Comparison of Simulated Low-Dose and Conventional-Dose CT for Preoperative Planning in Shoulder Arthroplasty.
Journal
The Journal of bone and joint surgery. American volume
ISSN: 1535-1386
Titre abrégé: J Bone Joint Surg Am
Pays: United States
ID NLM: 0014030
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
entrez:
1
6
2022
pubmed:
2
6
2022
medline:
7
6
2022
Statut:
ppublish
Résumé
Shoulder computed tomography (CT) is commonly utilized in preoperative planning for total shoulder arthroplasty. Conventional-dose shoulder CT may expose patients to more ionizing radiation than is necessary to provide high-quality images for this procedure. The purpose of this study was to evaluate the utility of simulated low-dose CT images for preoperative planning using manual measurements and common preoperative planning software. Eighteen shoulder CT scans obtained for preoperative arthroplasty planning were used to generate CT images as if they had been acquired at reduced radiation dose (RD) levels of 75%, 50%, and 25% using a simulation technique that mimics decreased x-ray tube current. This technique was validated by quantitative comparison of simulated low-dose scans of a cadaver with actual low-dose scans. Glenoid version, glenoid inclination, and humeral head subluxation were measured using 2 commercially available software platforms and were also measured manually by 3 physicians. These measurements were then analyzed for agreement across RD levels for each patient. Tolerances of 5° of glenoid version, 5° of glenoid inclination, and 10% humeral head subluxation were used as equivalent for preoperative planning purposes. At all RD levels evaluated, the preoperative planning software successfully segmented the CT images. Semiautomated software measurement of 25% RD images was within tolerances in 99.1% of measurements; for 50% RD images, within tolerances in 96.3% of measurements; and for 75% RD images, within tolerances in 100% of measurements. Manual measurements of 25% RD images were within these tolerances in 95.1% of measurements; for 50% RD images, in 98.8% of measurements; and for 75% RD images, in 99.4% of measurements. Simulated low-dose CT images were sufficient for reliable measurement of glenoid version, glenoid inclination, and humeral head subluxation by preoperative planning software as well as by physician-observers. These findings suggest the potential for substantial reduction in RD in preoperative shoulder CT scans without compromising surgical planning. The adoption of low-dose techniques in preoperative shoulder CT may lower radiation exposure for patients undergoing shoulder arthroplasty, without compromising image quality.
Sections du résumé
BACKGROUND
Shoulder computed tomography (CT) is commonly utilized in preoperative planning for total shoulder arthroplasty. Conventional-dose shoulder CT may expose patients to more ionizing radiation than is necessary to provide high-quality images for this procedure. The purpose of this study was to evaluate the utility of simulated low-dose CT images for preoperative planning using manual measurements and common preoperative planning software.
METHODS
Eighteen shoulder CT scans obtained for preoperative arthroplasty planning were used to generate CT images as if they had been acquired at reduced radiation dose (RD) levels of 75%, 50%, and 25% using a simulation technique that mimics decreased x-ray tube current. This technique was validated by quantitative comparison of simulated low-dose scans of a cadaver with actual low-dose scans. Glenoid version, glenoid inclination, and humeral head subluxation were measured using 2 commercially available software platforms and were also measured manually by 3 physicians. These measurements were then analyzed for agreement across RD levels for each patient. Tolerances of 5° of glenoid version, 5° of glenoid inclination, and 10% humeral head subluxation were used as equivalent for preoperative planning purposes.
RESULTS
At all RD levels evaluated, the preoperative planning software successfully segmented the CT images. Semiautomated software measurement of 25% RD images was within tolerances in 99.1% of measurements; for 50% RD images, within tolerances in 96.3% of measurements; and for 75% RD images, within tolerances in 100% of measurements. Manual measurements of 25% RD images were within these tolerances in 95.1% of measurements; for 50% RD images, in 98.8% of measurements; and for 75% RD images, in 99.4% of measurements.
CONCLUSIONS
Simulated low-dose CT images were sufficient for reliable measurement of glenoid version, glenoid inclination, and humeral head subluxation by preoperative planning software as well as by physician-observers. These findings suggest the potential for substantial reduction in RD in preoperative shoulder CT scans without compromising surgical planning.
CLINICAL RELEVANCE
The adoption of low-dose techniques in preoperative shoulder CT may lower radiation exposure for patients undergoing shoulder arthroplasty, without compromising image quality.
Identifiants
pubmed: 35648067
doi: 10.2106/JBJS.20.01916
pii: 00004623-202206010-00007
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1004-1014Informations de copyright
Copyright © 2022 by The Journal of Bone and Joint Surgery, Incorporated.
Déclaration de conflit d'intérêts
Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H13).
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