PurposeMobile C-arm systems represent the standard imaging devices within the field of spine surgery. In addition to 2D imaging, they allow for 3D scans while preserving unrestricted patient access. For viewing, the acquired volumes are adjusted such that their anatomical standard planes align with the axes of the viewing modality. This difficult and time-consuming step is currently performed manually by the leading surgeon. This process is automatized within this work to improve the usability of C-arm systems. Thereby, the spinal region consisting of multiple vertebrae and the standard planes of all vertebrae being of interest to the surgeon need to be taken into account.ApproachAn object detection algorithm based on the you only look once version 3 architecture, adapted to 3D inputs, is compared with a segmentation-based approach employing a 3D U-Net. Both algorithms are trained on a dataset of 440 and tested on 218 spinal volumes.ResultsAlthough the detection-based algorithm is slightly inferior concerning the detection (91% versus 97% accuracy), localization (1.26 mm versus 0.74 mm error) and alignment accuracy (5.00 deg versus 4.73 deg error), it outperforms the segmentation-based one in terms of speed (5 s versus 38 s).ConclusionsBoth algorithms show similar good results. However, the speed gain of the detection-based algorithm, resulting in a run time of 5 s, makes it more suitable for usage in an intra-operative scenario.
To support the development of an automatic path-planning procedure for bronchoscopy, semantic segmentation of pulmonary nodules and airways is required. The segmentation should happen simultaneously and automatically to save time and effort during the intervention. The challenges of the combined segmentation are the different shapes, frequencies, and sizes of airways, lungs, and pulmonary nodules. Therefore, a sampling strategy is explored using especially relevant crops of the volumes during training and weighting the classes differently, counteracting class imbalance. For the segmentation, a 3D U-Net is used. The proposed algorithm is compared to nnU-Net. First, it is trained as a one-class problem on all classes individually and in a second approach as a multi-label problem. The developed Multi-Label Segmentation network (MLS) is trained with full supervision. The results of the experiments have shown that without further adaption, a combined segmentation of nodules, airways, and lungs is complex. The multi-label nnU-Net failed to find nodules. Considering the different properties of the three classes, MLS accomplishes segmenting all classes simultaneously.
Purpose: To assess the result in orthopedic trauma surgery, usually three-dimensional volume data of the treated region is acquired. With mobile C-arm systems, these acquisitions can be performed intraoperatively, reducing the number of required revision surgeries. However, the acquired volumes are typically not aligned to the anatomical regions. Thus, the multiplanar reconstructed (MPR) planes need to be adjusted manually during the review of the volume. To speed up and ease the workflow, an automatic parameterization of these planes is needed.
Approach: We present a detailed study of multitask learning (MTL) regression networks to estimate the parameters of the MPR planes. First, various mathematical descriptions for rotation, including Euler angle, quaternion, and matrix representation, are revised. Then, two different MTL network architectures based on the PoseNet are compared with a single task learning network.
Results: Using a matrix description rather than the Euler angle description, the accuracy of the regressed normals improves from 7.7 deg to 7.3 deg in the mean value for single anatomies. The multihead approach improves the regression of the plane position from 7.4 to 6.1 mm, whereas the orientation does not benefit from this approach. Thus, the achieved accuracy meets the reported interrater variance in similarly complex body regions of up to 6.3 deg for the normals and up to 9.3 mm for the plane position.
Conclusions: The use of a multihead approach with shared features leads to more accurate plane regression compared with the use of individual networks for each task. It also improves the angle estimation for the ankle region. The reported results are in the same range as manual plane adjustments. The use of a combined network with shared parameters requires less memory, which is a great benefit for the implementation of an application for the surgical environment.
Purpose: The choice of input normalization has effects on the generalization and performance of deep neural networks. While this topic is explored for 2D imaging applications, the influence of different normalization techniques on medical imaging modalities, e.g. cone-beam CT (CBCT), differs due to a different value range and distribution. In this paper a good normalization technique for intra-operatively acquired surgical CBCT volumes is presented. Methods: A set of normalization strategies, namely histogram equalization, min-max scaling, z-score normalization, linear look up table (LUT) with clipping and sigmoid function with clipping is compared on a CBCT volume classification task. Results: The results show that a combination of parameterized LUTs and clipping with the range [-710, 1640] HU independent of the underlying intensity histogram provides the best performance for the task at hand. Conclusions: The clipping based normalization technique helps to compress the feature space to the relevant range. By this approach, most of the information about the intensity values of soft tissue and bone is retained. The clipping range presented in this paper is valid for surgical CBCTs.
For many medical questions, X-ray imaging belongs to the gold standard for diagnosis, treatment planning, treatment guidance, and surgery assessment. To improve the reading performance, standardized image rotation is an important step. We propose a new algorithm to estimate the correct image rotation. For many body regions, one line can be defined that is aligned with the upright orientation of the X-ray image. This line can be, for example, the shaft axis of a long bone or the axis of the spine. In this paper, we propose a strategy to automatically align X-ray images with their standard orientation. In a first step, the heatmap of this line is determined using the segmentation network D-LinkNet. The rotation direction, up to a top-down flip, is obtained by computing the orientation of the main axis of this heatmap. For the orientation computation, we compare PCA and Hu moments. While the PCA requires to threshold the heatmap, Hu moments can be used directly on the output values of the network, preserving the (un)certainty of the segmentation. We compare these two methods with a ResNet-18 for the direct estimation of the image rotation on 220 X-ray images from the MURA dataset showing the wrist in the AP view. With the heatmap-based approach followed by Hu moments analysis, the median absolute error for the angle estimation can be reduced to 0.7° compared to 1.7° by a direct estimation method. PCA suffers from noisy heatmaps for images of bad quality degrading the overall performance of this approach.
Access to the requested content is limited to institutions that have purchased or subscribe to SPIE eBooks.
You are receiving this notice because your organization may not have SPIE eBooks access.*
*Shibboleth/Open Athens users─please
sign in
to access your institution's subscriptions.
To obtain this item, you may purchase the complete book in print or electronic format on
SPIE.org.
INSTITUTIONAL Select your institution to access the SPIE Digital Library.
PERSONAL Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.