Three-dimensional preoperative planning in the weight-bearing state: validation and clinical evaluation

Autor: Roth, Tabitha, Carrillo, Fabio, Wieczorek, Matthias, Ceschi, Giulia, Esfandiari, Hooman, Sutter, Reto, Vlachopoulos, Lazaros, Wein, Wolfgang, Fucentese, Sandro F, Fürnstahl, Philipp
Přispěvatelé: University of Zurich, Roth, Tabitha
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Insights into Imaging, Vol 12, Iss 1, Pp 1-11 (2021)
Insights into Imaging
Insights into Imaging, 12 (1)
ISSN: 1869-4101
Popis: Objectives 3D preoperative planning of lower limb osteotomies has become increasingly important in light of modern surgical technologies. However, 3D models are usually reconstructed from Computed Tomography data acquired in a non-weight-bearing posture and thus neglecting the positional variations introduced by weight-bearing. We developed a registration and planning pipeline that allows for 3D preoperative planning and subsequent 3D assessment of anatomical deformities in weight-bearing conditions. Methods An intensity-based algorithm was used to register CT scans with long-leg standing radiographs and subsequently transform patient-specific 3D models into a weight-bearing state. 3D measurement methods for the mechanical axis as well as the joint line convergence angle were developed. The pipeline was validated using a leg phantom. Furthermore, we evaluated our methods clinically by applying it to the radiological data from 59 patients. Results The registration accuracy was evaluated in 3D and showed a maximum translational and rotational error of 1.1 mm (mediolateral direction) and 1.2° (superior-inferior axis). Clinical evaluation proved feasibility on real patient data and resulted in significant differences for 3D measurements when the effects of weight-bearing were considered. Mean differences were 2.1 ± 1.7° and 2.0 ± 1.6° for the mechanical axis and the joint line convergence angle, respectively. 37.3 and 40.7% of the patients had differences of 2° or more in the mechanical axis or joint line convergence angle between weight-bearing and non-weight-bearing states. Conclusions Our presented approach provides a clinically feasible approach to preoperatively fuse 2D weight-bearing and 3D non-weight-bearing data in order to optimize the surgical correction.
Insights into Imaging, 12 (1)
ISSN:1869-4101
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje