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A hybrid registration method using the mandibular bone surface for electromagnetic navigation in mandibular surgery
A F de Geer1,2, M J A van Alphen3, C L Zuur1,4
1Verwelius 3D Lab, Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
Summary
This study shows a noninvasive hybrid registration method accurately aligns preoperative CT scans with patient anatomy for navigated mandibular surgery. The technique requires minimal exposed bone surface, achieving clinically acceptable accuracy in phantom models.
Area of Science:
- Medical imaging and surgical navigation
- Biomedical engineering
- Oral and maxillofacial surgery
Background:
- Accurate registration of preoperative CT scans with intraoperative patient anatomy is crucial for navigated mandibular reconstructive surgery.
- Current methods may have limitations in accuracy or invasiveness.
Purpose of the Study:
- To assess the feasibility and accuracy of a noninvasive hybrid registration method for navigated mandibular surgery.
- To evaluate a method combining point-based initialization with surface-based optimization.
Main Methods:
- A hybrid registration technique using anatomic landmarks and bare mandibular bone surface was tested on 3D-printed mandible phantoms.
- An electromagnetic tracking system and 3D Slicer software facilitated navigation.
- Simulated intraoperative conditions with varying phantom anatomies were employed.
Main Results:
- The hybrid registration method consistently achieved a mean Target Registration Error (TRE) below 2.0 mm across all tested phantom configurations.
- Accuracy was not significantly affected by variations in surface point area, number, or configuration.
- Registration accuracy in simulated intraoperative settings ranged from 0.93 (0.26) mm to 1.50 (0.28) mm.
Conclusions:
- The noninvasive hybrid registration method demonstrates high accuracy in phantom settings for navigated mandibular surgery.
- This technique requires only a small area of exposed mandibular bone surface.
- Further clinical validation during actual surgery is recommended.
