Chaochao Zhou

Chaochao Zhou, Syed Hasib Akhter Faruqui, Abhinav Patel et al.

Many tasks performed in image-guided procedures can be cast as pose estimation problems, where specific projections are chosen to reach a target in 3D space. In this study, we first develop a differentiable projection (DiffProj) rendering framework for the efficient computation of Digitally Reconstructed Radiographs (DRRs) with automatic differentiability from either Cone-Beam Computerized Tomography (CBCT) or neural scene representations, including two newly proposed methods, Neural Tuned Tomography (NeTT) and masked Neural Radiance Fields (mNeRF). We then perform pose estimation by iterative gradient descent using various candidate loss functions, that quantify the image discrepancy of the synthesized DRR with respect to the ground-truth fluoroscopic X-ray image. Compared to alternative loss functions, the Mutual Information loss function can significantly improve pose estimation accuracy, as it can effectively prevent entrapment in local optima. Using the Mutual Information loss, a comprehensive evaluation of pose estimation performed on a tomographic X-ray dataset of 50 patients$'$ skulls shows that utilizing either discretized (CBCT) or neural (NeTT/mNeRF) scene representations in DiffProj leads to comparable performance in DRR appearance and pose estimation (3D angle errors: mean $\leq$ 3.2° and 90% quantile $\leq$ 3.4°), despite the latter often incurring considerable training expenses and time. These findings could be instrumental for selecting appropriate approaches to improve the efficiency and effectiveness of fluoroscopic X-ray pose estimation in widespread image-guided interventions.

Chaochao Zhou, Bo Yang

Many analysis and prediction tasks require the extraction of structured data from unstructured texts. However, an annotation scheme and a training dataset have not been available for training machine learning models to mine structured data from text without special templates and patterns. To solve it, this paper presents an end-to-end machine learning pipeline, Text2Struct, including a text annotation scheme, training data processing, and machine learning implementation. We formulated the mining problem as the extraction of metrics and units associated with numerals in the text. Text2Struct was trained and evaluated using an annotated text dataset collected from abstracts of medical publications regarding thrombectomy. In terms of prediction performance, a dice coefficient of 0.82 was achieved on the test dataset. By random sampling, most predicted relations between numerals and entities were well matched to the ground-truth annotations. These results show that Text2Struct is viable for the mining of structured data from text without special templates or patterns. It is anticipated to further improve the pipeline by expanding the dataset and investigating other machine learning models. A code demonstration can be found at: https://github.com/zcc861007/Text2Struct

Yehyun Suh, Lin Li, Aric Plumley et al.

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.

Chaochao Zhou, Thomas Cha, Yun Peng et al.

Registration of 3D anatomic structures to their 2D dual fluoroscopic X-ray images is a widely used motion tracking technique. However, deep learning implementation is often impeded by a paucity of medical images and ground truths. In this study, we proposed a transfer learning strategy for 3D-to-2D registration using deep neural networks trained from an artificial dataset. Digitally reconstructed radiographs (DRRs) and radiographic skull landmarks were automatically created from craniocervical CT data of a female subject. They were used to train a residual network (ResNet) for landmark detection and a cycle generative adversarial network (GAN) to eliminate the style difference between DRRs and actual X-rays. Landmarks on the X-rays experiencing GAN style translation were detected by the ResNet, and were used in triangulation optimization for 3D-to-2D registration of the skull in actual dual-fluoroscope images (with a non-orthogonal setup, point X-ray sources, image distortions, and partially captured skull regions). The registration accuracy was evaluated in multiple scenarios of craniocervical motions. In walking, learning-based registration for the skull had angular/position errors of 3.9 +- 2.1 deg / 4.6 +- 2.2 mm. However, the accuracy was lower during functional neck activity, due to overly small skull regions imaged on the dual fluoroscopic images at end-range positions. The methodology to strategically augment artificial training data can tackle the complicated skull registration scenario, and has potentials to extend to widespread registration scenarios.