Minh Nhat Phung

Cranial reconstruction is a critical task in computer-assisted surgery, requiring both high geometric accuracy and computational efficiency for patient-specific implant design. While recent deep learning approaches, particularly 3D UNet-based models, have demonstrated promising performance, most studies primarily focus on architectural modifications, with limited attention to the systematic impact of data preparation and training strategies on reconstruction quality. In this study, we present a comprehensive data-centric investigation of key factors influencing the performance of a baseline 3D UNet for cranial defect reconstruction. Specifically, we analyze the effects of data preprocessing (denoising), dataset organization (ordered versus randomized training), defect morphology diversity, convolutional kernel size, and loss function design under controlled experimental conditions. Experiments were conducted on 250 complete skulls (NRRD format) from the MUG500+ dataset, with synthetically generated defects across multiple anatomical regions. From these volumes, a total of 3750 training samples were generated, including: (i) 1250 noisy samples with diverse defect morphologies, (ii) 1250 denoised samples with ellipsoidal defects, and (iii) 1250 denoised samples with multiple defect types. The results demonstrate that data-centric and training-related factors have a substantial impact on model performance, in several cases exceeding the influence of architectural design. In particular, denoising significantly improves boundary stability and reduces geometric error, while incorporating diverse defect morphologies enhances generalization to unseen shapes. Additionally, ordered training contributes to more stable convergence, and an optimal kernel size of (3 × 3 × 3) achieves the best trade-off between accuracy and computational efficiency. A hybrid Dice and boundary loss further improves boundary precision compared to conventional Dice loss. The optimized configuration achieves a Dice Similarity Coefficient of 0.94 and a Hausdorff Distance of 3.8 mm, with an average inference time of 0.004 s per case. These results demonstrate that data-centric optimization can be as influential as, or even more impactful than, architectural design in cranial defect reconstruction. The findings provide practical and reproducible guidelines for developing efficient, robust, and clinically applicable deep learning-based systems for patient-specific cranial implant design.