Fluoro-CT technology (IsoC3D)

		Isocentric fluoroscopy device (Siremobil IsoC3D, Siemens Medical Systems, Erlangen, Germany) Segmentation and noise reduction of IsoC3D images. Top: result by simple thresholding; Bottom: result of our segmentation method.

In collaboration with Siemens Medical Systems (Erlangen, Germany), a mobile 3D fluoroscopy device, Siremobil IsoC3D, was thoroughly evaluated and validated for its use as an intraoperative imaging device in orthopaedics. Several theoretically and clinically oriented aspects have been studied relating to the use of this device in image-guided surgery (issues regarding data-transfer, OR table, validation, number of projections, angle range). Methods for the compensation of image distortions and breathing artefacts were devised. A full surgical IsoC3D navigation module has been developed and extensively tested in several clinics. A custom set of stereotactic instruments for IsoC3D based navigated kyphoplasty, a surgical intervention to prevent and/or treat osteoporotic vertebral fractures has been developed in collaboration with the trauma unit of the University of Heidelberg. The navigation module is now in routine clinical use.

Several segmentation methods were developed for the automatic segmentation of bony structures in IsoC3D datasets. 3D visualisation of these segmentations are planned to enhance the surgical navigation in spine and pelvic surgery. All methods were evaluated on a large in-house database of IsoC3D images from different anatomical locations. Registration methods to put into correspondence IsoC3D and CT datasets were also developed and thoroughly validated.