Planning, guidance, and quality assurance of pelvic screw placement using deformable image registration.

Planning, guidance, and quality assurance of pelvic screw placement using deformable image registration. Phys Med Biol. 2017 Oct 23;: Authors: Goerres J, Uneri A, Jacobson MW, Ramsay B, De Silva T, Ketcha MD, Han R, Manbachi A, Vogt S, Kleinszig G, Wolinsky JP, Osgood GM, Siewerdsen JH 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 accur...
Source: Physics in Medicine and Biology - Category: Physics Authors: Tags: Phys Med Biol Source Type: research

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