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The Feasibility of High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) in Patients with Suspected Scaphoid Fractures.
- Source :
-
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry [J Clin Densitom] 2020 Jul - Sep; Vol. 23 (3), pp. 432-442. Date of Electronic Publication: 2019 Aug 16. - Publication Year :
- 2020
-
Abstract
- Introduction: Diagnosing scaphoid fractures remains challenging. High-resolution peripheral quantitative computed tomography (HR-pQCT) might be a potential imaging technique, but no data are available on its feasibility to scan the scaphoid bone in vivo.<br />Methodology: Patients (≥18 years) with a clinically suspected scaphoid fracture received an HR-pQCT scan of the scaphoid bone (three 10.2-mm stacks, 61-μm voxel size) with their wrist immobilized with a cast. Scan quality assessment and bone contouring were performed using methods originally developed for HR-pQCT scans of radius and tibia. The contouring algorithm was applied on coarse hand-drawn pre-contours of the scaphoid bone, and the resulting contours (AUTO) were manually corrected (sAUTO) when visually deviating from bone margins. Standard morphologic analyses were performed on the AUTO- and sAUTO-contoured bones.<br />Results: Ninety-one patients were scanned. Two out of the first five scans were repeated due to poor scan quality (40%) based on standard quality assessment during scanning, which decreased to three out of the next 86 scans (3.5%) when using an additional thumb cast. Nevertheless, after excluding one scan with an incompletely scanned scaphoid bone, post hoc grading revealed a poor quality in 14.9% of the stacks and 32.9% of the scans in the remaining 85 patients. After excluding two scans with contouring problems due to scan quality, bone indices obtained by AUTO- and sAUTO-contouring were compared in 83 scans. All AUTO-contours were manually corrected, resulting in significant but small differences in densitometric and trabecular indices (<1.0%).<br />Conclusions: In vivo HR-pQCT scanning of the scaphoid bone is feasible in patients with a clinically suspected scaphoid fracture when using a cast with thumb part. The proportion of poor-quality stacks is similar to radius scans, and AUTO-contouring appears appropriate in good- and poor-quality scans . Thus, HR-pQCT may be promising for diagnosis of and microarchitectural evaluations in suspected scaphoid fractures.<br /> (Copyright © 2019 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Feasibility Studies
Female
Fractures, Bone therapy
Humans
Image Processing, Computer-Assisted methods
Logistic Models
Male
Middle Aged
Scaphoid Bone injuries
Tomography, X-Ray Computed methods
Wrist Injuries therapy
Casts, Surgical
Fractures, Bone diagnostic imaging
Scaphoid Bone diagnostic imaging
Wrist Injuries diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1094-6950
- Volume :
- 23
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry
- Publication Type :
- Academic Journal
- Accession number :
- 31495579
- Full Text :
- https://doi.org/10.1016/j.jocd.2019.08.003