Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery

J. Goerres; M. Jacobson; A. Uneri; T. De Silva; M. Ketcha; S. Reaungamornrat; S. Vogt; G. Kleinszig; J. P. Wolinsky; G. Osgood; J. H. Siewerdsen

doi:10.1117/12.2255952

Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery

J. Goerres, M. Jacobson, A. Uneri, T. De Silva, M. Ketcha, S. Reaungamornrat, S. Vogt, G. Kleinszig, J. P. Wolinsky, G. Osgood, J. H. Siewerdsen

Neurological Surgery

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

2 Scopus citations

Abstract

Pelvic Kirschner wire (K-wire) insertion is a challenging surgical task requiring interpretation of complex 3D anatomical shape from 2D projections (fluoroscopy) and delivery of device trajectories within fairly narrow bone corridors in proximity to adjacent nerves and vessels. Over long trajectories (∼10-25 cm), K-wires tend to curve (deform), making conventional rigid navigation inaccurate at the tip location. A system is presented that provides accurate 3D localization and guidance of rigid or deformable surgical devices ("components" - e.g., K-wires) based on 3D-2D registration. The patient is registered to a preoperative CT image by virtually projecting digitally reconstructed radiographs (DRRs) and matching to two or more intraoperative x-ray projections. The K-wire is localized using an analogous procedure matching DRRs of a deformably parametrized model for the device component (deformable known-component registration, or dKC-Reg). A cadaver study was performed in which a K-wire trajectory was delivered in the pelvis. The system demonstrated target registration error (TRE) of 2.1 ± 0.3 mm in location of the K-wire tip (median ± interquartile range, IQR) and 0.8 ± 1.4± in orientation at the tip (median ± IQR), providing functionality analogous to surgical tracking/navigation using imaging systems already in the surgical arsenal without reliance on a surgical tracker. The method offers quantitative 3D guidance using images (e.g., inlet/outlet views) already acquired in the standard of care, potentially extending the advantages of navigation to broader utilization in trauma surgery to improve surgical precision and safety.

Original language	English (US)
Title of host publication	Medical Imaging 2017
Subtitle of host publication	Image-Guided Procedures, Robotic Interventions, and Modeling
Editors	Robert J. Webster, Baowei Fei
Publisher	SPIE
ISBN (Electronic)	9781510607156
DOIs	https://doi.org/10.1117/12.2255952
State	Published - 2017
Event	Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling - Orlando, United States Duration: Feb 14 2017 → Feb 16 2017

Publication series

Name	Progress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume	10135
ISSN (Print)	1605-7422

Other

Other	Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling
Country/Territory	United States
City	Orlando
Period	2/14/17 → 2/16/17

Keywords

3D/2D registration
Deformable registration
Image guidance
Surgical navigation
Trauma surgery

ASJC Scopus subject areas

Electronic, Optical and Magnetic Materials
Atomic and Molecular Physics, and Optics
Radiology Nuclear Medicine and imaging
Biomaterials

Access to Document

10.1117/12.2255952

Cite this

Goerres, J., Jacobson, M., Uneri, A., De Silva, T., Ketcha, M., Reaungamornrat, S., Vogt, S., Kleinszig, G., Wolinsky, J. P., Osgood, G., & Siewerdsen, J. H. (2017). Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery. In R. J. Webster, & B. Fei (Eds.), Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling Article 101350A (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 10135). SPIE. https://doi.org/10.1117/12.2255952

@inproceedings{29bfded238784b31ae659ea372194e1b,

title = "Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery",

abstract = "Pelvic Kirschner wire (K-wire) insertion is a challenging surgical task requiring interpretation of complex 3D anatomical shape from 2D projections (fluoroscopy) and delivery of device trajectories within fairly narrow bone corridors in proximity to adjacent nerves and vessels. Over long trajectories (∼10-25 cm), K-wires tend to curve (deform), making conventional rigid navigation inaccurate at the tip location. A system is presented that provides accurate 3D localization and guidance of rigid or deformable surgical devices ({"}components{"} - e.g., K-wires) based on 3D-2D registration. The patient is registered to a preoperative CT image by virtually projecting digitally reconstructed radiographs (DRRs) and matching to two or more intraoperative x-ray projections. The K-wire is localized using an analogous procedure matching DRRs of a deformably parametrized model for the device component (deformable known-component registration, or dKC-Reg). A cadaver study was performed in which a K-wire trajectory was delivered in the pelvis. The system demonstrated target registration error (TRE) of 2.1 ± 0.3 mm in location of the K-wire tip (median ± interquartile range, IQR) and 0.8 ± 1.4± in orientation at the tip (median ± IQR), providing functionality analogous to surgical tracking/navigation using imaging systems already in the surgical arsenal without reliance on a surgical tracker. The method offers quantitative 3D guidance using images (e.g., inlet/outlet views) already acquired in the standard of care, potentially extending the advantages of navigation to broader utilization in trauma surgery to improve surgical precision and safety.",

keywords = "3D/2D registration, Deformable registration, Image guidance, Surgical navigation, Trauma surgery",

author = "J. Goerres and M. Jacobson and A. Uneri and {De Silva}, T. and M. Ketcha and S. Reaungamornrat and S. Vogt and G. Kleinszig and Wolinsky, {J. P.} and G. Osgood and Siewerdsen, {J. H.}",

note = "Publisher Copyright: {\textcopyright} 2017 SPIE.; Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling ; Conference date: 14-02-2017 Through 16-02-2017",

year = "2017",

doi = "10.1117/12.2255952",

language = "English (US)",

series = "Progress in Biomedical Optics and Imaging - Proceedings of SPIE",

publisher = "SPIE",

editor = "Webster, {Robert J.} and Baowei Fei",

booktitle = "Medical Imaging 2017",

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Goerres, J, Jacobson, M, Uneri, A, De Silva, T, Ketcha, M, Reaungamornrat, S, Vogt, S, Kleinszig, G, Wolinsky, JP, Osgood, G & Siewerdsen, JH 2017, Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery. in RJ Webster & B Fei (eds), Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling., 101350A, Progress in Biomedical Optics and Imaging - Proceedings of SPIE, vol. 10135, SPIE, Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling, Orlando, United States, 2/14/17. https://doi.org/10.1117/12.2255952

Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery. / Goerres, J.; Jacobson, M.; Uneri, A. et al.
Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling. ed. / Robert J. Webster; Baowei Fei. SPIE, 2017. 101350A (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 10135).

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

TY - GEN

T1 - Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery

AU - Goerres, J.

AU - Jacobson, M.

AU - Uneri, A.

AU - De Silva, T.

AU - Ketcha, M.

AU - Reaungamornrat, S.

AU - Vogt, S.

AU - Kleinszig, G.

AU - Wolinsky, J. P.

AU - Osgood, G.

AU - Siewerdsen, J. H.

PY - 2017

Y1 - 2017

N2 - Pelvic Kirschner wire (K-wire) insertion is a challenging surgical task requiring interpretation of complex 3D anatomical shape from 2D projections (fluoroscopy) and delivery of device trajectories within fairly narrow bone corridors in proximity to adjacent nerves and vessels. Over long trajectories (∼10-25 cm), K-wires tend to curve (deform), making conventional rigid navigation inaccurate at the tip location. A system is presented that provides accurate 3D localization and guidance of rigid or deformable surgical devices ("components" - e.g., K-wires) based on 3D-2D registration. The patient is registered to a preoperative CT image by virtually projecting digitally reconstructed radiographs (DRRs) and matching to two or more intraoperative x-ray projections. The K-wire is localized using an analogous procedure matching DRRs of a deformably parametrized model for the device component (deformable known-component registration, or dKC-Reg). A cadaver study was performed in which a K-wire trajectory was delivered in the pelvis. The system demonstrated target registration error (TRE) of 2.1 ± 0.3 mm in location of the K-wire tip (median ± interquartile range, IQR) and 0.8 ± 1.4± in orientation at the tip (median ± IQR), providing functionality analogous to surgical tracking/navigation using imaging systems already in the surgical arsenal without reliance on a surgical tracker. The method offers quantitative 3D guidance using images (e.g., inlet/outlet views) already acquired in the standard of care, potentially extending the advantages of navigation to broader utilization in trauma surgery to improve surgical precision and safety.

AB - Pelvic Kirschner wire (K-wire) insertion is a challenging surgical task requiring interpretation of complex 3D anatomical shape from 2D projections (fluoroscopy) and delivery of device trajectories within fairly narrow bone corridors in proximity to adjacent nerves and vessels. Over long trajectories (∼10-25 cm), K-wires tend to curve (deform), making conventional rigid navigation inaccurate at the tip location. A system is presented that provides accurate 3D localization and guidance of rigid or deformable surgical devices ("components" - e.g., K-wires) based on 3D-2D registration. The patient is registered to a preoperative CT image by virtually projecting digitally reconstructed radiographs (DRRs) and matching to two or more intraoperative x-ray projections. The K-wire is localized using an analogous procedure matching DRRs of a deformably parametrized model for the device component (deformable known-component registration, or dKC-Reg). A cadaver study was performed in which a K-wire trajectory was delivered in the pelvis. The system demonstrated target registration error (TRE) of 2.1 ± 0.3 mm in location of the K-wire tip (median ± interquartile range, IQR) and 0.8 ± 1.4± in orientation at the tip (median ± IQR), providing functionality analogous to surgical tracking/navigation using imaging systems already in the surgical arsenal without reliance on a surgical tracker. The method offers quantitative 3D guidance using images (e.g., inlet/outlet views) already acquired in the standard of care, potentially extending the advantages of navigation to broader utilization in trauma surgery to improve surgical precision and safety.

KW - 3D/2D registration

KW - Deformable registration

KW - Image guidance

KW - Surgical navigation

KW - Trauma surgery

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DO - 10.1117/12.2255952

M3 - Conference contribution

C2 - 28989221

AN - SCOPUS:85020477012

T3 - Progress in Biomedical Optics and Imaging - Proceedings of SPIE

BT - Medical Imaging 2017

A2 - Webster, Robert J.

A2 - Fei, Baowei

PB - SPIE

T2 - Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling

Y2 - 14 February 2017 through 16 February 2017

ER -

Goerres J, Jacobson M, Uneri A, De Silva T, Ketcha M, Reaungamornrat S et al. Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery. In Webster RJ, Fei B, editors, Medical Imaging 2017: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE. 2017. 101350A. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE). doi: 10.1117/12.2255952

Deformable 3D-2D registration for guiding K-wire placement in pelvic trauma surgery

Abstract

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