Automation improves the efficiency of weightbearing CT scan 3D volumetric assessments of the syndesmosis.

IF 1.9 3区 医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-05-22 DOI:10.1016/j.fas.2024.05.010
Soheil Ashkani-Esfahani, Olivia Lucchese, Rohan Bhimani, Atta Taseh, Gregory Waryasz, Gino M M Kerkhoffs, Mario Maas, Christopher W DiGiovanni, Daniel Guss
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Abstract

Background: Weight-bearing CT (WBCT) 3D volumetric measurement has shown promising accuracy for the diagnosis of syndesmotic instability. However, these measurements are rather complex and time-consuming, rendering them a clinically unfavorable option. We hypothesized that automatized measurements would be more accurate and time-efficient than manual ones.

Methods: Thirty cases of intraoperatively confirmed syndesmotic instability along with thirty individuals with no injuries to the ankle joint were recruited as cases and controls, retrospectively. Two observers conducted the manual volumetric measurements two times, at a one-week interval. An automated algorithm for 3D WBCT measurements was developed to conduct the measurements on the axial images. The time spent on each method was recorded. Mann-Whitney U test was used to compare the values between human raters and computers. Inter- and intra-class reliability were calculated.

Results: The intra-class correlation coefficient was found to be "excellent" for the automated measurements (0.97) and "good" for the observers (0.75). Similarly, the Cronbach's alpha was shown to be higher for the computer (0.88) than the observers (0.60 and 0.62). The mean time spent on the measurements was different between human raters and the computer-assisted method (p < 0.001).

Conclusion: Automated volumetric assessment of syndesmosis seems to be a faster and more reliable option than the manual one. We suggest future larger-scale prospective studies conducted under actual clinical circumstances for more definitive conclusions.

Level of evidence: Retrospective case-control study - Level 3.

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自动化提高了负重 CT 扫描三维巩膜容积评估的效率。
背景:负重 CT(WBCT)三维容积测量显示了诊断椎弓根联合不稳的良好准确性。然而,这些测量相当复杂且耗时,因此在临床上并不适用。我们假设自动测量比手动测量更准确、更省时:方法:我们以回顾性的方式招募了 30 例经术中证实的踝关节联合不稳定病例和 30 例踝关节未受伤者作为病例和对照组。两名观察者进行了两次人工体积测量,每次间隔一周。开发了一种三维 WBCT 测量自动算法,用于对轴向图像进行测量。每种方法所花费的时间都被记录下来。曼-惠特尼 U 检验用于比较人类评分员和计算机之间的数值。计算了类间和类内的可靠性:结果发现,自动测量的类内相关系数(0.97)为 "优",而观察者的类内相关系数(0.75)为 "良"。同样,计算机的 Cronbach's alpha(0.88)也高于观察者的 Cronbach's alpha(0.60 和 0.62)。人类评定者和计算机辅助方法的平均测量时间不同(p 结论:计算机辅助方法的平均测量时间比人类评定者更长:与人工方法相比,自动评估腓骨联合的体积似乎更快、更可靠。我们建议今后在实际临床情况下进行更大规模的前瞻性研究,以得出更明确的结论:回顾性病例对照研究 - 3 级。
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来源期刊
Foot and Ankle Surgery
Foot and Ankle Surgery ORTHOPEDICS-
CiteScore
4.60
自引率
16.00%
发文量
202
期刊介绍: Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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