Evaluation of 3D imaging.

Interactive computer-based simulation is gaining acceptance for craniofacial surgical planning. Subjective visualization without objective measurement capability, however, severely limits the value of simulation since spatial accuracy must be maintained. This study investigated the error sources involved in one method of surgical simulation evaluation. Linear and angular measurement errors were found to be within +/- 1 mm and 1 degree. Surface match of scanned objects was slightly less accurate, with errors up to 3 voxels and 4 degrees, and Boolean subtraction methods were 93 to 99% accurate. Once validated, these testing methods were applied to objectively compare craniofacial surgical simulations to post-operative outcomes, and verified that the form of simulation used in this study yields accurate depictions of surgical outcome. However, to fully evaluate surgical simulation, future work is still required to test the new methods in sufficient numbers of patients to achieve statistically significant results. Once completely validated, simulation cannot only be used in pre-operative surgical planning, but also as a post-operative descriptor of surgical and traumatic physical changes. Validated image comparison methods can also show discrepancy of surgical outcome to surgical plan, thus allowing evaluation of surgical technique.