compared to the diagnosis derived from the other imaging modalities and intraoperative findings. Intrarater and interrater agreement was calculated using Cohen’s κ. Results Of the 22 patients 8 had a metopic, 4 a coronal and 2 a sagittal craniosynostosis and 2 patients showed a complex combination of craniosynostoses. The agreement between the diagnosis based on the T1SGRE and the final diagnosis was substantial (Cohen’s κ = 0.92, 95% confidence interval (CI) 0.77–1.00 for radiologist 1 and κ = 0.76, CI 0.51–1.00 for radiologist 2). Of the patients with fractures, one presented with a ping pong fracture and one with a fracture of the temporal bone. Both radiologists could identify the fractures using the T1SGRE. Conclusion The visualization of the pediatric skull and the assessment of sutures using a CT-like T1SGRE MR-sequence is feasible and comparable to other imaging modalities, and thus may help to reduce radiation exposure in pediatric patients. The technique may also be a promising imaging tool for other pathologies, such as fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CT-like MR-derived Images for the Assessment of Craniosynostosis and other Pathologies of the Pediatric Skull

et al. 2022

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“…Three-dimensional surface images provided by stereophotogrammetric photography allow for full representation of the entire contour of the head without ionizing radiation (Shah et al, 2011; Engel et al, 2012). As an aside, MR protocols, such as Black Bone MRI and GA-VIBE MRI, have been recently published as a new alternative to CT for pre- and postoperative evaluation of head shape (Patel et al, 2020; Saarikko et al, 2020). Three-dimensional photography has been shown to be equivalent to CT scans for anthropometric measurements (Mendonca et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Three-dimensional stereophotogrammetric photography is susceptible to hair artifacts as the child ages, which is not true with CT scans. Even though the risk of ionizing radiation can be significantly limited using special bone imaging protocols (Stewart et al, 2018), it seems clear that “ALARA” principles (As Low As Reasonably Achievable), as well as new MR protocols being developed, will only continue to favor limiting the use of CT for shape outcomes in studies of craniosynostosis outcomes (Patel et al, 2020; Saarikko et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Head Shape Outcomes in Metopic Synostosis Using Limited Strip Craniectomy and Open Vault Reconstruction Techniques

Pressler

Hallac

Geisler

et al. 2020

The Cleft Palate Craniofacial Journal

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Aim: Metopic craniosynostosis (MCS), with its trigonocephalic head shape, is often treated with either limited incision strip craniectomy (LISC) followed by helmet orthotic treatment, or open cranial vault reconstruction techniques (OCVR). There is controversy regarding resultant shape outcomes among craniofacial surgeons. Those adverse to LISC claim normal head shape is never attained, while proponents believe there is gradual correction to an equivalent outcome. This study aims to quantitate, over time, the three-dimensional (3D) head shapes in patients who have undergone LISC or OCVR intervention for MCS. Methods: Sixty-three 3D images of 26 patients with MCS were analyzed retrospectively. Head shape analyses were performed at: (1) preoperative, (2) 1-month postoperative, (3) 10 to 14 months postoperative (1 year), and (4) 2 years postoperative. Composite 3D head shapes of patients were compared at each time point. Two-dimensional (2D) standardized cross sections of the forehead were also compared. Results: Composite head shapes for both groups were nested, to allow visual comparison as the child’s forehead grows and expands. The difference between LISC and OCVR 2D cross sections was calculated; 108.26 mm preoperatively, 127.18 mm after 1-month postoperative, 51.05 mm after 10 to 14 months postoperative, and 27.03 mm after 2 years postoperative. Conclusions: This study found excellent head shape outcomes for both the LISC and OCVR techniques at 2 years of age. It also corroborates the slow and progressive improvement in head shape with the LISC technique. This study highlights the advantages of 3D photography for measurement of contour outcomes, utilizing both 2D vector and 3D whole head analytical techniques.

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“…The researchers rated each statement using a 5-point Likert scale [26][27][28] (ranging from 1 to 5 points with 1 = strongly disagree and 5 = strongly agree) to assess each image. The score of each statement was aggregated into a total for each image.…”

Section: Testmentioning

confidence: 99%

A novel 3D-vision–based collaborative robot as a scope holding system for port surgery: a technical feasibility study

Xiong

Zhang

Gan

et al. 2022

Neurosurgical Focus

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OBJECTIVE A clear, stable, suitably located vision field is essential for port surgery. A scope is usually held by hand or a fixing device. The former yields fatigue and requires lengthy training, while the latter increases inconvenience because of needing to adjust the scope. Thus, the authors innovated a novel robotic system that can recognize the port and automatically place the scope in an optimized position. In this study, the authors executed a preliminary experiment to test this system’s technical feasibility and accuracy in vitro. METHODS A collaborative robotic (CoBot) system consisting of a mechatronic arm and a 3D camera was developed. With the 3D camera and programmed machine vision, CoBot can search a marker attached to the opening of the surgical port, followed by automatic alignment of the scope’s axis with the port’s longitudinal axis so that optimal illumination and visual observation can be achieved. Three tests were conducted. In test 1, the robot positioned a laser range finder attached to the robot’s arm to align the sheath’s center axis. The laser successfully passing through two holes in the port sheath’s central axis defined successful positioning. Researchers recorded the finder’s readings, demonstrating the actual distance between the finder and the sheath. In test 2, the robot held a high-definition exoscope and relocated it to the setting position. Test 3 was similar to test 2, but a metal holder substituted the robot. Trained neurosurgeons manually adjusted the holder. The manipulation time was recorded. Additionally, a grading system was designed to score each image captured by the exoscope at the setting position, and the scores in the two tests were compared using the rank-sum test. RESULTS The CoBot system positioned the finder successfully in all rounds in test 1; the mean height errors ± SD were 1.14 mm ± 0.38 mm (downward) and 1.60 mm ± 0.89 mm (upward). The grading scores of images in tests 2 and 3 were significantly different. Regarding the total score and four subgroups, test 2 showed a more precise, better-positioned, and more stable vision field. The total manipulation time in test 2 was 20 minutes, and for test 3 it was 52 minutes. CONCLUSIONS The CoBot system successfully acted as a robust scope holding system to provide a stable and optimized surgical view during simulated port surgery, providing further evidence for the substitution of human hands, and leading to a more efficient, user-friendly, and precise operation.

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3D pediatric cranial bone imaging using high-resolution MRI for visualizing cranial sutures: a pilot study

Cited by 18 publications

References 40 publications

CT-like MR-derived Images for the Assessment of Craniosynostosis and other Pathologies of the Pediatric Skull

CT-like MR-derived Images for the Assessment of Craniosynostosis and other Pathologies of the Pediatric Skull

Comparison of Head Shape Outcomes in Metopic Synostosis Using Limited Strip Craniectomy and Open Vault Reconstruction Techniques

A novel 3D-vision–based collaborative robot as a scope holding system for port surgery: a technical feasibility study

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