Sternal transplant using cadaveric allograft: quantitative and qualitative assessment of bone healing by computed tomography.
Bone transplantation
computed tomography (CT)
imaging
thoracic surgery
Journal
Quantitative imaging in medicine and surgery
ISSN: 2223-4292
Titre abrégé: Quant Imaging Med Surg
Pays: China
ID NLM: 101577942
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
entrez:
3
2
2021
pubmed:
4
2
2021
medline:
4
2
2021
Statut:
ppublish
Résumé
Sternal transplant using cadaveric allograft (STCA) is a complex and rarely performed surgical procedure usually applied for massive bone tissue loss, sternotomy complications, or neoplastic resections. Although radiological imaging and especially computed tomography (CT) is routinely applied for the post-surgical assessment, up to now, a standardized approach evaluating the outcome of STCAs is missing. Therefore, aim of this study was to qualitatively and quantitatively evaluate, by CT, bone healing after STCA. The first and the last available postsurgical CT of patients who underwent STCA in two tertiary centers between 2009 and 2017 were collected. Standardized regions of interest were applied on the cancellous bone along the transplanted sternum, and, as reference, on the fourth thoracic vertebra, at both time points, collecting the density values. The areas nearby the fixation devices were assessed by a four-points qualitative score. To evaluate the mineralization, the analysis of the variance (ANOVA) with Fourteen patients (11 females, 61±12.8 years) were examined. The first control CTs were performed 32±40.26 days after the STCA and the last CT were acquired after 729±745 days. The quantitative and the qualitative score significantly increased between the two intervals (P<0.05, each). The density of the transplanted sternum was lower than that of the vertebral reference at the first CT (P=0.006) while no differences occurred at the last control (P=0.361). The assessments showed high intra-rater reliability and agreement (ICC ≥0.890, k≥0.906). The hereby-proposed qualitative and quantitative methods demonstrated to be good tools for assessing bone healing after STCA.
Sections du résumé
BACKGROUND
BACKGROUND
Sternal transplant using cadaveric allograft (STCA) is a complex and rarely performed surgical procedure usually applied for massive bone tissue loss, sternotomy complications, or neoplastic resections. Although radiological imaging and especially computed tomography (CT) is routinely applied for the post-surgical assessment, up to now, a standardized approach evaluating the outcome of STCAs is missing. Therefore, aim of this study was to qualitatively and quantitatively evaluate, by CT, bone healing after STCA.
METHODS
METHODS
The first and the last available postsurgical CT of patients who underwent STCA in two tertiary centers between 2009 and 2017 were collected. Standardized regions of interest were applied on the cancellous bone along the transplanted sternum, and, as reference, on the fourth thoracic vertebra, at both time points, collecting the density values. The areas nearby the fixation devices were assessed by a four-points qualitative score. To evaluate the mineralization, the analysis of the variance (ANOVA) with
RESULTS
RESULTS
Fourteen patients (11 females, 61±12.8 years) were examined. The first control CTs were performed 32±40.26 days after the STCA and the last CT were acquired after 729±745 days. The quantitative and the qualitative score significantly increased between the two intervals (P<0.05, each). The density of the transplanted sternum was lower than that of the vertebral reference at the first CT (P=0.006) while no differences occurred at the last control (P=0.361). The assessments showed high intra-rater reliability and agreement (ICC ≥0.890, k≥0.906).
CONCLUSIONS
CONCLUSIONS
The hereby-proposed qualitative and quantitative methods demonstrated to be good tools for assessing bone healing after STCA.
Identifiants
pubmed: 33532251
doi: 10.21037/qims-20-90
pii: qims-11-02-502
pmc: PMC7779938
doi:
Types de publication
Journal Article
Langues
eng
Pagination
502-509Informations de copyright
2021 Quantitative Imaging in Medicine and Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/qims-20-90). Prof. GG serves as an unpaid editorial board member of Quantitative Imaging in Medicine and Surgery. The other authors have no conflicts of interest to declare.
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