Craniosynostosis is the premature fusion of cranial sutures and occurs in approximately one in 2000 live births. It results in cranial malformation that can lead to elevated intra-cranial pressure, brain growth impairment, and developmental deficiency. The most common treatment option for craniosynostosis is surgery. Currently, surgical treatment planning of craniosynostosis is mostly qualitative, subjective and irreproducible guided mainly by the surgeon's experience. While virtual planning has been successfully introduced in niche areas of craniofacial surgery, such as corrective jaw surgery applications, clinical tools that provide accurate and reproducible evaluation of cranial morphology to guide cranial vault remodeling do not yet exist. To cover this gap in current clinical practice, we will develop personalized preoperative planning for infants with craniosynostosis that allows for decreased operative time and blood loss, thereby reducing perioperative morbidity, but also facilitates an optimized and more durable long-term outcome. In this Phase I STTR project, our goal is to design, develop and validate a virtual surgery system for optimal treatment planning for cranial remodeling. The plan includes creating a normative multi-atlas database to capture a wide breadth of normal variations on cranial shape and patient ages, developing image processing and statistical shape analysis algorithms to identify desirable post-operative skull shapes, and analyzing biomechanical properties of cranial bones to evaluate osteotomy plans. The surgeon will be presented with a visual and quantitative map of the patient's cranial malformations, the desired post-treatment cranial shape, and a personalized plan of how cranial shape should be altered in the least invasive fashion to most accurately approach the normal head shape. The impact of our technology is reduced perioperative morbidity and lower treatment costs. The technology will also enable the precise, quantitative comparison of measurements before and after cranial vault reconstruction to determine the efficacy and durability of specific reconstructive techniques.

Public Health Relevance

Craniosynostosis is the premature fusion of cranial sutures and occurs in approximately one in 2000 live births. It results in cranial malformation that can lead to elevated intra-cranial pressure, brain growth impairment, and developmental deficiency. The most common treatment option for craniosynostosis is surgery. The standard planning techniques for surgical treatment of craniosynostosis are qualitative and subjective and guided mainly by surgeon's experience. For precise and reproducible outcomes, we will create and validate a software technology for treatment planning and evaluation of craniosynostosis using image analysis techniques.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Small Business Technology Transfer (STTR) Grants - Phase I (R41)
Project #
1R41HD081712-01
Application #
8778815
Study Section
Special Emphasis Panel (ZRG1-SBIB-V (55))
Program Officer
Willinger, Marian
Project Start
2014-09-26
Project End
2015-08-31
Budget Start
2014-09-26
Budget End
2015-08-31
Support Year
1
Fiscal Year
2014
Total Cost
$224,798
Indirect Cost
Name
Kitware, Inc.
Department
Type
DUNS #
010926207
City
Clifton Park
State
NY
Country
United States
Zip Code
12065
Porras, Antonio R; Zukic, D; Equobahrie, A et al. (2016) Personalized Optimal Planning for the Surgical Correction of Metopic Craniosynostosis. Clin Image Based Proced 2016:60-67