Stricter enforcement of work at height guidelines are now in place.
#Marched to the scaffold meaning registration
This preprocessing can be performed by custom-written codes using the Insight Segmentation and Registration Toolkit (ITK) open-source libraries. This can be the removal of low- or high-intensity values to keep a particular grayscale range. Depending on the obtained DICOM dataset, an image preprocessing might be needed, for example, cleaning of the undesired artifacts from the images because of acquisition irregularities.
#Marched to the scaffold meaning manual
This includes some manual refinements to increase the accuracy of the meniscus extraction. Besides, when using a semiautomatic segmentation method, manual corrections on the segmented images are needed. have reported in detail the use of an interactive, real-time geodesic level-set algorithm, a variation of the level-set algorithm to extract meniscus for the use of meniscus tissue engineering (Fig. There are several tools for segmentation including but not limited to MITK, GIST, and Analyze. Digital extraction means the segmentation of the meniscus tissue in the knee DICOM images that came from the MRI. Digital extraction of the meniscus: Digital extraction of the meniscus through medical image segmentation is a critical step in the manufacture of a patient-specific meniscal scaffold. Since meniscus surgeries are the most frequent orthopedic procedures, perhaps when the ideal meniscus implant is developed by the tissue engineers, a dramatic change will happen in the health-care system and/or in the health insurance system. If there are any changes in the knee osteochondral tissues, probably the size and shape of the original healthy meniscus will be lost. Thus, if the patient’s MRI is from a date that the patient needs a meniscus implant, probably the obtained 3D model of the meniscus will not be the model of the healthy meniscus. The challenge in this step is that the extracted 3D model is directly coming from the patient’s MRI.
The technical details should be well communicated between the MRI technician and the tissue engineer who will perform the meniscus extraction and manufacture the scaffold. This brings two challenges in the MRI room: increased cost and keeping the patient still during the entire scan since each time when the patient is not still, the acquisition must be repeated. This MRI acquisition will take longer than the routine ones. Isotropic sequence means that the volumetric images have the same resolution in all dimensions. The acquisition should have a 3D isotropic sequence providing a high-spatial-resolution Digital Imaging and Communications in Medicine (DICOM) dataset. The routine MRI acquisition is not sufficient to extract the meniscus therefore, a specific imaging protocol should be used.
As diagnosed by the patient’s orthopedic surgeon, the implanted-needing leg of the patient is scanned in feet-first supine position preferably with sagittal plane as the acquisition plane either as T1- or T2-weighted MRI. MRI is the most used medical imaging method for the knee in the clinics and also safer than the CT for the patient. The MRI acquisition: Static medical imaging of the patient’s knee is the starting point of the patient-specific meniscal scaffold development, but dynamic MRI can be a future approach.
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