C-arm導引系統於椎莖路徑的定位誤差分析及規劃

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姓名

劉又銘(Yo-ming Liu) 查詢紙本館藏

畢業系所

生物醫學工程研究所

論文名稱

C-arm導引系統於椎莖路徑的定位誤差分析及規劃
(Spine pedicle path locate error assessment and spine pedicle path planning in C-arm navigation system.)

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摘要(中)

骨科手術用的C-arm影像輔助手術導引系統已經在臨床上使用多年，椎莖螺絲植入手術是重要的應用之一，然而導引定位的準確性欠缺定量的分析，且在前後向(Anterior–Posterior View, AP-View)的C-arm影像上很難決定植入的方向，所以本論文針對實驗室所研發的導引系統進行誤差分析與改善，並以DRR(Digitally Reconstructed Radiographs)資料歸納方式建立在AP影像上進行路徑規劃的依據。
在導引誤差部分，本論文採用三種方法進行驗證，包括1.計算手術器械在AP-View、LA-View上的投影，再比較其和器械影像的距離誤差；2.將器械影像進行逆投影得到空間座標，再比較其和實際量測的器械空間座標的誤差；3.設定植入的安全範圍，評估器械是否於安全範圍內。實驗結果顯示導引誤差主要是人體呼吸造成影像與影像投射方位資料的接收不同步，反光球的新舊對DRF(Dynamic Reference Frame)座標量測值影響相對微小。
在手術規劃方面，先在重建的3D CT模型上進行路徑規劃，之後進行DRR投影，得到AP影像上的路徑方位，並據以歸納出以脊椎特徵點為依據的路徑規劃原則。手術時醫生依此一原則在AP影像上進行手術路徑規劃，如此應可降低人為路徑規劃的不確定性，提高手術的成功率。

摘要(英)

C-arm image assisted navigation system for orthopedic surgery has been applied clinically for several years. Pedicle screw implantation is one of the important applications. However, positioning accuracy is still lack of quantification analysis. Also, the implantation direction on the Anterior/Posterior-view image is difficult to plan. Therefore, in this research, we analyze and improve positioning errors of the C-arm assisted navigation system developed by our laboratory and establish a path planning reference on the AP image based on Digitally Reconstructed Radiographs of CT images.
Three methods are applied to verify positioning errors. One is to calculate the position errors of calculated AP-View and LA-View images with the real image of the surgical instrument. Two is to calculate the errors of the inversely projected spatial position according to the AP-View image and LA-View image of the surgical instrument with its measured spatial position. Three is to define a safe zone and evaluate whether the instrument is within the zone. The experimental results show that the main factor of positioning error is due to respiration of the patient, which causes the asynchronous catch of C-arm images and the corresponding coordinates of the X-ray source. On the other hand, the new or used reflective balls only have minor effect in measuring the DRF coordinates.
As to surgical path planning, the path is planned on the reconstructed 3D CT model. Then, it is projected onto so-called AP-view through Digitally Reconstructed Radiographs algorithm. The projected paths are defined according to the feature points of the spine. The average location of the paths is the reference to plan surgical path on the AP-view, which might reduce the uncertainty of path planning and promote success rate of operation.

關鍵字(中)

★ 誤差分析
★ 脊椎手術
★ 手術導引系統
★ 路徑規劃

關鍵字(英)

★ Surgical navigation system
★ Spine surgery
★ Path planning
★ Error assessment

論文目次

中文摘要 I
ABSTRACT II
誌謝 III
目錄 IV
圖目錄 VII
表目錄 X
第一章緒論 1
1-1 研究動機 1
1-2 文獻回顧 2
1-3 研究方法簡介 5
1-4 論文架構 6
第二章研究方法 7
2-1手術導引系統路徑規劃改善方法 7
2-1-1 三維脊椎模型建立 8
2-1-2 主成分分析 10
2-1-3 DRR投影-濺射法 12
2-1-4 影像相似性量測 13
2-2 手術導引系統準確度驗證方法 15
2-2-1 逆投影 16
2-2-2 手術導引系統影像座標系轉換關係 17
2-2-3 準確度驗證方法一 20
2-2-4 準確度驗證方法二 24
2-2-5 準確度驗證方法三 26
第三章系統流程介紹 29
3-1系統流程介紹 29
3-2硬體架構 30
3-3座標系關係 34
3-4開發軟體介紹 35
第四章實驗結果與討論 36
4-1 驗證DRF反光球誤差 36
4-2 手術導引系統誤差分析 47
4-3 手術導引系統路徑規劃改善 56
4-3-1 理想 AP-View和手術AP-View的角度調整 57
4-3-2 椎莖定位路經規劃 64
第五章結論 75
參考文獻 76

參考文獻

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指導教授

曾清秀(Ching-shiow Tseng)

審核日期

2011-7-21

推文