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  • Title: Measurement of the Acetabular Cup Orientation After Total Hip Arthroplasty Based on 3-Dimensional Reconstruction From a Single X-Ray Image Using Generative Adversarial Networks.
    Author: Fujita A, Goto K, Ueda A, Kuroda Y, Kawai T, Okuzu Y, Okuno Y, Matsuda S.
    Journal: J Arthroplasty; 2025 Jan; 40(1):136-143.e1. PubMed ID: 38944061.
    Abstract:
    BACKGROUND: The purpose of this study was to reconstruct 3-dimensional (3D) computed tomography (CT) images from single anteroposterior (AP) postoperative total hip arthroplasty (THA) X-ray images using a deep learning algorithm known as generative adversarial networks (GANs) and to validate the accuracy of cup angle measurement on GAN-generated CT. METHODS: We used 2 GAN-based models, CycleGAN and X2CT-GAN, to generate 3D CT images from X-ray images of 386 patients who underwent primary THAs using a cementless cup. The training dataset consisted of 522 CT images and 2,282 X-ray images. The image quality was validated using the peak signal-to-noise ratio and the structural similarity index measure. The cup anteversion and inclination measurements on the GAN-generated CT images were compared with the actual CT measurements. Statistical analyses of absolute measurement errors were performed using Mann-Whitney U tests and nonlinear regression analyses. RESULTS: The study successfully achieved 3D reconstruction from single AP postoperative THA X-ray images using GANs, exhibiting excellent peak signal-to-noise ratio (37.40) and structural similarity index measure (0.74). The median absolute difference in radiographic anteversion was 3.45° and the median absolute difference in radiographic inclination was 3.25°, respectively. Absolute measurement errors tended to be larger in cases with cup malposition than in those with optimal cup orientation. CONCLUSIONS: This study demonstrates the potential of GANs for 3D reconstruction from single AP postoperative THA X-ray images to evaluate cup orientation. Further investigation and refinement of this model are required to improve its performance.
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