Methodological improvement of 3D fluoroscopic analysis for the robust quantification of 3D kinematics of human joints

3D video-fluoroscopy is an accurate but cumbersome technique to estimate natural or prosthetic human joint kinematics. This dissertation proposes innovative methodologies to improve the 3D fluoroscopic analysis reliability and usability. Being based on direct radiographic imaging of the joint, and avoiding soft tissue artefact that limits the accuracy of skin marker based techniques, the fluoroscopic analysis has a potential accuracy of the order of mm/deg or better. It can provide fundamental informations for clinical and methodological applications, but, notwithstanding the number of methodological protocols proposed in the literature, time consuming user interaction is exploited to obtain consistent results. The user-dependency prevented a reliable quantification of the actual accuracy and precision of the methods, and, consequently, slowed down the translation to the clinical practice. The objective of the present work was to speed up this process introducing methodological improvements in the analysis. In the thesis, the fluoroscopic analysis was characterized in depth, in order to evaluate its pros and cons, and to provide reliable solutions to overcome its limitations. To this aim, an analytical approach was followed. The major sources of error were isolated with in-silico preliminary studies as: (a) geometric distortion and calibration errors, (b) 2D images and 3D models resolutions, (c) incorrect contour extraction, (d) bone model symmetries, (e) optimization algorithm limitations, (f) user errors. The effect of each criticality was quantified, and verified with an in-vivo preliminary study on the elbow joint. The dominant source of error was identified in the limited extent of the convergence domain for the local optimization algorithms, which forced the user to manually specify the starting pose for the estimating process. To solve this problem, two different approaches were followed: to increase the optimal pose convergence basin, the local approach used sequential alignments of the 6 degrees of freedom in order of sensitivity, or a geometrical feature-based estimation of the initial conditions for the optimization; the global approach used an unsupervised memetic algorithm to optimally explore the search domain. The performances of the technique were evaluated with a series of in-silico studies and validated in-vitro with a phantom based comparison with a radiostereometric gold-standard. The accuracy of the method is joint-dependent, and for the intact knee joint, the new unsupervised algorithm guaranteed a maximum error lower than 0.5 mm for in-plane translations, 10 mm for out-of-plane translation, and of 3 deg for rotations in a mono-planar setup; and lower than 0.5 mm for translations and 1 deg for rotations in a bi-planar setups. The bi-planar setup is best suited when accurate results are needed, such as for methodological research studies. The mono-planar analysis may be enough for clinical application when the analysis time and cost may be an issue. A further reduction of the user interaction was obtained for prosthetic joints kinematics. A mixed region-growing and level-set segmentation method was proposed and halved the analysis time, delegating the computational burden to the machine. In-silico and in-vivo studies demonstrated that the reliability of the new semiautomatic method was comparable to a user defined manual gold-standard. The improved fluoroscopic analysis was finally applied to a first in-vivo methodological study on the foot kinematics. Preliminary evaluations showed that the presented methodology represents a feasible gold-standard for the validation of skin marker based foot kinematics protocols.

Spectral-Element and Adjoint 3D Full-Wave Tomography for the Lithosphere of Central Italy

The primary objective of this thesis is to obtain a better understanding of the 3D velocity structure of the lithosphere in central Italy. To this end, I adopted the Spectral-Element Method to perform accurate numerical simulations of the complex wavefields generated by the 2009 Mw 6.3 L’Aquila event and by its foreshocks and aftershocks together with some additional events within our target region. For the mainshock, the source was represented by a finite fault and different models for central Italy, both 1D and 3D, were tested. Surface topography, attenuation and Moho discontinuity were also accounted for. Three-component synthetic waveforms were compared to the corresponding recorded data. The results of these analyses show that 3D models, including all the known structural heterogeneities in the region, are essential to accurately reproduce waveform propagation. They allow to capture features of the seismograms, mainly related to topography or to low wavespeed areas, and, combined with a finite fault model, result into a favorable match between data and synthetics for frequencies up to ~0.5 Hz. We also obtained peak ground velocity maps, that provide valuable information for seismic hazard assessment. The remaining differences between data and synthetics led us to take advantage of SEM combined with an adjoint method to iteratively improve the available 3D structure model for central Italy. A total of 63 events and 52 stations in the region were considered. We performed five iterations of the tomographic inversion, by calculating the misfit function gradient - necessary for the model update - from adjoint sensitivity kernels, constructed using only two simulations for each event. Our last updated model features a reduced traveltime misfit function and improved agreement between data and synthetics, although further iterations, as well as refined source solutions, are necessary to obtain a new reference 3D model for central Italy tomography.

Numerical models of trench migration for lateral heterogeneous subducting plates

The aim of this Thesis is to investigate the effect of heterogeneities within the subducting plate on the dynamics of subduction. In particular, I study the motion of the trench for oceanic and continental subduction, first, separately, and, then, together in the same system to understand how they interact. The understanding of these features is fundamental to reconstruct the evolution of complex subduction zones, such as the Central Mediterranean. For this purpose, I developed 2D and 3D numerical models of oceanic and continental subduction where the rheological, geometrical and compositional properties of the plates are varied. In these models, the trench and the overriding plate move self-consistently as a function of the dynamics of the system. The effect of continental subduction on trench migration is largely investigated. Results from a parametric study showed that despite different rheological properties of the plates, all models with a uniform continental crust share the same kinematic behaviour: the trench starts to advance once the continent arrives at the subduction zone. Hence, the advancing mode in continental collision scenarios is at least partly driven by an intrinsic feature of the system. Moreover, the presence of a weak lower crust within the continental plate can lead to the occurrence of delamination. Indeed, by changing the viscosity of the lower crust, both delamination and slab detachment can occur. Delamination is favoured by a low viscosity value of the lower crust, because this makes the mechanical decoupling easier between crust and lithospheric mantle. These features are observed both in 2D and 3D models, but the numerical results of the 3D models also showed that the rheology of the continental crust has a very strong effect on the dynamics of the whole system, since it influences not only the continental part of plate but also the oceanic sides.

La Ricostruzione 3D di Bologna nel XVI Secolo

Il lavoro presentato ha come oggetto la ricostruzione tridimensionale della città di Bologna nella sua fase rinascimentale. Tale lavoro vuole fornire un modello 3D delle architetture e degli spazi urbani utilizzabile sia per scopi di ricerca nell’ambito della storia delle città sia per un uso didattico-divulgativo nel settore del turismo culturale. La base del lavoro è una fonte iconografica di grande importanza: l’affresco raffigurante Bologna risalente al 1575 e situato in Vaticano; questa è una veduta a volo d’uccello di grandi dimensioni dell’intero tessuto urbano bolognese all’interno della terza cerchia di mura. In esso sono rappresentate in maniera particolareggiata le architetture civili e ecclesiastiche, gli spazi ortivi e cortilivi interni agli isolati e alcune importanti strutture urbane presenti in città alla fine del Cinquecento, come l’area portuale e i canali interni alla città, oggi non più visibili. La ricostruzione tridimensionale è stata realizzata tramite Blender, software per la modellazione 3D opensource, attraverso le fasi di modellazione, texturing e creazione materiali (mediante campionamento delle principali cromie presenti nell’affresco), illuminazione e animazione. Una parte della modellazione è stata poi testata all’interno di un GIS per verificare l’utilizzo delle geometrie 3D come elementi collegabili ad altre fonti storiche relative allo sviluppo urbano e quindi sfruttabili per la ricerca storica. Grande attenzione infine è stata data all’uso dei modelli virtuali a scopo didattico-divulgativo e per il turismo culturale. La modellazione è stata utilizzata all’interno di un motore grafico 3D per costruire un ambiente virtuale interattivo nel quale un utente anche non esperto possa muoversi per esplorare gli spazi urbani della Bologna del Cinquecento. In ultimo è stato impostato lo sviluppo di un’applicazione per sistemi mobile (Iphone e Ipad) al fine di fornire uno strumento per la conoscenza della città storica in mobilità, attraverso la comparazione dello stato attuale con quello ricostruito virtualmente.

A comparison between 2D and 3D cephalometry on CBCT scans of human skulls

The purpose of this study was to evaluate whether measurements on conventional cephalometric radiographs are comparable with 3D measurements on 3D models of human skulls, derived from cone beam CT (CBCT) data. A CBCT scan and a conventional cephalometric radiograph were made of 40 dry skulls. Standard cephalometric software was used to identify landmarks on both the 2D images and the 3D models. The same operator identified 17 landmarks on the cephalometric radiographs and on the 3D models. All images and 3D models were traced five times with a time-interval of 1 week and the mean value of repeated measurements was used for further statistical analysis. Distances and angles were calculated. Intra-observer reliability was good for all measurements. The reproducibility of the measurements on the conventional cephalometric radiographs was higher compared with the reproducibility of measurements on the 3D models. For a few measurements a clinically relevant difference between measurements on conventional cephalometric radiographs and 3D models was found. Measurements on conventional cephalometric radiographs can differ significantly from measurements on 3D models of the same skull. The authors recommend that 3D tracings for longitudinal research are not used in cases were there are only 2D records from the past.

Single fluoroscopic image based 2D/3D reconstruction of a scaled, patient-specific vertebral model

Purpose Accurate three-dimensional (3D) models of lumbar vertebrae can enable image-based 3D kinematic analysis. The common approach to derive 3D models is by direct segmentation of CT or MRI datasets. However, these have the disadvantages that they are expensive, timeconsuming and/or induce high-radiation doses to the patient. In this study, we present a technique to automatically reconstruct a scaled 3D lumbar vertebral model from a single two-dimensional (2D) lateral fluoroscopic image. Methods Our technique is based on a hybrid 2D/3D deformable registration strategy combining a landmark-to-ray registration with a statistical shape model-based 2D/3D reconstruction scheme. Fig. 1 shows different stages of the reconstruction process. Four cadaveric lumbar spine segments (total twelve lumbar vertebrae) were used to validate the technique. To evaluate the reconstruction accuracy, the surface models reconstructed from the lateral fluoroscopic images were compared to the associated ground truth data derived from a 3D CT-scan reconstruction technique. For each case, a surface-based matching was first used to recover the scale and the rigid transformation between the reconstructed surface model Results Our technique could successfully reconstruct 3D surface models of all twelve vertebrae. After recovering the scale and the rigid transformation between the reconstructed surface models and the ground truth models, the average error of the 2D/3D surface model reconstruction over the twelve lumbar vertebrae was found to be 1.0 mm. The errors of reconstructing surface models of all twelve vertebrae are shown in Fig. 2. It was found that the mean errors of the reconstructed surface models in comparison to their associated ground truths after iterative scaled rigid registrations ranged from 0.7 mm to 1.3 mm and the rootmean squared (RMS) errors ranged from 1.0 mm to 1.7 mm. The average mean reconstruction error was found to be 1.0 mm. Conclusion An accurate, scaled 3D reconstruction of the lumbar vertebra can be obtained from a single lateral fluoroscopic image using a statistical shape model based 2D/3D reconstruction technique. Future work will focus on applying the reconstructed model for 3D kinematic analysis of lumbar vertebrae, an extension of our previously-reported imagebased kinematic analysis. The developed method also has potential applications in surgical planning and navigation.

3D bloodstain pattern analysis: ballistic reconstruction of the trajectories of blood drops and determination of the centres of origin of the bloodstains

For crime scene investigation in cases of homicide, the pattern of bloodstains at the incident site is of critical importance. The morphology of the bloodstain pattern serves to determine the approximate blood source locations, the minimum number of blows and the positioning of the victim. In the present work, the benefits of the three-dimensional bloodstain pattern analysis, including the ballistic approximation of the trajectories of the blood drops, will be demonstrated using two illustrative cases. The crime scenes were documented in 3D, using the non-contact methods digital photogrammetry, tachymetry and laser scanning. Accurate, true-to-scale 3D models of the crime scenes, including the bloodstain pattern and the traces, were created. For the determination of the areas of origin of the bloodstain pattern, the trajectories of up to 200 well-defined bloodstains were analysed in CAD and photogrammetry software. The ballistic determination of the trajectories was performed using ballistics software. The advantages of this method are the short preparation time on site, the non-contact measurement of the bloodstains and the high accuracy of the bloodstain analysis. It should be expected that this method delivers accurate results regarding the number and position of the areas of origin of bloodstains, in particular the vertical component is determined more precisely than using conventional methods. In both cases relevant forensic conclusions regarding the course of events were enabled by the ballistic bloodstain pattern analysis.

3D documentation of footwear impressions and tyre tracks in snow with high resolution optical surface scanning

The three-dimensional documentation of footwear and tyre impressions in snow offers an opportunity to capture additional fine detail for the identification as present photographs. For this approach, up to now, different casting methods have been used. Casting of footwear impressions in snow has always been a difficult assignment. This work demonstrates that for the three-dimensional documentation of impressions in snow the non-destructive method of 3D optical surface scanning is suitable. The new method delivers more detailed results of higher accuracy than the conventional casting techniques. The results of this easy to use and mobile 3D optical surface scanner were very satisfactory in different meteorological and snow conditions. The method is also suitable for impressions in soil, sand or other materials. In addition to the side by side comparison, the automatic comparison of the 3D models and the computation of deviations and accuracy of the data simplify the examination and delivers objective and secure results. The results can be visualized efficiently. Data exchange between investigating authorities at a national or an international level can be achieved easily with electronic data carriers.

Application of 3D documentation and geometric reconstruction methods in traffic accident analysis: with high resolution surface scanning, radiological MSCT/MRI scanning and real data based animation

The examination of traffic accidents is daily routine in forensic medicine. An important question in the analysis of the victims of traffic accidents, for example in collisions between motor vehicles and pedestrians or cyclists, is the situation of the impact. Apart from forensic medical examinations (external examination and autopsy), three-dimensional technologies and methods are gaining importance in forensic investigations. Besides the post-mortem multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) for the documentation and analysis of internal findings, highly precise 3D surface scanning is employed for the documentation of the external body findings and of injury-inflicting instruments. The correlation of injuries of the body to the injury-inflicting object and the accident mechanism are of great importance. The applied methods include documentation of the external and internal body and the involved vehicles and inflicting tools as well as the analysis of the acquired data. The body surface and the accident vehicles with their damages were digitized by 3D surface scanning. For the internal findings of the body, post-mortem MSCT and MRI were used. The analysis included the processing of the obtained data to 3D models, determination of the driving direction of the vehicle, correlation of injuries to the vehicle damages, geometric determination of the impact situation and evaluation of further findings of the accident. In the following article, the benefits of the 3D documentation and computer-assisted, drawn-to-scale 3D comparisons of the relevant injuries with the damages to the vehicle in the analysis of the course of accidents, especially with regard to the impact situation, are shown on two examined cases.

An integrated approach for reconstructing surface models of the proximal femur from sparse input data for surgical navigation

A patient-specific surface model of the proximal femur plays an important role in planning and supporting various computer-assisted surgical procedures including total hip replacement, hip resurfacing, and osteotomy of the proximal femur. The common approach to derive 3D models of the proximal femur is to use imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). However, the high logistic effort, the extra radiation (CT-imaging), and the large quantity of data to be acquired and processed make them less functional. In this paper, we present an integrated approach using a multi-level point distribution model (ML-PDM) to reconstruct a patient-specific model of the proximal femur from intra-operatively available sparse data. Results of experiments performed on dry cadaveric bones using dozens of 3D points are presented, as well as experiments using a limited number of 2D X-ray images, which demonstrate promising accuracy of the present approach.

3D documentation and visualization of external injury findings by integration of simple photography in CT/MRI data sets (IprojeCT).

This study evaluated the feasibility of documenting patterned injury using three dimensions and true colour photography without complex 3D surface documentation methods. This method is based on a generated 3D surface model using radiologic slice images (CT) while the colour information is derived from photographs taken with commercially available cameras. The external patterned injuries were documented in 16 cases using digital photography as well as highly precise photogrammetry-supported 3D structured light scanning. The internal findings of these deceased were recorded using CT and MRI. For registration of the internal with the external data, two different types of radiographic markers were used and compared. The 3D surface model generated from CT slice images was linked with the photographs, and thereby digital true-colour 3D models of the patterned injuries could be created (Image projection onto CT/IprojeCT). In addition, these external models were merged with the models of the somatic interior. We demonstrated that 3D documentation and visualization of external injury findings by integration of digital photography in CT/MRI data sets is suitable for the 3D documentation of individual patterned injuries to a body. Nevertheless, this documentation method is not a substitution for photogrammetry and surface scanning, especially when the entire bodily surface is to be recorded in three dimensions including all external findings, and when precise data is required for comparing highly detailed injury features with the injury-inflicting tool.

Accuracy of linear measurements using three imaging modalities: two lateral cephalograms and one 3D model from CBCT data

BACKGROUND The aim of this study was to evaluate the accuracy of linear measurements on three imaging modalities: lateral cephalograms from a cephalometric machine with a 3 m source-to-mid-sagittal-plane distance (SMD), from a machine with 1.5 m SMD and 3D models from cone-beam computed tomography (CBCT) data. METHODS Twenty-one dry human skulls were used. Lateral cephalograms were taken, using two cephalometric devices: one with a 3 m SMD and one with a 1.5 m SMD. CBCT scans were taken by 3D Accuitomo® 170, and 3D surface models were created in Maxilim® software. Thirteen linear measurements were completed twice by two observers with a 4 week interval. Direct physical measurements by a digital calliper were defined as the gold standard. Statistical analysis was performed. RESULTS Nasion-Point A was significantly different from the gold standard in all methods. More statistically significant differences were found on the measurements of the 3 m SMD cephalograms in comparison to the other methods. Intra- and inter-observer agreement based on 3D measurements was slightly better than others. LIMITATIONS Dry human skulls without soft tissues were used. Therefore, the results have to be interpreted with caution, as they do not fully represent clinical conditions. CONCLUSIONS 3D measurements resulted in a better observer agreement. The accuracy of the measurements based on CBCT and 1.5 m SMD cephalogram was better than a 3 m SMD cephalogram. These findings demonstrated the linear measurements accuracy and reliability of 3D measurements based on CBCT data when compared to 2D techniques. Future studies should focus on the implementation of 3D cephalometry in clinical practice.

A Novel Method for Radio Propagation Simulation Based on Automatic 3D Environment Reconstruction

In this paper, a novel method to simulate radio propagation is presented. The method consists of two steps: automatic 3D scenario reconstruction and propagation modeling. For 3D reconstruction, a machine learning algorithm is adopted and improved to automatically recognize objects in pictures taken from target regions, and 3D models are generated based on the recognized objects. The propagation model employs a ray tracing algorithm to compute signal strength for each point on the constructed 3D map. Our proposition reduces, or even eliminates, infrastructure cost and human efforts during the construction of realistic 3D scenes used in radio propagation modeling. In addition, the results obtained from our propagation model proves to be both accurate and efficient

A novel method for radio propagation simulation based on automatic 3D environment reconstruction

In this paper, a novel method to simulate radio propagation is presented. The method consists of two steps: automatic 3D scenario reconstruction and propagation modeling. For 3D reconstruction, a machine learning algorithm is adopted and improved to automatically recognize objects in pictures taken from target region, and 3D models are generated based on the recognized objects. The propagation model employs a ray tracing algorithm to compute signal strength for each point on the constructed 3D map. By comparing with other methods, the work presented in this paper makes contributions on reducing human efforts and cost in constructing 3D scene; moreover, the developed propagation model proves its potential in both accuracy and efficiency.

Experimental Prototype Merging Stereo Panoramic Video and Interactive 3D Content in a 5-sided CAVETM

Immersion and interaction have been identified as key factors influencing the quality of experience in stereoscopic video systems. An experimental prototype designed to explore the influence of these factors in 3D video applications is described here1. The focus is on the real-time insertion algorithm of new 3D models into the original video streams. Using this algorithm, our prototype is aimed to explore a new interaction paradigm ? similar to the augmented reality approach ? with 3D video applications.