Nimeskern, L and Feldmann, E-M and Kuo, W and Schwarz, S and Goldberg-Bockhorn, E and Durr, S and Muller, R and Rotter, N and Stok, KS, Magnetic resonance imaging of the ear for patient-specific reconstructive surgery, PLoS ONE, 9, (8) pp. e104975. ISSN 1932-6203 (2014) [Refereed Article]
Copyright 2014 Nimeskern et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/
Introduction: Like a fingerprint, ear shape is a unique personal feature that should be reconstructed with a high fidelity during reconstructive surgery. Ear cartilage tissue engineering (TE) advantageously offers the possibility to use novel 3D manufacturing techniques to reconstruct the ear, thus allowing for a detailed auricular shape. However it also requires detailed patient-specific images of the 3D cartilage structures of the patientís intact contralateral ear (if available). Therefore the aim of this study was to develop and evaluate an imaging strategy for acquiring patient-specific ear cartilage shape, with sufficient precision and accuracy for use in a clinical setting.
Methods and Materials: Magnetic resonance imaging (MRI) was performed on 14 volunteer and six cadaveric auricles and manually segmented. Reproducibility of cartilage volume (Cg.V), surface (Cg.S) and thickness (Cg.Th) was assessed, to determine whether raters could repeatedly define the same volume of interest. Additionally, six cadaveric auricles were harvested, scanned and segmented using the same procedure, then dissected and scanned using high resolution micro-CT. Correlation between MR and micro-CT measurements was assessed to determine accuracy.
Results: Good inter- and intra-rater reproducibility was observed (precision errors <4% for Cg.S and <9% for Cg.V and Cg.Th). Intraclass correlations were good for Cg.V and Cg.S (>0.82), but low for Cg.Th (<0.23) due to similar average Cg.Th between patients. However Pearsonís coefficients showed that the ability to detect local cartilage shape variations is unaffected. Good correlation between clinical MRI and micro-CT (r>0.95) demonstrated high accuracy.
Discussion and Conclusion: This study demonstrated that precision and accuracy of the proposed method was high enough to detect patient-specific variation in ear cartilage geometry. The present study provides a clinical strategy to access the necessary information required for the production of 3D ear scaffolds for TE purposes, including detailed patient-specific shape. Furthermore, the protocol is applicable in daily clinical practice with existing infrastructure.
|Item Type:||Refereed Article|
|Keywords:||cartilage, ears, magnetic resonance imaging, plastic surgery and reconstructive techniques|
|Research Group:||Biomedical engineering|
|Research Field:||Biomechanical engineering|
|Objective Division:||Expanding Knowledge|
|Objective Group:||Expanding knowledge|
|Objective Field:||Expanding knowledge in engineering|
|UTAS Author:||Stok, KS (Dr Kathryn Stok)|
|Web of Science® Times Cited:||8|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||5 View Download Statistics|
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