Evidence map›Paper›PMID 32333361›Full record

ArticleInternational journal of computer assisted radiology and surgery2020

Automatic annotation of hip anatomy in fluoroscopy for robust and efficient 2D/3D registration.

Robert B Grupp, Mathias Unberath, Cong Gao, Rachel A Hegeman, Ryan J Murphy, Clayton P Alexander, Yoshito Otake, Benjamin A McArthur, Mehran Armand, Russell H Taylor

Open access · greenAbstract read
In one paragraph

Article in International journal of computer assisted radiology and surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed
7.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 70 citations in OpenAlex.

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  5. PolyPose: Deformable 2D/3D Registration via Polyrigid Transformations.Advances in neural information processing systems · 2025
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  9. Automatic multi-view X-ray/CT registration using bone substructure contours.International journal of computer assisted radiology and surgery · 2025
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  10. Uncertainty Quantification in Image-based 2D/3D Registration and Its Relationship with Accuracy.International journal of computer assisted radiology and surgery · 2025
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  11. Intelligent control of robotic X-ray devices using a language-promptable digital twin.International journal of computer assisted radiology and surgery · 2025
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  12. Autonomous Robotic Systems in Otolaryngology-Head and Neck Surgery.Otolaryngologic clinics of North America · 2024
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  13. Take a shot! Natural language control of intelligent robotic X-ray systems in surgery.International journal of computer assisted radiology and surgery · 2024
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  14. Intraoperative 2D/3D Image Registration via Differentiable X-ray Rendering.Proceedings. IEEE Computer Society Conference on Computer Vision and Pattern Recognition · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Robert B GruppDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, USA. grupp@jhu.edu.ORCID http://orcid.org/0000-0003-3386-5839
Mathias UnberathDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, USA.
Cong GaoDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, USA.
Rachel A HegemanResearch and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA.
Ryan J MurphyAuris Health, Inc., Redwood City, CA, USA.
Clayton P AlexanderDepartment of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD, USA.
Yoshito OtakeGraduate School of Information Science, Nara Institute of Science and Technology, Ikoma, Nara, Japan.
Benjamin A McArthurDepartment of Surgery and Perioperative Care, Dell Medical School, University of Texas, Austin, TX, USA.
Mehran ArmandResearch and Exploratory Development Department, Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USA.
Russell H TaylorDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, USA.
Johns Hopkins University · USAuris Health (United States) · USJohns Hopkins University Applied Physics Laboratory · USNara Institute of Science and Technology · JPTexas Oncology · US

Funding

Robot-Assisted Femoroplasty with Intraoperative Biomechanical FeedbackR01EB023939 · NIBIB · JOHNS HOPKINS UNIVERSITY · PI ARMAND, MEHRAN · 2017 to 2020
$1.6M
Computer-Assisted Orthopaedic Surgery with Intra-Operative Biomechanical GuidanceR01EB006839 · NIBIB · JOHNS HOPKINS UNIVERSITY · PI ARMAND, MEHRAN · 2007 to 2010
$1.5M
X-Ray Image-based Biomechanical Guidance for Hip SurgeryR21EB020113 · NIBIB · JOHNS HOPKINS UNIVERSITY · PI ARMAND, MEHRAN · 2015 to 2016
$397k
Johns Hopkins University Applied Physics Laboratory FNACCX24NIBIB NIH HHS R01 EB006839NIBIB NIH HHS R01EB006839NIBIB NIH HHS R01 EB023939NIBIB NIH HHS R21 EB020113NIBIB NIH HHS R21EB020113
6 · The paper itself

Abstract

purposeFluoroscopy is the standard imaging modality used to guide hip surgery and is therefore a natural sensor for computer-assisted navigation. In order to efficiently solve the complex registration problems presented during navigation, human-assisted annotations of the intraoperative image are typically required. This manual initialization interferes with the surgical workflow and diminishes any advantages gained from navigation. In this paper, we propose a method for fully automatic registration using anatomical annotations produced by a neural network.

methodsNeural networks are trained to simultaneously segment anatomy and identify landmarks in fluoroscopy. Training data are obtained using a computationally intensive, intraoperatively incompatible, 2D/3D registration of the pelvis and each femur. Ground truth 2D segmentation labels and anatomical landmark locations are established using projected 3D annotations. Intraoperative registration couples a traditional intensity-based strategy with annotations inferred by the network and requires no human assistance.

resultsGround truth segmentation labels and anatomical landmarks were obtained in 366 fluoroscopic images across 6 cadaveric specimens. In a leave-one-subject-out experiment, networks trained on these data obtained mean dice coefficients for left and right hemipelves, left and right femurs of 0.86, 0.87, 0.90, and 0.84, respectively. The mean 2D landmark localization error was 5.0 mm. The pelvis was registered within [Formula: see text] for 86% of the images when using the proposed intraoperative approach with an average runtime of 7 s. In comparison, an intensity-only approach without manual initialization registered the pelvis to [Formula: see text] in 18% of images.

conclusionsWe have created the first accurately annotated, non-synthetic, dataset of hip fluoroscopy. By using these annotations as training data for neural networks, state-of-the-art performance in fluoroscopic segmentation and landmark localization was achieved. Integrating these annotations allows for a robust, fully automatic, and efficient intraoperative registration during fluoroscopic navigation of the hip.

Indexed as

AlgorithmsFemurFluoroscopyHumansImaging, Three-DimensionalNeural Networks, ComputerPelvisTomography, X-Ray Computed2D/3D registrationLandmark detectionOrthopedicsSemantic segmentationX-ray navigation

Identifiers

PMID32333361
PMCPMC7263976
OpenAlexW3017446891

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.