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Biomedical subjects

M P Zeleznik

Publications and source records attributed to M P Zeleznik.

10 recordsLinked to original sources

Fusion of radiostereometric analysis data into computed tomography space: application to the elbow joint.

Improvement of joint prostheses is dependent upon information concerning the biomechanical properties of the joint. Radiostereometric analysis (RSA) and electromagnetic techniques have been applied in previous cadaver and in vivo studies on the elbow joint to provide valuable information concerning joint motion axes. However, such information is limited to mathematically calculated positions of the axes according to an orthogonal coordinate system and is difficult to relate to individual skeletal anatomy. The aim of this study was to evaluate the in vivo application of a new fusion method to provide three-dimensional (3D) visualization of flexion axes according to bony landmarks. In vivo RSA data of the elbow joint's flexion axes was combined with data obtained by 3D computed tomography (CT). Results were obtained from five healthy subjects after one was excluded due to an instable RSA marker. The median error between imported and transformed RSA marker coordinates and those obtained in the CT volume was 0.22 mm. Median maximal rotation error after transformation of the rigid RSA body to the CT volume was 0.003 degrees . Points of interception with a plane calculated in the RSA orthogonal coordinate system were imported into the CT volume, facilitating the 3D visualization of the flexion axes. This study demonstrates a successful fusion of RSA and CT data, without significant loss of RSA accuracy. The method could be used for relating individual motion axes to a 3D representation of relevant joint anatomy, thus providing important information for clinical applications such as the development of joint prostheses.

Adult↗

Assessing wear of the acetabular cup using computed tomography: an ex vivo study.

PURPOSE: To validate a clinically useful method for measuring acetabular cup wear using computed tomography (CT). MATERIAL AND METHODS: Eight uncemented acetabular cups were scanned twice ex vivo using CT. The linear penetration depth of the femoral component head into the cup and the thickness of the remaining polyethylene liner were measured in the CT volumes using dedicated software. Two independent examiners twice assessed each volume. The CT measurements were compared to direct measurements using a coordinate measuring device and micrometer measurements. RESULTS: Accuracy of wear measurements expressed as penetration depth was +/-0.6 and +/- 1.0 mm for the two examiners, respectively, with no significant differences between examiners, trials, and CT scans. Accuracy of measurements of remaining polyethylene was +/- 1.3 and +/- 1.0 mm, respectively, for the two examiners. Systematic differences between examiners were found, but no significant differences between trials and CT scans. These differences were due to different interpretations of metal artifacts in the volumes. CONCLUSION: The proposed CT method for evaluating wear as head penetration depth allows for reliable wear detection at a clinically relevant level. Measurements of remaining polyethylene on CT volumes are not as reliable as wear measurements owing to metal artifacts.

Device Removal↗

Standard orientation of the pelvis: validation on a model and ten patients.

PURPOSE: To validate an image post-processing method for re-orienting the pelvis in CT volumes to a standardized orientation in a model and in 10 patients. MATERIAL AND METHODS: Twenty-four CT volumes of a pelvic model and 10 pairs of postoperative total hip arthroplasty (THA) patient CT scans were rotated to a defined pelvic standard orientation and the rotation was recorded. For precision, a test-retest procedure was used. For accuracy, three exactly represented coordinate points were used. For clinical application, the standard orientation was used for calculating the direction of acetabular cup migration from a previous model study. RESULTS: Precision of pelvic standard orientation, calculated as maximal directional error, was better than 1 degrees in the model study and better than 1.5 degrees in the patient study. Accuracy, expressed as angle between ideal and measured coordinate axes, was 0.1 degrees for x, y, z axes. No measurable systematic errors were found. When applied to acetabular cup migration in the model, standardization of pelvic orientation had no significant effect on the measurements. CONCLUSION: Reorienting the pelvis during image post-processing was shown to be accurate. It enables measurements relative to the pelvis and minimizes the dependency of patient positioning.

Adult↗

Evaluation of a semiautomatic 3D fusion technique applied to molecular imaging and MRI brain/frame volume data sets.

A generally applicable 3D fusion method was evaluated using molecular imaging and MRI volumetric data sets from 15 brain tumor patients with stereotactic frames attached to their skull. Point pairs, placed on the frame only, were chosen, polynomial warping coefficients were generated to map voxels from one coordinate space to the other. The MRI frame was considered the reference structure and the standard for "correct" registration. An ANOVA test (p > 0.05) confirmed the point pair choice to be consistent. The 95% confidence interval for the t-test showed the measured distance difference between the registered volumes was within one MRI voxel. A further experiment was conducted to independently evaluate the brain registration based on testing for consistency of randomly selected interior/exterior points. A t-test result (p < 0.05) showed that the consistency (i.e., both interior or both exterior) before and after volume registration were significantly different. This fusion method may be a viable alternative when other methods fail.

Analysis of Variance↗

Stability of acetabular axis after total hip arthroplasty, repeatability using CT and a semiautomated program for volume fusion.

PURPOSE: To validate a CT method for detecting changes in acetabular cup orientation after THA. MATERIAL AND METHODS: 26 CT examinations were obtained from a pelvic model with an uncemented acetabular cup. The model position was altered between acquisitions, but the cup axis angle vis-à-vis the pelvis was maintained. Data sets were combined into 37 pairs, each containing a unique positioning error. The pelvi in different examinations were fused, creating transformed volumes. Landmarks corresponding to the cup before and after fusion were placed interactively by two independent examiners. The orientation of the acetabular axis was calculated for each volume and compared across volumes. RESULTS: Before fusion the mean angle error between the acetabular axes was 4.17 degrees (SD +/- 1.95 degrees ). After fusion the mean angle error was 0.36 degrees (SD +/- 0.17). The 95% repeatability limits were below 0.7 degrees. There was no significant interobserver difference. Analysis of the cup landmarking pattern by condition numbers and individual landmark errors showed stability. CONCLUSION: Non-invasive fusion of CT volumes and a stable landmarking pattern for the acetabular cup outperforms routine plain radiography in detecting changes in the orientation of the acetabular axis over time. The method delivers both visual and numerical output and could be used in clinical practice.

Acetabulum↗

Model studies on acetabular component migration in total hip arthroplasty using CT and a semiautomated program for volume merging.

PURPOSE: Validation of a non-invasive CT method for detection of acetabular cup migration after total hip arthroplasty in a phantom study. MATERIAL AND METHODS: 26 CT examinations were obtained of a pelvic model while altering the position of the acetabular cup. Using a previously described program for volume merging, the pelvi in different examinations were fused and the 3D alterations of the position of the acetabular cup were evaluated visually and numerically and correlated to direct measurements on the model. RESULTS: Visually, two independent examiners differentiated between 0, 1 and 2 to 3 mm migration with 100% specificity and sensitivity. Numerically, the mean error over all cases between model and CT measurements was 0.04 mm (SD +/- 0.33). The mean absolute error between model and CT data was 0.26 mm (SD +/- 0.19). Intra- and interobserver 95% accuracy and repeatability limits were below 0.5/0.7 mm, respectively. No significant interobserver difference occurred. The data were normally distributed and not dependent on observer. CONCLUSION: The accuracy of this non-invasive method out-performs routine plain radiography. The method gives both visual and numerical correlates to migration and can be used in clinical practice.

Arthroplasty, Replacement, Hip↗

Spatial component position in total hip arthroplasty. Accuracy and repeatability with a new CT method.

PURPOSE: 3D detection of centerpoints of prosthetic cup and head after total hip arthroplasty (THA) using CT. MATERIAL AND METHODS: Two CT examinations, 10 min apart, were obtained from each of 10 patients after THA. Two independent examiners placed landmarks in images of the prosthetic cup and head. All landmarking was repeated after 1 week. Centerpoints were calculated and compared. RESULTS: Within volumes, all measurements of centerpoints of cup and head fell, with a 95% confidence, within one CT-voxel of any other measurement of the same object. Across two volumes, the mean error of distance between center of cup and prosthetic head was 1.4 mm (SD 0.73). Intra- and interobserver 95% accuracy limit was below 2 mm within and below 3 mm across volumes. No difference between intra- and interobserver measurements occurred. A formula for converting finite sets of point landmarks in the radiolucent tread of the cup to a centerpoint was stable. The percent difference of the landmark distances from a calculated spherical surface was within one CT-voxel. This data was normally distributed and not dependent on observer or trial. CONCLUSION: The true 3D position of the centers of cup and prosthetic head can be detected using CT. Spatial relationship between the components can be analyzed visually and numerically.

Arthroplasty, Replacement, Hip↗

Acetabular component migration in total hip arthroplasty using CT and a semiautomated program for volume merging.

PURPOSE: To develop a non-invasive method for detection of acetabular cup migration after total hip arthroplasty (THA) with a higher degree of accuracy than routine plain radiography. MATERIAL AND METHODS: Two CT examinations, 10 min apart, were obtained from each of 10 patients that had undergone THA. Using an in-house developed semiautomated program for volume merging, the pelves in the two examinations were fused and the acetabular cup was visually and numerically evaluated to test the method's accuracy in detecting migration. RESULTS: In the visual evaluation of the best match a 1-mm translation of the cup was detectable. The numerical evaluation, comparing landmarks placed in the images of the acetabular cup and the head of the femur component in the two examinations, showed the mean difference in orientation of acetabular axes to be 2.5 degrees, the mean distance between centre of cup face to be 2.5 mm and the mean distance between centre of the head of the prosthetic femoral component to be 1 mm. CONCLUSION: This method has a significantly higher accuracy than routine plain radiography in detecting acetabular cup migration and could be used in clinical practice. It gives both a visual and a numerical correlate to migration.

Algorithms↗

A versatile functional-anatomic image fusion method for volume data sets.

We describe and validate a volumetric three-dimensional registration method, and compare it to our previously validated two-dimensional/three-dimensional method. CT/MRI and SPECT data from 14 patients were interactively fused using a polynomial warping technique. Registration accuracy was confirmed visually and by a nonsignificant F value from multivariate analysis of the transformed landmarks, a significant difference of the squared sum of intensity differences between the transformed/untransformed and the reference volume both at the 0.05 (p > 0.05) confidence level and an average 31% improvement of the correlation coefficient and cross correlation. For the two-dimensional/three-dimensional method, ROI center-to-center distance ranged from 1.42 to 11.32 mm (for liver) with an average of 6.13 mm +/- 3.09 mm. The average ROI overlap was 92.51% with a 95% confidence interval of 90.20-96.88%. The new method is superior because it operates on the true three-dimensional volume. Both methods give good registration results, take 10 to 30 min, and require anatomic knowledge.

Humans↗

A distribution system for digital images from diverse image sources. Incorporating a local area network in an imaging environment.

This paper proposes a unified image-processing and viewing system as a viewing station and initially as the central file server in a unified digital image distribution and processing network, linking various digital image sources through a high speed data link and a common image format. The network allows for viewing and processing of all images produced within the complex and for locating viewing stations in any number of convenient areas. The system proposed can be slowly expanded to include all the digital images produced within the department of institution.

Computers↗