Quantifying differences in femoral head and neck asphericity in CAM type femoroacetabular impingement and hip dysplasia versus controls using radial 3DCT imaging and volumetric segmentation

2020 ◽  
Vol 93 (1110) ◽  
pp. 20190039 ◽  
Author(s):  
Natalie Schauwecker ◽  
Yin Xi ◽  
Chenelle Slepicka ◽  
Riham Dessouky ◽  
Nicholas Fey ◽  
...  
Keyword(s):  
Femoral Head ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Femoroacetabular Impingement ◽  
Hip Dysplasia ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Area Under The Curve ◽  
Α Angle ◽  
Volumetric Segmentation

Objective: Femoroacetabular impingement (FAI) and hip dysplasia are the most common causes of groin pain originating from the hip joint. To date, there is controversy over cut-off values for the evaluation of abnormal femoral head-neck anatomy with significant overlap between the normal and abnormal hips. Our aim was to perform three-dimensional CT analysis of femoral head and bump anatomy to quantify common hip pathologies (FAI and hip dysplasia) vs controls. Methods: Consecutive patients who underwent three-dimensional CT imaging for hip dysplasia or CAM type FAI were compared to asymptomatic controls. α angles on radial CT and 3D volumetric femoral head and bump segmentations were performed by two readers. Inter- and intrapatient comparisons were performed including interreader and receiver operating characteristic analyses. Results: 25 FAI patients, 16 hip dysplasia patients and 38 controls were included. FAI and dysplasia patients exhibited higher α angles and higher bump-head volume ratios than the controls (p < 0.05). Larger bump volumes were found among FAI than dysplasia patients and contralateral hips of FAI patients were also different than the controls. α angle at 2 o’clock and bump to head ratio showed the highest area under the curve for patients vs controls. The interreader reliability was better for volumetric segmentation (intraclass correlation coefficient = 0.35–0.84) as compared to the α angles (intraclass correlation coefficient = 0.11–0.44). Conclusion: Patients with FAI and dysplasia exhibit different femoral head anatomy than asymptomatic controls. Volumetric segmentation of femoral head and bump is more reliable and better demonstrates the bilateral femoral head anatomy differences in hip patients vs controls. Advances in knowledge: Utilizing information from 3D volumetric bump assessment in patients with FAI and dysplasia, the physicians may be able to more objectively and reliably evaluate the altered anatomy for better pre-surgical evaluation.

scholarly journals 1183 Three-dimensional echocardiographic paramenters for mitral valve quantification: a feasibility and validation study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Tafciu ◽  
G Granata ◽  
F Ancona ◽  
S Stella ◽  
C Capogrosso ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Volumetric Method ◽  
Systolic Pulmonary Artery Pressure ◽  
Observer Variability ◽  
Vena Contracta ◽  
Valvular Surgery

Abstract Introduction Mitral regurgitation (MR) severity affects prognosis and a correct quantification is key for surgical indication. A multiparametric approach (MPA) is recommended, as singular parameters suffer pitfalls. Recently suggested three-dimensional echocardiographic (3DE) parameters lack clear reference values. No studies have assessed the feasibility of regurgitant volume (RV) and fraction (RF) using the 3D planimetric area of the mitral annulus (MAA) and of the left ventricular outflow tract (LVOTA). Purpose To assess the feasibility and reliability of 3DE, RV and RF obtained by doppler volumetric method using MAA and LVOTA, compare results with 2DE and 3D vena contracta area (VCA) and propose cut-offs for these parameters using MPA as gold standard. Methods Patients referred to our Department for MR assessment were enrolled from September 2018 to February 2019 without more than mild aortic regurgitation or severe stenosis, mitral stenosis and previous valvular surgery. Transthoracic 2DE was used to calculate a multiparametric index of MR severity including: jet area/left atrium (LA) area, CW characteristics, 2D vena contracta, PISA, pulmonary vein flow, LA volume and systolic pulmonary artery pressure. Transoesophageal 3DE was used to assess MAA and LVOTA from a 3D dataset. RV and RF were calculated by Doppler volumetric method using the planimetric areas instead of diameters. VCA 3D was calculated from a 3D color dataset as the cross-sectional area of the regurgitant jet. We compared the results between 2DE and 3DE and between functional and organic MR. ROC curves were analyzed to assess diagnostic performance and identify cut-offs for severity prediction. Intraclass correlation coefficient was calculated to assess variability in measurements. Results Population was composed by 87 patients (56 male, 65 ± 13 years), 72% organic MR. MAA was larger in 2DE (10.4 ± 3.2 vs 9.8 ± 2.9 cm2,) as was the RV (76.6 ± 36.1 vs 66.4 ± 31.9 ml) and RF (55.4 ± 12.4 vs 50.4 vs 10.9%, all p &lt; 0.0001), while LVOTA was smaller (3.9 ± 0.98 vs 4.1 ± 1.0 cm2, p &lt; 0.0001). RV 2D and RF 2D were larger in the organic MR group (p &lt; 0.0001), meanwhile VCA 3D, RV 3D and RF 3D did not show a significant difference (all p &gt; 0.1). VCA 3D had a good correlation with RV 3D (r = 0.593, p &lt; 0.0001) and RF 3D (r = 0.576, p &lt; 0.0001). We proposed a cut-off value of 41.5 mm2 for VCA 3D (94% sens, 96% spec, AUC 0.978), 52 ml for RV 3D (84% sens, 78% spec, AUC 0.901) and 47.6% for RF 3D (91% sens, 90% spec, AUC 0.966) to predict MR severity as assessed by MPA. Intraclass correlation coefficient was 0.980 for MAA and 0.985 for LVOTA for intra-observer variability, while for inter-observer variability it was 0.951 for MAA and 0.962 for LVOTA. Conclusion 2DE overestimates MA dimensions and underestimates LVOT dimensions thus overestimating RV and RF. 3DE measures are relatively simple and reproducible. Proposed cut-offs for RV, RF and VCA 3D have a good diagnostic power.

scholarly journals Cardiac Magnetic Resonance–Derived Extracellular Volume Mapping for the Quantification of Hepatic and Splenic Amyloid

2021 ◽  
Vol 14 (4) ◽  
Author(s):  
Liza Chacko ◽  
Michele Boldrini ◽  
Raffaele Martone ◽  
Steven Law ◽  
Ana Martinez-Naharrro ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Extracellular Volume ◽  
Area Under The Curve ◽  
Systemic Amyloidosis ◽  
Amyloid Load ◽  
Hepatic Amyloidosis

Background: Systemic amyloidosis is characterized by amyloid deposition that can involve virtually any organ. Splenic and hepatic amyloidosis occurs in certain types, in some patients but not others, and may influence prognosis and treatment. SAP (serum amyloid P component) scintigraphy is uniquely able to identify and quantify amyloid in the liver and spleen, thus informing clinical management, but it is only available in 2 centers globally. The aims of this study were to examine the potential for extracellular volume (ECV) mapping performed during routine cardiac magnetic resonance to: (1) detect amyloid in the liver and spleen and (2) estimate amyloid load in these sites using SAP scintigraphy as the reference standard. Methods: Five hundred thirty-three patients referred to the National Amyloidosis Centre, London, between 2015 and 2017 with suspected systemic amyloidosis who underwent SAP scintigraphy and cardiac magnetic resonance with T1 mapping were studied. Results: The diagnostic performance of ECV to detect splenic and hepatic amyloidosis was high for both organs (liver: area under the curve, −0.917 [95% CI, 0.880–0.954]; liver ECV cutoff, 0.395; sensitivity, 90.7%; specificity, 77.7%; P <0.001; spleen: area under the curve, −0.944 [95% CI, 0.925–0.964]; spleen ECV cutoff, 0.385; sensitivity, 93.6%; specificity, 87.5%; P <0.001). There was good correlation between liver and spleen ECV and amyloid load assessed by SAP scintigraphy (r=0.504, P <0.001; r=0.693, P <0.001, respectively). There was high interobserver agreement for both the liver and spleen (ECV liver intraclass correlation coefficient, 0.991 [95% CI, 0.984–0.995]; P <0.001; ECV spleen intraclass correlation coefficient, 0.995 [95% CI, 0.991–0.997]; P <0.001) with little bias across a wide range of ECV values. Conclusions: Our study demonstrates that ECV measurements obtained during routine cardiac magnetic resonance scans in patients with suspected amyloidosis can identify and measure the magnitude of amyloid infiltration in the liver and spleen, providing important clues to amyloid type and offering a noninvasive measure of visceral amyloid burden that can help guide and track treatment.

Are Three-Dimensional–Printed Foot Orthoses Able to Cover the Podiatric Physician's Needs?

2021 ◽  
Vol 111 (5) ◽  
Author(s):  
Edem Allado ◽  
Mathias Poussel ◽  
Isabelle Chary-Valckenaere ◽  
Clément Potier ◽  
Damien Loeuille ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Thermoplastic Polyurethane ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Strong Relationship ◽  
Foot Orthoses ◽  
The Relationship ◽  
Hardness Values

Background Current management of foot pain requires foot orthoses (FOs) with various design features (eg, wedging, height) and specific mechanical properties (eg, hardness, volume). Development of additive manufacturing (three-dimensional [3-D] printing) raises the question of applying its technology to FO manufacturing. Recent studies have demonstrated the physical benefits of FO parts with specific mechanical properties, but none have investigated the relationship between honeycomb architecture (HcA) infilling density and Shore A hardness of thermoplastic polyurethane (TPU) used to make FOs, which is the aim of this study. Methods Sixteen different FO samples were made with a 3-D printer using TPU (97 Shore A), with HcA infilling density ranging from 10 to 40. The mean of two Shore A hardness measurements was used in regression analysis. Results Interdurometer reproducibility was excellent (intraclass correlation coefficient, 0.91; 95% confidence interval [CI], 0.64–0.98; P &lt; .001) and interprinter reproducibility was excellent/good (intraclass correlation coefficient, 0.84; 95% CI, 0.43–0.96; P &lt; .001). Linear regression showed a positive significant relationship between Shore A hardness and HcA infilling density (R2 = 0.955; P &lt; .001). Concordance between evaluator and durometer was 86.7%. Conclusions This study revealed a strong relationship between Shore A hardness and HcA infilling density of TPU parts produced by 3-D printing and highlighted excellent concordance. These results are clinically relevant because 3-D printing can cover Shore A hardness values ranging from 40 to 70, representing most FO production needs. These results could provide important data for 3-D manufacturing of FOs to match the population needs.

scholarly journals Three-dimensional Acetabular Bone Defect Classification System Aided with Rapid Prototyping Model and Reliability and Validity Test

2021 ◽  
Author(s):  
Jingwei Zhang ◽  
Yi Hu ◽  
Hua Ying ◽  
Yuanqing Mao ◽  
Zhenan Zhu ◽  
...  
Keyword(s):  
Rapid Prototyping ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Bone Defect ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Revision Arthroplasty ◽  
Reliability And Validity ◽  
Defect Classification ◽  
Observer Reliability

Abstract Background: Accurately assessing acetabular defects and designing precise and feasible surgical plans are important before hip revision arthroplasty. With the development of three-dimensional printing, rapid prototyping is a novel technique used to print isometric physical object models. We aimed to propose a three-dimensional acetabular bone defect classification system aided with rapid prototyping and evaluated its reliability and validity.Methods: We reviewed 104 consecutive patients who underwent hip revision arthroplasty in our department between January 2014 and December 2019. Forty five of them had rapid prototyping and were included for reliability and validity test. Three doctors retrospectively evaluated bone defects of these 45 patients with this classification and made surgical plans, and repeated it after 2 weeks. The intra- and inter-observer reliability and the validity to surgical records were assessed using intraclass correlation coefficient or Kappa correlation coefficient.Results: The reliability and validity for classification results were high. The mean initial intraclass correlation coefficient for inter-observer reliability was 0.947, which increased to 0.972 when texted second time. As for inter-observer reliability, it ranged from 0.958 to 0.980. The validity showed high Kappa correlation coefficient of 0.951 to 0.967. When considering detailed surgical plans, the reliability and validity were also high with intraclass correlation coefficient and Kappa correlation coefficient all over 0.9.Conclusions: This three-dimensional acetabulum defect classification was of high reliability and convincing validity. With this classification and objective rapid prototyping models, accurate bone defect assessment and reliable surgical plans were achieved. This classification aided with rapid prototyping could serve as a promising tool for surgeons for preoperative evaluation.

scholarly journals Accuracy of single-breath counting test to determine slow vital capacity in hospitalized patients

Revista CEFAC ◽  
2019 ◽  
Vol 21 (2) ◽  
Author(s):  
Anna Luiza Escóssio ◽  
Rodrigo Cappato de Araújo ◽  
Nicole Oliver ◽  
Emília Chagas Costa ◽  
José Ângelo Rizzo ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Vital Capacity ◽  
Operating Characteristic ◽  
Intraclass Correlation ◽  
Area Under The Curve ◽  
Hospitalized Patients ◽  
Single Breath ◽  
Receiver Operating

ABSTRACT Purpose: to identify the accuracy of the single-breath counting test to determine slow vital capacity in hospitalized patients and to evaluate the repeatability of the same examiner. Methods: a diagnostic study and the choice of techniques were randomly assigned. The area under the curve (receiver operating characteristic) was calculated from the slow vital capacity (20ml/kg) to evaluate the best psychometric characteristics of single-breath counting Test for this cutoff point. Repeatability observed by the same examiner was assessed using the Intraclass Correlation Coefficient. Results: 516 patients hospitalized for various diseases were analyzed. In the curve analysis (receiver operating characteristic/slow vital capacity=20ml/Kg), the value of 21 in single-breath counting test with a sensitivity of 94.44% and specificity of 76.62% (area under the curve =0.93, p<0.005) was found. The intraclass correlation coefficient value for the single-breath counting test was 0.976 with p>0.005. Conclusion: the single-breath counting test was a valid and repetitive technique, and may be an important screening option for assessment of lung function in the absence of specific equipment. This technique opens perspectives to replace slow vital capacity measurement in hospitals, which lack spirometric equipment, or in patients who may have a contagious disease, which has a risk of contamination and spread of disease from one patient to another.

scholarly journals Biomechanical Measurement of Rabbit Cornea by a Modified Scheimpflug Device

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Bo Zhang ◽  
Jianjun Gu ◽  
Xiaoxiao Zhang ◽  
Bin Yang ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Bulk Modulus ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Anterior Segment ◽  
Intraobserver Reliability ◽  
Rabbit Cornea ◽  
Deformation Response ◽  
Biomechanical Measurements ◽  
Biomechanical Measurement

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.

scholarly journals A preliminary study of intensivist-performed DVT ultrasound screening in trauma ICU patients (APSIT Study)

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Lloyd Roberts ◽  
Tom Rozen ◽  
Deirdre Murphy ◽  
Adam Lawler ◽  
Mark Fitzgerald ◽  
...  
Keyword(s):  
Intensive Care ◽  
Deep Vein Thrombosis ◽  
High Risk ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Major Trauma ◽  
Intraclass Correlation ◽  
Trauma Patients ◽  
Vein Thrombosis ◽  
Deep Vein

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.

Test-Retest-Reliability of Computer-Based Metamorphopsia Measurement in Macular Diseases

2020 ◽  
Author(s):  
Daniela Claessens ◽  
Alexander K. Schuster ◽  
Ronald V. Krüger ◽  
Marian Liegl ◽  
Laila Singh ◽  
...  
Keyword(s):  
Macular Edema ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Intraclass Correlation ◽  
Measuring Method ◽  
Repeated Measurements ◽  
Retest Reliability ◽  
Macular Diseases ◽  
Computer Based ◽  
Test Retest Reliability

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.

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