Intra-operative assessment of fractured articular surfaces in cone beam CT image data View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-04

AUTHORS

Michael Brehler, Joseph Görres, Sven Y. Vetter, Jochen Franke, Paul A. Grützner, Hans-Peter Meinzer, Ivo Wolf

ABSTRACT

PURPOSE: The assessment of intra-operatively acquired volumetric data is a difficult and often time-consuming task, which demands a new set of skills from the surgeons. In the case of orthopedic surgeries such as the treatment of calcaneal fractures, the correctness of the reduction of the bone fragments can be verified with the help of C-arm CT volumetric images. For an accurate intra-operative assessment of the displaced fragments, an automatic segmentation of the articular surfaces and color-coded visualization was developed. METHODS: Our automatic approach consists of three major steps: first, using adjusted standard planes intersecting the articular region, the joint space is localized with an intensity profile-based method. In a second step, the localized joint space is segmented on the Laplacian of Gaussian filtered volumetric image by a modified binary flood fill algorithm. Finally, a 3D surface model of the segmented joint space is analyzed and visualized with focus on critical displacements of the surface. RESULTS: A specifically designed human cadaver study consisting of ten lower legs of ten different donors was conducted to acquire 48 realistic C-arm CT images of misaligned bone fragments (steps of varying sizes) in the posterior talar articular surface of the calcaneus. The proposed algorithmic pipeline was verified by the acquired image data and showed very good results with no false positives and an overall correct displacement assessment of 93.8%. CONCLUSIONS: The proposed algorithmic pipeline can be easily integrated into the clinical workflow and qualifies for intra-operative usage. It showed very good results on the reference data set of the cadaver study. With the help of such an assistance system, the time-consuming process of 2D view adjustment and visual assessment of the gray value images can be greatly simplified. More... »

PAGES

603-612

References to SciGraph publications

  • 2014-11. Intraoperative detection and localization of cylindrical implants in cone-beam CT image data in INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY
  • 2012-03. Die intraoperative 3D-C-Bogen-Anwendung in DER UNFALLCHIRURG
  • 2010. Automatic Aorta Segmentation and Valve Landmark Detection in C-Arm CT: Application to Aortic Valve Implantation in MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION – MICCAI 2010
  • 2013-07. The Medical Imaging Interaction Toolkit: challenges and advances in INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY
  • 2012. International Advances in Foot and Ankle Surgery in NONE
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11548-015-1304-0

    DOI

    http://dx.doi.org/10.1007/s11548-015-1304-0

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26450104


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    33 schema:description PURPOSE: The assessment of intra-operatively acquired volumetric data is a difficult and often time-consuming task, which demands a new set of skills from the surgeons. In the case of orthopedic surgeries such as the treatment of calcaneal fractures, the correctness of the reduction of the bone fragments can be verified with the help of C-arm CT volumetric images. For an accurate intra-operative assessment of the displaced fragments, an automatic segmentation of the articular surfaces and color-coded visualization was developed. METHODS: Our automatic approach consists of three major steps: first, using adjusted standard planes intersecting the articular region, the joint space is localized with an intensity profile-based method. In a second step, the localized joint space is segmented on the Laplacian of Gaussian filtered volumetric image by a modified binary flood fill algorithm. Finally, a 3D surface model of the segmented joint space is analyzed and visualized with focus on critical displacements of the surface. RESULTS: A specifically designed human cadaver study consisting of ten lower legs of ten different donors was conducted to acquire 48 realistic C-arm CT images of misaligned bone fragments (steps of varying sizes) in the posterior talar articular surface of the calcaneus. The proposed algorithmic pipeline was verified by the acquired image data and showed very good results with no false positives and an overall correct displacement assessment of 93.8%. CONCLUSIONS: The proposed algorithmic pipeline can be easily integrated into the clinical workflow and qualifies for intra-operative usage. It showed very good results on the reference data set of the cadaver study. With the help of such an assistance system, the time-consuming process of 2D view adjustment and visual assessment of the gray value images can be greatly simplified.
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