3D CT Models Research Articles

Fusing binocular vision and deep learning to detect dynamic wheel-rail displacement of high-speed trains

Large displacements between the wheel and rail lead to track damage or even train derailment. Detecting dynamic wheel-rail displacement (DWRD) can provide a technical means for discriminating the operational health status of rail vehicles and formulating active control strategies. In this paper, a new method, which fuses binocular vision (BV) and deep learning (DL), is proposed to detect the DWRD online, the method is abbreviated as BV-DL. First, a binocular camera is used to capture the dynamic wheel-rail contact video online, while two lasers are equipped to focus on the wheel-rail contact region to locate some keypoints in the wheel-rail contact images. Then, an ROI (region of interest) detection network is proposed to recognize the wheel-rail contact region automatically, and a keypoint detection network is proposed to detect the wheel-rail pixel displacement (WRPD). Finally, a 3D coordinate transformation (3DCT) model is built to calculate the wheel-rail world displacement in real-time, i.e., the DWRD between the keypoints. To test the performance of the method, a laser displacement sensor-based method is used to verify the reliability of the 3DCT model. Meanwhile, a traditional image processing method, a MobileNet V3-based method, and a YOLOX-s-based method are introduced to predict the WRPD. Experimental results show that compared with the four methods, the proposed BV-DL method can achieve optimal results in pixel coordinate calculation and 3D coordinate computation.

203 Should interactive 3D-CT models be used as an alternative to repeat contrast computed tomography in lung cancer screening programme patients for surgical planning?

203 Should interactive 3D-CT models be used as an alternative to repeat contrast computed tomography in lung cancer screening programme patients for surgical planning?

Prioritizing a high posterior probability threshold leading to low error rate over high classification accuracy: the validity of MorphoPASSE software for cranial morphological sex estimation in a contemporary population.

An increasing number of software tools can be used in forensic anthropology to estimate a biological profile, but further studies in other populations are required for more robust validation. The present study aimed to evaluate the validity of MorphoPASSE software for sex estimation from sexually dimorphic cranial traits recorded on 3D CT models (n = 180) from three populations samples (Czech, French, and Egyptian). Two independent observers performed scoring of 4 cranial traits (2 of them bilateral) in each population sample of 30 males and 30 females. The accuracy of sex estimation using traditional posterior probability threshold (pp = 0.5) ranged from 85.6% to 88.3% and overall classification error from 14.4% to 11.7% for both observers, and corresponds to the previously published values of the method. The MorphoPASSE method is also affected by the subjectivity of the observers, as both observers show agreement in sex assignment in 83.9% of cases, regardless of the accuracy of the estimates. Applying a higher posterior probability threshold (pp 0.95) provided classification accuracy of 97.9% and 93.3% of individuals (for observer A and B respectively), minimizing the risk of error to 2.1% and 6.7%, respectively. However, sex estimation can only be applied to 54% and 66% of individuals, respectively. Our results demonstrate the validity of the MorphoPASSE software for cranial sex estimation outside the reference population. However, the achieved classification success is accompanied by a high risk of errors, the reduction of which is only possible by increasing the posterior probability threshold.

Validation of a Three-Dimensional Weight-Bearing Measurement Protocol for Medial Open-Wedge High Tibial Osteotomy.

Three-dimensional (3D) deformity assessment and leg realignment planning is emerging. The aim of this study was to (1) validate a novel 3D planning modality that incorporates the weight-bearing (WB) state (3D WB) by comparing it to existing modalities (3D non-weight-bearing (NWB), 2D WB) and (2) evaluate the influence of the modality (2D vs. 3D) and the WB condition on the measurements. Three different planning and deformity measurement protocols were analyzed in 19 legs that underwent medial open-wedge high tibial osteotomy (HTO): (1) a 3D WB protocol, after 2D/3D registration of 3D CT models onto the long-leg radiograph (LLR) (3D WB), (2) a 3D NWB protocol based on the 3D surface models obtained in the supine position (3D NWB), and (3) a 2D WB protocol based on the LLR (2D WB). The hip-knee-ankle angle (HKA), joint line convergence angle (JLCA), and the achieved surgical correction were measured for each modality and patient. All the measurement protocols demonstrated excellent intermodal agreement for the achieved surgical correction, with an ICC of 0.90 (95% CI: 0.76-0.96)) (p < 0.001). Surgical correction had a higher mean absolute difference compared to the 3D opening angle (OA) when measured with the WB protocols (3D WB: 2.7 ± 1.8°, 3D NWB: 1.9 ± 1.3°, 2D WB: 2.2 ± 1.3°), but it did not show statistical significance. The novel planning modality (3D WB) demonstrated excellent agreement when measuring the surgical correction after HTO compared to existing modalities.

Development and validation of a multimodal model in predicting severe acute pancreatitis based on radiomics and deep learning

ObjectiveAim to establish a multimodal model for predicting severe acute pancreatitis (SAP) using machine learning (ML) and deep learning (DL). MethodsIn this multicentre retrospective study, patients diagnosed with acute pancreatitis at admission were enrolled from January 2017 to December 2021. Clinical information within 24 h and CT scans within 72 h of admission were collected. First, we trained Model α based on clinical features selected by least absolute shrinkage and selection operator analysis. Second, radiomics features were extracted from 3D-CT scans and Model β was developed on the features after dimensionality reduction using principal component analysis. Third, Model γ was trained on 2D-CT images. Lastly, a multimodal model, namely PrismSAP, was constructed based on aforementioned features in the training set. The predictive accuracy of PrismSAP was verified in the validation and internal test sets and further validated in the external test set. Model performance was evaluated using area under the curve (AUC), accuracy, sensitivity, specificity, recall, precision and F1-score. ResultsA total of 1,221 eligible patients were randomly split into a training set (n = 864), a validation set (n = 209) and an internal test set (n = 148). Data of 266 patients were for external testing. In the external test set, PrismSAP performed best with the highest AUC of 0.916 (0.873–0.960) among all models [Model α: 0.709 (0.618–0.800); Model β: 0.749 (0.675–0.824); Model γ: 0.687 (0.592–0.782); MCTSI: 0.778 (0.698–0.857); RANSON: 0.642 (0.559–0.725); BISAP: 0.751 (0.668–0.833); SABP: 0.710 (0.621–0.798)]. ConclusionThe proposed multimodal model outperformed any single-modality models and traditional scoring systems.

Measurement of functional acetabular column sizes using a 3D CT model, for guiding percutaneous screw fixation of acetabular fractures using fluoroscopy

Measurement of functional acetabular column sizes using a 3D CT model, for guiding percutaneous screw fixation of acetabular fractures using fluoroscopy

Using Dual-Orthogonal Fluoroscopy and CT to Assess the Relationship Between Knee Morphology and Patellar Kinematics in Patients With Patellofemoral Pain.

Patellofemoral pain (PFP) is one of the most common knee overuse injuries, with studies suggesting PFP as a precursor for early knee osteoarthritis. The etiology of PFP is multi-factorial; however, patellar mal-tracking has been regarded as a primary mechanism. Details of this multi-factorial mechanism have been unclear because of the limitations in evaluating in-vivo, three-dimensional (3D) patellofemoral joint movement during dynamic activities accurately. Alternatively, studies have demonstrated the high accuracy and repeatability of dual fluoroscopy and CT/MRI for measuring knee joint motion. This study uses dual fluoroscopy and CT to investigate the associations between joint morphology and patellar kinematics in healthy controls and subjects with PFP. Eight PFP females (29.7±10.6 years) and 10 healthy females (25.0±7.7 years) were recruited and screened by a sports medicine physician. CT imaging was performed on participants in a supine with the knee extended, and ankle and hip in neutral alignment. Dual-orthogonal fluoroscopy measured patellar movement while participants performed a lunge task. A calibration algorithm was used to register the 3D CT model to 2D fluoroscopy image to calculate the relative position and angles of the patella based on the clinical definition of patellar motion. Measures of patellar and trochlear morphology were generated and correlated to kinematic data. There was a significant difference in the patellar-to-trochlear width ratio; however, no other significant differences in CT morphology measurements were present between groups. For PFP patients in the weight-bearing extended position, there was a moderate positive correlation between the patellar-to-trochlear width ratio and medial-lateral patellar shift (τ = 0.643, p = 0.026). Healthy controls in this position demonstrated a moderate positive correlation between the lateral-trochlear inclination angle and medial-lateral patellar shift (τ = 0.600, p = 0.016) and moderate negative correlation between medial trochlear inclination angle and medial-lateral patellar shift (τ = -0.511, p = 0.040).The findings suggest that, for this cohort, there is correlation between morphology and patellar kinematics. Passive and active stabilizers likely have a role in mal-tracking.

Multidetector-row CT features and histopathological analysis of pericardial recesses in dogs.

At the level of pericardial reflections and near the great thoracic vessels, pericardial recesses (PRs) are present, where fluid can collect to increase the pericardial reserve volume. To date, these structures have not been described in vivo in veterinary patients. The aims of this observational and descriptive study were to describe the location and appearance of PRs in dogs, as seen with multidetector-row CT (MDCT), and to develop a dedicated imaging technique for their best visualization. Dogs who underwent MDCT examination of the whole body were included in the study and CT data were retrospectively evaluated. Dogs with any thoracic abnormality were excluded. MDCT analysis of the PR's was compared with the pathological features of PRs. PRs were identified as fluid-attenuating (10-30 HU), non-enhancing structures showing varied appearance. Two types of PRs were identified at the level of the transverse sinus of the pericardium and classified on the basis of their anatomic location: the aortic recess and the pulmonic recess. A third pericardial fluid-containing structure was seen in a little number of cases, at the level of the termination of the caudal vena cava into the right atrium. A dorsal, slight oblique multiplanar section through the aortic bulb resulted the best technique for visualization of all the recesses. Anatomo-pathological evaluation confirmed the location and the presence of pocket-like reflections of the pericardium identified with 3D-CT models. Knowledge of the CT appearance of the pericardial recesses is necessary in order to avoid their misinterpretation and subsequent unnecessary invasive investigations.

Guiding prosthetic femoral version using 3D-printed patient-specific instrumentation (PSI): a pilot study

BackgroundImplantation of the femoral component with suboptimal version is associated with instability of the reconstructed hip joint. High variability of Prosthetic Femoral Version (PFV) has been reported in primary Total Hip Arthroplasty (THA). Three-dimensional (3D) Patient-Specific Instrumentation (PSI) has been recently developed and may assist in delivering a PFV within the intended range.We performed a pilot study to better understand whether the intra-operative use of a novel PSI guide, designed to deliver a PFV of 20°, results in the target range of PFV in primary cemented THA.MethodsWe analysed post-operative Computed-Tomography (CT) data of two groups of patients who underwent primary cemented THA through posterior approach; 1. A group of 11 patients (11 hips) for which the surgeon used an intra-operative 3D-printed stem positioning guide (experimental) 2. A group of 24 patients (25 hips) for which the surgeon did not use the guide (control). The surgeon aimed for a PFV of 20°, and therefore the guide was designed to indicate the angle at which the stem was positioned intra-operatively. PFV angles were measured using the post-operative 3D-CT models of the proximal femurs and prosthetic components in both groups. Our primary objective was to compare the PFV in both groups. Our secondary objective was to evaluate the clinical outcome.ResultsMean (± SD) values for the PFV was 21.3° (± 4.6°) and 24.6° (± 8.2°) for the experimental and control groups respectively. In the control group, 20% of the patients reported a PFV outside the intended range of 10° to 30° anteversion. In the experimental group, this percentage dropped to 0%. Satisfactory clinical outcome was recorded in both groups.ConclusionThe intra-operative use of a PSI PFV guide helped the surgeon avoid suboptimal PFV in primary cemented THA. Further studies are needed to evaluate if the PSI guide directly contributes to a better clinical outcome.

Statistical classification methods for estimating sex based on five skull traits: A nonmetric assessment using 3D CT models.

Five cranial nonmetric traits for sex estimation for sex estimation are classified by score according to geometry. The population of origin is one of the factors influencing cranial nonmetric traits. Moreover, among the five cranial traits, the robust traits for estimating sex varied across population. The aim of this study is to suggest the most useful method for sex estimation and demonstrate the need of a suitable method for each population. One-hundred thirty-five three-dimensional skull images from 21st century Korean autopsy cadavers were evaluated using the ordinal scoring system of five cranial nonmetric traits as outlined in Buikstra & Ubelaker (1994). All scores of each trait were analyzed by linear discriminant and decision tree analyses for sex estimation. The frequency of each trait was analyzed and compared to populations from other studies. The accuracy for both sexes was 88.1% by discriminant analysis and 90.4% by decision tree. The traits with the highest accuracy were the glabella and mastoid process in both discriminant analysis and decision tree. Sex estimation in modern Korean cadavers using the cranial nonmetric method was shown to be highly accurate by both discriminant analysis and decision tree. When comparing the pattern of frequency scores in this study with those of other populations, the pattern of trait scores for estimating sex was different for each population, even among populations in the same Asian region, which suggests the need for methods suited for specific populations.

Glenoid bony morphology along long diameter is associated with the occurrence of recurrent anterior shoulder dislocation: a case-control study based on three-dimensional CT measurements.

The purpose of our study is to compare the anatomic parameters of proximal humerus, glenoid, and glenohumeral joint between patients with recurrent anterior shoulder dislocation (RASD) and patients without RASD with the assistance of three-dimensional (3D) CT scans. Sixty patients were included in the study and divided into group RASD and group control. 3D-CT models of shoulder joint for each included patient were reconstructed and multiple anatomic parameters were measured. There were no statistically significant differences between the two groups in morphological parameters of humerus and glenohumeral joints. Long diameter of glenoid was 3.50 ± 0.34cm for patients in group RASD and 3.31 ± 0.32cm in group control (p = 0.039). There was a statistically significant difference in the ratio of long to short diameter of glenoid (p < 0.001). Ratio of humeral head height to glenoid long diameter (Hhh/Gld) was 1.02 ± 0.07 in group RASD, significantly lower than 1.09 ± 0.08 in group control (p = 0.001). Longitudinal depth of glenoid was significantly higher in group RASD (p = 0.013). The glenoid morphology along long diameter is closely correlated with the stability of glenohumeral joint, including glenoid long diameter and glenoid longitudinal depth. It is especially noteworthy that the value of Hhh/Gld decreases in patients with RASD. The difference of Hhh/Gld between the two groups reminds us that the correlation of bony structure along long diameter between glenoid and humeral head plays an important role in RASD.

Underwater passive manoeuvring target tracking with isogradient sound speed profile

Compared with the traditional tracking problem, the underwater 3-D passive manoeuvring target tracking faces the following challenging problems: (1) Since the signal propagation delay is varying and unknown, the relationship between the two adjacent target states is hard to describe; (2) limited by the underwater environment, it is more difficult to establish a target manoeuvring motion model; (3) the propagation speed of the underwater acoustic signal varies with the depth, and the propagation path will be curved instead of straight. Various parameters including signal propagation delay, target pitch angle and receiving frequency measured by the observer cannot be calculated as usual. In this paper, we improved a 3-D constant turn (3D-CT) model to match the underwater target motion. For the problems (1) and (3), this paper proposes a novel interacting multiple model underwater Gauss-Helmert unscented Kalman filter (IMM-UGHUKF) with isogradient sound velocity profile, which analytically describes the relationship between the state to be estimated and the passive measurement. This method augments the unknown signal emission time into the state with implicit equations, and transits the state by the Gauss–Helmert model. Simulation tests have been carried out, and the results show that IMM-UGHUKF can significantly reduce the estimation error compared with other approaches.

Comparison of in vivo hindfoot joints motion changes during stance phase between non-flatfoot and stage II adult acquired flatfoot

BackgroundTo compare the kinematic characteristics of hindfoot joints in stage II adult acquired flatfoot deformity (AAFD) with those of non-flatfoot through the 3D-to-2D registration technology and single fluoroscopic imaging system.MethodsEight volunteers with stage II AAFD and seven volunteers without stage II AAFD were recruited and CT scans were performed bilateral for both groups in neutral positions. Their lateral dynamic X-ray data during the stance phase, including 14 non-flatfeet and 10 flatfeet, was collected. A computer-aided simulated light source for 3D CT model was applied to obtain the virtual images, which were matched with the dynamic X-ray images to register in the “Fluo” software, so that the spatial changes during the stance phase could be calculated.ResultsDuring the early-stance phase, the calcaneous was more dorsiflexed, everted, and externally-rotated relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). During the mid-stance phase, the calcaneous was more dorsiflexed and everted relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05); however, the rotation did not differ significantly between the two groups (p > 0.05). During the late-stance phase, the calcaneous was more plantarflexed, but less inverted and internally-rotated, relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). During the early- and mid-stance phase, the navicular was more dorsiflexed, everted, and externally-rotated relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). During the late-stance phase, the navicular was more plantarflexed, but less inverted and internally-rotated, relative to the talus in flatfoot compared with that in non-flatfoot (p < 0.05). There was no difference in the motion of cuboid between the two groups during the whole stance phase (p > 0.05).ConclusionsDuring the early- and mid-stance phase, excessive motion was observed in the subtalar and talonavicular joints in stage II AAFD. During the late-stance phase, the motion of subtalar and talonavicular joints appeared to be in the dysfunction state. The current study helps better understanding the biomechanics of the hindfoot during non-flatfoot and flatfoot condition which is critical to the intervention to the AAFD using conservative treatment such as insole or surgical treatment for joint hypermotion.

Preoperative Evaluation and Surgical Simulation for Osteochondritis Dissecans of the Elbow Using Three-Dimensional MRI-CT Image Fusion Images.

We used our novel three-dimensional magnetic resonance imaging-computed tomography fusion images (3D MRI-CT fusion images; MCFIs) for detailed preoperative lesion evaluation and surgical simulation in osteochondritis dissecans (OCD) of the elbow. Herein, we introduce our procedure and report the findings of the assessment of its utility. We enrolled 16 men (mean age: 14.0 years) and performed preoperative MRI using 7 kg axial traction with a 3-Tesla imager and CT. Three-dimensional-MRI models of the humerus and articular cartilage and a 3D-CT model of the humerus were constructed. We created MCFIs using both models. We validated the findings obtained from the MCFIs and intraoperative findings using the following items: articular cartilage fissures and defects, articular surface deformities, vertical and horizontal lesion diameters, the International Cartilage Repair Society (ICRS) classification, and surgical procedures. The MCFIs accurately reproduced the lesions and correctly matched the ICRS classification in 93.5% of cases. Surgery was performed as simulated in all cases. Preoperatively measured lesion diameters exhibited no significant differences compared to the intraoperative measurements. MCFIs were useful in the evaluation of OCD lesions and detailed preoperative surgical simulation through accurate reproduction of 3D structural details of the lesions.

Automatic, global registration in laparoscopic liver surgery

PurposeThe initial registration of a 3D pre-operative CT model to a 2D laparoscopic video image in augmented reality systems for liver surgery needs to be fast, intuitive to perform and with minimal interruptions to the surgical intervention. Several recent methods have focussed on using easily recognisable landmarks across modalities. However, these methods still need manual annotation or manual alignment. We propose a novel, fully automatic pipeline for 3D–2D global registration in laparoscopic liver interventions.MethodsFirstly, we train a fully convolutional network for the semantic detection of liver contours in laparoscopic images. Secondly, we propose a novel contour-based global registration algorithm to estimate the camera pose without any manual input during surgery. The contours used are the anterior ridge and the silhouette of the liver.ResultsWe show excellent generalisation of the semantic contour detection on test data from 8 clinical cases. In quantitative experiments, the proposed contour-based registration can successfully estimate a global alignment with as little as 30% of the liver surface, a visibility ratio which is characteristic of laparoscopic interventions. Moreover, the proposed pipeline showed very promising results in clinical data from 5 laparoscopic interventions.ConclusionsOur proposed automatic global registration could make augmented reality systems more intuitive and usable for surgeons and easier to translate to operating rooms. Yet, as the liver is deformed significantly during surgery, it will be very beneficial to incorporate deformation into our method for more accurate registration.

Morphologic Analysis of Nonosseous Talocalcaneal Coalitions Using 3D Reconstruction.

Background:Resection of talocalcaneal coalitions has generally involved osseous coalitions. We attempted to evaluate the morphology of nonosseous talocalcaneal coalitions. This study aimed to investigate if the calcaneal articular surface area of feet with talocalcaneal coalitions is different than that of normal feet.Methods:Twenty nonosseous talocalcaneal coalition cases with analyzable computed tomography (CT) scans were compared to 20 control cases. Three-dimensional models of the talus and calcaneus were constructed, and the surface areas of the posterior facet (SPF), whole talocalcaneal joint of the calcaneus (SWJ), and coalition site (SCS) of each 3D-CT model were measured. “Calibrated” values of the 2 groups were created to adjust for relative size of the tali and then compared. The preoperative and postoperative AOFAS Ankle-Hindfoot scale was calculated for 9 cases that had undergone single coalition resection.Results:The calibrated SPF and SWJ were significantly greater in the coalition group than in the control group (40% and 12%, respectively). No significant difference was detected between the calibrated (SWJ – SCS) value of the coalition group and the calibrated SWJ value of the control group. The AOFAS scale was improved postoperatively in all 9 cases analyzed.Conclusion:The calcaneal articular surface of nonosseous talocalcaneal coalition feet in our series was larger than that of the normal feet. This study indicates that the total calcaneal articular surface after coalition resection may be comparable to the calcaneal articular surface of normal feet. We suggest that the indication for coalition resection be reconsidered for nonosseous coalition.Level of Evidence:Level III, retrospective comparative study.

Cervical endplate bone density distribution measured by CT osteoabsorptiometry and direct comparison with mechanical properties of the endplate.

Intervertebral device subsidence is one of the complications of anterior cervical discectomy and fusion. The biomechanical properties of vertebral bony endplate may be related to device subsidence. The aim of this study is to measure the cervical endplate bone density distribution using a novel 3D measurement method. Eight human cadaver cervical spines were obtained and levels C3-C7 were dissected and CT scanned. Three-dimensional (3D) CT model was created with the same 3D coordinates of the original DICOM dataset. The regional strength and stiffness of the endplate were determined by indentation testing. The indentation points were recorded by a photograph and the location of the indentation points was projected to the 3D CT model. Three-dimensional coordinates of the indentation point was obtained in the 3D space determined by the DICOM dataset. The area underneath the indentation point was calculated by a trilinear interpolation method directly. Data in HU and correlations with the indentation strength and stiffness were analysed. A positive correlation was found between HU and strength (r = 0.52) and between HU and stiffness (r = 0.41). Overall, mechanical strength and stiffness and HU in the superior endplate of the caudal vertebra were lower than those in the inferior endplate of the cranial vertebra in the same intervertebral disc. The mechanical properties and the HU were found to be significantly correlated, which employed a novel 3D HU measurement method, thus demonstrating potential to predict cervical endplate failure risk in a clinical setting.

Open anatomical glenoid reconstruction with an iliac crest bone autograft effectively resolves off-track Hill-Sachs lesions to on-track lesions.

The purpose of this study was to determine if "off-track" Hill-Sachs lesions in patients with dynamic anteroinferior instability were transformed into "on-track" lesions using iliac bone autografts with screw fixation. The secondary purpose was to observe if postoperative bony remodeling would occur over time, resulting in recurrent "off-track" Hill-Sachs lesions with corresponding instability. We retrospectively reviewed clinical and CT records of 8 patients with an "off-track" Hill-Sachs lesion who underwent open anatomical glenoid reconstruction with an iliac crest bone autograft. Hill-Sachs lesions, glenoid track widths, and glenoid surface areas were measured on a preoperative and two postoperative (6weeks, ≥ 2years) 3D-CT models to determine graft resorption over time. All patients were available for postoperative clinical and CT final follow-up 3years (2-4years) postoperatively. In all patients, the Hill-Sachs lesions were "on-track" 6weeks postoperatively and remained "on-track" at final-follow-up. Compared to preoperative values, the glenoid track width and glenoid surface area both were higher 6weeks postoperatively (p < 0.001 and p = 0.023, respectively) and at final follow-up (p < 0.001 and p = 0.023, respectively). Whereas the glenoid track width between 6weeks and final follow-up showed no decrease (p = 0.234), glenoid surface area tended to decrease (p = 0.055). The median SSV was 93 points (85-95 points), the Rowe score 90 points (80-100 points) and the WOSI 1980 points (1783-2067 points) at final follow-up. No recurrent dislocations or subluxations were observed. An open anatomical glenoid reconstruction with an iliac crest bone autograft technique using screw fixation effectively transformed "off-track" Hill-Sachs lesions to "on-track" lesions, resulting in good short-term clinical outcomes. Whereas glenoid surface area tended to be reduced by bony remodeling processes over time, the glenoid track width did not decrease at final follow-up and consequently no recurrence of "off-track" lesions occurred. Case series; Level of evidence, IV.

3D MRI Models of the Musculoskeletal System.

Computed tomography (CT) is most commonly used to produce three-dimensional (3D) models for evaluating bone and joint morphology in clinical practice. However, 3D models created from magnetic resonance imaging (MRI) data can be equally effective for comprehensive and accurate assessment of osseous and soft tissue structure morphology and pathology. The quality of 3D MRI models has steadily increased over time, with growing potential to replace 3D CT models in various musculoskeletal (MSK) applications. In practice, a single MRI examination for two-dimensional and 3D assessments can increase the value of MRI and simplify the pre- and postoperative imaging work-up. Multiple studies have shown excellent performance of 3D MRI models in shoulder injuries, in the hip in the setting of femoroacetabular impingement, and in the knee for the creation of bone surface models. Therefore, the utility of 3D MRI postprocessed models is expected to continue to rise and broaden in applications. Computer-based and artificial intelligence-assisted postprocessing techniques have tremendous potential to improve the efficiency of 3D model creation, opening many research avenues to validate the applicability of 3D MRI and establish 3D-specific quantitative assessment criteria. We provide a practice-focused overview of 3D MRI acquisition strategies, postprocessing techniques for 3D model creation, MSK applications of 3D MRI models, and an illustration of cases from our daily clinical practice.

Accuracy of free-hand humeral head resection planned on 3D-CT models in shoulder arthroplasty: an in vitro analysis.

Three-dimensional planning of humeral head osteotomy in shoulder arthroplasty (SA) is understudied. This study evaluated whether a standard osteotomy technique along the anterosuperior anatomic neck (ASOT) could be surgically reproduced as pre-operatively planned on 3D-CT models. Pre-operative planning in 12 cadaver shoulders was performed on a 3D-CT model of the humerus to calculate the planned osteotomy plane (planned OP). The osteotomy was then performed using a free-hand technique, and a post-operative CT scan was obtained for analysis (performed OP). Planes were compared with regards to inclination, retroversion, and resected humeral head thickness so the accuracy could be quantified. The absolute errors between the performed and planned OP were 2° (0-10°), 5° (0-14°), and 4 mm (1-7 mm) for inclination, retroversion, and resected head thickness, respectively. Deviation < 10° for inclination and retroversion and < 5 mm for resected humeral head thickness between planned and performed OP was achieved in 92%, 83%, 58% of cases, respectively. No differences were found for inclination (p = 0.289), whereas retroversion and resected head thickness were smaller than planned (p ≤ 0.027). Pre-operative planning of the ASOT using a 3D-CT model is accurate within a threshold of 10° when using a free-hand technique in 92% of cases for inclination. Retroversion and resected head thickness differed from the pre-operative plan, thereby limiting the unrestricted use of humeral head osteotomy planning from 3D-CT models in SA. These findings are a reference for further studies to develop and quantify the accuracy of pre-operative planning software including cutting guides for SA using 3D-CT models. Basic science article.