DICOM International Conference Seminar Work Item Implants Current State and Outlook

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DICOM International Conference & Seminar Work Item Implants – Current State and Outlook Michael Gessat michael.gessat@iccas.de Thomas Trommer, Armin Löpfe, Oliver Burgert

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Outline Implant Templates and Implantation Planning Motivation Features Information Models Examples

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Implant Templates & Implantation Planning The pre-agent choice of the most appropriate embed and the assurance of the ideal position and obsession of an embed in the patient's body is called implantation arranging . Arranging is finished with radiological pictures and graphical representations of inserts, called embed layouts .

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Implant Templates & Implantation Planning

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Motivation At present: No institutionalized semantics and linguistic structure for embed layouts No institutionalized configuration for arranging comes about No coordination of data stream into PACS HIS PACS Server EHR Data Planning Report Patient Images Planning Workstation Required Templates Implant Templates Vendor Template Repository Intraoperative System Patient Images

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Motivation Our objective: Implant formats institutionalized in DICOM Implantation arranges institutionalizes in DICOM All information put away in PACS server Whole information is traded by means of PACS Required Templates HIS Planning Workstation EHR Data Planning Report Planning Report PACS Server incl. Temp. Rep. Tolerant Images Required Templates Implant Templates Intraoperative System Patient Images

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Required Concepts Patient's Morphology X-Rays, CTs, 3D Ultrasound Segmentation and Classification Implant Geometry 2D 3D Result Simulation Biomechanical properties Tissue distortion Transfer into the OR Network innovation & Displays Transfer conventions and organizations

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DICOM Sup. 131 and 134 Implants Stents, Valves, … Bone Mounted Implants Many more Implant Repository: Bone Mounted Implant Template Storage SOP Class Patient Specific Plan/Report: Implantation Plan Document SOP Class General Surface Mesh Module Encapsulated HPGL 2 Based on SR Spine Middle Ear Hip Shoulder Dental

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Workshops In workshops with delegates from the embed business and implantation arranging programming industry. Leipzig, December 13, 2007 San Francisco, March 3, 2008 An arrangement of elements and qualities was expounded. Working Group 24 is taking a shot at the interpretation of the workshop comes about into DICOM Supplements. In parallel, ICCAS takes a shot at a test execution of the new DICOM SOP Classes.

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Features Implant Templates contain 2D or potentially 3D representation, contain (anatomical) milestones for enrollment with patient pictures, contain data about sign, and can comprise of a few segments, Component get together is portrayed: similarity, geometric imperatives, and degrees of flexibility.

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1-n 1 Implant produces Manufacturer 1 comprises of 1-n spatially characterizes Frame of Reference 1-n 1 0-n 1-n acknowledges Component 1 has 0-n 0-n 0-n 0-1 Contact Surface Model 2D Template Fiducial Information Model - Implant Templates

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Example Component 1 "Hip Joint Head" "Material: Porcelain" Contact 1 Coordinates Axes Link: Comp. 2, CP 1 Component 2 "Hip Joint Shaft" "Material: Titan" Contact 1 Coordinates Axes Link: Comp. 1, CP 1 Fiducial 1 Femur Axis

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Implant Types Implants for various purposes contrast particularly in the Attributes and historic points that portray them. We propose an encoding instrument that leaves space for a considerable measure of adaptability. Just the Attributes that are relevant to the kind of embed that is depicted in one Instance should be available. General Implant Attributes Hip Joint Assembly Dental Implant

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Implantation Plan SR Document: Features Implantation Plan Assembly depiction Planning Information Registration Templates (Implant Components) Derived Fiducials Anatomical Fiducials Patient Image Visualization Images: ENDOTEC

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Image IOD Implantation Plan SR alludes to Surface Seg. IOD references Spatial Fiducials IOD spatially adjusts Registration IOD Implant IOD contains 2D Templates Fiducials Surface Model Information Model - Implantation Plan SR Document

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Thank you particularly for your consideration! Affirmations The Innovation Center Computer Assisted Surgery (ICCAS) at the Faculty of Medicine at the University of Leipzig is supported by the German Federal Ministry for Education and Research (BMBF) and the Saxon Ministry of Science and the Fine Arts (SMWK) in the extent of the activity "Unternehmen Region" with the give numbers 03 ZIK 031 and 03 ZIK 032. Gefördert im Rahmen der Technologieförderung mit Mitteln des Europäischen Fonds für regionale Entwicklung (EFRE) und mit Mitteln des Freistaates Sachsen.