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Feasibility analysis of a 3D U-Net algorithm assisted automatic pedicle screw planning

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机构: [1]Department of orthopedics, Beijing Tongren Hospital, Capital Medical University, Beijing , China. [2]School of Life Sciences, Tsinghua University, Beijing, China [3]Institute of Biomedical and Health Engineering (iBHE), Tsinghua Shenzhen International Graduate School [4]Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China [5]Longwood Valley Medical Technology Co Ltd, Beijing, China.
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关键词: 3D U-Net Pedicle screw planning Artificial intelligence

摘要:
To develop and validate a 3D U-Net algorithm for automated pedicle screw planning in thoracolumbosacral regions.The model was trained on 1,235 retrospective cases (1,005 public datasets [CTSpine1K] and 230 clinical cases from Beijing Tongren Hospital), including 1,165 for training (160 clinical + public data) and 70 for validation. Performance was assessed using Dice coefficient for spinal segmentation, Gertzbein-Robbins scale for screw accuracy, Babu scale for facet joint invasion, and Kappa statistics for inter-observer consistency.In 70 patients, 840 T12-S1 screws were automatically planned. Segmentation achieved a Dice coefficient of 0.9495. Screw accuracy showed 98.8% Gertzbein-Robbins grade A (830) and 1.2% grade B (10), with no C-E grades. Facet joint invasion grades were 96.43% grade 0 (810), 2.38% grade 1 (20), 0.95% grade 2 (8), and 0.24% grade 3 (2). Kappa values indicated strong agreement for Gertzbein-Robbins grading (κ=0.661, p<0.001) and facet assessment (κ=0.878, p<0.001). Algorithm runtime averaged 26 seconds for T12-S1 segmentation and 2 seconds per screw plan.The 3D U-Net algorithm enables rapid, accurate automated pedicle screw planning with high clinical feasibility. It demonstrates robust segmentation precision (Dice >0.94), excellent screw placement accuracy (98.8% grade A), and efficient processing times, supporting its potential to optimize robot-assisted spinal surgery workflows.Copyright © 2025. Published by Elsevier Inc.

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出版当年[2025]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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第一作者机构: [1]Department of orthopedics, Beijing Tongren Hospital, Capital Medical University, Beijing , China.
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通讯机构: [4]Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China [5]Longwood Valley Medical Technology Co Ltd, Beijing, China.
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