A complete-pelvis segmentation framework for image-free total hip arthroplasty (THA): methodology and clinical study

Xie, Weiguo; Franke, Jochen; Chen, Cheng; Grützner, Paul A.; Schumann, Steffen; Nolte, Lutz-Peter; Zheng, Guoyan (2014). A complete-pelvis segmentation framework for image-free total hip arthroplasty (THA): methodology and clinical study. International journal of medical robotics and computer assisted surgery, 11(2), pp. 166-180. Wiley 10.1002/rcs.1619

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Background Complete-pelvis segmentation in antero-posterior pelvic radiographs
is required to create a patient-specific three-dimensional pelvis model
for surgical planning and postoperative assessment in image-free navigation
of total hip arthroplasty.
Methods A fast and robust framework for accurately segmenting the complete
pelvis is presented, consisting of two consecutive modules. In the first
module, a three-stage method was developed to delineate the left hemipelvis
based on statistical appearance and shape models. To handle complex
pelvic structures, anatomy-specific information processing techniques were
employed. As the input to the second module, the delineated left hemi-pelvis
was then reflected about an estimated symmetry line of the radiograph to initialize
the right hemi-pelvis segmentation. The right hemi-pelvis was segmented
by the same three-stage method,
Results Two experiments conducted on respectively 143 and 40 AP radiographs
demonstrated a mean segmentation accuracy of 1.61±0.68 mm. A clinical
study to investigate the postoperative assessment of acetabular cup
orientations based on the proposed framework revealed an average accuracy
of 1.2°±0.9° and 1.6°±1.4° for anteversion and inclination, respectively. Delineation
of each radiograph costs less than one minute.
Conclusions Despite further validation needed, the preliminary results implied
the underlying clinical applicability of the proposed framework for
image-free THA.

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