Annals of Biomedical Engineering ( IF 3.8 ) Pub Date : 2020-06-12 , DOI: 10.1007/s10439-020-02546-5 Andrew Chan 1 , Brendan Coutts 2 , Eric Parent 3 , Edmond Lou 1, 2
Posterior spinal fusion surgery requires careful insertion of screws into the spine to avoid neurologic injury. While current systems use CT-scans, three-dimensional ultrasound (3DUS) could provide guidance by reconstructing the vertebral surface, and then registering a pre-operative vertebral model to that surface for localization. The aim of this study was to evaluate the accuracy and processing time of a custom CT-3DUS registration algorithm. A phantom human vertebra was 3D-printed and scanned with a motion capture-based 3D ultrasound (3DUS) system. Image registration was performed that included a pre-alignment phase using vertebral symmetry information, and then comparing Gaussian pyramid intensity-based registration with iterative-closest-point registration for final transformations. Image registration was performed 192 times while surgical registration between CT and real-world position was performed 84 times. The accuracy of image registration (CT-to-3DUS) was 0.3 ± 0.2 mm and 0.9 ± 0.8° completed in 13.3 ± 2.9 s. The surgical navigation accuracy (CT model to real-world position) of the system was 1.2 ± 0.5 mm and 2.2 ± 2.0° completed in 16.2 ± 3.0 s. Both meet accuracy thresholds of < 2 mm and < 5° required for the surgery. A feasibility study on porcine spine qualitatively showed appropriate overlapping anatomy in CT-3DUS registrations. The usage of 3D ultrasound for navigation has demonstrated accuracy to provide radiation-free image guidance for spine surgery.
中文翻译:
CT-to-3D 超声图像配准算法在脊柱手术椎体模型中的开发和评估。
脊柱后路融合手术需要小心地将螺钉插入脊柱以避免神经损伤。虽然当前的系统使用 CT 扫描,但三维超声 (3DUS) 可以通过重建椎体表面,然后将术前椎体模型注册到该表面以进行定位来提供指导。本研究的目的是评估自定义 CT-3DUS 配准算法的准确性和处理时间。一个幻影人体椎骨是 3D 打印的,并使用基于运动捕捉的 3D 超声 (3DUS) 系统进行扫描。执行图像配准,包括使用椎体对称信息的预对准阶段,然后比较基于高斯金字塔强度的配准与迭代最近点配准以进行最终变换。图像配准进行了 192 次,而 CT 和真实世界位置之间的手术配准进行了 84 次。图像配准 (CT 到 3DUS) 的精度为 0.3 ± 0.2 毫米和 0.9 ± 0.8°,在 13.3 ± 2.9 秒内完成。该系统的手术导航精度(CT 模型到真实世界位置)为 1.2 ± 0.5 mm 和 2.2 ± 2.0°,在 16.2 ± 3.0 s 内完成。两者都满足手术所需的 < 2 mm 和 < 5° 的准确度阈值。对猪脊柱的可行性研究定性地显示了 CT-3DUS 配准中适当的重叠解剖结构。使用 3D 超声进行导航已证明可以为脊柱手术提供无辐射图像引导的准确性。8° 在 13.3 ± 2.9 秒内完成。该系统的手术导航精度(CT 模型到真实世界位置)为 1.2 ± 0.5 mm 和 2.2 ± 2.0°,在 16.2 ± 3.0 s 内完成。两者都满足手术所需的 < 2 mm 和 < 5° 的准确度阈值。对猪脊柱的可行性研究定性地显示了 CT-3DUS 配准中适当的重叠解剖结构。使用 3D 超声进行导航已证明可以为脊柱手术提供无辐射图像引导的准确性。8° 在 13.3 ± 2.9 秒内完成。该系统的手术导航精度(CT 模型到真实世界位置)为 1.2 ± 0.5 mm 和 2.2 ± 2.0°,在 16.2 ± 3.0 s 内完成。两者都满足手术所需的 < 2 mm 和 < 5° 的准确度阈值。对猪脊柱的可行性研究定性地显示了 CT-3DUS 配准中适当的重叠解剖结构。使用 3D 超声进行导航已证明可以为脊柱手术提供无辐射图像引导的准确性。