Quantitative assessment of weight-bearing fracture biomechanics using extremity cone-beam CT

The purpose of this article is to determine the orientation and relative position of the foot bones in Weight Bearing CT, highlighting the effect of the load and the shoe with the heel. Thanks to a Cone Beam CT (OnSight 3D Extremity System, Carestream) equipment, three scans of the foot of a healthy young subject were carried out in three conditions: "unloading", "loading", and wearing a shoe with "heel". In order to assess the accuracy of the articular angles of the foot through non-invasive measurements, a measurement was performed by Gait-Analysis with passive markers in the same conditions. The effect of the "load" resulted in a significant alteration of the foot posture especially in the sagittal plane, with crushing of the longitudinal medial arch. The heeled shoe involves enormous deformations at the level of the metatarsophalangeal joints and the ankle.

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A robotic x-ray cone-beam CT system: trajectory optimization for 3D imaging of the weight-bearing spine

Medical Imaging 2019: Physics of Medical Imaging ◽

10.1117/12.2513433 ◽

2019 ◽

Cited By ~ 1

Author(s):

Chumin Zhao ◽

Magdalena Herbst ◽

Sebastian Vogt ◽

Ludwig Ritschl ◽

Steffen Kappler ◽

...

Keyword(s):

Trajectory Optimization ◽

3D Imaging ◽

Cone Beam Ct ◽

Weight Bearing ◽

Cone Beam ◽

X Ray ◽

System Trajectory ◽

Ct System

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SU-GG-I-24: A Quantitative Assessment of the Effects of a Simple Dead Detector Pixel Correction Method for Megavoltage Cone Beam CT Images

Medical Physics ◽

10.1118/1.2961423 ◽

2008 ◽

Vol 35 (6Part3) ◽

pp. 2648-2648

Author(s):

R Flynn ◽

H Shukla ◽

E Nixon ◽

J Bayouth

Keyword(s):

Quantitative Assessment ◽

Cone Beam Ct ◽

Correction Method ◽

Ct Images ◽

Cone Beam ◽

Megavoltage Cone Beam Ct

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SU-E-T-64: Quantitative Assessment of Dose Differences Between CT and Cone-Beam CT Using Pencil Beam Convolution and Analytical Anisotropic Algorithms

Medical Physics ◽

10.1118/1.3612015 ◽

2011 ◽

Vol 38 (6Part11) ◽

pp. 3500-3500 ◽

Cited By ~ 1

Author(s):

I Ali ◽

S Oyewale ◽

S Ahmad

Keyword(s):

Quantitative Assessment ◽

Cone Beam Ct ◽

Cone Beam ◽

Pencil Beam

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Uncertainties and CTV to PTV margins quantitative assessment using cone-beam CT technique in clinical application for prostate, and head and neck irradiation tumours

Clinical & Translational Oncology ◽

10.1007/s12094-011-0740-8 ◽

2011 ◽

Vol 13 (11) ◽

pp. 819-825 ◽

Cited By ~ 6

Author(s):

Xavier Jordi Juan-Senabre ◽

Juan López-Tarjuelo ◽

Antonio Conde-Moreno ◽

Agustín Santos-Serra ◽

Ángel L. Sánchez-Iglesias ◽

...

Keyword(s):

Head And Neck ◽

Clinical Application ◽

Quantitative Assessment ◽

Cone Beam Ct ◽

Cone Beam ◽

Ct Technique ◽

Neck Irradiation ◽

Head And Neck Irradiation

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Weight-Bearing Cone-Beam CT Scan Assessment of Stability of Supination External Rotation Ankle Fractures in a Cadaver Model

Foot & Ankle International ◽

10.1177/1071100718761035 ◽

2018 ◽

Vol 39 (7) ◽

pp. 850-857 ◽

Cited By ~ 14

Author(s):

Mark C. Lawlor ◽

Melissa A. Kluczynski ◽

John M. Marzo

Keyword(s):

Ct Scan ◽

Ankle Fracture ◽

External Rotation ◽

Imaging Modality ◽

Cone Beam Ct ◽

Weight Bearing ◽

Ankle Fractures ◽

Cone Beam ◽

Clear Space ◽

Supination External Rotation

Background: The utility of computed tomography (CT) for measuring medial clear space (MCS) for determination of the stability of supination external rotation (SER) ankle fractures and in comparison to standard radiographs is unknown. We compared MCS on gravity stress (GS) radiographs to GS and weight bearing (WB) cone-beam CT (CBCT). Methods: An AO SER 44B3.1 ankle fracture was simulated in 10 human cadavers, also serving as controls. MCS was measured on GS radiographs, GS CBCT, and a simulated WB CBCT scan. Specimens were stable if MCS was <5 mm and unstable if MCS was ≥5 mm. Paired t tests were used to compare MCS from each imaging modality for controls versus SER injuries and stable versus unstable specimens. Results: Compared with controls assessed by GS radiographs, MCS was greater for an SER injury when assessed by GS radiograph and GS CBCT scan within the stable group. Compared with controls assessed by GS radiographs, MCS was greater for SER injuries when assessed by GS radiograph, GS CBCT scan, and WB CBCT within the unstable group. MCS was reduced for stable versus unstable SER injuries assessed by WB CBCT. Conclusion: In a cadaveric model of SER ankle fracture, the medial clear space was statistically significantly greater for the experimental condition when assessed by gravity stress radiograph and gravity stress CBCT scan. Under weight-bearing conditions, the cone-beam CT scanner distinguished between stable and unstable ankles in the experimental condition. Clinical Relevance: This study suggests that a WB cone-beam CT scan may be able to distinguish between stable and unstable SER ankle fractures and influence operative decision making.

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WEIGHT-BEARING CONE BEAM CT SCANS AND ITS USES IN ANKLE, FOOT, AND KNEE: AN UPDATE ARTICLE

Acta Ortopédica Brasileira ◽

10.1590/1413-785220212902236939 ◽

2021 ◽

Vol 29 (2) ◽

pp. 105-110

Author(s):

CARLOS FELIPE TEIXEIRA LÔBO ◽

MARCELO BORDALO-RODRIGUES ◽

Alexandre Leme Godoy-Santos ◽

Riccardo Gomes Gobbi ◽

Cesar de Cesar Netto ◽

...

Keyword(s):

Clinical Practice ◽

Cone Beam Ct ◽

Weight Bearing ◽

Cone Beam ◽

Extensive Literature ◽

Level Of Evidence ◽

Orthopedic Surgeons ◽

Quality Costs ◽

Potential Applications ◽

High Resolution Images

ABSTRACT Imaging plays a key role in the preoperative diagnosis, surgical planning, and postsurgical assessment of the foot, ankle, and knee pathologies. Interpreting diagnostic imaging accurately is crucial for the clinical practice of orthopedic surgeons. Although among the most used imaging modalities, radiographic assessments are amenable to errors for various technical reasons and superposition of bones. Computed tomography (CT) is a conventional imaging procedure that provides high-resolution images, but fails in considering a truly weight-bearing (WB) condition. In an attempt to overcome this limitation, WB cone beam CT technology has being successfully employed in the clinical practice for the past decade. Besides economically viable and safe, the WB cone beam CT considers WB conditions and provides high-quality scans, thus allowing an equitable and correct interpretation. This review aims to address extensive description and discussion on WBCT, including imaging quality; costs; time consumption; and its applicability in common foot, ankle, and knee, conditions. With this technology increasing popularity, and considering the extensive literature on medical research, radiologists and orthopedic surgeons need to understand its potential applications and use it optimally. Level of Evidence III, Systematic review of level III studies.

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