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Reliability and Correlation Analysis of Computed Methods to Convert Conventional 2D Radiological Hindfoot Measurements to 3D Equivalents Using Weight Bearing CT

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Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle
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Abstract

To assess the use of computed methods to convert standard hindfoot 2D measurements towards their 3D equivalents. Forty-eight patients, mean age 39.6 ± 13.2 years, with absence of hindfoot pathology were included. A WBCT allowed to perform 2D and 3D hindfoot measurements.

The mean HA2D was 0.79° ± 3.2 valgus, and HA3D was 8.08° ± 6.5 valgus and differed significantly (P < 0.001). The correlation was good r = 0.72. The ICC3D showed to be excellent when compared to the ICC2D, which was good. Similar findings were obtained in other angles. This study shows a good correlation between 2D and 3D hindfoot measurements but a higher reliability of 3D measurements.

Based on Burssens A, Peeters J, Peiffer M, Marien R, Lenaerts T, WBCT ISG, Vandeputte G, Victor J. Reliability and correlation analysis of computed methods to convert conventional 2D radiological hindfoot measurements to a 3D setting using weight bearing CT. Int J Comp Assisted Radiol Surg 2018;13(12): 1999–2008 [50].

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References

  1. Cobey JC. Posterior roentgenogram of the foot. Clin Orthop Relat Res. 1976;118:202–7.

    Google Scholar 

  2. Saltzman CL, El-Khoury GY. The hindfoot alignment view. Foot Ankle Int. 1995;16(9):572–6.

    Article  CAS  PubMed  Google Scholar 

  3. Reilingh ML, Beimers L, Tuijthof GJM, Stufkens SAS, Maas M, van Dijk CN. Measuring hindfoot alignment radiographically: the long axial view is more reliable than the hindfoot alignment view. Skelet Radiol. 2010;39(11):1103–8.

    Article  Google Scholar 

  4. Buck FM, Hoffmann A, Mamisch-Saupe N, Espinosa N, Resnick D, Hodler J. Hindfoot alignment measurements: rotation-stability of measurement techniques on hindfoot alignment view and long axial view radiographs. Am J Roentgenol. 2011;197(3):578–82.

    Article  Google Scholar 

  5. Barg A, Amendola RL, Henninger HB, Kapron AL, Saltzman CL, Anderson AE. Influence of ankle position and radiographic projection angle on measurement of supramalleolar alignment on the anteroposterior and hindfoot alignment views. Foot Ankle Int. 2011;36(11):1352–61.

    Article  Google Scholar 

  6. Ikoma K, Noguchi M, Nagasawa K, Maki M, Kido M, Hara Y, Kubo T. A new radiographic view of the hindfoot. J Foot Ankle Res. 2013;6(1):48.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Richter M, Seidl B, Zech S, Hahn S. PedCAT for 3D-imaging in standing position allows for more accurate bone position (angle) measurement than radiographs or CT. Foot Ankle Surg. 2014;20(3):201–7.

    Article  PubMed  Google Scholar 

  8. Burssens A, Peeters J, Buedts K, Victor J, Vandeputte G. Measuring hindfoot alignment in weight bearing CT: a novel clinical relevant measurement method. Foot Ankle Surg. 2011;22(4):233–8.

    Article  Google Scholar 

  9. Colin F, Lang TH, Zwicky L, Hintermann B, Knupp M. Subtalar joint configuration on weightbearing CT scan. Foot Ankle Int. 2014;35(10):1057–62. 1071100714540890.

    Article  PubMed  Google Scholar 

  10. Krähenbühl N, Tschuck M, Bolliger L, Hintermann B, Knupp M. Orientation of the subtalar joint measurement and reliability using weightbearing CT scans. Foot Ankle Int. 2016;37(1):109–14.

    Article  PubMed  Google Scholar 

  11. Tuominen EK, Kankare J, Koskinen SK, Mattila KT. Weight-bearing CT imaging of the lower extremity. AJR Am J Roentgenol. 2013;200(1):146–8.

    Article  PubMed  Google Scholar 

  12. O’Connor JF, Cohen J. Computerized tomography (CAT scan, CT scan) in orthopaedic surgery. J Bone Joint Surg Am. 1978;60(8):1096–8.

    Article  PubMed  Google Scholar 

  13. Wicky S, Blaser P, Blanc C, Leyvraz P, Schnyder P, Meuli R. Comparison between standard radiography and spiral CT with 3D reconstruction in the evaluation, classification and management of tibial plateau fractures. Eur Radiol. 2000;10(8):1227–32.

    Article  CAS  PubMed  Google Scholar 

  14. te Stroet MA, Holla M, Biert J, van Kampen A. The value of a CT scan compared to plain radiographs for the classification and treatment plan in tibial plateau fractures. Emerg Radiol. 2011;18(4):279–83.

    Article  Google Scholar 

  15. Sanders R. Current concepts review-displaced intra-articular fractures of the calcaneus. J Bone Joint Surg. 2000;82(2):225–50.

    Article  CAS  PubMed  Google Scholar 

  16. Auricchio F, Marconi S. 3D printing: clinical applications in orthopaedics and traumatology. EFORT Open Rev. 2016;1(5):121–7.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Richter M. Computer aided surgery in foot and ankle: applications and perspectives. Int Orthop. 2013;37(9):1737–45.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Tack P, Victor J, Gemmel P, Annemans L. 3D-printing techniques in a medical setting: a systematic literature review. Biomed Eng Online. 2016;15(1):115.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jacxsens M, Van Tongel A, Willemot LB, Mueller AM, Valderrabano V, De Wilde L. Accuracy of the glenohumeral subluxation index in nonpathologic shoulders. J Shoulder Elbow Surg. 2015;24(4):541–6.

    Article  PubMed  Google Scholar 

  20. Victor J, Premanathan A. Virtual 3D planning and patient specific surgical guides for osteotomies around the knee. Bone Joint J. 2013;95(11 Supple A):153–8.

    Article  PubMed  Google Scholar 

  21. Audenaert EA, Baelde N, Huysse W, Vigneron L, Pattyn C. Development of a three-dimensional detection method of cam deformities in femoroacetabular impingement. Skelet Radiol. 2011;40(7):921–7.

    Article  Google Scholar 

  22. Hirschmann A, Pfirrmann CWA, Klammer G, Espinosa N, Buck FM. Upright cone CT of the hindfoot: comparison of the non-weight-bearing with the upright weight-bearing position. Eur Radiol. 2013;24(3):553–8.

    Article  PubMed  Google Scholar 

  23. de Cesar Netto C, Schon LC, Thawait GK, da Fonseca LF, Chinanuvathana A, Zbijewski WB, Siewerdsen JH, Demehri S. Flexible adult acquired flatfoot deformity: comparison between weight-bearing and non-weight-bearing measurements using cone-beam computed tomography. J Bone Joint Surg. 2017;99(18):e98.

    PubMed  Google Scholar 

  24. Burssens A, Van Herzele E, Buedts K, Leenders T, Clockaerts S, Vandeputte G, Victor J. Weightbearing CT in normal hindfoot alignment – presence of constitutional valgus? Foot Ankle Surg. 2017;23:16.

    Article  Google Scholar 

  25. Barg A, Harris MD, Henninger HB, Amendola RL, Saltzman CL, Hintermann B, Anderson AE. Medial distal tibial angle: comparison between weightbearing mortise view and hindfoot alignment view. Foot Ankle Int. 2012;33(8):655–61.

    Article  PubMed  Google Scholar 

  26. Neri T, Barthelemy R, Tourné Y. Radiologic analysis of hindfoot alignment: comparison of Méary, long axial, and hindfoot alignment views. Orthop Traumatol Surg Res. 2017;103(8):1211–6.

    Article  CAS  PubMed  Google Scholar 

  27. Dagneaux L, Moroney P, Maestro M. Reliability of hindfoot alignment measurements from standard radiographs using the methods of Meary and Saltzman. Foot Ankle Surg. 2019;25(2):237–41.

    Article  PubMed  Google Scholar 

  28. Iseki Y, Takahashi T, Takeda H, Tsuboi I, Imai H, Mashima N, Watanabe S, Yamamoto H. Defining the load bearing axis of the lower extremity obtained from anterior-posterior digital radiographs of the whole limb in stance. Osteoarthr Cartil. 2009;17(5):586–91.

    Article  CAS  Google Scholar 

  29. Guichet J-M, Javed A, Russell J, Saleh M. Effect of the foot on the mechanical alignment of the lower limbs. Clin Orthop Relat Res. 2009;415:193–201.

    Article  Google Scholar 

  30. Brage ME, Bennett CR, Whitehurst JB, Getty PJ, Toledano A. Observer reliability in ankle radiographic measurements. Foot Ankle Int. 1997;18(6):324–9.

    Article  CAS  PubMed  Google Scholar 

  31. Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420.

    Article  CAS  PubMed  Google Scholar 

  32. Hamel J. Calcaneal Z osteotomy for correction of subtalar hindfoot varus deformity. Oper Orthop Traumatol. 2015;27(4):308.

    Article  CAS  PubMed  Google Scholar 

  33. Lundberg A, Svensson O. The axes of rotation of the talocalcaneal and talonavicular joints. Foot. 1993;3(2):65–70.

    Article  Google Scholar 

  34. Almeida DF, Ruben RB, Folgado J, Fernandes PR, Audenaert E, Verhegghe B, De Beule M. Fully automatic segmentation of femurs with medullary canal definition in high and in low resolution CT scans. Med Eng Phys. 2016;38(12):1474–80.

    Article  PubMed  Google Scholar 

  35. Chen Y, Qiang M, Zhang K, Li H, Dai H. A reliable radiographic measurement for evaluation of normal distal tibiofibular syndesmosis: a multi-detector computed tomography study in adults. J Foot Ankle Res. 2015;8(1):1.

    Article  Google Scholar 

  36. Hansen M, Le L, Wertheimer S, Meyer E, Haut R. Syndesmosis fixation: analysis of shear stress via axial load on 3.5-mm and 4.5-mm quadricortical syndesmotic screws. J Foot Ankle Surg. 2006;45(2):65–9.

    Article  PubMed  Google Scholar 

  37. Quill GE. Reconstruction of multiplanar ankle and hindfoot deformity with intramedullary techniques. Foot Ankle Clin. 2009;14(3):533–47.

    Article  PubMed  Google Scholar 

  38. Van den Broeck J, Vereecke E, Wirix-Speetjens R, Vander Sloten J. Segmentation accuracy of long bones. Med Eng Phys. 2014;36(7):949–53.

    Article  PubMed  Google Scholar 

  39. Al-Rawi B, Hassan B, Vandenberge B, Jacobs R. Accuracy assessment of three-dimensional surface reconstructions of teeth from cone beam computed tomography scans. J Oral Rehabil. 2010;37(5):352–8.

    Article  CAS  PubMed  Google Scholar 

  40. Rathnayaka K, Sahama T, Schuetz MA, Schmutz B. Effects of CT image segmentation methods on the accuracy of long bone 3D reconstructions. Med Eng Phys. 2011;33(2):226–33.

    Article  PubMed  Google Scholar 

  41. Ebinger T, Goetz J, Dolan L, Phisitkul P. 3D model analysis of existing CT syndesmosis measurements. Iowa Orthop J. 2013;33:40.

    PubMed  PubMed Central  Google Scholar 

  42. Stufkens SA, Barg A, Bolliger L, Stucinskas J, Knupp M, Hintermann B. Measurement of the medial distal tibial angle. Foot Ankle Int. 2011;32(3):288–93.

    Article  PubMed  Google Scholar 

  43. Victor J, Van Doninck D, Labey L, Van Glabbeek F, Parizel P, Bellemans J. A common reference frame for describing rotation of the distal femur. Bone Joint J. 2009;91(5):683–90.

    CAS  Google Scholar 

  44. Lintz F, Barton T, Millet M, Harries WJ, Hepple S, Winson IG. Ground reaction force calcaneal offset: a new measurement of hindfoot alignment. Foot Ankle Surg. 2012;18(1):9–14.

    Article  PubMed  Google Scholar 

  45. Arunakul M, Amendola A, Gao Y, Goetz JE, Femino JE, Phisitkul P. Tripod index: a new radiographic parameter assessing foot alignment. Foot Ankle Int. 2013;34(10):1411–20.

    Article  PubMed  Google Scholar 

  46. Lintz F, Welck M, Bernasconi A, Thornton J, Cullen NP, Singh D, Goldberg A. 3D biometrics for Hindfoot alignment using weightbearing CT. Foot Ank Int. 2017;38(6):684–9.1071100717690806.

    Article  Google Scholar 

  47. Ludlow JB, Ivanovic M. Weightbearing CBCT, MDCT, and 2D imaging dosimetry of the foot and ankle. Int J Diagn Imaging. 2014;1(2):1.

    Article  Google Scholar 

  48. Barg A, Saltzman CL. Single-stage supramalleolar osteotomy for coronal plane deformity. Curr Rev Musculoskelet Med. 2014;7(4):277–91.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Van Gestel L, Van Bouwel S, Somville J. Surgical treatment of the adult acquired flexible flatfoot. Acta Orthop Belg. 2015;81(2):172–83.

    PubMed  Google Scholar 

  50. Burssens A, Peeters J, Peiffer M, Marien R, Lenaerts T, WBCT ISG, Vandeputte G, Victor J. Reliability and correlation analysis of computed methods to convert conventional 2D radiological hindfoot measurements to a 3D setting using weight bearing CT. Int J Comp Assisted Radiol Surg. 2018;13(12):1999–2008.

    Google Scholar 

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Acknowledgments

The authors wish to thank Ir. Karim Chellaoui, as a clinical engineer for his attributive remarks to the study design and thorough review of the statistics.

The linguistic and structural support was provided by Maxwell Weinberg, research assistant at the University of Utah and Hannes Van Wynendaele, MLing of Ugent.

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Correspondence to Arne Burssens .

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Burssens, A. (2020). Reliability and Correlation Analysis of Computed Methods to Convert Conventional 2D Radiological Hindfoot Measurements to 3D Equivalents Using Weight Bearing CT. In: Weight Bearing Cone Beam Computed Tomography (WBCT) in the Foot and Ankle. Springer, Cham. https://doi.org/10.1007/978-3-030-31949-6_10

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  • DOI: https://doi.org/10.1007/978-3-030-31949-6_10

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