Geometric and volumetric relationship between human lumbar vertebrae and “Black‐bone” MRI‐based models

Kanawati, Andrew; Fernandes, Renan; Gee, Aaron; Urquhart, Jennifer; Bailey, Chris; Rasoulinejad, Parham

doi:10.1002/rcs.2220

Cited by 5 publications

(12 citation statements)

References 25 publications

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“…The geometrical accuracy of bone segmentation has been evaluated on long bones and vertebrae in ex vivo studies so that MR segmentation could be compared to the physical bone shape using 3D printing, 47 mechanical contact/optical scanners, 18,[31][32][33] or micro-CT. 31,82 Bone specimens were processed to remove soft tissues, resulting in a potential shrinkage of the gold standard compared to the bone as scanned using MRI and CT. 18,25,33,82 On average, CT segmentation overestimated the actual bone shape, whereas MR segmentation mostly underestimated it, [31][32][33]47 although not consistently. 25,82 Nevertheless, surface distances between the MR-based segmentation and the cadaveric specimen were on average submillimeter, 17,25,31,33,82 with mean absolute surface distances ranging from 0.23 mm to 0.41 mm for MR-segmentations and from 0.15 mm to 0.51 mm for CT-based segmentations. 17,25,31,33 Similarly, root mean square error (RMSE) was mainly submillimeter, 18,31,33 although it could reach 1.2 mm 32 in the knee for MRI models (vs. 0.5 mm for CT models).…”

Section: Bone Geometrical Accuracymentioning

confidence: 96%

“…Some of the images were fat‐suppressed (eg, S‐GRE of the shoulder) or post‐processed (eg, VS‐GRE of the shoulder). Some images are reprinted with permissions from the reference given in the top left‐hand corner of the images 16–24 . Black bone/skull was reprinted by permission from Springer Nature 20 .…”

Section: Mri‐based Visualization Of the Bone Morphologymentioning

confidence: 99%

“…With such parameters, cortical bone appears as a low-intensity structure whereas soft tissues have a uniform intermediate intensity. Originally developed for craniofacial imaging, 60 BB-MRI has been further applied to image the spine, 17,71 and long bones. 18 ULTRASHORT AND ZERO ECHO TIME IMAGING.…”

Section: Conventional Clinical Mr Sequencesmentioning

confidence: 99%

“…When imaging the spine, MRI is the modality of choice in many applications as it offers valuable information on the neural structures, the intervertebral discs, bone marrow, and the surrounding soft tissues. 17,36 CT is typically acquired to assess the osseous involvement of soft tissue pathologies, for assessing bony abnormalities such as fractures, spondylosis, spondylolysis, or for surgical planning, 5,17,39 owing to the superior cortical bone contrast and to the isotropic resolution of CT that enables multiplanar reformatting. 5 STRUCTURAL CHANGES.…”

Section: Spinementioning

confidence: 99%

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Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Florkow

Willemsen

Mascarenhas

et al. 2022

Magnetic Resonance Imaging

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Magnetic resonance imaging (MRI) is increasingly utilized as a radiation‐free alternative to computed tomography (CT) for the diagnosis and treatment planning of musculoskeletal pathologies. MR imaging of hard tissues such as cortical bone remains challenging due to their low proton density and short transverse relaxation times, rendering bone tissues as nonspecific low signal structures on MR images obtained from most sequences. Developments in MR image acquisition and post‐processing have opened the path for enhanced MR‐based bone visualization aiming to provide a CT‐like contrast and, as such, ease clinical interpretation. The purpose of this review is to provide an overview of studies comparing MR and CT imaging for diagnostic and treatment planning purposes in orthopedic care, with a special focus on selective bone visualization, bone segmentation, and three‐dimensional (3D) modeling. This review discusses conventional gradient‐echo derived techniques as well as dedicated short echo time acquisition techniques and post‐processing techniques, including the generation of synthetic CT, in the context of 3D and specific bone visualization. Based on the reviewed literature, it may be concluded that the recent developments in MRI‐based bone visualization are promising. MRI alone provides valuable information on both bone and soft tissues for a broad range of applications including diagnostics, 3D modeling, and treatment planning in multiple anatomical regions, including the skull, spine, shoulder, pelvis, and long bones. Level of Evidence 3 Technical Efficacy Stage 3

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Section: Bone Geometrical Accuracymentioning

confidence: 96%

Section: Mri‐based Visualization Of the Bone Morphologymentioning

confidence: 99%

Section: Conventional Clinical Mr Sequencesmentioning

confidence: 99%

Section: Spinementioning

confidence: 99%

See 2 more Smart Citations

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Florkow

Willemsen

Mascarenhas

et al. 2022

Magnetic Resonance Imaging

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“…Several studies have validated CT and MRI in the creation of accurate 3D-printed models, as well as the use of 3D Slicer in the creation of musculoskeletal segmentation. Several of our previous reports have demonstrated the dimensional and volumetric accuracy of both CT and MRI data when compared to bone and 3D-printed models [ 10 , 11 ]. In a comparison of the 3D model and the cadaver pelvis, 3D printing resulted in accurate models suitable for preoperative workup [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

3D printed composite model of pelvic osteochondroma and nerve roots

Fox

Kanawati

2021

3D Print Med

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Background 3D-printing has become increasingly utilized in the preoperative planning of clinical orthopaedics. Surgical treatment of bone tumours within the pelvis is challenging due to the complex 3D bone structure geometry, as well as the proximity of vital structures. We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Case presentation We present a unique case where a composite bone and nerve model of the lower lumbar spine, pelvis and accompanying nerve roots was created using 3D-printing. The bony pelvis and spine model was created using the CT, whereas the nerve roots were derived from the MRI and printed in an elastic material. 3D-printed model created an accurate reconstruction of the pelvic tumour and traversing nerves for preoperative planning and allowed for efficient and safe surgery. Pelvic tumour surgery is inherently dangerous due to the delicate nature of the surrounding anatomy. The composite model enabled the surgeon to very carefully navigate the anatomy with a focused resection and extreme care knowing the exact proximity of the L3 and L4 nerve roots. Conclusion The patient had complete resection of this tumour, no neurological complication and full resolution of his symptoms due to careful, preoperative planning with the use of the composite 3D model.

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Generating patient‐matched 3D‐printed pedicle screw and laminectomy drill guides from Cone Beam CT images: Studies in ovine and porcine cadavers

et al. 2022

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Background The emergence of robotic Cone Beam Computed Tomography (CBCT) imaging systems in trauma departments has enabled 3D anatomical assessment of musculoskeletal injuries, supplementing conventional 2D fluoroscopic imaging for examination, diagnosis, and treatment planning. To date, the primary focus has been on trauma sites in the extremities. Purpose To determine if CBCT images can be used during the treatment planning process in spinal instrumentation and laminectomy procedures, allowing accurate 3D‐printed pedicle screw and laminectomy drill guides to be generated for the cervical and thoracic spine. Methods The accuracy of drill guides generated from CBCT images was assessed using animal cadavers (ovine and porcine). Preoperative scans were acquired using a robotic CBCT C‐arm system, the Siemens ARTIS pheno (Siemens Healthcare, GmbH, Germany). The CBCT images were imported into 3D‐Slicer version 4.10.2 (http://www.slicer.org) where vertebral models and specific guides were developed and subsequently 3D‐printed. In the ovine cadaver, 11 pedicle screw guides from the T1–T5 and T7–T12 vertebra and six laminectomy guides from the C2–C7 vertebra were planned and printed. In the porcine cadaver, nine pedicle screw guides from the C3–T4 vertebra were planned and printed. For the pedicle screw guides, accuracy was assessed by three observers according to pedicle breach via the Gertzbein–Robbins grading system as well as measured mean axial and sagittal screw error via postoperative CBCT and CT scans. For the laminectomies, the guides were designed to leave 1 mm of lamina. The average thickness of the lamina at the mid‐point was used to assess the accuracy of the guides, measured via postoperative CBCT and CT scans from three observers. For all measurements, the intraclass correlation coefficient (ICC) was calculated to determine observer reliability. Results Compared with the planned screw angles for both the ovine and porcine procedures (n = 32), the mean axial and sagittal screw error measured on the postoperative CBCT scans from three observers were 3.9 ± 1.9° and 1.8 ± 0.8°, respectively. The ICC among the observes was 0.855 and 0.849 for the axial and sagittal measurements, respectively, indicating good reliability. In the ovine cadaver, directly comparing the measured axial and sagittal screw angle of the visible screws (n = 14) in the postoperative CBCT and conventional CT scans from three observers revealed an average difference 1.9 ± 1.0° in axial angle and 1.8 ± 1.0° in the sagittal angle. The average thickness of the lamina at the middle of each vertebra, as measured on‐screen in the postoperative CBCT scans by three observes was 1.6 ± 0.2 mm. The ICC among observers was 0.693, indicating moderate reliability. No lamina breaches were observed in the postoperative images. Conclusion Here, CBCT images have been used to generate accurate 3D‐printed pedicle screw and laminectomy drill guides for use in the cervical and thoracic spine. The results demonstrate sufficient precision compared with th...

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Geometric and volumetric relationship between human lumbar vertebrae and “Black‐bone” MRI‐based models

Cited by 5 publications

References 25 publications

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

3D printed composite model of pelvic osteochondroma and nerve roots

Generating patient‐matched 3D‐printed pedicle screw and laminectomy drill guides from Cone Beam CT images: Studies in ovine and porcine cadavers

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