This guide explains what a case needs to be processed successfully in CustoMED: the anatomy and imaging requirements, supported inputs, the outputs to expect and how cases are reviewed and approved. It applies to all surgical indications and anatomical regions.
1. What makes a case eligible?
To allow accurate segmentation, planning and patient-specific outputs, each case must meet basic technical and anatomical requirements:
The relevant anatomy for the selected procedure must be clearly visible.
All key anatomical landmarks needed for planning must be included.
Imaging quality must allow reliable segmentation and 3D reconstruction.
If only part of the required anatomy is available, you may still be able to plan the case, limited to the anatomy provided.
2. Imaging requirements (CT)
For best results, CT scans should meet these criteria. For the full scan protocol, see Supported File Formats & Scan Protocols.
Parameter | Requirement |
Slice thickness | ≤ 1.5 mm |
Slice spacing | ≤ 1.5 mm |
Pixel spacing | ≤ 1.0 mm |
Series length | At least 30 slices |
Motion artifact | Minimal (the patient should remain still) |
Metal artifact | If present, uploading your own STL models is recommended |
When you upload, CustoMED checks each series and flags slice thickness above 1.5 mm, slice spacing of 1.5 mm or more and pixel spacing above 1.5 mm. CT series with fewer than 30 slices can't be used. See Preparing & Uploading Your CT Scan (DICOM).
Important: Severe artifacts that obscure bone anatomy may result in case rejection.
3. Uploading your own STL models (optional)
You may upload your own STL models instead of, or in addition to, the CT scan. Clinicians, Medical Assistants and Sales Reps can upload DICOM only; other roles can upload STL files.
Supported when
The CT scan is not suitable for segmentation
Metal artifacts are present
The case is for validation, training or review
STL guidelines
STL files must represent complete, clinically relevant anatomy.
Files must follow CustoMED naming conventions.
Save each bone as one STL file.
STL files must align correctly with the original CT orientation.
Don't include pre-implanted devices or artifacts (unless for review only).
4. Supported case scope
CustoMED supports cases that:
Match a supported indication in the platform
Are left or right sided (when applicable)
Include anatomy relevant to the selected procedure
Are submitted by authorized users
The level of support depends on the selected indication, the available anatomy, imaging quality and case completeness.
5. Unsupported or rejected cases
Cases may be rejected if they include:
Anatomy not supported by the selected indication
Severe imaging artifacts preventing segmentation
Large existing implants that obscure landmarks (for example, revision cases)
Missing required anatomical coverage
Non-clinical or non-medical datasets
Rejected cases are not charged.
6. What happens after upload?
Your browser anonymizes the data before it is uploaded.
The case shows Segmenting while the scan is processed.
When the segmentation is ready, you review it and confirm it or send it back.
You then go through each planning step, such as landmarks, surgery planning and PSI design. You can adjust what you see, then confirm or reject the step.
Finally, you approve the case.
The segmentation is typically ready for your review within 24 hours. For urgent cases, contact support.
7. Platform outputs
After final approval, the case outputs can include:
Anatomical models
Procedure-focused anatomy models (.STL)
Full anatomy models (.STL), where applicable
Patient-specific outputs
Surgical guides (.STL), based on the available anatomy
Additional indication-specific outputs
Case documentation
A PDF case report including the planning summary, measurements, design details and visual references
Available outputs depend on the indication and the approved anatomy. See Downloading Files & Plan Reports.
8. Case charges policy
Case status | Charged |
Rejected by CustoMED (technical or incomplete) | No |
Cancelled or rejected by the user before approval | No |
Validation or training cases | No |
Fully approved, with case outputs | Yes |
A case counts against your organization's case limit when it is approved. See Case Quotas & Billing Alerts.
9. Clinical responsibility and intended use
The CustoMED platform:
Does not provide diagnoses or treatment decisions
Does not replace clinical judgment
Is intended to support visualization, planning and communication
All final decisions regarding implant choice, implant positioning and surgical execution must be made by a licensed healthcare professional, who remains fully responsible for patient care. See Regulatory Status and Use of the CustoMED Platform.
10. Need help?
If you're not sure whether your case meets the requirements, or you run into problems during upload, check the file contents and anatomy coverage, then contact CustoMED Support. We're here to help your case run smoothly.