Image Fusion in Preoperative Planning

This article presents a comprehensive overview of generating a digital Patient-Specific Anatomic Reconstruction (PSAR) model of the craniofacial complex as the foundation for a more objective surgical planning platform. The technique explores fusing the patient’s 3D radiograph with the corresponding high-precision 3D surface image within a biomechanical context. As taking 3D radiographs has been common practice for many years, this article describes various approaches to 3D surface imaging and the importance of achieving high-precision anatomical results to simulate surgical outcomes that can be measured and quantified. With the PSAR model readily available for facial assessment and virtual surgery, the advantages of this surgical planning technique are discussed.

A patient-centric surgical planning paradigm

To achieve the best possible outcomes in facial cosmetic and reconstructive surgery, many clinicians are starting to embrace the use of powerful software tools that enable them to plan surgeries in a digital three-dimensional (3D) environment. The foundation of these tools is based on the patient’s unique anatomic model that fuses the patient’s 3D soft tissue surface with the underlying 3D skeletal structure ( Fig. 1 ). Although morphing a 3D surface to generate a desired result is generally accepted in the animation and character modeling world, true surgical planning requires that the software tool incorporate a firm understanding of the various anatomic components, their relative positions to one another, and the biomechanical relationships within the craniofacial complex.