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Michael Wehrli

Publications and source records attributed to Michael Wehrli.

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SA-Profile: Automated Sulcus Angle Profiling from Super-Resolution MRI

Trochlear dysplasia (TD) is an abnormality of the femoral trochlea associated with anterior knee pain and patellar instability. The sulcus angle (SA) is used to assess trochlear morphology, but it is typically measured on a single axial MR slice with no clear guidance on which to select, making it sensitive to slice selection and landmark placement. We propose an automatic framework for continuous SA profiling from super-resolved MR volumes. Clinically acquired axial, coronal, and sagittal MR scans are combined using implicit neural representations to reconstruct a high-resolution volume. SA measurements are computed across the trochlear region using two landmark detection U-Net models. The approach was evaluated on the public fastMRI dataset and a small in-house cohort of patients with TD. Compared with conventional manual single-slice SA measurements, the proposed automated method yielded a mean absolute error of 11.6$^\circ$ while providing continuous characterization of trochlear morphology. Population-level analysis demonstrated distinct mean SA profiles between the public cohort and the in-house TD cohort, highlighting the potential of profile-based assessment to characterize TD. By reducing reliance on a single manually selected axial slice, the proposed framework extends conventional SA assessment to a continuous profile-based description of trochlear morphology without additional imaging, while remaining conceptually linked to current clinical assessment. Further validation is required. The code is available: https://github.com/wehrlimi/SA_Profile.

cs.CV

NOIR: Neural Operator mapping for Implicit Representations

This paper presents NOIR, a framework that reframes core medical imaging tasks as operator learning between continuous function spaces, challenging the prevailing paradigm of discrete grid-based deep learning. Instead of operating on fixed pixel or voxel grids, NOIR embeds discrete medical signals into shared Implicit Neural Representations and learns a Neural Operator that maps between their latent modulations, enabling resolution-independent function-to-function transformations. We evaluate NOIR across multiple 2D and 3D downstream tasks, including segmentation, shape completion, image-to-image translation, and image synthesis, on several public datasets such as Shenzhen, OASIS-4, SkullBreak, fastMRI, as well as an in-house clinical dataset. It achieves competitive performance at native resolution while demonstrating strong robustness to unseen discretizations, and empirically satisfies key theoretical properties of neural operators. The project page is available here: https://github.com/Sidaty1/NOIR-io.

cs.CV

End2Reg: Learning Task-Specific Segmentation for Markerless Registration in Spine Surgery

Intraoperative navigation in spine surgery demands millimeter-level accuracy. Currently, this is achieved through radiation-intensive intraoperative imaging and bone-anchored markers that are invasive and disrupt surgical workflow. Markerless RGB-D registration methods offer a promising alternative. However, existing approaches rely on weak segmentation labels to isolate relevant anatomical structures, potentially propagating errors through the registration process. We present End2Reg, an end-to-end deep learning framework that jointly optimizes segmentation and registration, eliminating the need for segmentation labels and manual steps. The network learns task-specific segmentation masks optimized for registration, guided solely by the registration objective without explicit segmentation supervision. End2Reg achieves state-of-the-art performance on ex- and in-vivo benchmarks, reducing median Target Registration Error by 32% and mean Root Mean Square Error by 61%, while maintaining robust performance under partial occlusions. Ablation results confirm that end-to-end optimization significantly improves registration accuracy. Overall, End2Reg advances towards fully automatic, markerless intraoperative navigation. Code and interactive visualizations are available at: https://lorenzopettinari.github.io/end-2-reg/.

cs.CV

Towards MR-Based Trochleoplasty Planning

To treat Trochlear Dysplasia (TD), current approaches rely mainly on low-resolution clinical Magnetic Resonance (MR) scans and surgical intuition. The surgeries are planned based on surgeons experience, have limited adoption of minimally invasive techniques, and lead to inconsistent outcomes. We propose a pipeline that generates super-resolved, patient-specific 3D pseudo-healthy target morphologies from conventional clinical MR scans. First, we compute an isotropic super-resolved MR volume using an Implicit Neural Representation (INR). Next, we segment femur, tibia, patella, and fibula with a multi-label custom-trained network. Finally, we train a Wavelet Diffusion Model (WDM) to generate pseudo-healthy target morphologies of the trochlear region. In contrast to prior work producing pseudo-healthy low-resolution 3D MR images, our approach enables the generation of sub-millimeter resolved 3D shapes compatible for pre- and intraoperative use. These can serve as preoperative blueprints for reshaping the femoral groove while preserving the native patella articulation. Furthermore, and in contrast to other work, we do not require a CT for our pipeline - reducing the amount of radiation. We evaluated our approach on 25 TD patients and could show that our target morphologies significantly improve the sulcus angle (SA) and trochlear groove depth (TGD). The code and interactive visualization are available at https://wehrlimi.github.io/sr-3d-planning/.

cs.CV

Generating 3D Pseudo-Healthy Knee MR Images to Support Trochleoplasty Planning

Purpose: Trochlear Dysplasia (TD) is a common malformation in adolescents, leading to anterior knee pain and instability. Surgical interventions such as trochleoplasty require precise planning to correct the trochlear groove. However, no standardized preoperative plan exists to guide surgeons in reshaping the femur. This study aims to generate patient-specific, pseudo-healthy MR images of the trochlear region that should theoretically align with the respective patient's patella, potentially supporting the pre-operative planning of trochleoplasty. Methods: We employ a Wavelet Diffusion Model (WDM) to generate personalized pseudo-healthy, anatomically plausible MR scans of the trochlear region. We train our model using knee MR scans of healthy subjects. During inference, we mask out pathological regions around the patella in scans of patients affected by TD, and replace them with their pseudo-healthy counterpart. An orthopedic surgeon measured the sulcus angle (SA), trochlear groove depth (TGD) and D\'ejour classification in MR scans before and after inpainting. The code is available at https://github.com/wehrlimi/Generate-Pseudo-Healthy-Knee-MRI . Results: The inpainting by our model significantly improves the SA, TGD and D\'ejour classification in a study with 49 knee MR scans. Conclusion: This study demonstrates the potential of WDMs in providing surgeons with patient-specific guidance. By offering anatomically plausible MR scans, the method could potentially enhance the precision and preoperative planning of trochleoplasty, and pave the way to more minimally invasive surgeries.

eess.IV