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Statistically Deformable 2D/3D Registration for Estimating Post-operative Cup Orientation from a Single Standard AP X-ray Radiograph

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Abstract

The widely used procedure of estimating post-operative cup orientation based on a single standard AP X-ray radiograph is known inaccurate, largely due to the wide variability in individual pelvic orientation relative to X-ray plate. CT-based 2D/3D rigid image registration methods have been developed to measure post-operative cup orientation. Although encouraging results have been reported, their extensive usage in clinical routine is still limited. This may be explained by their requirement of having a CT study of the patient at some point during treatment, which is not available for vast majority of Total Hip Arthroplasty procedures performed nowadays. To address this limitation, this article proposes a statistically deformable 2D/3D registration approach for estimating post-operative cup orientation. No CT study of the patient is required any more. Compared to ground truths established from post-operative CT images, the cup orientations measured by the present technique in a cadaver experiment showed differences of 1.7 ± 1.4° for anteversion and difference of 1.5 ± 1.5° for inclination. When the present technique was evaluated on patients’ datasets, differences of 2.2 ± 1.3° and differences of 2.0 ± 0.8° were found for the anteversion and the inclination, respectively. The experimental results, though still preliminary, demonstrated the efficacy of the present approach.

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Abbreviations

THA:

Total Hip Arthroplasty

AP:

Antero-Posterior

3D:

Three-dimensional

2D:

Two-dimensional

CT:

Computed Tomography

APP:

Anterior Pelvic Plane

ASIS:

Anterior Superior Iliac Spine

SSM:

Statistical Shape Model

DRR:

Digitally Reconstructed Radiograph

PDM:

Point Distribution Model

DICOM:

Digital Imaging and COmmunication in Medicine

PCA:

Principal Component Analysis

LM:

Lateral-Medial

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Acknowledgments

The author gratefully acknowledges the financial support from the Swiss National Centers of Competence in Research CO-ME. The author would also like to thank the associated editor and the anonymous reviewers for their constructive comments and suggestions.

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  1. Institute for Surgical Technology and Biomechanics, University of Bern, Stauffacherstrasse 78, CH-3014, Bern, Switzerland

    Guoyan Zheng

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  1. Guoyan Zheng
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Correspondence to Guoyan Zheng.

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Associate Editor Larry V. McIntire oversaw the review of this article.

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Zheng, G. Statistically Deformable 2D/3D Registration for Estimating Post-operative Cup Orientation from a Single Standard AP X-ray Radiograph. Ann Biomed Eng 38, 2910–2927 (2010). https://doi.org/10.1007/s10439-010-0060-0

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