Toward Precise Osteotomies: A Coarse-to-Fine 3D Cut Plane Planning Method for Image-Guided Pelvis Tumor Resection Surgery.

Surgical resection is the main clinical method for the treatment of bone tumors. A critical procedure for bone tumor resection is to plan a set of cut planes that enable resecting the bone tumor with a safe margin while preserving the maximum amount of healthy bone. Currently, the surgeons rely on manual methods to plan the cut planes, which highly depend on the surgeons' experiences and have been demonstrated to be error-prone, and in turn, increase the recurrence rate or resect much healthy bone. This study targets on improving the precision of cut plane planning for the image guided pelvis tumor resection surgeries. A semi-automatic approach to cut plane planning was proposed via a coarse-to-fine strategy. It can efficiently identify a dangerous region in the 3D space, which contains the bone tumor and its surrounding normal tissue with a safe margin. By projecting the dangerous region into an appropriate 2D space, a segmented boundary-constrained linear regression method was leveraged to plan a set of 3D cut planes that ensure the minimum area of the resected specimen in the 2D space while having the dangerous region cleared. Further, a coarse-to-fine 3D cut plane planning method was developed by incorporating a 3D cut plane refinement scheme with our 2D planning method. Extensive experiments, on the surgical data from nine previous pelvis tumor resection surgeries, demonstrated that our proposed approach substantially improved the localization precision of cut planes ( ) and decreased the amount of resected specimen ( ), as compared to the manual method.

Automatic allograft bone selection through band registration and its application to distal femur.

Clinical reports suggest that large bone defects could be effectively restored by allograft bone transplantation, where allograft bone selection acts an important role. Besides, there is a huge demand for developing the automatic allograft bone selection methods, as the automatic methods could greatly improve the management efficiency of the large bone banks. Although several automatic methods have been presented to select the most suitable allograft bone from the massive allograft bone bank, these methods still suffer from inaccuracy. In this paper, we propose an effective allograft bone selection method without using the contralateral bones. Firstly, the allograft bone is globally aligned to the recipient bone by surface registration. Then, the global alignment is further refined through band registration. The band, defined as the recipient points within the lifted and lowered cutting planes, could involve more local structure of the defected segment. Therefore, our method could achieve robust alignment and high registration accuracy of the allograft and recipient. Moreover, the existing contour method and surface method could be unified into one framework under our method by adjusting the lift and lower distances of the cutting planes. Finally, our method has been validated on the database of distal femurs. The experimental results indicate that our method outperforms the surface method and contour method.