Three-dimensional photography for intraoperative morphometric analysis in metopic craniosynostosis surgery

• Published in: International journal for computer assisted radiology and surgery Vol. 16; no. 2; pp. 277 - 287
• Main Authors: García-Mato, David, García-Sevilla, Mónica, Porras, Antonio R., Ochandiano, Santiago, Darriba-Allés, Juan V., García-Leal, Roberto, Salmerón, José I., Linguraru, Marius George, Pascau, Javier
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-02-2021; Springer Nature B.V
• Subjects: Child, Preschool; Computed tomography; Computer Imaging; Computer Science; Craniosynostoses - surgery; Error analysis; Evaluation; Female; Forehead; Health Informatics; Humans; Image reconstruction; Imaging; Imaging, Three-Dimensional; Infant; Ionizing radiation; Male; Medicine; Medicine & Public Health; Model accuracy; Morphology; Original Article; Pattern Recognition and Graphics; Photography; Plastic Surgery Procedures - methods; Radiology; Skull - surgery; Surgery; Three dimensional models; Tomography, X-Ray Computed - methods; Vision; Workflow; Shape analysis; 3D photography; Craniosynostosis; Surgery; Outcome
• ISSN: 1861-6410; 1861-6429
• DOI: 10.1007/s11548-020-02301-0

Purpose
Surgical correction of metopic craniosynostosis typically involves open cranial vault remodeling. Accurate translation of the virtual surgical plan into the operating room is challenging due to the lack of tools for intraoperative analysis of the surgical outcome. This study aimed to evaluate the feasibility of using a hand-held 3D photography device for intraoperative evaluation and guidance during cranial vault surgical reconstruction.
Methods
A hand-held structured light scanner was used for intraoperative 3D photography during five craniosynostosis surgeries, obtaining 3D models of skin and bone surfaces before and after the remodeling. The accuracy of this device for 3D modeling and morphology quantification was evaluated using preoperative computed tomography imaging as gold-standard. In addition, the time required for intraoperative 3D photograph acquisition was measured.
Results
The average error of intraoperative 3D photography was 0.30 mm. Moreover, the interfrontal angle and the transverse forehead width were accurately measured in the 3D photographs with an average error of 0.72 degrees and 0.62 mm. Surgeon’s feedback indicates that this technology can be integrated into the surgical workflow without substantially increasing surgical time.
Conclusion
Hand-held 3D photography is an accurate technique for objective quantification of intraoperative cranial vault morphology and guidance during metopic craniosynostosis surgical reconstruction. This noninvasive technique does not substantially increase surgical time and does not require exposure to ionizing radiation, presenting a valuable alternative to computed tomography imaging. The proposed methodology can be integrated into the surgical workflow to assist during cranial vault remodeling and ensure optimal surgical outcomes.