Accuracy and Safety of Image-Guided Freehand Pin Placement in Canine Cadaveric Vertebrae

Author(s):  
Eva S. Samer ◽  
Franck Forterre ◽  
Justus M.K. Rathmann ◽  
Veronika M. Stein ◽  
Christina M. Precht ◽  
...  

Abstract Objective The aim of this study was to validate an imaging technique for evaluation of spinal surgery accuracy and to establish accuracy and safety of freehand technique in the thoracolumbar spine of large breed dogs. Study Design After thoracolumbar spine computed tomography (CT), 26 drilling corridors were planned then drilled to receive 3.2 mm positive profile pins using a freehand technique. After pin removal, CT was repeated. All entry points, exit points and angles of the preoperative planned trajectories were compared with postoperative ones using an image registration and fusion technique by three observers. Corridor coordinates for entry and exit points were evaluated in three dimensions and angles were measured in one plane. Intraclass correlation coefficient (ICC) was used to establish the imaging technique reliability and descriptive statistics were used to report on the freehand technique accuracy. Safety was evaluated using a vertebral cortical breach grading scheme. Results Intraclass correlation coefficient for the entry points, exit points and angle were 0.79, 0.96 and 0.92 respectively. Mean deviations for the entry points, exit points and angle were 3.1 mm, 6.3 mm and 7.6 degrees respectively. Maximum deviations were 6.3 mm, 11.0 mm and 16.4 degrees. Most deviations were lateral and caudal. All corridors were judged as safe. Conclusion The imaging technique reliability was good to excellent to study spinal surgery accuracy. Implant deviations should be anticipated when planning stabilization surgery in large breed dogs using the freehand-guided technique.

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Bo Zhang ◽  
Jianjun Gu ◽  
Xiaoxiao Zhang ◽  
Bin Yang ◽  
Zheng Wang ◽  
...  

Purpose. To explore the probability and variation in biomechanical measurements of rabbit cornea by a modified Scheimpflug device.Methods. A modified Scheimpflug device was developed by imaging anterior segment of the model imitating the intact eye at various posterior pressures. The eight isolated rabbit corneas were mounted on the Barron artificial chamber and images of the anterior segment were taken at posterior pressures of 15, 30, 45, 60, and 75 mmHg by the device. The repeatability and reliability of the parameters including CCT, ACD, ACV, and CV were evaluated at each posterior pressure. All the variations of the parameters at the different posterior pressures were calculated.Results. All parameters showed good intraobserver reliability (Cronbach’s alpha; intraclass correlation coefficient,α, ICC > 0.96) and repeatability in the modified Scheimpflug device. With the increase of posterior pressures, the ratio of CCT decreased linearly and the bulk modulus gradually reduced to a platform. The increase of ACD was almost linear with the posterior pressures elevated.Conclusions. The modified Scheimpflug device was a valuable tool to investigate the biomechanics of the cornea. The posterior pressure 15–75 mmHg range produced small viscoelastic deformations and nearly linear pressure-deformation response in the rabbit cornea.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lloyd Roberts ◽  
Tom Rozen ◽  
Deirdre Murphy ◽  
Adam Lawler ◽  
Mark Fitzgerald ◽  
...  

Abstract Background Multiple screening Duplex ultrasound scans (DUS) are performed in trauma patients at high risk of deep vein thrombosis (DVT) in the intensive care unit (ICU). Intensive care physician performed compression ultrasound (IP-CUS) has shown promise as a diagnostic test for DVT in a non-trauma setting. Whether IP-CUS can be used as a screening test in trauma patients is unknown. Our study aimed to assess the agreement between IP-CUS and vascular sonographer performed DUS for proximal lower extremity deep vein thrombosis (PLEDVT) screening in high-risk trauma patients in ICU. Methods A prospective observational study was conducted at the ICU of Alfred Hospital, a major trauma center in Melbourne, Australia, between Feb and Nov 2015. All adult major trauma patients admitted with high risk for DVT were eligible for inclusion. IP-CUS was performed immediately before or after DUS for PLEDVT screening. The paired studies were repeated twice weekly until the DVT diagnosis, death or ICU discharge. Written informed consent from the patient, or person responsible, or procedural authorisation, was obtained. The individuals performing the scans were blinded to the others’ results. The agreement analysis was performed using Cohen’s Kappa statistics and intraclass correlation coefficient for repeated binary measurements. Results During the study period, 117 patients had 193 pairs of scans, and 45 (39%) patients had more than one pair of scans. The median age (IQR) was 47 (28–68) years with 77% males, mean (SD) injury severity score 27.5 (9.53), and a median (IQR) ICU length of stay 7 (3.2–11.6) days. There were 16 cases (13.6%) of PLEDVT with an incidence rate of 2.6 (1.6–4.2) cases per 100 patient-days in ICU. The overall agreement was 96.7% (95% CI 94.15–99.33). The Cohen’s Kappa between the IP-CUS and DUS was 0.77 (95% CI 0.59–0.95), and the intraclass correlation coefficient for repeated binary measures was 0.75 (95% CI 0.67–0.81). Conclusions There is a substantial agreement between IP-CUS and DUS for PLEDVT screening in trauma patients in ICU with high risk for DVT. Large multicentre studies are needed to confirm this finding.


Author(s):  
Daniela Claessens ◽  
Alexander K. Schuster ◽  
Ronald V. Krüger ◽  
Marian Liegl ◽  
Laila Singh ◽  
...  

AbstractIn this study, the test-retest-reliability as one aspect of reliability of metamorphopsia measurements using a computer-based measuring method was determined in patients with macular diseases. Metamorphopsia amplitude, position, and area were quantified using AMD – A Metamorphopsia Detector software (app4eyes GmbH & Co. KG, Germany) in patients with diabetic, myopic, or uveitic macular edema, intermediate or neovascular age-associated macular degeneration, epiretinal membrane, vitelliform maculopathy, Irvine-Gass syndrome, or macular edema due to venous retinal occlusion. The intraclass correlation coefficient (ICC) was calculated in order to determine the repeatability of two repeated measurements and was used as an indicator of the reliability of the measurements. In this study, metamorphopsia measurements were conducted on 36 eyes with macular diseases. Metamorphopsia measurements made using AMD – A Metamorphopsia Detector software were highly reliable and repeatable in patients with maculopathies. The intraclass correlation coefficient of all indices was excellent (0.95 – 0.97). For diseases of the vitreoretinal interface or macular diseases with intra- or subretinal edema, this metamorphopsia measurement represents a supplement for visual function testing in the clinic, as well as in clinical studies.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1423.2-1424
Author(s):  
J. A. Mendonça ◽  
I. Siste de Almeida Aoki ◽  
C. C. Cavuto ◽  
V. A. Leandro-Merhi ◽  
J. L. B. D. Aquino

Background:The gray scale (GS) in high resolution ultrasound is already well validated for use in rheumatological diseases, but the color map or the histogram, can be considered a new proposal, to better define and complement the echotextural damages detection1.Objectives:To calculate the lesions area measures reproducibility index in arthropathies, between 3 blind evaluators and correlate these measures using the GS and the histogram.Methods:Observational and retrospective study approved by the ethics committee of the Pontifical Catholic University of Campinas, with the opinion number: 1.526.307. A total of 29 patients have been assessed (31% males and 69% females) on period 2014 to 2019 in Rheumatology service. A MyLab 50 -Esaote equipment was used with frequency transducer that ranged between 6.0 and 18.0 MHz, 10 different area measures were performed from each recorded images previously, by the GS and the histogram. Statistical analysis: Spearman’s correlation coefficients, Lin’s concordance coefficient (CCC) and the intraclass correlation coefficient (ICC) and their respective 95% confidence intervals, with the SPSS software package for Windows v. 17.0 (SPSS Inc., Chicago, IL, USA).Results:Average age 43.5 ± 21.5 years of age; with disease duration that varied between ≤ 1 month (48.3%) and ≥36 months (24.1%); with the following diseases: juvenile idiopathic arthritis (17.24%); osteoarthritis (13.79%); psoriatic arthritis (13.79%); undifferentiated spondyloarthritis (3.44%); gout (20.68%); rheumatoid arthritis (27.58%) and reactive arthritis (3.44%). A total of 840 measures of exudative (27.58%), proliferative (27.58%) and snowstorm appearance (6.89%) synovitis were performed; femoral-condyle cartilage (3.44%); synovial cyst (3.44%); paratendinitis (6.89%); calcification (3.44%); nail enthesitis (3.44%); tenosynovitis (6.89%) and tophi (10.34%) (Figure 1). The concordance correlation coefficient showed values closer to 1; p <0.001, the intraclass correlation coefficients with excellent reproducibility (ICC ≥ 0.75); p <0.001, always in relation to the three evaluators (Table 1) and the Spearman correlation between the GS and the histogram ranged from rs = 0.665 to rs = 1,000; p <0.001.Conclusion:The histogram can be considered an image method to better identify echotextural damages.References:[1]Mendonça J, Provenza J, Guissa V, et al AB1059 2D Histogram Ultrasound and 3D Ultrasound Correlation in Rheumatic Diseases Annals of the Rheumatic Diseases 2015; 74:1253-1254.Table 1.Concordance Correlation Coefficient (CCC) and Intraclass Correlation Coefficient (ICC):EvaluatorsGS - CCC(IC 95%)p-valorHistogram (IC 95%)p-valor1 e 20,998(0,994-0,999)<0,0010,999(0,995-1,000)<0,0011 e 30,998(0,995-0,999)<0,0010,999(0,995-1,000)<0,0012 e 30,992(0,980-0,997)<0,010,996(0,979-0,999)<0,01Standard by US 2DICCp-valorGS0,997(0,992-0,999)<0,001Histogram0,998(0,992-0,999)<0,001Legends: Gray Scale (GS).Figure 1.Patient with gout: A and B: Tophi area measures (star) in right metatarsos and efusion (arrow) by GS (45 mm2) and histogram (39 mm2), respectively.Disclosure of Interests:José Alexandre Mendonça Speakers bureau: Novartis, Janssen, Bristol, UCB, Isabella Siste de Almeida Aoki: None declared, Caique Chagas Cavuto: None declared, Vânia Aparecida Leandro-Merhi: None declared, José Luis Braga de Aquino: None declared


Lupus ◽  
2021 ◽  
pp. 096120332110610
Author(s):  
Cecilia Catoggio ◽  
Alejandro Martínez Muñoz ◽  
Rafael Chaparro del Moral ◽  
Diana S Klajn ◽  
Silvia B Papasidero ◽  
...  

Objectives To validate the systemic lupus activity questionnaire (SLAQ) in Spanish language. Methods The SLAQ questionnaire was translated and adapted in Spanish. Consecutive SLE patients from 8 centers in Argentina were included. A rheumatologist completed a Systemic Lupus Activity Measure (SLAM), Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2K, and a physician’s assessment. Reliability was assessed by internal consistency (Cronbach’s alpha), stability by test–retest reliability (intraclass correlation coefficient), and construct validity by evaluating the correlation with clinically relevant scores. Sensitivity and specificity for clinically significant disease activity (SLEDAI ≥6) of different S-SLAQ cut-off points were evaluated. Results We included 97 patients ((93% female, mean age: 40 years (SD14.7)). Internal consistency was excellent (Cronbach’s alpha = 0.84, p < 0.001), and the intraclass correlation coefficient was 0.95 ( p < 0.001). Mean score of S-SLAQ was 8.2 (SD 7.31). Correlation of S-SLAQ was moderate with Patient NRS (r= 0.63 p< 0.001), weak with SLAM-no lab ( r = 0.42, p <0.001) and SLAM ( r = 0.38, p < 0.0001), and very weak with SLEDAI-2K ( r = 0.15, p =0.1394). Using the S-SLAQ cutoff of five points, the sensitivity was 72.2% and specificity was 37.9%, for clinically significant disease activity. Conclusions The S-SLAQ showed good validity and reliability. A good correlation, similar to the original instrument, was observed with patient´s global disease activity. No correlation was found between S-SLAQ and gold standard disease activity measures like SLEDAI-2K and SLAM. The S-SLAQ cutoff point of 5 showed a good sensitivity to identify the active SLE population and therefore could be an appropriate screening instrument for disease activity in clinical and epidemiological studies.


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