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- Försth, Peter, 1966-, et al.
(författare)
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Motion Analysis in Lumbar Spinal Stenosis With Degenerative Spondylolisthesis : A Feasibility Study of the 3DCT Technique Comparing Laminectomy Versus Bilateral Laminotomy.
- 2018
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Ingår i: Clinical spine surgery. - : Wolters Kluwer. - 2380-0186 .- 2380-0194. ; 31:8, s. E397-E402
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: This was a randomized radiologic biomechanical pilot study in vivo. Objective: The objectives of this study was to evaluate if 3-dimensional computed tomography is a feasible tool in motion analyses of the lumbar spine and to study if preservation of segmental midline structures offers less postoperative instability compared with central decompression in patients with lumbar spinal stenosis with degenerative spondylolisthesis. Summary of Background Data: The role of segmental instability after decompression is controversial. Validated techniques for biomechanical evaluation of segmental motion in human live subjects are lacking. Methods: In total, 23 patients (mean age, 68 y) with typical symptoms and magnetic resonance imaging findings of spinal stenosis with degenerative spondylolisthesis (>3 mm) in 1 or 2 adjacent lumbar levels from L3 to L5 were included. They were randomized to either laminectomy (LE) or bilateral laminotomy (LT) (preservation of the midline structures). Documentation of segmental motion was made preoperatively and 6 months postoperatively with CT in provoked flexion and extension. Analyses of movements were performed with validated software. The accuracy for this method is 0.6 mm in translation and 1 degree in rotation. Patient-reported outcome measures were collected from the Swespine register preoperatively and 2-year postoperatively. Results: The mean preoperative values for 3D rotation and translation were 6.2 degrees and 1.8 mm. The mean increase in 3D rotation 6 months after surgery was 0.25 degrees after LT and 0.7 degrees after LE (P=0.79) while the mean increase in 3D translation was 0.15 mm after LT and 1.1 mm after LE (P=0.42). Both surgeries demonstrated significant improvement in patient-reported outcome measures 2 years postoperatively. Conclusions: The 3D computed tomography technique proved to be a feasible tool in the evaluation of segmental motion in this group of older patients. There was negligible increase in segmental motion after decompressive surgery. LE with removal of the midline structures did not create a greater instability compared with when these structures were preserved.
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| 3. |
- Alcala, Yvonne, et al.
(författare)
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Qualifying CT for wrist arthroplasty : Extending techniques for total hip arthroplasty to total wrist arthroplasty
- 2005
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Ingår i: Medical Imaging 2005. - : SPIE - The International Sooceity for Optical Engineeering. - 0819457213 ; , s. 1155-1164
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Konferensbidrag (refereegranskat)abstract
- The purpose of this study was to extend previous work to detect migration of total wrist arthroplasty non-invasively, and with greater accuracy. Two human cadaverous arms, each with a cemented total wrist implant, were used in this study. In one of the arms, I mm tantalum balls were implanted, six in the carpal bones and five in the radius. Five CT scans of each arm were acquired, changing the position of the arm each time to mimic different positions patients might take on repeated examinations. Registration of CT volume data sets was performed using an extensively validated, 3D semi-automatic volume fusion tool in which co-homologous point pairs (landmarks) are chosen on each volume to be registered. Three sets of ten cases each were obtained by placing landmarks on 1) bone only (using only arm one), 2) tantalum implants only, and 3) bone and tantalum implants (both using only arm two). The accuracy of the match was assessed visually in 2D and 3D, and numerically by calculating the distance difference between the actual position of the transformed landmarks and their ideal position (i.e., the reference landmark positions). All cases were matched visually within one width of cortical bone and numerically within one half CT voxel (0.32 mm, p = 0.05). This method matched only the bone/arm and not the prosthetic component per se, thus making it possible to detect prosthetic movement and wear. This method was clinically used for one patient with pain. Loosening of the carpal prosthetic component was accurately detected and this was confirmed at surgery.
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| 5. |
- Brodén, Cyrus, et al.
(författare)
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Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups : An Experimental Study
- 2016
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Ingår i: BioMed Research International. - : Hindawi Publishing Corporation. - 2314-6133 .- 2314-6141.
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty.Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated.Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv.Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting.
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| 6. |
- Crafoord, Joakim, et al.
(författare)
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Comparison of two landmark based image registration methods for use with a body atlas
- 2000
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Ingår i: Physica medica (Testo stampato). - 1120-1797 .- 1724-191X. ; 16:2, s. 75-82
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Tidskriftsartikel (refereegranskat)abstract
- We describe preliminary work registering abdominal MRI images from three healthy male volunteers. Anatomically selected 3D homologous point pairs (landmarks), from which eigenvalues were generated to form the basis for a 3D non-affine polynomial transformation, were placed on axial slices alone and on axial, coronal and sagittal slices. Registration accuracy was judged visually by comparing superimposed 3D isosurfaces from the reference, untransformed, and transformed volume data and by comparing merged 2D slices projected fi om the transformed and reference volume data superimposed with 2D isolines. The squared sum of intensity differences between the transformed/untransformed and the reference volume was significant at the 0.05 (p >0.05) confidence level. The correlation coefficient improved by an average of 38% and the cross correlation between pixel values improved by an average of 22%. In each trial, the standard deviation of the landmarks after transformation was within one voxel and the standard error of the mean was not significantly different from zero at the 0.05 confidence level. Abdominal isosurface volume differences (between individuals) changed from an average of 14.5% before registration to 2.9% after registration. This experiment shows that it is possible to choose landmarks such that abdominal data from different subject volumes can be mapped to a common reference, and thus that it is possible to use this combined volume both to form an atlas and to warp abdominal data from an atlas to a patient volume.
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| 7. |
- Dewyngaert, J. Keith, et al.
(författare)
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Procedure for unmasking localization information from ProstaScint scans for prostate radiation therapy treatment planning
- 2004
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Ingår i: International Journal of Radiation Oncology, Biology, Physics. - : Elsevier BV. - 0360-3016 .- 1879-355X. ; 60:2, s. 654-662
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To demonstrate a method to extract the meaningful biologic information from In-111-radiolabeled capromab pendetide (ProstaScint) SPECT scans for use in radiation therapy treatment planning by removing that component of the In-111 SPECT images associated with normal structures. Methods and Materials: We examined 20 of more than 80 patients who underwent simultaneous Tc-99m/In-111 SPECT scans, which were subsequently registered to the corresponding CT/MRI scans. A thresholding algorithm was used to identify Tc-99m uptake associated with blood vessels and CT electron density associated with bone marrow. Corresponding voxels were removed from the In-111 image set. Results: No single threshold value was found to be associated with the Tc-99m uptake that corresponded to the blood vessels. Intensity values were normalized to a global maximum and, as such, were dependent upon the quantity of Tc-99m pooled in the bladder. The reduced ProstaScint volume sets were segmented by use of a thresholding feature of the planning system and superimposed on the CT/MRI scans. Conclusions: ProstaScint images are now closer to becoming a biologically and therapeutically useful and accurate image set. After known sources of normal intensity are stripped away, the remaining areas that demonstrate uptake may be segmented and superimposed on the treatment-planning CT/MRI volume.
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| 8. |
- Ericson, Anne, et al.
(författare)
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Computed tomography analysis of radiostereometric data to determine flexion axes after total joint replacement : Application to the elbow joint
- 2010
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Ingår i: Journal of Biomechanics. - : Elsevier BV. - 0021-9290 .- 1873-2380. ; 43:10, s. 1947-1952
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Tidskriftsartikel (refereegranskat)abstract
- Kinematic analysis for in vivo assessment of elbow endoprostheses requires knowledge of the exact positions of motion axes relative to bony landmarks or the prosthesis. A prosthesis-based reference system is required for comparison between individuals and studies. The primary aim of this study was to further develop an earlier described algorithm for fusion of radiostereometric analysis (RSA) data and data obtained in 3D computed tomography (CT) for application to the elbow after total joint replacement. The secondary aim was to propose a method for marking of prostheses in 3D CT, enabling definition of a prosthesis-based reference system. Six patients with elbow endoprostheses were investigated. The fusion of data made it possible to visualize the motion axes in relation to the prostheses in the 3D CT volume. The differences between two repeated positioning repetitions of the longitudinal prosthesis axis were less than 0.6 degrees in the frontal and sagittal planes. Corresponding values for the transverse axis were less than 0.6 degrees in the frontal and less than 1.4 degrees (in four out of six less than 0.6 degrees) in the horizontal plane. This study shows that by fusion of CT and RSA data it is possible to determine the accurate position of the flexion axes of the elbow joint after total joint replacement in vivo. The proposed method for implant marking and registration of reference axes enables comparison of prosthesis function between patients and studies.
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| 9. |
- Ericson, Anne, et al.
(författare)
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Fusion of radio stereometric analysis data into computed tomography space : Application to the elbow joint
- 2007
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Ingår i: Journal of Biomechanics. - Oxford, UK : Elsevier Science Ltd. - 0021-9290 .- 1873-2380. ; 40:2, s. 296-304
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Tidskriftsartikel (refereegranskat)abstract
- Improvement of joint prostheses is dependent upon information concerning the biomechanical properties of the joint. Radiostereometric analysis (RSA) and electromagnetic techniques have been applied in previous cadaver and in vivo studies on the elbow joint to provide valuable information concerning joint motion axes. However, such information is limited to mathematically calculated positions of the axes according to an orthogonal coordinate system and is difficult to relate to individual skeletal anatomy. The aim of this study was to evaluate the in vivo application of a new fusion method to provide three-dimensional (31)) visualization of flexion axes according to bony landmarks. In vivo RSA data of the elbow joint's flexion axes was combined with data obtained by 3D computed tomography (CT). Results were obtained from five healthy subjects after one was excluded due to an instable RSA marker. The median error between imported and transformed RSA marker coordinates and those obtained in the CT volume was 0.22mm. Median maximal rotation error after transformation of the rigid RSA body to the CT volume was 0.003 degrees. Points of interception with a plane calculated in the RSA orthogonal coordinate system were imported into the CT volume, facilitating the 3D visualization of the flexion axes. This study demonstrates a successful fusion of RSA and CT data, without significant loss of RSA accuracy. The method could be used for relating individual motion axes to a 3D representation of relevant joint anatomy, thus providing important information for clinical applications such as the development of joint prostheses.
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| 10. |
- Eriksson, Thomas, et al.
(författare)
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Are low-dose CT scans a satisfactory substitute for stereoradiographs for migration studies? A preclinical test of low-dose CT scanning protocols and their application in a pilot patient.
- 2019
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Ingår i: Acta Radiologica. - : Sage Publications. - 0284-1851 .- 1600-0455.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Computed tomography (CT) has the potential to acquire the data needed for migration studies of orthopedic joint implants of patients who have had tantalum beads implanted at the time of joint replacement surgery. This can be accomplished with the same precision as radiostereometric analysis (RSA). Switching to CT would increase availability without the need for the specific facilities required for RSA. However, higher effective dose is a concern.PURPOSE: To investigate if migration measurements can be done with CT with an accuracy and effective dose comparable to that of conventional RSA.MATERIAL AND METHODS: Fourteen scanning protocols were tested in a hip phantom that incorporated tantalum beads and an uncemented femoral stem. The protocols were graded for clinical practice according to the three parameters of image quality, effective dose, and robustness of numerical data. After grading, the two protocols that graded best overall were applied to a pilot patient.RESULTS: All protocols produced scans in which the numerical data were sufficient for a migration analysis at least as precise as would be expected using RSA. A protocol with an effective dose of 0.70 mSv was shown to be applicable in a pilot patient.CONCLUSION: Low-dose CT scans with an effective dose comparable to a set of routine plain radiographs can be used for precise migration measurements.
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