Surgical Instrument Positioning via 2D-3D Image Registration
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Solution Overview
Problem
Current methods for determining the optimal position of surgical instruments relative to patient bones during surgery often require multiple steps and expose patients to significant X-ray radiation, especially when considering the patient's standing position for optimal results.
Innovation Solution
The method utilizes a cone beam computed tomography (CBCT) imaging system and a computer to determine the optimal position of surgical instruments relative to bone trackers, acquiring preoperative 2D X-ray images and intraoperative 3D images, and registering them to represent the bone in a position of interest, such as standing, without the need for CT scans.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If preoperative 3D CT scan is acquired to obtain image quality adapted to segmentation, then manufacturing precision is improved, but patient exposure to X-rays increases and cost increases
Solution Approach 1:
The patent performs image registration and bone model reorientation to standing position preoperatively, but uses lower-radiation 2D X-ray images instead of 3D CT scans. The 2D images are registered and processed in advance to create the planning models needed for surgery, eliminating the need for high-radiation 3D CT while maintaining sufficient image quality for segmentation and planning.
Solution Approach 2:
The patent replaces expensive, high-radiation 3D CT scans with cheaper, lower-radiation 2D X-ray images. The 2D images serve as a sufficient alternative for preoperative planning when processed through registration and reorientation algorithms, reducing both cost and radiation exposure while maintaining adequate manufacturing precision for surgical planning.
2Manufacturing precision
If 3D CT scan is used instead of MRI, then manufacturing precision is improved, but patient exposure to X-rays increases
Solution Approach 1:
The patent performs the necessary image processing, registration, and bone model reorientation to standing position preoperatively using 2D X-ray images. This preliminary processing creates sufficiently accurate 3D models for surgical planning without requiring actual 3D CT scanning during the preoperative phase, thereby eliminating unnecessary radiation exposure while maintaining manufacturing precision.
Solution Approach 2:
The patent substitutes expensive, radiation-intensive 3D CT scans with cheaper 2D X-ray images that are then computationally transformed into 3D models through registration and reorientation. This approach achieves adequate 3D image quality for surgical planning while avoiding the harmful radiation exposure associated with 3D CT scans.
3Measurement precision
If multiple registration steps are performed to account for patient position, then measurement precision is improved, but device complexity increases
Solution Approach 1:
The patent combines the registration process with the bone model reorientation to standing position in a single integrated computational workflow. Instead of performing separate registration steps for different positions, the method merges these operations into one unified process that directly transforms 2D X-ray images into standing-position 3D models, reducing procedural complexity while maintaining measurement precision.
Solution Approach 2:
The patent changes the reference frame parameter by reorienting bone models to represent the patient in standing position rather than supine position. This parameter change is achieved through computational transformation of the registered images, allowing accurate measurement in the clinically relevant standing position without adding physical registration steps or device complexity.
4Object-affected harmful factors
If 2D X-ray images are used instead of 3D CT, then patient X-ray exposure is reduced, but manufacturing precision deteriorates
Solution Approach 1:
The patent transforms 2D X-ray images into 3D bone models through computational registration and reorientation processes. By changing from 2D input to 3D output through mathematical transformation, the method achieves sufficient 3D image quality for surgical planning while using only 2D X-ray input, thereby reducing radiation exposure without sacrificing manufacturing precision.
Solution Approach 2:
The patent uses computational registration and reorientation algorithms as intermediaries to bridge 2D X-ray images and the required 3D models for surgical planning. These intermediary processing steps transform the 2D image data into accurate 3D representations, maintaining manufacturing precision while avoiding the need for direct 3D CT scanning and its associated radiation exposure.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach minimizes the number of surgical procedure steps, reduces patient X-ray exposure, and allows for accurate planning and execution of surgical procedures considering the patient's position of interest, all while avoiding the need for costly and radiation-intensive CT scans.
Implementation Method 1
acquiring an intraoperative 3D medical image of the bone by a cone beam computed tomography (CBCT) imaging system
Implementation Method 2
registering the intraoperative 3D medical image onto the at least one preoperative 2D X-ray image, so as to obtain a registered 3D image representing the bone in the position of interest
Data Source
AI summary
The invention relates to a system for determining an optimal position of a surgical instrument relative to a patient's bone tracker, the system comprising:—a medical imaging system configured to acquire at least one cone beam computed tomography intraoperative image of the patient;—a localization device;—a computer configured to receive images from the medical imaging system and localization data from the localization device and to implement the following method: the method comprising: ⋅(a) receiving at least one preoperative 2D X-ray image of the bone while the patient is in a position of interest; ⋅(b) acquiring an intraoperative 3D medical image of the bone by cone beam computed tomography while the patient is in an operative position different from the position of interest, the 3D image being registered with the coordinate system of the bone tracker; ⋅(c) registering the intraoperative 3D medical image onto the at least one preoperative 2D X-ray image, so as to obtain a registered 3D image representing the bone in the position of interest; ⋅(d) planning a surgical procedure on the registered 3D medical image taking into account said position of interest; ⋅(e) determining an optimal position of the surgical instrument relative to the patient's bone tracker for implementing said planned surgical procedure.