Slicer Software Research Articles

Cephalometric Analysis of Maxillary Sinus for Gender Determination Using Lateral Cephalogram: A Novel Retrospective Study in the North Indian Population.

Underlying disorders of the maxillary sinus (MS), including a history of sinus surgeries, chronic sinusitis, or congenital anomalies can potentially impact sinus function and structure, necessitating careful evaluation and management. Moreover, intact sinuses are crucial in gender determination in forensic anthropology. The present study was undertaken to check the accuracy and reliability of MS in gender determination using morphometric parameters. This retrospective study was carried out on 74 lateral cephalograms (37 males and 37 females) aged between 18 to 50 years from the North Indian population. The MS area was measured using a NewTom CBCT machine (NewTom,Imola, Italy) with slicer software. The anatomical landmarks for the sinus were identified, and the area was calculated in square millimeters (mm2). In terms of surface area, females had a mean of 13,210.40 mm2 with a standard error of 713.46. Males, however, exhibited a higher mean surface area of 18,713.82 mm2, but with a significantly larger standard error of 3,371.70. The difference in MS area between males and females was statistically significant (p<0.01). In the receiver operating characteristic (ROC) curve, the area under the curve (AUC) was 0.77, suggesting good discriminative ability. The MS area on lateral cephalograms shows significant sexual dimorphism. Overall, the findings suggest that the MS surface area can be a useful anatomical feature for distinguishing between male and female North Indian subjects, given the statistically significant difference and the good discriminative performance indicated by the ROC curve analysis.

AB089. Improving decision-making in traumatic brain injury patients via 3D volumetric analysis of epidural haematoma.

Epidural haematoma (EDH) is a common finding in many traumatic brain injury scenarios, which necessitates surgical evacuation if the volume equals 30 cm3. The Tada formula, despite its convenience, have been observed to inaccurately depict haemorrhage volume, which can lead to inappropriate decision-making. Objective: (I) to determine if there are statistical differences between EDH volumes as calculated using three-dimensional (3D) software versus Tada's formula; and (II) whether this difference leads to differences in treatment options. Computed tomography (CT)-scan of 15 traumatic brain injury (TBI) patients with EDH in January-February 2024 were obtained, and the volumetric analysis was performed using the (I) 3D Slicer software; and the (II) Tada formula for each scan. In addition, characteristics such as patient demographics and region were noted. We performed a paired t-test to scrutinise whether there were any differences between the volumes obtained via the two methods. There was a significant difference (P≤0.05) between the EDH volumes as calculated via 3D software and the Tada formula. We also noted that some patients who should have been treated surgically were not operated on, and vice versa. The process of 3D segmentation only takes an average of 8.2 minutes per patient; which is comparable to using the Tada formula. The inaccuracy of the Tada formula could be attributed to the irregular volume of the bleeding foci, contrary to the prototypical biconvex shape. 3D segmentation should be routinely employed in EDH and other TBI-related haemorrhage cases when available, to aid in decision-making. Extensive development is needed to explore the utility of 3D software in emergency neurosurgery.

Volumetric Analysis of Carpal Bones by Sex with 3D Slicer Software Program

Volumetric Analysis of Carpal Bones by Sex with 3D Slicer Software Program

Detection of subsurface archaeological features using the GPR method with a 250 MHz antenna in Borsippa site, Babylon, Iraq

The GPR method was used to determine the depth and extent of the subsurface archaeological features at the archaeological site of Borsippa. The extensions of the archaeological walls were identified through the creation of three-dimensional maps. The LMX200 device conducted the survey using a 250 MHZ antenna. sixty parallel profiles were collected and processed by GPR Slice software. Several reflections of possible archaeological walls buried at different depths and extensions of 2, 4, 6, 11, and 20 m were identified. The 250 MHz antenna gave clear reflections of the archaeological walls, with a penetration depth of up to 4 meters. The time slice map identified a buried archaeological structure at 1–1.1 m deep, consisting of many rooms with thick walls up to 2-3 m.

Comparative assessment of the capability of machine learning-based radiomic models for predicting omental metastasis in locally advanced gastric cancer

The study aims to investigate the predictive capability of machine learning algorithms for omental metastasis in locally advanced gastric cancer (LAGC) and to compare the performance metrics of various machine learning predictive models. A retrospective collection of 478 pathologically confirmed LAGC patients was undertaken, encompassing both clinical features and arterial phase computed tomography images. Radiomic features were extracted using 3D Slicer software. Clinical and radiomic features were further filtered through lasso regression. Selected clinical and radiomic features were used to construct omental metastasis predictive models using support vector machine (SVM), decision tree (DT), random forest (RF), K-nearest neighbors (KNN), and logistic regression (LR). The models’ performance metrics included accuracy, area under the curve (AUC) of the receiver operating characteristic curve, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). In the training cohort, the RF predictive model surpassed LR, SVM, DT, and KNN in terms of accuracy, AUC, sensitivity, specificity, PPV, and NPV. Compared to the other four predictive models, the RF model significantly improved PPV. In the test cohort, all five machine learning predictive models exhibited lower PPVs. The DT model demonstrated the most significant variation in performance metrics relative to the other models, with a sensitivity of 0.231 and specificity of 0.990. The LR-based predictive model had the lowest PPV at 0.210, compared to the other four models. In the external validation cohort, the performance metrics of the predictive models were generally consistent with those in the test cohort. The LR-based model for predicting omental metastasis exhibited a lower PPV. Among the machine learning algorithms, the RF predictive model demonstrated higher accuracy and improved PPV relative to LR, SVM, KNN, and DT models.

Custom fabricated three-dimensional printed surgical guide for trephine bur in autogenous bone graft: A technique report.

This technique presents a workflow that designs the custom surgical guide to cover a trephine bur using simple slicer software and three-dimensional (3D) printing to perform the semilunar technique. This method in autogenous bone grafting surgery harvests a thin layer of cortical bone in the donor site with a trephine bur. Its biologically favorable, round shape can be used as a shell to reconstruct the ridge with a 3D contour acceptable for future implant placement. A 78-year-old female patient required vertical and horizontal bone grafting for future implant placement due to the infection caused by the vertically fractured root of a premolar. The patient's cone beam computed tomography (CBCT) file was translated into a standard tessellation language (STL) file, and recipient and donor site models were created. Simulated surgery was done using the software first to detect any possible complications during surgery. The trephine bur planned for use in surgery was measured in necessary dimensions, and the values were added to create a guide for surgery in slicer software. Then, it was 3D-printed with a stereolithography (SLA) printer. After testing the fit of the guide, it was further tested on a fused filament fabrication (FFF) printed donor site model to check if the desired shape and size of the plate were acquired after harvest. Then, the plates were used for model surgery on the recipient site model. After no issues from the previous steps, the final patient surgery was approved and completed with success. This technique utilizes the SLA printing method to create the custom surgical guide for a trephine bur without using commercially available products. Moreover, it could be tested on FFF 3D-printed anatomical models to ensure its validity. With this innovative technique, clinicians can efficiently perform a semilunar technique, facilitating the surgery and improving patient care.

Evaluation of mandibular condyle position in Class III patients after bimaxillary orthognathic surgery: A cone-beam computed tomography study.

This retrospective study evaluated the mandibular condyle position before and after bimaxillary orthognathic surgery performed with the mandibular condyle positioned manually in patients with mandibular prognathism using cone-beam computed tomography. Overall, 88 mandibular condyles from 44 adult patients (20 female and 24 male) diagnosed with mandibular prognathism due to skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I performed using the manual condyle positioning method were included. Cone-beam computed tomography images obtained 1-2 weeks before (T0) and approximately 6 months after (T1) surgery were analyzed in three planes using 3D Slicer software. Statistical significance was set at P < 0.05 level. Significant inward rotation of the left mandibular condyle and significant outward rotation of the right mandibular condyle were observed in the axial and coronal planes (P < 0.05). The positions of the right and left condyles in the sagittal plane and the distance between the most medial points of the condyles in the coronal plane did not differ significantly (P > 0.05). While the change in the sagittal plane can be maintained as before surgery with manual positioning during the BSSRO procedure, significant inward and outward rotation was observed in the axial and coronal planes, respectively, even in the absence of concomitant temporomandibular joint disorder before or after the operation. Further long-term studies are needed to correlate these findings with possible clinical consequences.

Machine learning‑based radiomics models accurately predict Crohn's disease‑related anorectal cancer.

The radiological diagnosis of Crohn's disease (CD)-related anorectal cancer is difficult; it is often found in advanced stages and has a poor prognosis because of the difficulty of curative surgery. However, there are no studies on predicting the diagnosis of CD-related cancer. The present study aimed to develop a predictive model to diagnose CD cancerous lesions more accurately in a way that can be interpreted by clinicians. Patients with CD who developed anorectal CD lesions at Hyogo Medical University (Nishinomiya, Japan) between March 2009 and June 2022 were included in the present study. T2-weighted and T1-weighted magnetic resonance (MR) images were utilized for our analysis. Images of anorectal lesions were segmented using open-source 3D Slicer software, and radiomic features were extracted using PyRadiomics. Six machine learning models were investigated and compared: i) Support vector machine; ii) naive Bayes; iii) random forest; iv) light gradient boosting machine; v) extremely randomized trees; vi) and regularized greedy forest (RGF). SHapley Additive exPlanations (SHAP) values were calculated to assess the extent to which each radiomic feature contributed to the model's predictions compared to baseline, represented as the average of the model's predictions for all test data. The T2-weighted images of 28 patients with anorectal cancer and 40 non-cancer patients were analyzed and the contrast-enhanced T1-weighted images of 22 cancer and 40 non-cancer patients. The model with the highest area under the curve (AUC) was the RGF-based model constructed using T2-weighted image features, achieving an AUC of 0.944 (accuracy, 0.862; recall, 0.830). The SHAP-based model explanation suggested a strong association between the diagnosis of CD-related anorectal cancer and features such as complex lesion texture; greater pixel separation within the same coronal cross-section; larger, randomly distributed clumps of pixels with the same signal intensity; and a more spherical lesion shape on T2-weighted images. The MRI radiomics-based RGF model demonstrated outstanding performance in predicting CD-related anorectal cancer. These results may affect the diagnosis and surveillance strategies of CD-related colorectal cancer.

Application of virtual endoscopic imaging to parapelvic cyst incision by flexible ureteroscopy: a multicenter retrospective cohort study.

A three-dimensional (3D) reconstruction of the kidney, parapelvic cyst and the collecting system was conducted using the 3D Slicer software. The reconstructed image was used to form a virtual endoscope to assist flexible ureteroscopic incision and drainage was performed with a holmium laser for treating parapelvic cysts. The effectiveness of this assistive technique was assessed. This was a retrospective cohort study. The clinical information of 59 patients undergoing flexible ureteroscopic incision and drainage for parapelvic cysts in two medical centers was collected. 3D Slicer software reconstruction and virtual endoscopic imaging were performed for 28 cases. Before the operation, the best point for incision on the collecting system's mucosa was assessed by virtual endoscope imaging. Propensity score matching was adopted for the reconstructive and non-reconstructive groups. After matching, the reconstructive group and non-reconstructive group both had 21 cases each. The operation time in the reconstructive and non-reconstructive groups was 38.81±5.01 and 51.00±18 minutes, respectively. Statistically significant differences existed between the two groups (t=7.024, P<0.001). No statistical significance was found in postoperative fever, immediate postoperative C reactive protein (CRP), length of postoperative hospital stay and cyst diameter three months after the operation. The operator was provided with a more direct and real vision when 3D Slicer software reconstruction was adopted via virtual endoscopic imaging to assist flexible ureteroscopic parapelvic cyst incision. This helped reduce the operation time. Further follow-ups and observations are required to assess the long-term efficacy of flexible ureteroscopic parapelvic cyst incision.

Improvements of the shape and strength of the diaphragm after endoscopic lung volume reduction

RationaleEndoscopic lung volume reduction improves lung function, quality of life and exercise capacity in severe emphysema patients. However, its effect on the diaphragm function is not well understood. We hypothesised...

Enhancing Visualization of the Foramen Ovale in Percutaneous Microcompression: A Preoperative Image Simulation Technique

Introducing a preoperative image simulation technique to streamline the visualization of the foramen ovale in percutaneous microcompression. Twenty-five trigeminal neuralgia patients were included in the study. Preoperative cranial computed tomography scans were processed with 3D Slicer software to create simulated fluoroscopic skulls. The angulations required for precise visualization of the foramen ovale were established via simulated anteroposterior imaging. These simulations informed the C-arm's angulations for foramen ovale targeting during surgery. The preoperative simulations accurately forecasted skull rotation angulations, aligning closely with intraoperative observations with negligible discrepancies (0-2 degrees). In 17 patients, the foramen ovale was distinctly visible, while in 8 patients, it was partially obscured yet discernible using the simulated angles. Nonvisible of the foramen ovale did not occur. Postoperative pain relief and complications were recorded. Based on our initial findings, the application of preoperative image simulation shows significant referential value in achieving accurate visualization of the foramen ovale in percutaneous microcompression for trigeminal neuralgia.

DIPG-09. PROGNOSTIC FACTORS IN REIRRADIATED DIFFUSE INTRINSIC PONTINE GLIOMA: CLINICAL AND RADIOMIC ANALYSIS

Abstract BACKGROUND Diffuse Intrinsic Pontine Glioma (DIPG) is a lethal pediatric brain tumor. Radiation therapy (RT) is the standard treatment, with reirradiation considered at progression. However, the prognostic factors for reirradiation remain unclear. This study aims to investigate the outcomes of patients with DIPG undergoing reirradiation and to identify radiomic prognostic factors. METHODS We analyzed patients with histopathologically proven DIPG who underwent reirradiation at our institution. We delineated pre-reirradiation tumors using 3D Slicer software and extracted radiomic features from FLAIR MRI sequences using the Python package PyRadiomics. Finally, we used the least absolute shrinkage and selection operator (Lasso) for Cox’s proportional hazard model with leave-one-out cross-validation to select optimal prognostic factors for survival after reirradiation. We have also compared the reirradiated group with our cohort of 22 non-reirradiated DIPG patients eligible for reirradiation but whose parents chose only supportive care at progression. RESULTS The study included 15 patients who received reirradiation at the first progression, with a total dose of 20 Gy or 24 Gy in 2 Gy fractions. Reirradiation was well tolerated, without grade &amp;gt;2 toxicity. Neurological improvement was observed in 80% of patients. Median survival from the end of the first RT was significantly (p = 0.01) longer in the reirradiated group (68 weeks) compared to the non-reirradiated group (25 weeks). The Cox model demonstrated a concordance of 0.88 (95% CI: 0.83–0.92), revealing that tumor sphericity and structural gray-level heterogeneity in FLAIR MRI images were associated with more prolonged survival in reirradiated patients. CONCLUSIONS Reirradiation is a safe and effective approach for patients with DIPG. MRI-based radiomic models could help predict survival after treatment. Our results revealed that tumors with low sphericity and high homogeneity of gray levels are associated with a worse prognosis after reirradiation.

Optimal Timing of Cranioplasty After Decompressive Craniectomy: Timing or Collapse Ratio.

Although cranioplasty (CP) is a relatively straightforward surgical procedure, it is associated with a high complication rate. The optimal timing for this surgery remains undetermined. This study aimed to identify the most suitable timing for CP to minimize postoperative complications. We conducted a retrospective analysis of all CP cases performed in our department from August 2015 to March 2022. Data were gathered through case statistics and categorized based on the occurrence of complications. The collapse ratio was determined using 3-dimensional Slicer software. In our retrospective study of 266 patients, 51 experienced postoperative complications, including hydrocephalus, epidural effusion, subdural hematoma, epilepsy, and subcutaneous infection. Logistic regression analysis identified independent predictors of postcranioplasty complications, and a nomogram was developed. The predictive value of the logistic regression model, collapse ratio, and decompression craniotomy-CP operation interval for post-skull repair complications was assessed using receiver operating characteristic curve analysis. No significant differences were observed in postoperative complications and decompression craniotomy-CP intervals between the groups (P = .07, P > .05). However, significant differences were noted in postoperative collapse ratios and CP complications between the groups (P = .023, P < .05). Logistic regression revealed that the collapse ratio (odds ratio = 1.486; 95% CI: 1.001-2.008; P = .01) and CP operation time (odds ratio = 1.017; 95% CI: 1.008-1.025, P < .001) were independent risk factors for postoperative complications. Receiver operating characteristic curve analysis indicated that the collapse ratio could predict CP postoperative complications, with a cutoff value of 0.274, an area under the curve of 0.621, a sensitivity of 62.75%, and a specificity of 63.26%. The post-skull repair collapse ratio is a significant predictor of postoperative complications. It is advisable to base the timing of surgery on the extent of brain tissue collapse, rather than solely on the duration between cranial decompression and CP.

DentalSegmentator: Robust open source deep learning-based CT and CBCT image segmentation

ObjectivesSegmentation of anatomical structures on dento-maxillo-facial (DMF) computed tomography (CT) or cone beam computed tomography (CBCT) scans is increasingly needed in digital dentistry. The main aim of this research was to propose and evaluate a novel open source tool called DentalSegmentator for fully automatic segmentation of five anatomical structures on DMF CT and CBCT scans: maxilla/upper skull, mandible, upper teeth, lower teeth, and the mandibular canal. MethodsA retrospective sample of 470 CT and CBCT scans was used as a training/validation set. The performance and generalizability of the tool was evaluated by comparing segmentations provided by experts and automatic segmentations in two hold-out test datasets: an internal dataset of 133 CT and CBCT scans acquired before orthognathic surgery and an external dataset of 123 CBCT scans randomly sampled from routine examinations in 5 institutions. ResultsThe mean overall results in the internal test dataset (n = 133) were a Dice similarity coefficient (DSC) of 92.2 ± 6.3 % and a normalised surface distance (NSD) of 98.2 ± 2.2 %. The mean overall results on the external test dataset (n = 123) were a DSC of 94.2 ± 7.4 % and a NSD of 98.4 ± 3.6 %. ConclusionsThe results obtained from this highly diverse dataset demonstrate that this tool can provide fully automatic and robust multiclass segmentation for DMF CT and CBCT scans. To encourage the clinical deployment of DentalSegmentator, the pre-trained nnU-Net model has been made publicly available along with an extension for the 3D Slicer software. Clinical significanceDentalSegmentator open source 3D Slicer extension provides a free, robust, and easy-to-use approach to obtaining patient-specific three-dimensional models from CT and CBCT scans. These models serve various purposes in a digital dentistry workflow, such as visualization, treatment planning, intervention, and follow-up.

Noninvasive quantitative ultrasound fatty liver evaluation of hepato-renal index in pediatric patients using 3D-slicer

AimHepato-renal index (HRI) calculated by ultrasound images has been shown to be an effective, noninvasive tool to screen patients with steatosis. The aim of this study was to non-invasively explore a new method for the calculation, directly on DICOM images, of HRI in pediatric patients using 3D Slicer, a free and open-source software for medical image analysis, especially used for artificial intelligence data annotation. Previous studies in literature were based on non-medical image format (such as png and tiff) and analyzed by using ImageJ, a popular image analysis software.Materials and methodsDICOM images were collected retrospectively between November 2022 and December 2023 at a tertiary institution on any patient under 18 years referred to US assessment of suspected steatosis. The HRI was measured on sagittal images with a clear visualization of both the liver and the kidney by 3D Slicer. The HRI was calculated as the ratio of average pixel intensity values between the two ROIs. Also, we correlated the index with the qualitative operator assessment grade of steatosis made by two expert radiologists with more than 15 years of experience.Results49 patients (59% male, age 11.6 ± 2.6 year) were recruited. Of these, 29 (59%) had qualitative ultrasound confirmation of the diagnosis. The Bland–Altman plots showed a good agreement between the HRI indexes calculated with the standard tool ImageJ and 3D Slicer. Furthermore, the quantitative HRI calculated by the two software showed a correlation (Spearman’s coefficient = 0.52, P < 0.0001) with the qualitative operator measurement.ConclusionsFor the first time, an estimation of HRI directly on DICOM images was executed by using 3D Slicer, obtained quantitative information directly from clinically approved image format.

3D Printing of Subclavian Artery: Utility for Preprocedural Planning and Correlation With Subclavian Artery Percutaneous Vascular Interventions.

Three-dimensional (3D) printing for subclavian artery (SA) percutaneous vascular interventions (PVI) may allow superior understanding of patient specific complex anatomy and aid with preprocedural planning. Five patients with computed tomography angiography (CTA) of the neck who underwent SA PVI were queried retrospectively. 3D printing of aortic arch and great vessels was accomplished with 3D slicer software and painted with acrylic paint to highlight anatomic features. The aortic arch type and implications for preprocedural planning for SA interventions including complex chronic total occlusion (CTO) lesions were determined. Comparisons were made with SA angiograms and 3D-CTA. Of the 5 patients, type I (n = 2), type II (n = 1), and type III (n = 2) aortic arches were identified. Proximal and distal reference vessel size and total lesion length were determined using a digital millimeter caliper and correlated with intraprocedural balloons and stents. In 3D-printed models (3D-PMs) of patients with SA-CTO (n = 2), cap morphology (tapered vs blunt) and distal vessel filling were visualized, permitting optimal arterial access site selection for successful cap crossing. The vertebral arteries (VAs) were also 3D printed which further allowed the ability to delineate optimal stent deployment site (proximal or distal to VA), a common dilemma that is faced intraprocedurally. The 3D-PMs also allowed preprocedural precision in stent and balloon size and length, potentially leading to procedural efficiency and cost-effectiveness. 3D printing of aortic arch and great vessel anatomy for SA-PVI allows multiple procedure-related factors to be predicted in advance, translating to decrease in contrast volume, radiation time, procedure and fluoroscopic time, thereby improving procedure and cost efficiency.

Relationship Between Temporomandibular Joint Effusion, Pain, and Jaw Function Limitation: A 2D and 3D Comparative Study.

This study aimed to investigate the relationship between temporomandibular joint (TMJ) effusion and TMJ pain, as well as jaw function limitation in patients via two-dimensional (2D) and three-dimensional (3D) magnetic resonance imaging (MRI) evaluation. 121 patients diagnosed with temporomandibular disorder (TMD) were included. TMJ effusion was assessed qualitatively using MRI and quantified with 3D Slicer software, then graded accordingly. In addition, a visual analogue scale (VAS) was employed for pain reporting and an 8-item Jaw Functional Limitations Scale (JFLS-8) was utilized to evaluate jaw function limitation. Statistical analyses were performed appropriately for group comparisons and association determination. A probability of p<0.05 was considered statistically significant. 2D qualitative and 3D quantitative strategies were in high agreement for TMJ effusion grades (κ = 0.766). No significant associations were found between joint effusion and TMJ pain, nor with disc displacement and JLFS-8 scores. Moreover, the binary logistic regression analysis showed significant association between sex and the presence of TMJ effusion, exhibiting an Odds Ratio of 5.168 for females (p = 0.008). 2D qualitative evaluation was as effective as 3D quantitative assessment for TMJ effusion diagnosis. No significant associations were found between TMJ effusion and TMJ pain, disc displacement or jaw function limitation. However, it was suggested that female patients suffering from TMD may be at a risk for TMJ effusion. Further prospective research is needed for validation.

Time-of-Flight MRA of Intracranial Aneurysms with Interval Surveillance, Clinical Segmentation and Annotations

Intracranial aneurysms (IAs) are present in 2–6% of the global population and can be catastrophic upon rupture with a mortality rate of 30–50%. IAs are commonly detected through time-of-flight magnetic resonance angiography (TOF-MRA), however, this data is rarely available for research and training purposes. The provision of imaging resources such as TOF-MRA images is imperative to develop new strategies for IA detection, rupture prediction, and surgical training. To support efforts in addressing data availability bottlenecks, we provide an open-access TOF-MRA dataset comprising 63 patients, of which 24 underwent interval surveillance imaging by TOF-MRA. Patient scans were evaluated by a neuroradiologist, providing aneurysm and vessel segmentations, clinical annotations, 3D models, in addition to 3D Slicer software environments containing all this data for each patient. This dataset is the first to provide interval surveillance imaging for supporting the understanding of IA growth and stability. This dataset will support computational and experimental research into IA dynamics and assist surgical and radiology training in IA treatment.

Three-dimensional geometric analysis of facial symmetry in skeletal class I individuals

Aim: Our aim in this study is to determine anatomical points to detect asymmetry on both sides of the face, to make morphometric measurements according to age/sex, and to compare facial asymmetry index values according to sex. Methods: Three-dimensional (3D) Computed Tomography (CT) images of 90 individuals of both sexes (45 female, 45 male) were included in our study. Morphometric measurements of the face were made using the 3D Slicer software package on these images. To evaluate facial asymmetry in more detail, measurements were made using 3D-CT, and asymmetry index values were calculated. Results: When we analyzed according to sex, female right Condylion-Gonion-Menton angle (CoGoMe_Rˆ) values were statistically higher than males (p=0.049). There was no statistical difference between the asymmetry index values of males and females (p&gt;0.05). According to the Pearson correlation test, a statistically weak positive correlation was found between age with CoGoMe_Rˆ, left Condylion-Gonion-Menton angle (CoGoMe_Lˆ) (in both r=0.228, p=0.031), and Condylion-Menton (CoMe) asymmetry (r=0.237, p=0.024). According to the Pearson correlation test, a statistically weak negative correlation was found between age and Condylion-Subspinale (CoSs) asymmetry (r=-0.209, p=0.048). Conclusions: It is observed that the measurements around the mandible show more changes with age. In sex comparisons, although most of the facial morphometric measurements of males were significantly larger than those of females, no significant difference was found in the asymmetry index values.

Development of a 3D-printed nuchal translucency model: a pilot study for prenatal ultrasound training

BackgroundWe used two 3D ultrasound volumes of fetal heads at 13 weeks to create live-size 3D-printed phantoms with a view to training or assessment of diagnostic abilities for normal and abnormal nuchal translucency measurements. The phantoms are suitable for use in a water bath, imitating a real-life exam. They were then used to study measurement accuracy and reproducibility in examiners of different skill levels.MethodsUltrasound scans of a 13 + 0-week fetus were processed using 3D Slicer software, producing a stereolithography file for 3D printing. The model, crafted in Autodesk Fusion360™, adhered to FMF guidelines for NT dimensions (NT 2.3 mm). Additionally, a model with pathologic NT was designed (NT 4.2 mm). Printing was performed via Formlabs Form 3® printer using High Temp Resin V2. The externally identical looking 3D models were embedded in water-filled condoms for ultrasound examination. Eight specialists of varying expertise levels conducted five NT measurements for each model, classifying them in physiological and abnormal models.ResultsClassification of the models in physiological or abnormal NT resulted in a detection rate of 100%. Average measurements for the normal NT model and the increased NT model were 2.27 mm (SD ± 0.38) and 4.165 mm (SD ± 0.51), respectively. The interrater reliability was calculated via the intraclass correlation coefficient (ICC) which yielded a result of 0.883, indicating robust agreement between the raters. Cost-effectiveness analysis demonstrated the economical nature of the 3D printing process.DiscussionThis study underscores the potential of 3D printed fetal models for enhancing ultrasound training through high inter-rater reliability, consistency across different expert levels, and cost-effectiveness. Limitations, including population variability and direct translation to clinical outcomes, warrant further exploration. The study contributes to ongoing discussions on integrating innovative technologies into medical education, offering a practical and economical method to acquire, refine and revise diagnostic skills in prenatal ultrasound. Future research should explore broader applications and long-term economic implications, paving the way for transformative advancements in medical training and practice.