arXiv:2608.25845cs.CV2026-08

用AI从术前CT生成多种合理假体方案,辅助髋关节置换手术规划。

THA-Flow Generative Model: Prosthesis Geometry Prediction from Preoperative CT

论文配图:THA-Flow Generative Model: Prosthesis Geometry Prediction from Preoperative CT
图 1 · 摘自论文原文
  • 基于3D流匹配模型,从术前CT直接生成假体三维几何。
  • 在1355例数据上实现93.4%假体类型全覆盖,重建质量峰值信噪比达47.11dB。
  • 支持多解生成,保持关键位置与界面稳定,适合临床决策参考。

髋关节置换术前规划通常被简化为选择单一假体配置,但同一骨骼结构可能对应多个合理方案,本质上是“一对多”问题,更宜用条件概率分布表示。本文提出THA-Flow,一种基于条件流匹配的生成模型,可直接从术前CT生成三维假体几何。通过独立的AutoencoderKL压缩骨结构与假体形状,再利用3D UNet在空间骨条件与可选结构参数下学习从高斯噪声到假体潜在空间的校正流。回顾性队列包含1,355个髋关节(来自1,149名患者)的初次全髋置换。术后CT经刚性配准至术前CT后,实际假体根据骨盆与股骨配准独立变换,并以双通道截断有符号距离场表示。假体自编码器在验证集上达到47.11 dB的峰值信噪比与0.9964的结构相似性指数。模型成功生成了涵盖七种主流柄型、覆盖93.4%队列的完整髋臼与股骨几何。重复骨条件采样在保持组件位置、对齐及主要骨-假体界面的同时,允许局部几何变化。据我们所知,THA-Flow是首个将生成式AI应用于三维髋关节置换术前规划的研究。

原文摘要 · Abstract (English)

Preoperative planning for total hip arthroplasty (THA) is commonly framed as selecting a single prosthesis configuration and placement for a patient's osseous anatomy. In practice, however, the same anatomy may admit several clinically reasonable solutions, making planning inherently a one-to-many problem that is better represented by a conditional probability distribution. We present THA-Flow, a conditional flow-matching model that generates three-dimensional prosthesis geometry directly from preoperative CT. Separate AutoencoderKL models compress preoperative bone anatomy and prosthesis geometry, while a three-dimensional UNet learns a rectified flow from Gaussian noise to the prosthesis latent space under spatial bone conditioning and optional structured prosthesis parameters. The retrospective cohort comprised 1,355 hips from 1,149 patients undergoing primary THA. Following rigid registration of postoperative CT to preoperative CT, the actual postoperative prostheses were transformed independently according to the pelvic and femoral registrations and represented as a dual-channel truncated signed distance field. The prosthesis autoencoder achieved a peak signal-to-noise ratio of 47.11 dB and a structural similarity index of 0.9964 on the validation set. Complete acetabular and femoral geometries were generated across seven major stem models representing 93.4% of the cohort. Repeated bone-conditioned sampling preserved component position, alignment, and the principal bone-prosthesis interfaces while allowing limited local geometric variation. To our knowledge, THA-Flow represents the first application of generative AI to three-dimensional surgical planning for THA.

医学影像生成模型手术规划三维重建

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