1. An Automated Method for Geometric Reconstruction of Vertebrae from Clinical CT Scans Yifei Dai 10/19/2006

2. Introduction Finite element models of biomechanics of spinal fusion – Stress shielding in stabilization Goel et al 1988 – Effect of bone graft characteristics Zander et al 2002 – Stress investigation of fusion systems Adam et al 2003 Generic model used to provide insight into global trends Cross-sectional experimental studies are used to investigate surgical techniques and devices Boden et al 1995, Erulkar et al 2001, Sandhu et al 1996, Hojo et al 2005 Models could provide means to perform longitudinal studies – In vivo µ-CT or clinical CT scanners can provide data – Use subject-specific meshes to simulate behavior

3. Mesh generation CT is the most common source for generation of finite element meshes – Must be converted to geometric format compatible with analysis software Voxel based meshes – Neglect or approximate apophyseal joints Weinans et al 2000, Crawford et al 2003 2004, Adam et al 2003 – Large number of elements are required to ensure accuracy Crawford et al 2003 Geometric generation techniques – Border tracing Testi et al 2001 – Marching cubes Viceconti et al 1998, 1999

4. Objectives Fast and accurate mesh generation is needed for application to clinical evaluation or longitudinal studies Objective: develop a semi-automated technique to obtain geometric models of lumbar vertebrae from clinical CT scans – Develop an iterative curve fitting technique – Construct least-squares B-spline contours of one vertebra from clinical CT scans – Develop an atlas based semi-automated geometry reconstruction technique – Apply technique to reconstruct a different vertebra

5. Methods CT scan data of vertebra Image-processing: – Smoothing with 5×5 median filter – Edge detection Canny 1986 – Remove spurious edges

6. Least-squares B-spline fitting Parametric coordinates from closest projection to initial curve Edge ordering B-spline fitting results in smooth curve Convergence based on movement of control points Implemented in Matlab on1.4 GHZ AMD Opteron workstation

7. Iterative fitting Iteration 1 Iteration 2Iteration 3 Edge ordering – Sort points in parametric coordinates – Points that are out of order in Euclidean space are excluded from fit Estimate of parametric coordinates improves with iteration

8. Definition of initial atlas curves Defined from CT scan of an L2 vertebra – Initial approximating curves defined manually – 5 curves representing different geometric features from vertebra – 3 simple geometric shapes

9. Atlas based fitting Interactively choose initial curve with appropriate geometric features Reorient initial curve to edge points using the axes of the 2-D inertia tensor Scale based on a minimax bounding box Applied to CT images of an L3 vertebra from a different subject

10. Results Atlas definition

11. Maximum of six iterations were required Maximum of 10 min user time were needed for one slice Atlas based fitting

12. Discussion A semi-automated method was developed to construct geometric models from clinical CT scans – The technique could be further automated to select appropriate initial approximating curves from atlas using artificial intelligence Robust to missing data – Missing edges are interpolated

13. Discussion Automatically and objectively smooth noisy or pixilated edge data – Fidelity to original data determined by number of B-spline points

14. Smoothness of fit Curvature fluctuation determine by number of control points

15. Discussion Stacked contours can provide geometric input for generation of finite element models Meshes of atlas shapes in parametric space could be distorted to automatically generate meshes Can be applied to a variety of orthopaedic structures by construction of a corresponding atlas

16. Dr. Glen L. Niebur Memorial Lighthouse Medical Imaging Center, Mishawaka, IN Center for Disease Control CE000789 Acknowledgements