WHITEPAPER

Finding the Optimal X-Ray Imaging Protocol for Accurate 2D/3D Registration Using Virtual X-Rays

Although 2D/3D registration has shown to be a low radiation and low cost alternative to CT for measuring 3D implant position, finding a good imaging protocol for complex anatomies like the shoulder can be challenging. Since the presence of other bones in the area reduces the visibility of the contours of bones and the implant, standard X-rays taken for diagnosis and follow-up are not necessarily optimal for 2D/3D registration. Virtual X-ray images, simulating realistic post-operative imaging conditions, can be used to find the best angles, thus eliminating the need for physical experiments. This case study on total reverse shoulder arthroplasty serves as an example of how virtual X-ray images can help determine the optimal angles for accurate 2D/3D registration.