透视立体影像分析技术在假体无菌性松动检测中的应用研究

doi:10.3969/j.issn.1674-8115.2024.09.001

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (9): 1061-1068.doi: 10.3969/j.issn.1674-8115.2024.09.001

• 论著 · 基础研究 •

透视立体影像分析技术在假体无菌性松动检测中的应用研究

杨涵¹(), 雷浩²(), 徐彼得¹, 吴淏³, 马寻君⁴, 皇艳波⁵, 毛远青⁶, 张经纬⁶, 王金武⁶()

^1.上海交通大学生物医学工程学院数字医学临床转化教育部工程研究中心，上海 200030
^2.上海徐汇卓越医工交叉与医学人工智能技术创新中心，上海 200233
^3.上海大学医学院，上海 200444
^4.徐州医科大学医学信息与工程学院，徐州 221004
^5.上海理工大学健康科学与工程学院，上海 200082
^6.上海交通大学医学院附属第九人民医院骨科，上海 200011

收稿日期:2024-01-10 接受日期:2024-02-09 出版日期:2024-09-28 发布日期:2024-10-09
通讯作者: 王金武 E-mail:yanghan0609@sjtu.edu.cn;haolei@emeai.org.cn;Jinwu_wang@163.com
作者简介:杨　涵（1993—），男，硕士；电子信箱：yanghan0609@sjtu.edu.cn
雷　浩（1975—），男，硕士；电子信箱：haolei@emeai.org.cn。第一联系人：（杨　涵、雷　浩并列第一作者）
基金资助:
国家重点研发计划(2022YFF1202600);上海市科学技术委员会“科技创新行动计划”国内科技合作领域项目(22015820100);上海交通大学医学院双百人项目(20152224);上海交通大学医学院转化医学创新基金(TM201613)

Application of fluoroscopic stereophotogrammetric analysis in the detection of aseptic loosening of prostheses

YANG Han¹(), LEI Hao²(), XU Bide¹, WU Hao³, MA Xunjun⁴, HUANG Yanbo⁵, MAO Yuanqing⁶, ZHANG Jingwei⁶, WANG Jinwu⁶()

^1.Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of China, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
^2.Shanghai Xuhui Excellent Medical and Industrial Intersection and Medical Artificial Intelligence Technology Innovation Center, Shanghai 200233, China
^3.School of Medicine, Shanghai University, Shanghai 200444, China
^4.School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou 221004, China
^5.School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai 200082, China
^6.Department of Orthopaedic Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2024-01-10 Accepted:2024-02-09 Online:2024-09-28 Published:2024-10-09
Contact: WANG Jinwu E-mail:yanghan0609@sjtu.edu.cn;haolei@emeai.org.cn;Jinwu_wang@163.com
Supported by:
National Key R&D Program of China(2022YFF1202600);Science and Technology Innovation Action Plan of Shanghai Science and Technology Committee(22015820100);“Two-hundred Talents” Program of Shanghai Jiao Tong University School of Medicine(20152224);Translational Medicine Innovation Project of Shanghai Jiao Tong University School of Medicine(TM201613)

摘要/Abstract

摘要：

目的·验证基于2D?3D配准的透视立体影像分析（fluoroscopic stereophotogrammetric analysis，FSA）技术在关节假体无菌性松动早期迁移检测的精度及临床应用可行性。方法·通过图像合成实验验证以光源为中心和以投影物体为中心的二维（two dimension，2D）?三维（three dimension，3D）配准算法在不同工况下FSA技术的精度，通过真实模型实验验证临床应用可行性。图像合成实验通过在虚拟环境下建立与真实环境参数相同的透视投影，记录3D模型（骨或假体）在六自由度变换时的2D透视图像，使用不同的2D?3D配准算法还原3D模型的六自由度变换，计算配准算法的误差。真实模型验证通过骨?假体高精度迁移模拟器模拟关节置换术后骨与假体之间的迁移，利用计算机断层成像及光学扫描重建骨或假体的3D模型，使用透视设备拍摄假体迁移前后的2D透视图像，再通过基于2D?3D配准的FSA技术还原假体的迁移，计算FSA技术的误差。结果·以光源为中心的2D?3D配准算法在不同工况下的精度均高于以投影物体为中心的算法。配准初始条件较好时，以光源为中心的算法与以投影物体为中心的算法相比：旋转误差降低，差异存在统计学意义（P=0.021）；位移误差降低，差异存在统计学意义（P=0.000）。并且，以光源为中心的算法满足临床应用要求所需的相似度更低、配准次数更少。结论·基于2D?3D配准的FSA技术在人工关节假体早期迁移检测中精度满足临床应用要求。该技术可通过检测关节置换术后假体的早期迁移预警假体的晚期无菌性松动，有望通过进一步研究应用于临床。

关键词: 关节假体, 无菌性松动, 早期迁移检测, 透视分析技术

Abstract:

Objective ·To verify the accuracy and clinical feasibility of fluoroscopic stereophotogrammetric analysis (FSA) technology based on two dimension (2D)-three dimension (3D) registration for early migration detection of aseptic loosening of joint prostheses. Methods ·2D-3D registration algorithms centering on the light source and projected object respectively in FSA technology were verified under various working conditions through image synthesis experiments, and the feasibility of clinical application was verified through real model experiments. The image synthesis experiment established a perspective projection environment with the same parameters as the real environment in a virtual environment, the 2D perspective images of the 3D model (bone or prosthesis) during the six degrees of freedom transformation were recorded, and the six degrees of freedom transformation of the 3D model was restored by using different 2D-3D registration algorithms. The error of each registration algorithm was calculated. For real model validation, the migration between bone and prosthesis after joint replacement surgery was simulated with a high precision bone prosthesis migration simulator. The 3D model of the bone or prosthesis was reconstructed by using computed tomograph (CT) images and optical scanning, and the 2D perspective images before and after prosthesis migration were captured by using a fluoroscopy device. The migration of the prosthesis was restored by using FSA technology based on 2D-3D registration, and the error of FSA technology was calculated. Results ·The accuracy of the 2D-3D registration algorithm centering on the light source was higher than that of the algorithm centering on the projected object under different working conditions. When the initial registration conditions were favorable, the algorithm centering on the light source reduced the rotation error compared to the algorithm centering on the projected object, with a statistical difference (P=0.021), and the displacement error decreases, with a significant statistical difference (P=0.000). Moreover, algorithms centering on the light sources required lower similarity and fewer registration times to meet clinical application requirements. Conclusion ·The accuracy of FSA technology based on 2D-3D registration in early migration detection of artificial joint prostheses meets clinical application requirements. This technology can warn of late aseptic loosening of prostheses by detecting early migration of prostheses after joint replacement surgery, and is expected to be applied to clinical practice through further research.

Key words: joint prosthesis, aseptic loosening, early migration detection, fluoroscopic analysis technology

中图分类号:

R319

杨涵, 雷浩, 徐彼得, 吴淏, 马寻君, 皇艳波, 毛远青, 张经纬, 王金武. 透视立体影像分析技术在假体无菌性松动检测中的应用研究[J]. 上海交通大学学报（医学版）, 2024, 44(9): 1061-1068.

YANG Han, LEI Hao, XU Bide, WU Hao, MA Xunjun, HUANG Yanbo, MAO Yuanqing, ZHANG Jingwei, WANG Jinwu. Application of fluoroscopic stereophotogrammetric analysis in the detection of aseptic loosening of prostheses[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(9): 1061-1068.

图/表 15

图1 数字重建放射影像投影原理

Fig 1 Principles of digitally reconstructured radiograph (DRR) image projection

图2 骨?假体高精度迁移模拟器

Fig 2 High precision bone-prosthesis migration simulator

图3 骨的3D模型

Fig 3 3D bone model

图4 假体及假体光学扫描模型Note： A. Prosthesis. B. Optical scanning model of prosthesis.

Fig 4 Prosthesis and optical scanning model

图5 假体2D?3D配准过程Note： A. Window width and window level adjustment. B. Loading a 3D model. C. Manual adjustment. D. Registration completed.

Fig 5 2D-3D registration process of prostheses

图6 模拟双平面示意

Fig 6 Simulated dual FSA

图7 算法1在工况1下的配准结果

Fig 7 Registration results of algorithm 1 under condition 1

图8 算法1在工况2下的配准结果

Fig 8 Registration results of algorithm 1 under condition 2

图9 算法2在工况1下的配准结果

Fig 9 Registration results of algorithm 2 under condition 1

图10 算法2在工况2下的配准结果

Fig 10 Registration results of algorithm 2 under condition 2

表1 2种工况下算法1和算法2误差对比

Tab 1 Error comparison of algorithm 1 and algorithm 2 under different working conditions

Item	Algorithm 1	Algorithm 2	t value	P value
Working condition 1
r_y /(°)	6.06±5.95	3.79±3.36	2.352	0.021
t_y /mm	1.91±1.15	0.20±0.17	10.436	0.000
Working condition 2
r_y /(°)	4.15±3.18	3.47±2.79	1.135	0.259
t_y /mm	2.68±1.95	0.34±0.28	8.396	0.000

表2 算法1与算法2临床应用要求满足情况比较

Tab 2 Comparison of clinical application requirements satisfied by algorithm 1 and algorithm 2

Item	Algorithm 1		Algorithm 2
Item	Working condition 1	Working condition 2	Working condition 1	Working condition 2
Minimum similarity to meet clinical application requirements/%	99.987	/	99.984	99.997
Average number of registrations required to meet clinical application requirements/n	16.67	/	5.56	50.00
r_y error that meets clinical application requirements/(°)	0.60±0.13	/	0.40±0.27	0.81±0.50
t_y error that meets clinical application requirements/mm	0.59±0.24	/	0.06±0.04	0.03±0.02

表3 真实模型验证实验结果

Tab 3 Experimental results of real model validation

Error	Zero migration	Relative displacement 5 mm, relative rotation 5°	t value	P value
r_y /(°)	0.37±0.21	0.84±0.15	4.879	0.000
t_y /mm	0.44±0.22	0.47±0.19	0.073	0.943

图11 双平面算法2在工况2下的配准结果

Fig 11 Registration results of simulated dual FSA algorithm 2 under condition 2

表4 相同工况下算法2在单平面和双平面的误差对比

Tab 4 Comparison of errors of algorithm 2 in FSA and simulated dual FSA under the same operating conditions

Error	FSA	Dual FSA	t value	P value
r_y /(°)	6.06±5.95	0.41±0.67	6.666	0.000
t_y /mm	0.20±0.17	0.12±0.11	2.680	0.009

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透视立体影像分析技术在假体无菌性松动检测中的应用研究

Application of fluoroscopic stereophotogrammetric analysis in the detection of aseptic loosening of prostheses

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