EOS imaging of the human pelvis: reliability, validity, and controlled comparison with radiography

Area of Science:

• Radiology
• Orthopedics
• Medical Imaging

Background:

• EOS imaging offers low radiation exposure and high image quality.
• Pelvic imaging applications are expanding, necessitating evaluation of new techniques.
• This study assessed the validity and reliability of EOS for pelvic and acetabular morphology.

Purpose of the Study:

• To evaluate the validity and reliability of the EOS imaging technique for assessing gross pelvic and acetabular morphology.
• To compare EOS imaging with conventional radiography for pelvic measurements.
• To assess the reproducibility of EOS imaging measurements.

Main Methods:

• Conventional and EOS radiographs of a cadaveric pelvis were acquired at varying tilt and rotation angles.
• Six key pelvic measurements and specific signs (coxa profunda, crossover sign) were evaluated.
• Measurements were correlated between EOS, conventional radiography, and true cadaveric measurements, with inter- and intraobserver reliability assessed.

Main Results:

• Strong correlation found between EOS and conventional radiography (Pearson's r: 0.644-0.998).
• High intra- and interobserver reproducibility for EOS measurements (ICC: 0.795-1.000).
• Significant differences in linear measurements between modalities due to conventional radiography's magnification effects.

Conclusions:

• EOS imaging is a reliable method for assessing gross pelvic and acetabular morphology.
• EOS may serve as a viable alternative to conventional radiography for primary pelvic imaging in pediatric and adult populations.
• Further studies are needed to evaluate EOS for detecting subtle anatomical abnormalities.