Title
Assessing the accuracy of a new 3D2D registration algorithm based on a non-invasive skin marker model for navigated spine surgery
Abstract
We assessed the accuracy of a new 3D2D registration algorithm to be used for navigated spine surgery and explored anatomical and radiologic parameters affecting the registration accuracy. Compared to existing 3D2D registration algorithms, the algorithm does not need bone-mounted or table-mounted instruments for registration. Neither does the intraoperative imaging device have to be tracked or calibrated. The rigid registration algorithm required imaging data (a pre-existing CT scan (3D) and two angulated fluoroscopic images (2D)) to register positions of vertebrae in 3D and is based on non-invasive skin markers. The algorithm registered five adjacent vertebrae and was tested in the thoracic and lumbar spine from three human cadaveric specimens. The registration accuracy was calculated for each registered vertebra and measured with the target registration error (TRE) in millimeters. We used multivariable analysis to identify parameters independently affecting the algorithm’s accuracy such as the angulation between the two fluoroscopic images (between 40° and 90°), the detector-skin distance, the number of skin markers applied, and waist circumference. The algorithm registered 780 vertebrae with a median TRE of 0.51 mm [interquartile range 0.32–0.73 mm] and a maximum TRE of 2.06 mm. The TRE was most affected by the angulation between the two fluoroscopic images obtained (p < 0.001): larger angulations resulted in higher accuracy. The algorithm was more accurate in thoracic vertebrae (p = 0.004) and in the specimen with the smallest waist circumference (p = 0.003). The algorithm registered all five adjacent vertebrae with similar accuracy. We studied the accuracy of a new 3D2D registration algorithm based on non-invasive skin markers. The algorithm registered five adjacent vertebrae with similar accuracy in the thoracic and lumbar spine and showed a maximum target registration error of approximately 2 mm. To further evaluate its potential for navigated spine surgery, the algorithm may now be integrated into a complete navigation system.
Year
DOI
Venue
2022
10.1007/s11548-022-02733-w
International Journal of Computer Assisted Radiology and Surgery
Keywords
DocType
Volume
Surgical navigation, Image-guidance, Computer-assisted surgery, Fluoroscopy, Spine, Vertebra
Journal
17
Issue
ISSN
Citations 
10
1861-6429
0
PageRank 
References 
Authors
0.34
6
7