Arulampalam Jevan, Ehlke Moritz F, Plaskos Christopher, Li Qing, Stambouzou Catherine Z, Sullivan James A, Solomon Michael I, Slotkin Eric M
Corin Group, Raynham, MA, USA.
School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, Sydney, Australia.
Int J Comput Assist Radiol Surg. 2025 May 11. doi: 10.1007/s11548-025-03389-y.
This study evaluated the accuracy of an automated 2D-3D registration software for matching preoperative 3D models of the pelvis and acetabular component to intraoperative 2D fluoroscopy images in total hip arthroplasty (THA).
We developed a 2D-3D registration software that registers a 3D model of the pelvis from preoperative CT and a 3D model of the acetabular implant to intraoperative fluoroscopic imaging, thereby calculating the implant position relative to the 3D pelvic reference frame. A total of 145 datasets were used including 65 digitally reconstructed radiographs, 20 dry bone phantoms datasets and 60 clinical datasets with preoperative CT and intraoperative fluoroscopy imaging. Achieved acetabular positions from the clinical images were determined from post-operative CT using a 3D/3D registration method. Accuracy was assessed by comparing the calculated acetabular position from the 2D-3D software to the ground truth data.
Mean absolute difference between ground truth and the 2D-3D software was 1.9° [signed error range: -4.4, 4.8] for inclination, 1.5° [-7.3, 4.1] for anteversion, 1.6 mm [-5, 3.8] for cup height and 1.8 mm [-7.3, 4.1] for depth across all datasets. In total, 100% of inclination results and 98% of anteversion results were within 5° while 90% of height and 81% of depth results were within 3 mm.
We validated the accuracy of an automated 2D-3D registration software for use in THA. While our method requires preoperative data from CT, the results are comparable to robotics and image-based navigation, and present a promising, simple technology that can be easily integrated into an operating room for THA.
本研究评估了一种自动二维 - 三维配准软件在全髋关节置换术（THA）中用于将术前骨盆和髋臼假体的三维模型与术中二维透视图像进行匹配的准确性。
我们开发了一种二维 - 三维配准软件，该软件将术前CT扫描的骨盆三维模型和髋臼假体的三维模型与术中透视成像进行配准，从而计算出假体相对于三维骨盆参考框架的位置。总共使用了145个数据集，包括65个数字重建射线照片、20个干骨模型数据集以及60个具有术前CT和术中透视成像的临床数据集。通过三维/三维配准方法从术后CT确定临床图像中髋臼的实际位置。通过将二维 - 三维软件计算出的髋臼位置与真实数据进行比较来评估准确性。
在所有数据集中，真实值与二维 - 三维软件之间的平均绝对差值为：倾斜度1.9°[符号误差范围：-4.4, 4.8]，前倾角1.5°[-7.3, 4.1]，髋臼杯高度1.6毫米[-5, 3.8]，深度1.8毫米[-7.3, 4.1]。总体而言，100%的倾斜度结果和98%的前倾角结果在5°以内，而90%的高度结果和81%的深度结果在3毫米以内。
我们验证了一种用于THA的自动二维 - 三维配准软件的准确性。虽然我们的方法需要术前CT数据，但其结果与机器人技术和基于图像的导航技术相当，并且提供了一种有前景的、简单的技术，可轻松集成到THA手术室中。
