[Customized 3D radiographic reconstruction of the human pelvis]

The pelvis is an essential element in the study of scoliosis since it constitutes the base of the spine and its orientation may affects postural balance. In order to study the role of the pelvis in the evolution and treatment of this disease, a new technique for the 3D personalised reconstruction of the pelvis was developed. It consists in identifying and digitizing 19 pelvic anatomical landmarks on postero-anterior and lateral x-rays and to reconstruct them in 3D with two techniques: the DLT algorithm developed by Marzan (1976) and, for 6 of the 19 landmarks, an adaptation of it called DLT with confidence coefficients. The latter takes into account the confidence given to the identification of the landmarks on each x-rays. Two methods were used to validate the reconstruction of the pelvis. The first one, used for 11 scoliotic patients and 2 dry pelvis specimens, consists in applying the reconstruction algorithm in an inverse way on the 3D coordinates of the reconstructed landmarks to obtain their 2D retroprojection on the x-ray planes, and thus comparing the retroprojected coordinates with the 2D digitized coordinates. The second method consists in measuring a dry pelvis specimen and comparing the 3D measured landmarks with the ones reconstructed with the x-rays of this specimen. For the first validation, results have shown that the lowest retroprojection errors (less than 2.5 +/- 2.6 mm) for the scoliotic patient group are located on the superior base of the sacrum, on the sacral curve and on the acetabula, while the highest (6.4 +/- 7.2 mm) were on the iliac crests. For the dry specimens, the retroprojection errors were below the millimeter. The second validation method showed 3D differences of 2.4 +/- 1.2 mm between measured and reconstructed landmarks of a dry specimen, which is of the same order of magnitude as what is reported in the literature for vertebrae. The reconstruction of the pelvis is thus considered adequate and its graphical wireframe representation allows to visualise and measure clinical indices concerning its orientation in space. Moreover, the reconstructed landmarks will be used to develop a personalised geometrical and mechanical model of the pelvis which, when integrated with the one for the spine and rib cage, will allow to simulate in a more realistic manner the biomechanical behaviour of the scoliotic trunk, particularly for the study of orthopaedic treatments with braces leaning on it.