Automatic Multi-View X-Ray/CT Registration Using Bone Substructure Contours

Purpose: Accurate intraoperative X-ray/CT registration is essential for surgical navigation in orthopedic procedures. However, existing methods struggle with consistently achieving sub-millimeter accuracy, robustness under broad initial pose estimates or need manual key-point annotations. This work aims to address these challenges by proposing a novel multi-view X-ray/CT registration method for intraoperative bone registration. Methods: The proposed registration method consists of a multi-view, contour-based iterative closest point (ICP) optimization. Unlike previous methods, which attempt to match bone contours across the entire silhouette in both imaging modalities, we focus on matching specific subcategories of contours corresponding to bone substructures. This leads to reduced ambiguity in the ICP matches, resulting in a more robust and accurate registration solution. This approach requires only two X-ray images and operates fully automatically. Additionally, we contribute a dataset of 5 cadaveric specimens, including real X-ray images, X-ray image poses and the corresponding CT scans. Results: The proposed registration method is evaluated on real X-ray images using mean reprojection error (mRPD). The method consistently achieves sub-millimeter accuracy with a mRPD 0.67mm compared to 5.35mm by a commercial solution requiring manual intervention. Furthermore, the method offers improved practical applicability, being fully automatic. Conclusion: Our method offers a practical, accurate, and efficient solution for multi-view X-ray/CT registration in orthopedic surgeries, which can be easily combined with tracking systems. By improving registration accuracy and minimizing manual intervention, it enhances intraoperative navigation, contributing to more accurate and effective surgical outcomes in computer-assisted surgery (CAS).

UltraBoneUDF: Self-supervised Bone Surface Reconstruction from Ultrasound Based on Neural Unsigned Distance Functions

Background: Bone surface reconstruction plays a critical role in computer-assisted orthopedic surgery. Compared to traditional imaging modalities such as CT and MRI, ultrasound offers a radiation-free, cost-effective, and portable alternative. Continuous bone surface reconstruction can be employed for many clinical applications. However, due to the inherent limitations of ultrasound imaging, B-mode ultrasound typically capture only partial bone surfaces. Existing reconstruction methods struggle with such incomplete data, leading to artifacts and increased reconstruction errors. Effective techniques for accurately reconstructing thin and open bone surfaces from real-world 3D ultrasound volumes remain lacking. Methods: We propose UltraBoneUDF, a self-supervised framework designed for reconstructing open bone surfaces from ultrasound using neural Unsigned Distance Functions. To enhance reconstruction quality, we introduce a novel global feature extractor that effectively fuses ultrasound-specific image characteristics. Additionally, we present a novel loss function based on local tangent plane optimization that substantially improves surface reconstruction quality. UltraBoneUDF and baseline models are extensively evaluated on four open-source datasets. Results: Qualitative results highlight the limitations of the state-of-the-art methods for open bone surface reconstruction and demonstrate the effectiveness of UltraBoneUDF. Quantitatively, UltraBoneUDF significantly outperforms competing methods across all evaluated datasets for both open and closed bone surface reconstruction in terms of mean Chamfer distance error: 1.10 mm on the UltraBones100k dataset (39.6\% improvement compared to the SOTA), 0.23 mm on the OpenBoneCT dataset (69.3\% improvement), 0.18 mm on the ClosedBoneCT dataset (70.2\% improvement), and 0.05 mm on the Prostate dataset (55.3\% improvement).