Development of Novel Medical Image-Based Techniques for In Vivo Measurement of Three-Dimensional Vertebral Kinematics

• Main Authors: Cheng-Chung Lin, 林正忠
• Other Authors: Tung-Wu Lu
• Format: Others
• Language: en_US
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/27773324052567951251

博士 === 國立臺灣大學 === 醫學工程學研究所 === 101 === Accurate measurement of in vivo vertebral kinematics of the spine during functional activities is essential for better understanding of its function and for many clinical applications. While several techniques have been developed to measure the spinal kinematics, not many allow for non-invasive measurement of the 3D and dynamic intervertebral motion under physiological weight-bearing conditions. Although a few model-based 2D-to-3D registration methods are available in measuring 3D vertebral motion recently, their performance has not been evaluated under the same experimental protocol. The existing methods are also limited either in their accuracy or difficulties in implementation. Four major types of 2D-to-3D registration methods (projection-based methods) were established and experimentally evaluated, namely STS (surface, single-plane), VTS (volumetric, single-plane), STB (surface, bi-plane) and VTB (volumetric, bi-plane). A new single-plane fluoroscopy-to-CT registration method (VTS) integrated with intervertebral anti-collision constraints was proposed. The validated registration methods were then applied to measure the 3D motion of cervical vertebrae during the flexion/extension, lateral bending and axial rotation in normal subjects. In addition to the projection-based registration methods, a new slice-to-volume registration method that integrated 3D static MRI volumes of the vertebrae with an advanced single-slice, real-time radial FLASH MRI was developed and experimentally evaluated. It was concluded that (a) The VTB was found to have the highest precision, comparable with the VTS in rotations, and the STB in translations. The STS had the lowest precision. (b) The fluoroscopy-to-CT registration (i.e. VTS) integrated with anti-collision constraints successfully reduced the out-of-plane translation errors for intervertebral kinematic measurements while keeping the measurement accuracies for the other five degrees-of-freedom more or less unaltered. (c) With the validated volumetric model-based registration methods, the 3D kinematics of the sub-axial cervical spine during activities had been accurately measured. (d) With the accuracy and repeatability achieved, and without the use of ionizing radiation, the slice-to-volume registration combining the real-time radial FLASH MR imaging is potential to be a low-risk, valuable tool for studying 3D vertebral kinematics non-invasively.