3-D Imaging

What is 3-D imaging?

3-D imaging uses special cameras, CT (computed tomography) scans, advanced software and powerful computers to make detailed pictures of your child’s face or head. Your child’s healthcare team uses the detailed views to accurately diagnose your child and help guide their treatment.

At Seattle Children’s, we use:

• Three-dimensional (3-D) CT scans and advanced software to build precise maps of the bones and muscles of your child’s face and head. To make the images, your child lies on a bed that moves through the CT scanner. The entire scan only takes about 15 seconds.
• A 3dMD camera system to get a 3-D map of your child’s face or head. The system has 15 cameras that capture much more detailed information than a regular photograph. The 3dMD system does not use radiation to make an image.

With both of these 3-D technologies, data is fed into a computer. Software merges the many viewpoints into a single 3-D image. The system creates realistic color images with depth, context and detail of your child’s face and head.

Why choose Seattle Children’s for care?

We are one of the few children’s hospital in the region using a 3dMD system to create clinically accurate 3-D surface images of children with conditions that affect the skull and facial bones, such as craniosynostosis and craniofacial microsomia.

The 3-D CT images we can make at Seattle Children’s help doctors understand where bones have developed in ways that aren’t typical.

Our team is experienced using these detailed images to:

• Diagnose your child’s condition with greater precision
• Plan the best treatment for them
• Guide surgery in the operating room
• Evaluate the results of treatment

How can 3-D imaging help my child?

Fast, accurate scans with less radiation

We use very low-dose, high-speed CT scan imaging compared to conventional CT scanners. This lets us get the best image with the lowest possible radiation exposure for your child. It also means your child needs to stay still for less time during the scan.

In a published study, we showed how we reduced the number of full-dose CT scans by 42% in a 1-year period. The low-dose scans used one-half or less radiation than a standard CT scan of the head. Even with less radiation, images were of a high quality and reliable for diagnosis and management.

With our high-speed scanner, CT exams that once took many minutes now take less than 15 seconds. This makes it less likely that your child will move during imaging, so there is less need to:

• Give your child medicine to prevent them from moving
• Repeat imaging because of movement during the scan

The high-speed CT scanner also lets doctors capture activity in the body that lasts a very short time. An example is CT scanning that requires injecting a dye to highlight blood vessels as the dye passes through them. The dye remains in 1 place for only a few seconds before it flows away. Conventional CT technology is too slow to make a picture of the blood vessels before the dye disappears. By capturing 16 cross-sectional images (slices) per half-second, the high-speed scanner gets the job done.

More effective craniofacial surgery

Some children with craniofacial conditions need surgery to move bones of their face or head. Using 3-D imaging and advanced software, our team can:

• Predict your child’s future growth and plan for the desired position of bones at adulthood
• Create physical models that are so realistic surgeons can practice upcoming operations
• Create precise splints and surgical plates designed for your child’s anatomy
• Plan the exact steps in complex surgeries and refer to the plan in the operating room
• Make surgeries faster and more efficient, which shortens the time your child is under anesthesia

Computer-assisted surgical planning (CASP) has revolutionized the way surgeries are done. With virtual 3-D planning, our surgeons can design the bone cuts and movements, and they can simulate the effects on the facial form and tooth alignment. CASP gives patients and families a chance to see before surgery, in 3 dimensions, the potential changes that may result from an operation.

This child with achondroplasia had severe obstructive sleep apnea due to the size and position of bones in their face.

Before (left): (Panel A) A 3D CT scan done before surgery shows that the child’s cheekbones, upper jaw and lower jaw were small and their teeth didn’t fit together well. (Panel C) The blue area shows the child’s airway, which was smaller than typical for their age.

After (right): (Panel B) A 3D CT scan after surgery shows the new position of the child’s bones. They had a series of surgeries to bring their nose and cheekbones forward (segmental Le Fort III osteotomy), their upper jaw and teeth forward (Le Fort I osteotomy) and their lower jaw forward (bilateral mandibular osteotomies). (Panel D) The green area shows the child’s larger airway. Their sleep improved, and they needed no further treatment for obstructive sleep apnea.

Making treatment choices clearer

The detail in 3-D images makes it easier for doctors to show you how treatment is likely to improve your child’s condition.

Seeing a 3-D image of the expected results for your child can help as you make decisions about their treatment.

Predicting how facial implants will affect appearance

Some children need implants to help make their bones and tissue look more typical. Facial implants are artificial, bonelike structures. Doctors insert them under your child’s skin to support the face and restore its shape.

Our doctors use 3-D images to decide where to use implants and predict how they will affect your child’s appearance.

3-D images and computer-assisted design (CAD) technology help the team design implants that are custom-made for your child’s face.

Measuring treatment results

After surgery, we often use 3-D imaging to measure your child’s results. This helps us assess the need for more treatment, improve surgical techniques and invent new ones.

Knowing which treatments have the best results helps us choose the right procedure for your child.

Research to Improve Craniofacial Care

Many of our doctors use 3-D images in their research to:

• Measure how severe a cleft is and how much surgery has changed it. Dr. Raymond Tse’s goal is to help surgeons decide on the best treatment for each child.
• Develop tools to measure how craniofacial microsomia and other conditions change facial features.
• Create a searchable library of 3-D images of children before and after surgery for craniosynostosis. Accurately measuring the changes in a child’s skull and face will help providers show which surgeries have the best results for specific conditions.
• Study how changes in genes disrupt typical development of the roof of the mouth (palate). Dr. Kai Yu combines mouse models and 3-D micro-CT to understand how the palate forms.
• Study obstructive sleep apnea in babies with craniofacial conditions, including Robin sequence. A team led by Dr. Kelly Evans aims to use 3-D images to tell how severe a child’s breathing problem is, tell which treatment they need and design a device that goes in their mouth to relieve their airway problem (orthodontic airway plate).

Scheduling an Appointment With the Craniofacial Center

• Contact the Craniofacial Center at 206-987-2208 for an appointment, a second opinion or more information.
• How to schedule an appointment at Seattle Children’s.
• If you already have an appointment, learn more about how to prepare.
• Learn about Craniofacial Center resources such as useful links, videos and recommended reading for you and your family.

Contact Us

Contact the Craniofacial Center at 206-987-2208 for an appointment, a second opinion or more information.

If you live outside of Washington, Alaska, Montana and Idaho, please contact our coordinator for out-of-area patients at 206-987-0814.

Providers, see how to refer a patient.