# US 2014/0278322 A1 · Systems and methods for using generic anatomy models in surgical planning

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- Number: US 2014/0278322 A1
- Document ID: US20140278322A1
- Status: Published application
- Kind: A1
- Application number: 14/164,883
- Filed: 2014-01-27
- Published: 2014-09-18
- Earliest claimed: 2013-03-13
- Assignees: Blue Belt Technologies, Inc.
- Inventors: Branislav Jaramaz; Constantinos Nikou
- Web page: https://patentgrep.com/patent/US20140278322A1

## CPC

- G16Z 99/00: Subject matter not provided for in other main groups of this subclass
- A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations
- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- G16H 50/50: for simulation or modelling of medical disorders
- A61B 5/4504: {Bones (A61B5/4547 takes precedence)}
- A61B 5/4571: {Evaluating the hip}
- A61B 17/175: {for preparing the femur for hip prosthesis insertion}
- A61B 2017/564: {Methods for bone or joint treatment}
- A61B 2034/101: {Computer-aided simulation of surgical operations}
- A61B 2034/105: {Modelling of the patient, e.g. for ligaments or bones}
- A61B 2090/364: {Correlation of different images or relation of image positions in respect to the body}
- G16Z: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

Systems and methods for generating a surgical plan for altering an abnormal bone using a generic normal bone model are discussed. For example, a system for planning a surgery on an abnormal bone can include a model receiver module configured to receive a generic normal bone model. The generic normal bone model, such as a parametric model derived from statistical shape data, can include a data set representing a normal bone having an anatomical origin comparable to the abnormal bone. An input interface can be configured to receive an abnormal bone representation including a data set representing the abnormal bone. A surgical planning module can include a registration module configured to register the generic normal bone model to the abnormal bone representation by creating a registered generic model. A surgical plan formation module can be configured to identify one or more abnormal regions of the abnormal bone using the registered generic model.

## Claims

### Claim 1

A system for planning a surgery on an abnormal bone, comprising:
a model receiver module configured to receive a generic normal bone model, the generic normal bone model including a data set representing a normal bone having an anatomical origin comparable to the abnormal bone;
an input interface configured to receive an abnormal bone representation, the abnormal bone representation including a data set representing the abnormal bone; and
a surgical planning module configured to generate a surgical plan for altering a portion of the abnormal bone, the surgical planning module including:
a registration module configured to register the generic normal bone model to the abnormal bone representation by creating a registered generic model; and
a surgical plan formation module configured to identify one or more abnormal regions of the abnormal bone.

### Claim 2 (depends on 1)

The system of claim 1, comprising:
a memory circuit configured to store the generic normal bone model, the abnormal bone representation, and a set of instructions controlling operation of the system; and
a controller circuit coupled to the surgical planning module and the memory circuit, the controller circuit configured to execute the set of instructions to cause the surgical planning module to generate the surgical plan for altering the portion of the abnormal bone from the one or more abnormal regions.

### Claim 3 (depends on 2)

The system of claim 2, further comprising a communication interface coupled to the surgical planning module and the memory circuit, the communication interface configured to generate a representation illustrating one or more of the generic normal bone model, the abnormal bone representations, or the surgical plan, and to receive user input to accept or modify the surgical plan.

### Claim 4 (depends on 1)

The system of claim 1, wherein the registration module comprises:
a segmentation module configured to partition one or both of the generic normal bone model and the abnormal bone representation each into a plurality of segments, and to identify from the segments of the abnormal bone an abnormity-free registration area;
a model transformation module configured to transform the generic normal bone model to create the registered generic model using a comparison between the abnormity-free registration area of the abnormal bone and a corresponding segment of the generic normal bone model;
a matching module configured to match, in response to identifying the abnormity-free registration area of the abnormal bone, the abnormity-free registration area of the abnormal bone to a corresponding segment of the registered generic model; and
an alignment module configured to align the remaining segments of the registered generic model with the remaining segments of the abnormal bone based at least in part on the matching.

### Claim 5 (depends on 4)

The system of claim 4, wherein the segmentation module is configured to assign a label to each of the segments such that segments with the same label share specified characteristics.

### Claim 6 (depends on 1)

The system of claim 1, wherein the surgical plan formation module comprises:
a feature extraction module configured to extract a plurality of model features from the registered generic model and a plurality of abnormal bone features from the abnormal bone;
an abnormality detection module configured to identify the one or more abnormal regions of the abnormal bone using a comparison between the model features and the abnormal bone features; and
an alteration decision module configured to:
subtract, for each of the one or more abnormal regions, a volumetric parameter (Xmodel(k)) of the segment of the registered generic model from a volumetric parameter (Xabnormal(k)) of the segment of the abnormal bone, the volumetric parameters Xmodel(k) and Xabnormal(k) each representing a shape or a volume of respective segment; and
determine a part of alteration using the subtracted volumetric parameter for each of the one or more abnormal regions.

### Claim 7 (depends on 6)

The system of claim 6, wherein the abnormality detection module is configured to determine a segment of the abnormal bone (Rabnormal(k)) as an abnormal region in response to a volumetric difference between a segment of the registered generic model (Rmodel(k)) and the Rabnormal(k) meeting a specified criterion, the segment of the registered generic model Rmodel(k) corresponding to a anatomical region comparable to the Rabnormal(k).

### Claim 8 (depends on 1)

The system of claim 1, wherein the model receiver module is configured to receive a statistical shape (SS) model generated using a plurality of images of normal bones of comparable anatomical origin from a group of subjects having normal bone anatomy.

### Claim 9 (depends on 1)

The system of claim 1, wherein the model receiver module is configured to receive a parametric model comprising one or more parameters characterizing the normal bone anatomy.

### Claim 10

A machine-readable storage medium including instructions that, when executed by a machine, cause the machine to:
receive an abnormal bone representation, the abnormal bone representation including a data set representing an abnormal bone;
receive a generic normal bone model, the generic normal bone model including a data set representing a normal bone having an anatomical origin comparable to the abnormal bone;
register the generic normal bone model to the abnormal bone representation to create a registered generic model;
identify one or more abnormal regions of the abnormal bone using a comparison between the registered generic model and the abnormal bone representation; and
generate a surgical plan for altering a portion of the abnormal bone from the one or more abnormal regions.

### Claim 11 (depends on 10)

The machine-readable storage medium of claim 10, wherein the instruction causing the machine to generate the surgical plan includes causing the machine to:
calculate a relative measure between the one or more abnormal regions of the abnormal bone and the generic normal bone model, the relative measure representing at least one of a shape, a location, an orientation, or a volume of the portion of the abnormal bone; and
generate instructions to guide a surgical tool in altering the portion of the abnormal bone.

### Claim 12 (depends on 10)

The machine-readable storage medium of claim 10, further comprising instructions that cause the machine to generate a graphical representation illustrating one or more of the generic normal bone model, the abnormal bone representations, or the surgical plan, and to receive command from a system user to accept or modify the surgical plan.

### Claim 13

A method for planning a surgery on an abnormal bone, comprising:
receiving an abnormal bone representation, the abnormal bone representation including a data set representing the abnormal bone;
receiving a generic normal bone model, the generic normal bone model including a data set representing a normal bone having an anatomical origin comparable to the abnormal bone;
registering the generic normal bone model to the abnormal bone representation;
detecting one or more abnormal regions of the abnormal bone using a comparison between the registered generic model and the abnormal bone representation; and
generating a surgical plan for altering a portion of the abnormal bone from the one or more abnormal regions.

### Claim 14 (depends on 13)

The method of claim 13, wherein registering the generic normal bone model to the abnormal bone representation comprises:
partitioning one or both of the generic normal bone model and the abnormal bone representation each into a plurality of segments;
identifying from the segments of the abnormal bone a anatomical abnormity-free registration area;
transforming the generic normal bone model to create the registered generic model using a comparison between the abnormity-free registration area and a corresponding segment of the registered generic model;
matching the abnormity-free registration area of the abnormal bone to a corresponding segment of the registered generic model; and
aligning the remaining segments of the registered generic model with the remaining segments of the abnormal bone based at least in part on the matching.

### Claim 15 (depends on 13)

The method of claim 13, wherein detecting the one or more abnormal regions of the abnormal bone comprises:
extracting a plurality of model features from the registered generic model and a plurality of abnormal bone features from the abnormal bone;
calculating a degree of disconformity between a segment of the registered generic model and a segment of the abnormal bone using the extracted model features and the abnormal bone features, the segment of the registered generic model having a anatomical region comparable to the segment of the abnormal bone; and
determining the segment of the abnormal bone to be abnormal in response to the degree of disconformity meeting a specified criterion.

### Claim 16 (depends on 15)

The method of claim 15, wherein calculating the degree of disconformity includes calculating a volumetric difference in a normed vector space.

### Claim 17 (depends on 15)

The method of claim 15, wherein calculating the degree of disconformity comprises:
extracting a plurality of model features from the segment of the registered generic model and a plurality of abnormal bone features from the segment of the abnormal bone;
calculating a statistical distribution of the model features using the data of the normal bones from which the generic normal bone model is derived; and
calculating a statistical distance between the model features and the abnormal bone features using the statistical distribution of the model features.

### Claim 18 (depends on 13)

The method of claim 13, wherein generating the surgical plan comprises:
subtracting, for each of the one or more abnormal regions, a volumetric parameter of the segment of the registered generic model from a volumetric parameter of the segment of the abnormal bone; and
determining a part of alteration using the subtracted volumetric parameter for each of the one or more abnormal regions.

### Claim 19 (depends on 18)

The method of claim 18, wherein the volumetric parameter includes one or more of a volume, a shape, a location, or an orientation.

### Claim 20 (depends on 13)

The method of claim 13, wherein receiving the generic normal bone model includes creating a statistical shape (SS) model using a plurality of images of normal bones of comparable anatomical origin from a group of subjects having normal bone anatomy.

### Claim 21 (depends on 13)

The method of claim 13, wherein receiving the generic normal bone model includes creating a parametric model comprising one or more parameters characterizing the normal bone anatomy.

### Claim 22 (depends on 13)

The method of claim 13, further comprising generating a graphical representation illustrating one or more of the generic normal bone model, the abnormal bone representations, or the surgical plan, the graphical representation providing feedback to enable a system user to accept or modify the surgical plan.

### Claim 23

A method for planning a surgical alteration of a portion of a diseased femur, comprising:
receiving one or more medical images of the diseased femur;
receiving a statistical shape (SS) model of a normal femur using medical images of normal femurs from a group of subjects, the medical images of the normal femurs having modalities comparable to the one or more images of the diseased femur;
registering the SS model to the one or more images of the diseased femur;
identifying one or more abnormal regions of the diseased femur in response to a volumetric difference between the registered SS model and the one or more images of the diseased femur exceeding a specified threshold; and
generating a surgical plan for altering the portion of the diseased femur, the surgical plan including data representing one or more of a volume, a shape, a location, or an orientation of the one or more abnormal regions in reference to the registered SS model, and instructions to guide a surgical tool in altering the portion of the abnormal bone.

### Claim 24 (depends on 23)

The method of claim 23, wherein generating a surgical plan includes:
performing a first simulation of the diseased femur and a second simulation of the surgically altered femur, the first and the second simulations each including a biomechanical simulation for evaluating range of motion of the respective femur; and
determining the one or more abnormal regions using a comparison between the first simulation and the second simulation.