Biomedical subjects

C Nikou

Publications and source records attributed to C Nikou.

6 recordsLinked to original sources

PubMed2001

Accuracy in tunnel placement for ACL reconstruction. Comparison of traditional arthroscopic and computer-assisted navigation techniques.

The purpose of this randomized, prospective study was to compare accuracy in tunnel placement as performed with a traditional arthroscopic anterior cruciate ligament (ACL) reconstruction technique and with KneeNavTM ACL, a computer-assisted surgical navigation technique. Two surgeons experienced in ACL reconstruction, but inexperienced in computer-assisted surgical navigation technique, each randomly used traditional arthroscopic guides or KneeNavTM ACL to drill a tunnel in twenty identical foam knees. Placement of the resulting tibial and femoral tunnels was measured with a computer-assisted digitizing method and compared to traditional biplanar radiographs. Statistical analysis with Student's t-test was used to compare the distance from the ideal tunnel placement to the femoral and tibial tunnels. Accuracy of tunnel placement with KneeNavTM ACL was significantly better than that obtained with the traditional arthroscopic technique. Distances from the ideal tunnel placement to the femoral and tibial tunnels were 4.2 +/- 1.8 mm (mean +/- SD) and 4.9 +/- 2.3 mm, respectively, for the traditional arthroscopic technique, and 2.7 +/- 1.9 mm (femur) and 3.4 +/- 2.3 mm (tibia) for KneeNavTM ACL. These differences were statistically different. Tunnel placement for ACL reconstruction with KneeNavTM ACL, an image-based, computer-assisted surgical navigation device with a simple and intuitive interface, was more accurate than with the traditional arthroscopic technique.

Anterior Cruciate Ligament↗

PubMed2001

A joint physics-based statistical deformable model for multimodal brain image analysis.

A probabilistic deformable model for the representation of multiple brain structures is described. The statistically learned deformable model represents the relative location of different anatomical surfaces in brain magnetic resonance images (MRIs) and accommodates their significant variability across different individuals. The surfaces of each anatomical structure are parameterized by the amplitudes of the vibration modes of a deformable spherical mesh. For a given MRI in the training set, a vector containing the largest vibration modes describing the different deformable surfaces is created. This random vector is statistically constrained by retaining the most significant variation modes of its Karhunen-Loève expansion on the training population. By these means, the conjunction of surfaces are deformed according to the anatomical variability observed in the training set. Two applications of the joint probabilistic deformable model are presented: isolation of the brain from MRI using the probabilistic constraints embedded in the model and deformable model-based registration of three-dimensional multimodal (magnetic resonance/single photon emission computed tomography) brain images without removing nonbrain structures. The multi-object deformable model may be considered as a first step toward the development of a general purpose probabilistic anatomical atlas of the brain.

Anatomy, Cross-Sectional↗

PubMed2000

An image overlay system for medical data visualization.

Image Overlay is a computer display technique which superimposes computer images over the user's direct view of the real world. The images are transformed in real-time so they appear to the user to be an integral part of the surrounding environment. By using Image Overlay with three-dimensional medical images such as CT reconstructions, a surgeon can visualize the data 'in-vivo', exactly positioned within the patient's anatomy, and potentially enhance the surgeon's ability to perform a complex procedure. This paper describes prototype Image Overlay systems and initial experimental results from those systems.

Computer Graphics↗

PubMed1998

Registration of MR/MR and MR/SPECT brain images by fast stochastic optimization of robust voxel similarity measures.

This paper describes a robust, fully automated algorithm to register intrasubject 3D single and multimodal images of the human brain. The proposed technique accounts for the major limitations of the existing voxel similarity-based methods: sensitivity of the registration to local minima of the similarity function and inability to cope with gross dissimilarities in the two images to be registered. Local minima are avoided by the implementation of a stochastic iterative optimization technique (fast simulated annealing). In addition, robust estimation is applied to reject outliers in case the images show significant differences (due to lesion evolution, incomplete acquisition, non-Gaussian noise, etc.). In order to evaluate the performance of this technique, 2D and 3D MR and SPECT human brain images were artificially rotated, translated, and corrupted by noise. A test object was acquired under different angles and positions for evaluating the accuracy of the registration. The approach has also been validated on real multiple sclerosis MR images of the same patient taken at different times. Furthermore, robust MR/SPECT image registration has permitted the representation of functional features for patients with partially complex seizures. The fast simulated annealing algorithm combined with robust estimation yields registration errors that are less than 1 degree in rotation and less than 1 voxel in translation (image dimensions of 128(3)). It compares favorably with other standard voxel similarity-based approaches.

Algorithms↗

PubMed1998

Computer assisted measurement of cup placement in total hip replacement.

The introduction of image guided systems in total hip replacement surgery provides the ability to plan precisely the alignment of the acetabular cup before surgery, and to perform the surgery according to the preoperative plan. Preoperative planners (interactive computer programs for surgical planning) based on three-dimensional medical images allow planning of optimal placement of implant components based on simulated implant performance. Exact measurement of the cup position during surgery allows precise placement of the cup and accurate measurement of the final position of the cup relative to the pelvis. This measurement is used to evaluate the radiographic techniques for postoperative measurement of cup alignment. Malposition of the acetabular component increases the occurrence of impingement, reduces the safe range of motion, and increases the risk of dislocation and wear. Dislocation of the implant after total hip replacement remains a significant clinical problem. Not fully understanding the interaction between pelvic orientation and final acetabular cup alignment may be one of the main contributing factors in the continued significant incidence of dislocations after total hip replacement. In this study an attempt was made to link the preoperative planning, intraoperative placement, and postoperative measurement of cup placement in total hip replacement using computer assisted techniques.

Acetabulum↗

PubMed1998

The Otto Aufranc Award. Image guided navigation system to measure intraoperatively acetabular implant alignment.

There has been little clinical research to examine the effects of patient positioning and pelvic motion on the alignment of the acetabular implant during total hip replacement surgery. Until now, no tools were capable of accurately measuring these variables during the actual procedure. As part of a broader program in medical robotics and computer assisted surgery, a clinical system has been developed that includes several enabling technologies. The hip navigation system (HipNav) continuously and precisely measures pelvic location and tracks relative implant alignment intraoperatively. HipNav technology is used to gauge current clinical practice and provide intraoperative feedback to surgeons with the goal of improving the precision and accuracy of acetabular alignment during total hip replacement. This system provides surgeons with a new class of image guided measurement tools and assist devices. These tools successfully were introduced into the clinical practice of surgery with results showing the following: (1) There exist unpredictable and large variations in the initial position of patients' pelves on the operating room table and significant pelvic movement during surgery and during intraoperative range of motion testing; (2) current mechanical acetabular alignment guides do not account for these variations, and result in variable and in the majority of cases unacceptable acetabular alignment; and (3) press fitting oversized acetabular components influences the final cup orientation.

Anthropometry↗