Postoperative imaging of orthopaedic hardware in the hand and wrist: is there an added value for tomosynthesis?

Silvestro, Alexandra De; Martini, Katharina; Becker, Anton S.; Kim-Nguyen, T D L; Guggenberger, Roman; Calcagni, Maurizio; Frauenfelder, Thomas

doi:10.1016/j.crad.2017.08.001

Cited by 11 publications

(7 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Digital tomosynthesis performs significantly better than plain radiographs in the assessment of fracture healing and delineation of fracture margins, with less obscuration by hardware with acceptable interobserver reliability. 21,22 This study is not without limitation. There is no direct comparison of diagnostic performance with the new gold standard, MRI.…”

Section: Discussionmentioning

confidence: 93%

“…[18][19][20] Digital tomosynthesis has also been shown to better evaluate fracture union and hardware placement than plain radiography. 21,22 The purpose of this study is to report the diagnostic performance of DTS for occult scaphoid fracture and quantify noncontributory potentially avoidable advanced imaging in scaphoid fracture management using DTS at our institution. We hypothesize that DTS provides adequate diagnostic performance as a screening test for occult scaphoid fracture and can lead to a reduction in advanced imaging utilization in the management of scaphoid fractures.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic Performance and Advanced Imaging Reduction With Digital Tomosynthesis in Scaphoid Fracture Management

Perloff

Cole

Sternbach

et al. 2021

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background Management of scaphoid fractures often requires advanced imaging to achieve accurate diagnoses and appropriate treatment. Digital tomosynthesis (DTS) is a cross-sectional imaging modality that may be used to substitute magnetic resonance imaging or computed tomographic scans. The purpose of this study is to: (1) determine the diagnostic accuracy of DTS in occult scaphoid fractures; and (2) report on the reduction of other advanced imaging when using DTS. Methods From May 2014 to October 2017, the charts of all patients who underwent scaphoid tomogram were retrospectively reviewed. The diagnostic accuracy of DTS for occult fracture was compared with 2-week follow-up plain films. To measure the reduction in utilization of advanced imaging, it was determined whether DTS eliminated the need for advanced imaging by providing adequate information regarding the clinical question. Results A total of 78 patients underwent scaphoid tomography in this time frame: 39 for occult fracture, 33 for fracture union, 5 for fracture morphology, and 1 for hardware positioning. For the detection of occult fracture, DTS had a sensitivity of 100%, specificity of 83%, positive predictive value of 64%, and negative predictive value of 100%. Advanced imaging was not used in 35 of the remaining 39 patients based on the results obtained by DTS. In patients who did receive advanced imaging, 83% of tomograms provided conclusive diagnostic information. Conclusions Digital tomosynthesis increases the diagnostic sensitivity of occult scaphoid fractures, reducing unnecessary immobilization and advanced imaging. Digital tomosynthesis provides clinical detail beyond plain film, which reduces the need to obtain advanced imaging when assessing union, fracture pattern, and hardware placement.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Diagnostic Performance and Advanced Imaging Reduction With Digital Tomosynthesis in Scaphoid Fracture Management

Perloff

Cole

Sternbach

et al. 2021

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…The general exposure dose for hand radiography was calculated from previous studies and compared with each device [41,42]. The exposure dose was lower in the order of HR-pQCT (10 μSv), radiography (65.8 μSv), dental CBCT (71.3 μSv), 320-row MDCT (271.3 μSv), and tomosynthesis (4745 μSv).…”

Section: Discussionmentioning

confidence: 99%

Quantification of Joint Space Width Difference on Radiography Via Phase-Only Correlation (POC) Analysis: a Phantom Study Comparing with Various Tomographical Modalities Using Conventional Margin-Contouring

Taguchi

Shishido

et al. 2020

J Digit Imaging

View full text Add to dashboard Cite

Several visual scoring methods are currently used to assess progression of rheumatoid arthritis (RA) on radiography. However, they are limited by its subjectivity and insufficient sensitivity. We have developed an original measurement system which uses a technique called phase-only correlation (POC). The purpose of this study is to validate the system by using a phantom simulating the joint of RA patients. A micrometer measurement apparatus that can adjust arbitrary joint space width (JSW) in a phantom joint was developed to define true JSW. The phantom was scanned with radiography, 320 multi detector CT (MDCT), high-resolution peripheral quantitative CT (HR-pQCT), cone beam CT (CBCT), and tomosynthesis. The width was adjusted to the average size of a women's metacarpophalangeal joint, from 1.2 to 2.2 mm with increments of 0.1 mm and 0.01 mm. Radiographical images were analyzed by the POC-based system and manual method, and images from various tomographical modalities were measured via the automatic margin detection method. Correlation coefficients between true JSW difference and measured JSW difference were all strong at 0.1 mm intervals with radiography (POC-based system and manual method), CBCT, 320MDCT, HR-pQCT, and tomosynthesis. At 0.01 mm intervals, radiography (POC-based system), 320MDCT, and HR-pQCT had strong correlations, while radiography (manual method) and CBCT had low correlations, and tomosynthesis had no statistically significant correlation. The smallest detectable changes for radiography (POC-based system), radiography (manual method), 320MDCT, HR-pQCT, CBCT, and tomosynthesis were 0.020 mm, 0.041 mm, 0.076 mm, 0.077 mm, 0.057 mm, and 0.087 mm, respectively. We conclude that radiography analyzed with the POC-based system might sensitively detect minute joint space changes of the finger joint.

show abstract

“…31 Tomosynthesis and 3D CT in defining skeletal complications of orthopaedic hardware in the postoperative patient is increasingly being considered. 32,33 Similarly MRI has evolved into a robust diagnostic tool for the evaluation of hip arthroplasty implants. Optimized conventional pulse sequences and MARS imaging technique can reveal improved depiction of bone, implant-tissue interfaces, and periprosthetic soft tissue for the diagnosis of arthroplasty-related complications.…”

Section: Post-operative Orthopaedic Imagingmentioning

confidence: 99%

What does the orthopaedic surgeon want in the radiology report?

Iyengar

Ngo

Jain

et al. 2021

Journal of Clinical Orthopaedics and Trauma

View full text Add to dashboard Cite

Complementary imaging is crucial in the diagnosis and management of the spectrum of Musculoskeletal (MSK) pathologies. Like in all medical specialities, its role in trauma and orthopaedic conditions has evolved. A radiology report following an imaging study should provide an accurate, timely interpretation of images and be presented in a format that allows formal analysis or clarification of a patient's diagnostic dilemma. It is essential that it is descriptive enough to allow clinico-pathological correlation to a patient's condition. A high-quality report follows clinical governance processes, provides clinical feedback, and when appropriate, incorporates advice regarding differential diagnosis or further investigation/ management that can be undertaken, permitting the attending clinician to formulate a suitable treatment plan for their patient.In this narrative we explore common radiological investigations and reporting information in trauma and orthopaedic conditions, which would be useful to the attending surgeon.

show abstract

Postoperative imaging of orthopaedic hardware in the hand and wrist: is there an added value for tomosynthesis?

Cited by 11 publications

References 22 publications

Diagnostic Performance and Advanced Imaging Reduction With Digital Tomosynthesis in Scaphoid Fracture Management

Diagnostic Performance and Advanced Imaging Reduction With Digital Tomosynthesis in Scaphoid Fracture Management

Quantification of Joint Space Width Difference on Radiography Via Phase-Only Correlation (POC) Analysis: a Phantom Study Comparing with Various Tomographical Modalities Using Conventional Margin-Contouring

What does the orthopaedic surgeon want in the radiology report?

Contact Info

Product

Resources

About