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3D-modeling of the spine using EOS imaging system: Inter-reader reproducibility and reliability.

Johannes Rehm1, Thomas Germann1, Michael Akbar2

  • 1Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany.

Plos One
|February 3, 2017
PubMed
Summary

EOS 3D reconstructions of the spine are reliable for adolescent idiopathic scoliosis (AIS) assessment. While axial rotation accuracy has limitations in the upper thoracic spine, overall vertebral rotation measurements are reproducible and efficient.

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Area of Science:

  • Orthopedics
  • Radiology
  • Biomedical Engineering

Background:

  • Adolescent idiopathic scoliosis (AIS) requires accurate spinal measurements for effective management.
  • EOS 3D imaging offers low-dose biplanar radiography for spinal assessment.
  • Evaluating the reliability of 3D reconstructions is crucial for clinical application.

Purpose of the Study:

  • To assess the interreader reproducibility and reliability of EOS 3D full spine reconstructions in AIS patients.
  • To evaluate the accuracy of vertebral rotation and spinal curvature measurements.
  • To determine the time efficiency and radiation dose of the EOS 3D reconstruction process.

Main Methods:

  • Retrospective analysis of 73 AIS patients (mean age 17 years) with moderate scoliosis (median Cobb Angle 18.2°).
  • EOS low-dose standing biplanar radiographs were used for "full spine" 3D reconstructions (Th1-L5).
  • Two independent readers assessed interreader reproducibility for vertebral rotation (coronal, sagittal, axial planes) and spinal/pelvic parameters.

Main Results:

  • High interclass correlation coefficients (ICCs) were observed for frontal (0.83-0.98) and lateral (0.94-0.99) vertebral rotation.
  • ICCs for axial vertebral rotation ranged from 0.51 to 0.88, indicating some limitations in the upper/mid-thoracic spine.
  • Spinal curvatures (kyphosis, lordosis) and pelvic parameters demonstrated excellent ICCs (0.85-0.97).
  • Mean reconstruction time was 14.9 minutes with a mean absorbed dose of 593.4μGy per patient.

Conclusions:

  • EOS 3D full spine reconstructions provide reliable measurements of vertebral rotation in AIS patients.
  • Reconstruction time is acceptable, and radiation dose is low.
  • Interreader reproducibility for axial rotation is limited in the upper and mid-thoracic spine due to anatomical complexities.