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Int J Comput Assist Radiol Surg. 2019 Jun 28. doi: 10.1007/s11548-019-02020-1. [Epub ahead of print]

Toward real-time rigid registration of intra-operative ultrasound with preoperative CT images for lumbar spinal fusion surgery.

Author information

1
McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB221, 3801 University Street, Montreal, QC, H3A 2B4, Canada. houssem.gueziri@mcgill.ca.
2
McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB221, 3801 University Street, Montreal, QC, H3A 2B4, Canada.
3
Department of Medical Imaging, University of Toronto, 263 McCaul Street, Toronto, ON, M5T 1W7, Canada.

Abstract

PURPOSE:

Accurate and effective registration of the vertebrae is crucial for spine surgical navigation procedures. Patient movement, surgical instrumentation or inadvertent contact with the tracked reference during the intervention may invalidate the registration, requiring a rapid correction of the misalignment. In this paper, we present a framework to rigidly align preoperative computed tomography (CT) with the intra-operative ultrasound (iUS) images of a single vertebra.

METHODS:

We use a single caudo-cranial axial sweep procedure to acquire iUS images, from which the scan trajectory is exploited to initialize the registration transform. To refine the transform, locations of the posterior vertebra surface are first extracted, then used to compute the CT-to-iUS image intensity gradient-based alignment. The approach was validated on a lumbosacral section of a porcine cadaver.

RESULTS:

We achieved an overall median accuracy of 1.48 mm (success rate of 84.42%) in [Formula: see text] 11 s of computation time, satisfying the clinically accepted accuracy threshold of 2 mm.

CONCLUSION:

Our approach using intra-operative ultrasound to register patient vertebral anatomy to preoperative images matches the clinical needs in terms of accuracy and computation time, facilitating its integration into the surgical workflow.

KEYWORDS:

Computed tomography; GPU acceleration; Registration; Spine surgery; Ultrasound; Vertebra

PMID:
31254179
DOI:
10.1007/s11548-019-02020-1

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