Design of Proposed Software System for Prediction of Iliosacral Screw Placement for Iliosacral Joint Injuries Based on X-ray and CT Images

Vojtech Benda; Jan Kubicek; Roman Madeja; David Oczka; Martin Cerny; Kamila Dostalova

doi:10.3390/jcm12062138

Design of Proposed Software System for Prediction of Iliosacral Screw Placement for Iliosacral Joint Injuries Based on X-ray and CT Images

J Clin Med. 2023 Mar 9;12(6):2138. doi: 10.3390/jcm12062138.

Authors

Vojtech Benda¹, Jan Kubicek¹, Roman Madeja², David Oczka¹, Martin Cerny¹, Kamila Dostalova¹

Affiliations

¹ Department of Cybernetics and Biomedical Engineering, VŠB-Technical University of Ostrava, 17. listopadu 2172/15, Poruba, 708 00 Ostrava, Czech Republic.
² Trauma Center, University Hospital Ostrava, 17. listopadu 1790, Poruba, 708 52 Ostrava, Czech Republic.

Abstract

One of the crucial tasks for the planning of surgery of the iliosacral joint is placing an iliosacral screw with the goal of fixing broken parts of the pelvis. Tracking of proper screw trajectory is usually done in the preoperative phase by the acquisition of X-ray images under different angles, which guide the surgeons to perform surgery. This approach is standardly complicated due to the investigation of 2D X-ray images not showing spatial perspective. Therefore, in this pilot study, we propose complex software tools which are aimed at making a simulation model of reconstructed CT (DDR) images with a virtual iliosacral screw to guide the surgery process. This pilot study presents the testing for two clinical cases to reveal the initial performance and usability of this software in clinical conditions. This model is consequently used for a multiregional registration with reference intraoperative X-ray images to select the slide from the 3D dataset which best fits with reference X-ray. The proposed software solution utilizes input CT slices of the pelvis area to create a segmentation model of individual bone components. Consequently, a model of an iliosacral screw is inserted into this model. In the next step, we propose the software CT2DDR which makes DDR projections with the iliosacral screw. In the last step, we propose a multimodal registration procedure, which performs registration of a selected number of slices with reference X-ray, and based on the Structural Similarity Index (SSIM) and index of correlation, the procedure finds the best match of DDR with X-ray images. In this pilot study, we also provide a comparative analysis of the computational costs of the multimodal registration upon various numbers of DDR slices to show the complex software performance. The proposed complex model has versatile usage for modeling and surgery planning of the pelvis area in fractures of iliosacral joints.

Keywords: DDR projection; iliosacral screw; multimodal image registration; multiregional image segmentation; software materialize mimics.

Grants and funding

This paper was supported by project No. CZ.02.1.01/0.0/0.0/17 049/0008441, Innovative Therapeutic Methods of Musculoskeletal System in Accident Surgery within the Operational Programme Research, Development and Education financed by the European Union and by the state budget of the Czech Republic. The work and the contributions were supported by the project SV4502261/SP2022/98 ‘Biomedical Engineering systems XVIII’.