Automatic localization of target vertebrae in spine surgery: clinical evaluation of the LevelCheck registration algorithm.
Automatic localization of target vertebrae in spine surgery: clinical evaluation of the LevelCheck registration algorithm.
复制标题
DOI：
10.1097/brs.0000000000000814
复制
发表时间：
2015-04-15
期刊：
影响因子：
3
通讯作者：
Siewerdsen JH
中科院分区：
文献类型：
--
作者：
Lo SF;Otake Y;Puvanesarajah V;Wang AS;Uneri A;De Silva T;Vogt S;Kleinszig G;Elder BD;Goodwin CR;Kosztowski TA;Liauw JA;Groves M;Bydon A;Sciubba DM;Witham TF;Wolinsky JP;Aygun N;Gokaslan ZL;Siewerdsen JH
3D-2D图像配准算法“LevelCheck”用于在脊柱手术期间获得的术中移动的X线照片中自动标记椎骨。在20例患者的回顾性研究中评价了准确性、计算时间和潜在失效模式。使用脊柱手术期间采集的临床图像测量LevelCheck算法的性能。在脊柱手术中，由于仅根据视觉印象、触诊和荧光镜检查难以定位目标椎骨，因此错误节段手术的可能性很大。为了解决这一困难并降低错误节段手术的风险，我们的团队引入了一个程序（称为LevelCheck），使用强大的3D-2D图像配准术前CT，在移动的X光片中自动定位目标椎骨。回顾性分析了20例接受胸腰椎手术的患者，术前CT扫描和术中移动的X线片均可用。一个委员会认证的神经放射科医生确定了每张照片中的“真实”椎骨水平。通过LevelCheck计算术前CT与术中X线片的配准情况，并分析投影距离误差。对每位患者进行500次随机初始化，并进行算法设置（即，鲁棒多启动的数目，范围为50到200）被改变以评估配准误差和计算时间之间的折衷。通过单独分析50次多次启动时观察到的不成功配准（>5 mm距离误差）进行失效模式分析。在200次稳健的多次启动（计算时间为1.26秒）时，所有10，000次试验的配准准确度均为100%。随着多次启动次数（和计算时间）的减少，配准仍然相当稳健，在50次多次启动时（计算时间为1.77秒），配准精度下降到99.3%。LevelCheck算法正确识别了胸腰椎术中移动的X线片中的靶椎体，证明了计算时间可接受，与常规术前CT扫描兼容，并在前瞻性研究中进行了初步调查。N/A
A 3D-2D image registration algorithm, “LevelCheck,” was used to automatically label vertebrae in intraoperative mobile radiographs obtained during spine surgery. Accuracy, computation time, and potential failure modes were evaluated in a retrospective study of 20 patients. To measurethe performance of the LevelCheck algorithm using clinical images acquired during spine surgery. In spine surgery, the potential for wrong level surgery is significant due to the difficulty of localizing target vertebrae based solely on visual impression, palpation, and fluoroscopy. To remedy this difficulty and reduce the risk of wrong-level surgery, our team introduced a program (dubbed LevelCheck) to automatically localize target vertebrae in mobile radiographs using robust 3D-2D image registration to preoperative CT. Twenty consecutive patients undergoing thoracolumbar spine surgery, for whom both a preoperative CT scan and an intraoperative mobile radiograph were available, were retrospectively analyzed. A board-certified neuroradiologist determined the “true” vertebra levels in each radiograph. Registration of the preoperative CT to the intraoperative radiographwere calculated via LevelCheck, and projection distance errors were analyzed. Five hundred random initializations were performed for eachpatient, andalgorithm settings (viz., the number of robust multi-starts, ranging 50 to 200) were varied to evaluate the tradeoff between registration error and computation time. Failure mode analysis was performed by individually analyzing unsuccessful registrations (>5 mm distance error) observed with 50 multi-starts. At 200 robust multi-starts (computation time of ∼26 seconds), the registration accuracy was 100% across all 10,000 trials. As the number of multi-starts (and computation time) decreased, the registration remained fairly robust, down to 99.3% registration accuracy at 50 multi-starts (computation time ∼7 seconds). The LevelCheck algorithm correctly identified target vertebrae in intraoperative mobile radiographs of the thoracolumbar spine, demonstrating acceptable computation time, compatibility with routinely obtained preoperative CT scans, and warranting investigation in prospective studies. N/A