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Comparison of 3D and 2D characterization of spinal geometry from biplanar X-rays: a large cohort study

Article dans une revue avec comité de lecture
Author
HU, Zongshan
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
333404 Nanjing Medical University
ccVERGARI, Claudio
ccGAJNY, Laurent
1001017 Institut de Biomécanique Humaine Georges Charpak [IBHGC]
LIU, Zhen
333404 Nanjing Medical University
LAM, Tsz-Ping
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
ZHU, Zezhang
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
333404 Nanjing Medical University
QIU, Yong
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
333404 Nanjing Medical University
MAN, Gene C. W.
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
YEUNG, Kwong-Hang
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
CHU, Winnie C. W.
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
CHENG, Jack C. Y.
93116 The Chinese University of Hong Kong [Hong Kong] [CUHK]
ccSKALLI, Wafa

URI
http://hdl.handle.net/10985/20219
DOI
10.21037/qims-20-861
Date
2021
Journal
Quantitative imaging in medicine and surgery

Abstract

Background: Biplanar X-ray system providing anteroposterior and sagittal plane with an ultra-low radiation dose and in weight-bearing position is increasingly used for spine imaging. The original three-dimensional (3D) reconstruction method from biplanar X-rays has been widely used for clinical parameters, however, the main issue is that manual adjustments of the 3D model was quite time-consuming and limited to thoracolumbar spine. A quasi-automated 3D reconstruction method of the spine from cervical vertebra to pelvis was proposed, which proved fast and accurate in 57 patients with adolescent idiopathic scoliosis. The aim of this study was to compare the newly developed technique of quasi-automatic 3D measurement with classical 2D measurements in a large cohort. Methods: A total of 494 adults with biplanar EOS X-ray scanning were included in this study and divided into health and deformity group according to the presence of spinal deformity. The proposed method of quasi-automatic 3D measurement was applied to all these subjects. The radiographic parameters included: thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sagittal vertical axis (SVA), T1 pelvic angle (TPA) in sagittal plane, and cobb angle in coronal plane. Comparison was made between quasi-automatic and manual measurement. Results: The mean age was 53.7±19.9 years old. In the whole population, the mean differences between the two methods were 3.9° for TK (30.5°±9.9° vs. 26.5°±9.3°, P<0.001), –5.2° for LL (–47.5°±11.2° vs. –42.4°±11.0°, P<0.001), 3.6° for PI (46.9°±10.3° vs. 43.9°±10.3°, P<0.001), –0.2° for PT (11.9°±7.7° vs. 12.0°±8.2°, P=0.328), –2.1 mm for SVA (15.7±26.2 vs. 17.8±26.3 mm, P=0.221) and –1.1° for TPA (9.0°±7.6° vs. 10.1°±7.8°, P=0.051). The deformity group had similar mean differences with the asymptomatic group with the values ranged from –4.1° to 3.8° for sagittal parameters. The mean differences of Cobb angle were 1.9° for patients with Cobb angle <30° and 2.3° for patients with Cobb angle >30°, respectively. Correlation analysis showed r2 for all clinical parameters ranged from 0.667 to 0.923. On average, the new method takes 5 minutes to compute all the parameters for one case. Conclusions: In conclusion, this ergonomic and efficient quasi-automatic method for full spine proved fast and accurate measurement in a large population, which showed great potential in extensive clinical application

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