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Intraoperative detection and localization of cylindrical implants in cone-beam CT image data

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Orthopedic fractures are often fixed using metal implants. The correct positioning of cylindrical implants such as surgical screws, rods and guide wires is highly important. Intraoperative 3D imaging is often used to ensure proper implant placement. However, 3D image interaction is time-consuming and requires experience. We developed an automatic method that simplifies and accelerates location assessment of cylindrical implants in 3D images.

Methods

Our approach is composed of three major steps. At first, cylindrical characteristics are detected by analyzing image gradients in small image regions. Next, these characteristics are grouped in a cluster analysis. The clusters represent cylindrical implants and are used to initialize a cylinder-to-image registration. Finally, the two end points are optimized regarding image contrast along the cylinder axis.

Results

A total of 67 images containing 420 cylindrical implants were used for testing. Different anatomical regions (calcaneus, spine) and various image sources (two mobile devices, three reconstruction methods) were investigated. Depending on the evaluation set, the detection performance was between 91.7 and 96.1 % true- positive rate with a false-positive rate between 2.0 and 3.2 %. The end point distance errors ranged from \(1.0 \pm 1.2\) to \(4.3 \pm 2.9\) mm and the orientation errors from \(1.6 \pm 2.2\) to \(2.3 \pm 2.2\) degrees. The average computation time was less than 5 seconds.

Conclusions

An automatic method was developed and tested that obviates the need for 3D image interaction during intraoperative assessment of cylindrical orthopedic implants. The required time for working with the viewing software of cone-beam CT device is drastically reduced and leads to a shorter time under anesthesia for the patient.

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Acknowledgments

This work was partially funded by Siemens Healthcare, X-ray Products.

Conflict of interest

Authors declare no conflict of interest.

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Authors and Affiliations

  1. Division of Medical and Biological Informatics (E130), German Cancer Research Center, Im Neuenheimer Feld 280, 69120 , Heidelberg, Germany

    Joseph Görres, Michael Brehler, Hans-Peter Meinzer & Diana Nabers

  2. BG Trauma Center, Ludwig-Guttmann-Straße 13, 67071 , Ludwigshafen am Rhein, Germany

    Jochen Franke, Sven Y. Vetter & Paul A. Grützner

  3. Siemens AG, Healthcare Sector, Henkestr. 127, 91052 , Erlangen, Germany

    Karl Barth

  4. Mannheim University of Applied Sciences, Paul-Wittsack-Str. 10, 68163 , Mannheim, Germany

    Ivo Wolf

  5. Clínica Alemana de Santiago, Avenida Vitacura 5951, Santiago de Chile, Chile

    Andrés Córdova

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  1. Joseph Görres
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  2. Michael Brehler
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  3. Jochen Franke
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  4. Karl Barth
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  5. Sven Y. Vetter
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  6. Andrés Córdova
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  7. Paul A. Grützner
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  8. Hans-Peter Meinzer
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  9. Ivo Wolf
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  10. Diana Nabers
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Corresponding author

Correspondence to Joseph Görres.

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Görres, J., Brehler, M., Franke, J. et al. Intraoperative detection and localization of cylindrical implants in cone-beam CT image data. Int J CARS 9, 1045–1057 (2014). https://doi.org/10.1007/s11548-014-0998-8

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  • DOI: https://doi.org/10.1007/s11548-014-0998-8

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