Toward automated classification of acetabular shape in ultrasound for diagnosis of DDH: Contour alpha angle and the rounding index

Hareendranathan, Abhilash Rakkunedeth; Mabee, Myles; Punithakumar, Kumaradevan; Noga, Michelle; Jaremko, Jacob L.

doi:10.1016/j.cmpb.2016.03.013

Cited by 27 publications

(19 citation statements)

References 14 publications

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“…5), and (ii) an approximate line of action for the force of gravity, in calculation of loads, stresses and strains at the hip joint. Purely geometric measurements taken to assess hip dysplasia on 3-D ultrasound, such as the Graf alpha angle or novel indices which are currently in development seeking to characterize the 3-D morphology of the hip (19–20–21), would be made with respect to patient-specific acetabular landmarks as seen on the individual ultrasound images, and are independent of iliac angle variation. Further, an exact measurement is not necessary as biomechanical modeling can include a sensitivity analysis testing the effect on hip stability of the entire expected ±15° range of random individual variation in the Iliac angle.…”

Section: Discussionmentioning

confidence: 99%

Normal Values and Variation of Radiographic and CT Infant Lateral Iliac Wall Angles in Normal and Dysplastic Hips

et al. 2016

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The radiographic infant lateral iliac wall angle has mean value 53-56° in dysplastic and normal hips with consistent range of variation approximately ±15°, was measured with high reliability, does not differ by sex, and is only slightly lower in the youngest infants. The iliac wall angle is an unbiased reference axis that may be suitable to establish general spatial orientation of 3-D hip ultrasound images.

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Section: Discussionmentioning

confidence: 99%

Normal Values and Variation of Radiographic and CT Infant Lateral Iliac Wall Angles in Normal and Dysplastic Hips

et al. 2016

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“…acetabular contact angle were found to be unhelpful. The acetabular contact angle, another 3D index of acetabular angularity, was previously found to be highly accurate for diagnosis of DDH (18). In that study, the acetabular contact angle was calculated on smooth, manually segmented acetabular surface models.…”

Section: Pediatric Imaging: Developmental Hip Dysplasia Diagnosis At mentioning

confidence: 99%

“…By December 31, 2016, we had 1884 consecutively scanned hips, performed at mean age 67 days (age range, 3-238 days; Fig 1). In some of our early work (16)(17)(18) relatively high interobserver (6)(7)(8) and interscan (9,10) variability, potentially altering the final diagnosis in 50%-75% of infants if scanned by a nonexpert (8). In practice, over diagnosis of DDH leads to increased health care costs and unnecessary treatment (2).…”

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confidence: 99%

“…Three-dimensional US for DDH was first proposed and studied in the 1990s (11)(12)(13)(14)(15), but probes used slow manual sweeps to produce scans and cumbersome postprocessing was necessary, limiting real-world utility of 3D US. More recently, probes with increases in processing power that perform automatic rapid 3D sweeps underpin a renewed interest in 3D US for DDH (16)(17)(18)(19)(20)(21)(22). Three-dimensional US surface models have high fidelity to 3D magnetic resonance imaging reconstructions (21).…”

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confidence: 99%

“…Three-dimensional US surface models have high fidelity to 3D magnetic resonance imaging reconstructions (21). In small pilot studies (17,18,23), indexes from these surface models helped to predict DDH at least as accurately and reliably as the conventional 2D US alpha angle. However, these findings have not been validated in a large patient group, and it remains unclear to what extent 3D US could reduce borderline scans requiring repeated assessment.…”

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Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study

et al. 2018

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Purpose To validate accuracy of diagnosis of developmental dysplasia of the hip (DDH) from geometric properties of acetabular shape extracted from three-dimensional (3D) ultrasonography (US). Materials and Methods In this retrospective multi-institutional study, 3D US was added to conventional two-dimensional (2D) US of 1728 infants (mean age, 67 days; age range, 3-238 days) evaluated for DDH from January 2013 to December 2016. Clinical diagnosis after more than 6 months follow-up was normal (n = 1347), borderline (Graf IIa, later normalizing spontaneously; n = 140) or dysplastic (Graf IIb or higher, n = 241). Custom software accessible through the institution's research portal automatically calculated indexes including 3D posterior and anterior alpha angle and osculating circle radius from hip surface models generated with less than 1 minute of user input. Logistic regression predicted clinical diagnosis (normal = 0, dysplastic = 1) from 3D indexes (ie, age and sex). Output represented probability of hip dysplasia from 0 to 1 (output: >0.9, dysplastic; 0.11-0.89, borderline; <0.1, normal). Software can be accessed through the research portal. Results Area under the receiver operating characteristic curve was equivalently high for 3D US indexes and 2D US alpha angle (0.996 vs 0.987). Three-dimensional US helped to correctly categorize 97.5% (235 of 241) dysplastic and 99.4% (1339 of 1347) normal hips. No dysplastic hips were categorized as normal. Correct diagnosis was provided at initial 3D US scan in 69.3% (97 of 140) of the studies diagnosed as borderline at initial 2D US scans. Conclusion Automatically calculated 3D indexes of acetabular shape performed equivalently to high-quality 2D US scans at tertiary medical centers to help diagnose DDH. Three-dimensional US reduced the number of borderline studies requiring follow-up imaging by over two-thirds.

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Study on multiplanar measurements of infant hips with three‐dimensional ultrasonography

Cui

Chen

et al. 2022

J of Clinical Ultrasound

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Purpose An automatic evaluation technology based on artificial intelligence and three‐dimensional ultrasonography (3D US) is proposed for hip US inspection plane selection. This study aimed to evaluate the consistency of the α angle as measured using 3D US to select the section plane and two‐dimensional ultrasonography (2D US) to manually select the Graf image, as well as to explore the feasibility of diagnosing developmental dysplasia of the hip (DDH) using 3D US and reconstruction technology. Methods A total of 216 infant hips were included and assessed by doctors using 3D US layer‐by‐layer. The researchers used a computer to identify the coronal images that met the Graf standard and then compared the αX values obtained with the αG values measured artificially by 2D US. Results Compared with 2D US, 3D US more clearly showed the relative positions of the ilium, ischia, and pubis. The measured α value of the optimal section obtained by 3D US showed good agreement with the measured α value of the standard Graf section. Conclusion The artificial intelligence and 3D US‐based automatic evaluation technology for section selection and inspection for DDH showed good agreement with the Graf method based on standard sections.

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Toward automated classification of acetabular shape in ultrasound for diagnosis of DDH: Contour alpha angle and the rounding index

Cited by 27 publications

References 14 publications

Normal Values and Variation of Radiographic and CT Infant Lateral Iliac Wall Angles in Normal and Dysplastic Hips

Normal Values and Variation of Radiographic and CT Infant Lateral Iliac Wall Angles in Normal and Dysplastic Hips

Developmental Hip Dysplasia Diagnosis at Three-dimensional US: A Multicenter Study

Study on multiplanar measurements of infant hips with three‐dimensional ultrasonography

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