{Reference Type}: Journal Article {Title}: Contactless surface registration of featureless anatomy using structured light camera: application to fibula navigation in mandible reconstruction. {Author}: Cuau L;De Boutray M;Cavalcanti Santos J;Zemiti N;Poignet P; {Journal}: Int J Comput Assist Radiol Surg {Volume}: 18 {Issue}: 11 {Year}: 2023 Nov 4 {Factor}: 3.421 {DOI}: 10.1007/s11548-023-02966-3 {Abstract}: OBJECTIVE: Mandibular reconstruction using fibula free flap is a challenging surgical procedure. To assist osteotomies, computer-assisted surgery (CAS) can be used. Nevertheless, precise registration is required and often necessitates anchored markers that disturb the patient and clinical flow. This work proposes a new contactless surface-based method adapted to featureless anatomies such as fibula to achieve a fast, precise, and reproducible registration.
METHODS: Preoperatively, a CT-scan of the patient is realized and osteotomies are virtually planned. During surgery, a structured light camera digitizes the fibula. The obtained intraoperative point cloud is coarsely registered with the preoperative model using 3 points defined in the CT-scan and located on the patient's bone with a laser beam. Then, a fine registration is performed using an ICP algorithm. The registration accuracy was evaluated comparing the position of points engraved in a 3D-printed fibula with their position in the registered model and evaluating resulting osteotomies. Accuracy and execution time were compared to a conventional stylus-based registration method. The work was validated in vivo.
RESULTS: The experiment performed on a 3D-printed model showed that execution time is equivalent to surface-based registration using a stylus, with a better accuracy (mean TRE of 0.9 mm vs 1.3 mm using stylus) and guarantee good osteotomies. The preliminary in vivo study proved the feasibility of the method.
CONCLUSIONS: The proposed contactless surface-based registration method using structured light camera gave promising results in terms of accuracy and execution speed and should be useful to implement CAS for mandibular reconstruction.