Rapid Modeling für bildgestützte Interventionen Prof. Dr.-Ing. Stefan Weber ARTORG - Research Center ISTB - Institute for Surgical Technology and Biomechanics University of Bern
Outline > Clinical Challenge: Precise Surgical Planning > Approach: Using 3D Models created by Rapid Prototyping > Workflow for creation of 3D planning models > Examples > Conclusion 2
Implantation Technology within ARTORG Cooperation and Research Focus Implantation Technology Artificial - Lung - Kidney - Liver - Bladder Research Artificial - Eye - Ear Research Artificial - Heart - Cardiac Assist Devices - Cardiovascular Intervention Research Mechatronic Device Technology Image Analysis / Computer Vision Computer Assisted Surgery / Surgical Navigation Tissue Engineering 3
Center for Computer Aided Surgery Center for Computer Aided Surgery (Directors: M. Caversaccio, S. Weber) Medical Image Processing (Head: Mauricio Reyes Surgical Navigation (Head: Guoyan Zheng) Surgical Instruments (Head: Stefan Weber) Statistical Shape Models 2D-3D Registration Medical Robotics Image Analysis Orthopaedic Navigation Smart Instruments Soft Tissue Simulation Statistical Shape Models Rapid Prototyping Soft Tissue Navigation 4
Clinical Challenge Planning of Treatment > Multimodal Image Analysis > Identification of ROI > Creation of patient model > Precise diagnosis > Optimal treatment decision > Preparation of treatment > Performing of treatment 3D Subtraction 3D Angio Angio CT 5
Approach: Application of 3D Models Advanced Surgical Planning > Multimodal image representation in one model > Emphasis on details > Incorporation of additional functional features Technical Challenge > Multimodal image handling > Advanced Image Segmentation > Useful model design > Actual Model creation RP process, handling of fragile structures 6
Overview on Workflow Oberflächenerstellung Nachbearbeitung Rapid Modelling Rapid Manufacturing 3D Scan NextEngine Volumendaten MeVisLab 3D Druck ZCorp Vakuumguss MCP CAD Catia, Solidworks Modellierung 3DS Max February 3D-Bilddaten 25, 2009Dicom 7
Step1: Image Processing Adobe Acrobat Document > Multimodal Image Registration (CT, MRI, 3DAngio, Fluoro > Segmentation of interesting organs, vessel, structures > Important: Communication with medical partners 8
Step 2: Model Preparation > Creation of separate surface models > Preparation of additional surface properties > Cropping, scaling, smoothing > Additional features: stand, rests, support structures 9
Step 3: Printing of 3D Model > 3D Printing technology: Z-Corporation > Building Size: 300 x 200 x 300 mm > CYMK Coloring of models > Creation of rigid and flexible Models 10
Step 4: Post Processing > Removal of model from machine > Cleaning: removal of powder, Cleaning of hollow structures > Maintain delicate structures i.e. thin vessels, thin surfaces > Infiltration with cast resin 11
Advanced Surgical Planning EXAMPLES 12
Example: 3D Printing of Aneurysms (together with Dept. Neurosurgery, Profs. Raabe, Schroth) > Challenge: Image registration (CT, MRI, Angio) > Segmentation of thin vessels: < 1 mm > Preparation of small vessels in 3D print 13
Example: 3D Printing of Aneurysms (together with Dept. Neurosurgery, Profs. Raabe, Schroth) > Preparation of postoperative model > Printing in 2:1 for optimal display of thin vessel 14
Example: 3D Printing of Aneurysms (together with Dept. Neurosurgery, Profs. Raabe, Schroth) 1:1 1.5:1 2:1 15
Pre-Bending of implants based on 3D jaw models (Courtesy: Hallermann, Olsen, Bardyn, Smolka, Iizuka, Büchler) > Planning of reconstruction of Mandible with fibula > 3D print of Reconstruction plan > Prebending of plate implant system for geometric accuracy > n = 20 16
Planning of complex liver resections (together with Prof. Candinas, Drs. Interbitzin, vom Berg) > Creation of functional liver model (by MeVis FhG, Germany) > Definition of surgical strategy (green = resection plane) Medical Imaging Phantoms > Printing of complete model 1:1 17
Planning Radiooncology / -surgery (together with Prof. Aebershold, Dr. Pica, CHUV) > Challenge: Various Imaging from different points in time > Model of anatomical situation for planning of brachytherapy 18
Soft Tissue Guidance Future Projects (Profs. Carrel, Tevaearai, Vandenbergh, Drs. von Garnier, Carboni) > Thoracic surgery Image based planning for tumour resections, biopsies, radiation therapy Instrument guidance during Video Assisted Thoracic Surgery > Cardiovascular Surgery Catheter tracking, Instrument guidance near the heart 19
Treatment of Femoroacetabular Impingement (FAI) (together with Prof. K. Siebenrock, Drs. Tannast, Steppacher, Ecker) Challenges > Navigation accuracy study > Automatic planning of hip joint preserving treatments > Based on 3D alpha and 3D LCE angle 20
RP for Computer Aided Surgery (together with Profs. Caversaccio, Stieger ENT) > Needle tracker (Prototype) for PET / CT Biopsies > Housing for robotic system for ENT Surgery 21
Complex Imaging Phantoms for PET/CT (together with Dept. Nuclear Medicine, Prof. Krause, T. Weitzel) 22
Conclusion > 3D Modelling is a means of Computer Aided Surgery > 3D Modelling is not just Rapid Prototyping it requires knowledge Medicine, Imaging, Image processing, prototyping > Clinicians benefit by image processing and actual 3D model > Benefit for clinicians Confident intervention preparation (Confidence) Reproducible treatment decision finding (Reasoning) Implant / Template design (Precision, Time) 23
Thanks to.. >. Clinical Network in Bern Neurosurgery (Prof. Raabe) Neuroradiology (Dr. J. Gralla, Prof. G. Schroth) Angiology (Prof. I. Baumgartner) Urology (Prof. G. Thalmann) Visceral Surgery (Prof. D. Candinas) Cardiology (PD Dr. A. Kadner, Profs. H. Tevaearai, T. Carrel) Radiooncology (Dr. A. Pica, Dr. N. Blumstein, Prof. Aebershold) ENT Surgery (Prof. Caversaccio) Audiology (Prof. C. Stieger) >. and of course the whole ARTORG / ISTB team 24
Contact Details > University of Bern > ARTORG Center for Biomedical Engineering Research > > Prof. Dr.-Ing. > Stefan Weber > Implantation Technology of Artificial Organs > Stauffacherstrasse 78 > CH-3014 Bern > Tel +41 31 631 59 51 > Fax +41 31 631 59 60 > Mob +41 78 30 10 910 > email: stefan.weber@artorg.unibe.ch > http: www.artorg.unibe.ch and www.memcenter.unibe.ch 25