title: Automated cement segmentation in vertebroplasty.
abstract: Vertebroplasty is a minimally invasive procedure with many benefits; however, the procedure is not without risks and potential complications, of which leakage of the cement out of the vertebral body and into the surrounding tissues is one of the most serious. Cement can leak into the spinal canal, venous system, soft tissues, lungs and intradiscal space, causing serious neurological complications, tissue necrosis or pulmonary embolism. We present a method for automatic segmentation and tracking of bone cement during vertebroplasty procedures, as a first step towards developing a warning system to avoid cement leakage outside the vertebral body. We show that by using active contours based on level sets the shape of the injected cement can be accurately detected. The model has been improved for segmentation as proposed in our previous work by including a term that restricts the level set function to the vertebral body. The method has been applied to a set of real intra-operative X-ray images and the results show that the algorithm can successfully detect different shapes with blurred and not well-defined boundaries, where the classical active contours segmentation is not applicable. The method has been positively evaluated by physicians.
authors.affiliation: Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland. kozic.nina@gmail.com
authors.forename: Nina
authors.initials: N
authors.lastname: Kozic
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
authors.forename: Miguel A González
authors.initials: MA
authors.lastname: Ballester
authors.forename: German
authors.initials: G
authors.lastname: Abdo
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Rüfenacht
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Ferguson
authors.forename: Mauricio
authors.initials: M
authors.lastname: Reyes
mesh_terms: D001843:Bone Cements / Q000493:pharmacokinetics*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging / Q000517:prevention & control; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008962:Models, Theoretical; D010024:Osteoporosis / Q000175:diagnosis / Q000601:surgery*; D013122:Spinal Diseases / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
chemical_list: D001843:Bone Cements