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Copyright © Gabor Fichtinger, 2008 Laboratory for Percutaneous Surgery – The Perk Lab Fluoroscopy and CT Fluoroscopy and CT Imaging Imaging

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  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Fluoroscopy and CTFluoroscopy and CTImagingImaging

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    3D coordinate space3D coordinate space

    Source-1 Source-2

    X-ray film-1

    X-ray coordsystem

    Film-1 coordsystem

    Film-2 coordsystem

    X-ray film-2

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Edison in his fluoroscope, 1896Edison in his fluoroscope, 1896

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    The first commercial fluoroscopeThe first commercial fluoroscope

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    XX--ray + Television = Fluoroscopyray + Television = Fluoroscopy

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    XX--ray image intensifier tuberay image intensifier tube

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Siemens

    C-arm fluoroscopy

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Fluoroscopy images

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Biplane fluoroscopy

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    • Mobile• Real-time• Inexpensive• Good bone contrast• Broad insurance coverage

    • Poor soft tissue contrast• Limited rotation• Limited field of view (9-15”)• Often non-isocentric• Object truncation• High X-ray dose to all parties• Need for calibration• Poor/no joint encoding• Image warping• Loss of depth & volume

    Siemens

    Pros and Cons for C-arm in Surgery

    LL

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Calibration = determine unknown constant Calibration = determine unknown constant parametersparameters

    target

    SADSDD

    Beam central

    Field of View (FOV)

    Detector plane

    X-ray source

    image

    Pixel size

    x

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Typical calibration: Typical calibration: shoot images from various shoot images from various angles of a known object and calculate unknown Cangles of a known object and calculate unknown C--arm arm

    parametersparameters

    The calibration fixture:• A priori known• Precisely machined• Asymmetric• Easy to pick feature points

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Image warpingImage warping

    Courtesy of Yao & Taylor

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Dewarping stepDewarping step--1: Find groove points1: Find groove points

    •Find image points corresponding to the centerline of each vertical and horizontal groove

    Courtesy of Yao & Taylor

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Dewarping stepDewarping step--2 : Fit 52 : Fit 5’’th order th order Bernstein Polynomial CurvesBernstein Polynomial Curves

    •Fit a least square smooth curve to each vertical and horizontal groove

    •5’th order Bernstein Polynomial

    ( ) ( )∑=

    −−⎟⎟⎠

    ⎞⎜⎜⎝

    ⎛=

    5

    0

    550 1

    5;,,

    k

    kkk vvk

    avaaB K

    Courtesy of Yao & Taylor

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Dewarping stepDewarping step--3 : Unbend the plate3 : Unbend the plate’’s s imageimage

    • Unbend the Bersteinpolynomial to straight lines

    • Employ a two pass scan line algorithm to dewarp the image with using bilinear interpolation

    Courtesy of Yao & Taylor

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Full sweep cone beamFull sweep cone beam

    • May give perfect volume• Lots of shots• Lots of dose to patient• Ever faster on computer• Possible in realtime

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Cone beam CT reconstruction examplesCone beam CT reconstruction examples

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Concept of Computed Tomography (CT)Concept of Computed Tomography (CT)

    Type1

    Type2

    Planar fan beam

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Beam configurationsBeam configurations

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Spiral CTSpiral CT

    Spiral path with 4,8,16,32,64, 128, 256 rows

    Scan Examples: Scan Examples: http://www.radiology.uiowa.edu/3d/http://www.radiology.uiowa.edu/3d/

    SINGLE SLICE SPIRAL MULTISLICE SPIRAL

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    CT scannersCT scanners

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Examples to CT imagingExamples to CT imaging

  • Copyright © Gabor Fichtinger, 2008Laboratory for Percutaneous Surgery – The Perk Lab

    Measuring in CT imageMeasuring in CT image

    Slice thickness

    543210

    Slice index

    Field of v

    iew X

    pixe

    l Y

    pixel X

    Field of view X