Intrinsic Tolerance in C-Arm Imaging: How Extrinsic Re-optimization Preserves 3D Reconstruction Accuracy

\textbf{Purpose:} C-arm fluoroscopy's 3D reconstruction relies on accurate intrinsic calibration, which is often challenging in clinical practice. This study ensures high-precision reconstruction accuracy by re-optimizing the extrinsic parameters to compensate for intrinsic calibration errors. \noindent\textbf{Methods:} We conducted both simulation and real-world experiments using five commercial C-arm systems. Intrinsic parameters were perturbed in controlled increments. Focal length was increased by 100 to 700 pixels ($\approx$20 mm to 140 mm) and principal point by 20 to 200 pixels. For each perturbation, we (1) reconstructed 3D points from known phantom geometries, (2) re-estimated extrinsic poses using standard optimization, and (3) measured reconstruction and reprojection errors relative to ground truth. \noindent\textbf{Results:} Even with focal length errors up to 500 pixels ($\approx$100 mm, assuming a nominal focal length of $\sim$1000 mm), mean 3D reconstruction error remained under 0.2 mm. Larger focal length deviations (700 pixels) elevated error to only $\approx$0.3 mm. Principal point shifts up to 200 pixels introduced negligible reconstruction error once extrinsic parameters were re-optimized, with reprojection error increases below 0.5 pixels. \noindent\textbf{Conclusion:} Moderate errors in intrinsic calibration can be effectively mitigated by extrinsic re-optimization, preserving submillimeter 3D reconstruction accuracy. This intrinsic tolerance suggests a practical pathway to relax calibration precision requirements, thereby simplifying C-arm system setup and reducing clinical workflow burden without compromising performance.

Pedicle Screw Pairing and Registration for Screw Pose Estimation from Dual C-arm Images Using CAD Models

Accurate matching of pedicle screws in both anteroposterior (AP) and lateral (LAT) images is critical for successful spinal decompression and stabilization during surgery. However, establishing screw correspondence, especially in LAT views, remains a significant clinical challenge. This paper introduces a method to address pedicle screw correspondence and pose estimation from dual C-arm images. By comparing screw combinations, the approach demonstrates consistent accuracy in both pairing and registration tasks. The method also employs 2D-3D alignment with screw CAD 3D models to accurately pair and estimate screw pose from dual views. Our results show that the correct screw combination consistently outperforms incorrect pairings across all test cases, even prior to registration. After registration, the correct combination further enhances alignment between projections and images, significantly reducing projection error. This approach shows promise for improving surgical outcomes in spinal procedures by providing reliable feedback on screw positioning.