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ArticleInternational journal of computer assisted radiology and surgery2026

Quantitative intraoperative assessment of fronto-orbital advancement and remodelling in craniosynostosis.

Wuyang Shui, Vejay Vakharia, Aitor de Gea Rico, Martin Van Carlen, Ce Liang, Mehran Moazen, Roman Hossein Khonsari, Anusha Hennedige, Ajay Sinha, Chris Parks and 1 more

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Article in International journal of computer assisted radiology and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

11 authors.

Wuyang ShuiAlder Hey Children's Hospital, Liverpool, L14 5AB, UK. wuyang.shui@alderhey.nhs.uk.ORCID http://orcid.org/0000-0002-1596-852X
Vejay VakhariaAlder Hey Children's Hospital, Liverpool, L14 5AB, UK.
Aitor de Gea RicoAlder Hey Children's Hospital, Liverpool, L14 5AB, UK.
Martin Van CarlenAlder Hey Children's Hospital, Liverpool, L14 5AB, UK.
Ce LiangDepartment of Mechanical Engineering, University College London, London, WC1E 7JE, UK.
Mehran MoazenDepartment of Mechanical Engineering, University College London, London, WC1E 7JE, UK.
Roman Hossein KhonsariService de Chirurgie Maxillofaciale Et Chirurgie Plastique, Hôpital Necker - Enfants Malades, 75015, Paris, France.
Anusha HennedigeAlder Hey Children's Hospital, Liverpool, L14 5AB, UK.
Ajay SinhaAlder Hey Children's Hospital, Liverpool, L14 5AB, UK.
Chris ParksAlder Hey Children's Hospital, Liverpool, L14 5AB, UK.
Christian DuncanAlder Hey Children's Hospital, Liverpool, L14 5AB, UK. christian.duncan@alderhey.nhs.uk.

Funding

Engineering and Physical Science Research Council EP/W008092/1
6 · The paper itself

Abstract

purposeIntraoperative morphometric analysis provides immediate feedback for evaluating surgical outcomes in infants with craniosynostosis undergoing fronto-orbital advancement and remodelling. However, current intraoperative assessment primarily relies on surgeon's judgement and clinical experience. This study aimed to develop a computational method for comprehensive analysis of detailed morphological features in the intraoperative 3D surface scan acquired with a structured-light handheld scanner.

methodsOur method consists of three stages: First, we computed cephalometric measurements, such as interfrontal angle (IFA) and cranial index (CI). Second, we developed a coarse-to-fine registration method to align the pre- and intraoperative surfaces, enabling accurate superimposition of non-operated region. Finally, we employed geometric morphometrics to examine frontal morphological shape differences. The proposed method was applied to one patient with trigonocephaly and one with Saethre-Chotzen syndrome (SCS).

resultsA small root mean square error (0.5-0.6 mm) indicated high registration accuracy. The cephalometric measurements and colour maps of intraoperative geometric changes indicated frontal advancement in both the anterior and lateral directions, with an increased IFA in the trigonocephaly case and a decreased CI in the SCS case. Geometric morphometric analysis suggested that the central forehead remained relatively flat on the intraoperative 3D surface, although the overall frontal morphology approached that of the control group.

conclusionThe proposed analytical method combined with 3D scanning provides new insights into quantitative intraoperative assessment through the comparison of cephalometric measurements, quantification of geometric surface changes, and examination of morphological variation. This framework has the potential to be integrated into routine surgical workflows for craniosynostosis treatment.

Indexed as

Cephalometric measurementCraniosynostosisGeometric morphometricsIntraoperative assessmentMesh registration

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.