Novel 3-dimensional analysis to evaluate temporomandibular joint space and shape.

INTRODUCTION: The purpose of this study was to present and validate a novel semiautomated method for 3-dimensional evaluation of the temporomandibular joint (TMJ) space and condylar and articular shapes using cone-beam computed tomographic data. METHODS: The protocol for 3-dimensional analysis with the Checkpoint software (Stratovan, Davis, Calif) was established by analyzing cone-beam computed tomographic images of 14 TMJs representing a range of TMJ shape variations. Upon establishment of the novel method, analysis of 5 TMJs was further repeated by several investigators to assess the reliability of the analysis. RESULTS: Principal components analysis identified 3 key components that characterized how the condylar head shape varied among the 14 TMJs. Principal component analysis allowed determination of the minimum number of landmarks or patch density to define the shape variability in this sample. Average errors of landmark placement ranged from 1.15% to 3.65%, and none of the 121 landmarks showed significant average errors equal to or greater than 5%. Thus, the mean intraobserver difference was small and within the clinically accepted margin of error. Interobserver error was not significantly greater than intraobserver error, indicating that this is a reliable methodology. CONCLUSIONS: This novel semiautomatic method is a reliable tool for the 3-dimensional analysis of the TMJ including both the form and the space between the articular eminence and the condylar head.

Interactive processing and visualization of image data for biomedical and life science applications.

BACKGROUND: Applications in biomedical science and life science produce large data sets using increasingly powerful imaging devices and computer simulations. It is becoming increasingly difficult for scientists to explore and analyze these data using traditional tools. Interactive data processing and visualization tools can support scientists to overcome these limitations. RESULTS: We show that new data processing tools and visualization systems can be used successfully in biomedical and life science applications. We present an adaptive high-resolution display system suitable for biomedical image data, algorithms for analyzing and visualization protein surfaces and retinal optical coherence tomography data, and visualization tools for 3D gene expression data. CONCLUSION: We demonstrated that interactive processing and visualization methods and systems can support scientists in a variety of biomedical and life science application areas concerned with massive data analysis.

Adaptation of a support vector machine algorithm for segmentation and visualization of retinal structures in volumetric optical coherence tomography data sets.

Recent developments in Fourier domain-optical coherence tomography (Fd-OCT) have increased the acquisition speed of current ophthalmic Fd-OCT instruments sufficiently to allow the acquisition of volumetric data sets of human retinas in a clinical setting. The large size and three-dimensional (3D) nature of these data sets require that intelligent data processing, visualization, and analysis tools are used to take full advantage of the available information. Therefore, we have combined methods from volume visualization, and data analysis in support of better visualization and diagnosis of Fd-OCT retinal volumes. Custom-designed 3D visualization and analysis software is used to view retinal volumes reconstructed from registered B-scans. We use a support vector machine (SVM) to perform semiautomatic segmentation of retinal layers and structures for subsequent analysis including a comparison of measured layer thicknesses. We have modified the SVM to gracefully handle OCT speckle noise by treating it as a characteristic of the volumetric data. Our software has been tested successfully in clinical settings for its efficacy in assessing 3D retinal structures in healthy as well as diseased cases. Our tool facilitates diagnosis and treatment monitoring of retinal diseases.

On a construction of a hierarchy of best linear spline approximations using a finite element approach.

We present a method for the hierarchical approximation of functions in one, two, or three variables based on the finite element method (Ritz approximation). Starting with a set of data sites with associated function, we first determine a smooth (scattered-data) interpolant. Next, we construct an initial triangulation by triangulating the region bounded by the minimal subset of data sites defining the convex hull of all sites. We insert only original data sites, thus reducing storage requirements. For each triangulation, we solve a minimization problem: computing the best linear spline approximation of the interpolant of all data, based on a functional involving function values and first derivatives. The error of a best linear spline approximation is computed in a Sobolev-like norm, leading to element-specific error values. We use these interval/triangle/tetrahedron-specific values to identify the element to subdivide next. The subdivision of an element with largest error value requires the recomputation of all spline coefficients due to the global nature of the problem. We improve efficiency by 1) subdividing multiple elements simultaneously and 2) by using a sparse-matrix representation and system solver.

Individual differences in transcranial electrical stimulation current density.

Transcranial electrical stimulation (TCES) is effective in treating many conditions, but it has not been possible to accurately forecast current density within the complex anatomy of a given subject's head. We sought to predict and verify TCES current densities and determine the variability of these current distributions in patient-specific models based on magnetic resonance imaging (MRI) data. Two experiments were performed. The first experiment estimated conductivity from MRIs and compared the current density results against actual measurements from the scalp surface of 3 subjects. In the second experiment, virtual electrodes were placed on the scalps of 18 subjects to model simulated current densities with 2 mA of virtually applied stimulation. This procedure was repeated for 4 electrode locations. Current densities were then calculated for 75 brain regions. Comparison of modeled and measured external current in experiment 1 yielded a correlation of r = .93. In experiment 2, modeled individual differences were greatest near the electrodes (ten-fold differences were common), but simulated current was found in all regions of the brain. Sites that were distant from the electrodes (e.g. hypothalamus) typically showed two-fold individual differences. MRI-based modeling can effectively predict current densities in individual brains. Significant variation occurs between subjects with the same applied electrode configuration. Individualized MRI-based modeling should be considered in place of the 10-20 system when accurate TCES is needed.

Preformed vs intraoperative bending of titanium mesh for orbital reconstruction.

OBJECTIVE: The most accurate orbital reconstructions result from an anatomic repair of the premorbid orbital architecture. Many different techniques and materials have been used; unfortunately, there is currently no optimal method. This study compares the use of preformed vs intraoperative bending of titanium mesh for orbital reconstruction in 2-wall orbital fractures. STUDY DESIGN: Cadaver-based study. SETTING: University hospital. SUBJECTS AND METHODS: Preinjury computed tomography scans were obtained in 15 cadaveric heads (30 orbits). Stereolithographic (STL) models were fabricated for 5 of the specimens (10 orbits). Two wall fractures (lamina papyracea and floor) were then generated in all orbits. Surgical reconstruction was performed in all orbits using 1 of 3 techniques (10 orbits each): (1) patient-specific implant molded from the preinjury STL model, (2) titanium mesh sheet bent freehand, and (3) preformed titanium mesh. Each technique was evaluated for orbital volume correction, contour accuracy, ease of use, and cost. RESULTS: No difference in volume restoration was found between the 3 techniques. Patient-specific implants had the greatest contour accuracy, poor ease of use, and highest cost. Freehand bending implants had the poorest contour accuracy, acceptable ease of use, and lowest cost. Preformed mesh implants had intermediate contour accuracy, excellent ease of use, and low cost. CONCLUSION: All 3 techniques provide equivalent orbital volume correction. However, preformed mesh implants have many advantages based on contour accuracy, ease of use, and relative cost.