Summary
Objectives:
Trauma surgeons possess specific anticipative pathoanatomical and procedural domain
knowledge that can be used for information extraction from original CT image data.
This knowledge so far remains unused in clinical workflow and surgeons do not take
an active part in the process of image generation and processing. The objectives of
our work are to propose and employ a strategy to directly involve surgeons in a dynamic
image exploration process and to exemplarily assess the clinical use of this appoach
for pre-operative diagnosis of complex articular fractures.
Methods:
We used an interactive 3D navigation tool with a novel human-computer interface for
the exploration of articular fractures of two selected anatomical structures. The
system offers dynamic interaction with a virtual 3D reconstruction model and the possibility
to create on-the-fly oblique multiplanar reformations by tracking hand movements.
Three expert surgeons performed exemplary explorations and rated the use of the method
for preoperative diagnosis in informal interviews.
Results:
The approach and the system were well received by the three surgeons. The dynamic
interaction was rated to be helpful in understanding fracture morphology. Two examples
– a radius and a calcaneal fracture – are presented.
Conclusions:
Surgeons with their specific domain knowledge should be involved in the process of
image processing. The benefit of using oblique multiplanar reformations for pre-operative
planning in articular fractures appears to be substantial and they should therefore
be included in radiological and surgical textbooks. Further evaluation is necessary
to assess the use of interactive exploration systems in routine diagnosis.
Keywords
Diagnostic imaging - human-computer interface - articular fractures - visualization
- pre-operative planning
