Recovering the 6-DoF pose of the knee bones from a plain radiograph, given the patient's segmented pre-operative CT, turns a routine low-dose image into a quantitative measurement of joint geometry, without the added dose of a repeat CT or a fixed biplanar rig. Classic solutions align a rendered bone silhouette to image edges; recent alternatives refine pose by backpropagating an image-similarity loss through a differentiable X-ray renderer. Both operate one patient at a time and are fragile under a single view. Silhouettes are depth-ambiguous, and differentiable-rendering refinement has a narrow capture range at substantial per-iteration cost. We instead learn an amortized, subject-agnostic dense 2D-3D correspondence, supervised solely by projection geometry. One shared-weight model per bone, trained across 758 patients, registers patients unseen during training. The pose then follows in closed form from a global, initialization-free, render-free PnP+RANSAC solve. Because X-ray formation is transmissive, our correspondence target is transmission-aware rather than tied to a single surface. Though trained only to register, the representation is anatomically semantic: a simple classifier reads a landmark's anatomical region from its embedding across held-out patients, and the same features separate the knee's bones into a 2D-3D-consistent identity learned without any bone label. On a large single-institution cohort the model generalizes well to held-out patients.
This paper addresses a special Perspective-n-Point (PnP) problem: estimating the optimal pose to align 3D and 2D shapes in real-time without correspondences, termed as correspondence-free PnP. While several studies have focused on 3D and 2D shape registration, achieving both real-time and accurate performance remains challenging. This study specifically targets the 3D-2D geometric shape registration tasks, applying the recently developed Reproducing Kernel Hilbert Space (RKHS) to address the "big-to-small" issue. An iterative reweighted least squares method is employed to solve the RKHS-based formulation efficiently. Moreover, our work identifies a unique and interesting observability issue in correspondence-free PnP: the numerical ambiguity between rotation and translation. To address this, we proposed DynaWeightPnP, introducing a dynamic weighting sub-problem and an alternative searching algorithm designed to enhance pose estimation and alignment accuracy. Experiments were conducted on a typical case, that is, a 3D-2D vascular centerline registration task within Endovascular Image-Guided Interventions (EIGIs). Results demonstrated that the proposed algorithm achieves registration processing rates of 60 Hz (without post-refinement) and 31 Hz (with post-refinement) on modern single-core CPUs, with competitive accuracy comparable to existing methods. These results underscore the suitability of DynaWeightPnP for future robot navigation tasks like EIGIs.
3D/2D registration serves as a cornerstone technique in surgical navigation. Traditional iterative optimization algorithms suffer from low efficiency and high failure rates in intraoperative settings. Deep learning-based methods reformulate registration from iterative optimization to a regression problem that maps image appearance features to spatial pose, typically achieving improved real-time performance and accuracy. However, such learnable methods are confined to memory-driven retrieval of specific pose features rather than understanding the task of image alignment itself, which limits their generalization in complex scenarios. We propose LayersReg, a pioneering regression paradigm that endows the model with 3D anatomical awareness and searches for the correct pose in a progressive, layer-by-layer manner. Inspired by the iterative pose-searching optimization criterion of classical registration, LayersReg searches for correlations between the moving and fixed images in feature space, capturing the trend of pixel flow and thereby converging iteratively toward the correct spatial pose transformation. We further design a coupling of node-wise regression with the progressive registration framework to enhance the model's perception of spatial pose changes. Experimental results demonstrate that under large offsets and multimodality conditions, LayersReg achieves high accuracy on both X-ray/CT registration (0.68°, 1.41 mm) and slice localization (0.73°, 1.55 mm) tasks, outperforming existing state-of-the-art methods while meeting the intraoperative demands for precision and real-time capability.
In computer- and robot-assisted orthopedic surgery (CAOS), patient-specific surgical plans derived from preoperative imaging define target locations and implant trajectories. During surgery, these plans must be accurately transferred, relying on precise cross-registration between preoperative and intraoperative data. However, substantial modality heterogeneity across imaging modalities makes this registration challenging and error-prone. Robust, automatic, and modality-agnostic bone surface registration is therefore clinically important. We propose NeuralBoneReg, a self-supervised, surface-based framework that registers bone surfaces using 3D point clouds as a modality-agnostic representation. NeuralBoneReg includes two modules: an implicit neural unsigned distance field (UDF) that learns the preoperative bone model, and an MLP-based registration module that performs global initialization and local refinement by generating transformation hypotheses to align the intraoperative point cloud with the neural UDF. Unlike SOTA supervised methods, NeuralBoneReg operates in a self-supervised manner, without requiring inter-subject training data. We evaluated NeuralBoneReg against baseline methods on two publicly available multi-modal datasets: a CT-ultrasound dataset of the fibula and tibia (UltraBones100k) and a CT-RGB-D dataset of spinal vertebrae (SpineDepth). The evaluation also includes a newly introduced CT-ultrasound dataset of cadaveric subjects containing femur and pelvis (UltraBones-Hip), which will be made publicly available. NeuralBoneReg matches or surpasses existing methods across all datasets, achieving mean RRE/RTE of 1.83°/2.02 mm on UltraBones100k, 1.90°/1.56 mm on UltraBones-Hip, and 3.78°/2.80 mm on SpineDepth. These results demonstrate strong generalizability across anatomies and modalities, providing robust and accurate cross-modal alignment for CAOS.
Luohong Wu, Matthias Seibold, Nicola A. Cavalcanti +5