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

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

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 \(\sim \) 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.

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Funding

This study was funded by grants from the Canadian Institutes of Health Research (246067) and from the Natural Sciences and Engineering Research Council of Canada (396395).

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Authors and Affiliations

  1. McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, WB221, 3801 University Street, Montreal, QC, H3A 2B4, Canada

    Houssem-Eddine Gueziri, Simon Drouin, Charles X. B. Yan & D. Louis Collins

  2. Department of Medical Imaging, University of Toronto, 263 McCaul Street, Toronto, ON, M5T 1W7, Canada

    Charles X. B. Yan

Authors
  1. Houssem-Eddine Gueziri
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  2. Simon Drouin
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  3. Charles X. B. Yan
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  4. D. Louis Collins
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Correspondence to Houssem-Eddine Gueziri.

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Gueziri, HE., Drouin, S., Yan, C.X.B. et al. Toward real-time rigid registration of intra-operative ultrasound with preoperative CT images for lumbar spinal fusion surgery. Int J CARS 14, 1933–1943 (2019). https://doi.org/10.1007/s11548-019-02020-1

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  • DOI: https://doi.org/10.1007/s11548-019-02020-1

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