International journal of computer assisted radiology and surgery
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Int J Comput Assist Radiol Surg · Jan 2017
The production of digital and printed resources from multiple modalities using visualization and three-dimensional printing techniques.
Virtual digital resources and printed models have become indispensable tools for medical training and surgical planning. Nevertheless, printed models of soft tissue organs are still challenging to reproduce. This study adopts open source packages and a low-cost desktop 3D printer to convert multiple modalities of medical images to digital resources (volume rendering images and digital models) and lifelike printed models, which are useful to enhance our understanding of the geometric structure and complex spatial nature of anatomical organs. ⋯ We present an available and cost-effective method for producing both digital resources and printed models. The choice of modality in medical images and the processing approach is important when reproducing soft tissue organs models. The accuracy of the printed model is determined by the quality of organ models and 3DP. With the ongoing improvement of printing techniques and the variety of materials available, 3DP will become an indispensable tool in medical training and surgical planning.
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Int J Comput Assist Radiol Surg · Jan 2017
Review Comparative Study2D versus 3D fluoroscopy-based navigation in posterior pelvic fixation: review of the literature on current technology.
Percutaneous sacroiliac (SI) fixation of unstable posterior pelvic ring injuries is a widely accepted procedure. The complex sacral anatomy with narrow osseous corridors for SI screw placement makes this procedure technically challenging. Techniques are constantly evolving as a result of better understanding of the posterior pelvic anatomy. Recently developed tools include fluoroscopy-based computer-assisted navigation, which can be two-dimensional (2D) or three-dimensional (3D). Our goal is to determine the relevant technical considerations and clinical outcomes associated with these modalities by reviewing the published research. We hypothesize that 3D fluoroscopy-based navigation is safer and superior to its 2D predecessor with respect to lower radiation dose and more accurate SI screw placement. ⋯ It may be advantageous to combine modern imaging modalities such as 3D fluoroscopy with computer-assisted navigation for percutaneous screw fixation in the posterior pelvis.
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Int J Comput Assist Radiol Surg · Jan 2017
Automated multiple trajectory planning algorithm for the placement of stereo-electroencephalography (SEEG) electrodes in epilepsy treatment.
About one-third of individuals with focal epilepsy continue to have seizures despite optimal medical management. These patients are potentially curable with neurosurgery if the epileptogenic zone (EZ) can be identified and resected. Stereo-electroencephalography (SEEG) to record epileptic activity with intracranial depth electrodes may be required to identify the EZ. Each SEEG electrode trajectory, the path between the entry on the skull and the cerebral target, must be planned carefully to avoid trauma to blood vessels and conflicts between electrodes. In current clinical practice trajectories are determined manually, typically taking 2-3 h per patient (15 min per electrode). Manual planning (MP) aims to achieve an implantation plan with good coverage of the putative EZ, an optimal spatial resolution, and 3D distribution of electrodes. Computer-assisted planning tools can reduce planning time by quantifying trajectory suitability. ⋯ MTP is computationally efficient, determining implantation plans containing 7-12 electrodes within 1 min, compared to 2-3 h for MP.