RayEmb: Arbitrary Landmark Detection in X-Ray Images Using Ray Embedding Subspace

Intra-operative 2D-3D registration of X-ray images with pre-operatively acquired CT scans is a crucial procedure in orthopedic surgeries. Anatomical landmarks pre-annotated in the CT volume can be detected in X-ray images to establish 2D-3D correspondences, which are then utilized for registration. However, registration often fails in certain view angles due to poor landmark visibility. We propose a novel method to address this issue by detecting arbitrary landmark points in X-ray images. Our approach represents 3D points as distinct subspaces, formed by feature vectors (referred to as ray embeddings) corresponding to intersecting rays. Establishing 2D-3D correspondences then becomes a task of finding ray embeddings that are close to a given subspace, essentially performing an intersection test. Unlike conventional methods for landmark estimation, our approach eliminates the need for manually annotating fixed landmarks. We trained our model using the synthetic images generated from CTPelvic1K CLINIC dataset, which contains 103 CT volumes, and evaluated it on the DeepFluoro dataset, comprising real X-ray images. Experimental results demonstrate the superiority of our method over conventional methods. The code is available at https://github.com/Pragyanstha/rayemb.

X-Ray to CT Rigid Registration Using Scene Coordinate Regression

Intraoperative fluoroscopy is a frequently used modality in minimally invasive orthopedic surgeries. Aligning the intraoperatively acquired X-ray image with the preoperatively acquired 3D model of a computed tomography (CT) scan reduces the mental burden on surgeons induced by the overlapping anatomical structures in the acquired images. This paper proposes a fully automatic registration method that is robust to extreme viewpoints and does not require manual annotation of landmark points during training. It is based on a fully convolutional neural network (CNN) that regresses the scene coordinates for a given X-ray image. The scene coordinates are defined as the intersection of the back-projected rays from a pixel toward the 3D model. Training data for a patient-specific model were generated through a realistic simulation of a C-arm device using preoperative CT scans. In contrast, intraoperative registration was achieved by solving the perspective-n-point (PnP) problem with a random sample and consensus (RANSAC) algorithm. Experiments were conducted using a pelvic CT dataset that included several real fluoroscopic (X-ray) images with ground truth annotations. The proposed method achieved an average mean target registration error (mTRE) of 3.79 mm in the 50th percentile of the simulated test dataset and projected mTRE of 9.65 mm in the 50th percentile of real fluoroscopic images for pelvis registration.