Integration of high-resolution data for temporal bone surgical simulations

Abstract

Purpose To report on the state of the art in obtaining high-resolution 3D data of the microanatomy of the temporal bone and to process that data for integration into a surgical simulator. Specifically, we report on our experience in this area and discuss the issues involved to further the field. Data Sources Current temporal bone image acquisition and image processing established in the literature as well as in house methodological development. Review Methods We reviewed the current English literature for the techniques used in computer-based temporal bone simulation systems to obtain and process anatomical data for use within the simulation. Search terms included “temporal bone simulation, surgical simulation, temporal bone.” Articles were chosen and reviewed that directly addressed data acquisition and processing/segmentation and enhancement with emphasis given to computer based systems. We present the results from this review in relationship to our approach. Conclusions High-resolution CT imaging (≤100μm voxel resolution), along with unique image processing and rendering algorithms, and structure specific enhancement are needed for high-level training and assessment using temporal bone surgical simulators. Higher resolution clinical scanning and automated processes that run in efficient time frames are needed before these systems can routinely support pre-surgical planning. Additionally, protocols such as that provided in this manuscript need to be disseminated to increase the number and variety of virtual temporal bones available for training and performance assessment.

High-Resolution CT Imaging of the Temporal Bone: A Cadaveric Specimen Study

“…3D printing of the anatomy of the temporal bone utilizing higher spatial resolution CT for better detailed delineation of small osseous structures can be helpful for educational and surgical teaching. 26…”

“…3D printing of the anatomy of the temporal bone utilizing higher spatial resolution CT for better detailed delineation of small osseous structures can be helpful for educational and surgical teaching. 26 Limitations of this study includes a small sample size and use of cadaveric specimens, which was necessary to eliminate radiation dose from being a limiting factor in this comparative analysis. We used the FC35 standard sharp bone reconstruction kernel.…”

Further Validity Evidence for Patient‐Specific Virtual Reality Temporal Bone Surgical Simulation

“…10,11 Generally, patient-specific simulation might benefit not only the training of novices but also more experienced surgeons. 12 There are several challenges for feasible patient-specific simulation in temporal bone surgery such as accurate image processing to delineate anatomical structures that are key surgical landmarks and boundaries, 13 accurate haptic feedback, 14 realistic and real-time visualization with colorization, pattern tinting, and texturization of imaging datasets in VR simulation. 15 Time-consuming image processing [16][17][18] and/or 3D printing 5 might be among the limiting factors for implementation of patient-specific simulation into clinical practice.…”

Patient‐specific Virtual Temporal Bone Simulation Based on Clinical Cone‐beam Computed Tomography

“…Highquality models for temporal bone simulation training have traditionally been based on high-resolution imaging of cadaveric specimens and manual/semimanual processing to delineate key anatomy such as the facial nerve, chorda tympani, and lateral semicircular canal. 12 In contrast, patient-specific simulation requires the simulation to be (1) based on clinical imaging with a limited radiation dose, resulting in lower signal-to-noise ratio and resolution, and (2) clinically feasible and therefore dependent on automated processing routines to limit time-consuming manual processes and surgeon involvement in the generation of the model. Altogether, for patient-specific simulation to be useful, the surgeon or trainee must derive benefit from the simulation with regard to perceiving the rehearsal as realistic (e.g., providing visual and tactile cues) and the simulated anatomy needs to accurately correlate with the patient's actual surgical anatomy.…”