Using Black Bone Magnetic Resonance Imaging in Craniofacial Virtual Surgical Planning: A Comparative Cadaver Study

Area of Science:

• Medical Imaging
• Surgical Planning
• Biomedical Engineering

Background:

• Computed tomography (CT) scans expose children to ionizing radiation, increasing cancer risk.
• Over 600,000 CT scans are performed annually on children in the US.
• Virtual surgical planning using magnetic resonance imaging (MRI) has not been previously described.

Purpose of the Study:

• To evaluate the accuracy of three-dimensionally-printed craniofacial surgical guides created from "black bone" MRI.
• To compare the accuracy of MRI-based guides with those created from CT scans.

Main Methods:

• A mock craniosynostosis surgery was virtually planned and performed on 10 cadavers.
• Five specimens used "black bone" MRI for planning and guide creation.
• Five specimens used standard CT scans for planning and guide creation.
• Accuracy was assessed by comparing postoperative anatomy to preoperative plans.

Main Results:

• The average deviation between preoperative MRI and CT scans was 1.37 mm.
• No statistically significant difference in fit accuracy was found between MRI- and CT-created guides.
• Postoperative anatomical deviation from the preoperative plan was within 1.5 mm for both modalities.
• No significant difference in skull volume accuracy was observed between MRI and CT groups.

Conclusions:

• Virtual surgical planning and 3D craniofacial guide creation are feasible using "black bone" MRI.
• MRI-based guides demonstrate accuracy comparable to CT-based guides.
• This MRI approach can significantly reduce radiation exposure in craniofacial reconstruction patients.