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Cited by 36Medical Image Segmentation TechniquesSpinal Fractures and Fixation TechniquesBone fractures and treatments

Fiducial-Free 2D/3D Registration for Robot-Assisted Femoroplasty

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Gao, Cong, Farvardin, Amirhossein, Grupp, Robert B., Bakhtiarinejad, Mahsan, Ma, Liuhong, Thies, Mareike, Unberath, Mathias, Taylor, Russell H. +1 more·2020·IEEE Transactions on Medical Robotics and Bionics
DOI 10.1109/tmrb.2020.3012460PMC PMC7982989
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Abstract

Femoroplasty is a proposed alternative therapeutic method for preventing osteoporotic hip fractures in the elderly. Previously developed navigation system for femoroplasty required the attachment of an external X-ray fiducial to the femur. We propose a fiducial-free 2D/3D registration pipeline using fluoroscopic images for robot-assisted femoroplasty. Intraoperative fluoroscopic images are taken from multiple views to perform registration of the femur and drilling/injection device. The proposed method was tested through comprehensive simulation and cadaveric studies. Performance was evaluated on the registration error of the femur and the drilling/injection device. In simulations, the proposed approach achieved a mean accuracy of 1.26±0.74 mm for the relative planned injection entry point; 0.63±0.21° and 0.17±0.19° for the femur injection path direction and device guide direction, respectively. In the cadaver studies, a mean error of 2.64 ± 1.10 mm was achieved between the planned entry point and the device guide tip. The biomechanical analysis showed that even with a 4 mm translational deviation from the optimal injection path, the yield load prior to fracture increased by 40.7%. This result suggests that the fiducial-less 2D/3D registration is sufficiently accurate to guide robot assisted femoroplasty.

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  • Due to the lack of distinct features of the proximal femur in DRRs, Gao et al. proposed a two-step registration where the pelvis is first registered for better femoral pose initialization because the pelvis has a rich collection of distinct features leading to accurate registration.

    “Due to the lack of distinct features of the proximal femur in the DRRs, Gao et al. have proposed a two-step registration where the pelvis is first registered for a better femoral pose initialization since the pelvis has a rich collection of distinct features that leads to accurate registration accuracy (Gao et al. 2020).”

    From Towards 2D/3D Registration of the Preoperative MRI to Intraoperative Fluoroscopic Images for Visualisation of Bone Defects (2023) · cites this paper as Gao et al. 2020

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Research works printed but not linked: 31

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Cited by

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Authors
Gao, C., Farvardin, A., Grupp, R. B., Bakhtiarinejad, M., Ma, L., Thies, M., Unberath, M., Taylor, R. H., & Armand, M.
Affiliations
  • Johns Hopkins University (US)
  • Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
ORCID
Venue
IEEE Transactions on Medical Robotics and Bionics
Publisher
Institute of Electrical and Electronics Engineers (IEEE)
Published
2020-08
Volume
2
Issue
3
Pages
437-446
ISSN
2576-3202 (ISSN-L)
DOI
10.1109/tmrb.2020.3012460
PMC
PMC7982989
OpenAlex
W3046011767
Cited by
36
References
5
Citations by year
2026: 2 · 2025: 6 · 2024: 9 · 2023: 11 · 2022: 5 · 2021: 2 · 2020: 1
FWCI
1.85
Type
journal article
Language
en
Open access
Licence
Locations
  • IEEE Transactions on Medical Robotics and Bionics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • NIH (R01EB023939, R21EB020113)
  • Johns Hopkins University Applied Physics Laboratory internal funds
Topics
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
  • Health Sciences › Medicine › Surgery › Spinal Fractures and Fixation Techniques
  • Health Sciences › Medicine › Epidemiology › Bone fractures and treatments
Keywords
2D-3D registration, fluoroscopy, surgical navigation, femur, yield load, cadaveric study, biomechanical analysis

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