Barry S. Brunsden

Facial surface scanner

An optical noncontact 3-D digitizing system developed to acquire, process, display, and replicate the surface of the human head is described. The modification of the digitizer to help plan and evaluate facial plastic surgery is discussed. The quality and accuracy of the images produced are examined, and some medically relevant results are considered.<<ETX>>

Computer-Assisted 3D Reconstruction of Serial Sections of Cortical Bone to Determine the 3D Structure of Osteons

Abstract. The objective of this study was to create three-dimensional (3D) images for the histomorphological study of osteons. Medical imaging technology was used to register digitized 2D images of serial decalcified histological sections of bone, to segment the tissues of interest from the surrounding tissues, and to create 3D reconstructions from the segmented structures. Examination of the 3D reconstructions did not support suggestions in the literature that osteons have a spiraling organization. In contrast, the 3D reconstructions indicated that osteons have a complex pattern of organization that is dominated by branching. Examination of the reconstructions also suggested that osteons described in the literature as being dumbbell shaped are actually artifacts of the plane of sectioning. This study demonstrated the applicability of imaging and visualization technology developed for the 3D reconstruction of medical images to the reconstruction of digitized 2D images of serial sections of bone and additionally demonstrated the feasibility of using 3D reconstructions for the histomorphological study of osteons.

Stereological MRI volumetry of the frontal lobe

Stereology was used to measure frontal lobe volume on magnetic resonance imaging (MRI) scans in a multi-observer repeated-measures trial in 17 adults. Prior to measurement, MR image volumes were reoriented into coronal sections perpendicular to the bicommissural plane. Three observers blinded to subject identify repeatedly used fixed grid stereology to estimate frontal lobe volumes, defined as all sections of the frontal lobe anterior to the anterior commissure. The lateral ventricles were excluded. Stereological measurement yielded high repeatability and precision, and was time efficient for the raters. The coefficient of error was 0.03. The inter-rater correlation coefficient = 0.95 for three raters; intra-rater correlation coefficients = 0.95-0.98. A comparison was made between stereological and traditional edge tracing measurement of the frontal lobe volumes. The overall correlation between the two methods was 0.95. The use of internal landmarks to define orientation and 3-D orthogonal views to define frontal lobe boundaries on 3-D images was critical to obtaining repeatable measurements. Frontal lobe volumetry by brain MR used to estimate small differences postulated to occur in certain psychiatric and neurologic disorders requires high precision and repeatability. Stereology, a semi-automated method, can reliably estimate frontal lobe volumes. This method may distinguish small frontal lobe volume differences within individuals and between groups.

Quantitative three-dimensional assessment of face-lift with an optical facial surface scanner.

Three-dimensional computed tomographic scan images of facial deformities provide information that has been useful in planning and evaluating therapy. However, the benefits of computed tomographic imaging in cosmetic plastic surgery are often insufficient to justify exposing the patient to radiation. This report describes application of an optical, noncontact, threedimensional surface digitizer with subsecond scanning time for 360-degree examination of the human head. The resultant threedimensional surface data are suitable for computer graphics display and manipulation, and for noncontact skin surface measurement. The scanner provides accurate and complete coverage of complex facial surfaces. This system was applied to digitization of the human head in the planning and evaluation of facial plastic surgery. The results indicate that the resulting image is accurate enough to detect subtle dimensional changes resulting from surgery, including postoperative edema and surface changes due to face-lift. This type of scanning can assist in a number of tasks performed by plastic surgeons, including collecting anthropomorphic measurements, preoperative and postoperative assessment, volume monitoring, customizing of implants, and interactive planning.

Below-knee residual limb shape change measurement and visualization

OBJECTIVE The ability to measure and visualize shape change (deformation) of a residual limb within and between prostheses is an important step toward improved prosthetic fit assessment. The objective was to develop measurement and visualization methods for below-knee residual limb soft tissue shape change after donning and loading a prosthesis to detect small shape changes (30mm or less). DESIGN Spiral X-ray computed tomography imaging was utilized to acquire 3D volumetric data of the below-knee residual limb and prosthesis in situ from poor- and a good-fitting prostheses without and with a load. A new sum projection depth-shaded cylindrical mapping technique to measure and visualize small changes in shape was developed. From the volumetric data, the relative displacement of small lead markers placed on the residual limbs skin surface were measured using multiplanar reconstruction images and cylindrical maps. Displacement measurements averaging 15mm or less were obtained. RESULTS The precision and accuracy was 1mm and 2mm, respectively, when measuring the shape change or deformation of the skin surface from the sum projection cylindrical maps. The skin surface deformation was at least 7mm or greater when comparing marker locations between scans with the prostheses in situ. CONCLUSION These new image-based measurement and visualization methods provide a feasible means for measuring and displaying lower extremity residual limb shape change within and between different prostheses with and without loading.

Use of Computed Tomography Scans for Cochlear Implants

While 3-dimensional (3D) imaging by computed tomography has long been desirable for research and treatment of cochlear-implant patients, technical challenges have limited its wide application. Recent developments in scanner hardware and image processing techniques now allow image quality improvements that make clinical applications feasible. Validation experiments were performed to characterize a new methodology and its imaging performance.

Visualization of prosthesis fit in lower-limb amputees

Lower-limb prosthesis quality-of-fit assessment is purely subjective in routine clinical practice, relying on patient reports of discomfort, erythema (localized pain), and palpation. Wide variations in residual limb physical characteristics and conditions preclude a rigid approach to prosthesis prescription. With relatively long life expectancy for many lower-limb amputees, clinicians measure outcome in terms of return to work and quality of life, which have important social and economic consequences. An objective quantitative metric of fit that predicts functional outcome has not been described to date. Volumetric CT scanning provides in situ static 3D determination of residual limb soft tissue changes caused by the prosthesis socket. This mapping aids in prosthesis design and evaluation.

MRI volumetry of prefrontal cortex

Prefrontal cortex volumetry by brain magnetic resonance (MR) is required to estimate changes postulated to occur in certain psychiatric and neurologic disorders. A semiautomated method with quantitative characterization of its performance is sought to reliably distinguish small prefrontal cortex volume changes within individuals and between groups. Stereological methods were tested by a blinded comparison of measurements applied to 3D MR scans obtained using an MPRAGE protocol. Fixed grid stereologic methods were used to estimate prefrontal cortex volumes on a graphic workstation, after the images are scaled from 16 to 8 bits using a histogram method. In addition images were resliced into coronal sections perpendicular to the bicommissural plane. Prefrontal cortex volumes were defined as all sections of the frontal lobe anterior to the anterior commissure. Ventricular volumes were excluded. Stereological measurement yielded high repeatability and precision, and was time efficient for the raters. The coefficient of error was <EQ 0.03. The overall 3-way inter- rater ICC equals 0.95; intra-rater ICCs equals 0.95 - 0.98. The use of specific internal landmarks to define prefrontal cortex boundaries on 3D images was critical to obtaining accurate measurements. MR prefrontal cortex volumetry by stereology can yield accurate and repeatable measurements. Small frontal lobe volume reductions in patients with brain disorders such as depression and schizophrenia can be efficiently assessed using this method.

Medical facial surface scanner

Optical, non-contact three-dimensional range surface digitizers are employed in the 360-degree examination of object surfaces, especially the heads and faces of individuals. The resultant 3- D surface data is suitable for computer graphics display and manipulation, for numerically controlled object replications, or for further processing such as surface measurement extraction. We employed a scanner with a basic active sensor element consisting of a synchronized pattern projector employing flashtubes that illuminate a surface, with a CID camera to detect, digitize, and transmit the sequence of 24 images (per camera) to a digital image processor for surface triangulation, calibration, and fusion into a single surface description of the headform. A major feature of this unit is its use of multiple (typically 6) stationary active sensor elements, with efficient calibration algorithms that achieve nearly seamless superposition of overlapping surface segments seen by individual cameras. The result is accurate and complete coverage of complex contoured surfaces. Application of this system to digitization of the human head in the planning and evaluation of facial plastic surgery is presented.

CT artifacts in virtual colonoscopy

A phantom representation of typical colon structures with precisely known geometrical measurements was designed and fabricated. Computed tomography (CT) data were collected using a range of protocols typical for spiral CT colonography. Analysis methods were developed to measure the acquired geometry of the phantom data and characterize distortions/degradation. Simple models were proposed to explain the trends in degradation in the acquisition process versus scanner protocol. Preliminary results indicate that degradation due to CT acquisition will not significantly impact the detection of clinically relevant lesions (dimensions greater than 1 cm). However, the CT acquisition process does place a lower limit on detection size of several millimeters.