Scan-Free and Fully Automatic Tracking of Native Knee Anatomy from Dynamic Stereo-Radiography with Statistical Shape and Intensity Models

Kinematic tracking of native anatomy from stereo-radiography provides a quantitative basis for evaluating human movement. Conventional tracking procedures require significant manual effort and call for acquisition and annotation of subject-specific volumetric medical images. The current work introduces a framework for fully automatic tracking of native knee anatomy from dynamic stereo-radiography which forgoes reliance on volumetric scans. The method consists of three computational steps. First, captured radiographs are annotated with segmentation maps and anatomic landmarks using a convolutional neural network. Next, a non-convex polynomial optimization problem formulated from annotated landmarks is solved to acquire preliminary anatomy and pose estimates. Finally, a global optimization routine is performed for concurrent refinement of anatomy and pose. An objective function is maximized which quantifies similarities between masked radiographs and digitally reconstructed radiographs produced from statistical shape and intensity models. The proposed framework was evaluated against manually tracked trials comprising dynamic activities, and additional frames capturing a static knee phantom. Experiments revealed anatomic surface errors routinely below 1.0 mm in both evaluation cohorts. Median absolute errors of individual bone pose estimates were below 1.0∘ or mm for 15 out of 18 degrees of freedom in both evaluation cohorts. Results indicate that accurate pose estimation of native anatomy from stereo-radiography may be performed with significantly reduced manual effort, and without reliance on volumetric scans.