CT and MRI of hip arthroplasty

Cahir, John; Toms, Andoni P.; Marshall, T.; Wimhurst, J.A.; Nolan, John

doi:10.1016/j.crad.2007.04.018

Cited by 95 publications

(75 citation statements)

References 31 publications

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“…Despite CT's proven diagnostic superiority over standard radiographs [8,34], it is still not routinely performed on patients suffering osteolysis and therefore limited our access to clinical data. Traditional open revision surgery is performed under visual guidance and therefore does not require accurate 3D-image-based tissue segmentation.…”

Section: Discussionmentioning

confidence: 99%

“…1a are the default imaging modality for diagnosing osteolysis [6]. While sufficient for diagnosis, radiographs do not capture the 3D distribution of periprosthetic tissues, where computed tomography (CT) remains the imaging modality of choice [7,8]. Unfortunately, CT suffers from image degradation in the vicinity of metal prostheses [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Voxel classification and graph cuts for automated segmentation of pathological periprosthetic hip anatomy

2012

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Purpose Automated patient-specific image-based segmentation of tissues surrounding aseptically loose hip prostheses is desired. For this we present an automated segmentation pipeline that labels periprosthetic tissues in computed tomography (CT). The intended application of this pipeline is in pre-operative planning. Methods Individual voxels were classified based on a set of automatically extracted image features. Minimum-cost graph cuts were computed on the classification results. The graphcut step enabled us to enforce geometrical containment constraints, such as cortical bone sheathing the femur's interior. The solution's novelty lies in the combination of voxel classification with multilabel graph cuts and in the way label costs were defined to enforce containment constraints.Results The segmentation pipeline was tested on a set of twelve manually segmented clinical CT volumes. The distribution of healthy tissue and bone cement was automatically determined with sensitivities greater than 82% and pathological fibrous interface tissue with a sensitivity exceeding 73%. Specificity exceeded 96% for all tissues. Conclusions The addition of a graph-cut step improved segmentation compared to voxel classification alone. The pipeline described in this paper represents a practical approach to segmenting multitissue regions from CT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Voxel classification and graph cuts for automated segmentation of pathological periprosthetic hip anatomy

2012

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Section: Introductionmentioning

confidence: 99%

“…In recent years, there have been numerous studies examining its role in imaging THA [3,7,38,39,46,[50][51][52]. MRI is effective for detecting periarticular bony and soft-tissue abnormalities in patients with a postarthroplasty hip [3,39,46,52], as well as determining the source of enigmatic hip following THA [7]. Due to its direct multiplanar capabilities and superior soft-tissue contrast, MRI is able to visualize intracapsular synovitis [7,39,52] and is more sensitive in the detection of osteolytic lesions than radiographs or CT [50,51].…”

Section: Introductionmentioning

confidence: 99%

Early Reactive Synovitis and Osteolysis after Total Hip Arthroplasty

Cooper

Ranawat

Potter

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Little is known about intraarticular pathology following THA prior to the radiographic appearance of osteolysis, primarily due to imaging limitations. MRI has recently been applied to imaging the postarthroplasty hip with the ability to detect periarticular bony and soft tissue pathology; specifically, it is able to detect abnormal synovial patterns and focal bone loss well before the radiographic appearance of osteolysis. Questions/purposes We therefore used MRI to determine the incidence of early reactive synovitis and osteolysis in asymptomatic patients after THA, and whether there is an association between these MRI findings and clinical outcomes or radiographic wear measurements at this early stage. Methods We recruited 31 patients (33 hips) who underwent routine noncemented THA with one of three types of bearing surfaces: metal-on-cross-linked polyethylene (n = 7), ceramic-on-ceramic (n = 12), and ceramic-on-cross-linked polyethylene (n = 14). Patients underwent specialized MRI at a minimum of 12 months (mean, 23 months; range, 12-37 months) after surgery. MR images were analyzed for the presence of synovitis or osteolysis. WOMAC scores, patient assessment questionnaires, and radiographic wear measurements were correlated with MRI findings. Results Reactive synovitis was observed in 13 of 33 patients (39%) and focal osteolysis in one of 33 (3%). The presence of synovitis did not correlate with pain, activity level, patient satisfaction or clinical outcome scales, nor did it correlate with radiographic wear measurements at early followup. Conclusions Our observations suggest reactive synovitis is common yet asymptomatic at short-term followup. We do not know either the etiology or the long-term implications of these observations.

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“…Techniques for reducing the artifacts seen on MRI exist [24], but they are still generally not enough to enable adequate evaluation of the surrounds of the prosthesis [25][26][27].…”

Section: Clinical Presentations and Diagnosismentioning

confidence: 99%

Periprosthetic Joint Infections

2016

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CT and MRI of hip arthroplasty

Cited by 95 publications

References 31 publications

Voxel classification and graph cuts for automated segmentation of pathological periprosthetic hip anatomy

Voxel classification and graph cuts for automated segmentation of pathological periprosthetic hip anatomy

Early Reactive Synovitis and Osteolysis after Total Hip Arthroplasty

Periprosthetic Joint Infections

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