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Liu X, Li S, Zou X, Chen X, Xu H, Yu Y, Gu Z, Liu D, Li R, Wu Y, Wang G, Liao H, Qian W, Zhang Y. Development and clinical validation of a deep learning-based knee CT image segmentation method for robotic-assisted total knee arthroplasty. Int J Med Robot 2024; 20:e2664. [PMID: 38994900 DOI: 10.1002/rcs.2664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 06/24/2024] [Accepted: 07/03/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND This study aimed to develop a novel deep convolutional neural network called Dual-path Double Attention Transformer (DDA-Transformer) designed to achieve precise and fast knee joint CT image segmentation and to validate it in robotic-assisted total knee arthroplasty (TKA). METHODS The femoral, tibial, patellar, and fibular segmentation performance and speed were evaluated and the accuracy of component sizing, bone resection and alignment of the robotic-assisted TKA system constructed using this deep learning network was clinically validated. RESULTS Overall, DDA-Transformer outperformed six other networks in terms of the Dice coefficient, intersection over union, average surface distance, and Hausdorff distance. DDA-Transformer exhibited significantly faster segmentation speeds than nnUnet, TransUnet and 3D-Unet (p < 0.01). Furthermore, the robotic-assisted TKA system outperforms the manual group in surgical accuracy. CONCLUSIONS DDA-Transformer exhibited significantly improved accuracy and robustness in knee joint segmentation, and this convenient and stable knee joint CT image segmentation network significantly improved the accuracy of the TKA procedure.
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Affiliation(s)
- Xingyu Liu
- School of Life Sciences, Tsinghua University, Beijing, China
- Institute of Biomedical and Health Engineering (iBHE), Tsinghua Shenzhen International Graduate School, Shenzhen, China
- School of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Songlin Li
- Department of Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiongfei Zou
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Chen
- Departments of Orthopedics, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Hongjun Xu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Yu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhao Gu
- Longwood Valley Medical Technology Co. Ltd, Beijing, China
| | - Dong Liu
- Longwood Valley Medical Technology Co. Ltd, Beijing, China
| | - Runchao Li
- Longwood Valley Medical Technology Co. Ltd, Beijing, China
| | - Yaojiong Wu
- Institute of Biomedical and Health Engineering (iBHE), Tsinghua Shenzhen International Graduate School, Shenzhen, China
| | - Guangzhi Wang
- School of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Hongen Liao
- School of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Wenwei Qian
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiling Zhang
- School of Biomedical Engineering, Tsinghua University, Beijing, China
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Garzia S, Capellini K, Gasparotti E, Pizzuto D, Spinelli G, Berti S, Positano V, Celi S. Three-Dimensional Multi-Modality Registration for Orthopaedics and Cardiovascular Settings: State-of-the-Art and Clinical Applications. SENSORS (BASEL, SWITZERLAND) 2024; 24:1072. [PMID: 38400229 PMCID: PMC10891817 DOI: 10.3390/s24041072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024]
Abstract
The multimodal and multidomain registration of medical images have gained increasing recognition in clinical practice as a powerful tool for fusing and leveraging useful information from different imaging techniques and in different medical fields such as cardiology and orthopedics. Image registration could be a challenging process, and it strongly depends on the correct tuning of registration parameters. In this paper, the robustness and accuracy of a landmarks-based approach have been presented for five cardiac multimodal image datasets. The study is based on 3D Slicer software and it is focused on the registration of a computed tomography (CT) and 3D ultrasound time-series of post-operative mitral valve repair. The accuracy of the method, as a function of the number of landmarks used, was performed by analysing root mean square error (RMSE) and fiducial registration error (FRE) metrics. The validation of the number of landmarks resulted in an optimal number of 10 landmarks. The mean RMSE and FRE values were 5.26 ± 3.17 and 2.98 ± 1.68 mm, respectively, showing comparable performances with respect to the literature. The developed registration process was also tested on a CT orthopaedic dataset to assess the possibility of reconstructing the damaged jaw portion for a pre-operative planning setting. Overall, the proposed work shows how 3D Slicer and registration by landmarks can provide a useful environment for multimodal/unimodal registration.
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Affiliation(s)
- Simone Garzia
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
- Department of Information Engineering, University of Pisa, 56122 Pisa, Italy;
| | - Katia Capellini
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
| | - Emanuele Gasparotti
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
| | - Domenico Pizzuto
- Department of Information Engineering, University of Pisa, 56122 Pisa, Italy;
| | - Giuseppe Spinelli
- Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria Careggi, 50134 Firenze, Italy;
| | - Sergio Berti
- Diagnostic and Interventional Cardiology Department, Fondazione Toscana G. Monasterio, 54100 Massa, Italy;
| | - Vincenzo Positano
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
| | - Simona Celi
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, 54100 Massa, Italy; (S.G.); (K.C.); (E.G.); (V.P.)
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