A fast rigid-registration method of inferior limb X-ray image and 3D CT images for TKA surgery

Abstract

In this paper, we propose a fast rigid-registration method of inferior limb X-ray films (two-dimensional Computed Radiography (CR) images) and three-dimensional Computed Tomography (CT) images for Total Knee Arthroplasty (TKA) surgery planning. The position of the each bone, such as femur and tibia (shin bone), in X-ray film and 3D CT images is slightly different, and we must pay attention how to use the two different images, since X-ray film image is captured in the standing position, and 3D CT is captured in decubitus (face up) position, respectively. Though the conventional registration mainly uses cross-correlation function between two images,and utilizes optimization techniques, it takes enormous calculation time and it is difficult to use it in interactive operations. In order to solve these problems, we calculate the center line (bone axis) of femur and tibia (shin bone) automatically, and we use them as initial positions for the registration. We evaluate our registration method by using three patient's image data, and we compare our proposed method and a conventional registration, which uses down-hill simplex algorithm. The down-hill simplex method is an optimization algorithm that requires only function evaluations, and doesn't need the calculation of derivatives. Our registration method is more effective than the downhill simplex method in computational time and the stable convergence. We have developed the implant simulation system on a personal computer, in order to support the surgeon in a preoperative planning of TKA. Our registration method is implemented in the simulation system, and user can manipulate 2D/3D translucent templates of implant components on X-ray film and 3D CT images.