Annotation-guided encoder-decoder network for bone extraction in ultrasound-assisted orthopedic surgery

The patients and surgeons are usually exposed in massive ionizing radiation during fluoroscopy-based navigation orthopedic surgery. Comparatively, ultrasound-assisted orthopedic surgery could not only decrease the risk of radiation but also provide rich navigation information. However, due to the artifacts in ultrasound images, the extraction of bone structure from ultrasound sequences can be a particularly difficult task, which leads to some major challenges in ultrasound-assisted orthopedic navigation. In this paper, we propose an annotation-guided encoder-decoder network (AGN) to extract bone structure from the radiation-free ultrasound sequences. Specifically, the variability of the ultrasound probe's pose leads to the change of the ultrasound frame during the acquisition of ultrasound sequences. Therefore, a feature alignment module deployed in the AGN model is used to achieve reliable matching across ultrasound frames. Moreover, inspired by the interactive ultrasound analysis, where user annotated foreground information can help target extraction, our AGN model incorporates the annotation information obtained by Siamese networks. Experimental results validated that the AGN model not only produced better bone surface extraction than state-of-the-art methods (IOU: 0.92 versus. 0.88), but also achieved almost real-time extraction with the speed about 15 frames per second. In addition, the acquired bone surface further provided radiation-free 3D intraoperative bone structure for the intuitive navigation of orthopedic surgery.