title: Bone enhancement in ultrasound using local spectrum variations for guiding percutaneous scaphoid fracture fixation procedures.
abstract: OBJECTIVE
  The scaphoid bone is the most frequently fractured bone in the wrist. When fracture fixation is indicated, a screw is inserted into the bone either in an open surgical procedure or percutaneously under fluoroscopic guidance. Due to the complex geometry of the wrist, fracture fixation is a challenging task. Fluoroscopic guidance exposes both the patient and the physician to ionizing radiation. Ultrasound-based guidance has been suggested as a real-time, radiation-free alternative. The main challenge of using ultrasound is the difficulty in interpreting the images due to the low contrast and noisy nature of the data.
  
  
  METHODS
  We propose a bone enhancement method that exploits local spectrum features of the ultrasound image. These features are utilized to design a set of quadrature band-pass filters and subsequently estimate the local phase symmetry, where high symmetry is expected at the bone locations. We incorporate the shadow information below the bone surfaces to further enhance the bone responses. The extracted bone surfaces are then used to register a statistical wrist model to ultrasound volumes, allowing the localization and interpretation of the scaphoid bone in the volumes.
  
  
  RESULTS
  Feasibility experiments were performed using phantom and in vivo data. For phantoms, we obtain a surface distance error 1.08 mm and an angular deviation from the main axis of the scaphoid bone smaller than 5°, which are better compared to previously presented approaches.
  
  
  CONCLUSIONS
  The results are promising for further development of a surgical guidance system to enable accurate anatomy localization for guiding percutaneous scaphoid fracture fixations.
authors.affiliation: Electrical and Computer Engineering, University of British Columbia, Vancouver, BC, Canada, emrana@ece.ubc.ca.
authors.forename: Emran Mohammad
authors.initials: EM
authors.lastname: Abu Anas
authors.forename: Alexander
authors.initials: A
authors.lastname: Seitel
authors.forename: Abtin
authors.initials: A
authors.lastname: Rasoulian
authors.forename: Paul
authors.initials: P
authors.lastname: St John
authors.forename: David
authors.initials: D
authors.lastname: Pichora
authors.forename: Kathryn
authors.initials: K
authors.lastname: Darras
authors.forename: David
authors.initials: D
authors.lastname: Wilson
authors.forename: Victoria A
authors.initials: VA
authors.lastname: Lessoway
authors.forename: Ilker
authors.initials: I
authors.lastname: Hacihaliloglu
authors.forename: Parvin
authors.initials: P
authors.lastname: Mousavi
authors.forename: Robert
authors.initials: R
authors.lastname: Rohling
authors.forename: Purang
authors.initials: P
authors.lastname: Abolmaesumi
mesh_terms: D001863:Bone Screws; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D021361:Scaphoid Bone / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery*; D018084:Ultrasonography, Interventional
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