Vergleich der Bildqualität zweier unterschiedlicher mobiler 3-dimensionaler Röntgen-C-Bögen mit einem konventionellen CT bei der Darstellung relevanter Strukturen am knöchernen Becken

Stuby, Fabian; Seethaler, A. C.; Shiozawa, Thomas; Weise, K.; Mroue, A.; Badke, Andreas; Buchgeister, Markus; Ochs, Björn Gunnar

doi:10.1055/s-0030-1271136

Cited by 11 publications

(3 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The image quality of mobile 3D devices is limited, in comparison to conventional CT scanners [28, 29]. Nevertheless, an evaluation of the bone morphology and implant position is possible [28, 30].…”

Section: Discussionmentioning

confidence: 99%

Real-time intraoperative 3D image intensifier-based navigation in reversed shoulder arthroplasty- analyses of image quality

Theopold

Pieroh

Henkelmann

et al. 2019

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Due to the high anatomical variability and limited visualization of the scapula, optimal screw placement for baseplate anchorage in reversed total shoulder arthroplasty (rTSA) is challenging. Image quality plays a key role regarding the decision of an appropriate implant position. However, these data a currently missing for rTSA and were investigated in the present study. Furthermore, the rate of required K-wire changes for the central peg as well as post-implantation inclination and version were assessed. Methods In ten consecutive patients (8 female, 86 years, range 74–94) with proximal humeral fracture and indication for rTSA, an intraoperative 3D-scan of the shoulder with a 3D image intensifier (Ziehm Vision FD Vario 3D© [Ziehm Imaging GmbH, Nürnberg, Germany]) was performed after resection of the humeral head. Using the Vectorvision© Software (Brainlab AG, Feldkirchen, Germany), the virtual anatomy was compared to the visible anatomical landmarks. After implantation of the baseplate, a 3D scan was performed. All 3D scans included multiplanar reconstruction (MPR) and the cinemode to examine screw and baseplate placement. The rate of required K-wire changes was assessed. The intraoperative 3D image quality (modified visual analogue scale [VAS] and point system) was assessed before and after implantation of the glenoid component. Inclination and version were determined in post-implantation scans. Results The virtually presented anatomical landmarks always correlated to the anatomical visible points indicating an good virtual accuracy. The central K-wire position was corrected in three cases due to a deviation from the face plane technique position. The VAS was higher for the pre-implantation MPR (6.7, range 5–8) compared to the post-implantation acquired MPR (5.1, range 4–6; p = 0.0002). The point system showed a reduced quality in all subcategories, especially regarding the grading of the articular surfaces. The preoperative (7.9, range 6–9) and post-implantation (7.9, range 6–9) cinemode displayed no significant differences ( p = 0.6). Conclusion The present study underlines the need for the improvement of 3D image intensifiers algorithms to reduce artifact associated impaired image quality to enhance the benefit of real-time intraoperative 3D scans and navigation.

show abstract

Section: Discussionmentioning

confidence: 99%

Real-time intraoperative 3D image intensifier-based navigation in reversed shoulder arthroplasty- analyses of image quality

Theopold

Pieroh

Henkelmann

et al. 2019

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…Often, these 3D scans are considered equal to CT scans regarding the parameters reduction and implant placement. Standardized technical evaluation of possible image quality of intraoperative and image quality in anatomical regions without implants has been described in several publications [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative assessment of reduction and implant placement in acetabular fractures—limitations of 3D-imaging compared to computed tomography

et al. 2018

View full text Add to dashboard Cite

BackgroundIn acetabular fractures, the assessment of reduction and implant placement has limitations in conventional 2D intraoperative imaging. 3D imaging offers the opportunity to acquire CT-like images and thus to improve the results. However, clinical experience shows that even 3D imaging has limitations, especially regarding artifacts when implants are placed. The purpose of this study was to assess the difference between intraoperative 3D imaging and postoperative CT regarding reduction and implant placement.MethodsTwenty consecutive cases of acetabular fractures were selected with a complete set of intraoperative 3D imaging and postoperative CT data. The largest detectable step and the largest detectable gap were measured in all three standard planes. These values were compared between the 3D data sets and CT data sets. Additionally, possible correlations between the possible confounders age and BMI and the difference between 3D and CT values were tested.ResultsThe mean difference of largest visible step between the 3D imaging and CT scan was 2.0 ± 1.8 mm (0.0–5.8, p = 0.02) in the axial, 1.3 ± 1.4 mm (0.0–3.7, p = 0.15) in the sagittal and 1.9 ± 2.4 mm (0.0–7.4, p = 0.22) in the coronal views. The mean difference of largest visible gap between the 3D imaging and CT scan was 3.1 ± 3.6 mm (0.0–14.1, p = 0.03) in the axial, 4.6 ± 2.7 mm (1.2–8.7, p = 0.001) in the sagittal and 3.5 ± 4.0 mm (0.0–15.4, p = 0.06) in the coronal views. A positive correlation between the age and the difference in gap measurements in the sagittal view was shown (rho = 0.556, p = 0.011).ConclusionsIntraoperative 3D imaging is a valuable adjunct in assessing reduction and implant placement in acetabular fractures but has limitations due to artifacts caused by implant material. This can lead to missed malreduction and impairment of clinical outcome, so postoperative CT should be considered in these cases.

show abstract

“…Our institution has the distinctive availability of several intraoperative imaging systems from which to select, including a multidetector CT (MDCT) scanner (CT A); two mobile CT units (CT B and CT C); a C-arm (D); and fluoroscopy (E). Although a number of studies have reported the radiation exposure of some of the modalities, 4 , 5 and just recently, Hecht et al 6 published the accuracy of instrumentation using CT B, we are unaware of any literature examining the radiation exposure of MDCT A or CT B. In addition, we are unaware of any study that has directly compared all these modalities with respect to commonly performed spinal surgery.…”

mentioning

confidence: 99%

Patient Dose Comparison for Intraoperative Imaging Devices Used in Orthopaedic Lumbar Spinal Surgery

et al. 2018

View full text Add to dashboard Cite

Background:The aim of this study was to determine the amount of radiation exposure from intraoperative imaging during two-level and four-level lumbar fusions.Methods:Five imaging systems were studied: multidetector CT (MDCT) scanner (CT A); two mobile CT units (CT B and CT C); a C-arm (D); and fluoroscopy (E). Metal oxide semiconductor field effect transistor dosimeters measured doses at 25 organ locations using an anthropomorphic phantom. A fat-equivalent phantom was used to simulate an obese body mass index (BMI).Results:The effective dose (ED) for C-arm D was estimated using commercial software. The ED for others was computed from the measured mean organ doses. EDs for a normal BMI patient, receiving a four-level fusion, are as follows: CT A (12.00 ± 0.30 mSv), CT B (5.90 ± 0.25 mSv), CT C (2.35 ± 0.44 mSv), C-arm D (0.44 mSv), and fluoroscopy E (0.30 ± 0.3 mSv). The rankings are consistent across all three BMI values except CT C and fluoroscopy E, which peaked in the overweight size because of system limitations. The other machines' ED trended with patient BMI.Conclusion:The dose reduction protocols were confirmed according to the manufacturer's specifications. The results of this study emphasize the need for the appropriate selection of the imaging system, especially because the type of device could have a substantial effect on patient radiation risk.

show abstract

Vergleich der Bildqualität zweier unterschiedlicher mobiler 3-dimensionaler Röntgen-C-Bögen mit einem konventionellen CT bei der Darstellung relevanter Strukturen am knöchernen Becken

Cited by 11 publications

References 25 publications

Real-time intraoperative 3D image intensifier-based navigation in reversed shoulder arthroplasty- analyses of image quality

Real-time intraoperative 3D image intensifier-based navigation in reversed shoulder arthroplasty- analyses of image quality

Intraoperative assessment of reduction and implant placement in acetabular fractures—limitations of 3D-imaging compared to computed tomography

Patient Dose Comparison for Intraoperative Imaging Devices Used in Orthopaedic Lumbar Spinal Surgery

Contact Info

Product

Resources

About