An Automated Three-Dimensional Bone Pose Tracking Method Using Clinical Interleaved Biplane Fluoroscopy Systems: Application to the Knee

Cheng-Chung Lin,Chien-Chun Kuo,Jia-Da Li,Horng-Chuang Hsu,Tung-Wu Lu,Mei-Ying Kuo

doi:10.3390/app10238426

Abstract

Model-based tracking of the movement of the tibiofemoral joint via a biplane X-ray imaging system has been commonly used to reproduce its accurate, three-dimensional kinematics. To accommodate the approaches to existing clinical asynchronous biplane fluoroscopy systems and achieve comparable accuracy, this study proposed an automated model-based interleaved biplane fluoroscopy image tracking scheme (MIBFT) by incorporating information of adjacent image frames. The MIBFT was evaluated with a cadaveric study conducted on a knee specimen. The MIBFT reproduced skeletal poses and tibiofemoral kinematics that were in good agreement with the standard reference kinematics provided by an optical motion capture system, in which the root-mean-squared (Rms) errors of the skeletal pose parameters ranged from 0.11 to 0.35 mm in translation and 0.18 to 0.49° in rotation. The influences of rotation speed on the pose errors were below 0.23 mm and 0.26°. The MIBFT-determined bias, precision, and Rms error were comparable to those of the reported model-based tracking techniques using custom-made synchronous biplane fluoroscopy. The results suggested that the further use of the clinical imaging system is feasible for the noninvasive and precise examination of dynamic joint functions and kinematics in clinical practice and biomechanical research.

Highlights

Accurate and noninvasive measurement of the three-dimensional (3D) kinematics of human limbs is fundamental for exploring their biomechanical characteristics [1]
X-ray fluoroscopy [13], four-dimensional computed tomography (4D CT) [14], and dynamic magnetic resonance (MR) image technologies [15,16] enable the recording of continuous two-dimensional (2D)
The errors in the pose parameters were successively reduced throughout the model-based interleaved biplane fluoroscopy image tracking scheme (MIBFT) process, in which the initial pose parameters taken from the registered pose in the preceding frame gave averaged absolute errors up to 2 mm in translations and 1.1◦ in rotations that were reduced to 0.6 mm and 0.5◦, respectively, after 2D/2D template registration

Summary

Introduction

Accurate and noninvasive measurement of the three-dimensional (3D) kinematics of human limbs is fundamental for exploring their biomechanical characteristics [1]. With quantified data of rigid-body kinematics and cartilage contact arthrokinematics of the tibiofemoral joint, both subject- and task-specific biomechanics and pathomechanics can be explored further [2,3], leading to a more objective and precise evaluation of functional performance in normally healthy [4,5,6], injured [7], and treated knee joints [8,9]. The registration of volumetric bone models obtained from high-resolution CT or MR images to a series of continuous images of dynamic joint movement, which is commonly called model-based tracking, can take advantage of the functionalities of different image modalities, yielding continuous six-degree-of-freedom (6-dof) data of skeletal and joint motion. Model-based tracking can be conducted fully based on MR images by registering MR-derived bone models to each frame of a relatively lower-resolution set of dynamic

Methods

Results

Discussion

Conclusion