Utility of the LevelCheck Algorithm for Decision Support in Vertebral Localization

被引：16

作者：

De Silva, Tharindu ^{[1
]}

Lo, Sheng-Fu L. ^{[2
]}

Aygun, Nafi ^{[3
]}

Aghion, Daniel M. ^{[2
]}

Boah, Akwasi ^{[2
]}

Petteys, Rory ^{[2
]}

Uneri, Ali ^{[4
]}

Ketcha, Michael D. ^{[1
]}

Yi, Thomas ^{[1
]}

Vogt, Sebastian ^{[5
]}

Kleinszig, Gerhard ^{[5
]}

Wei, Wei ^{[5
]}

Weiten, Markus ^{[5
]}

Ye, Xiaobu ^{[2
]}

Bydon, Ali ^{[2
]}

Sciubba, Daniel M. ^{[2
]}

Witham, Timothy F. ^{[2
]}

Wolinsky, Jean-Paul ^{[2
]}

Siewerdsen, Jeffrey H. ^{[1
,2
,4
]}

机构：

[1] Johns Hopkins Univ, Dept Biomed Engn, Traylor Bldg,Room 622,720 Rutland Ave, Baltimore, MD 21205 USA

[2] Johns Hopkins Univ, Sch Med, Dept Neurosurg, Baltimore, MD 21205 USA

[3] Johns Hopkins Univ, Russell H Morgan Dept Radiol, Baltimore, MD USA

[4] Johns Hopkins Univ, Dept Comp Sci, Baltimore, MD 21218 USA

[5] Siemens Healthcare, Erlangen, Germany

来源：

SPINE | 2016年 / 41卷 / 20期

基金：

美国国家卫生研究院;

关键词：

3D-2D registration; intraoperative imaging; level counting; level localization; LevelCheck; spine surgery; utility; wrong-level surgery; wrong-site surgery; CONE-BEAM CT; 3D-2D IMAGE REGISTRATION; AUTOMATIC LOCALIZATION; SURGERY; INTERVENTIONS; QUALITY;

D O I：

10.1097/BRS.0000000000001589

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design. An automatic radiographic labeling algorithm called "LevelCheck" was analyzed as a means of decision support for target localization in spine surgery. The potential clinical utility and scenarios in which LevelCheck is likely to be the most beneficial were assessed in a retrospective clinical data set (398 cases) in terms of expert consensus from a multi-reader study (three spine surgeons). Objective. The aim of this study was to evaluate the potential utility of the LevelCheck algorithm for vertebrae localization. Summary of Background Data. Three hundred ninety-eight intraoperative radiographs and 178 preoperative computed tomographic (CT) images for patients undergoing spine surgery in cervical, thoracic, lumbar regions. Methods. Vertebral labels annotated in preoperative CT image were overlaid on intraoperative radiographs via 3D-2D registration. Three spine surgeons assessed the radiographs and LevelCheck labeling according to a questionnaire evaluating performance, utility, and suitability to surgical workflow. Geometric accuracy and registration run time were measured for each case. Results. LevelCheck was judged to be helpful in 42.2% of the cases (168/398), to improve confidence in 30.6% of the cases (122/398), and in no case diminished performance (0/398), supporting its potential as an independent check and assistant to decision support in spine surgery. The clinical contexts for which the method was judged most likely to be beneficial included the following scenarios: images with a lack of conspicuous anatomical landmarks; level counting across long spine segments; vertebrae obscured by other anatomy (e.g., shoulders); poor radiographic image quality; and anatomical variations/abnormalities. The method demonstrated 100% geometric accuracy (i. e., overlaid labels within the correct vertebral level in all cases) and did not introduce ambiguity in image interpretation. Conclusion. LevelCheck is a potentially useful means of decision support in vertebral level localization in spine surgery.

引用

页码：E1249 / E1256

页数：8

共 17 条

[1] Image quality and localization accuracy in C-arm tomosynthesis-guided head and neck surgery [J].

Bachar, G. ;

Siewerdsen, J. H. ;

Daly, M. J. ;

Jaffray, D. A. ;

Irish, J. C. .

MEDICAL PHYSICS, 2007, 34 (12) :4664-4677

[2] Image-Guided Interventions: Technology Review and Clinical Applications [J].

Cleary, Kevin ;

Peters, Terry M. .

ANNUAL REVIEW OF BIOMEDICAL ENGINEERING, VOL 12, 2010, 12 :119-142

[3] 3D-2D image registration for target localization in spine surgery: investigation of similarity metrics providing robustness to content mismatch [J].

De Silva, T. ;

Uneri, A. ;

Ketcha, M. D. ;

Reaungamornrat, S. ;

Kleinszig, G. ;

Vogt, S. ;

Aygun, N. ;

Lo, S-F ;

Wolinsky, J-P ;

Siewerdsen, J. H. .

PHYSICS IN MEDICINE AND BIOLOGY, 2016, 61 (08) :3009-3025

[4] Automatic image-to-world registration based on x-ray projections in cone-beam CT-guided interventions [J].

Hamming, N. M. ;

Daly, M. J. ;

Irish, J. C. ;

Siewerdsen, J. H. .

MEDICAL PHYSICS, 2009, 36 (05) :1800-1812

[5]

Ketcha MD, 2016, SPIE MED IMAGING

[6] Lumbosacral Transitional Vertebrae: Classification, Imaging Findings, and Clinical Relevance [J].

Konin, G. P. ;

Walz, D. M. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2010, 31 (10) :1778-1786

[7] Automatic Localization of Target Vertebrae in Spine Surgery [J].

Lo, Sheng-fu L. ;

Otake, Yoshito ;

Puvanesarajah, Varun ;

Wang, Adam S. ;

Uneri, Ali ;

De Silva, Tharindu ;

Vogt, Sebastian ;

Kleinszig, Gerhard ;

Elder, Benjamin D. ;

Goodwin, C. Rory ;

Kosztowski, Thomas A. ;

Liauw, Jason A. ;

Groves, Mari ;

Bydon, Ali ;

Sciubba, Daniel M. ;

Witham, Timothy F. ;

Wolinsky, Jean-Paul ;

Aygun, Nafi ;

Gokaslan, Ziya L. ;

Siewerdsen, Jeffrey H. .

SPINE, 2015, 40 (08) :E476-E483

[8] Surgical never events in the United States [J].

Mehtsun, Winta T. ;

Ibrahim, Andrew M. ;

Diener-West, Marie ;

Pronovost, Peter J. ;

Makary, Martin A. .

SURGERY, 2013, 153 (04) :465-472

[9] The prevalence of wrong level surgery among spine surgeons [J].

Mody, Milan G. ;

Nourbakhsh, Ali ;

Stahl, Daniel L. ;

Gibbs, Mark ;

Alfawareh, Mohammad ;

Garges, Kim J. .

SPINE, 2008, 33 (02) :194-198

[10] Automatic localization of vertebral levels in x-ray fluoroscopy using 3D-2D registration: a tool to reduce wrong-site surgery [J].

Otake, Y. ;

Schafer, S. ;

Stayman, J. W. ;

Zbijewski, W. ;

Kleinszig, G. ;

Graumann, R. ;

Khanna, A. J. ;

Siewerdsen, J. H. .

PHYSICS IN MEDICINE AND BIOLOGY, 2012, 57 (17) :5485-5508

← 1 2 →