Statistical shape model-based reconstruction of a scaled, patient-specific surface model of the pelvis from a single standard AP x-ray radiograph

Abstract

The aim of this article is to investigate the feasibility of using a statistical shape model (SSM)-based reconstruction technique to derive a scaled, patient-specific surface model of the pelvis from a single standard anteroposterior (AP) x-ray radiograph and the feasibility of estimating the scale of the reconstructed surface model by performing a surface-based 3D/3D matching. Data sets of 14 pelvises (one plastic bone, 12 cadavers, and one patient) were used to validate the single-image based reconstruction technique. This reconstruction technique is based on a hybrid 2D/3D deformable registration process combining a landmark-to-ray registration with a SSM-based 2D/3D reconstruction. The landmark-to-ray registration was used to find an initial scale and an initial rigid transformation between the x-ray image and the SSM. The estimated scale and rigid transformation were used to initialize the SSM-based 2D/3D reconstruction. The optimal reconstruction was then achieved in three stages by iteratively matching the projections of the apparent contours extracted from a 3D model derived from the SSM to the image contours extracted from the x-ray radiograph: Iterative affine registration, statistical instantiation, and iterative regularized shape deformation. The image contours are first detected by using a semiautomatic segmentation tool based on the Livewire algorithm and then approximated by a set of sparse dominant points that are adaptively sampled from the detected contours. The unknown scales of the reconstructed models were estimated by performing a surface-based 3D/3D matching between the reconstructed models and the associated ground truth models that were derived from a CT-based reconstruction method. Such a matching also allowed for computing the errors between the reconstructed models and the associated ground truth models. The technique could reconstruct the surface models of all 14 pelvises directly from the landmark-based initialization. Depending on the surface-based matching techniques, the reconstruction errors were slightly different. When a surface-based iterative affine registration was used, an average reconstruction error of 1.6 mm was observed. This error was increased to 1.9 mm, when a surface-based iterative scaled rigid registration was used. It is feasible to reconstruct a scaled, patient-specific surface model of the pelvis from single standard AP x-ray radiograph using the present approach. The unknown scale of the reconstructed model can be estimated by performing a surface-based 3D/3D matching.