Spine Recognition: From Medical Image Analysis to Image- Guided - - PowerPoint PPT Presentation

Spine Recognition: From Medical Image Analysis to Image- Guided Interventions

脊柱骨骼识别:从医学图像分析到图像引导介入治疗

Yunliang Cai

Background

• Spine structure:
• Contain 24 bones (vertebra)
• Strong but highly deformable
• Combined w/ bone, soft tissue, nerve …

胸椎 腰椎 头椎 椎体 棘突 橫突 脊髓

Background

• Some common spine problems
• Spondylolysis 腰椎脱离
• Fractures 椎体骨折
• Deformity 畸形
• Degenerative disc 椎间盘退化
• Some spinal surgeries
• Spine fusion 融合手术
• Discectomy 椎间盘切除
• Laminectomy 椎弓切除

Spine Fusion

Background

• How to automate diagnosis?
• How to automate surgery?

Computational Spine Model

脊骨计算模型

Computational Spine Model

• Our Approach --- Computational Anatomy

Parameterized Computation Model

Multi-Modality/View/Subject

Optimal Geometric Parameters

For Diagnosis For Surgery Guidance

Deform & Match Extract

Computational Spine Model

• Hierarchical Model Design

Computational Spine Model

• Spine Image Analysis: Basic Workflow
• Y. Cai et al, TMI 2015

Spine Image Analysis

脊骨图像分析

Spine Image Analysis

• Local Appearance Module
• Use Multi-Modal Deep Net for Cross-Modality Detection

Cross Modality

Spine Image Analysis

• Global Geometry Module
• Use universal 3D CAD model for spine shape analysis
• Register by point registration method (Coherent Point Drift,

Myronenko et al PAMI 2010)

Spine Shape Analysis

Spine Image Analysis

• Local Geometry Module
• Use Lie-Group-based Congealing for vertebra pose

estimation (Y. Cai et al TIP 2013)

• Use tri-planar estimation for 3D pose

Vertebra Pose

Spine Image Analysis

• Multi-view, multi-modal, and whole spine recognition
• For diagnosis of spondylolysis, deformity, …

Image-Guided Spinal Surgery

图像引导脊骨手术

Image-Guided Spinal Surgery

• Why need it?
• Precision!!
• How to?
• Patient Registration:

Pre-Operative Images (手术前) register with Intra-Operative Structure (手术进行时)

?

Pre-Operative CT Surgery on going…

Image-Guided Spinal Surgery

• Pre-Operative Modalities:
• CT, MR
• Intra-Operative Modalities:
• Ultrasound 超声, Fluoroscopy 透视, Cone Beam CT 锥束CT
• …

Image-Guided Spinal Surgery

• Our Pre-Op Images: CT
• Our Intra-Op Images: Stereovision(SV)

CT SV images SV surface 立体视觉 Microscopy

(拍摄用)

Stealth Station

(实时跟踪用) Pre-Op CT

• S. Ji et al, TBME 2015

Radiation Free

Image-Guided Spinal Surgery

• Our method: Rectify the spine to a “deformation-free” pose

NLPCA Flattening Inverse NLPCA

CT

NLPCA Flattening Inverse NLPCA

SV

Non-linear PCA: Auto-associate Network (Auto-Encoder Network)

• M. Scholz et al LNCS 2007

Image-Guided Spinal Surgery

• Y. Cai et al, SPIE 2016
• 2D image reg. (faster!)
• Dense point-point correspondence

(more accurate)

Demo

Accuracy Test: Err < 1.5 mm ! Image-Guided Drilling

Future Directions: Spine Image Analysis

• Explore on Soft Tissue
• Explore on Spinal Cord

PET/CT SPECT/CT Diffusion Tensor Imaging Analysis for: Cancer Infectious Disease Trauma … Analysis for: Neural Trauma Vascular Function … CT Angiography PET/MR

Future Directions: Image- Guided Interventions

• Multimodality Integration
• Towards Robotic Surgery

CT + Ultrasound + SV + ….?

Mazor Robotics (Technion)

微创手术机器人 (第三军医大学新桥医院 中科院渖阳自动化研究所)

Surgical Robot Assistant (Wright State Univ.) AQRate Robotic System (EPFL)

Conclusions

• Spine Image Analysis
• Computational spinal model
• Cross-modality vertebra detection
• Spine shape analysis
• Vertebra pose estimation
• Image guidance spinal surgery
• CT-SV image guidance system
• Geometric rectification for deformed spines
• Image-guided spinal fusion surgery
• Future work
• Towards hybrid modality analysis
• Towards robotic spinal surgery

Acknowledgment

• Research led by
• Surgical team
• Projects funded by

PI: Prof. Shuo LI PI: Prof. Songbai JI

• Dr. Scott S. Lollis, MD

(Primary Surgeon)

R21 NS078607

Thank You!

• Q & A