Computer assisted assessment of progressing osteoradionecrosis of the jaw for clinical diagnosis and treatment

Abstract

Osteoradionecrosis (ORN) is a serious side effect of oncologic radiation therapy. Often, surgical removal of the affected skeletal tissue is indicated. In cranio-maxillofacial surgery, partial or total resection of the upper or lower jaw implies a severe impairment of the patient‘s quality of life. Up to now, clear display of ORN is still a challenge. This part of the project is dedicated to medical visualization of progressing ORN for clinical diagnosis. Currently, clinical diagnosis of ORN is mostly based on computer tomography (CT). With regard to its high advantages as e.g. reduced radiation dose, we additionally evaluate cone beam computer tomography (CBCT). After registration on a suitable reference and refined image processing and segmentation, all patient’s CT-/CBCT-data are subjected to various rendering techniques configured for the respective purpose, namely visualization of destructive and/or sclerotic skeletal alterations, consideration of cortical or trabecular bone, and analysis based on CT or CBCT. Recent achievements within the project were demonstrated with special focus on evaluation of both, CT and CBCT as well as on close cooperation with the clinical setting.