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Registration of a statistical model to intraoperative ultrasound for scaphoid screw fixation

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada

    Emran Mohammad Abu Anas, Alexander Seitel, Abtin Rasoulian, David Wilson, Robert Rohling & Purang Abolmaesumi

  2. Kingston General Hospital, Kingston, ON, Canada

    Paul St. John, Michelle Zec & David Pichora

  3. School of Computing, Queen’s University, Kingston, ON, Canada

    Tamas Ungi, Andras Lasso, Gabor Fichtinger & Parvin Mousavi

  4. Vancouver General Hospital, Vancouver, BC, Canada

    Kathryn Darras

  5. Department of Orthopaedics and Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada

    David Wilson

  6. BC Women’s Hospital, Vancouver, BC, Canada

    Victoria A. Lessoway

  7. Mechanical Engineering, University of British Columbia, Vancouver, BC, Canada

    Robert Rohling

Authors
  1. Emran Mohammad Abu Anas
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  2. Alexander Seitel
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  3. Abtin Rasoulian
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  4. Paul St. John
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  5. Tamas Ungi
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  6. Andras Lasso
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  7. Kathryn Darras
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  8. David Wilson
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  9. Victoria A. Lessoway
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  10. Gabor Fichtinger
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  11. Michelle Zec
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  12. David Pichora
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  13. Parvin Mousavi
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  14. Robert Rohling
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  15. Purang Abolmaesumi
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Corresponding author

Correspondence to Emran Mohammad Abu Anas.

Additional information

We would like to thank the Natural Sciences and Engineering Research Council (NSERC), and the Canadian Institutes of Health Research (CIHR) for funding this project.

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Anas, E.M.A., Seitel, A., Rasoulian, A. et al. Registration of a statistical model to intraoperative ultrasound for scaphoid screw fixation. Int J CARS 11, 957–965 (2016). https://doi.org/10.1007/s11548-016-1370-y

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  • DOI: https://doi.org/10.1007/s11548-016-1370-y

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