J Shanghai Jiaotong Univ Sci

Journal of Shanghai Jiaotong University(Science) >

2021 , Vol. 26 >Issue 3: 306 - 311

DOI: https://doi.org/10.1007/s12204-021-2297-1

Medical 3D Printing and Personalised Medicine

Image Registration Technique for Assessing the Accuracy of  Intraoperative Osteotomy for Pelvic Tumors by 3D-Printed Patient-Specific Templates

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  • (a. Department of Radiology; b. Shanghai Key Laboratory of Orthopaedic Implants; Department of Orthopaedics,
    Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China)

Online published: 2021-06-02

Supported by

the Technology Project of Shanghai Science
and Technology Commission (Nos. 19441902700
and 18441903100), the Clinical Research Plan of SHDC
(No. SHDC2020CR3083B), and the Shanghai Municipal
Education Commission (No. 20152221)

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Abstract

The study aimed to explore the feasibility of an image registration technique for assessing the accuracy  of intraoperative osteotomy of pelvic tumors by 3-dimensional (3D)-printed patient-specific templates. Patients  with malignant pelvic tumors who were admitted to our hospital between March 2014 and December 2020 were  retrospectively enrolled. Patients underwent hemi-pelvic resection and reconstruction by 3D-printed individualized  prostheses. The registration between the designed model and the postoperative segmented model of the prosthesis  was used to obtain the intraoperative osteotomy plane and reduce metal artifacts in postoperative computed  tomography (CT) images. The distance and angle between the planned and actual osteotomy planes were then  used to assess the accuracy of the intraoperative osteotomy. Eight patients with 13 osteotomy planes were  enrolled, including four males and four females. The median age at the time of imaging examination was 44 years  (range, 33—54 years). All intraoperative osteotomy planes were assessed successfully. The mean distance between  the planned and true intraoperative osteotomy planes was ?0.69 cm (?7.5—7.35 cm), and the mean angle was  6.57?±3.36?(1.05?—11.88?). This new assessment method of registering the designed model and the postoperative  CT segmented model of the prosthesis may be used to assess the accuracy of intraoperative osteotomy for pelvic  tumors, using 3D printed patient-specific templates.

Cite this article

QU Yang (曲扬), YAN Mengning (严孟宁), LI Xiaomin (李小敏), WU Bing (吴兵), LIU Siyu (柳思宇), WANG Liao (王燎), WU Wen(武文), AI Songtao(艾松涛) . Image Registration Technique for Assessing the Accuracy of  Intraoperative Osteotomy for Pelvic Tumors by 3D-Printed Patient-Specific Templates[J]. Journal of Shanghai Jiaotong University(Science), 2021 , 26(3) : 306 -311 . DOI: 10.1007/s12204-021-2297-1

References

[1] LEWIS V O. What’s new in musculoskeletal oncology [J]. The Journal of Bone and Joint Surgery -American Volume, 2009, 91(6): 1546-1556.

[2] PRING M E, WEBER K L, UNNI K K, et al. Chondrosarcoma of the pelvis. A review of sixty-four cases [J]. The Journal of Bone and Joint Surgery American Volume, 2001, 83(11): 1630-1642.

[3] CARTIAUX O, PAUL L, DOCQUIER P L, et al. Computer-assisted and robot-assisted technologies to improve bone-cutting accuracy when integrated with a freehand process using an oscillating saw [J]. Journal of Bone and Joint Surgery, 2010, 92(11): 2076-2082.

[4] CARTIAUX O, DOCQUIER P L, PAUL L, et al. Surgical inaccuracy of tumor resection and reconstruction within the pelvis: An experimental study [J]. Acta Orthopaedica, 2008, 79(5): 695-702.

[5] WONG K C, KUMTA S M, CHIU K H, et al. Precision tumor resection and reconstruction using image-guided computer navigation [J]. The Journal of Bone and Joint Surgery -British Volume, 2007, 89-B(7): 943- 947.

[6] FU L J, HAO Y Q. Development and prospect of 3D printing technique in bone tumors [J]. Chinese Journal of Bone and Joint, 2018, 7(1): 4-6 (in Chinese).

[7] WYLIE J D, FERRER M G, MCCLINCY M P, et al. What is the reliability and accuracy of intraoperative fluoroscopy in evaluating anterior, lateral, and posterior coverage during periacetabular osteotomy? [J]. Clinical Orthopaedics and Related Research, 2019, 477(5): 1138-1144.

[8] HAYASHI S, HASHIMOTO S, MATSUMOTO T, et al. Computer-assisted surgery prevents complications during peri-acetabular osteotomy [J]. International Orthopaedics, 2018, 42(11): 2555-2561.

[9] HOLZAPFEL B M, PILGE H, PRODINGER P M, et al. Customised osteotomy guides and endoprosthetic reconstruction for periacetabular tumors [J]. International Orthopaedics, 2014, 38(7): 1435-1442.

[10] GAO L G, NI X Y. Study of metal artifacts reduction method of CT image [J]. International Journal of Biomedical Engineering, 2015, 38(2): 124-128 (in Chinese).

[11] YIN B X, CHEN X C. Comparison of clinical values of spectral CT with metal artifacts reduction system and high-spatial resolution algorithm CT scans in reducing metallic artifacts [J]. Chinese Journal of Anatomy and Clinics, 2017, 22(6): 448-451(in Chinese).

[12] RITACCO L E, MILANO F E, FARFALLI G L, et al. Accuracy of 3-D planning and navigation in bone tumor resection [J]. Orthopedics, 2013, 36(7): e942- e950.

[13] LIN F, LU S B, WANG J F. Classification and related operation procedures of pelvic tumor treated with partial pelvic resection [J]. Chiese Journal of Surgery, 1998, 36(10): 582-584 (in Chinese).

[14] O’CONNOR M I, SIM F H. Salvage of the limb in the treatment of malignant pelvic tumors [J]. The Journal of Bone and Joint Surgery -American Volume, 1989, 71(4): 481-494. [15] MALAWER M M, CHOU L B. Prosthetic survival and clinical results with use of large-segment replacements in the treatment of high-grade bone sarcomas [J]. The Journal of Bone & Joint Surgery, 1995, 77(8): 1154- 1165.

[16] DELLOYE C, BANSE X, BRICHARD B, et al. Pelvic reconstruction with a structural pelvic allograft after resection of a malignant bone tumor [J]. The Journal of Bone and Joint Surgery -American Volume, 2007, 89(3): 579-587.

[17] HILLMANN A, HOFFMANN C, GOSHEGER G, et al. Tumors of the pelvis: Complications after reconstruction [J]. Archives of Orthopaedic and Trauma Surgery, 2003, 123(7): 340-344.

[18] HENDERSON E R, GROUNDLAND J S, PALA E, et al. Failure mode classification for tumor endoprostheses: Retrospective review of five institutions and a literature review [J]. The Journal of Bone and Joint Surgery -American Volume, 2011, 93(5): 418-429.

[19] SO T Y, LAM Y L, MAK K L. Computer-assisted navigation in bone tumor surgery: Seamless workflow model and evolution of technique [J]. Clinical Orthopaedics and Related Research, 2010, 468(11): 2985- 2991.

[20] GIBSON I, CHEUNG L K, CHOW S P, et al. The use of rapid prototyping to assist medical applications [J]. Rapid Prototyping Journal, 2006, 12(1): 53-58.

[21] DAI K R, YAN M N, ZHU Z N, et al. Computer-aided custom-made hemipelvic prosthesis used in extensive pelvic lesions [J]. The Journal of Arthroplasty, 2007, 22(7): 981-986.

[22] GUO W, WANG Y F, ZHANG Y D, et al. Reconstruction with 3D-printed modular pelvic endoprostheses after pelvic tumor resection [J]. Chinese Journal of Orthopaedics, 2016(20): 1302-1311 (in Chinese).

[23] LEE Y H, PARK K K, SONG H T, et al. Metal artifact reduction in gemstone spectral imaging dual-energy CT with and without metal artifact reduction software [J]. European Radiology, 2012, 22(6): 1331-1340.

[24] VETH R P, NIELSEN H K, OLDHOFF J, et al. Megaprostheses in the treatment of primary malignant and metastatic tumors in the hip region [J]. Journal of Surgical Oncology, 1989, 40(3): 214-218.

[25] WATTS H G. Introduction to resection of musculoskeletal sarcomas [J]. Clinical Orthopaedics and Related Research, 1980, 153: 31-38.

[26] JIANG Z M, ZHANG H Z, HUANG J, et al. Values and limitations of intraoperative frozen section diagnosis in orthopedics pathology [J]. Chinese Journal of Pathology, 2006, 35(6): 365-368 (in Chinese).

[27] XIE B, ZHOU J S. The margining of osteosarcoma on MRI and its significance in surgical planning [J]. Chinese Journal of Bone Tumor and Bone Disease, 2008(1): 14-18 (in Chinese). 
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