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- Mandible/Fibula Segmentation are inputs of this module. The segment at position zero (first segment of the segmentation) should be the mandible/fibula bone segment because it is used to make the 3D bone model used in BoneReconstructionPlanner.
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- Mandible/Fibula segments shouldn't have holes inside because they confuse the positioning algorithm of the sawBoxes/miterBoxes. To eliminate holes from a segment use WrapSolidify effect in the segment editor.
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- BoneReconstructionPlanner module is made to do virtual surgical planning and design of patient-specific surgical guides for mandibular reconstruction.
1. Download Slicer Stable Release from here: https://download.slicer.org/ It's version is 4.11.20210226
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2. Install Slicer
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3. Open Slicer
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4. Press Ctrl+4 to open the extension manager. Or click the upper-right icon with the letter 'E'
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5. Go to 'Install Extensions' tab
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6. On the upper-right search box write "BoneReconstructionPlanner"
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7. Click install and give okay to install other extensions if asked.
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8. Tell me if there are some errors till here.
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## Segmentation (Preparation for Virtual Surgical Planning)
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Make a mandible segmentation and a fibula segmentation.
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Example:
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0. CTs should have a recommended slice thickness of 0.65mm (or a maximum slice thickness of 1mm)
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1. Go to the segment editor. Create a new segmentation. Create a new segment, name it 'fibula'.
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2. Use threshold effect to select bone but not connecting tissue (like ligaments). Check if your selected threshold value is okay if there is no connection of the segmented bones near the joint. Threshold value should not be too low to not lose detail. Suggested value: 200
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3. Use Islands effect, select 'keep selected island' and click over the fibula to keep it.
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4. If successful continue. If not start over and use a higher threshold value or use scissors to isolate the fibula
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5. Go to Wrap Solidify effect and click apply. (This is needed because it is recommended that bone segmentations have no holes inside so the assisted miterBox positioning algorithms work well)
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6. Correct errors on segmentations with scissors if needed.
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7. The bone segment (fibula or mandible) should be the first of the segment-list of the segmentation. In other words the bone segment should be in position zero of the list.
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## Virtual Surgical Planning
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1. Click the search icon on the left of the module selector and write 'BoneReconstructionPlanner'. Click switch to module.
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2. Select the mandibular segmentation and the fibula segmentation.
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3. Click "Create bone models from segmentations"
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4. Click "Add mandibular curve" and create a curve along the mandible. This will help giving the cut planes their initial position.
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5. Click "Add cut plane" and click where you want plane. Add as many planes as needed. There will be a bone piece between every two adjacent planes. So the number of mandible planes should be the desired number of bone pieces for the reconstruction plus one. The first and the last mandible planes will be the mandible resection cuts.
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6. Click "Add fibula line". Draw a line over the fibula on the 3D view. First point distal, last point proximal.
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7. Click "Center fibula line using fibula model" to make the line be similar to the anatomical axis of the fibula.
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8. Tick these options: "Automatic mandibular planes positioning for maximum bones contact area", "Make all mandible planes rotate together"
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9. Click "Update fibula planes over fibula line; update fibula bone pieces and transform them to mandible" to make the reconstruction and create the fibula cut planes.
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10. Move the mandible planes as desired to change the position/orientation of the cuts.
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11. Click "Update fibula planes over fibula line; update fibula bone pieces and transform them to mandible" again. And repeat as many times as needed.
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