scholarly journals In-vivo precision of a non-invasive ultrasound-based device to measure pelvic tilt for THA

10.29007/ql68 ◽  
2019 ◽  
Author(s):  
Guillaume Dardenne ◽  
Jean-Philippe Pluchon ◽  
Hoel Letissier ◽  
Aziliz Guezou-Philippe ◽  
Romain Gérard ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Intraclass Correlation ◽  
High Body Mass Index ◽  
Standing Position ◽  
Patient Specific ◽  
Non Invasive ◽  
User Expertise ◽  
Hip Kinematics ◽  
Expertise Level

The cup orientation plays a major role in the long-term implant stability following Total Hip Arthroplasty (THA). Because of the patient specific spine-hip kinematics, the safe zone introduced by Lewinnek is more and more controversial. Several solutions have been recently developed to take into account such parameter for THA but are all either invasive, difficult to use or expensive. A non-invasive ultrasound (US) based device has been recently proposed which allows the acquisition of the pelvic tilt in different daily positions. The goal of this study is to analyze the in-vivo intra and inter-observer precision of this device. Measurements were realized by three physicians on three healthy subjects having a low, medium and high Body Mass Index (BMI). Among the three physicians, there were an expert, an intermediate, and a novice user. For each subject, the pelvic tilt was measured ten times by the three physicians in the supine, standing and sitting positions. The inter and intra-observer precisions have been analyzed using the intraclass correlation coefficient (ICC) and according to the BMI, the positions and the user expertise level. The inter-observer precision was therefore excellent whatever the BMI. It was also excellent regarding the supine and the sitting positions and good concerning the standing position. The in-vivo intra-observer precision was excellent for all measurements and whatever the user’s expertise, the BMI and the positions. This study shows therefore that the precision of our system meets the clinical requirement. Introduction

scholarly journals An Easy-to-Use Portable Ultrasound Based Device for the Measurement of the Pelvic Tilt

10.29007/pwhr ◽  
2018 ◽  
Author(s):  
Guillaume Dardenne ◽  
Jean-Philippe Pluchon ◽  
Aziliz Guezou-Philippe ◽  
Hoel Letissier ◽  
Chafiaa Hamitouche ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Safe Zone ◽  
Individual Variability ◽  
Daily Activities ◽  
Patient Specific ◽  
Average Error ◽  
Portable Ultrasound ◽  
X Ray ◽  
Non Invasive ◽  
Specific Parameter

The orientation of the cup in Total Hip Arthroplasty plays a major role on the post- operative results. It has been considered for several decades that the cup should be oriented according to the safe zone defined by Lewinnek. However, this safe zone is not always suitable because of the inter-individual variability of the pelvic tilt during daily activities. We propose in this paper a non-invasive ultrasound based solution which can easily measure this patient specific parameter in order to thereafter otimise the cup orientation. The accuracy of this system was assessed with a specific pelvic phantom. A clinical pilot study was also performed on ten patients. The pelvic tilt was measured in three daily positions: the supine, sitting and standing positions. The average error was 1.15°±0.82°. The average pelvic tilt was -97.1°±28.6°, -46.3°±12.8° and -9.0°±8.3° for respectively the supine, the sitting and the standing positions. The high inter-individual variability of the pelvic tilt in different daily positions highlight the need to have a suitable device for the measurement of this patient specific parameter for THA. The proposed system is easy-to-use, portable and allows the pelvic tilt measurement in different positions without any additional x-ray radiation.

scholarly journals A Combined In Vivo, In Vitro, In Silico Approach for Patient-Specific Haemodynamic Studies of Aortic Dissection

2020 ◽  
Vol 48 (12) ◽  
pp. 2950-2964
Author(s):  
Mirko Bonfanti ◽  
Gaia Franzetti ◽  
Shervanthi Homer-Vanniasinkam ◽  
Vanessa Díaz-Zuccarini ◽  
Stavroula Balabani
Keyword(s):  
Aortic Dissection ◽  
In Silico ◽  
Clinical Decision ◽  
Patient Specific ◽  
Type B ◽  
Non Invasive ◽  
Cfd Models ◽  
Numerical Predictions

AbstractThe optimal treatment of Type-B aortic dissection (AD) is still a subject of debate, with up to 50% of the cases developing late-term complications requiring invasive intervention. A better understanding of the patient-specific haemodynamic features of AD can provide useful insights on disease progression and support clinical management. In this work, a novel in vitro and in silico framework to perform personalised studies of AD, informed by non-invasive clinical data, is presented. A Type-B AD was investigated in silico using computational fluid dynamics (CFD) and in vitro by means of a state-of-the-art mock circulatory loop and particle image velocimetry (PIV). Both models not only reproduced the anatomical features of the patient, but also imposed physiologically-accurate and personalised boundary conditions. Experimental flow rate and pressure waveforms, as well as detailed velocity fields acquired via PIV, are extensively compared against numerical predictions at different locations in the aorta, showing excellent agreement. This work demonstrates how experimental and numerical tools can be developed in synergy to accurately reproduce patient-specific AD blood flow. The combined platform presented herein constitutes a powerful tool for advanced haemodynamic studies for a range of vascular conditions, allowing not only the validation of CFD models, but also clinical decision support, surgical planning as well as medical device innovation.

scholarly journals In-vivo precision of a non-invasive ultrasound-based device to measure pelvic tilt for THA

2019 ◽  
Vol 22 (sup1) ◽  
pp. S251-S252
Author(s):  
A. Guezou-Philippe ◽  
G. Dardenne ◽  
J.-P Pluchon ◽  
H. Letissier ◽  
R. Gérard ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Non Invasive

scholarly journals A Study on the Reliability and Validity of the Standing Lateral Radiograph Method to Assess Acetabular Component Version

2021 ◽  
Author(s):  
wenhui Zhang ◽  
Jie Xu ◽  
Deng Li ◽  
Hao Sun ◽  
Zhiqing Cai ◽  
...  
Keyword(s):  
Acetabular Component ◽  
Pelvic Tilt ◽  
Intraclass Correlation ◽  
Reliability And Validity ◽  
Standing Position ◽  
Outer Edge ◽  
Adverse Outcomes ◽  
Acetabular Cup ◽  
Radiographic Measurements ◽  
The Mean

Abstract Objectives: Version of the acetabular component on standing position is an important factor influencing the risk of adverse outcomes during functional activities after total hip arthroplasty (THA). The main objective of this study was to evaluate the reliability and validity of a method for measuring cup version on standing lateral (SL) radiograph.Methods: 87 consecutive patients who underwent primary THA were included. SL radiograph and computed tomography (CT) scan were taken 7 days after THA to measure the cup version. The measurement method was based on the cross-table lateral (CL) radiograph. The tangential line of the cup opening face was determined through two intersecting points of the cup outer edge circle and the opening face elliptical arc. The version was measured between the horizonal line and the tangent line by two independent examiners. Radiographic measurements were compared with CT measurements after the uniformization of pelvic tilt (PT).Results: All measurements had excellent intra- and inter-observer reliabilities with an intraclass correlation coefficient (ICC) >0.90. The mean version was 15.56° (SD 11.22°, -19.82° to 38.74°) for SL radiographs and 16.19° (SD 12.09°, -23.00° to 47.20°) for PT-matched CT. There was a positive correlation (r = 0.901, p < 0.001) between radiographic versions and CT versions. The mean difference was -0.63° (SD 5.25°, -14.92° to 12.72°) and the differences were almost within the 95% limits of agreement. Conclusion: SL radiograph allows accurate and practicable evaluation of post-operative functional acetabular cup version, with an advantage to identify the pelvic tilt simultaneously.

Identification of malignant ascites using MR-based T1 mapping.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16719-e16719
Author(s):  
Fabian Kuetting ◽  
Alois Martin Sprinkart ◽  
Anton Faron ◽  
Lisa Meffert ◽  
Christian Jansen ◽  
...  
Keyword(s):  
T1 Mapping ◽  
Roc Analysis ◽  
Ex Vivo ◽  
Intraclass Correlation ◽  
Malignant Ascites ◽  
Non Invasive ◽  
Albumin Content ◽  
Malignant Effusions

e16719 Background: Non-invasive identification of malignant ascites is a challenge in clinical practice.Thus, we decided to assess if an MR-based T1 mapping approach allows non-invasive differentiation of malignant and non-malignant effusions. Methods: In-vitro and ex-vivo MR-examinations were performed on a clinical 1.5T MR-system. T1 mapping was performed with spectroscopy and an adapted modified Look-Locker inversion-recovery (MOLLI) acquisition. For in-vitro experiments 13 titrated solutions with varying albumin content (0 to 200 g/l) were examined. For ex-vivo evaluation 27 ascites/pleural effusion samples from patients with malignancy (19 with histologic tumor confirmation in effusion) and 18 samples from patients without malignancy were examined. All samples underwent histological and laboratory testing. Samples were classified as malignant-positive histology, malignant-negative histology and non-malignant negative histology. Lab values were correlated with T1 maps and receiver operating characteristic (ROC) analysis was used to determine the optimal T1-value threshold to differentiate malignant and non-malignant ascites. Results: In in-vitro analysis both methods showed a high correlation with albumin-content (MOLLI: r = -0.97; Spectroscopy: -0.98). T1-values derived from the reference standard (Spectroscopy) and the MOLLI technique had a high agreement (intraclass correlation single measures: 0,9889, 95% CI: 0,52 to 0,99; average measures: 9,994, 95% CI 0,69 to 0,99). Bland-Altman analysis showed a strong agreement between both methods: 62.5 ± 35 (95% CI: 41.2 to 83.8) Ex-vivo analysis revealed significant differences between T1 values from patients with malignant+ histology (median: 2237; IQR: 2132 to 2327.5) and patients with non malignant- negative histology (median: 2611; IQR: 2548 to 2803, p < 0.0001) as well as between malignant+ histology and all other included patients (median: 2585; IQR: 2503 to 2710, p < 0.0001) Multiple regression analysis of in-vivo results revealed that only albumin content correlated with MOLLI based T1 measurements (p < 0.0001; r = -0.65) ROC analysis for differentiation between malignant and non-malignant effusions (malignant+ histology vs. all other) showed an AUC of 0.897; 95% CI: 0.769 to 0.967). Malignant+ histology vs. non-malignant- histology showed an AUC of 1.000 (cut off Lolli > 2419; 95% CI: 0.905 to 1). Conclusions: T1 Mapping shows excellent correlation with protein content of fluids.MR- T1 mapping allows for non-invasive differentiation of malignant and non-malignant effusions in an ex-vivo set up.

scholarly journals Relationship between pelvic morphology and functional parameters in standing position for patient-specific cup planning in THA

10.29007/41f9 ◽  
2018 ◽  
Author(s):  
Maximilian Fischer ◽  
Stephanie Schörner ◽  
Stefan Rohde ◽  
Christian Lüring ◽  
Klaus Radermacher
Keyword(s):  
Pelvic Tilt ◽  
Planning Process ◽  
Pelvic Incidence ◽  
Pubic Symphysis ◽  
Standing Position ◽  
Patient Specific ◽  
Automatic Process ◽  
Sacral Slope ◽  
Functional Parameters ◽  
Eos Imaging

The sagittal orientation of the pelvis commonly called pelvic tilt has an effect on the orientation of the cup in total hip arthroplasty (THA). Pelvic tilt is different between individuals and changes during activities of daily living. In particular, the pelvic tilt in standing position should be considered during the planning of THA to adapt the target angles of the cup patient-specifically to minimize wear and the risk of dislocation. Methods to measure pelvic tilt require an additional step in the planning process, may be time consuming and additional devices or x-ray imaging are necessary.In this study, the relationship between three functional parameters describing the sagittal pelvic orientation in standing position and seven morphological parameters of the pelvis was investigated. Correlations might be used to estimate the pelvic tilt in standing position by the morphology of the pelvis in order to avoid additional measuring techniques of pelvic tilt in the planning process of THA. For 18 subjects a semi-automatic process was established to match a 3D-reconstruction of the pelvis from CT scans to orthogonal EOS imaging in standing position and to calculate the morphological and functional parameters of the pelvis subsequently.The two strongest correlations of the linear correlation analysis were observed between morphological pelvic incidence and functional sacral slope (r = 0.78; p = 0.0001) and between morphological pubic symphysis-posterior superior iliac spines- ratio and functional tilt of anterior pelvic plane (r = -0.59; p = 0.0098). The results of this study suggest that patient-specific adjustments to the orientation of the cup in planning of THA without additional measurement of the sagittal pelvic orientation in standing position should be based on the correlation between morphological pelvic incidence and functional sacral slope.

scholarly journals REPRODUCIBILITY AND EQUIVALENCE OF COBBMETER APPLICATION IN THE SAGITTAL EVALUATION OF THE SPINE

2016 ◽  
Vol 15 (4) ◽  
pp. 279-282 ◽  
Author(s):  
Luis Marchi ◽  
Fernanda Fortti ◽  
Rodrigo Amaral ◽  
Leonardo Oliveira ◽  
Joes Nogueira-Neto ◽  
...  
Keyword(s):  
Lumbar Lordosis ◽  
Pelvic Tilt ◽  
Pelvic Incidence ◽  
Intraclass Correlation ◽  
Smartphone Application ◽  
Standing Position ◽  
Lateral View ◽  
Cross Sectional ◽  
K Value ◽  
Sagittal Spinal Alignment

ABSTRACT Objective: This study aims to evaluate the reliability and equivalency of using the Cobbmeter application for iPhone compared to the manual measurement method in the analysis of the sagittal spinal alignment. Methods: Cross-sectional, prospective, single-center study that had 20 panoramic radiographs of the spine in lateral view, in a neutral standing position, analyzed blindly and randomly by three independent examiners in three different times. The parameters were pelvic incidence (PI), pelvic tilt (PT) and lumbar lordosis (LL). The statistical analysis was performed to measure the intraclass correlation coefficient (ICC) between the two measurement methods, in addition to measuring the intra and inter-evaluators reliability. Results: For reproducibility analysis, the intra-evaluators ICC using the application resulted in a Kappa (K) of 0.975 for the evaluation of pelvic incidence (PI) evaluation. For pelvic tilt (PT), the K value obtained was 0.981 and the K measured for lumbar lordosis (LL) analysis was 0.987. The inter-evaluators evaluation of reproducibility using the application resulted in a K value of 0.917 for PI, 0.930 for PT and 0.951 for LL. For the assessment of equivalency of methods, comparing the application to the standard method, with a goniometer and dermographic pencil, the K value found for PI was 0.873, for PV was 0.939 and for LL was 0.914. All values were significant (p<0.001) against the null hypothesis. Conclusion: This smartphone application is a valid and reliable instrument for measuring the angle involved in the sagittal balance of the spine. Furthermore, the results show that its applicability is not inferior to the manual method with goniometer and dermographic pencil.

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