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However, in contrast to standing radiographs, a CT scan is not part of the standard protocol but is usually acquired for preoperative planning purposes only. Additionally, it is costly, exposes the patients to high doses of radiation and is acquired in a non-weight-bearing position.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this study, we develop a deep-learning based pipeline to facilitate 3D preoperative planning for high tibial osteotomies, based on 3D models reconstructed from low-dose biplanar standing EOS radiographs. Using digitally reconstructed radiographs, we train networks to localize the clinically required landmarks, separate the two legs in the sagittal radiograph and finally reconstruct the 3D bone model. Finally, we evaluate the accuracy of the reconstructed 3D models for the particular application case of preoperative planning, with the aim of eliminating the need for a CT scan in specific cases, such as high tibial osteotomies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The mean Dice coefficients for the tibial reconstructions were 0.92 and 0.89 for the right and left tibia, respectively. The reconstructed models were successfully used for clinical-grade preoperative planning in a real patient series of 52 cases. The mean differences to ground truth values for mechanical axis and tibial slope were 0.52\u00b0 and 4.33\u00b0, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We contribute a novel framework for the 2D\u20133D reconstruction of bone models from biplanar standing EOS radiographs and successfully use them in automated clinical-grade preoperative planning of high tibial osteotomies. However, achieving precise reconstruction and automated measurement of tibial slope remains a significant challenge.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11548-024-03110-5","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T15:02:26Z","timestamp":1712242946000},"page":"1843-1853","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Deep-learning based 3D reconstruction of lower limb bones from biplanar radiographs for preoperative osteotomy planning"],"prefix":"10.1007","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2342-9710","authenticated-orcid":false,"given":"Tabitha","family":"Arn Roth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Jokeit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reto","family":"Sutter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lazaros","family":"Vlachopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro F.","family":"Fucentese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Carrillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jess G.","family":"Snedeker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Esfandiari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"F\u00fcrnstahl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"key":"3110_CR1","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1080\/10255842.2010.540758","volume":"15","author":"Y Chaibi","year":"2012","unstructured":"Chaibi Y, Cresson T, Aubert B, Hausselle J, Neyret P, Hauger O, De Guise J, Skalli W (2012) Fast 3D reconstruction of the lower limb using a parametric model and statistical inferences and clinical measurements calculation from biplanar X-rays. 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