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Solid models for CT/MR image display: accuracy and utility in surgical planning

Medical imaging can now take wider advantage of Computer-Aided-Manufacturing through rapid prototyping technologies (RPT) such as stereolithography, laser sintering, and laminated object manufacturing to directly produce solid models of patient anatomy from processed CT and MR images. While conventional surgical planning relies on consultation with the radiologist combined with direct reading and measurement of CT and MR studies, 3-D surface and volumetric display workstations are providing a more easily interpretable view of patient anatomy. RPT can provide the surgeon with a life size model of patient anatomy constructed layer by layer with full internal detail. Although this life-size anatomic model is more easily understandable by the surgeon, its accuracy and true surgical utility remain untested. We have developed a prototype image processing and model fabrication system based on stereolithography, which provides the neurosurgeon with models of the skull base. Parallel comparison of the model with the original thresholded CT data and with a CRT displayed surface rendering showed that both have an accuracy of 99.6 percent. Because of the ease of exact voxel localization on the model, its precision was high with the standard deviation of measurement of 0.71 percent. The measurements on the surface rendered display proved more difficult to exactly locate and yielded a standard deviation of 2.37 percent. This paper presents our accuracy study and discussed ways of assessing the quality of neurosurgical plans when 3-D models a made available as planning tools.