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Niu K, Sluiter V, Lan B, Homminga J, Sprengers A, Verdonschot N. A Method to Track 3D Knee Kinematics by Multi-Channel 3D-Tracked A-Mode Ultrasound. SENSORS (BASEL, SWITZERLAND) 2024; 24:2439. [PMID: 38676056 PMCID: PMC11053743 DOI: 10.3390/s24082439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
This paper introduces a method for measuring 3D tibiofemoral kinematics using a multi-channel A-mode ultrasound system under dynamic conditions. The proposed system consists of a multi-channel A-mode ultrasound system integrated with a conventional motion capture system (i.e., optical tracking system). This approach allows for the non-invasive and non-radiative quantification of the tibiofemoral joint's six degrees of freedom (DOF). We demonstrated the feasibility and accuracy of this method in the cadaveric experiment. The knee joint's motions were mimicked by manually manipulating the leg through multiple motion cycles from flexion to extension. To measure it, six custom ultrasound holders, equipped with a total of 30 A-mode ultrasound transducers and 18 optical markers, were mounted on various anatomical regions of the lower extremity of the specimen. During experiments, 3D-tracked intra-cortical bone pins were inserted into the femur and tibia to measure the ground truth of tibiofemoral kinematics. The results were compared with the tibiofemoral kinematics derived from the proposed ultrasound system. The results showed an average rotational error of 1.51 ± 1.13° and a translational error of 3.14 ± 1.72 mm for the ultrasound-derived kinematics, compared to the ground truth. In conclusion, this multi-channel A-mode ultrasound system demonstrated a great potential of effectively measuring tibiofemoral kinematics during dynamic motions. Its improved accuracy, nature of non-invasiveness, and lack of radiation exposure make this method a promising alternative to incorporate into gait analysis and prosthetic kinematic measurements later.
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Affiliation(s)
- Kenan Niu
- Robotics and Mechatronics Group, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands;
| | - Victor Sluiter
- Department of Biomechanical Engineering, University of Twente, 7521 HK Enschede, The Netherlands (J.H.)
| | - Bangyu Lan
- Robotics and Mechatronics Group, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands;
| | - Jasper Homminga
- Department of Biomechanical Engineering, University of Twente, 7521 HK Enschede, The Netherlands (J.H.)
| | - André Sprengers
- Orthopaedic Research Lab, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Nico Verdonschot
- Department of Biomechanical Engineering, University of Twente, 7521 HK Enschede, The Netherlands (J.H.)
- Orthopaedic Research Lab, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Theodorakos I, Andersen MS. Improving ultrasound-based bone registration using the iterative closest point algorithm paired with a complex optimization solver. Med Eng Phys 2024; 126:104153. [PMID: 38621850 DOI: 10.1016/j.medengphy.2024.104153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 01/23/2024] [Accepted: 03/16/2024] [Indexed: 04/17/2024]
Abstract
The Iterative Close Point (ICP) algorithm is used for bone registrations based on ultrasound measurements. However, the ICP has been shown to suffer from local minima. The Complex optimization, as a more robust routine compared to the commonly used gradient-based algorithms, could be an alternative for solving the ICP problem. In this study, we investigated the effect of the initial estimate and the number of registration points on bone registrations achieved using the ICP and a Complex optimization routine and we compared it against using Quadratic Sequential Programming (SQP). Ultrasound measurements were performed with an A-mode probe on a bovine humerus and an ovine femur embedded into ballistic gel. Simultaneously, the bones and the probe were tracked in 3D space using retroreflective markers. Kinematic, ultrasound and geometrical data obtained from scans of the specimens and the probe served as input to a bone registrations routine. Registrations were performed using two ICP solvers for different initial estimates and number of registration points. On average, 68 % of the Complex optimization registrations had less than 1 mm translation error and less than 1° rotational error for perturbations of the initial estimate from the reference measurements compared to the 35 % of the SQP ones. Similar medians of registration errors were observed between the two methods for variations of the number of the employed registration points. Although the Complex optimization provided accurate bone registrations for all cases, the objective function could not always determine the registrations with the smallest registration error. Future research should explore methodologies to overcome this challenge.
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Affiliation(s)
- Ilias Theodorakos
- Department of Materials and Production, Aalborg University, Aalborg, Denmark.
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Gueziri HE, Santaguida C, Collins DL. The state-of-the-art in ultrasound-guided spine interventions. Med Image Anal 2020; 65:101769. [PMID: 32668375 DOI: 10.1016/j.media.2020.101769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 02/07/2023]
Abstract
During the last two decades, intra-operative ultrasound (iUS) imaging has been employed for various surgical procedures of the spine, including spinal fusion and needle injections. Accurate and efficient registration of pre-operative computed tomography or magnetic resonance images with iUS images are key elements in the success of iUS-based spine navigation. While widely investigated in research, iUS-based spine navigation has not yet been established in the clinic. This is due to several factors including the lack of a standard methodology for the assessment of accuracy, robustness, reliability, and usability of the registration method. To address these issues, we present a systematic review of the state-of-the-art techniques for iUS-guided registration in spinal image-guided surgery (IGS). The review follows a new taxonomy based on the four steps involved in the surgical workflow that include pre-processing, registration initialization, estimation of the required patient to image transformation, and a visualization process. We provide a detailed analysis of the measurements in terms of accuracy, robustness, reliability, and usability that need to be met during the evaluation of a spinal IGS framework. Although this review is focused on spinal navigation, we expect similar evaluation criteria to be relevant for other IGS applications.
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Affiliation(s)
- Houssem-Eddine Gueziri
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, Montreal (QC), Canada; McGill University, Montreal (QC), Canada.
| | - Carlo Santaguida
- Department of Neurology and Neurosurgery, McGill University Health Center, Montreal (QC), Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, Montreal (QC), Canada; McGill University, Montreal (QC), Canada
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Huang Q, Yao J, Li J, Li M, Pickering MR, Li X. Measurement of Quasi-Static 3-D Knee Joint Movement Based on the Registration From CT to US. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2020; 67:1141-1150. [PMID: 31944953 DOI: 10.1109/tuffc.2020.2965149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The measurement of quasi-static 3-D knee joint movement is an important basis for studying the mechanism of knee joint injury. Most of the existing measurement methods make use of computed tomography (CT) and nuclear magnetic resonance (MR) imaging technology and hence have the disadvantages of invasiveness, ionizing radiation, low accuracy, and high cost. To overcome those drawbacks, this article innovatively proposes a 3-D motion measurement system for the knee joint based on the registration of CT images to ultrasound (US) images. More specifically, the lower limbs of a subject were first scanned once to acquire the CT images. A portable handheld device was designed to control a US probe for mechanically scanning the subject's lower limbs in a linear trajectory. During the movement of the subject's lower limbs, the US scanning was performed quasi-statically. The acquired US images were then registered to the CT images, and the 3-D motions of the lower limb bones could be recreated with the bones scanned in CT images. To guarantee the registration accuracy and efficiency, we used the H-shaped multiview slice assembly as the structural image content for the registration process. The experimental results show that our approach can accurately measure the 3-D motion of the knee joint and meet the needs of 3-D motion analysis of knee joint in practice.
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Recent Trends, Technical Concepts and Components of Computer-Assisted Orthopedic Surgery Systems: A Comprehensive Review. SENSORS 2019; 19:s19235199. [PMID: 31783631 PMCID: PMC6929084 DOI: 10.3390/s19235199] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
Computer-assisted orthopedic surgery (CAOS) systems have become one of the most important and challenging types of system in clinical orthopedics, as they enable precise treatment of musculoskeletal diseases, employing modern clinical navigation systems and surgical tools. This paper brings a comprehensive review of recent trends and possibilities of CAOS systems. There are three types of the surgical planning systems, including: systems based on the volumetric images (computer tomography (CT), magnetic resonance imaging (MRI) or ultrasound images), further systems utilize either 2D or 3D fluoroscopic images, and the last one utilizes the kinetic information about the joints and morphological information about the target bones. This complex review is focused on three fundamental aspects of CAOS systems: their essential components, types of CAOS systems, and mechanical tools used in CAOS systems. In this review, we also outline the possibilities for using ultrasound computer-assisted orthopedic surgery (UCAOS) systems as an alternative to conventionally used CAOS systems.
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Niu K, Homminga J, Sluiter VI, Sprengers A, Verdonschot N. Feasibility of A-mode ultrasound based intraoperative registration in computer-aided orthopedic surgery: A simulation and experimental study. PLoS One 2018; 13:e0199136. [PMID: 29897987 PMCID: PMC5999105 DOI: 10.1371/journal.pone.0199136] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/01/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE A fast and accurate intraoperative registration method is important for Computer-Aided Orthopedic Surgery (CAOS). A-mode ultrasound (US) is able to acquire bone surface data in a non-invasive manner. To utilize A-mode US in CAOS, a suitable registration algorithm is necessary with a small number of registration points and the presence of measurement errors. Therefore, we investigated the effects of (1) the number of registration points and (2) the Ultrasound Point Localization Error (UPLE) on the overall registration accuracy. METHODS We proposed a new registration method (ICP-PS), including the Iterative Closest Points (ICP) algorithm and a Perturbation Search algorithm. This method enables to avoid getting stuck in the local minimum of ICP iterations and to find the adjacent global minimum. This registration method was subsequently validated in a numerical simulation and a cadaveric experiment using a 3D-tracked A-mode US system. RESULTS The results showed that ICP-PS outperformed the standard ICP algorithm. The registration accuracy improved with the addition of ultrasound registration points. In the numerical simulation, for 25 sample points with zero UPLE, the averaged registration error of ICP-PS reached 0.25 mm, while 1.71 mm for ICP, decreasing by 85.38%. In the cadaver experiment, using 25 registration points, ICP-PS achieved an RMSE of 2.81 mm relative to 5.84 mm for the ICP, decreasing by 51.88%. CONCLUSIONS The simulation approach provided a well-defined framework for estimating the necessary number of ultrasound registration points and acceptable level of UPLE for a given required level of accuracy for intraoperative registration in CAOS. ICP-PS method is suitable for A-mode US based intraoperative registration. This study would facilitate the application of A-mode US probe in registering the point cloud to a known shape model, which also has the potential for accurately estimating bone position and orientation for skeletal motion tracking and surgical navigation.
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Affiliation(s)
- Kenan Niu
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Enschede, the Netherlands
- * E-mail:
| | - Jasper Homminga
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - Victor I. Sluiter
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - André Sprengers
- Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nico Verdonschot
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Enschede, the Netherlands
- Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, the Netherlands
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Niu K, Homminga J, Sluiter V, Sprengers A, Verdonschot N. Measuring relative positions and orientations of the tibia with respect to the femur using one-channel 3D-tracked A-mode ultrasound tracking system: A cadaveric study. Med Eng Phys 2018; 57:61-68. [PMID: 29759948 DOI: 10.1016/j.medengphy.2018.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 04/11/2018] [Accepted: 04/30/2018] [Indexed: 11/18/2022]
Abstract
The purpose of this study is to investigate the technical feasibility of measuring relative positions and orientations of the tibia with respect to the femur in an in-vitro experiment by using a 3D-tracked A-mode ultrasound system and to determine its accuracy of angular and translational measurements. As A-mode ultrasound is capable of detecting bone surface through soft tissue in a non-invasive manner, the combination of a single A-mode ultrasound transducer with an optical motion tracking system provides the possibility for digitizing the 3D locations of bony points at different anatomical regions on the thigh and the shank. After measuring bony points over a large area of both the femur and tibia, the bone models of the femur and tibia that were segmented from CT or MRI images were registered to the corresponding bony points. Then the relative position of the tibia with respect to the femur could be obtained and the angular and translational components could also be measured. A cadaveric experiment was conducted to assess its accuracy compared to the reference measurement obtained by optical markers fixed to intra-cortical bone pins placed in the femur and tibia. The results showed that the ultrasound system could achieve 0.49 ± 0.83°, 0.85 ± 1.86° and 1.85 ± 2.78° (mean ± standard deviation) errors for Flexion-Extension, Adduction-Abduction and External-Internal rotations, respectively, and -2.22 ± 3.62 mm, -2.80 ± 2.35 mm and -1.44 ± 2.90 mm errors for Anterior-Posterior, Proximal-Distal and Lateral-Medial translations, respectively. It was concluded that this technique is feasible and facilitates the integration of arrays of A-mode ultrasound transducers with an optical motion tracking system for non-invasive dynamic tibiofemoral kinematics measurement.
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Affiliation(s)
- Kenan Niu
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands.
| | - Jasper Homminga
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - Victor Sluiter
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands
| | - André Sprengers
- Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nico Verdonschot
- Laboratory of Biomechanical Engineering, Faculty of Engineering Technology, MIRA Institute, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; Orthopaedic Research Lab, Radboud University Medical Center, Nijmegen, The Netherlands
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Chong SY, Röhrle O. Exploring the Use of Non-Image-Based Ultrasound to Detect the Position of the Residual Femur within a Stump. PLoS One 2016; 11:e0164583. [PMID: 27764120 PMCID: PMC5072695 DOI: 10.1371/journal.pone.0164583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 09/27/2016] [Indexed: 11/19/2022] Open
Abstract
A satisfactorily fitted socket interacts dynamically with the stump in order to support body weight, transmit load effectively, enhance dynamic stability, and enable the control and stabilization of the residual limb. The internal dynamics occurring within a socket is important in determining optimal fit. Many measurement and imaging techniques, such as X-rays, have been utilized to investigate the movement of the residual femur within the stump during gait. However, due to associated health risks and costs, none of the current techniques have been extended to clinical prosthetics. The use of B-mode ultrasound has been suggested as a safe and cheap alternative, and has been utilized in previous studies to monitor the motion of the femur. However, the need to create a duplicate socket and time-consuming analysis of the images were obstacles to the system being applied clinically. This study aims to gauge the effectiveness of a non-image based ultrasound system. Here, we determined errors expected from the measurements. Accuracy errors of 2.9 mm to 8.4 mm and reproducibility measurements within a standard deviation of 3.9 mm are reported. We also estimated errors up to 14.4 mm in in-vivo measurements. We think there is potential in developing this technique, and we hope to reduce some technical difficulties such that it can, one day, be easily incorporated into prosthetic fitting.
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Affiliation(s)
- Sook-Yee Chong
- Institute of Applied Mechanics, University of Stuttgart, Stuttgart, Germany
| | - Oliver Röhrle
- Institute of Applied Mechanics, University of Stuttgart, Stuttgart, Germany
- Biomechatronics System, Fraunhofer IPA, Stuttgart, Germany
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State of the Art of Ultrasound-Based Registration in Computer Assisted Orthopedic Interventions. COMPUTATIONAL RADIOLOGY FOR ORTHOPAEDIC INTERVENTIONS 2016. [DOI: 10.1007/978-3-319-23482-3_14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Masum MA, Pickering M, Lambert A, Scarvell J, Smith P. Accuracy assessment of Tri-plane B-mode ultrasound for non-invasive 3D kinematic analysis of knee joints. Biomed Eng Online 2014; 13:122. [PMID: 25159051 PMCID: PMC4162952 DOI: 10.1186/1475-925x-13-122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 08/01/2014] [Indexed: 11/17/2022] Open
Abstract
Background Currently the clinical standard for measuring the motion of the bones in knee joints with sufficient precision involves implanting tantalum beads into the bones. These beads appear as high intensity features in radiographs and can be used for precise kinematic measurements. This procedure imposes a strong coupling between accuracy and invasiveness. In this paper, a tri-plane B-mode ultrasound (US) based non-invasive approach is proposed for use in kinematic analysis of knee joints in 3D space. Methods The 3D analysis is performed using image processing procedures on the 2D US slices. The novelty of the proposed procedure and its applicability to the unconstrained 3D kinematic analysis of knee joints is outlined. An error analysis for establishing the method’s feasibility is included for different artificial compositions of a knee joint phantom. Some in-vivo and in-vitro scans are presented to demonstrate that US scans reveal enough anatomical details, which further supports the experimental setup used using knee bone phantoms. Results The error between the displacements measured by the registration of the US image slices and the true displacements of the respective slices measured using the precision mechanical stages on the experimental apparatus is evaluated for translation and rotation in two simulated environments. The mean and standard deviation of errors are shown in tabular form. This method provides an average measurement precision of less than 0.1 mm and 0.1 degrees, respectively. Conclusion In this paper, we have presented a novel non-invasive approach to measuring the motion of the bones in a knee using tri-plane B-mode ultrasound and image registration. In our study, the image registration method determines the position of bony landmarks relative to a B-mode ultrasound sensor array with sub-pixel accuracy. The advantages of our proposed system over previous techniques are that it is non-invasive, does not require the use of ionizing radiation and can be used conveniently if miniaturized.
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Affiliation(s)
- Md Abdullah Masum
- School of Engineering & IT, UNSW Canberra, Northcott Drive, Campbell, Canberra, Australia.
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Statistical model based shape prediction from a combination of direct observations and various surrogates: Application to orthopaedic research. Med Image Anal 2012; 16:1156-66. [DOI: 10.1016/j.media.2012.04.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 04/18/2012] [Accepted: 04/19/2012] [Indexed: 11/20/2022]
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Ultrasound-CT registration of vertebrae without reconstruction. Int J Comput Assist Radiol Surg 2012; 7:901-9. [DOI: 10.1007/s11548-012-0771-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 05/31/2012] [Indexed: 10/28/2022]
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Yan CXB, Goulet B, Chen SJS, Tampieri D, Collins DL. Validation of automated ultrasound-CT registration of vertebrae. Int J Comput Assist Radiol Surg 2011; 7:601-10. [DOI: 10.1007/s11548-011-0666-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 11/08/2011] [Indexed: 10/15/2022]
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Towards accurate, robust and practical ultrasound-CT registration of vertebrae for image-guided spine surgery. Int J Comput Assist Radiol Surg 2010; 6:523-37. [DOI: 10.1007/s11548-010-0536-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Accepted: 10/11/2010] [Indexed: 10/18/2022]
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