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Vertebrae segmentation in reduced radiation CT imaging for augmented reality applications.

Authors :
Schonfeld E
de Lotbiniere-Bassett M
Jansen T
Anthony D
Veeravagu A
Source :
International journal of computer assisted radiology and surgery [Int J Comput Assist Radiol Surg] 2022 Apr; Vol. 17 (4), pp. 775-783. Date of Electronic Publication: 2022 Jan 13.
Publication Year :
2022

Abstract

Purpose: There is growing evidence for the use of augmented reality (AR) navigation in spinal surgery to increase surgical accuracy and improve clinical outcomes. Recent research has employed AR techniques to create accurate auto-segmentations, the basis of patient registration, using reduced radiation dose intraoperative computed tomography images. In this study, we aimed to determine if spinal surgery AR applications can employ reduced radiation dose preoperative computed tomography (pCT) images.<br />Methods: We methodically decreased the imaging dose, with the addition of Gaussian noise, that was introduced into pCT images to determine the image quality threshold that was required for auto-segmentation. The Gaussian distribution's standard deviation determined noise level, such that a scalar multiplier (L: [0.00, 0.45], with steps of 0.03) simulated lower doses as L increased. We then enhanced the images with denoising algorithms to evaluate the effect on the segmentation.<br />Results: The pCT radiation dose was decreased to below the current lowest clinical threshold and the resulting images produced segmentations that were appropriate for input into AR applications. This held true at simulated dose Lā€‰=ā€‰0.06 (estimated 144 mAs) but not at Lā€‰=ā€‰0.09 (estimated 136 mAs). The application of denoising algorithms to the images resulted in increased artifacts and decreased bone density.<br />Conclusions: The pCT image quality that is required for AR auto-segmentation is lower than that which is currently employed in spinal surgery. We recommend a reduced radiation dose protocol of approximately 140 mAs. This has the potential to reduce the radiation experienced by patients in comparison to procedures without AR support. Future research is required to identify the specific, clinically relevant radiation dose thresholds required for surgical navigation.<br /> (© 2022. CARS.)

Details

Language :
English
ISSN :
1861-6429
Volume :
17
Issue :
4
Database :
MEDLINE
Journal :
International journal of computer assisted radiology and surgery
Publication Type :
Academic Journal
Accession number :
35025073
Full Text :
https://doi.org/10.1007/s11548-022-02561-y