Saracco A, Grassi A, Romagnoli M, Camarda L, Logishetty K, Zaffagnini S, Cobb J. Reduced-dose computed tomography is the most accurate method to measure ceramic hip resurfacing cup version.
Eur J Radiol 2020;
128:109040. [PMID:
32442835 DOI:
10.1016/j.ejrad.2020.109040]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 04/22/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND
A precise assessment of cup version after hip resurfacing is generally requested, especially in clinical trials or in case of complications.
AIMS
To identify which diagnostic imaging modality, between AP pelvis X-rays, the AP Pelvis CT Scout image and reduced-dose axial CT scan, is the most precise to assess cup version of an all-ceramic hip resurfacing implant in a first-in-human clinical trial.
METHODS
We retrospectively assessed the cup version of the first 20 patients who underwent an experimental all-ceramic hip resurfacing on AP pelvis X-rays (0.8 mSv of radiation), AP pelvis CT scout images (0.016 mSv) and axial CT slices performed using a reduced dose protocol (0.3 mSv). The intra-observer and inter-observer reliabilities were calculated.
RESULTS
Reduced dose Pelvis CT scan was the most precise imaging modality to detect cup version (Pearson Correlation Coefficient, PCC = 0.98, p < 0.001). The AP Pelvis CT Scout image was found to be sufficient to measure cup version within an acceptable margin of tolerance (mean difference ± 4.7° from pelvis CT scan) and highly correlated to axial pelvis CT scan measurements (PCC 0.97, p < 0.001). Analysis of cup version from AP X-rays poorly correlated with measurements from Pelvis CT (PCC 0.59, p = 0.006).
CONCLUSIONS
Due to lower radiation exposure and highest accuracy, reduced dose CT is a valid modality to measure acetabular cup version after ceramic hip resurfacing. Plain X-rays are not accurate nor precise to measure version, whereas high agreement of measurements between AP Pelvis CT Scout and axial pelvis CT scan was found.
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