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Custom implant design for large cranial defects
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Department of Science and Technology, Media and Information Technology.
Université de Bordeaux, Allée Geoffroy de Saint Hilaire Bat. B8, CS 50023, 33615, Pessac Cedex, France.
Department of Radiology, Innsbruck Medical University, Innrain 52, Christoph-Probst-Platz, 6020, Innsbruck, Austria.
Innsbruck Medical University, Innrain 52, Christoph-Probst-Platz, 6020, Innsbruck, Austria.
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2016 (English)In: International Journal of Computer Assisted Radiology and Surgery, ISSN 1861-6410, E-ISSN 1861-6429, 1-14 p.Article in journal (Refereed) Epub ahead of print
Abstract [en]


The aim of this work was to introduce a Computer Aided Design (CAD)tool that enables the design of large skull defects (> 100cm2) implants. Functional and aesthetically correct custom implants are extremely important for patients with large cranial defects. For these cases pre-operative fabrication of implants is recommended to avoid problems of donor site morbidity, sufficiencyof donor material and quality. Finally, crafting the correct shape is a non-trivial task increasingly complicated by defect size.


We present a Computer Aided Design (CAD) tool to design such implants for the neurocranium. A combination of Geometric Morphometrics (GM) and Radial Basis Functions (RBF), namely Thin Plate Splines (TPS), allows semiautomatic implant generation. The method uses symmetry and the best fitting shape to estimate missing data directly within the radiologic volume data. In addition, this approach delivers correct implant fitting via a boundary fitting approach.


This method generates a smooth implant surface, free of sharp edges that follows the main contours of the boundary, enabling accurate implant placementin the defect site intraoperatively. The present approach is evaluated and compared to existing methods. A mean error of 89.29% (72.64% - 100%)missing landmarks with an error less or equal to 1 mm was obtained.


In conclusion, the results show that our Computer Aided Design (CAD)tool can generate patient specific implants with high accuracy.

Place, publisher, year, edition, pages
2016. 1-14 p.
Keyword [en]
Cranial reconstruction, Reconstructive surgery, Geometric morphometrics, Radial basis functions, thin-plate spline
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URN: urn:nbn:se:liu:diva-129988DOI: 10.1007/s11548-016-1454-8PubMedID: 27358081OAI: diva2:945886
EU, FP7, Seventh Framework Programme, MRTN-CT-2005-019564
Available from: 2016-07-04 Created: 2016-07-04 Last updated: 2016-09-15Bibliographically approved

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Maria Marreiros, Filipe Miguel
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Division of Radiological SciencesFaculty of Medicine and Health SciencesCenter for Medical Image Science and Visualization (CMIV)Media and Information Technology
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International Journal of Computer Assisted Radiology and Surgery

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