Upper ankle joint space detection on low contrast intraoperative fluoroscopic C-arm projections

Sarina Thomas; Marc Schnetzke; Michael Brehler; Benedict Swartman; Sven Vetter; Jochen Franke; Paul A. Grützner; Hans-Peter Meinzer; Marco Nolden

doi:10.1117/12.2255633

3 March 2017 Upper ankle joint space detection on low contrast intraoperative fluoroscopic C-arm projections

Sarina Thomas, Marc Schnetzke, Michael Brehler, Benedict Swartman, Sven Vetter, Jochen Franke, Paul A. Grützner, Hans-Peter Meinzer, Marco Nolden

Author Affiliations +

Proceedings Volume 10135, Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling; 101351I (2017) https://doi.org/10.1117/12.2255633
Event: SPIE Medical Imaging, 2017, Orlando, Florida, United States

Abstract

Intraoperative mobile C-arm fluoroscopy is widely used for interventional verification in trauma surgery, high flexibility combined with low cost being the main advantages of the method. However, the lack of global device-to- patient orientation is challenging, when comparing the acquired data to other intrapatient datasets. In upper ankle joint fracture reduction accompanied with an unstable syndesmosis, a comparison to the unfractured contralateral site is helpful for verification of the reduction result. To reduce dose and operation time, our approach aims at the comparison of single projections of the unfractured ankle with volumetric images of the reduced fracture. For precise assessment, a pre-alignment of both datasets is a crucial step. We propose a contour extraction pipeline to estimate the joint space location for a prealignment of fluoroscopic C-arm projections containing the upper ankle joint. A quadtree-based hierarchical variance comparison extracts potential feature points and a Hough transform is applied to identify bone shaft lines together with the tibiotalar joint space. By using this information we can define the coarse orientation of the projections independent from the ankle pose during acquisition in order to align those images to the volume of the fractured ankle. The proposed method was evaluated on thirteen cadaveric datasets consisting of 100 projections each with manually adjusted image planes by three trauma surgeons. The results show that the method can be used to detect the joint space orientation. The correlation between angle deviation and anatomical projection direction gives valuable input on the acquisition direction for future clinical experiments.

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Sarina Thomas, Marc Schnetzke, Michael Brehler, Benedict Swartman, Sven Vetter, Jochen Franke, Paul A. Grützner, Hans-Peter Meinzer, and Marco Nolden "Upper ankle joint space detection on low contrast intraoperative fluoroscopic C-arm projections", Proc. SPIE 10135, Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling, 101351I (3 March 2017); https://doi.org/10.1117/12.2255633

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