Matthias Thépaut1,2, Sylvain Brochard1,3,4, Julien Leboucher1, Mathieu Lempereur1,3, Eric Stindel1,5,4, Valentin Tissot6, Bhushan S Borotikar7,8. 1. Laboratoire de Traitement de l'Information Médicale, INSERM U1101, Batiment 1, Premier etage, CHRU Morvan - 2 Ave. Foch, Brest, France, 29609. 2. CHRU de Brest, Hôpital Morvan, Service de chirurgie pédiatrique, Brest, France. 3. CHRU de Brest, Hôpital Morvan, Service de Médecine Physique et de Réadaptation, Brest, France. 4. Université de Bretagne Occidentale, Brest, France. 5. CHRU de Brest, La Cavale Blanche, Service d'Orthopédie-Traumatologie, Brest, France. 6. CHRU de Brest, Service de radiologie, Brest, France. 7. Laboratoire de Traitement de l'Information Médicale, INSERM U1101, Batiment 1, Premier etage, CHRU Morvan - 2 Ave. Foch, Brest, France, 29609. bhushan.borotikar@telecom-bretagne.eu. 8. Institut Mines-Telecom, Telecom Bretagne, Brest, France. bhushan.borotikar@telecom-bretagne.eu.
Abstract
OBJECTIVE: The aims of this study were to evaluate the concurrent validity and reliability of a low-dose biplanar X-ray system (Ld-BPR) for the measurement of femoral anteversion (FA) by comparing Ld-BPR-based three-dimensional measures with CT-scan-based measures and to assess the discriminative ability of this method in children with cerebral palsy. MATERIALS AND METHODS: Fifty dry femora were scanned using both a CT scan and the Ld-BPR system. Ten femora were artificially modified to mimic a range of anteversion from -30° to +60° and scanned by both modalities. FA was quantified using the images from both modalities and statistically compared for concurrent validity. Intra- and inter-observer reliability of the Ld-BPR system was also determined. Further, Ld-BPR data from 16 hemiplegic and 22 diplegic children were analyzed for its discriminative ability. RESULTS: The concurrent validity between the Ld-BPR and CT-scan measures was excellent (R (2) = 0.83-0.84) and no significant differences were found. The intra- and inter-trial reliability were excellent (ICCs = 0.98 and 0.97) with limits of agreement of (-2.28°; +2.65°) and (-2.76°; +3.38°) respectively. Further, no significant effects of angle or method were found in the sample of modified femora. Ld-BPR measures for FA were significantly different between healthy and impaired femora. CONCLUSIONS: The excellent concurrent validity with the CT scan modality, the excellent reliability, and the ability to discriminate pathological conditions evaluated by this study make this radiological method suitable for a validated use across hospitals and research institutes.
OBJECTIVE: The aims of this study were to evaluate the concurrent validity and reliability of a low-dose biplanar X-ray system (Ld-BPR) for the measurement of femoral anteversion (FA) by comparing Ld-BPR-based three-dimensional measures with CT-scan-based measures and to assess the discriminative ability of this method in children with cerebral palsy. MATERIALS AND METHODS: Fifty dry femora were scanned using both a CT scan and the Ld-BPR system. Ten femora were artificially modified to mimic a range of anteversion from -30° to +60° and scanned by both modalities. FA was quantified using the images from both modalities and statistically compared for concurrent validity. Intra- and inter-observer reliability of the Ld-BPR system was also determined. Further, Ld-BPR data from 16 hemiplegic and 22 diplegic children were analyzed for its discriminative ability. RESULTS: The concurrent validity between the Ld-BPR and CT-scan measures was excellent (R (2) = 0.83-0.84) and no significant differences were found. The intra- and inter-trial reliability were excellent (ICCs = 0.98 and 0.97) with limits of agreement of (-2.28°; +2.65°) and (-2.76°; +3.38°) respectively. Further, no significant effects of angle or method were found in the sample of modified femora. Ld-BPR measures for FA were significantly different between healthy and impaired femora. CONCLUSIONS: The excellent concurrent validity with the CT scan modality, the excellent reliability, and the ability to discriminate pathological conditions evaluated by this study make this radiological method suitable for a validated use across hospitals and research institutes.
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