Fiducial marker recovery and detection from severely truncated data in navigation‐assisted spine surgery

Abstract

Purpose Fiducial markers are commonly used in navigation‐assisted minimally invasive spine surgery and they help transfer image coordinates into real‐world coordinates. In practice, these markers might be located outside the field‐of‐view (FOV) of C‐arm cone‐beam computed tomography (CBCT) systems used in intraoperative surgeries, due to the limited detector sizes. As a consequence, reconstructed markers in CBCT volumes suffer from artifacts and have distorted shapes, which sets an obstacle for navigation. Methods In this work, we propose two fiducial marker detection methods: direct detection from distorted markers (direct method) and detection after marker recovery (recovery method). For direct detection from distorted markers in reconstructed volumes, an efficient automatic marker detection method using two neural networks and a conventional circle detection algorithm is proposed. For marker recovery, a task‐specific data preparation strategy is proposed to recover markers from severely truncated data. Afterwards, a conventional marker detection algorithm is applied for position detection. The networks in both methods are trained based on simulated data. For the direct method, 6800 images and 10 000 images are generated, respectively, to train the U‐Net and ResNet50. For the recovery method, the training set includes 1360 images for FBPConvNet and Pix2pixGAN. The simulated data set with 166 markers and four cadaver cases with real fiducials are used for evaluation. Results The two methods are evaluated on simulated data and real cadaver data. The direct method achieves 100% detection rates within 1 mm detection error on simulated data with normal truncation and simulated data with heavier noise, but only detect 94.6% markers in extremely severe truncation case. The recovery method detects all the markers successfully in three test data sets and around 95% markers are detected within 0.5 mm error. For real cadaver data, both methods achieve 100% marker detection rates with mean registration error below 0.2 mm. Conclusions Our experiments demonstrate that the direct method is capable of detecting distorted markers accurately and the recovery method with the task‐specific data preparation strategy has high robustness and generalizability on various data sets. The task‐specific data preparation is able to reconstruct structures of interest outside the FOV from severely truncated data better than conventional data preparation.

Artifact Reduction in 3D and 4D Cone-Beam Computed Tomography Images With Deep Learning: A Review

“…Optimized conventional GANs can reduce metal artifacts in high-resolution and physically realistic CT scans, with good generalization to clinical CBCT imaging technologies for inner-ear scans [103]. Conditional GANs, inspired by the pix2pix-GAN [104], have successfully reduced metal artifacts in spine CBCT scans, enabling precise recovery of fiducial markers located outside the C-arm's field-ofview (FOV) [105]. A Cycle-GAN has also been employed to efficiently reduce metal artifacts by generating synthetic CT (sCT) from Megavolt CBCT (MVCBCT) and improving the quality of CBCT scans [106].…”

Abstract: Fiducial Marker Recovery and Detection From Severely Truncated Data in Navigation-assisted Spine Surgery

“…As a consequence, reconstructed markers in CBCT volumes suffer from artifacts and have distorted shapes, which sets an obstacle for navigation. In this work, we propose two fiducial marker detection methods: direct detection from distorted markers (direct method) and detection after marker recovery (recovery method) [1]. For direct detection from distorted markers in reconstructed volumes, an efficient automatic marker detection method using two neural networks and a conventional circle detection algorithm is proposed.…”