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Erschienen in: European Radiology 11/2018

07.05.2018 | Computer Applications

Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images

verfasst von: Masashi Okamoto, Fouad Jabour, Kenichiro Sakai, Shun Hatsushikano, J. C. Le Huec, Kazuhiro Hasegawa

Erschienen in: European Radiology | Ausgabe 11/2018

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Abstract

Purpose

An innovative low-dose X-ray biplanar imager (EOS®) allows measurement of the whole-body in standing-position which is necessary for the evaluation of spinal deformities.

Methods

A total of 60 asymptomatic subjects (ages 20–81 years) were evaluated using the 3D workflow called postural assessment and 2D measures. Subjects were measured twice each by two new observers following training, including: lordosis/kyphosis, pelvic parameters, sagittal-vertical axis, and spinal-sacral angle. Intra- and inter-observer reproducibility and similarity were compared between 2D and 3D measures.

Results

The intraclass correlation coefficient (ICC) was very high for the 3D measures (>0.9) and excellent for the 2D measures (>0.75). In all cases, the overall mean absolute difference between repeated 3D measures was less than 2°, or 2 mm. For all parameters, the inter- and intra-observer reproducibility in 3D measures were significantly superior to 2D measures (p < 0.03).

Conclusion

This study demonstrated that 3D measures have better reproducibility than 2D for sagittal balance.

Key Points

• Reproducibility of sagittal balance 2D/3D measurements was evaluated using EOS® full-body radiographs.
• Inter- and intra-observer reproducibility were significantly superior for 3D measures vs. 2D.
• 3D measures have better reproducibility than 2D for sagittal balance.
Literatur
1.
Zurück zum Zitat Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa 1976) 30(6):682–688CrossRef Glassman SD, Berven S, Bridwell K, Horton W, Dimar JR (2005) Correlation of radiographic parameters and clinical symptoms in adult scoliosis. Spine (Phila Pa 1976) 30(6):682–688CrossRef
2.
Zurück zum Zitat Lazennec JY, Ramaré S, Arafati N et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9(1):47–55CrossRef Lazennec JY, Ramaré S, Arafati N et al (2000) Sagittal alignment in lumbosacral fusion: relations between radiological parameters and pain. Eur Spine J 9(1):47–55CrossRef
4.
Zurück zum Zitat Steffen JS, Obeid I, Aurouer N et al (2010) 3D postural balance with regard to gravity line: an evaluation in the transversal plane on 93 patients and 23 asymptomatic volunteers. Eur Spine J 19(5):760–767CrossRef Steffen JS, Obeid I, Aurouer N et al (2010) 3D postural balance with regard to gravity line: an evaluation in the transversal plane on 93 patients and 23 asymptomatic volunteers. Eur Spine J 19(5):760–767CrossRef
5.
Zurück zum Zitat Illés T, Tunyogi-Csapo M, Somoskeöy S (2011) Breakthrough in three-dimensional scoliosis diagnosis: significance of horizontal plane view and vertebra vectors. Eur Spine J 20(1):135–143CrossRef Illés T, Tunyogi-Csapo M, Somoskeöy S (2011) Breakthrough in three-dimensional scoliosis diagnosis: significance of horizontal plane view and vertebra vectors. Eur Spine J 20(1):135–143CrossRef
6.
Zurück zum Zitat Gangnet N, Pomero V, Dumas R, Skalli W, Vital JM (2003) Variability of the spine and pelvis location with respect to the gravity line: a three-dimensional stereoradiographic study using a force platform. Surg Radiol Anat 25(5-6):424–433CrossRef Gangnet N, Pomero V, Dumas R, Skalli W, Vital JM (2003) Variability of the spine and pelvis location with respect to the gravity line: a three-dimensional stereoradiographic study using a force platform. Surg Radiol Anat 25(5-6):424–433CrossRef
7.
Zurück zum Zitat Schwab F, Lafage V, Boyce R, Skalli W, Farcy JP (2006) Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine (Phila Pa 1976) 31(25):E959–E967CrossRef Schwab F, Lafage V, Boyce R, Skalli W, Farcy JP (2006) Gravity line analysis in adult volunteers: age-related correlation with spinal parameters, pelvic parameters, and foot position. Spine (Phila Pa 1976) 31(25):E959–E967CrossRef
8.
Zurück zum Zitat Dolan P, Adams MA (2001) Recent advances in lumbar spinal mechanics and their significance for modelling. Clin Biomech (Bristol, Avon). 16 Suppl 1:S8–S16CrossRef Dolan P, Adams MA (2001) Recent advances in lumbar spinal mechanics and their significance for modelling. Clin Biomech (Bristol, Avon). 16 Suppl 1:S8–S16CrossRef
11.
Zurück zum Zitat Duval-Beaupere G, Lamireau T (1985) Scoliosis at less than 30 degrees. Properties of the evolutivity (risk of progression). Spine (Phila Pa 1976) 10(5):421–424CrossRef Duval-Beaupere G, Lamireau T (1985) Scoliosis at less than 30 degrees. Properties of the evolutivity (risk of progression). Spine (Phila Pa 1976) 10(5):421–424CrossRef
12.
Zurück zum Zitat Perdriolle R, Vidal J (1985) Thoracic idiopathic scoliosis cruve evolution and prognosis. Spine (Phila Pa 1976) 10(9):785–791CrossRef Perdriolle R, Vidal J (1985) Thoracic idiopathic scoliosis cruve evolution and prognosis. Spine (Phila Pa 1976) 10(9):785–791CrossRef
13.
Zurück zum Zitat Vedantam R, Lenke LG, Keeney JA, Bridwell KH (1998) Comparison of standing sagittal spinal alignment in asymptomatic adolescents and adults. Spine (Phila Pa 1976) 23(2):211–215CrossRef Vedantam R, Lenke LG, Keeney JA, Bridwell KH (1998) Comparison of standing sagittal spinal alignment in asymptomatic adolescents and adults. Spine (Phila Pa 1976) 23(2):211–215CrossRef
14.
Zurück zum Zitat Dubousset J, Charpak G, Skalli W, De Guise JA, Kalifa G (2010) EOS: a new imaging system with low dose radiation in standing position for spine and bone & joint disorders. J Musculoskelet Res 13(01):1–12CrossRef Dubousset J, Charpak G, Skalli W, De Guise JA, Kalifa G (2010) EOS: a new imaging system with low dose radiation in standing position for spine and bone & joint disorders. J Musculoskelet Res 13(01):1–12CrossRef
15.
Zurück zum Zitat Glaser DA, Doan J, Newton PO (2012) Comparison of 3D spinal reconstruction accuracy: biplanar radiographs with EOS versus computed tomography. Spine (Phila Pa 1976) 37:1391–1397CrossRef Glaser DA, Doan J, Newton PO (2012) Comparison of 3D spinal reconstruction accuracy: biplanar radiographs with EOS versus computed tomography. Spine (Phila Pa 1976) 37:1391–1397CrossRef
16.
Zurück zum Zitat Gille O, Champain N, Benchikh-El-Fegoun A, Vital JM, Skalli W (2007) Reliability of 3D reconstruction of the spine of mild scoliotic patients. Spine (Phila Pa 1976) 32(5):568–573CrossRef Gille O, Champain N, Benchikh-El-Fegoun A, Vital JM, Skalli W (2007) Reliability of 3D reconstruction of the spine of mild scoliotic patients. Spine (Phila Pa 1976) 32(5):568–573CrossRef
17.
Zurück zum Zitat Deschênes S, Charron G, Beaudoin G et al (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine (Phila Pa 1976) 35(9):989–994CrossRef Deschênes S, Charron G, Beaudoin G et al (2010) Diagnostic imaging of spinal deformities: reducing patients radiation dose with a new slot-scanning X-ray imager. Spine (Phila Pa 1976) 35(9):989–994CrossRef
18.
Zurück zum Zitat Carreau J, Bastrom T, Petcharapan M et al (2014) Computer-generated, three-dimensional spine model from biplanar radiographs: a validity study in idiopathic scoliosis curves greater than 50 degrees. Spine Deformity 2(2):81–88CrossRef Carreau J, Bastrom T, Petcharapan M et al (2014) Computer-generated, three-dimensional spine model from biplanar radiographs: a validity study in idiopathic scoliosis curves greater than 50 degrees. Spine Deformity 2(2):81–88CrossRef
19.
Zurück zum Zitat Ilharreborde B, Steffen JS, Nectoux E et al (2011) Angle measurement reproducibility using EOS three-dimensional reconstructions in adolescent idiopathic scoliosis treated by posterior instrumentation. Spine (Phila Pa 1976) 36(20):E1306–E1313CrossRef Ilharreborde B, Steffen JS, Nectoux E et al (2011) Angle measurement reproducibility using EOS three-dimensional reconstructions in adolescent idiopathic scoliosis treated by posterior instrumentation. Spine (Phila Pa 1976) 36(20):E1306–E1313CrossRef
20.
Zurück zum Zitat Yvert M, Diallo A, Bessou P, Rehel JL, Lhomme E, Chateil JF (2015) Radiography of scoliosis: comparative dose levels and image quality between a dynamic flat-panel detector and a slot-scanning device (EOS system). Diagn Interv Imaging 96:1177–1188CrossRef Yvert M, Diallo A, Bessou P, Rehel JL, Lhomme E, Chateil JF (2015) Radiography of scoliosis: comparative dose levels and image quality between a dynamic flat-panel detector and a slot-scanning device (EOS system). Diagn Interv Imaging 96:1177–1188CrossRef
21.
Zurück zum Zitat Dietrich TJ, Pfirrmann CW, Schwab A, Pankalla K, Buck FM (2013) Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol. https://doi.org/10.1007/s00256-013-1600-0 CrossRef Dietrich TJ, Pfirrmann CW, Schwab A, Pankalla K, Buck FM (2013) Comparison of radiation dose, workflow, patient comfort and financial break-even of standard digital radiography and a novel biplanar low-dose X-ray system for upright full-length lower limb and whole spine radiography. Skeletal Radiol. https://​doi.​org/​10.​1007/​s00256-013-1600-0 CrossRef
22.
Zurück zum Zitat Law M, Ma WK, Chan E et al (2017) Evaluation of cumulative effective dose and cancer risk from repetitive full spine imaging using EOS system: impact to adolescent patients of different populations. Eur J Radiol 96:1–5CrossRef Law M, Ma WK, Chan E et al (2017) Evaluation of cumulative effective dose and cancer risk from repetitive full spine imaging using EOS system: impact to adolescent patients of different populations. Eur J Radiol 96:1–5CrossRef
23.
Zurück zum Zitat Le Huec JC, Leijssen P, Duarte M, Aunoble S (2011) Thoracolumbar imbalance analysis for osteotomy planification using a new method: FBI technique. Eur Spine J 20(Suppl 5):669–680CrossRef Le Huec JC, Leijssen P, Duarte M, Aunoble S (2011) Thoracolumbar imbalance analysis for osteotomy planification using a new method: FBI technique. Eur Spine J 20(Suppl 5):669–680CrossRef
24.
Zurück zum Zitat Smith JS, Shaffrey CI, Bess S et al (2017) Recent and emerging advances in spinal deformity. Neurosurgery 80(3S):S70–S85CrossRef Smith JS, Shaffrey CI, Bess S et al (2017) Recent and emerging advances in spinal deformity. Neurosurgery 80(3S):S70–S85CrossRef
Metadaten
Titel
Sagittal balance measures are more reproducible when measured in 3D vs in 2D using full-body EOS® images
verfasst von
Masashi Okamoto
Fouad Jabour
Kenichiro Sakai
Shun Hatsushikano
J. C. Le Huec
Kazuhiro Hasegawa
Publikationsdatum
07.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 11/2018
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5485-0

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