Feasibility of virtual surgical simulation in the head and neck region for soft tissue reconstruction using free flap: a comparison of preoperative and postoperative volume measurement

Yokoi, Shigeki; Nishio, Naoki; Fujimoto, Yoshiyuki; Fujii, Masazumi; Iwami, Kenichiro; Hayashi, Yuichiro; Takanari, Keisuke; Hiramatsu, Masayuki; Mutoh, T.; Mukoyama, Nobuaki; Tsuzuki, Hidenori; Wada, Akihisa; Kamei, Yuzuru

doi:10.1016/j.ijom.2020.07.025

Cited by 8 publications

(3 citation statements)

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“…In addition, a subsequent flap shrinkage must be taken into account. It is recommended to include this shrinkage in the flap size planning beforehand [ 18 , 19 ]. Due to the possibility of precisely determining the volume of the resection cavity with the presented method, it could also help to calculate the amount of overcorrection.…”

Section: Discussionmentioning

confidence: 99%

Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery

et al. 2023

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Digital twins derived from 3D scanning data were developed to measure soft tissue deformation in head and neck surgery by an artificial intelligence approach. This framework was applied suggesting feasibility of soft tissue shift detection as a hitherto unsolved problem. In a pig head cadaver model 104 soft tissue resection had been performed. The surface of the removed soft tissue (RTP) and the corresponding resection cavity (RC) was scanned (N = 416) to train an artificial intelligence (AI) with two different 3D object detectors (HoloLens 2; ArtecEva). An artificial tissue shift (TS) was created by changing the tissue temperature from 7,91±4,1°C to 36,37±1,28°C. Digital twins of RTP and RC in cold and warm conditions had been generated and volumes were calculated based on 3D surface meshes. Significant differences in number of vertices created by the different 3D scanners (HoloLens2 51313 vs. ArtecEva 21694, p<0.0001) hence result in differences in volume measurement of the RTC (p = 0.0015). A significant TS could be induced by changing the temperature of the tissue of RC (p = 0.0027) and RTP (p = <0.0001). RC showed more correlation in TS by heating than RTP with a volume increase of 3.1 μl or 9.09% (p = 0.449). Cadaver models are suitable for training a machine learning model for deformable registration through creation of a digital twin. Despite different point cloud densities, HoloLens and ArtecEva provide only slightly different estimates of volume. This means that both devices can be used for the task.TS can be simulated and measured by temperature change, in which RC and RTP react differently. This corresponds to the clinical behaviour of tumour and resection cavity during surgeries, which could be used for frozen section management and a range of other clinical applications.

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Section: Discussionmentioning

confidence: 99%

Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery

et al. 2023

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“…To achieve complete en bloc resection of the tumor, accurate preoperative evaluation of tumor invasion based on CT and MRI and careful discussion among a multidisciplinary skull base surgery team are essential. A recent surgical virtual simulation using patient's original CT images is very helpful for bone resection and tissue reconstruction in extended craniofacial resection in the head and neck cancer, 17,26 enabling surgeons to understand the complicated skull base anatomy and to teach the surgical technique to young surgeons.…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy for Squamous Cell Carcinoma of the External Auditory Canal: Management of Locally Advanced Cases with Skull Base Involvement

Goto

Nishio

Iwami

et al. 2022

J Neurol Surg B Skull Base

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Objective Surgical indications for advanced-stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) are highly dependent on the skull base surgery team. The aim of this study was to evaluate the surgical outcomes in patients with SCC of the EAC and to clarify the surgical indication of far advanced cases using the T4-subclassification. Methods Patients with SCC of the EAC who underwent curative treatment from 2002-2021 were retrospectively reviewed at our hospital. Clinical and surgical results, including operative data, overall survival (OS), and disease-specific survival (DSS) were analyzed. To clarify the surgical indication for advanced stage, we proposed the T4-subclassification. Results In 46 patients, the tumors were in T1 stage in 8 patients, T2 in 10, T3 in 5, and T4 in 23. The 5-year DSS with T1, T2, T3, and T4 tumors were 100%, 85.7%, 100%, and 61.7%, respectively. No prognostic impacts for margin status were found between the 5-year OS and DSS (p = 0.23 and p = 0.13). Patients with far advanced stage (T4b) tumors were significantly associated with shorter DSS than those with early stage (T1/T2) and advanced stage (T3/T4a) tumors (p = 0.007 and p = 0.03). Conclusion The present study focused on patients with SCC of the EAC at a University hospital over a period of 20-years, especially with skull base involvement, and a T4-subclassification was proposed. Complete tumor resection in an en bloc fashion could help to achieve a good survival rate even in patients with locally advanced tumors.

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“…In addition, a subsequent flap shrinkage must be taken into account. It is recommended to include this shrinkage in the flap size planning beforehand (15,16). Due to the possibility of precisely determining the volume of the resection cavity with the presented method, it could also help to calculate the amount of overcorrection.…”

Section: Fig 5: Volume As a Function Of Tissue Type And Temperaturementioning

confidence: 99%

Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery

Männle

Pohlmann

Monji-Azad

et al. 2023

Preprint

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Introduction: Digital twins derived from 3D scanning data were developed to measure soft tissue deformation in head and neck surgery by an artificial intelligence approach. This framework was applied suggesting feasibility of soft tissue shift detection as a hitherto unsolved problem. Methods: In a pig head cadaver model 104 soft tissue resection had been performed. The surface of the removed soft tissue (RTP) and the corresponding resection cavity (RC) was scanned (N=416) to train an artificial intelligence (AI) with two different 3D object detectors (HoloLens 2; ArtecEva). An artificial tissue shift (TS) was created by changing the tissue temperature from 7,91±4,1°C to 36,37±1,28°C. Results: Digital twins of RTP and RC in cold and warm conditions had been generated and volumes were calculated based on 3D surface meshes. Significant differences in number of vertices created by the different 3D scanners (HoloLens2 51313 vs. ArtecEva 21694, p<0.0001) hence result in differences in volume measurement of the RTC (p=0.0015). A significant TS could be induced by changing the temperature of the tissue of RC (p=0.0027) and RTP (p=<0.0001). RC showed more correlation in TS by heating than RTP with a volume increase of 3.1 μl or 9.09% (p=0.449). Conclusions: Cadaver models are suitable for training a machine learning model for deformable registration through creation of a digital twin. Despite different point cloud densities, HoloLens and ArtecEva provide only slightly different estimates of volume. This means that both devices can be used for the task.TS can be simulated and measured by temperature change, in which RC and RTP react differently. This corresponds to the clinical behaviour of tumour and resection cavity during surgeries, which could be used for frozen section management and a range of other clinical applications.

show abstract

Feasibility of virtual surgical simulation in the head and neck region for soft tissue reconstruction using free flap: a comparison of preoperative and postoperative volume measurement

Cited by 8 publications

References 22 publications

Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery

Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery

Surgical Strategy for Squamous Cell Carcinoma of the External Auditory Canal: Management of Locally Advanced Cases with Skull Base Involvement

Artificial intelligence directed development of a digital twin to measure soft tissue shift during head and neck surgery

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