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3-D joint space mapping at the ankle from weight-bearing CT: reproducibility, repeatability, and challenges for standardisation.

Title: 3-D joint space mapping at the ankle from weight-bearing CT: reproducibility, repeatability, and challenges for standardisation.
Authors: Turmezei, Tom D; Malhotra, Karan; MacKay, James W; Gee, Andrew H; Treece, Graham M; Poole, Kenneth ES; Welck, Matthew J
Publisher Information: Springer Nature; //doi.org/10.1007/s00330-023-09718-6
Publication Year: 2023
Collection: Apollo - University of Cambridge Repository
Subject Terms: Ankle joint; Cone-beam computed tomography; Osteoarthritis; Reproducibility of results; Weight-bearing; Humans; Ankle; Tomography; X-Ray Computed
Description: OBJECTIVES: We present a 3-D approach to joint space width (JSW) measurement across the ankle from weight-bearing CT (WBCT) to demonstrate inter-operator reproducibility, test-retest repeatability, and how differences in angulation affect ankle JSW distribution. METHODS: One side from repeat WBCT imaging of both feet and ankles was analysed from 23 individuals as part of their routine clinical care pathway. Joint space mapping was performed at four facets across the talus: talonavicular, talar dome and medial gutter (dome-medial), lateral gutter, and posterior subtalar. Inter-operator reproducibility was calculated for two users, while test-retest repeatability was calculated by comparing the two visits, both presented as Bland-Altman statistics. Statistical parametric mapping determined any significant relationships between talocrural joint space angulation and 3-D JSW distribution. RESULTS: The average ± standard deviation interval between imaging was 74.0 ± 29.6 days. Surface averaged bias ± limits of agreement were similar for reproducibility and repeatability, the latter being: talonavicular 0.01 ± 0.26 mm, dome-medial 0.00 ± 0.28 mm, lateral gutter - 0.02 ± 0.40 mm, and posterior subtalar 0.02 ± 0.34 mm. Results are presented as 3-D distribution maps, with optimum test-retest repeatability reaching a smallest detectable difference of ± 0.15 mm. CONCLUSIONS: Joint space mapping is a robust approach to 3-D quantification of JSW measurement, inter-operator reproducibility, and test-retest repeatability at the ankle, with sensitivity reaching a best value of ± 0.15 mm. Standardised imaging protocols and optimised metal artefact reduction will be needed to further understand the clinical value of these 3-D measures derived from WBCT. CLINICAL RELEVANCE STATEMENT: Weight-bearing computed tomography is an increasingly important tool in the clinical assessment of orthopaedic ankle disorders. This paper establishes the performance of measuring 3-D joint space width using this technology, which is an important ...
Document Type: article in journal/newspaper
File Description: application/pdf; application/zip; text/xml
Language: English
Relation: 9718; https://www.repository.cam.ac.uk/handle/1810/358570
Availability: https://www.repository.cam.ac.uk/handle/1810/358570
Rights: Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.9FE74ADA
Database: BASE