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Title: WE-AB-BRA-08: Correction of Patient Motion in C-Arm Cone-Beam CT Using 3D-2D Registration

Abstract

Purpose: Intraoperative C-arm cone-beam CT (CBCT) is subject to artifacts arising from patient motion during the fairly long (∼5–20 s) scan times. We present a fiducial free method to mitigate motion artifacts using 3D-2D image registration that simultaneously corrects residual errors in geometric calibration. Methods: A 3D-2D registration process was used to register each projection to DRRs computed from the 3D image by maximizing gradient orientation (GO) using the CMA-ES optimizer. The resulting rigid 6 DOF transforms were applied to the system projection matrices, and a 3D image was reconstructed via model-based image reconstruction (MBIR, which accommodates the resulting noncircular orbit). Experiments were conducted using a Zeego robotic C-arm (20 s, 200°, 496 projections) to image a head phantom undergoing various types of motion: 1) 5° lateral motion; 2) 15° lateral motion; and 3) 5° lateral motion with 10 mm periodic inferior-superior motion. Images were reconstructed using a penalized likelihood (PL) objective function, and structural similarity (SSIM) was measured for axial slices of the reconstructed images. A motion-free image was acquired using the same protocol for comparison. Results: There was significant improvement (p < 0.001) in the SSIM of the motion-corrected (MC) images compared to uncorrected images. The SSIM inmore » MC-PL images was >0.99, indicating near identity to the motion-free reference. The point spread function (PSF) measured from a wire in the phantom was restored to that of the reference in each case. Conclusion: The 3D-2D registration method provides a robust framework for mitigation of motion artifacts and is expected to hold for applications in the head, pelvis, and extremities with reasonably constrained operative setup. Further improvement can be achieved by incorporating multiple rigid components and non-rigid deformation within the framework. The method is highly parallelizable and could in principle be run with every acquisition. Research supported by National Institutes of Health Grant No. R01-EB-017226 and academic-industry partnership with Siemens Healthcare (AX Division, Forcheim, Germany).« less

Authors:
; ; ;  [1];  [2]
  1. Johns Hopkins University, Baltimore, MD (United States)
  2. Siemens Medical Solutions USA, Inc., Hoffman Estates, IL (United States)
Publication Date:
OSTI Identifier:
22654098
Resource Type:
Journal Article
Resource Relation:
Journal Name: Medical Physics; Journal Volume: 43; Journal Issue: 6; Other Information: (c) 2016 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
60 APPLIED LIFE SCIENCES; 61 RADIATION PROTECTION AND DOSIMETRY; COMPUTERIZED TOMOGRAPHY; CORRECTIONS; FEDERAL REPUBLIC OF GERMANY; IMAGE PROCESSING; PATIENTS

Citation Formats

Ouadah, S, Jacobson, M, Stayman, JW, Siewerdsen, JH, and Ehtiati, T. WE-AB-BRA-08: Correction of Patient Motion in C-Arm Cone-Beam CT Using 3D-2D Registration. United States: N. p., 2016. Web. doi:10.1118/1.4957737.
Ouadah, S, Jacobson, M, Stayman, JW, Siewerdsen, JH, & Ehtiati, T. WE-AB-BRA-08: Correction of Patient Motion in C-Arm Cone-Beam CT Using 3D-2D Registration. United States. doi:10.1118/1.4957737.
Ouadah, S, Jacobson, M, Stayman, JW, Siewerdsen, JH, and Ehtiati, T. Wed . "WE-AB-BRA-08: Correction of Patient Motion in C-Arm Cone-Beam CT Using 3D-2D Registration". United States. doi:10.1118/1.4957737.
@article{osti_22654098,
title = {WE-AB-BRA-08: Correction of Patient Motion in C-Arm Cone-Beam CT Using 3D-2D Registration},
author = {Ouadah, S and Jacobson, M and Stayman, JW and Siewerdsen, JH and Ehtiati, T},
abstractNote = {Purpose: Intraoperative C-arm cone-beam CT (CBCT) is subject to artifacts arising from patient motion during the fairly long (∼5–20 s) scan times. We present a fiducial free method to mitigate motion artifacts using 3D-2D image registration that simultaneously corrects residual errors in geometric calibration. Methods: A 3D-2D registration process was used to register each projection to DRRs computed from the 3D image by maximizing gradient orientation (GO) using the CMA-ES optimizer. The resulting rigid 6 DOF transforms were applied to the system projection matrices, and a 3D image was reconstructed via model-based image reconstruction (MBIR, which accommodates the resulting noncircular orbit). Experiments were conducted using a Zeego robotic C-arm (20 s, 200°, 496 projections) to image a head phantom undergoing various types of motion: 1) 5° lateral motion; 2) 15° lateral motion; and 3) 5° lateral motion with 10 mm periodic inferior-superior motion. Images were reconstructed using a penalized likelihood (PL) objective function, and structural similarity (SSIM) was measured for axial slices of the reconstructed images. A motion-free image was acquired using the same protocol for comparison. Results: There was significant improvement (p < 0.001) in the SSIM of the motion-corrected (MC) images compared to uncorrected images. The SSIM in MC-PL images was >0.99, indicating near identity to the motion-free reference. The point spread function (PSF) measured from a wire in the phantom was restored to that of the reference in each case. Conclusion: The 3D-2D registration method provides a robust framework for mitigation of motion artifacts and is expected to hold for applications in the head, pelvis, and extremities with reasonably constrained operative setup. Further improvement can be achieved by incorporating multiple rigid components and non-rigid deformation within the framework. The method is highly parallelizable and could in principle be run with every acquisition. Research supported by National Institutes of Health Grant No. R01-EB-017226 and academic-industry partnership with Siemens Healthcare (AX Division, Forcheim, Germany).},
doi = {10.1118/1.4957737},
journal = {Medical Physics},
number = 6,
volume = 43,
place = {United States},
year = {Wed Jun 15 00:00:00 EDT 2016},
month = {Wed Jun 15 00:00:00 EDT 2016}
}
  • Purpose: Intraoperative x-ray radiography/fluoroscopy is commonly used to qualitatively assess delivery of surgical devices (e.g., spine pedicle screws) but can fail to reliably detect suboptimal placement (e.g., breach of adjacent critical structures). We present a method wherein prior knowledge of the patient and surgical components is leveraged to match preoperative CT and intraoperative radiographs for quantitative assessment of 3D pose. The method presents a new means of operating room quantitative quality assurance (ORQA) that could improve quality and safety, and reduce the frequency of revision surgeries. Methods: The algorithm (known-component registration, KC-Reg) uses patient-specific preoperative CT and parametrically defined surgicalmore » component models within a robust 3D-2D registration method to iteratively optimize gradient similarity using the covariance matrix adaptation evolution strategy. Advances from previous work address key challenges to clinical translation: i) absolving the need for offline geometric calibration of the C-arm; and ii) solving multiple component bodies simultaneously, thereby allowing QA in a single step (e.g., spinal construct with 4–20 screws), rather than sequential QA of each component. Performance was tested in a spine phantom with 10 pedicle screws, and first results from clinical studies are reported. Results: Phantom experiments demonstrated median target registration error (TRE) of (1.0±0.3) mm at the screw tip and (0.7°±0.4°) in angulation. The simultaneous multi-body registration approach improved TRE from the previous (sequential) method by 42%, reduced outliers, and fits into the natural workflow. Initial application of KC-Reg in clinical data shows TRE of (2.5±4.5) mm and (4.7°±0.5°). Conclusion: The KC-Reg algorithm offers a potentially valuable method for quantitative QA of the surgical product, using radiographic systems that are already within the surgical arsenal. For spine surgery, the method offers a near-real-time independent check on the quality of surgical product, facilitating immediate revision if necessary and potentially avoiding postoperative morbidity and/or revision surgery. Gerhard Kleinszig and Sebastian Vogt are employees of Siemens Healthcare.« less
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