Giuseppe Loggia

Luohong Wu, Matthias Seibold, Nicola A. Cavalcanti et al.

Bone surface reconstruction is an essential component of computer-assisted orthopedic surgery (CAOS), forming the foundation for preoperative planning and intraoperative guidance. Compared to traditional imaging modalities such as CT and MRI, ultrasound provides a radiation-free, and cost-effective alternative. While ultrasound offers new opportunities in CAOS, technical shortcomings continue to hinder its translation into surgery. In particular, due to the inherent limitations of ultrasound imaging, B-mode ultrasound typically capture only partial bone surfaces, posing major challenges for surface reconstruction. Existing reconstruction methods struggle with such incomplete data, leading to increased reconstruction errors and artifacts. Effective techniques for accurately reconstructing open bone surfaces from real-world 3D ultrasound volumes remain lacking. We propose UltraBoneUDF, a self-supervised framework specifically designed for reconstructing open bone surfaces from ultrasound data using neural unsigned distance functions (UDFs). In addition, we present a novel loss function based on local tangent plane optimization that substantially improves surface reconstruction quality. UltraBoneUDF and competing models are benchmarked on three open-source datasets and further evaluated through ablation studies. 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: 0.96 mm on the UltraBones100k dataset (28.9% improvement compared to the state-of-the-art), 0.21 mm on the OpenBoneCT dataset (40.0% improvement), and 0.18 mm on the ClosedBoneCT dataset (63.3% improvement).

Luohong Wu, Nicola A. Cavalcanti, Matthias Seibold et al.

Ultrasound-based bone surface segmentation is crucial in computer-assisted orthopedic surgery. However, ultrasound images have limitations, including a low signal-to-noise ratio, and acoustic shadowing, which make interpretation difficult. Existing deep learning models for bone segmentation rely primarily on costly manual labeling by experts, limiting dataset size and model generalizability. Additionally, the complexity of ultrasound physics and acoustic shadow makes the images difficult for humans to interpret, leading to incomplete labels in anechoic regions and limiting model performance. To advance ultrasound bone segmentation and establish effective model benchmarks, larger and higher-quality datasets are needed. We propose a methodology for collecting ex-vivo ultrasound datasets with automatically generated bone labels, including anechoic regions. The proposed labels are derived by accurately superimposing tracked bone CT models onto the tracked ultrasound images. These initial labels are refined to account for ultrasound physics. A clinical evaluation is conducted by an expert physician specialized on orthopedic sonography to assess the quality of the generated bone labels. A neural network for bone segmentation is trained on the collected dataset and its predictions are compared to expert manual labels, evaluating accuracy, completeness, and F1-score. We collected the largest known dataset of 100k ultrasound images of human lower limbs with bone labels, called UltraBones100k. A Wilcoxon signed-rank test with Bonferroni correction confirmed that the bone alignment after our method significantly improved the quality of bone labeling (p < 0.001). The model trained on UltraBones100k consistently outperforms manual labeling in all metrics, particularly in low-intensity regions (320% improvement in completeness at a distance threshold of 0.5 mm).