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American Association of Plastic Surgeons

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Blackbone MRI Is As Accurate As CT In Reconstructive And Craniofacial Surgical Planning: A Means To Reduce Radiation Exposure
Marissa Suchyta, BA, Waleed Gibreel, MBBS, Christopher H. Hunt, MD, Krzysztof Gorny, PhD, Samir Mardini, MD.
Mayo Clinic, Rochester, MN, USA.

Purpose: Virtual surgical planning and 3D printed guides enable more accurate, streamlined surgeries. However, these technologies require high resolution CT scanning, with radiation exposure. The purpose of this project is to demonstrate the state of BlackBone MRI in accurately planning and performing midface, orbital, cranial vault, and mandibular reconstructive surgery. Methods: For each mock surgical procedure (maxillary advancement, orbital floor reconstruction with patient-specific implants, cranial vault reconstruction, and fibular free flap reconstruction of the mandible), ten cadaver heads were used. Five of each surgery were planned and 3D printed guides were created utilizing BlackBone MRI, and other five were planned and performed using CT scans. Following mock surgeries, all specimens underwent a postoperative CT scan. 3d reconstruction of scans was performed and surgical accuracy compared to the plan was assessed using GeoMagic Wrap. Results: In all surgeries, guides created from BlackBone MRI demonstrated high accuracy to surgical plan. Average osteotomy deviation from plan was not statistically significantly different compared to CT scans for planning and guide creation in all surgeries performed. The average deviation of post-operative anatomy from pre-operative plan was also not statistically significant when BlackBone MRI versus CT scans were utilized in the surgeries. Conclusions: This study demonstrates that virtual surgical planning and 3d surgical guide creation can be performed using Blackbone MRI with comparable accuracy to CT scans in a wide variety of craniofacial and microsurgical reconstructions. This study demonstrates the potential to change the pre-operative planning standard of care, eliminating patient radiation exposure for surgical planning.


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