Emran Mohammad Abu Anas1, Alexander Seitel2, Abtin Rasoulian2, Paul St John3, Tamas Ungi4, Andras Lasso4, Kathryn Darras5, David Wilson2,6, Victoria A Lessoway7, Gabor Fichtinger4, Michelle Zec3, David Pichora3, Parvin Mousavi4, Robert Rohling2,8, Purang Abolmaesumi2. 1. Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada. emrana@ece.ubc.ca. 2. Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada. 3. Kingston General Hospital, Kingston, ON, Canada. 4. School of Computing, Queen's University, Kingston, ON, Canada. 5. Vancouver General Hospital, Vancouver, BC, Canada. 6. Department of Orthopaedics and Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada. 7. BC Women's Hospital, Vancouver, BC, Canada. 8. Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada.
Abstract
PURPOSE: Volar percutaneous scaphoid fracture fixation is conventionally performed under fluoroscopy-based guidance, where surgeons need to mentally determine a trajectory for the insertion of the screw and its depth based on a series of 2D projection images. In addition to challenges associated with mapping 2D information to a 3D space, the process involves exposure to ionizing radiation. Three-dimensional ultrasound has been suggested as an alternative imaging tool for this procedure; however, it has not yet been integrated into clinical routine since ultrasound only provides a limited view of the scaphoid and its surrounding anatomy. METHODS: We propose a registration of a statistical wrist shape + scale + pose model to a preoperative CT and intraoperative ultrasound to derive a patient-specific 3D model for guiding scaphoid fracture fixation. The registered model is then used to determine clinically important intervention parameters, including the screw length and the trajectory of screw insertion in the scaphoid bone. RESULTS: Feasibility experiments are performed using 13 cadaver wrists. In 10 out of 13 cases, the trajectory of screw suggested by the registered model meets all clinically important intervention parameters. Overall, an average 94 % of maximum allowable screw length is obtained based on the measurements from gold standard CT. Also, we obtained an average 92 % successful volar accessibility, which indicates that the trajectory is not obstructed by the surrounding trapezium bone. CONCLUSIONS: These promising results indicate that determining clinically important screw insertion parameters for scaphoid fracture fixation is feasible using 3D ultrasound imaging. This suggests the potential of this technology in replacing fluoroscopic guidance for this procedure in future applications.
PURPOSE: Volar percutaneous scaphoid fracture fixation is conventionally performed under fluoroscopy-based guidance, where surgeons need to mentally determine a trajectory for the insertion of the screw and its depth based on a series of 2D projection images. In addition to challenges associated with mapping 2D information to a 3D space, the process involves exposure to ionizing radiation. Three-dimensional ultrasound has been suggested as an alternative imaging tool for this procedure; however, it has not yet been integrated into clinical routine since ultrasound only provides a limited view of the scaphoid and its surrounding anatomy. METHODS: We propose a registration of a statistical wrist shape + scale + pose model to a preoperative CT and intraoperative ultrasound to derive a patient-specific 3D model for guiding scaphoid fracture fixation. The registered model is then used to determine clinically important intervention parameters, including the screw length and the trajectory of screw insertion in the scaphoid bone. RESULTS: Feasibility experiments are performed using 13 cadaver wrists. In 10 out of 13 cases, the trajectory of screw suggested by the registered model meets all clinically important intervention parameters. Overall, an average 94 % of maximum allowable screw length is obtained based on the measurements from gold standard CT. Also, we obtained an average 92 % successful volar accessibility, which indicates that the trajectory is not obstructed by the surrounding trapezium bone. CONCLUSIONS: These promising results indicate that determining clinically important screw insertion parameters for scaphoid fracture fixation is feasible using 3D ultrasound imaging. This suggests the potential of this technology in replacing fluoroscopic guidance for this procedure in future applications.
Authors: Erin J Smith; Hisham A Al-Sanawi; Braden Gammon; Paul J St John; David R Pichora; Randy E Ellis Journal: Int J Comput Assist Radiol Surg Date: 2011-06-25 Impact factor: 2.924
Authors: Mikael Brudfors; Alexander Seitel; Abtin Rasoulian; Andras Lasso; Victoria A Lessoway; Jill Osborn; Atsuto Maki; Robert N Rohling; Purang Abolmaesumi Journal: Int J Comput Assist Radiol Surg Date: 2015-04-18 Impact factor: 2.924
Authors: Nazlı Tümer; Aimee C Kok; Frans M Vos; Geert J Streekstra; Christian Askeland; Gabrielle J M Tuijthof; Amir A Zadpoor Journal: Sensors (Basel) Date: 2018-07-21 Impact factor: 3.576