Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement

A. Uneri; J. W. Stayman; T. De Silva; A. S. Wang; G. Kleinszig; S. Vogt; A. J. Khanna; J. P. Wolinsky; Z. L. Gokaslan; J. H. Siewerdsen

doi:10.1117/12.2082210

Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement

A. Uneri, J. W. Stayman, T. De Silva, A. S. Wang, G. Kleinszig, S. Vogt, A. J. Khanna, J. P. Wolinsky, Z. L. Gokaslan, J. H. Siewerdsen

Neurological Surgery

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

10 Scopus citations

Abstract

Purpose: To extend the functionality of radiographic/fluoroscopic imaging systems already within standard spine surgery workflow to: 1) provide guidance of surgical device analogous to an external tracking system; and 2) provide intraoperative quality assurance (QA) of the surgical product. Methods: Using fast, robust 3D-2D registration in combination with 3D models of known components (surgical devices), the 3D pose determination was solved to relate known components to 2D projection images and 3D preoperative CT in near-real-time. Exact and parametric models of the components were used as input to the algorithm to evaluate the effects of model fidelity. The proposed algorithm employs the covariance matrix adaptation evolution strategy (CMA-ES) to maximize gradient correlation (GC) between measured projections and simulated forward projections of components. Geometric accuracy was evaluated in a spine phantom in terms of target registration error at the tool tip (TRE_X), and angular deviation (TRE_φ) from planned trajectory. Results: Transpedicle surgical devices (probe tool and spine screws) were successfully guided with TRE_X<2 mm and TRE_φ <0.5° given projection views separated by at least >30° (easily accommodated on a mobile C-arm). QA of the surgical product based on 3D-2D registration demonstrated the detection of pedicle screw breach with TRE_X<1 mm, demonstrating a trend of improved accuracy correlated to the fidelity of the component model employed. Conclusions: 3D-2D registration combined with 3D models of known surgical components provides a novel method for near-real-time guidance and quality assurance using a mobile C-arm without external trackers or fiducial markers. Ongoing work includes determination of optimal views based on component shape and trajectory, improved robustness to anatomical deformation, and expanded preclinical testing in spine and intracranial surgeries.

Original language	English (US)
Title of host publication	Medical Imaging 2015
Subtitle of host publication	Image-Guided Procedures, Robotic Interventions, and Modeling
Editors	Robert J. Webster, Ziv R. Yaniv
Publisher	SPIE
ISBN (Electronic)	9781628415056
DOIs	https://doi.org/10.1117/12.2082210
State	Published - 2015
Event	Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling - Orlando, United States Duration: Feb 22 2015 → Feb 24 2015

Publication series

Name	Progress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume	9415
ISSN (Print)	1605-7422

Other

Other	Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling
Country/Territory	United States
City	Orlando
Period	2/22/15 → 2/24/15

Keywords

3d-2d image registration
Image-guided surgery
Quality assurance
Spine surgery
Surgical navigation

ASJC Scopus subject areas

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

Access to Document

10.1117/12.2082210

Cite this

Uneri, A., Stayman, J. W., De Silva, T., Wang, A. S., Kleinszig, G., Vogt, S., Khanna, A. J., Wolinsky, J. P., Gokaslan, Z. L., & Siewerdsen, J. H. (2015). Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement. In R. J. Webster, & Z. R. Yaniv (Eds.), Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling [94151F] (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 9415). SPIE. https://doi.org/10.1117/12.2082210

Uneri, A. ; Stayman, J. W. ; De Silva, T. et al. / Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement. Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling. editor / Robert J. Webster ; Ziv R. Yaniv. SPIE, 2015. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE).

@inproceedings{ea143d1ea1eb43c6b2b1be09c745493c,

title = "Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement",

abstract = "Purpose: To extend the functionality of radiographic/fluoroscopic imaging systems already within standard spine surgery workflow to: 1) provide guidance of surgical device analogous to an external tracking system; and 2) provide intraoperative quality assurance (QA) of the surgical product. Methods: Using fast, robust 3D-2D registration in combination with 3D models of known components (surgical devices), the 3D pose determination was solved to relate known components to 2D projection images and 3D preoperative CT in near-real-time. Exact and parametric models of the components were used as input to the algorithm to evaluate the effects of model fidelity. The proposed algorithm employs the covariance matrix adaptation evolution strategy (CMA-ES) to maximize gradient correlation (GC) between measured projections and simulated forward projections of components. Geometric accuracy was evaluated in a spine phantom in terms of target registration error at the tool tip (TREX), and angular deviation (TREφ) from planned trajectory. Results: Transpedicle surgical devices (probe tool and spine screws) were successfully guided with TREX<2 mm and TREφ <0.5° given projection views separated by at least >30° (easily accommodated on a mobile C-arm). QA of the surgical product based on 3D-2D registration demonstrated the detection of pedicle screw breach with TREX<1 mm, demonstrating a trend of improved accuracy correlated to the fidelity of the component model employed. Conclusions: 3D-2D registration combined with 3D models of known surgical components provides a novel method for near-real-time guidance and quality assurance using a mobile C-arm without external trackers or fiducial markers. Ongoing work includes determination of optimal views based on component shape and trajectory, improved robustness to anatomical deformation, and expanded preclinical testing in spine and intracranial surgeries.",

keywords = "3d-2d image registration, Image-guided surgery, Quality assurance, Spine surgery, Surgical navigation",

author = "A. Uneri and Stayman, {J. W.} and {De Silva}, T. and Wang, {A. S.} and G. Kleinszig and S. Vogt and Khanna, {A. J.} and Wolinsky, {J. P.} and Gokaslan, {Z. L.} and Siewerdsen, {J. H.}",

note = "Publisher Copyright: {\textcopyright} 2015 SPIE.; Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling ; Conference date: 22-02-2015 Through 24-02-2015",

year = "2015",

doi = "10.1117/12.2082210",

language = "English (US)",

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

publisher = "SPIE",

editor = "Webster, {Robert J.} and Yaniv, {Ziv R.}",

booktitle = "Medical Imaging 2015",

}

Uneri, A, Stayman, JW, De Silva, T, Wang, AS, Kleinszig, G, Vogt, S, Khanna, AJ, Wolinsky, JP, Gokaslan, ZL & Siewerdsen, JH 2015, Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement. in RJ Webster & ZR Yaniv (eds), Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling., 94151F, Progress in Biomedical Optics and Imaging - Proceedings of SPIE, vol. 9415, SPIE, Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling, Orlando, United States, 2/22/15. https://doi.org/10.1117/12.2082210

Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement. / Uneri, A.; Stayman, J. W.; De Silva, T. et al.

Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling. ed. / Robert J. Webster; Ziv R. Yaniv. SPIE, 2015. 94151F (Progress in Biomedical Optics and Imaging - Proceedings of SPIE; Vol. 9415).

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

TY - GEN

T1 - Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement

AU - Uneri, A.

AU - Stayman, J. W.

AU - De Silva, T.

AU - Wang, A. S.

AU - Kleinszig, G.

AU - Vogt, S.

AU - Khanna, A. J.

AU - Wolinsky, J. P.

AU - Gokaslan, Z. L.

AU - Siewerdsen, J. H.

PY - 2015

Y1 - 2015

N2 - Purpose: To extend the functionality of radiographic/fluoroscopic imaging systems already within standard spine surgery workflow to: 1) provide guidance of surgical device analogous to an external tracking system; and 2) provide intraoperative quality assurance (QA) of the surgical product. Methods: Using fast, robust 3D-2D registration in combination with 3D models of known components (surgical devices), the 3D pose determination was solved to relate known components to 2D projection images and 3D preoperative CT in near-real-time. Exact and parametric models of the components were used as input to the algorithm to evaluate the effects of model fidelity. The proposed algorithm employs the covariance matrix adaptation evolution strategy (CMA-ES) to maximize gradient correlation (GC) between measured projections and simulated forward projections of components. Geometric accuracy was evaluated in a spine phantom in terms of target registration error at the tool tip (TREX), and angular deviation (TREφ) from planned trajectory. Results: Transpedicle surgical devices (probe tool and spine screws) were successfully guided with TREX<2 mm and TREφ <0.5° given projection views separated by at least >30° (easily accommodated on a mobile C-arm). QA of the surgical product based on 3D-2D registration demonstrated the detection of pedicle screw breach with TREX<1 mm, demonstrating a trend of improved accuracy correlated to the fidelity of the component model employed. Conclusions: 3D-2D registration combined with 3D models of known surgical components provides a novel method for near-real-time guidance and quality assurance using a mobile C-arm without external trackers or fiducial markers. Ongoing work includes determination of optimal views based on component shape and trajectory, improved robustness to anatomical deformation, and expanded preclinical testing in spine and intracranial surgeries.

AB - Purpose: To extend the functionality of radiographic/fluoroscopic imaging systems already within standard spine surgery workflow to: 1) provide guidance of surgical device analogous to an external tracking system; and 2) provide intraoperative quality assurance (QA) of the surgical product. Methods: Using fast, robust 3D-2D registration in combination with 3D models of known components (surgical devices), the 3D pose determination was solved to relate known components to 2D projection images and 3D preoperative CT in near-real-time. Exact and parametric models of the components were used as input to the algorithm to evaluate the effects of model fidelity. The proposed algorithm employs the covariance matrix adaptation evolution strategy (CMA-ES) to maximize gradient correlation (GC) between measured projections and simulated forward projections of components. Geometric accuracy was evaluated in a spine phantom in terms of target registration error at the tool tip (TREX), and angular deviation (TREφ) from planned trajectory. Results: Transpedicle surgical devices (probe tool and spine screws) were successfully guided with TREX<2 mm and TREφ <0.5° given projection views separated by at least >30° (easily accommodated on a mobile C-arm). QA of the surgical product based on 3D-2D registration demonstrated the detection of pedicle screw breach with TREX<1 mm, demonstrating a trend of improved accuracy correlated to the fidelity of the component model employed. Conclusions: 3D-2D registration combined with 3D models of known surgical components provides a novel method for near-real-time guidance and quality assurance using a mobile C-arm without external trackers or fiducial markers. Ongoing work includes determination of optimal views based on component shape and trajectory, improved robustness to anatomical deformation, and expanded preclinical testing in spine and intracranial surgeries.

KW - 3d-2d image registration

KW - Image-guided surgery

KW - Quality assurance

KW - Spine surgery

KW - Surgical navigation

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M3 - Conference contribution

C2 - 26028805

AN - SCOPUS:84943576360

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

BT - Medical Imaging 2015

A2 - Webster, Robert J.

A2 - Yaniv, Ziv R.

PB - SPIE

T2 - Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling

Y2 - 22 February 2015 through 24 February 2015

ER -

Uneri A, Stayman JW, De Silva T, Wang AS, Kleinszig G, Vogt S et al. Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement. In Webster RJ, Yaniv ZR, editors, Medical Imaging 2015: Image-Guided Procedures, Robotic Interventions, and Modeling. SPIE. 2015. 94151F. (Progress in Biomedical Optics and Imaging - Proceedings of SPIE). doi: 10.1117/12.2082210

Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement

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