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European Radiology
Published in: European Radiology 9/2016

01-09-2016 | Musculoskeletal

Assessment of two-dimensional (2D) and three-dimensional (3D) lower limb measurements in adults: Comparison of micro-dose and low-dose biplanar radiographs

Authors: Andrea B. Rosskopf, Christian W. A. Pfirrmann, Florian M. Buck

Published in: European Radiology | Issue 9/2016

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Abstract

Objective

To evaluate reliability of 2D and 3D lower limb measurements in adults using micro-dose compared to low-dose biplanar radiographs(BPR).

Materials and methods

One hundred patients (mean 54.9 years) were examined twice using micro-dose and low-dose BPR. Length and mechanical axis of lower limbs were measured on the antero-posterior(ap) micro-dose and low-dose images by two independent readers. Femoral and tibial torsions of 50 patients were measured by two independent readers using reconstructed 3D-models based on the micro-dose and low-dose BPR. Intermethod and interreader agreements were calculated using descriptive statistics, intraclass-correlation-coefficient(ICC), and Bland-Altman analysis.

Results

Mean interreader-differences on micro-dose were 0.3 cm(range 0-1.0)/ 0.7°(0-2.9) for limb length/axis and 0.4 cm (0-1.0)/0.8°(0-3.3) on low-dose BPR. Mean intermethod-difference was 0.04 cm ± 0.2/0.04° ± 0.6 for limb length/axis. Interreader-ICC for limb length/axis was 0.999/0.991 on micro-dose and 0.999/0.987 on low-dose BPR. Interreader-ICC for micro-dose was 0.879/0.826 for femoral/ tibial torsion, for low-dose BPR was 0.924/0.909. Mean interreader-differences on micro-dose/low-dose BPR were 3°(0-13°)/2°(0°–12°) for femoral and 4°(0-18°)/3°(0°–10°) for tibial torsion. Mean intermethod-difference was -0.1° ± 5.0/-0.4° ± 2.9 for femoral/tibial torsion. Mean dose-area-product was significantly lower (9.9 times;p < 0.001) for micro-dose BPR.

Conclusion

2D-and 3D-measurements of lower limbs based on micro-dose BPR are reliable and provide a 10-times lower radiation dose.

Key points

• Lower limb length and mechanical axis can be reliably measured with micro-dose.
• Femoral and tibial torsion can be reliably assessed with micro-dose.
• Micro-dose allows a huge reduction of radiation exposure.
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Metadata
Title
Assessment of two-dimensional (2D) and three-dimensional (3D) lower limb measurements in adults: Comparison of micro-dose and low-dose biplanar radiographs
Authors
Andrea B. Rosskopf
Christian W. A. Pfirrmann
Florian M. Buck
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 9/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4166-5

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