3D/2D Image Registration Method for Joint Motion Analysis Using Low-Quality Images from Mini C-arm Machines

A 3D kinematic measurement of joint movement is crucial for orthopedic surgery assessment and diagnosis. This is usually obtained through a frame-by-frame registration of the 3D bone volume to a fluoroscopy video of the joint movement. The high cost of a high-quality fluoroscopy imaging system has hindered the access of many labs to this application. This is while the more affordable and low-dosage version, the mini C-arm, is not commonly used for this application due to low image quality. In this paper, we introduce a novel method for kinematic analysis of joint movement using the mini C-arm. In this method the bone of interest is recovered and isolated from the rest of the image using a non-rigid registration of an atlas to each frame. The 3D/2D registration is then performed using the weighted histogram of image gradients as an image feature. In our experiments, the registration error was 0.89 mm and 2.36 degrees for human C2 vertebra. While the precision is still lacking behind a high quality fluoroscopy machine, it is a good starting point facilitating the use of mini C-arms for motion analysis making this application available to lower-budget environments. Moreover, the registration was highly resistant to the initial distance from the true registration, converging to the answer from anywhere within 90 of it.