Abstract
Reconstructing a large skull defect is a challenge, as it normally involves the use of sophisticated proprietary image processing and expensive CAD software. As an alternative, open-source software can be used for this purpose. This study aimed to compare the 3D cranial implants reconstructed from computed tomography (CT) images using the open-source MITK software with commercial 3-matic software for ten decompressive craniectomy patients. The shape-based interpolation method was used, in which the technique of segmenting every fifth and tenth slice of CT data was performed. The final design of patient-specific implants from both software was exported to STL format for analysis. The results of the Kruskal–Wallis test for the surface and volume of cranial implants designed using 3-matic and the two MITK techniques showed no significant difference, p > 0.05. The results of the Hausdorff Distance (HD) and Dice Similarity Coefficient (DSC) analyses for cranial implants designed using 3-matic software and the two different MITK techniques showed that the average points distance for 3-matic versus MITK was 0.28 mm (every tenth slice) and 0.15 mm (every fifth slice), and the similarity between 3-matic and MITK on every tenth and fifth slices were 85.1% and 89.7%, respectively. The results also showed that the open-source MITK software is comparable with the commercial software for designing patient-specific implants.
Highlights
The three-dimensional (3D) reconstruction of the craniofacial region is a challenge if involving a very large defect, and it requires the use of sophisticated proprietary image processing and expensive computer-aided design (CAD) software
The surgical procedure for managing large defects of the skull was complicated as it must be performed manually based on two-dimensional (2D) imaging, namely the shaping, modelling, and placement of the implant, which is made of bone grafts, bone cement, or titanium meshes
With the advance in computer and additive manufacturing (AM) technology, an implant that exactly fits the defect can be manufactured pre-operatively from the radiographic data obtained from computed tomography (CT) scans
Summary
The three-dimensional (3D) reconstruction of the craniofacial region is a challenge if involving a very large defect, and it requires the use of sophisticated proprietary image processing and expensive computer-aided design (CAD) software. The surgical procedure for managing large defects of the skull was complicated as it must be performed manually based on two-dimensional (2D) imaging, namely the shaping, modelling, and placement of the implant, which is made of bone grafts, bone cement, or titanium meshes. Using this conventional method resulted in long and complex operations with poor aesthetic results. Studies reported the advantages of using several different computer-aided designs and computer-aided manufacturing (CAD/CAM) platforms [2], which resulted in perfectly fitted implants, less surgery time, and better aesthetic results [3]. This requires highquality computer hardware that can be costly, on top of the price of the CAD software [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
