Dynamic Stereo X-Ray (DSX) Suite

The sub-millimeter bone pose tool for joint movements from biplanar videoradiography data.

The DSX suite is designed to process data from biplanar videoradiography (a.k.a. dual fluoroscopy). It is software for generating rapid, robust, and reliable bone or implant pose estimation from radiographic image sequences with minimal operator intervention. The suite of applications enables the processing of the X-ray data from collection through analysis and reporting.

Dynamic X-ray is needed because joint translations of only a few millimeters are critical to estimating tissue stress or joint impingement during loaded functional movements, and Dynamic X-ray processing is the only currently available technology that can achieve sub-millimeter bone pose (position and orientation) estimation accuracy during a wide variety of functional movements.

Processing requires a hi-res CT scan of the subject, a local reference frame assigned to each bone to be tracked, and a time series of X-ray images containing the bones.

The DSX Application Suite Features


XManager lets you manage subject information and all of the system configurations, trials, and data files associated with it. The most important function of XManager is to create, store, and load the data associated with a subject.

XManager can then be used to launch any of the DSX applications in the DSX Suite with the subject information pre-loaded.



X4D tracks bones and implants in X-ray trials, using single-frame or 4D optimization. The DSX algorithm solves for the 3D pose by registering two non-coplanar X-ray images of a bone to two digitally reconstructed radiographs (DRRs).

Visual3D was extended to integrate directly with X4D. The surface models and associated reference frames and regions of interest are loaded for additional kinematics processing and reporting.

To match DRR images to X-ray images, both sets of images are processed first. X-ray images are smoothed with a convolution filter, and then an edge detection algorithm is performed on them. The final processed X-ray image that is used for tracking is the edge detection image times a weighting factor, plus the smoothed intensity image. DRR images are not smoothed, but are input to the edge detection algorithm. The final processed DRR image is the edge detection image time a weighting factor, plus the original DRR image.



CalibrateDSX calculates the 3D configuration parameters of the X-ray hardware (the Pose of the X-ray sources and image planes) from images of a calibration object. It also uniformity-corrects, distortion-corrects, and resizes all X-ray image files.



Surface3D allows you to segment individual objects from CT data, create surface models of the objects, and identify anatomical landmarks (e.g., ligament attachments). It uses 3D image data and creates tracking objects (as voxel data) and surface models (as polygons) from voxel data. It allows the user to identify anatomical landmarks that are easily identifiable in image data and to get everything (CT, surface models, landmarks, etc.) in the proper reference frames.

Surface3D can:
- Import DICOM files with CT data
- Use thresholding to label the voxels of the bone of interest
- Mask out the other voxels
- Crop the data
- Create a surface model

Note: For segmentation alone, alternative tools such as Mimics, ScanIP, and 3D-Slicer may also be used.



Orient3D prepares object surface models for tracking in X4D and kinematic analysis in Visual3D. It loads surface models and calculates anatomically meaningful reference frames and allows you to definelandmarks, and regions of interest, which are used to generate joint-distance maps.



Locate3D tracks points of interest (usually radiopaque beads) in X-ray image sequences.



PlanDSX (still in development) is a utility for designing the appropriate 3D configuration of the X-ray hardware for a specific subject and/or task.

Documentation Wiki

All product documentation is on-line and available for general access. Tutorials are there too.

Frequently Asked Questions

How much does the software cost?

The DSX Suite of tools costs $27,500 USD for a single license. Additional licenses are $5,000 USD.

How do I get the software?

Web download only. When purchased, an on-line customer account is created and all software is downloaded over the Internet from c-motion.com. C-Motion accepts purchase orders, credit cards, bitcoin, wire transfers, and checks.

How many copies can I install?

DSX is licensed per computer. Licenses are activated and deactivated locally and apply to the whole suite of applications.

Does it run on a MAC?

DSX is a Windows application. It will run on a MAC only in a VM, like Parallels or VMWare where Windows has been installed. Be sure to turn off any hardware graphics accelerators in a MAC VM for OpenGL compatibility.

Is paid support available?

Yes, and it is free the first year. Maintaining support is $1250 USD per year. DSX support keeps the web download access for updates active, and allows access to C-Motion's world-class experts for biomechanics assistance.

Is paid support required?

No, DSX will continue to run without purchasing support, you just won't be able to get updates or research help.

What are the corporate software policies?

A statement of C-Motion's support, user, and web access policies is available here.

How does licensing work?

A single installation file and license key are used by the entire lab. Each installed copy of the DSX Suite will activate its license over the Internet, limited to the number of licenses purchased. Licenses can be deactivated from the Help menu in XManager.