Automated and data-driven plate computation for presurgical cleft lip and palate treatment

PURPOSE

Presurgical orthopedic plates are widely used for the treatment of cleft lip and palate, which is the most common craniofacial birth defect. For the traditional plate fabrication, an impression is taken under airway-endangering conditions, which recent digital alternatives overcome via intraoral scanners. However, these alternatives demand proficiency in 3D modeling software in addition to the generally required clinical knowledge of plate design.

METHODS

We address these limitations with a data-driven and fully automated digital pipeline, endowed with a graphical user interface. The pipeline adopts a deep learning model to landmark raw intraoral scans of arbitrary mesh topology and orientation, which guides the nonrigid surface registration subsequently employed to segment the scans. The plates that are individually fit to these segmented scans are 3D-printable and offer optional customization.

RESULTS

With the distance to the alveolar ridges closely centered around the targeted 0.1 mm, our pipeline computes tightly fitting plates in less than 3 min. The plates were approved in 12 out of 12 cases by two cleft care professionals in a printed-model-based evaluation. Moreover, since the pipeline was implemented in clinical routine in two hospitals, 19 patients have been undergoing treatment utilizing our automated designs.

CONCLUSION

The results demonstrate that our automated pipeline meets the high precision requirements of the medical setting employed in cleft lip and palate care while substantially reducing the design time and required clinical expertise, which could facilitate access to this presurgical treatment, especially in low-income countries.

Spectral Shape Recovery and Analysis Via Data-driven Connections

We introduce a novel learning-based method to recover shapes from their Laplacian spectra, based on establishing and exploring connections in a learned latent space. The core of our approach consists in a cycle-consistent module that maps between a learned latent space and sequences of eigenvalues. This module provides an efficient and effective link between the shape geometry, encoded in a latent vector, and its Laplacian spectrum. Our proposed data-driven approach replaces the need for ad-hoc regularizers required by prior methods, while providing more accurate results at a fraction of the computational cost. Moreover, these latent space connections enable novel applications for both analyzing and controlling the spectral properties of deformable shapes, especially in the context of a shape collection. Our learning model and the associated analysis apply without modifications across different dimensions (2D and 3D shapes alike), representations (meshes, contours and point clouds), nature of the latent space (generated by an auto-encoder or a parametric model), as well as across different shape classes, and admits arbitrary resolution of the input spectrum without affecting complexity. The increased flexibility allows us to address notoriously difficult tasks in 3D vision and geometry processing within a unified framework, including shape generation from spectrum, latent space exploration and analysis, mesh super-resolution, shape exploration, style transfer, spectrum estimation for point clouds, segmentation transfer and non-rigid shape matching.

Volumetric parcellation of the cardiac right ventricle for regional geometric and functional assessment

3D echocardiography is an increasingly popular tool for assessing cardiac remodelling in the right ventricle (RV). It allows quantification of the cardiac chambers without any geometric assumptions, which is the main weakness of 2D echocardiography. However, regional quantification of geometry and function is limited by the lower spatial and temporal resolution and the scarcity of identifiable anatomical landmarks, especially within the ventricular cavity. We developed a technique for regionally assessing the volume of 3 relevant RV volumetric regions: apical, inlet and outflow. The proposed parcellation method is based on the geodesic distances to anatomical landmarks that are easily identifiable in the images: the apex and the tricuspid and pulmonary valves, each associated to a region. Based on these distances, we define a partition in the endocardium at end-diastole (ED). This partition is then interpolated to the blood cavity using the Laplace equation, which allows to compute regional volumes. For obtaining an end-systole (ES) partition, the endocardial partition is transported from ED to ES using a commercial image-based tracking software, and then the interpolation process is repeated. We assessed the intra- and inter-observer reproducibility using a 10-subjects dataset containing repeated quantifications of the same images, obtaining intra- and inter- observer errors (7-12% and 10-23% respectively). Finally, we propose a novel synthetic mesh generation algorithm that deforms a template mesh imposing a user-defined strain to a template mesh. We used this method to create a new dataset for involving distinct types of remodelling that were used to assess the sensitivity of the parcellation method to identify volume changes affecting different parts. We show that the parcellation method is adequate for capturing local circumferential and global circumferential and longitudinal RV remodelling, which are the most clinically relevant cases.