Accuracy Assessment of Image-Based Surface Meshing for Volumetric Computed Tomography Images in the Craniofacial Region

Background: Three-dimensional printing and computer-assisted surgery demand a high-precision three-dimensional mesh model created from computed tomography (CT) imaging data using an image-based meshing algorithm. We aimed to evaluate the three-dimensional geometric accuracy of surface meshes produced from CT images with commercially available software packages. Methods: The CT images were acquired for 3 human dry skulls and 10 manufactured plastic skulls. Four commercially available software packages were used to produce the surface meshes in stereolithography (STL) file format. These CT-based STL surface meshes were registered and compared with three-dimensional optical-scanned reference mesh surface for evaluating the accuracy of the STL mesh produced with each software package. Results: The surface geometries produced by the CT-image-based meshing process were all relatively accurate; differences from the three-dimensional optical-scanned data were in the voxel or subvoxel range. However, when comparisons with the three-dimensional optical-scanned surface data were performed in individual anatomic regions, we found significantly different accuracies of the CT-based STL surface meshes produced by the different software packages. Conclusions: We found that all 4 software packages showed reasonably good meshing accuracies for clinical use. However, the range of errors inherent in the CT-image-based meshing process demands that caution should be taken in selecting and manipulating the software to avoid potential errors in specific clinical applications.