Three-dimensional image registration of phantom vertebrae for image-guided surgery: a preliminary study.

Abstract

Applications of three-dimensional ultrasound (3D US) are emerging throughout the field of medicine. In this study, tracked, free-hand 3D phantom US images were mapped to computed tomograms (CT) as a development for image-guided surgery (IGS) of the spine. In the operating room, the registration of tracked 3D US images to other imaging modalities, such as CT, could allow the surgeon to identify more precisely the surgical target area prior to the incision. An independent quantitative measure of registration accuracy using a fiducial marker system was provided. Three-dimensional free-hand US images of a phantom spine were created by tracking the transducer with an optical sensing system. Two sets of images were acquired from three lumbar vertebrae using 4.5- and 7.5-MHz transducers. These images were then segmented for the extraction of the posterior vertebral surface. Next, a surface-based registration of US to the corresponding segmented CT images was performed. Registration errors were computed as the distance between a set of target points transformed using the experimental transformation and the same set of target points transformed using fiducial markers as a gold standard. Results indicated that alignment of these image sets is feasible using only part of the vertebral surface. In particular, the regions of the spinous process and laminae were used for registration. Target registration errors (TREs) were found to be lowest using the highest resolution CT images. Using the CT scans with 2-mm slice thickness, the TRE was calculated to be 1.33 +/- 0.30 mm for the 7.5-MHz US data set and 2.81 +/- 0.10 mm for the 4.5-MHz US data set. Moreover, residual errors in these surface alignments were 0.69 +/- 0.18 mm and 0.61 +/- 0.20 mm for the 4.5- and 7.5-MHz sets, respectively. A rigid, surface-based registration of CT images to phantom spinal US images, acquired with a free-hand, tracked transducer, is achievable with a limited, easily obtainable portion of the vertebral surface.