Medical Imaging and 3-D Hollywood Animation Combine to Aid in Face Transplants

CHICAGO - Combining medical imaging with the 3-D modeling used in Hollywood films offers new hope to victims of devastating facial injuries and defects, according to a study presented Monday at RSNA.

Patients with disfigurements become withdrawn and find it difficult to perform everyday activities said Vijay S. Gorantla, MD, PhD, administrative medical director of the Reconstructive Transplantation Program at University of Pittsburgh Medical Center (UPMC). For many patients, face transplantation may be the only option.

“The human face is extremely important for daily interactions, expression and communication,” he said. “The most important aspect of the human face is to look human.”

Facial damage is challenging for plastic surgeons to reconstruct. Surgery uses facial tissue from a donor to reconstruct the face and restore functions such as breathing, talking and eating.

Face transplantation is an emerging field with 18 face transplants performed worldwide in the past six years. The recent wars in Iraq and Afghanistan resulted in blast injuries among soldiers and civilians, which involve damage to bone and soft tissue.

Although there is a lot of data to help with reconstruction, it’s fragmented and you can’t manipulate it, said Darren M. Smith, MD, plastic surgery resident at UPMC who led the study. Currently, plastic or plaster models are created for mock cadaveric dissections that help in planning surgery.

Smith and Gorantla along with Joseph Losee, MD, combined Amira, conventional medical imaging software, with Maya, 3-D animation software to create a 3-D model of the patient's head and neck anatomy. The same technology is used in movies to animate characters with realistic features and expressions.

By integrating 3-D CT, CT angiography, MRI and high-definition tractography, researchers can better understand the extent of damage to patient’s craniofacial anatomy: the bones, muscles, nerves and vessels.

"We have integrated data from multiple imaging sources into a single 3-D representation that allows for real-time user interaction and modification," Smith said. "In assessing eligibility for this procedure, it is critical to understand whether the patient has enough blood vessels and bone structure to support new facial tissue. This 3-D modeling helps us customize the procedure to the patient's individual anatomy so that the donor tissue will fit like a puzzle piece onto the patient's face."

Gorantla says the technology also allows medical teams to measure return to function, reduce operative time and minimize the amount of deaths from surgery.