A system for ultrasound-guided computer-assisted orthopaedic surgery

• Published in: Computer aided surgery (New York, N.Y.) Vol. 10; no. 5-6; pp. 281 - 292
• Main Authors: Chen, Thomas Kuiran, Abolmaesumi, Purang, Pichora, David R., Ellis, Randy E.
• Format: Journal Article
• Language: English
• Published: Informa UK Ltd 01.01.2005; Taylor & Francis
• Subjects: Computer-assisted orthopedic surgery; entropy; image registration; image-guided surgery; ITK; mutual information; ultrasound calibration; ultrasound imaging; volume reconstruction; VTK
• ISSN: 1092-9088; 1097-0150; 1097-0150
• DOI: 10.3109/10929080500390017

Current computer-assisted orthopedic surgery (CAOS) systems typically use preoperative computed tomography (CT) and intraoperative fluoroscopy as their imaging modalities. Because these imaging tools use X-rays, both patients and surgeons are exposed to ionizing radiation that may cause long-term health damage. To register the patient with the preoperative surgical plan, these techniques require tracking of the targeted anatomy by invasively mounting a tracking device on the patient, which results in extra pain and may prolong recovery time. The mounting procedure also leads to a major difficulty of using these approaches to track small bones or mobile fractures. Furthermore, it is practically impossible to mount a heavy tracking device on a small bone, which thus restricts the use of CAOS techniques. This article presents a novel CAOS method that employs 2D ultrasound (US) as the imaging modality. Medical US is non-ionizing and real-time, and our proposed method does not require any invasive mounting procedures. Experiments have shown that the proposed registration technique has sub-millimetric accuracy in localizing the best match between the intraoperative and preoperative images, demonstrating great potential for orthopedic applications. This method has some significant advantages over previously reported US-guided CAOS techniques: it requires no segmentation and employs only a few US images to accurately and robustly localize the patient. Preliminary laboratory results on both a radius-bone phantom and human subjects are presented.