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WO2003030738A1 - Evaluation de pose bi- et tridimensionnelle d'articles a partir d'images bidimentionnelles - Google Patents

Evaluation de pose bi- et tridimensionnelle d'articles a partir d'images bidimentionnelles Download PDF

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Publication number
WO2003030738A1
WO2003030738A1 PCT/AU2002/001368 AU0201368W WO03030738A1 WO 2003030738 A1 WO2003030738 A1 WO 2003030738A1 AU 0201368 W AU0201368 W AU 0201368W WO 03030738 A1 WO03030738 A1 WO 03030738A1
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Prior art keywords
dimensional
prosthesis
bone
pose
determining
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PCT/AU2002/001368
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English (en)
Inventor
Jeremy Graham
John Stewien
Alexander Anderson
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INTEGRA MEDICAL IMAGING (AUST) Pty Ltd
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INTEGRA MEDICAL IMAGING (AUST) Pty Ltd
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/56—Details of data transmission or power supply, e.g. use of slip rings
    • A61B6/563—Details of data transmission or power supply, e.g. use of slip rings involving image data transmission via a network
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/12—Arrangements for detecting or locating foreign bodies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T7/00—Image analysis
    • G06T7/70—Determining position or orientation of objects or cameras
    • G06T7/73—Determining position or orientation of objects or cameras using feature-based methods
    • G06T7/74—Determining position or orientation of objects or cameras using feature-based methods involving reference images or patches
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/505—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for diagnosis of bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A61F2/36—Femoral heads ; Femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4603—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4607—Special tools for implanting artificial joints for insertion or extraction of endoprosthetic joints or of accessories thereof of hip femoral endoprostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/3094—Designing or manufacturing processes
    • A61F2/30942—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques
    • A61F2002/30948—Designing or manufacturing processes for designing or making customized prostheses, e.g. using templates, CT or NMR scans, finite-element analysis or CAD-CAM techniques using computerized tomography, i.e. CT scans
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2002/4632—Special tools for implanting artificial joints using computer-controlled surgery, e.g. robotic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4658—Measuring instruments used for implanting artificial joints for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools for implanting artificial joints
    • A61F2/4657—Measuring instruments used for implanting artificial joints
    • A61F2002/4668—Measuring instruments used for implanting artificial joints for measuring angles
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06T—IMAGE DATA PROCESSING OR GENERATION, IN GENERAL
    • G06T2207/00—Indexing scheme for image analysis or image enhancement
    • G06T2207/30—Subject of image; Context of image processing
    • G06T2207/30004—Biomedical image processing
    • G06T2207/30008—Bone

Definitions

  • This invention relates to the automatic analysis of two-dimensional images to determine the spatial orientation of a three-dimensional object within the two- dimensional image.
  • this invention can be applied to the analysis of the bonding of medically implanted orthopedic prosthesis in human bone.
  • the degree of loosening and migration of the implant relative to the bone can be quantified. It is also possible using the apparatus and method of the invention to assist in the classification and assessment of bone fractures.
  • This invention is applicable to image analysis the image itself being of any subject matter.
  • this specification will describe image analysis in the medical field and in particular, the analysis of radiographic images of the human skeleton involving an implanted prosthesis.
  • the medical procedures developed by surgeons for orthopaedic prosthesis implantation are now well developed and many bones and joints of the body damaged by disease and injury can now be replaced or supplemented.
  • the surgeon however, needs to maintain a constant watch over the development of the bonds that form between the implanted prosthesis and the natural bone.
  • the practitioner is ever mindful of the possibility of the bonds not being formed correctly or sufficiently.
  • the result of a less than acceptable bonding of the bone to the prosthesis or an avoidable misalignment can range from a failure of the supplemented joint or bone to support the patient's weight and consequent collapse of the patient, to minor patient discomfort.
  • the next, but much more expensive tool is three-dimensional tomography of the patient.
  • CAT scans being the typical apparatus used for this task will readily identify the three-dimensional form of both the implant and the bone. Not surprisingly this tool is used less than would be desired because it is so expensive.
  • the clinician may recommend more strenuous physiotherapy or advise the patient they can resume normal activity with the affected joint or limb.
  • Fractures are more difficult to identify. Hence, the variability of the assessed degree of fracture by the same clinician can be inconsistent. While there is also a likelihood that the same patient when assessed by different clinicians will have different fracture assessments even when the same tools are used. Unfortunately, human error and interpretation will always be present when two-dimensional and even three-dimensional imaging are the only tools available.
  • X-ray views are sometimes referred to as an Anterior Posterior (AP) radiograph and even with the use of filters and software, accurate migration analysis due to distortions caused by patient positioning can still occur.
  • AP Anterior Posterior
  • EBRA Ein Marsh Roentgen Analyse
  • RSA Roentgen Stereophotgr Ammetry
  • the method and apparatus of the invention will in part at least automate and make more consistent the assessment of two-dimensional images of implants in bone structures of bonding and fracture characteristics.
  • assessment information is provided to the clinician in a format that shows trends and highlights features for further consideration.
  • the system should be able to measure distances so that threshold distances, determined from an expert system environment, if exceeded can identify to clinicians, areas of the image deserving of further investigation and provide a way to display and thus analyze trends of migration over time.
  • a method for analysis of a two-dimensional image to determine the position of a three-dimensional object therein consisting of the steps; a) determining the form of said three-dimensional object in the two-dimensional image; b) determining the pose of a three-dimensional representation of said object that conforms to the form of the said three-dimensional object in the two-dimensional image; c) determining a first landmark with reference to said three-dimensional object; d) determining a second landmark on an other object in said two-dimensional image; and e) determining the distance between said landmarks.
  • a method of analysis of a two- dimensional image to determine the position and orientation of two three- dimensional objects therein consisting of the further steps of: f) determining a third landmark on either said three-dimensional object or on said other object; and g) further determining the pose of said three-dimensional object with respect to said first, second and third landmarks.
  • a method of analysis of a two- dimensional image to determine the position and orientation of two three- dimensional objects therein consisting of the further steps of: h) repeating steps a to g at another time; and i) comparing poses obtained in step g) to determine the relative movement of said three-dimensional object.
  • an apparatus for the analysis of a two-dimensional image to determine the position and orientation of a three-dimensional object therein consists of; a shape determining means for creating a silhouette of said three- dimensional object in said two-dimensional image; and a three-dimensional pose estimation means which matches a three-dimensional representation of said object to the two-dimensional silhouette of said object in said two-dimensional image.
  • an apparatus for analysis of a two- dimensional image comprises; a two-dimensional prosthesis pose estimation means for identifying a predetermined prosthesis in said two-dimensional image; a two- dimensional bone pose estimation means for identifying landmarks on said bone; and a two-dimensional measure determination means for determining a scale for said two-dimensional image and a measure of the relative distance of one or more of said landmarks from predetermined points on said prosthesis.
  • said apparatus for analysis further comprises; a three-dimensional prosthesis pose estimation means for identifying a predetermined prosthesis in said three-dimensional image; a three-dimensional bone pose estimation means for identifying a bone pose; and a three-dimensional measures determination means for determining the relative pose of said bone to said prosthesis.
  • the three- dimensional measures determination means provides the components of axial rotation, rotational and /or distal migration of the complex movement of said prosthesis relative to said bone.
  • Fig. 1 depicts a functional block diagram of an apparatus that is in accord with a method of analysis of a two-dimensional image to determine the relative two- dimensional position between a bone and an implanted prosthesis within the image;
  • Fig. 2 depicts a functional block diagram of the apparatus and method of Fig 1 supplemented with an apparatus that automates the analysis of a two-dimensional image to determine the relative two-dimensional position between a bone and an implanted prosthesis;
  • Fig. 3 depicts a functional block diagram of the apparatus of Figs 1 and 2 supplemented so that relative distances between the bone and prosthesis can be determined and outputs data that provides the basis for a three-dimensional presentation of the relationship between the position of a bone and an implanted prosthesis;
  • Fig. 4 depicts a graph showing a migration history of the anterior posterior distal movement of a prosthesis relative to a bone
  • Fig. 5 depicts a representation of a methodology for improving the relative measurement accuracy of the apparatus.
  • Fig. 6 depicts the nature of the possible migration and rotation of a prosthesis
  • Fig. 7 depicts a bone and prosthesis example and in particular identifies specific features of the said prosthesis.
  • Fig. 8 depicts examples of prosthesis shoulder position determination comparing prior methods and the method of the invention.
  • the inventors have identified and describe by way of example, an apparatus and method for the determination of the relative orientation of bone and implant, and over time track the effectiveness of bonding between the two.
  • the two- dimensional and three-dimensional position and orientation of the bone and implant will be referred to as its "pose”.
  • a patient having bone or joint problems presents to a clinician, X-rays and three-dimensional representations of the relevant body portion (including the affected bone) are obtained almost as a matter of course as an aid to the diagnosis of the problem.
  • An analysis of the medical condition of the patient may conclude the need for surgery and their suitability for prosthesis implant is undertaken and a suitable prosthesis is chosen.
  • a three-dimensional digital representation of the chosen prosthesis may also be created but this is not always done.
  • the prosthesis placement operation is performed and preferably during the following months X-rays are taken at convenient times.
  • the taking of a X-ray immediately following the operation greatly improves the detection of early failure of the bonding between bone and implant but X-rays become less frequent if no problems to the patient present themselves.
  • the inventors have determined that at least in this embodiment, it is preferable to break down the analysis process into steps.
  • an X-ray image of the bone and implant is cheap relative to other types of medical imaging. Taking an X-ray of the patient following surgery will ideally provide a well-contrasted shape of the outline of a solid three- dimensional object, such as an implant against the bone it has been surgically placed on or into. This X-ray can form the basis for a particular type of analysis by the apparatus of the invention that will firstly identify the outline (silhouette) of the implant.
  • the X-ray machine may produce a film which needs to be digitized or it may produce a digital image which itself can be used to produce a film image. Having an X-ray image provides a view of the prosthesis from only one perspective.
  • One of the main tasks identified by the inventors in providing the invention is the determination of the actual outline of the solid object (typically the prosthesis) solely from the typically gray scale image information contained in a digitized X-ray image.
  • any line shape (circle, ellipses, lines) in a two-dimensional image can be identified using a Hough transform. This is merely a preferred method for achieving this aim, as there are a number of other processes that could also be used.
  • shapes such as the ball and edges of the stem of the implant can be identified most easily. The remainder of the implant can then be identified using other methods and known geometric characteristics of the implant itself.
  • the next step is to determine the three-dimensional spatial orientation of the implant that would give that outline.
  • the EM algorithm is statistical in nature and deals with probability density functions for unknown variables, whereas the Hausdorff distance is geometrical in nature and compares the measured distances between a plurality of predetermined points on both the image and the actual three-dimensional shape of the implant which has been previously digitized.
  • an initial estimate of the pose of the implant is made. Once made, the apparatus assesses if a change in the pose will "improve" the fit of the silhouette of a three-dimensional implant that is evident in the digital X-ray image. The apparatus then selects a change and assesses whether the new pose created by the change improves the fit. The method then iterates these steps until convergence occurs.
  • the actual implementation and modification to an Expectation Maximization algorithm may include modifications to both the Generalized Expectation Maximization algorithm and the Expectation-Conditional Maximization algorithm such as the inclusion of nuisance variables (which have to be integrated out) related to the prosthesis modeling mesh as well as constraining pose changes to real rotations in three-dimensional space. These modifications are merely preferable and it is with in the skill of one in the art to implement both the EM algorithm and any modifications that are deemed useful.
  • a yet further method for determining the pose of the three-dimensional object (prosthesis) in a digitized two-dimensional image is to use an area-matching algorithm.
  • the area occupied by the three-dimensional object in the two-dimensional image can be equated to, for example, the number of picture element used to store and display it, while the number of picture elements used to display the representation of the actual three-dimensional object at different poses, can also be determined.
  • the area-matching algorithm can be implemented in a number of ways and preferably a clipped region minimization process is used to align the silhouette of the three-dimensional object in the two-dimensional image with pose of the representations of the prosthesis. Again this process is implement in steps that iterate until convergence occurs.
  • the pose of the implant has been determined from the two-dimensional X-ray image, it is then possible to use the same processes to determine the pose of the bone and thus determine the relative orientation in three dimensions of the implant to the bone. This is one way to establish a base line for future comparisons of the bone to implant union.
  • a reference point (either with the assistance of a clinician or by automatic image analysis techniques) can be identified on the bone and determination can then be made in two dimensions of the position of the implant relative to the landmark. Likewise this is another way to establish a base line.
  • reference points are located on or simply related to the respective objects. That is, it is possible for reference points to be any point in the co-ordinate system of either object or an actual point on the object, which of course, in any event, is a point in a co-ordinate system of choice. Distance measurements can be made between co-ordinate systems using one of them as a reference or a common origin of the two co-ordinate systems can be created. There are many ways in which the relative movement of the objects can be measured, that is, their orientation as well for the future their relative displacement over time.
  • Absolute measurements can be determined by knowing the actual dimensions of the prosthesis and the use of a scaling factor.
  • the invention provides much promise that clinicians will be encouraged to take relatively cheap X-rays of their patient's implants at appropriate intervals following surgery, to benefit from the increased bone /prosthesis bonding analysis that is possible using the invention.
  • the two-dimensional information from an X-ray will form the basis for an automatically generated bone to implant bonding assessment which will include the ability to flag the need for more detailed analysis of potential problem areas.
  • the apparatus and method of the invention can provide automatic, repeatable and consistent pose estimation of the bone and implant as well as a measure of the relative movement (lateral as well as rotational) between them.
  • Fig 1 depicts the first three main parts of the apparatus that is common to all other parts.
  • a means 10 is used to input a two-dimensional digital image to the apparatus.
  • the image of the bone and implant of a patient is recorded.
  • One way in which this is done is to X-ray the relevant part of the patient.
  • the X-ray image is digitized at a predetermined resolution direct so as to preserve as many details as possible of the image.
  • the preferred manner is to generate at the X-ray machine a digital X-ray image of the patent having the highest manageable resolution.
  • Some post digitizing filtering can be performed to clean up the image to better define the outlines of solid objects most particularly the prosthesis. Elimination of extraneous printed information on the image and any standard imperfections created by the imaging process are just some of the filtering that can be done. Such filters are well known in the art.
  • the second of the three elements of the apparatus shown in Fig. 1 is a means 12 to retrieve from digital storage, either or both of a three-dimensional digital model of the bone of the same patient that was digitized prior to the surgery and/or a three- dimensional model of the prosthesis, the later of the two being the most useful.
  • the three-dimensional image of the patient's bone or even a suitably manipulated contra-limb is preferably obtained from a CAT scan but it may also be possible to use a standardised bone model. The later would obviate taking the CAT scan.
  • the raw scan is used to create a surface model in a digital-modeling format that is consistent within the remainder of the apparatus and method, and such techniques are within the skill of those in the art.
  • the three-dimensional model of the implant is created from the implant manufacturing files or recreated from the actual object and is typically in the form of a "net" of control points located on a virtual surface.
  • the file representing those control points is provided in a digital modeling format that will be consistent within the remainder of the apparatus and method.
  • the two data files are stored in the historical data block 12 and are available for acceptance and manipulation by the two-dimensional pose estimator 14 which is the third of the elements of the first part of the apparatus disclosed in Fig. 1.
  • the two-dimensional pose estimator 14 may use a variety of techniques for determining pose, some of which have been described previously.
  • edge detection algorithms are used to identify boundaries in the image having particular characteristics.
  • a Hough transform can be used and the simplest shapes to identify in most prosthesis are their straight lines.
  • the next simplest shape to be identified depends on what type of prosthesis it is.
  • a hip joint replacement prosthesis has a spherical shape at one end that takes the place of the head of the femur in the hip joint.
  • a sphere or circular shape will be readily identifiable.
  • prosthesis shape identification is simple because the prosthesis has regular and consistent shape.
  • a subtractive clipped region process as the primary or even as a secondary confirmatory process or even in combination with other processes to align the prosthesis silhouette so as to determine its pose.
  • Fig 1 depicts a two-dimensional measure means 16 that receives the spatial data available from the two-dimensional pose estimation means and calculates a scaling factor with the available information.
  • the means 16 knows the actual dimensions of the prosthesis and can compare it with the two-dimensional image dimensions and thereby provide a scale for absolute and relative measurements on the two-dimensional image. Such measurements can be used when combining the method and apparatus of this invention with known EBRA methods and independently generated guidelines for comparability of two-dimensional images.
  • Fig 2 depicts a manual two-dimensional pose estimation means 20 which allows a clinician or other skilled person to identify landmarks on the two- dimensional representation of the bone surrounding the implanted prosthesis (in this example, a femur). Preferably, more than one and likely 10-20 landmarks are identified.
  • the form of the bone surrounding the prosthesis can be defined by that set of landmarks.
  • the two-dimensional measure means 16 Figs 1 and 2
  • the relative distance and known landmarks on the prosthesis from one or more of the landmarks can be calculated. If more than one X-ray image is available and the manual pose estimation step performed in 20 can be done for each, it is possible to more accurately determine the relative distances involved. This is in preparation for the time that the current determination is to be compared with historical image data determinations. The distances between landmarks on the femur and the prosthesis that are likely to have changed can be compared recognising that all measurement systems have error characteristics unique to that system.
  • Fig 3 depicts the third part of the apparatus.
  • the process conducted in 22 is a three-dimensional pose estimation of the prosthesis.
  • the two-dimensional pose estimation can be used as a starting point for the three-dimensional pose estimation.
  • the two-dimensional pose estimation is a likely orientation of the prosthesis, which is unlikely to be any more than 90° out along any axis. Therefore the use of the two- dimensional pose estimation as a starting point for the three-dimensional pose estimation can save a great deal of calculation.
  • Choice of a 3-dimensional co-ordinate system for this process will likely have coincidence with the 2-dimensional co- ordinate system of the 2-d pose estimation and 2-d measures processes but need not necessarily be so. When comparisons are required suitable translations can be provided.
  • Fig. 6 there are two types of migration (lateral with respect to the longitudinal axis of the implant and distal typically along the longitudinal axis of the implant) and one type of rotation (axial). It is the manipulation of the above calculation results into graphs or animations when presented to clinicians that will provide the greatest assistance to them. They will be better able to assess the bone prosthesis union characteristics and the result can then be relied upon for consideration as to whether an expensive CAT scan should be done and then based on all the information at hand whether further surgery should be contemplated.
  • Fig 4 is one example of a graph that discloses the migration of an implanted prosthesis over time in the distal direction of an AP view.
  • the vertical axis displays migration in millimetres while the horizontal axis displays years following the operation involving the implantation of the prosthesis into the bone.
  • the intervals between X-rays are not regular as is indicated by the crosses that denote the value of migration in millimetres at particular times following the operation.
  • the majority of movement occurs soon after the operation, while the degree of movement falls within a relatively narrow distance boundary as time progresses. Marked fluctuations outside an acceptable clinical variation will likely confirm patient experience and alert the clinician, sometimes though even without patient indications, that the bone prosthesis union is deteriorating.
  • Fig 4 is but one example of a way to depict the results of 2-d and 3-d measurements taken from images collected overtime. Error bars could be added and there could be use of representative images and measurements as well as expert systems information in the form of clinically acceptable migration boundaries overtime. Features of relevance to a clinician can be identified and highlighted by using look up tables and rules.
  • Fig 5 depicts a proposed approach for improving the two-dimensional and three-dimensional pose estimation processes by taking more than one X-ray record of the same limb containing the prosthesis from different angles about the prosthesis.
  • Using the two-dimensional and three-dimensional pose estimation techniques described above for both the prosthesis and the surrounding bone allows multiple calculations to occur and subsequently the two-dimensional measures as well as the three-dimensional relative distance and orientation measures can help to improve in accuracy.
  • Prior art two-dimensional techniques determine the migration of a prosthesis implant using the change in position, of a femoral landmark, along the axis of the stem of the prosthesis, relative to a fixed point on the stem.
  • the point regularly chosen is the shoulder of the stem - in other words, the edge of the stem, as viewed in the X-ray, where its axis crosses the stem edge (refer Fig. 7).
  • the tip and shoulder are defined with respect to the intersection points of the outer edge of the stem of the prosthesis silhouette and lie along the bisector of the prosthesis stem.
  • the shoulder is a useful reference point on the prosthesis for use in migration determinations, as long as in prior art determinations the view of the prosthesis is taken from a consistent angle about the stem's axis.
  • the method and apparatus of the invention determines the rotation of the view of the prosthesis about its axis, which, amongst other determinations, enables determination of an exact three-dimensional view of the prosthesis.
  • mapping the prosthesis model back on to the image it is thus possible to determine the exact position of the axis and shoulder point of the prosthesis in the image. Therefore it is possible to more accurately determine the actual migration of the shoulder with respect to another landmark on the bone of the patient.
  • all X-rays, whether AP or lateral can be used to calculate any amount migration that may have occurred.
  • a single, manually marked reference point on the femur can be used to calculate migration relative to the shoulder point on the prosthesis.
  • the point is either derived from the two-dimensional techniques of the invention or makes use of the three-dimensional pose determination to give a better 2-dimensional result.
  • the error due to manual point marking is approximately in the range of ⁇ 0.4mm. This has been calculated using the fact that the marker can be placed 2 to 3 picture elements away from the desired landmark, and that the images are generally processed at a resolution of around 0.1 to 0.2mm per picture elements.

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Abstract

Procédé et dispositif d'imagerie de prothèse et de repérage de migration analysant des images bidimensionnelles, telles que des clichés radiographiques, afin de déterminer la position et l'orientation d'un objet tridimensionnel, tel qu'une prothèse. On met en correspondance avec une silhouette une représentation tridimensionnelle de l'objet implanté tridimensionnel, de manière à évaluer sa pose. On peut également déterminer un facteur d'échelonnement afin d'indiquer des distances raisonnablement précises. Une fois déterminée la pose de l'objet tridimensionnel connu, on peut également identifier l'os environnant dans l'image bidimensionnelle au moyen de techniques de détermination d'objet ou par mise en correspondance avec une information de modèle ou d'historique de l'autre objet. On utilise la connaissance de la pose tridimensionnelle des objets afin de déterminer le déplacement complexe relatif de ces objets par comparaison de leurs poses pendant une certaine durée. Il est également possible de générer des enregistrements picturaux et graphiques afin d'apporter une assistance à l'évaluation clinique de l'appariement entre l'os et la prothèse. On peut également mettre en application ce procédé et ce dispositif sur des images historiques bidimensionnelles et plus le nombre de ces images est important, même celles qui présentent différents aspects du même membre, plus précise sera l'évaluation de la migration des objets identifiés.
PCT/AU2002/001368 2001-10-09 2002-10-09 Evaluation de pose bi- et tridimensionnelle d'articles a partir d'images bidimentionnelles Ceased WO2003030738A1 (fr)

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WO2007109467A1 (fr) * 2006-03-17 2007-09-27 Zimmer, Inc. Méthodes pour prédéterminer le contour d'une surface osseuse réséquée et pour estimer l'ajustement d'une prothèse sur l'os
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US9179983B2 (en) 2007-08-14 2015-11-10 Zimmer, Inc. Method of determining a contour of an anatomical structure and selecting an orthopaedic implant to replicate the anatomical structure
CN109191572A (zh) * 2018-07-27 2019-01-11 中国地质大学（武汉） 一种基于真值发现的三维地质模型寻优方法
CN110147767A (zh) * 2019-05-22 2019-08-20 深圳市凌云视迅科技有限责任公司 基于二维图像的三维手势姿态预测方法
EP4013488A4 (fr) * 2019-08-12 2023-08-30 Cochlear Limited Estimation en temps réel d'une pose de réseau d'électrodes pendant une insertion intracochléaire
CN120048003A (zh) * 2025-04-23 2025-05-27 华侨大学 基于数据扩充与多视图定位的三维姿态估计方法

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WO2005031647A1 (fr) * 2003-09-26 2005-04-07 Micro-Epsilon Messtechnik Gmbh & Co. Kg Procede et dispositif pour determiner, optiquement et sans contact, la situation tridimensionnelle d'un objet
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US7742639B2 (en) 2004-04-16 2010-06-22 Koninklijke Philips Electronics N.V. Data set visualization
US7471768B2 (en) 2006-03-07 2008-12-30 General Electric Company Systems and methods for estimating presence of a material within a volume of interest using x-ray
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US7842092B2 (en) 2006-03-14 2010-11-30 Mako Surgical Corp. Prosthetic device and system and method for implanting prosthetic device
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US8231634B2 (en) 2006-03-17 2012-07-31 Zimmer, Inc. Methods of predetermining the contour of a resected bone surface and assessing the fit of a prosthesis on the bone
AU2007227129B2 (en) * 2006-03-17 2012-06-14 Mohamed Mahfouz Methods of predetermining the contour of a resected bone surface and assessing the fit of a prosthesis on the bone
WO2007109467A1 (fr) * 2006-03-17 2007-09-27 Zimmer, Inc. Méthodes pour prédéterminer le contour d'une surface osseuse réséquée et pour estimer l'ajustement d'une prothèse sur l'os
US9179983B2 (en) 2007-08-14 2015-11-10 Zimmer, Inc. Method of determining a contour of an anatomical structure and selecting an orthopaedic implant to replicate the anatomical structure
US10881462B2 (en) 2007-08-14 2021-01-05 Zimmer, Inc. Method of determining a contour of an anatomical structure and selecting an orthopaedic implant to replicate the anatomical structure
US11488721B2 (en) 2008-09-19 2022-11-01 Smith & Nephew, Inc. Operatively tuning implants for increased performance
US8078440B2 (en) 2008-09-19 2011-12-13 Smith & Nephew, Inc. Operatively tuning implants for increased performance
US12205726B2 (en) 2008-09-19 2025-01-21 Smith & Nephew, Inc. Operatively tuning implants for increased performance
US10600515B2 (en) 2008-09-19 2020-03-24 Smith & Nephew, Inc. Operatively tuning implants for increased performance
CN109191572A (zh) * 2018-07-27 2019-01-11 中国地质大学（武汉） 一种基于真值发现的三维地质模型寻优方法
CN109191572B (zh) * 2018-07-27 2022-05-06 中国地质大学（武汉） 一种基于真值发现的三维地质模型寻优方法
CN110147767B (zh) * 2019-05-22 2023-07-18 深圳市凌云视迅科技有限责任公司 基于二维图像的三维手势姿态预测方法
CN110147767A (zh) * 2019-05-22 2019-08-20 深圳市凌云视迅科技有限责任公司 基于二维图像的三维手势姿态预测方法
EP4013488A4 (fr) * 2019-08-12 2023-08-30 Cochlear Limited Estimation en temps réel d'une pose de réseau d'électrodes pendant une insertion intracochléaire
US12172002B2 (en) 2019-08-12 2024-12-24 Cochlear Limited Real-time estimation of electrode array pose during intra-cochlear insertion
CN120048003A (zh) * 2025-04-23 2025-05-27 华侨大学 基于数据扩充与多视图定位的三维姿态估计方法

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