Registration of magnetic resonance and computed tomography images in patients with oral squamous cell carcinoma for three-dimensional virtual planning of mandibular resection and reconstruction

M Polfliet,M.S Hendriks,J.-M Guyader,I Ten Hove,H Mast,J Vandemeulebroucke,A Van Der Lugt,E.B Wolvius,S Klein

doi:10.1016/j.ijom.2021.01.003

Abstract

The aim of this study was to evaluate and present an automated method for registration of magnetic resonance imaging (MRI) and computed tomography (CT) or cone beam CT (CBCT) images of the mandibular region for patients with oral squamous cell carcinoma (OSCC). Registered MRI and (CB)CT could facilitate the three-dimensional virtual planning of surgical guides employed for resection and reconstruction in patients with OSCC with mandibular invasion. MRI and (CB)CT images were collected retrospectively from 19 patients. MRI images were aligned with (CB)CT images employing a rigid registration approach (stage 1), a rigid registration approach using a mandibular mask (stage 2), and two non-rigid registration approaches (stage 3). Registration accuracy was quantified by the mean target registration error (mTRE), calculated over a set of landmarks annotated by two observers. Stage 2 achieved the best registration result, with an mTRE of 2.5±0.7mm, which was comparable to the inter- and intra-observer variabilities of landmark placement in MRI. Stage 2 was significantly better aligned compared to all approaches in stage 3. In conclusion, this study demonstrated that rigid registration with the use of a mask is an appropriate image registration method for aligning MRI and (CB)CT images of the mandibular region in patients with OSCC.

Highlights

0901-5027/01001386 + 08 ã 2021 The Author(s)
The aim of this study was to evaluate and present an automated method to perform image registration of magnetic resonance imaging (MRI) and (CB) computed tomography (CT) in the mandibular region in patients with Oral squamous cell carcinoma (OSCC), which could subsequently be integrated into a pipeline for the virtual planning of mandibular resections and reconstructions
This study showed that the rigid registration with a mask is the recommended method for registering MRI and (CB)CT images in the mandibular region

Summary

Introduction

0901-5027/01001386 + 08 ã 2021 The Author(s). Published by Elsevier Inc. on behalf of International Association of Oral and Maxillofacial Surgeons. Achieving tumour-free resection margins is challenging, but crucial for disease control and survival[1,3,7,8,9,10,11,12]. The state-of-the-art mandibular reconstruction method is based on preoperative three-dimensional (3D) virtual surgical planning using 3D-printed surgical guides[12,13,14]. With this method, the patient undergoes the necessary imaging, after which the surgeon virtually defines the cutting planes and plans the resection and subsequent reconstruction. Accurate 3D virtual planning of the surgical cutting guides remains essential in order to achieve a complete resection

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Conclusion