Three-dimensional reconstruction of cranial defect using active contour model and image registration

Yuan Lin Liao, Chia Feng Lu, Yung Nien Sun, Chieh Tsai Wu, Jiann Der Lee, Shih Tseng Lee, Yu Te Wu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


In neurosurgery, cranial incisions during craniotomy can be recovered by cranioplasty-a surgical operation using cranial implants to repair skull defects. However, surgeons often encounter difficulties when grafting prefabricated cranial plates into defective areas, since a perfect match to the cranial incision is difficult to achieve. Previous studies using mirroring technique, surface interpolation, or deformed template had limitations in skull reconstruction to match the patient's original appearance. For this study, we utilized low-resolution and high-resolution computed tomography images from the patient to repair skull defects, whilst preserving the original shape. Since the accuracy of skull reconstruction was associated with the partial volume effects in the low-resolution images and the percentage of the skull defect in the high-resolution images, the low-resolution images with intact skull were resampled and thresholded followed by active contour model to suppress partial volume artifacts. The resulting low-resolution images were registered with the high-resolution ones, which exhibited different percentages of cranial defect, to extract the incised cranial part. Finally, mesh smoothing refined the three-dimensional model of the cranial defect. Simulation results indicate that the reconstruction was 93.94% accurate for a 20% skull material removal, and 97.76% accurate for 40% skull material removal. Experimental results demonstrate that the proposed algorithm effectively creates a customized implant, which can readily be used in cranioplasty.

Original languageEnglish
Pages (from-to)203-211
Number of pages9
JournalMedical and Biological Engineering and Computing
Issue number2
StatePublished - Feb 2011


  • Active contour model
  • Computed tomography
  • Cranial defect
  • Image registration
  • Skull reconstruction


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