Precise estimation of postoperative cup alignment from single standard X-ray radiograph with gonadal shielding

Authors:
Guoyan Zheng;Simon Steppacher;Xuan Zhang;Moritz Tannast
Affiliations:
MEM Research Center, University of Bern, Bern, Switzerland;Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland;MEM Research Center, University of Bern, Bern, Switzerland;Department of Orthopaedic Surgery, Inselspital, University of Bern, Switzerland
Venue:
MICCAI'07 Proceedings of the 10th international conference on Medical image computing and computer-assisted intervention
Year:
2007

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Abstract

This paper addresses the problem of estimating postoperative cup alignment from single standard X-ray radiograph with gonadal shielding. The widely used procedure of evaluation of cup orientation following total hip arthroplasty using single standard anteroposterior radiograph is known inaccurate, largely due to the wide variability in individual pelvic position relative to X-ray plate. 2D-3D image registration methods have been introduced to estimate the rigid transformation between a preoperative CT volume and postoperative radiograph(s) for an accurate estimation of the postoperative cup alignment relative to an anatomical reference extracted from the CT data. However, these methods require either multiple radiographs or a radiograph-specific calibration, both of which are not avaiable for most retrospective studies. Furthermore, these methods were only evaluated on X-ray radiograph(s) without gonadal shielding. In this paper, we propose to use a hybrid 2D-3D registration scheme combining an iterative landmark-to-ray registration with a 2D-3D intensity-based registration to estimate the rigid transfromation for a precise estimation of cup alignment. Quantitative and qualitative results evaluated on clinical and cadaveric datasets are given which indicate the validity of our approach.