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Is CT-based cinematic rendering superior to volume rendering technique in the preoperative evaluation of multifragmentary intraarticular lower extremity fractures?

Abstract：

PURPOSE:Cinematic rendering (CR), a recently launched, FDA-approved rendering technique converts CT image datasets into nearly photorealistic 3D reconstructions by using a unique lighting model. The purpose of this study was to compare CR to volume rendering technique (VRT) images in the preoperative visualization of multifragmentary intraarticular lower extremity fractures. METHOD:In this retrospective study, CT datasets of 41 consecutive patients (female: n = 13; male: n = 28; mean age: 52.3 ± 17.9y) with multifragmentary intraarticular lower extremity fractures (calcaneus: n = 16; tibial pilon: n = 19; acetabulum: n = 6) were included. All datasets were acquired using a 128-row dual-source CT. A dedicated workstation was used to reconstruct CR and VRT images which were reviewed independently by two experienced board-certified traumatologists trained in special trauma surgery. Image quality, anatomical accuracy and fracture visualization were assessed on a 6-point-Likert-scale (1 = non-diagnostic; 6=excellent). The regular CT image reconstructions served as reverence standard. For each score, median values between both readers were calculated. Scores of both reconstruction methods were compared using a Wilcoxon-Ranksum test with p < 0.05 indicating statistical significance. Inter-reader agreement was calculated using Spearman's rank correlation coefficient. RESULTS:Compared to VRT, CR demonstrated a higher image quality (VRT:2.5; CR:6.0; p < 0.001), a higher anatomical accuracy (VRT:3.5; CR:5.5; p < 0.001) and provided a more detailed visualization of the fracture (VRT:2.5; CR:6.0; p < 0.001). An additional benefit of CR reconstructions compared to VRT reconstructions was reported by both readers in 65.9 % (27/41) of all patients. CONCLUSIONS:CR reconstructions are superior to VRT due to higher image quality and higher anatomical accuracy. Traumatologists find CR reconstructions to improve visualization of lower extremity fractures which should thus be used for fracture demonstration during interdisciplinary conferences.

journal_name

Eur J Radiol

journal_title

European journal of radiology

authors

Wollschlaeger LM,Boos J,Jungbluth P,Grassmann JP,Schleich C,Latz D,Kroepil P,Antoch G,Windolf J,Schaarschmidt BM

doi

10.1016/j.ejrad.2020.108911

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

108911

eissn

0720-048X

issn

1872-7727

pii

S0720-048X(20)30100-5

journal_volume

126

pub_type

杂志文章

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Is CT-based cinematic rendering superior to volume rendering technique in the preoperative evaluation of multifragmentary intraarticular lower extremity fractures?