Cone beam CT for the assessment of bone microstructure to predict head shape changes after spring-assisted craniosynostosis surgery.

Wolffenbuttel, Tanya; Ajami, Sara; Borghi, Alessandro; Schievano, Silvia; Dunaway, David; Jeelani, Noor Ul Owase; Koudstaal, Maarten

Abstract

Head shape changes following spring-cranioplasty for craniosynostosis (CS) can be difficult to predict. While previous research has indicated a connection between surgical outcomes and calvarial bone microstructure ex-vivo, there exists a demand for identifying imaging biomarkers that can be translated into clinical settings and assist in predicting these outcomes. In this study, ten parietal (8 males, age 157 ± 26 days) and two occipital samples (males, age 1066 and 1162 days) were collected from CS patients who underwent spring cranioplasty procedures. Samples' microstructure were examined using clinical imaging modalities (dental CBCT, C-arm CT) and micro-CT. Cranial index (CI) was measured to evaluate patients' head shape before and after surgery, with an investigation into their relationship with morphometric measurements. Bone cross-sectional thickness (CsTh) showed significant correlation to CI increase post-SAC for C-arm CT (ρ = -0.857, p = 0.014) and 8.9 μm micro-CT (ρ = -0.857, p = 0.014). In addition, bone volume (BV) was correlated to CI increase for CBCT (ρ = -0.643, p = 0.013), 50 μm micro-CT (ρ = -0.857, p < 0.001) and 90 μm micro-CT (ρ = -0.679, p = 0.008). High correlation with micro-CT resampled to match respective voxel sizes was demonstrated for both CBCT and C-arm CT measurements of CsTh and BV (ρ ≥ 0.860, p < 0.001). This preliminary study demonstrates the potential of clinical CT devices to aid in pre-surgical decision making in CS. [Abstract copyright: Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.]

Citation

Wolffenbuttel, T., Ajami, S., Borghi, A., Schievano, S., Dunaway, D., Jeelani, N. U. O., & Koudstaal, M. (2025). Cone beam CT for the assessment of bone microstructure to predict head shape changes after spring-assisted craniosynostosis surgery. Journal of Cranio-Maxillofacial Surgery, 128(49), 142-153. https://doi.org/10.1016/j.jcms.2024.11.014

• Journal Article Type: Article
• Acceptance Date: Nov 15, 2024
• Online Publication Date: Nov 26, 2024
• Publication Date: 2025-02
• Deposit Date: Dec 18, 2024
• Journal: Journal of Cranio-Maxillofacial Surgery
• Print ISSN: 1010-5182
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 128
• Issue: 49
• Pages: 142-153
• DOI: https://doi.org/10.1016/j.jcms.2024.11.014
• Keywords: Cone beam CT, Cranial bone microstructure, Craniosynostosis, Spring-assisted cranioplasty, Preoperative planning
• Public URL: https://durham-repository.worktribe.com/output/3219623