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Brage K, Mussmann B, Geijer M, Larsen P, Jensen J. Clinical application of EOS imaging system: a scoping review protocol. JBI Evid Synth 2023; 21:1009-1015. [PMID: 36633464 DOI: 10.11124/jbies-22-00213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The objective of this scoping review is to examine and map the existing literature on the clinical application of the EOS imaging system and to identify related evidence gaps. INTRODUCTION The EOS imaging system was originally developed to conduct imaging for medical conditions, such as scoliosis and anisomelia. However, recent research suggests that the modality has other clinical uses that may benefit patients via reduced radiation dose and, thus, improve patient safety. INCLUSION CRITERIA This scoping review will consider all quantitative study designs, including systematic reviews and meta-analyses. Imaging phantom studies and conference abstracts will be excluded. METHODS Databases that will be searched include Embase, MEDLINE, CINAHL Complete, Scopus, Cochrane Library, Academic Search Premier, and OpenGrey. Relevant secondary material will be identified using citation searching (backwards and forwards) of included studies through Google Scholar. In addition, we will search by author name where more than 3 included studies from the same first author are identified. Articles published from 2003 in English, Danish, Norwegian, Swedish, French, and German will be included. Two independent reviewers will perform title/abstract screening, followed by full-text screening. Data extraction will include study type and design, age of participants, anatomical/physiological region, pathology, clinical endpoint, outcome measures, sample size, and clinical application. Data will be presented in tabular format and as a narrative summary. REVIEW REGISTRATION NUMBER Open Science Framework https://osf.io/yc85j/.
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Affiliation(s)
- Karen Brage
- Education of Radiography, UCL University College, Odense, Denmark.,Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Bo Mussmann
- Department of Radiology, Odense University Hospital, Odense, Denmark.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
| | - Mats Geijer
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Radiology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Palle Larsen
- Health Sciences Research Centre, UCL University College, Odense, Denmark
| | - Janni Jensen
- Department of Radiology, Odense University Hospital, Odense, Denmark.,Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark
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Alfuth M, Fichter P, Knicker A. Leg length discrepancy: A systematic review on the validity and reliability of clinical assessments and imaging diagnostics used in clinical practice. PLoS One 2021; 16:e0261457. [PMID: 34928991 PMCID: PMC8687568 DOI: 10.1371/journal.pone.0261457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A variety of assessments to determine leg length discrepancy (LLD) is used in clinical practice and evidence about validity and reliability may differ. OBJECTIVE The objective of this systematic review was to identify and describe the validity and reliability of different assessments and imaging diagnostics for the determination of LLD. MATERIALS AND METHODS The review was conducted following the recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The databases Medline (PubMed) and Index to Chiropractic Literature were systematically searched. Studies regarding clinical assessments and imaging diagnostics for the diagnosis of LLD, which reported the clinimetric properties for assessment of LLD, were included and screened for methodological quality using the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS-2) tool for validity studies and the Quality Appraisal of Diagnostic Reliability (QAREL) tool for reliability studies. RESULTS Thirty-seven articles on clinical assessments and 15 studies on imaging diagnostics met the eligibility criteria. Thirteen studies on the validity of clinical assessments and six studies on the validity of imaging diagnostics had a low risk of bias and low concerns regarding applicability for all domains. One study on the reliability of clinical assessments and one study on the reliability of imaging diagnostics had a low risk of bias. Main limitations were, that an analysis of sensitivity and specificity was only performed in a few studies and that a valid reference standard was lacking in numerous studies on clinical assessments. CONCLUSIONS For the clinical assessment of LLD, the block test appears to be the most useful method. Full-length standing anteroposterior radiography seems to be the most valid and reliable method and may be used as global reference standard to measure the anatomic LLD when comparing clinical methods and imaging diagnostics.
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Affiliation(s)
- Martin Alfuth
- Faculty of Health Care, Therapeutic Sciences, Niederrhein University of Applied Sciences, Krefeld, Germany
- Department of Further Education, M.Sc. Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
- * E-mail:
| | - Patrick Fichter
- Department of Further Education, M.Sc. Sport Physiotherapy, German Sport University Cologne, Cologne, Germany
| | - Axel Knicker
- Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
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Abdi AJ, Mussmann BR, Mackenzie A, Gerke O, Klaerke B, Andersen PE. Quantitative Image Quality Metrics of the Low-Dose 2D/3D Slot Scanner Compared to Two Conventional Digital Radiography X-ray Imaging Systems. Diagnostics (Basel) 2021; 11:1699. [PMID: 34574041 PMCID: PMC8472127 DOI: 10.3390/diagnostics11091699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to determine the quantitative image quality metrics of the low-dose 2D/3D EOS slot scanner X-ray imaging system (LDSS) compared with conventional digital radiography (DR) X-ray imaging systems. The effective detective quantum efficiency (eDQE) and effective noise quantum equivalent (eNEQ) were measured using chest and knee protocols. METHODS A Nationwide Evaluation of X-ray Trends (NEXT) of a chest adult phantom and a PolyMethylmethacrylate (PMMA) phantom were used for the chest and knee protocols, respectively. Quantitative image quality metrics, including effective normalised noise power spectrum (eNNPS), effective modulation transfer function (eMTF), eDQE and eNEQ of the LDSS and DR imaging systems were assessed and compared. RESULTS In the chest acquisition, the LDSS imaging system achieved significantly higher eNEQ and eDQE than the DR imaging systems at lower and higher spatial frequencies (0.001 ≤ p ≤ 0.044). For the knee acquisition, the LDSS imaging system also achieved significantly higher eNEQ and eDQE than the DR imaging systems at lower and higher spatial frequencies (0.001 ≤ p ≤ 0.002). However, there was no significant difference in eNEQ and eDQE between DR systems 1 and 2 at lower and higher spatial frequencies (0.10 < p < 1.00) for either chest or knee protocols. CONCLUSION The LDSS imaging system performed well compared to the DR systems. Thus, we have demonstrated that the LDSS imaging system has the potential to be used for clinical diagnostic purposes.
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Affiliation(s)
- Ahmed Jibril Abdi
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark; (B.R.M.); (O.G.); (P.E.A.)
- Region of Southern Denmark, Clinical Engineering Department, Area of Diagnostic Radiology, 5000 Odense C, Denmark;
| | - Bo R. Mussmann
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark; (B.R.M.); (O.G.); (P.E.A.)
- Department of Radiology, Odense University Hospital, 5000 Odense C, Denmark
| | - Alistair Mackenzie
- National Coordinating Centre for the Physics of Mammography, Royal Surrey NHS, Foundation Trust, Guildford GU2 7XX, UK;
| | - Oke Gerke
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark; (B.R.M.); (O.G.); (P.E.A.)
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense C, Denmark
| | - Benedikte Klaerke
- Region of Southern Denmark, Clinical Engineering Department, Area of Diagnostic Radiology, 5000 Odense C, Denmark;
| | - Poul Erik Andersen
- Department of Clinical Research, University of Southern Denmark, 5000 Odense C, Denmark; (B.R.M.); (O.G.); (P.E.A.)
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Jarrett DY, Ecklund K. EOS Imaging of Scoliosis, Leg Length Discrepancy and Alignment. Semin Roentgenol 2021; 56:228-244. [PMID: 34281677 DOI: 10.1053/j.ro.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Delma Y Jarrett
- Assistant Professor of Clinical Radiology, Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY.
| | - Kirsten Ecklund
- Assistant Professor of Radiology, Pediatric Radiology Division Chief, Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA
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Abdi AJ, Mussmann B, Mackenzie A, Klaerke B, Andersen PE. COMPARISON OF RADIATION EXPOSURE TO THE PATIENT AND CONTRAST DETAIL RESOLUTIONS ACROSS LOW DOSE 2D/3D SLOT SCANNER AND TWO CONVENTIONAL DIGITAL RADIOGRAPHY X-RAY IMAGING SYSTEMS. RADIATION PROTECTION DOSIMETRY 2019; 185:252-265. [PMID: 30809672 DOI: 10.1093/rpd/ncz006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 01/08/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE To assess and compare the radiation dose and image quality of the low dose 2D/3D EOS slot scanner (LDSS) to conventional digital radiography (DR) X-ray imaging systems for chest and knee examination protocols. METHODS AND MATERIALS The effective doses (ED) to the patient in the chest and knee clinical examination protocols for LDSS and DR X-ray imaging systems were determined using the dose area product and PCXMC Monte Carlo simulation software. The CDRAD phantom was imaged with 19 cm, and 13 cm thick Polymethyl Methacrylate (PMMA) blocks to simulate the chest and knees respectively of a patient of average adult size. The contrast detail resolution was calculated using image analysis software. RESULTS The EDs for the LDSS default setting were up to 69% and 51% lower than for the DR systems for the chest (speed 4) and knee (speed 6) protocols, respectively, while for the increased dose level setting then the EDs were up to 42% and 35% lower than for the DR systems for the chest (speed 6) and knee (speed 8) protocols respectively. At the default setting, the contrast detail was lowest for the default setting of the 2D/3D low dose slot scanner (LDSS) for both chest and knee examinations, but at the highest dose levels then the threshold were equal or higher than the contrast resolution of DR imaging systems. CONCLUSION The LDSS has the potential to be used for clinical diagnosis of chest and knee examinations using the higher dose level. For speed 6 in chest protocol and speed 8 in knee protocol, the measured contrast detail resolution was comparable with the DR systems but at a lower effective dose.
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Affiliation(s)
- Ahmed Jibril Abdi
- Region of Southern Denmark, Clinical Engineering Department, Area of Diagnostic Radiology, B. Winsløws Vej 4, Indgang 34, Odense C, Denmark
| | - Bo Mussmann
- Department of Radiology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Alistair Mackenzie
- National Coordinating Centre for the Physics of Mammography, Royal Surrey County Hospital, Guildford, United Kingdom
| | - Benedikte Klaerke
- Region of Southern Denmark, Clinical Engineering Department, Area of Diagnostic Radiology, B. Winsløws Vej 4, Indgang 34, Odense C, Denmark
| | - Poul Erik Andersen
- Department of Radiology, Odense University Hospital, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
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Mussmann B, Jensen C, Bensen AS, Torfing T, Ovesen O, Overgaard S. Radiographic signs of acetabular retroversion using a low-dose slot-scanning radiographic system (EOS ®). Radiography (Lond) 2019; 25:e53-e57. [PMID: 31301791 DOI: 10.1016/j.radi.2019.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 12/28/2018] [Accepted: 01/03/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Acetabular retroversion is assessed using pelvic X-ray. Cross-over-sign (COS), posterior-wall-sign (PWS) and ischial-spine-sign (ISS) are important radiographic signs of the condition. The pelvic area is sensitive to radiation and thus, possibilities to reduce dose should be considered. The purpose was to compare radiographic signs of acetabular retroversion on conventional pelvic anteroposterior (AP) X-rays with a low-dose slot-scanning system (EOS) in a sample of patients with retroversion of the acetabulum and to compare the radiation doses. METHODS 34 participants with radiographic signs of acetabular retroversion in one or both hips on conventional pelvic X-ray were consecutively recruited. Pelvic EOS-images were acquired in each patient and COS, PWS, ISS, COS-ratio and PWS-ratio was assessed. Radiation dose comparison of X-ray vs. EOS was performed using Dose-Area Products. RESULTS Retroversion was present in 57 out of 68 hips. The absolute agreement was 91%, 84% and 76% for COS, PWS and ISS, respectively. No statistically significant differences were present between COS-ratio and PWS-ratio in either modality and Bland-Altman limits of agreement were narrow. The mean radiation dose was 1053 mGy*cm2 in X-ray and 593 mGy*cm2 in EOS (p = 0.003). CONCLUSION The results indicate that pelvic EOS provides diagnostic qualities similar to conventional X-ray using 44% less radiation when radiographic signs of acetabular retroversion are assessed.
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Affiliation(s)
- B Mussmann
- Department of Radiology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
| | - C Jensen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark.
| | - A S Bensen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Orthopaedic Surgery, Aalborg University Hospital, DK-9000, Aalborg, Denmark.
| | - T Torfing
- Department of Radiology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
| | - O Ovesen
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark.
| | - S Overgaard
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, DK-5000, Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, DK-5000, Odense C, Denmark.
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