Strelko Oleksandr, Aryal Manish Raj, Zack Abigail, Alfawares Yara, Remenyi Roland, Bayan Ian Kristopher, Briones Yumi L, Holovenko Yaroslav, Maksymenko Maksym, Sirko Andrii, Anand Sam, Forbes Jonathan A
Stritch School of Medicine, Loyola University Chicago, Maywood, IL 601611, USA.
Center for Global Design and Manufacturing, Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH 45219, USA.
Biomimetics (Basel). 2024 Jul 16;9(7):430. doi: 10.3390/biomimetics9070430.
Traumatic Brain Injury (TBI) is a significant global health concern, particularly in low- and middle-income countries (LMICs) where access to medical resources is limited. Decompressive craniectomy (DHC) is a common procedure to alleviate elevated intracranial pressure (ICP) following TBI, but the cost of subsequent cranioplasty can be prohibitive, especially in resource-constrained settings. We describe challenges encountered during the beta-testing phase of CranialRebuild 1.0, an automated software program tasked with creating patient-specific cranial implants (PSCIs) from CT images. Two pilot clinical teams in the Philippines and Ukraine tested the software, providing feedback on its functionality and challenges encountered. The constructive feedback from the Philippine and Ukrainian teams highlighted challenges related to CT scan parameters, DICOM file arrays, software limitations, and the need for further software improvements. CranialRebuild 1.0 shows promise in addressing the need for affordable PSCIs in LMICs. Challenges and improvement suggestions identified throughout the beta-testing phase will shape the development of CranialRebuild 2.0, with the aim of enhancing its functionality and usability. Further research is needed to validate the software's efficacy in a clinical setting and assess its cost-effectiveness.
创伤性脑损伤（TBI）是一个重大的全球健康问题，在医疗资源获取有限的低收入和中等收入国家（LMICs）尤为突出。去骨瓣减压术（DHC）是缓解TBI后颅内压（ICP）升高的常见手术，但后续颅骨修补术的成本可能过高，尤其是在资源有限的环境中。我们描述了CranialRebuild 1.0软件测试阶段遇到的挑战，该软件是一个自动化程序，负责根据CT图像创建患者特异性颅骨植入物（PSCI）。菲律宾和乌克兰的两个试点临床团队对该软件进行了测试，并就其功能和遇到的挑战提供了反馈。菲律宾和乌克兰团队的建设性反馈突出了与CT扫描参数、DICOM文件阵列、软件限制以及进一步改进软件的必要性相关的挑战。CranialRebuild 1.0在满足LMICs对经济实惠的PSCI的需求方面显示出前景。在整个测试阶段确定的挑战和改进建议将塑造CranialRebuild 2.0的开发，旨在增强其功能和可用性。需要进一步研究以验证该软件在临床环境中的疗效并评估其成本效益。
