Print Email Facebook Twitter A fluoroscopy-based planning and guidance software tool for minimally invasive hip refixation by cement injection Title A fluoroscopy-based planning and guidance software tool for minimally invasive hip refixation by cement injection Author Malan, D.F. Van der Walt, S.J. Raidou, R.G. Van den Berg, B. Stoel, B.C. Botha, C.P. Nelissen, R.G.H.H. Valstar, E.R. Faculty Electrical Engineering, Mathematics and Computer Science Department Intelligent Systems Date 2015-08-11 Abstract Purpose In orthopaedics, minimally invasive injection of bone cement is an established technique. We present HipRFX, a software tool for planning and guiding a cement injection procedure for stabilizing a loosening hip prosthesis. HipRFX works by analysing a pre-operative CT and intraoperative C-arm fluoroscopic images. Methods HipRFX simulates the intraoperative fluoroscopic views that a surgeon would see on a display panel. Structures are rendered by modelling their X-ray attenuation. These are then compared to actual fluoroscopic images which allow cement volumes to be estimated. Five human cadaver legs were used to validate the software in conjunction with real percutaneous cement injection into artificially created periprothetic lesions. Results Based on intraoperatively obtained fluoroscopic images, our software was able to estimate the cement volume that reached the pre-operatively planned targets. The actual median target lesion volume was 3.58 ml (range 3.17–4.64 ml). The median error in computed cement filling, as a percentage of target volume, was 5.3 % (range 2.2–14.8 %). Cement filling was between 17.6 and 55.4 % (median 51.8 %). Conclusions As a proof of concept, HipRFX was capable of simulating intraoperative fluoroscopic C-arm images. Furthermore, it provided estimates of the fraction of injected cement deposited at its intended target location, as opposed to cement that leaked away. This level of knowledge is usually unavailable to the surgeon viewing a fluoroscopic image and may aid in evaluating the success of a percutaneous cement injection intervention. Subject fluoroscopydigitally reconstructed radiographpre-operative planninghip arthroplastypercutaneousx-raysimulation To reference this document use: http://resolver.tudelft.nl/uuid:63aae690-a048-422d-9aac-3c0607d2d9b6 Publisher Springer ISSN 1861-6410 Source https://doi.org/10.1007/s11548-015-1252-8 Source International Journal of Computer Assisted Radiology and Surgery, 11 (2), 2016 Part of collection Institutional Repository Document type journal article Rights © 2015 The Author(s)This article is published with open access at Springerlink.com Files PDF Malan_2015.pdf 3.97 MB Close viewer /islandora/object/uuid:63aae690-a048-422d-9aac-3c0607d2d9b6/datastream/OBJ/view