Planning, guidance, and quality assurance of pelvic screw placement using deformable image registration
Percutaneous pelvic screw placement is challenging due to narrow bone corridors surrounded by vulnerable structures and difficult visual interpretation of complex anatomical shapes in 2D x-ray projection images. To address these challenges, a system for planning, guidance, and quality assurance (QA)...
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Published in | Physics in medicine & biology Vol. 62; no. 23; pp. 9018 - 9038 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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England
IOP Publishing
13.11.2017
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Abstract | Percutaneous pelvic screw placement is challenging due to narrow bone corridors surrounded by vulnerable structures and difficult visual interpretation of complex anatomical shapes in 2D x-ray projection images. To address these challenges, a system for planning, guidance, and quality assurance (QA) is presented, providing functionality analogous to surgical navigation, but based on robust 3D-2D image registration techniques using fluoroscopy images already acquired in routine workflow. Two novel aspects of the system are investigated: automatic planning of pelvic screw trajectories and the ability to account for deformation of surgical devices (K-wire deflection). Atlas-based registration is used to calculate a patient-specific plan of screw trajectories in preoperative CT. 3D-2D registration aligns the patient to CT within the projective geometry of intraoperative fluoroscopy. Deformable known-component registration (dKC-Reg) localizes the surgical device, and the combination of plan and device location is used to provide guidance and QA. A leave-one-out analysis evaluated the accuracy of automatic planning, and a cadaver experiment compared the accuracy of dKC-Reg to rigid approaches (e.g. optical tracking). Surgical plans conformed within the bone cortex by 3-4 mm for the narrowest corridor (superior pubic ramus) and >5 mm for the widest corridor (tear drop). The dKC-Reg algorithm localized the K-wire tip within 1.1 mm and 1.4° and was consistently more accurate than rigid-body tracking (errors up to 9 mm). The system was shown to automatically compute reliable screw trajectories and accurately localize deformed surgical devices (K-wires). Such capability could improve guidance and QA in orthopaedic surgery, where workflow is impeded by manual planning, conventional tool trackers add complexity and cost, rigid tool assumptions are often inaccurate, and qualitative interpretation of complex anatomy from 2D projections is prone to trial-and-error with extended fluoroscopy time. |
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AbstractList | Percutaneous pelvic screw placement is challenging due to narrow bone corridors surrounded by vulnerable structures and difficult visual interpretation of complex anatomical shapes in 2D x-ray projection images. To address these challenges, a system for planning, guidance, and quality assurance (QA) is presented, providing functionality analogous to surgical navigation, but based on robust 3D-2D image registration techniques using fluoroscopy images already acquired in routine workflow. Two novel aspects of the system are investigated: automatic planning of pelvic screw trajectories and the ability to account for deformation of surgical devices (K-wire deflection). Atlas-based registration is used to calculate a patient-specific plan of screw trajectories in preoperative CT. 3D-2D registration aligns the patient to CT within the projective geometry of intraoperative fluoroscopy. Deformable known-component registration (dKC-Reg) localizes the surgical device, and the combination of plan and device location is used to provide guidance and QA. A leave-one-out analysis evaluated the accuracy of automatic planning, and a cadaver experiment compared the accuracy of dKC-Reg to rigid approaches (e.g. optical tracking). Surgical plans conformed within the bone cortex by 3-4 mm for the narrowest corridor (superior pubic ramus) and >5 mm for the widest corridor (tear drop). The dKC-Reg algorithm localized the K-wire tip within 1.1 mm and 1.4° and was consistently more accurate than rigid-body tracking (errors up to 9 mm). The system was shown to automatically compute reliable screw trajectories and accurately localize deformed surgical devices (K-wires). Such capability could improve guidance and QA in orthopaedic surgery, where workflow is impeded by manual planning, conventional tool trackers add complexity and cost, rigid tool assumptions are often inaccurate, and qualitative interpretation of complex anatomy from 2D projections is prone to trial-and-error with extended fluoroscopy time. Percutaneous pelvic screw placement is challenging due to narrow bone corridors surrounded by vulnerable structures and difficult visual interpretation of complex anatomical shapes in 2D x-ray projection images. To address these challenges, a system for planning, guidance, and quality assurance (QA) is presented, providing functionality analogous to surgical navigation, but based on robust 3D-2D image registration techniques using fluoroscopy images already acquired in routine workflow. Two novel aspects of the system are investigated: automatic planning of pelvic screw trajectories and the ability to account for deformation of surgical devices (K-wire deflection). Atlas-based registration is used to calculate a patient-specific plan of screw trajectories in preoperative CT. 3D-2D registration aligns the patient to CT within the projective geometry of intraoperative fluoroscopy. Deformable known-component registration (dKC-Reg) localizes the surgical device, and the combination of plan and device location is used to provide guidance and QA. A leave-one-out analysis evaluated the accuracy of automatic planning, and a cadaver experiment compared the accuracy of dKC-Reg to rigid approaches (e.g., optical tracking). Surgical plans conformed within the bone cortex by 3–4 mm for the narrowest corridor (superior pubic ramus) and >5 mm for the widest corridor (tear drop). The dKC-Reg algorithm localized the K-wire tip within 1.1 mm and 1.4° and was consistently more accurate than rigid-body tracking (errors up to 9 mm). The system was shown to automatically compute reliable screw trajectories and accurately localize deformed surgical devices (K-wires). Such capability could improve guidance and QA in orthopaedic surgery, where workflow is impeded by manual planning, conventional tool trackers add complexity and cost, rigid tool assumptions are often inaccurate, and qualitative interpretation of complex anatomy from 2D projections is prone to trial-and-error with extended fluoroscopy time. |
Author | Kleinszig, G Osgood, G Siewerdsen, J H Uneri, A Manbachi, A Han, R Jacobson, M Ramsay, B De Silva, T Wolinsky, J-P Ketcha, M Vogt, S Goerres, J |
AuthorAffiliation | 4 Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA 2 Siemens Healthineers, Erlangen, Germany 1 Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA 3 Neurological Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA |
AuthorAffiliation_xml | – name: 3 Neurological Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA – name: 4 Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA – name: 2 Siemens Healthineers, Erlangen, Germany – name: 1 Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA |
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References | 44 46 49 Yao J (53) 2003; 2 Uneri A (45) 2017; 62 50 51 52 10 54 12 13 Uneri A (48) 2015; 60 14 15 17 Roth H R (37) 2014 18 19 Seim H (42) 2008 Goerres J (16) 2017; 62 1 2 3 4 Otake Y (31) 2012; 57 5 6 7 8 9 Lamecker H (26) 2004 De Silva T (11) 2016; 61 20 21 22 23 Peters T M (34) 2006; 51 24 25 27 28 29 Uneri A (47) 2014; 59 Otake Y (32) 2013; 58 30 33 35 36 Seff A (41) 2014 38 39 40 43 |
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SubjectTerms | 3D-2D registration Algorithms atlas registration Bone Screws Cadaver Fluoroscopy - methods Humans Image Processing, Computer-Assisted - methods Imaging, Three-Dimensional - methods pelvic surgery Pelvis - diagnostic imaging Pelvis - surgery percutaneous screw quality assurance Quality Assurance, Health Care Surgery, Computer-Assisted - methods surgical navigation surgical planning Tomography, X-Ray Computed - methods |
Title | Planning, guidance, and quality assurance of pelvic screw placement using deformable image registration |
URI | https://iopscience.iop.org/article/10.1088/1361-6560/aa954f https://www.ncbi.nlm.nih.gov/pubmed/29058687 https://search.proquest.com/docview/1954420435 https://pubmed.ncbi.nlm.nih.gov/PMC5868367 |
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