CurveBeam AI Cast

The orthopedic specialty has progressed since the first robotic applications were first introduced 30 years ago. Dr. Stefano Bini, Chief Technology Officer for the University of California San Francisco (UCSF) Department of Orthopaedic Surgery, discussed these advancements with Host Vinti Singh.

Dr. Bini commented how some of the biggest impacts tech has had at UCSF has been on the administrative side, with improved tools for intake, referral management, surgical scheduling and patient engagement.

In the Operating Room, robotic surgery is a fast growing area, but challenges include the increasing costs for deployment.

In addition, UCSF doctors are using 3D printing to better prepare for complex pediatric deformities and spinal deformities. Dr. Bini himself uses 3D printing prior to hip surgeries to better understand bone loss in the pelvis, especially around the implants.

"The next generation of that, however, is you don't need to print a 3D model - you can create a 3D hologram," Dr. Bini said. "And visualize it using a VR or AR headset, but even a phone or iPad. And then you can literally manipulate it as if you had a 3D model in your hand."

These models, whether printed or virtual, or built from segmented medical images. Machine learning algorithms that automate that segmentation process are becoming stronger with each dataset they are fed.

These algorithms are developing so quickly that, "I’d say you will see clinical applications over the next two to three years,” Dr. Bini said.

Adoption of synthetic data, or manmade medical images statistically equal to but different from the original set, could drive AI modelling accuracy even more quickly, he said.

However, not all physicians are running to adopt these trends. Dr. Bini explained that resistance will eventually ease.

“When the technology is presented in such a way that it clearly solves a pain point, and it does so at a price point and at an adoption point that is manageable for that particular person in the environment, then it tends to be adopted rather quickly,” he stated.

Finally, Dr. Bini discussed the upcoming Digital Orthopaedics Conference in San Francisco, which he organizes. Visit docsf.health for more information.

For more information on these trends, subscribe to the podcast on Apple iTunes or Spotify and visit the curvebeam.com website for imaging solutions and AI insight.

Dive into the research and technology that can provide better alignment treatment.

To watch the video version of this conversation, please CLICK HERE.

Weight bearing CT imaging could change how surgeons approach hindfoot alignment (HA) & deformity. Multiple scientific papers delve into the difficulties of measuring HA on traditional radiographs. Challenges posed by 2D imaging include superimposition by the midfoot and dependency on patient position.

CurveBeam Connect host Vinti Singh spoke with Dr. Arne Burssens, Foot and Ankle Surgeon in Belgium, and Sorin Siegler, Mechanical Engineering and Mechanic Professor, Drexel University about different methodologies to measure HA via WBCT.

Dr. Siegler has devised a proposed method that takes the tibia, talus and calcaneus into account and is inspired by clinical measures that are done in a qualitative manner by surgeons in a surgical procedure. Siegler described his methodology in detail.

Meanwhile, Dr. Burssens et al have taken the approach of utilizing methods previously described in scientific literature for radiographic evaluation of the hindfoot. However, these methods account for internal rotation, which radiographs do not. These differ from Dr. Siegler’s in that they use the anatomical structure of the tibia rather than a centroid calculated from anatomical landmarks.

"Standards committees are being established to determine which measurements should be adapted as the standard." Burssens said.

Weight bearing CT imaging could change how surgeons approach hindfoot alignment (HA) & deformity. Multiple scientific papers delve into the difficulties of measuring HA on traditional radiographs. Challenges posed by 2D imaging include superimposition by the midfoot and dependency on patient position.

CurveBeam Connect host Vinti Singh spoke with Dr. Arne Burssens, Foot and Ankle Surgeon in Belgium, and Sorin Siegler, Mechanical Engineering and Mechanic Professor, Drexel University about different methodologies to measure HA via WBCT.

Dr. Siegler has devised a proposed method that takes the tibia, talus and calcaneus into account and is inspired by clinical measures that are done in a qualitative manner by surgeons in a surgical procedure. Siegler described his methodology in detail.

Meanwhile, Dr. Burssens et al have taken the approach of utilizing methods previously described in scientific literature for radiographic evaluation of the hindfoot. However, these methods account for internal rotation, which radiographs do not. These differ from Dr. Siegler’s in that they use the anatomical structure of the tibia rather than a centroid calculated from anatomical landmarks.

Standards committees are being established to determine which measurements should be adapted as the standard. Burssens said.

A Conversation With WBCT Society President-Elect Francois Lintz

When it comes to diagnostic imaging, 3D imaging provides an all-encompassing view of the body. For weight-bearing body parts, a 3D look can allow doctors to get an image, make a more accurate assessment and determine the best medical care.

When it comes to diagnostic imaging, 3D imaging provides an all-encompassing view of the body. For weight-bearing body parts, a 3D look can allow doctors to get an image, make a more accurate assessment and determine the best medical care.

Dr. Francois Lintz, a foot and ankle specialist and pioneer of 3D imaging, has used the methodology as a central tenant of his care. During his time as a doctoral fellow, he stumbled upon hindfoot alignment in 3D, which led to his partnership with CurveBeam.

On this episode of CurveBeam Connect, Host Vinti Singh, Marketing Director for Curvebeam, talked with Lintz about his career and his work with 3D imaging. The duo also dug into the history of the WBCT and Lintz’s current role as president-elect.

Francois, a foot and ankle surgeon, fell in love with this practice in 2006. The doctor he studied under during his fellowship had the intuition that the industry would switch to 3D sooner rather than later. He then asked Lintz to work on hindfoot alignment in 3D. Lintz, confused, asked the doctor what he should do. The answer? Just find something.

“We had this idea to measure hindfoot alignment in 3D and to define what this meant,” Lintz said. “This was the seminal work that led us to work with CurveBeam.”

Listen to learn more about Lintz’s career, history with 3D imaging and work with CurveBeam.

Turner Dean and Stuti Singh meet with podcast host Vinti Singh to explain what customers can expect from the new CurveBeam Cloud platform currently in development.

Despite all of the challenges that the COVID-19 pandemic has brought us over the past year, it's also shown us a silver lining: When it comes to the systems in our society, there's so much that we can still improve on.

Dr. Alireza Khosroabadi discusses his AMI (advanced minimally invasive) bunion procedure.

Dr. Alireza Khosroabadi, DPM, opened the Khosroabadi Institute in Los Angeles, CA to shift his practice from general podiatry to surgical procedures.

His minimally invasive bunion procedure has been featured on “The Doctors” television show. Dr. Khosroabadi spoke to CuveBeam’s Vinti Singh about his approach to bunion correction.

Dr. Selene Parekh discusses the latest trends in orthopedics.

Dr. Selene Parekh, MD, MBA, wears several different hats in the orthopedic world. He’s a Foot & Ankle Specialist at Duke Health. He is known as “The Fantasy Doctor” in media circles, and he uses his data-driven insights and medical expertise to guide sports enthusiasts through the precarious world of sports injuries to make accurate predictions on how an athlete’s injury might impact their fantasy team. And, to top it off, Parekh brings his knowledge and insights of foot and ankle injuries to India, where his mission is to provide the latest techniques and best practices to the surgeons there. One area of orthopedic medicine that’s making a lot of progress these days, Parekh said, is 3D printing.

Dr. David Soomekh discusses the benefits of having an onsite Cone Beam CT imager.

Dr. David Soomekh is a board-certified foot and ankle specialist and surgeon and founder of the Foot & Ankle Specialty Group in Beverly Hills, CA. Soomekh specializes in sports medicine and reconstructive foot and ankle surgery.

He’s practiced foot and ankle medicine and surgery for the past 20 years, and his goal is to provide a one-stop-shop for patients from examination to diagnosis to treatment.

To do that, Soomekh relies on on-site imaging and diagnostic equipment.

“Everything is all here at the facility, so I can treat patients from A-Z,” Soomekh said.

That includes a Cone Beam CT imaging system.

“What’s the most important thing for a physician to decide is how a technology is going to change my practice in terms of how this will help the patient and help me guide them into a better diagnosis, which then leads to better treatment,” Soomekh said.

The onset of COVID-19 provided an added benefit to having imaging equipment on-site by allowing for fewer patient appointments.

“Patients are fearful of having to go to multiple places to have the various steps of the diagnosis process performed,” Sommekh said. “In my office, a patient is only coming for a foot and ankle issue. You’re not going to have a sick patient here waiting to get an MRI or a CT.”

Dr. Chris O’Grady, an Orthopedic Surgeon who specializes in shoulder reconstruction and replacement, joins CurveBeam’s Jenna Roller for a conversation about innovations in robotic surgery and 3-D CT scans.

Dr. Chris O’Grady wants to see joints.

The Florida-based Orthopedic Surgeon who specializes in shoulder reconstruction and replacement has experienced first-hand how helpful it is to have 3-D images when he prepares to perform a procedure.

While O’Grady is much more familiar with shoulders than knees, he’s still excited to see CurveBeam’s upcoming entire lower extremity scanner, having seen how getting in-depth images before beginning a procedure can change the game.

“I really learned the importance of [understanding] the three-dimensional glenoid or socket of the shoulder. Where things have advanced to now is that, for every single shoulder replacement that I do, the patient gets a CAT scan, the 3-D images are then put into this proprietary software that really quite literally allows me to do the surgery long before the patient ever gets to the operating room.”

O’Grady has become an innovator in the robotic surgery space but said he still considers it more of a personal interest than something he frequently puts into practical application.

Robotic surgeons coming close to the same level of their human counterparts are still a ways off, but there is still reason to be excited about innovations in technology, O’Grady said, especially as information is being shared more widely than ever.

“What the future is going to allow are the surgeons that are kind of the onesy-twosy private practicing people in the middle of nowhere who don’t have the intricate systems that would allow them research assistance and all that sort of stuff, you might still have somebody there who does 1,000 knee replacements a year,” he said. “Well, now that person’s data will be able to get pooled into the ivory tower people running these massive studies that instead of having a few hundred patients can have tens of thousands of patients, involve many more surgeons and analyzing that data is very quickly going to solve some questions that I think people are still arguing on these podiums about.

Vinti Singh, Director of Global Marketing for Curvebeam, is joined by Dr. Frederik Vanrietvelde of AZ Groeninge Kortrijk, for a conversation about how cone beam CT is being legislated and utilized in Belgium.

Click here to view an article Dr. Vanrietvelde authored for his hospital newsletter to to educate orthopedic surgeons about weight bearing CT imaging.

Belgian surgeons were beginning to utilize cone beam CT several years ago.

Then, doctors like AZ Groeninge Kortrijk’s Dr. Frederik Vanrietvelde suddenly had to slow their use of the modality because of price concerns, with cone beam CT suddenly left off a crucial list made by legislators.

Vanrietvelde and some colleagues lobbied to make sure it was included, noting that it met the definition of a CT scan approved for reimbursement by the government and that its absence was simply a mistake.

“If you look very closely, you could tell cone beam CT also corresponds to these particular parameters they use, so it should have been on this list, anyway,” he said. “So, there was really no reason why it shouldn’t be on the list, and they really never argued that what we were asking was not correct. They simply said, ‘Sorry, we forgot it. We have to correct it.’”

Even still, the process took two years for hospitals to once again be able to bill cone beam CT in the same way they were billing a more traditional CT scan. With that being the case, the numbers of Belgian doctors utilizing the technology remain relatively small.

Still, Vanrietvelde is confident their numbers will grow now that the scans are more accessible, and he said the most important thing was to put himself into others’ shoes.

“It’s always a difficult balance you have to do as a legislator. I’m thinking as a radiologist, and the patient is thinking as a patient. A legislator has to think as a legislator and think about budget balance, so my main advice would be come together,” he said. “Let’s get all those people together with different mindsets and different perspectives before you decide how to reimburse something.”