Researchers and physicians at the University of Utah Orthopaedic Center hope to use 3-D images produced by a new biplane fluoroscopic camera system to unravel the mysteries of body mechanics.
It's a tool that could pinpoint the cause of hard-to-diagnose pain, help preserve joints, enhance accuracy of computer simulations and increase understanding of hard and soft tissue properties, according to Andrew E. Anderson, Ph.D., assistant professor and orthopedic researcher.
The system relies on biplane fluoroscopy and two high-speed, high-sensitivity cameras to quantify joint motions to determine the mechanics. Each camera produces a two-dimensional image of the subject which, combined, create a 3-D image.
A handful of research centers around the country have similar imaging systems, which use two c-arm fluoroscopes that track joint motion in real time. The U. system, which arrived in July, will be used in research and is expected in the future to aid with diagnosis and validation of treatments, Anderson said. But because they modified the system with high-speed, highly sensitive digital cameras (that can take 1,000 shots a second), it must be tested and validated before the Food and Drug Administration will allow its use with human subjects.
That validation process is under way, much of the work being done by graduate student Ashley Kapron. Validation could take as long as a year, Anderson said.
The biplane technique is being called CTX, short for computed tomography and X-ray. The fluoroscopes are positioned at precise angles to capture motion, then the CT image data of the same subject is used to make a 3D model. Combining the CT and the X-rays, they recreate the motion within .1 millimeter of accuracy. It's a 2008 version of "X-ray vision," showing what's moving around under the skin. While a moving image shown by fluoroscope is not novel, such a clear picture, using two planes to create 3-D, is.
The U. recently received a $1.5 million grant from the National Institutes of Health to create 3-D models of hip dysplasia. Dr. Jeffrey Weiss is principal investigator, with co-investigator Dr. Christopher Peters and researcher Anderson. Anderson said he'd like to use the biplane technology and animate the models for that research, once validation is achieved.
He believes the biplane fluoroscopic system could help diagnose what's going on in many different situations, such as in the young individual who suffers unexpectedly walking up stairs, with no clear impingement visible on imaging tests. The modeling could show a surgeon precisely where the problem is.
And in cases where there are different options, the biplane could help a surgeon determine which type of operation to use, Anderson said, adding it has powerful potential as a pre-surgery planning tool.Eventually, he said it's likely that the technology will pay for itself with savings from clearer diagnostics, shorter hospitalizations and other benefits.