DOI QR코드

DOI QR Code

AI-based Automatic Spine CT Image Segmentation and Haptic Rendering for Spinal Needle Insertion Simulator

척추 바늘 삽입술 시뮬레이터 개발을 위한 인공지능 기반 척추 CT 이미지 자동분할 및 햅틱 렌더링

  • Received : 2020.08.31
  • Accepted : 2020.11.10
  • Published : 2020.11.30

Abstract

Endoscopic spine surgery is an advanced surgical technique for spinal surgery since it minimizes skin incision, muscle damage, and blood loss compared to open surgery. It requires, however, accurate positioning of an endoscope to avoid spinal nerves and to locate the endoscope near the target disk. Before the insertion of the endoscope, a guide needle is inserted to guide it. Also, the result of the surgery highly depends on the surgeons' experience and the patients' CT or MRI images. Thus, for the training, a number of haptic simulators for spinal needle insertion have been developed. But, still, it is difficult to be used in the medical field practically because previous studies require manual segmentation of vertebrae from CT images, and interaction force between the needle and soft tissue has not been considered carefully. This paper proposes AI-based automatic vertebrae CT-image segmentation and haptic rendering method using the proposed need-tissue interaction model. For the segmentation, U-net structure was implemented and the accuracy was 93% in pixel and 88% in IoU. The needle-tissue interaction model including puncture force and friction force was implemented for haptic rendering in the proposed spinal needle insertion simulator.

Keywords

References

  1. K. H. Fuchs, "Minimally invasive surgery," Endoscopy, vol. 34, no. 2, pp. 154-159, 2002, DOI: 10.1055/s-2002-19857.
  2. G. Choi, C. S. Pophale, B. Patel, and P. Uniyal, "Endoscopic spine surgery," Journal of Korean Neurosurgical Society, vol. 60, no. 5, pp. 485-497, 2017, DOI: 10.3340/jkns.2017.0203.004.
  3. R. Assaker, R. Nicolas, P. Bruno, and P. L. Jean, "Image-guided endoscopic spine surgery: Part II: clinical applications," Spine, vol. 26, no. 15, pp. 1711-1718, 2001, [Online], https://journals.lww.com/spinejournal/Abstract/2001/08010/Image_Guided_Endoscopic_Spine_Surgery__Part_II_.16.aspx. https://doi.org/10.1097/00007632-200108010-00016
  4. A. F. Cristante, F. Barbieri, A. A. Rodrigues da Silva, and J. C. Dellamano, "Radiation exposure during spine surgery using C-ARM fluoroscopy," Acta ortopedica brasileira, vol. 27, no. 1, pp. 46-49, 2019, DOI: 10.1590/1413-785220192701172722.
  5. K. Lee, K. M. Lee, M. S. Park, B. Lee, D. G. Kwon, and C. Y. Chung, "Measurements of surgeons' exposure to ionizing radiation dose during intraoperative use of C-arm fluoroscopy," Spine, vol. 37, no. 14, pp. 1240-1244, 2012, DOI: 10.1097/BRS.0b013e31824589d5.
  6. E. Archavlis, E. Schwandt, M. Kosterhon, A. Gutenberg, P. Ulrich, A. Nimer, A. Giese, and S. R. Kantelhardt, "A modified microsurgical endoscopic-assisted transpedicular corpectomy of the thoracic spine based on virtual 3-dimensional planning," World neurosurgery, vol. 91, pp. 424-433, 2016, DOI: 10.1016/j.wneu.2016.04.043.
  7. Z. Hu, X. Li, J. Cui, X. He, C. Li, Y. Han, J. Pan, M. Yang, J. Tan, and L. Li, "Significance of preoperative planning software for puncture and channel establishment in percutaneous endoscopic lumbar DISCECTOMY: a study of 40 cases," International Journal of Surgery, vol. 41, pp. 97-103, 2017, DOI: 10.1016/j.ijsu.2017.03.059.
  8. H. Yu, Z. Zhou, X. Lei, H. Liu, G. Fan, and S. He, "Mixed Reality-Based Preoperative Planning for Training of Percutaneous Transforaminal Endoscopic Discectomy: A Feasibility Study," World neurosurgery, vol. 129, pp. 767-775, 2019, DOI: 10.1016/j.wneu.2019.06.020.
  9. P. Wei, Q. Yao, Y. Xu, H. Zhang, Y. Gu, and L. Wang, "Percutaneous kyphoplasty assisted with/without mixed reality technology in treatment of OVCF with IVC: a prospective study," Journal of orthopaedic surgery and research, vol. 14, no. 1, 2019, DOI: 10.1186/s13018-019-1303-x.
  10. P. Wucherer, P. Stefan, K. Abhari, P. Fallavollita, M. Weigl, M. Lazarovici, A. Winkler, S. Weidert, T. Peters, S. de Ribaupierre, R. Eagleson, and N. Navab, "Vertebroplasty performance on simulator for 19 surgeons using hierarchical task analysis," IEEE Transactions on Medical Imaging, vol. 34, no. 8, pp. 1730-1737, 2015, DOI: 10.1109/TMI.2015.2389033.
  11. J. B. Ra, S. M. Kwon, J. K. Kim, J. Yi, K. H. Kim, H. W. Park, K.-U. Kyung, D.-S. Kwon, H. S. Kang, L. Jiang, K. R. Cleary, J. Zeng, and S. K. Min, "Visually guided spine biopsy simulator with force feedback," Medical Imaging 2001, San Diego, United States, pp. 36-45, 2001, DOI: 10.1117/12.428072.
  12. M. Vania, D. Mureja, and D. Lee, "Automatic spine segmentation from CT images using convolutional neural network via redundant generation of class labels," Journal of Computational Design and Engineering, vol. 6, no. 2, pp. 224-232, 2019, DOI: 10.1016/j.jcde.2018.05.002.
  13. N. Lessmann, B. van Ginneken, P. A. de Jong, and I. Isgum, "Iterative fully convolutional neural networks for automatic vertebra segmentation and identification," Medical Image Analysis, vol. 53, pp. 142-155, 2019, DOI: 10.1016/j.media.2019.02.005.
  14. O. Ronneberger, P. Fischer, and T. Brox, "U-net: Convolutional networks for biomedical image segmentation," International Conference on Medical Image Computing and Computer-Assisted Intervention, pp. 234-241, 2015, DOI: 10.1007/978-3-319-24574-4_28.
  15. A. M. Okamura, C. Simone, and Mark D. O'leary, "Force modeling for needle insertion into soft tissue," IEEE Transactions on Biomedical Engineering, vol. 51, no. 10, pp. 1707-1716, 2004, DOI: 10.1109/TBME.2004.831542.
  16. J. Yao, J. E. Burns, H. Munoz, and R. M. Summers, "Detection of Vertebral Body Fractures Based on Cortical Shell Unwrapping," International Conference on Medical Image Computing and Computer Assisted Intervention, vol. 7512, pp. 509-516, 2012, DOI: 10.1007/978-3-642-33454-2_63.
  17. A. Sekuboyina, A. Bayat, M. E. Husseini, M. Loffler, M. Rempfler, J. Kukacka, G. Tetteh et al., "VerSe: A Vertebrae Labelling and Segmentation Benchmark," arXiv:2001.09193 [cs.CV], 2020, [Online], https://arxiv.org/abs/2001.09193v2.
  18. C. Payer, D. Stern, H. Bischof, and M. Urschler, "Coarse to Fine Vertebrae Localization and Segmentation with Spatial-Configuration-Net and U-Net," 15th International Joint Conference on Computer Vision, Imaging and Computer Graphics Theory and Applications - Volume 5: VISAPP, pp. 124-133, 2020, DOI: 10.5220/0008975201240133.