In the field of Radiology, the Computer Aided Diagnosis is the technology which gives valuable information for surgical purpose. For its importance, several computer vison methods are processed to obtain useful information of images acquired from the imaging devices such as X-ray, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT). These methods, called pattern recognition, extract features from images and feed them to some machine learning algorithm to find out meaningful patterns. Then the learned machine is then used for exploring patterns from unseen images. The radiologist can therefore easily find the information used for surgical planning or diagnosis of a patient through the Computer Aided Diagnosis. In this paper, we present a review on three widely-used methods applied to Computer Aided Diagnosis. The first one is the image processing methods which enhance meaningful information such as edge and remove the noise. Based on the improved image quality, we explain the second method called segmentation which separates the image into a set of regions. The separated regions such as bone, tissue, organs are then delivered to machine learning algorithms to extract representative information. We expect that this paper gives readers basic knowledges of the Computer Aided Diagnosis and intuition about computer vision methods applied in this area.

Purpose In this paper we proposed bi-directional hierarchical regression for accurate human finger landmark detection with only using depth information.Materials and Methods Our algorithm consisted of two different step, initialization and landmark estimation. To detect initial landmark, we used difference of random pixel pair as the feature descriptor. After initialization, 16 landmarks were estimated using cascaded regression methods. To improve accuracy and stability, we proposed bi-directional hierarchical structure.Results In our experiments, the ICVL database were used for evaluation. According to our experimental results, accuracy and stability increased when applying bi-directional hierarchical regression more than typical method on the test set. Especially, errors of each finger tips of hierarchical case significantly decreased more than other methods.Conclusion Our results proved that our proposed method improved accuracy and stability and also could be applied to a large range of applications such as augmented reality and simulation surgery.

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

Computed tomography (CT) can completely digitize the interior and the exterior of nearly any object without any destruction. Generally, the resolution for industrial CT is below a few microns. The industrial CT scanning, however, has a limitation because it requires long measuring and processing time. Whereas, 2D X-ray imaging is fast. In this paper, we propose a novel concept of 3D non-destructive inspection technique using the advantages of both micro-CT and dual X-ray images. After registering the master object’s CT data and the sample objects’ dual X-ray images, 3D non-destructive inspection is possible by analyzing the matching results. Calculation for the registration is accelerated by parallel computing using graphics processing unit (GPU).

Background Craniosynostosis management using distraction osteogensis represent a challenge for surgeons due to the great variability of the skull deformity even within the same etiology. The ability to apply the simulation surgery for improving the preoperative planning for distraction osteogensis could improve the results.Planning and Simulation 14 patients presented with craniosynostosis had been subjected to simulation surgery prior to real surgery. 3D CT scans was obtained upon patient admission. Adjustment of all skull position to Frankfort horizontal plane was done. 3 different distraction osteogensis plans were done for each patient according to the skull morphology. For each plane, movement for each bone segment was done according to the pre-planned distraction vectors. Also the distances of distractions were pre-determined according to the cephalic index as well as brain volume. Intraoperatively, we choose the most appropriate plan for the patient by the surgeon. At the end of distraction, 3D CT scan was obtained, and was compared to the simulation plan. Also the distance and the direction of distraction was compared to that of the plan. Accordingly, the distance was almost matching that of the simulation surgery, however the vector of distraction was not matched.Conclusion Preoperative stimulation planning for craniosynostosis patient is very valuable tool in the surgical management of craniosynostosis patients.

Background Congenital muscular torticollis (CMT) is a benign condition. With early diagnosis and appropriate management, it can be cured completely, leaving no residual deformity. However, long-standing, untreated CMT can lead to permanent craniofacial deformities and asymmetry.Methods Nineteen patients presented to the author with congenital muscular torticollis. Three dimensional computed tomography (3-D CT) scans was obtained upon patient’s admission. Adjustment of skull’s position to Frankfort horizontal plan was done. Cervical vertebral segmentation was done which allowed a 3D module to be separately created for each vertebra to detect any anatomical or positional changes.Results The segmented vertebrae showed an apparent anatomical changes, which were most noticeable at the level of the atlas and axis vertebrae. These changes decreased gradually till reaching the seventh cervical vertebra, which appeared to be normal in all patients. The changes in the atlas vertebra were mostly due to its intimate relation with the skull base, while the changes of the axis were the most significantConclusion Cervical vertebral segmentation is a reliable tool for isolation and studying cervical vertebral pathological changes of each vertebra separately. The accuracy of the procedures in addition to the availability of many software that can be used for segmentation will allow many surgeons to use segmentation of the vertebrae for diagnosis and even for preoperative simulation planning.

Fibrous dysplasia(FD) is a disorder in which normal bone is replaced with pathologic tissue. When occurring in craniofacial regions, the zygomaticomaxillary complex is most commonly affected and this pathologic lesion results in facial asymmetry. and By using computer-assisted virtual simulation, precise maxillofacial contouring was achieved for harmonious facial morphology and the surgical procedure was simplified and the surgery brought satisfactory results in terms of both esthetics and functionality.

Fibrous dysplasia is a relatively rare disease but the management would be quite challenging. Because this is not a malignant tumor, the preservation of the facial contour and the various functions seems to be important in treatment planning. Until now the facial bone reconstruction with autogenous bone would be the standard. Although the autogenous bone would be the ideal one for facial bone reconstruction, donor site morbidity would be the inevitable problem in many cases. Meanwhile, various types of allogenic and alloplastic materials have been also used. However, facial bone reconstruction with many alloplastic material have produced no less complications including infection, exposure, and delayed wound healing. Because the 3D printing technique evolved so fast that 3D printed titanium implant were possible recently. The aim of this trial is to try to restore the original maxillary anatomy as possible using the 3D printing model, based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. And we molded Titanium mesh to reconstruct three-dimensional maxillary structure during the operation. This prefabricated Titanium-mesh implant was then inserted onto the defected maxilla and fixed. Three dimensional printing technique of titanium material based on the computer simulation turned out to be successful in this patient. Individualized approach for each patient could be an ideal way to restore the facial bone.