Fiducial marker-based correction for involuntary motion in weight-bearing C-arm CT scanning of knees. II. Experiment

Jang-Hwan Choi; Andreas Maier; Andreas Keil; Saikat Pal; Emily J. McWalter; Gary S. Beaupré; Garry E. Gold; Rebecca Fahrig

doi:10.1118/1.4873675

Effective one step-iterative fiducial marker-based compensation for involuntary motion in weight-bearing C-arm cone-beam CT scanning of knees

10.1117/12.2043771 ◽

2014 ◽

Cited By ~ 2

Author(s):

Jang-Hwan Choi ◽

Andreas Maier ◽

Martin Berger ◽

Rebecca Fahrig

Keyword(s):

Cone Beam Ct ◽

Weight Bearing ◽

Ct Scanning ◽

Fiducial Marker ◽

Cone Beam ◽

One Step

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Fiducial marker-based correction for involuntary motion in weight-bearing C-arm CT scanning of knees. Part I. Numerical model-based optimization

Medical Physics ◽

10.1118/1.4817476 ◽

2013 ◽

Vol 40 (9) ◽

pp. 091905 ◽

Cited By ~ 25

Author(s):

Jang-Hwan Choi ◽

Rebecca Fahrig ◽

Andreas Keil ◽

Thor F. Besier ◽

Saikat Pal ◽

...

Keyword(s):

Numerical Model ◽

Weight Bearing ◽

Ct Scanning ◽

Fiducial Marker ◽

Model Based

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Frameless robotic stereotactic biopsies: a consecutive series of 100 cases

Journal of Neurosurgery ◽

10.3171/2014.9.jns14107 ◽

2015 ◽

Vol 122 (2) ◽

pp. 342-352 ◽

Cited By ~ 49

Author(s):

Michel Lefranc ◽

Cyrille Capel ◽

Anne-Sophie Pruvot-Occean ◽

Anthony Fichten ◽

Christine Desenclos ◽

...

Keyword(s):

Stereotactic Biopsy ◽

Clinical Symptoms ◽

Diagnostic Yield ◽

Ct Scanning ◽

Fiducial Marker ◽

Surface Registration ◽

Histological Diagnosis ◽

Consecutive Series ◽

Mortality And Morbidity ◽

Stereotactic Biopsies

OBJECT Stereotactic biopsy procedures are an everyday part of neurosurgery. The procedure provides an accurate histological diagnosis with the least possible morbidity. Robotic stereotactic biopsy needs to be an accurate, safe, frameless, and rapid technique. This article reports the clinical results of a series of 100 frameless robotic biopsies using a Medtech ROSA device. METHODS The authors retrospectively analyzed their first 100 frameless stereotactic biopsies performed with the robotic ROSA device: 84 biopsies were performed by frameless robotic surface registration, 7 were performed by robotic bone fiducial marker registration, and 9 were performed by scalp fiducial marker registration. Intraoperative flat-panel CT scanning was performed concomitantly in 25 cases. The operative details of the robotic biopsies, the diagnostic yield, and mortality and morbidity data observed in this series are reported. RESULTS A histological diagnosis was established in 97 patients. No deaths or permanent morbidity related to surgery were observed. Six patients experienced transient neurological worsening. Six cases of bleeding within the lesion or along the biopsy trajectory were observed on postoperative CT scans but were associated with transient clinical symptoms in only 2 cases. Stereotactic surgery was performed with patients in the supine position in 93 cases and in the prone position in 7 cases. The use of fiducial markers was reserved for posterior fossa biopsy via a transcerebellar approach, via an occipital approach, or for pediatric biopsy. CONCLUSIONS ROSA frameless stereotactic biopsies appear to be accurate and safe robotized frameless procedures.

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WE-G-217BCD-05: Fiducial Marker-Based Motion Compensation for the Acquisition of 3D Knee Geometry Under Weight-Bearing Conditions Using a C-Arm CT Scanner

Medical Physics ◽

10.1118/1.4736213 ◽

2012 ◽

Vol 39 (6Part28) ◽

pp. 3973-3973 ◽

Cited By ~ 1

Author(s):

J-H Choi ◽

A Keil ◽

A Maier ◽

S Pal ◽

EJ McWalter ◽

...

Keyword(s):

Motion Compensation ◽

Weight Bearing ◽

Fiducial Marker ◽

Ct Scanner

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OP45 HTA Of A Pediatric Biplanar Low-Dose X-Ray Imaging System

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462318000983 ◽

2018 ◽

Vol 34 (S1) ◽

pp. 17-18

Author(s):

Martina Andellini ◽

Francesco Faggiano ◽

Roxana di Mauro ◽

Pietro Derrico ◽

Matteo Ritrovato

Keyword(s):

3D Reconstruction ◽

Low Dose ◽

Imaging System ◽

Weight Bearing ◽

Ct Scanning ◽

Lower Limbs ◽

Final Decision ◽

X Ray ◽

Congenital Deformities ◽

X Ray Imaging

Introduction:Patients with adolescent idiopathic scoliosis frequently receive X-ray imaging at diagnosis and subsequent follow monitoring. To achieve the ALARA concept of radiation dose, a biplanar low-dose X-ray system (BLDS) has been proposed. The aim of the study is to gather evidence on safety, accuracy and overall effectiveness of a BLDS compared with CT scanning, in a pediatric population, in order to support the final decision on possible acquisition of such innovative diagnostic system.Methods:The new method Decision-oriented HTA (DoHTA) was applied to carefully assess the diagnostic technology. It was developed starting from the EUnetHTA Core Model® integrated with the analytic hierarchy process in order to identify all the relevant assessment aspects of the technology involved, identified from scientific literature, experts’ judgments and specific context analysis of Bambino Gesù Children's Hospital. A weight was associated to each assessment element and the alternatives’ ranking was defined.Results:This innovative system provides orthopedic images in standing or sitting position, being able to examine the spine and lower limbs under normal weight-bearing conditions. This system is recommended for particular clinical indications as scoliosis and other congenital deformities of the spine. It is able to acquire simultaneous posteroanterior and lateral images in a single scan without vertical distortion and with lower radiation exposure than CT scanning. 2D images acquired can be combined to obtain a 3D reconstruction scanning based on a semi-automated statistical model.Conclusions:The major advantages of BLDS are the relatively low dose of radiation and the possibility of obtaining a 3D reconstruction of the bones. Our preliminary results show that data on the clinical effectiveness are limited but the technical advancements of BLDS appear promising in terms of patient management and patient health outcomes associated with its use.

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Clinical Experience Using a 3D-Printed Patient-Specific Instrument for Medial Opening Wedge High Tibial Osteotomy

BioMed Research International ◽

10.1155/2018/9246529 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Jesse Chieh-Szu Yang ◽

Cheng-Fong Chen ◽

Chu-An Luo ◽

Ming-Chau Chang ◽

Oscar K. Lee ◽

...

Keyword(s):

High Tibial Osteotomy ◽

Weight Bearing ◽

Ct Scanning ◽

Tibial Slope ◽

Patient Specific ◽

Tibial Osteotomy ◽

Opening Wedge ◽

Time Saving ◽

X Ray ◽

Specific Instrument

Purpose. High tibial osteotomy (HTO) has been adopted as an effective surgery for medial degeneration of the osteoarthritis (OA) knee. However, satisfactory outcomes necessitate the precise creation and distraction of osteotomized wedges and the use of intraoperative X-ray images to continually monitor the wedge-related manipulation. Thus HTO is highly technique-demanding and has a high radiation exposure. We report a patient-specific instrument (PSI) guide for the precise creation and distraction of HTO wedge. Methods. This study first parameterized five HTO procedures to serve as a design rationale for an innovative PSI guide. Preoperative X-ray and computed tomography- (CT-) scanning images were used to design and fabricate PSI guides for clinical use. The weight-bearing line (WBL) of the ten patients was shifted to the Fujisawa’s point and instrumented using the TomoFix system. The radiological results of the PSI-guided HTO surgery were evaluated by the WBL percentage and tibial slope. Results. All patients consistently showed an increased range of motion and a decrease in pain and discomfort at about three-month follow-up. This study demonstrates the satisfactory accuracy of the WBL adjustment and tibial slope maintenance after HTO with PSI guide. For all patients, the average pre- and postoperative WBL are, respectively, 14.2% and 60.2%, while the tibial slopes are 9.9 and 10.1 degrees. The standard deviations are 2.78 and 0.36, respectively, in postoperative WBL and tibial slope. The relative errors of the pre- and postoperative WBL percentage and tibial slope averaged 4.9% and 4.1%, respectively. Conclusion. Instead of using navigator systems, this study integrated 2D and 3D preoperative planning to create a PSI guide that could most likely render the outcomes close to the planning. The PSI guide is a precise procedure that is time-saving, radiation-reducing, and relatively easy to use. Precise osteotomy and good short-term results were achieved with the PSI guide.

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Stability in ankle fractures

EFORT Open Reviews ◽

10.1302/2058-5241.3.170057 ◽

2018 ◽

Vol 3 (5) ◽

pp. 294-303 ◽

Cited By ~ 10

Author(s):

Vasileios Lampridis ◽

Nikolaos Gougoulias ◽

Anthony Sakellariou

Keyword(s):

Computed Tomography ◽

Weight Bearing ◽

Ct Scanning ◽

Ankle Fractures ◽

Deltoid Ligament ◽

Contact Pressure Distribution ◽

Distal Fibula ◽

Posterior Malleolus ◽

Surgical Fixation ◽

The Stability

Medial column (deltoid ligament) integrity is of key importance when considering the stability of isolated lateral malleolus ankle fractures. Weight-bearing radiographs are the best method of evaluating stability of isolated distal fibula fractures. Computed tomography (CT) scanning is mandatory for the assessment of complex ankle fractures, especially those involving the posterior malleolus. Most isolated trans-syndesmotic fibular fractures (Weber-B, SER, AO 44-B) are stable and can safely be treated non-operatively. Posterior malleolus fractures, regardless of size, should be considered for surgical fixation to restore stability, reduce the need for syndesmosis fixation, and improve contact pressure distribution. Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.170057

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Image-based compensation for involuntary motion in weight-bearing C-arm cone-beam CT scanning of knees

10.1117/12.2081559 ◽

2015 ◽

Cited By ~ 5

Author(s):

Mathias Unberath ◽

Jang-Hwan Choi ◽

Martin Berger ◽

Andreas Maier ◽

Rebecca Fahrig

Keyword(s):

Cone Beam Ct ◽

Weight Bearing ◽

Ct Scanning ◽

Cone Beam

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Inaccuracy of Forefoot Axial Radiographs in Determining the Coronal Plane Angle of Sesamoid Rotation in Adult Hallux Valgus Deformity. A Study using Weight-Bearing CT Scanning

Journal of the American Podiatric Medical Association ◽

10.7547/18-106 ◽

2020 ◽

Author(s):

Jill S Kawalec ◽

Duane J Ehredt Jr ◽

Kiarash Bakhaj ◽

Joseph Fleck ◽

Kelsi Nutter ◽

...

Keyword(s):

High Reliability ◽

Weight Bearing ◽

Ct Scanning ◽

Valgus Deformity ◽

Assessment Method ◽

Coronal Plane ◽

Hallux Valgus Deformity ◽

Plane Component ◽

Axial Radiograph ◽

The Mean

BACKGROUND:Hallux abducto valgus (HAV) is a triplane deformity with recent attention given to the significance of correcting the coronal plane component. This study explored the accuracy of the forefoot axial study as a standard radiographic assessment method compared to weight-bearing CT scanning.METHODS:Twelve feet with HAV from 12 subjects were included in this study. Three images of the affected foot were taken: 1) forefoot axial radiograph (FFA), 2) weight-bearing CT scan with the foot in a position of a) maximum pronation (Pronated CT) and b) maximum supination (Supinated CT). Five investigators (three faculty members and two podiatric16 medical students) determined the sesamoid rotation angle (SRA) from each of the images. The measurements from a single investigator were used to compare the SRA means from each of the image types, while those from all five investigators were used to determine reliability.RESULTS:The mean SRA for the pronated CT position was 22.1 {plus minus} 7.6 degrees, while that for the supinated CT image was 10.5 {plus minus} 5.0 degrees. In comparison, the mean SRA determined from the FFA image was 12.2 {plus minus} 9.4 degrees. The mean SRA from the Pronated CT was significantly greater than both the Supinated CT (p<0.001) and the FFA SRA (p<0.005). There were no significant differences in mean SRA between the FFA and Supinated CT images (p=1.000). Results indicated a high reliability in measurements between investigators.CONCLUSIONS:Using weight-bearing CT, the findings of this study indicate that the sesamoids significantly alter their position in the coronal plane, as determined by the SRA, with changes in weight-bearing subtalar joint position. Moreover, the affected foot positioning required for determining the SRA from the forefoot axial radiograph appears to significantly underestimate the true SRA value. Thus, the use of this image in surgical HAV planning is called into question.

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