Principal Deformations Modes of Articulated Models for the Analysis of 3D Spine Deformities

Articulated models are commonly used for recognition tasks in robotics and in gait analysis, but can also be extremely useful to develop analytical methods targeting spinal deformities studies. The threedimensional analysis of these deformities is critical since they are complex and not restricted to a given plane. Thus, they cannot be assessed as a two-dimensional phenomenon. However, analyzing large databases of 3D spine models is a difficult and time-consuming task. In this context, a method that automatically extracts the most important deformation modes from sets of articulated spine models is proposed. The spine was modeled with two levels of details. In the first level, the global shape of the spine was expressed using a set of rigid transformations that superpose local coordinates systems of neighboring vertebrae. In the second level, anatomical landmarks measured with respect to a vertebra's local coordinate system were used to quantify vertebra shape. These articulated spine models do not naturally belong to a vector space because of the vertebral rotations. The Fréchet mean, which is a generalization of the conventional mean to Riemannian manifolds, was thus used to compute the mean spine shape. Moreover, a generalized covariance computed in the tangent space of the Fréchet mean was used to construct a statistical shape model of the scoliotic spine. The principal deformation modes were then extracted by performing a principal component analysis (PCA) on the generalized covariance matrix. The principal deformations modes were computed for a large database of untreated scoliotic patients. The obtained results indicate that combining rotation, translation and local vertebra shape into a unified framework leads to an effective and meaningful analysis method for articulated anatomical structures. The computed deformation modes also revealed clinically relevant information. For instance, the first mode of deformation is associated with patients' growth, the second is a double thoraco-lumbar curve and the third is a thoracic curve. Other experiments were performed on patients classified by orthopedists with respect to a widely used two-dimensional surgical planning system (the Lenke classification) and patterns relevant to the definition of a new three-dimensional classification were identified. Finally, relationships between local vertebrae shapes and global spine shape (such as vertebra wedging) were demonstrated using a sample of 3D spine reconstructions with 14 anatomical landmarks per vertebra

Multimodal image fusion of anatomical structures for diagnosis, therapy planning and assistance

This paper provides an overview of work done in recent years by our research group to fuse multimodal images of the trunk of patients with Adolescent Idiopathic Scoliosis (AIS) treated at Sainte-Justine University Hospital Center (CHU). We first describe our surface acquisition system and introduce a set of clinical measurements (indices) based on the trunk's external shape, to quantify its degree of asymmetry. We then describe our 3D reconstruction system of the spine and rib cage from biplanar radiographs and present our methodology for multimodal fusion of MRI, X-ray and external surface images of the trunk We finally present a physical model of the human trunk including bone and soft tissue for the simulation of the surgical outcome on the external trunk shape in AIS.CIHR / IRS

Statistical Computing on Non-Linear Spaces for Computational Anatomy

International audienceComputational anatomy is an emerging discipline that aims at analyzing and modeling the individual anatomy of organs and their biological variability across a population. However, understanding and modeling the shape of organs is made difficult by the absence of physical models for comparing different subjects, the complexity of shapes, and the high number of degrees of freedom implied. Moreover, the geometric nature of the anatomical features usually extracted raises the need for statistics on objects like curves, surfaces and deformations that do not belong to standard Euclidean spaces. We explain in this chapter how the Riemannian structure can provide a powerful framework to build generic statistical computing tools. We show that few computational tools derive for each Riemannian metric can be used in practice as the basic atoms to build more complex generic algorithms such as interpolation, filtering and anisotropic diffusion on fields of geometric features. This computational framework is illustrated with the analysis of the shape of the scoliotic spine and the modeling of the brain variability from sulcal lines where the results suggest new anatomical findings

3D registration of MR and X-ray spine images using an articulated model

Présentation: Cet article a été publié dans le journal : Computerised medical imaging and graphics (CMIG). Le but de cet article est de recaler les vertèbres extraites à partir d’images RM avec des vertèbres extraites à partir d’images RX pour des patients scoliotiques, en tenant compte des déformations non-rigides due au changement de posture entre ces deux modalités. À ces fins, une méthode de recalage à l’aide d’un modèle articulé est proposée. Cette méthode a été comparée avec un recalage rigide en calculant l’erreur sur des points de repère, ainsi qu’en calculant la différence entre l’angle de Cobb avant et après recalage. Une validation additionelle de la méthode de recalage présentée ici se trouve dans l’annexe A. Ce travail servira de première étape dans la fusion des images RM, RX et TP du tronc complet. Donc, cet article vérifie l’hypothèse 1 décrite dans la section 3.2.1.Abstract This paper presents a magnetic resonance image (MRI)/X-ray spine registration method that compensates for the change in the curvature of the spine between standing and prone positions for scoliotic patients. MRIs in prone position and X-rays in standing position are acquired for 14 patients with scoliosis. The 3D reconstructions of the spine are then aligned using an articulated model which calculates intervertebral transformations. Results show significant decrease in regis- tration error when the proposed articulated model is compared with rigid registration. The method can be used as a basis for full body MRI/X-ray registration incorporating soft tissues for surgical simulation.Canadian Institute of Health Research (CIHR

Three-Dimensional Biplanar Reconstruction of the Scoliotic Spine for Standard Clinical Setup

Tese de Doutoramento. Engenharia Informática. Faculdade de Engenharia. Universidade do Porto. 201

A physically based trunk soft tissue modeling for scoliosis surgery planning systems

One of the major concerns of scoliotic patients undergoing spinal correction surgery is the trunk's external appearance after the surgery. This paper presents a novel incremental approach for simulating postoperative trunk shape in scoliosis surgery. Preoperative and postoperative trunk shapes data were obtained using three-dimensional medical imaging techniques for seven patients with adolescent idiopathic scoliosis. Results of qualitative and quantitative evaluations, based on the comparison of the simulated and actual postoperative trunk surfaces, showed an adequate accuracy of the method. Our approach provides a candidate simulation tool to be used in a clinical environment for the surgery planning process.IRSC / CIH

Statistical model based 3D shape prediction of postoperative trunks for non-invasive scoliosis surgery planning

One of the major concerns of scoliosis patients undergoing surgical treatment is the aesthetic aspect of the surgery outcome. It would be useful to predict the postoperative appearance of the patient trunk in the course of a surgery planning process in order to take into account the expectations of the patient. In this paper, we propose to use least squares support vector regression for the prediction of the postoperative trunk 3D shape after spine surgery for adolescent idiopathic scoliosis. Five dimensionality reduction techniques used in conjunction with the support vector machine are compared. The methods are evaluated in terms of their accuracy, based on the leave-one-out cross-validation performed on a database of 141 cases. The results indicate that the 3D shape predictions using a dimensionality reduction obtained by simultaneous decomposition of the predictors and response variables have the best accuracy.CIHR / IRS

Modified Large Margin Nearest Neighbor Metric Learning for Regression

The main objective of this letter is to formulate a new approach of learning a Mahalanobis distance metric for nearest neighbor regression from a training sample set. We propose a modified version of the large margin nearest neighbor metric learning method to deal with regression problems. As an application, the prediction of post-operative trunk 3-D shapes in scoliosis surgery using nearest neighbor regression is described. Accuracy of the proposed method is quantitatively evaluated through experiments on real medical data.IRSC / CIH

Scaled, patient-specific 3D vertebral model reconstruction based on 2D lateral fluoroscopy

Backgrounds: Accurate three-dimensional (3D) models of lumbar vertebrae are required for image-based 3D kinematics analysis. MRI or CT datasets are frequently used to derive 3D models but have the disadvantages that they are expensive, time-consuming or involving ionizing radiation (e.g., CT acquisition). An alternative method using 2D lateral fluoroscopy was developed. Materials and methods: A technique was developed to reconstruct a scaled 3D lumbar vertebral model from a single two-dimensional (2D) lateral fluoroscopic image and a statistical shape model of the lumbar vertebrae. Four cadaveric lumbar spine segments and two statistical shape models were used for testing. Reconstruction accuracy was determined by comparison of the surface models reconstructed from the single lateral fluoroscopic images to the ground truth data from 3D CT segmentation. For each case, two different surface-based registration techniques were used to recover the unknown scale factor, and the rigid transformation between the reconstructed surface model and the ground truth model before the differences between the two discrete surface models were computed. Results: Successful reconstruction of scaled surface models was achieved for all test lumbar vertebrae based on single lateral fluoroscopic images. The mean reconstruction error was between 0.7 and 1.6mm. Conclusions: A scaled, patient-specific surface model of the lumbar vertebra from a single lateral fluoroscopic image can be synthesized using the present approach. This new method for patient-specific 3D modeling has potential applications in spine kinematics analysis, surgical planning, and navigatio

Manifold Learning in Medical Imaging

Manifold learning theory has seen a surge of interest in the modeling of large and extensive datasets in medical imaging since they capture the essence of data in a way that fundamentally outperforms linear methodologies, the purpose of which is to essentially describe things that are flat. This problematic is particularly relevant with medical imaging data, where linear techniques are frequently unsuitable for capturing variations in anatomical structures. In many cases, there is enough structure in the data (CT, MRI, ultrasound) so a lower dimensional object can describe the degrees of freedom, such as in a manifold structure. Still, complex, multivariate distributions tend to demonstrate highly variable structural topologies that are impossible to capture with a single manifold learning algorithm. This chapter will present recent techniques developed in manifold theory for medical imaging analysis, to allow for statistical organ shape modeling, image segmentation and registration from the concept of navigation of manifolds, classification, as well as disease prediction models based on discriminant manifolds. We will present the theoretical basis of these works, with illustrative results on their applications from various organs and pathologies, including neurodegenerative diseases and spinal deformities