A semi-automatic approach for longitudinal 3D upper airway analysis using voxel based registration

2021 ◽  
Author(s):  
Alexandru Diaconu ◽  
Michael Boelstoft Holte ◽  
Paolo Maria Cattaneo ◽  
Else Marie Pinholt
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
Upper Airway ◽  
Observer Agreement ◽  
3D Analysis ◽  
Anatomic Landmarks ◽  
Cross Sectional ◽  
Method Error ◽  
Anterior Cranial Base ◽  
Intraclass Correlations

Objectives: To propose and validate a reliable semi-automatic approach for three-dimensional (3D) analysis of the upper airway (UA) based on voxel-based registration (VBR). Methods: Post-operative cone beam computed tomography (CBCT) scans of ten orthognathic surgery patients were superimposed to the pre-operative CBCT scans by VBR using the anterior cranial base as reference. Anatomic landmarks were used to automatically cut the UA and calculate volumes and cross-sectional areas (CSA). The 3D analysis was performed by two observers twice, at an interval of two weeks. Intraclass correlations and Bland-Altman plots were used to quantify the measurement error and reliability of the method. The relative Dahlberg error was calculated and compared with a similar method based on landmark re-identification and manual measurements. Results: Intraclass correlation coefficient (ICC) showed excellent intra- and inter observer reliability (ICC ≥0.995). Bland-Altman plots showed good observer agreement, low bias and no systematic errors. The relative Dahlberg error ranged between 0.51–4.30% for volume and 0.24–2.90% for CSA. This was lower when compared with a similar, manual method. Voxel-based registration introduced 0.05–1.44% method error. Conclusions: The proposed method is shown to have excellent reliability and high observer agreement. The method is feasible for longitudinal clinical trials on large cohorts due to being semi-automatic.

scholarly journals Three-dimensional analysis of upper airway morphology in skeletal Class III patients with and without mandibular asymmetry

2017 ◽  
Vol 87 (4) ◽  
pp. 526-533 ◽  
Author(s):  
Xi Wen ◽  
Xiyu Wang ◽  
Shuqi Qin ◽  
Lorenzo Franchi ◽  
Yan Gu
Keyword(s):  
Symmetry Group ◽  
Three Dimensional ◽  
Upper Airway ◽  
Class Iii ◽  
Cross Sectional ◽  
Skeletal Class ◽  
Mandibular Asymmetry ◽  
Subgroup Ii ◽  
Group D ◽  
Inferior Limit

ABSTRACT Objective: To compare the three-dimensional (3D) morphology of the upper airway in skeletal Class III patients with and without mandibular asymmetry and to investigate the possible underlying correlations between the morphology of the upper airway and mandibular deviation. Materials and Methods: Cone-beam computed tomography images of 54 subjects with skeletal Class III malocclusion (ANB angle ≤ 0.4°, Wits ≤ −5.5°) were taken and 3D upper airway models were reconstructed using Dolphin 3D software. According to the distance (d) from symphysis menti to the sagittal plane, all subjects were divided into a symmetry group (d ≤ 2 mm) and an asymmetry group (d ≥ 4 mm). Based on the severity of mandibular deviation, the asymmetry group was divided into subgroup I (4 mm ≤d <10 mm) and subgroup II (d ≥ 10 mm). Cross-sectional linear distances, areas, and volumetric variables of the upper airway were measured in the 3D airway model. Results: Width of the inferior limit of the glossopharynx (P3W), cross-sectional area of the anterior limit of the nasal airway (P5S), and height of the glossopharynx (GPH) in the asymmetry group were significantly larger than in the symmetry group. As for subjects with severe mandibular deviation in subgroup II (d ≥ 10 mm), volume of the glossopharynx (GPV), total volume of the pharynx (TPV), length of the inferior limit of the velopharynx (P2L), and ratio of length to width of the inferior limit of the velopharynx (P2L/P2W) showed significantly negative correlations with mandibular deviation (r > 0.7, P < .05). Conclusions: In Class III subjects with severe mandibular asymmetry, the pharyngeal airway showed a tendency toward constriction and presented a more elliptical shape as mandibular deviation became more severe (P < .01).

scholarly journals Reproducibility in pelvic floor biometric parameters of nulliparous women assessed by translabial three-dimensional ultrasound using Omniview reformatting technique.

2016 ◽  
Vol 18 (3) ◽  
pp. 345 ◽  
Author(s):  
Zsuzsanna Ilona Katalin Jármy-Di Bella ◽  
Edward Araujo Júnior ◽  
Claudinei Alves Rodrigues ◽  
Luiza Torelli ◽  
Wellington P. Martins ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Three Dimensional ◽  
3D Ultrasound ◽  
Observer Agreement ◽  
Cross Sectional ◽  
Biometric Parameters ◽  
Observer Reliability ◽  
Hiatal Area ◽  
Nulliparous Women

Aim: To assess the reproducibility of pelvic floor biometric parameters by translabial three-dimensional ultrasound compared with the OmniView® reformatting technique. Material and methods: We performed a cross-sectional study involving 47 nulliparous women without symptoms of pelvic floor dysfunction. The hiatal area and right pubovisceral muscle width measurements were performed in the axial plane using both 3D ultrasound in the rendering mode and OmniView® techniques. To determine the occurrence of standardized error between examiners and the two sonographic methods, the paired t-test was used. The intra- and inter-observer reliability and agreement were estimated by concordance correlation coefficient (CCC) and limits of agreement, respectively. Results: We did not observe significant statistical differences among both measurements performed by the first examiner, both examiners and both methods in the assessment of the hiatal area; however, the measurements of the right pubovisceral muscle were significantly lower using OmniView®. The intra-observer reliability was good in the evaluation of all pelvic floor parameters; however, the inter-observer reliability was good only to the 3D rendering mode (CCC=0.87). The intra-observer agreement was good in the assessment of all pelvic floor parameters; however, the inter-observer agreement was found to be good only when 3DUS in the rendering mode was used (<±15%). Conclusion: Both 3D ultrasound in the rendering mode and OmniView® reformatting techniques were concordant in the assessment of pelvic floor parameters; however, the 3D ultrasound rendering in the mode demonstrated better inter-observer reliability and agreement.

scholarly journals Assessment of interobserver reliability in localization of hard and soft tissue landmarks and three-dimensional measurements of the upper airway based on these landmarks using CBCT images

2021 ◽  
Vol 7 (2) ◽  
pp. 54-60
Author(s):  
Jangam Daya K ◽  
Talreja Kajol M ◽  
Garcha Vikram ◽  
Patil Abhijeet V ◽  
Swatantramath Sunaina M ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Internal Consistency ◽  
Interobserver Reliability ◽  
Three Dimensional ◽  
Upper Airway ◽  
Anatomical Landmarks ◽  
Cross Sectional ◽  
Full Field ◽  
Excellent Internal Consistency ◽  
Dimensional Measurements

: To assess reliability in localization of hard and soft tissue landmarks of the upper airway and three-dimensional measurements of the upper airway based on these landmarks using CBCT images. : 22 full field of view (FOV) CBCT scan volumes were selected randomly and retrospectively made at the CBCT unit of Department of Oral Medicine and Radiology. Six anatomic landmarks that are relevant for upper airway analysiswere located and subsequently three-dimensional measurements (volume, minimum cross-sectional area (CSA), location of the CSA, anteroposterior and lateral dimensions of the CSA) in all planes (coronal, sagittal, axial) were performed based on these land marks by two observers, using Romexis software (4.2.0 R 10/13/15). : Correlation analysis by Cronbach’s Alpha.: Interobserver reliability of the landmark localization was excellent (Internal consistency 0.97-0.99) and for the three-dimensional upper airway measurements were good (Internal consistency 0.62-0.99).: The interobserver reliability of anatomical landmarks localization and three-dimensional measurements of the upper airway are good to excellent using Romexis software. Therefore, this methodology can be recommended for the upper airway analysis using CBCT images.

High-Fidelity Anthropometric Facial Measurements Can Be Obtained From a Single Stereophotograph From the Vectra H1 3-Dimensional Camera

2019 ◽  
Vol 56 (9) ◽  
pp. 1164-1170 ◽  
Author(s):  
Diana S. Jodeh ◽  
S. Alex Rottgers
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
Young Patients ◽  
Correlation Coefficients ◽  
Anthropometric Measurements ◽  
3D Analysis ◽  
Facial Morphology ◽  
Anthropometric Measures ◽  
3D Images ◽  
3 Dimensional

Background: Anthropometry is a well-established means of measuring facial morphology. Although reliable, direct anthropometry can be time-consuming and not conducive to a busy clinical practice. The Vectra H1 handheld stereophotogrammetric system requires 3 stereophotographs taken from different perspectives to generate a three-dimensional (3D) surface. The time needed to take the 3 stereophotographs can increase the possibility of involuntary movements, precluding its use to assess young patients. To overcome this limitation, we evaluated if accurate linear facial measurements can be obtained from a single stereophotograph and compare these to the measurements taken by direct anthropometry. Methods: Twenty pediatric patients, aged 0 to 10 years, who were undergoing minor surgical procedures at Johns Hopkins All Children’s Hospital were recruited. Fourteen linear facial distances were obtained from each participant using direct anthropometry under general anesthesia. These same distances were measured using Mirror 3D analysis. Intraclass correlation was used to determine intrarater reliability on duplicate 3D images. Results: Correlation coefficients between 3D imaging in frontal view and direct anthropometric measurements were excellent for 13 measures taken, ranging from 0.8 (subnasale to columella and subnasale to stomion superius) to 0.98 (nasion to subnasale and subnasale to labiale superius). Correlation coefficients between submental view and direct anthropometric measurements were excellent for 13 measures as well, ranging from 0.77 (subnasale to columella) to 0.98 (nasion to subnasale). Conclusions: Linear anthropometric measurements taken from 3D surfaces generated from a single stereophotograph correlate closely with direct anthropometric measures. This improves workflow and applicability of anthropometric studies to our youngest patients.

scholarly journals Anatomic development of the upper airway during the first five years of life: A three-dimensional imaging study

2021 ◽  
Author(s):  
Ying Ji Chuang ◽  
Seong Jae Hwang ◽  
Kevin A Buhr ◽  
Courtney A Miller ◽  
Gregory D Avey ◽  
...  
Keyword(s):  
Data Extraction ◽  
Three Dimensional ◽  
Upper Airway ◽  
Imaging Study ◽  
Typically Developing ◽  
Cross Sectional ◽  
Airway Segmentation ◽  
Methodological Considerations ◽  
2D And 3D ◽  
Position Histogram

Purpose. Normative data on the growth and development of the upper airway across the sexes is needed for the diagnosis and treatment of congenital and acquired respiratory anomalies and to gain insight on developmental changes in speech acoustics and disorders with craniofacial anomalies. Methods. The growth of the upper airway in children ages birth-to-five years, as compared to adults, was quantified using an imaging database with computed tomography studies from typically developing individuals. Methodological criteria for scan inclusion and airway measurements included: head position, histogram-based airway segmentation, anatomic landmark placement, and development of a semi-automatic centerline for data extraction. A comprehensive set of 2D and 3D supra- and sub-glottal measurements from the choanae to tracheal opening were obtained including: naso-oro-laryngo-pharynx subregion volume and length, each subregion superior and inferior cross-sectional-area, and antero-posterior and transverse/width distances. Results. Growth of the upper airway during the first five years of life was more pronounced in the vertical and transverse/lateral dimensions than in the antero-posterior dimension. By age five years, females have larger pharyngeal measurement than males. Prepubertal sex-differences were identified in the subglottal region. Conclusions. Our findings demonstrate the importance of studying the growth of the upper airway in 3D. As the lumen length increases, its shape changes, becoming increasingly elliptical during the first five years of life. This study also emphasizes the importance of methodological considerations for both image acquisition and data extraction, as well as the use of consistent anatomic structures in defining pharyngeal regions.

Two-dimensional versus three-dimensional Frӓnkel Manoeuvre: a reproducibility study

2019 ◽  
Vol 42 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Roberto Rongo ◽  
Rosaria Bucci ◽  
Raffaella Adaimo ◽  
Massimo Amato ◽  
Stefano Martina ◽  
...  
Keyword(s):  
Gold Standard ◽  
Three Dimensional ◽  
Class Ii ◽  
Observer Agreement ◽  
3D Analysis ◽  
Two Dimensional ◽  
Skeletal Class ◽  
Reproducibility Study ◽  
Skeletal Class Ii ◽  
3D Scans

Summary Background/Objectives To assess intra- and inter-observer reproducibility of the evaluation of the Frӓnkel Manoeuvre (FM) on three-dimensional (3D) scans and to compare it to the assessment on two-dimensional (2D) pictures. Materials/Methods This study included 44 individuals with a skeletal Class II malocclusion [9–16-years old mean age ± standard deviation: 13.5 ± 2.01 years]. All patients had a full Class II molar relationship, overjet ≥6 mm and point A, Nasion, point B angle (ANB) ≥5 degrees. During the FM, each patient was invited to bite in centric occlusion and then to posture the mandible forward to reach a Class I molar relationship. The FM was recorded both by a normal camera and a 3D scanner (3dMD system). Six examiners divided into two groups according to their orthodontic clinical experience (&lt;5 and &gt;10 years), and one gold standard in the evaluation of FM, commented twice (every 15 days) on both 2D photographs (T0 and T2) and 3D scans (T1 and T3). The intra-observer agreement and the inter-observer agreement compared to the gold standard were evaluated by computing the Cohen’s K. Results The agreement between observations for each examiner ranged from 0.36 to 1 on 2D pictures (T0 versus T2), and from 0.22 to 0.69 on 3D scans (T1 versus T3). The overall agreement was 0.63 (95 per cent CI = 0.35–0.91) in 2D analysis and 0.5 (95 per cent CI = 0.35–0.64) in 3D analysis. Conclusions/Implications The FM was less reproducible when performed on 3D records than on 2D pictures.

scholarly journals Volumetric Changes in the Upper Airways after Rapid and Slow Maxillary Expansion in Growing Patients: A Case-Control Study

Materials ◽  
2020 ◽  
Vol 13 (10) ◽  
pp. 2239 ◽  
Author(s):  
Valentina Lanteri ◽  
Marco Farronato ◽  
Alessandro Ugolini ◽  
Gianguido Cossellu ◽  
Francesca Gaffuri ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Upper Airway ◽  
T Test ◽  
Leaf Spring ◽  
Second Primary ◽  
Maxillary Expansion ◽  
Upper Airways ◽  
Method Error ◽  
Significant Difference ◽  
Group Comparisons

The aim is to evaluate changes in the volume of the upper airways before and after slow maxillary expansion (SME) obtained with the flexible properties of a nickel titanium leaf spring and rapid maxillary expansion (RME) with a conventional Hyrax appliance in growing patients. The records of 1200 orthodontic patients undergoing maxillary expansion from 2018 to 2019 were analyzed; among these pre and post treatment CBCT scans of 22 patients (mean age 8.2 ± 0.6 years old) treated by SME were compared with those obtained from 22 patients (mean age 8.1 ± 0.7 years old) treated by RME banded on the second primary molars. The following inclusion criteria were used: Maxillary transverse constriction, good general health, and no previous orthodontic treatment. Volumes of nasal cavity (NCavV), nasopharynx (NsPxV), and right and left maxillary sinuses (MSV) were calculated with ITK-SNAP. Shapiro–Wilk test revealed a normal distribution of data in each group. Paired t-test was used for within-group comparisons and independent t-test for between-group comparisons. Statistically significant increases occurred in NCavV, NsPxV, and MSVs after treatment with both appliances. No statistically significant difference between the appliances occurred in NCavV, NsPxV, and MSVs. Method error was considered negligible (mean intra-operator and inter-operator intraclass correlation coefficient were 0.928 and 0.911, respectively). It appears that both appliances produce similar effects on the different segments of the upper airway tract.

Anatomical plane and transverse axis of the scapula: Reliability of manual positioning of the anatomical landmarks

2021 ◽  
pp. 175857322110017
Author(s):  
Adrien Jacquot ◽  
Marc-Olivier Gauci ◽  
Manuel Urvoy ◽  
François Boux de Casson ◽  
Julien Berhouet ◽  
...  
Keyword(s):  
Intraclass Correlation ◽  
Three Dimensional ◽  
Correlation Method ◽  
Observer Agreement ◽  
Anatomical Landmarks ◽  
Positioning Error ◽  
Key Points ◽  
The Mean ◽  
Anatomical Plane

Background The aim of our study was to evaluate the accuracy of manual determination of the three key points defining the anatomical plane of the scapula, which conditions the reliability of planning software programs based on manual method. Method We included 82 scapula computed tomography scans (56 pathologic and 26 normal glenoid), excluding truncation and major three-dimensional artifact. Four observers independently picked the three key points for each case. Inter- and intra-observer agreement was calculated for each point, using the intraclass correlation method. The mean error (mm) between the observers was calculated as the diameter of the smallest sphere including the four chosen positions. Results Lower inter-observer agreement was found for the trigonum superoinferior position and for the glenoid center anteroposterior position. The mean positioning error between the four observers was 6.9 mm for the trigonum point, and error greater than 10 mm was recorded in 25% of the cases. The mean positioning error was 3.5 mm for the glenoid center in altered glenoid, compared to 1.8 mm for normal glenoid. Discussion Manual determination of an anatomical plane of the scapula suffers from inaccuracy especially due to the variability in trigonum picking, and in a lesser extent, to the variability of glenoid center picking in altered glenoid.

scholarly journals Comparison of reliability of magnetic resonance imaging using cartilage and T1-weighted sequences in the assessment of the closure of the growth plates at the knee

2020 ◽  
Vol 9 (9) ◽  
pp. 205846012096273
Author(s):  
Ola FT Kvist ◽  
Ana Luiza Dallora ◽  
Ola Nilsson ◽  
Peter Anderberg ◽  
Johan Sanmartin Berglund ◽  
...  
Keyword(s):  
Young Adults ◽  
Growth Plate ◽  
Intraclass Correlation ◽  
Cross Sectional Study ◽  
Observer Agreement ◽  
Adolescents And Young Adults ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Bone Structures ◽  
Weighted Sequences

Background Growth development is traditionally evaluated with plain radiographs of the hand and wrist to visualize bone structures using ionizing radiation. Meanwhile, MRI visualizes bone and cartilaginous tissue without radiation exposure. Purpose To determine the state of growth plate closure of the knee in healthy adolescents and young adults and compare the reliability of staging using cartilage sequences and T1-weighted (T1W) sequence between pediatric and general radiologists. Material and Methods A prospective, cross-sectional study of MRI of the knee with both cartilage and T1W sequences was performed in 395 male and female healthy subjects aged between 14.0 and 21.5 years old. The growth plate of the femur and the tibia were graded using a modified staging scale by two pediatric and two general radiologists. Femur and tibia were graded separately with both sequences. Results The intraclass correlation was overall excellent. The inter- and intra-observer agreement for pediatric radiologists on T1W was 82% (κ  = 0.73) and 77% (κ  = 0.65) for the femur and 90% (κ  = 0.82) and 87% (κ  = 0.75) for the tibia. The inter-observer agreement for general radiologists on T1W was 69% (κ  = 0.56) for the femur and 56% (κ  = 0.34) for the tibia. Cohen’s kappa coefficient showed a higher inter- and intra-observer agreement for cartilage sequences than for T1W: 93% (κ  = 0.86) and 89% (κ  = 0.79) for the femur and 95% (κ = 0.90) and 91% (κ  = 0.81) for the tibia. Conclusion Cartilage sequences are more reliable than T1W sequence in the assessment of the growth plate in adolescents and young adults. Pediatric radiology experience is preferable.

Development and Validation of the Nurse Prescribing Self-Efficacy Scale

2020 ◽  
pp. 019394592096250
Author(s):  
Teresa Galiana-Camacho ◽  
María Dolores Ruiz-Fernandez ◽  
Iria Dobarrio-Sanz ◽  
José Granero-Molina ◽  
Cayetano Fernandez-Sola ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Content Validity ◽  
Self Efficacy ◽  
Intraclass Correlation ◽  
Temporal Stability ◽  
Three Dimensional ◽  
Cross Sectional Study ◽  
Dimensional Structure ◽  
Cross Sectional ◽  
Nurse Prescribing

Low self-efficacy is a barrier to effective nurse prescribing. Therefore, nurses’ self-efficacy should be assessed using validated tools. We aimed to develop and psychometrically test the Nurse Prescribing Self-Efficacy Scale (NP-SES). We conducted an observational cross-sectional study with 290 nurses between January and June 2019. We studied the NP-SES’ reliability (i.e., internal consistency and temporal stability), validity (i.e., content, criterion, and construct) and legibility. The NP-SES showed good internal consistency (Cronbach’s alpha=0.958) and temporal stability (intraclass correlation coefficient=0.783). The NP-SES also showed good content validity (scale’s content validity index=0.98) and criterion validity ( r=0.75; p<0.001). Construct validity analysis revealed the NP-SES’ three-dimensional structure and showed its ability to detect significant differences between nurses with different levels of experience. Our psychometric analysis suggests that the NP-SES is a reliable and valid instrument that could be used to assess nurses’ self-efficacy in nurse prescribing.

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