Original ContributionToward Registration of 3D Ultrasound and CT Images of the Spine in Clinical Praxis: Design and Evaluation of a Data Acquisition Protocol
Section snippets
Introduction and Literature
Pedicle screw fixation for spinal column fusion is an established procedure for the treatment of spinal instability (Roy-Camille et al. 1986; Krismer et al. 1997). The screws have to be inserted through the spinal pedicles into the vertebrae, and the surgeon has to decide where to place the screws and how they should be angled. For purposes of orientation, the surgeon needs a good anatomical overview. This can usually be achieved only at the cost of considerable tissue disruption. Image-guided
Materials and Methods
If diagnostic ultrasound is used as intraoperative imaging modality for registration, the ultrasound data acquisition has to be integrated into the surgical procedure.
The concept of image-guided surgery with intraoperative ultrasound imaging is presented in Fig. 1. The 3-D CT data obtained preoperatively for diagnosis and operation planning have to be matched with the intraoperatively recorded 3-D ultrasound data as the operation progresses. Because ultrasound data acquisition, preprocessing of
Results
For the design and evaluation of our registration algorithm and the registration protocol, we considered the first eight datasets from Winter et al. (2008). For evaluation of the clinical protocol we considered these eight and the four new data sets. We show that it is possible to decide before surgery whether ultrasound can be used for intraoperative registration. In addition, we present an evaluation of our registration algorithm, focusing on the clinical relevant aspects.
Discussion
There are only a few studies on the registration of bony structures in ultrasound and CT or MRI data. Existing volume-based techniques such as gray-value correlation or maximization of mutual information (Pluim et al. 2003; Studholme et al. 1996; Wells et al. 1996), which belong to the standard procedures in registration of CT or MRI data, cannot be used for ultrasound registration of the spine because it is a prerequirement of volume-based approaches that the same structures be visualized in
Summary
Few attempts have been made to register bony structures of the spine with ultrasound and CT or MRI data. Automatic methods that require segmentation of the bone surface in the ultrasound datasets have not yet been successfully applied to the spinal column in vivo. The method we used, however, can register the vertebrae of patients in ultrasound and CT data.
Because our method depends on the quality of the acquired ultrasound data, two questions remain. The first is how to guarantee a
Acknowledgment
This work was an activity of the Kompetenzzentrum Medizintechnik Ruhr (KMR), Bochum. It was supported by the Bundesministerium für Bildung und Forschung (Az. 13N8079).
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2020, Ultrasound in Medicine and BiologyThe state-of-the-art in ultrasound-guided spine interventions
2020, Medical Image AnalysisCitation Excerpt :On the CT image, the density of bone tissues correlates with the CT intensity which lies between 140 to 260 Hounsfield units (HU) (Yan et al., 2011; Sugano, 2003; Winter et al., 2008). The posterior surface of the vertebrae can be obtained by ray tracing a line going from posterior to anterior, in which the surface location corresponds to the first occurrence of voxels above a given threshold, typically 150 HU (Brendel et al., 2002; 2005; Winter et al., 2008; 2009; Yan et al., 2011; 2012b; 2012a; Gueziri et al., 2019). The approach yields satisfactory results to extract the posterior vertebral surface.
Navigated 3-Dimensional Intraoperative Ultrasound for Spine Surgery
2019, World NeurosurgeryCitation Excerpt :The change of spinal alignment due to patient positioning, which is completely different in preoperative imaging in supine position compared with the intraoperative situation with the patient in prone position, can only be accounted for by intraoperative imaging, as we had implemented it with iCT for registration. iUS itself might be an alternative for registration, however, iUS-based registration of spinal structures is still in a very experimental state and not yet accurate enough for clinical application.29-32 Improved surface-based registration techniques of CT and reconstructed bony structures in intraoperative 3D-US, as demonstrated in a tibia phantom, might be helpful for registration in spine surgery as well.33
In Vivo Measurement of the Human Lumbar Spine Using Magnetic Resonance Imaging to Ultrasound Registration
2019, Journal of Manipulative and Physiological TherapeuticsCitation Excerpt :Although excluding the TP would reduce the area of available posterior vertebral surface for registration use, which might have a negative effect on the registration accuracy, our results implied that the spatial noise and artifacts in the surrounding soft tissues was a more critical factor that could affect the robustness of our MRI-ultrasound registration algorithm. Given that the success of the MRI-ultrasound registration depends heavily on the quality of acquired ultrasound images,22 to avoid the waste of time, effort, and money, it is imperative to check for ultrasound image quality before proceeding with any image processing work and MRI scan. In this study, a dated ultrasound scanner (Ultramark 400c, ATL Ultrasound Inc) was used.
Fast and Accurate Data Extraction for Near Real-Time Registration of 3-D Ultrasound and Computed Tomography in Orthopedic Surgery
2015, Ultrasound in Medicine and BiologyCitation Excerpt :Many groups have tried eliminating the need for of bone localization by registering the US and CT volumes using intensity-based registration methods. Brendel et al. (2002, 2005); Dekomien et al. (2007) and Winter et al. (2002, 2009) fused CT and US volumes of the spine and developed an intensity-based algorithm that required minimal US pre-processing. They proposed several registration methods that took advantage of the segmentation of CT volumes and the ridgelike structures of bone in US volumes.