An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.

High-resolution CT images are essential in clinical practice to accurately replicate patient anatomy for 3D virtual surgical planning and designing patient-specific surgical guides. These technologies are commonly used in corrective osteotomy of the distal radius. This study evaluated how the virtua...

Full description

Saved in:
Bibliographic Details
Main Authors: Emilia Gryska, Per Fredrikson, Katleen Libberecht, Charlotte Stor Swinkels, Peter Axelsson, Anders Björkman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0311805
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849761381587353600
author Emilia Gryska
Per Fredrikson
Katleen Libberecht
Charlotte Stor Swinkels
Peter Axelsson
Anders Björkman
author_facet Emilia Gryska
Per Fredrikson
Katleen Libberecht
Charlotte Stor Swinkels
Peter Axelsson
Anders Björkman
author_sort Emilia Gryska
collection DOAJ
description High-resolution CT images are essential in clinical practice to accurately replicate patient anatomy for 3D virtual surgical planning and designing patient-specific surgical guides. These technologies are commonly used in corrective osteotomy of the distal radius. This study evaluated how the virtual radius models and the surgical guides' surface that is in contact with the bone vary between experienced raters. Further, the discrepancies from the reference radius of surgical guides and radius models created from CT images with slice thicknesses larger than the reference standard of 0.625mm were assessed. Maximum overlap with radius model was measured for guides, and absolute average distance error was measured for radius models. The agreement between the lower-resolution guides surface and the raters' guide surface was evaluated. The average inter-rater guide surface overlap was -0.11mm [95% CI: -0.13-0.09]. The surface of surgical guides designed on CT images with a 1mm slice thickness deviated from the reference radius within the inter-rater range (0.03mm). For slice thicknesses of 1.25mm and 1.5mm, the average guide surface overlap was 0.12mm and 0.15mm, respectively. The average inter-rater radius surface variability was 0.03mm [95% CI: 0.025-0.035]. The discrepancy from the reference of all radius models created from CT images with a slice thickness larger than the reference slice thickness was notably larger than the inter-rater variability but, excluding one case, did not exceed 0.2mm. The results suggest that 1mm CT images are suitable for surgical guide design. While 1.25mm slices are commonly used for virtual planning in hand and forearm surgery, slices larger than 1mm may approach the limit of clinical acceptability. Discrepancies in radius models were below 1mm, likely below clinical relevance.
format Article
id doaj-art-2e0bee4c6819436eade7f4ff350da30a
institution DOAJ
issn 1932-6203
language English
publishDate 2024-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-2e0bee4c6819436eade7f4ff350da30a2025-08-20T03:06:02ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011910e031180510.1371/journal.pone.0311805An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.Emilia GryskaPer FredriksonKatleen LibberechtCharlotte Stor SwinkelsPeter AxelssonAnders BjörkmanHigh-resolution CT images are essential in clinical practice to accurately replicate patient anatomy for 3D virtual surgical planning and designing patient-specific surgical guides. These technologies are commonly used in corrective osteotomy of the distal radius. This study evaluated how the virtual radius models and the surgical guides' surface that is in contact with the bone vary between experienced raters. Further, the discrepancies from the reference radius of surgical guides and radius models created from CT images with slice thicknesses larger than the reference standard of 0.625mm were assessed. Maximum overlap with radius model was measured for guides, and absolute average distance error was measured for radius models. The agreement between the lower-resolution guides surface and the raters' guide surface was evaluated. The average inter-rater guide surface overlap was -0.11mm [95% CI: -0.13-0.09]. The surface of surgical guides designed on CT images with a 1mm slice thickness deviated from the reference radius within the inter-rater range (0.03mm). For slice thicknesses of 1.25mm and 1.5mm, the average guide surface overlap was 0.12mm and 0.15mm, respectively. The average inter-rater radius surface variability was 0.03mm [95% CI: 0.025-0.035]. The discrepancy from the reference of all radius models created from CT images with a slice thickness larger than the reference slice thickness was notably larger than the inter-rater variability but, excluding one case, did not exceed 0.2mm. The results suggest that 1mm CT images are suitable for surgical guide design. While 1.25mm slices are commonly used for virtual planning in hand and forearm surgery, slices larger than 1mm may approach the limit of clinical acceptability. Discrepancies in radius models were below 1mm, likely below clinical relevance.https://doi.org/10.1371/journal.pone.0311805
spellingShingle Emilia Gryska
Per Fredrikson
Katleen Libberecht
Charlotte Stor Swinkels
Peter Axelsson
Anders Björkman
An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.
PLoS ONE
title An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.
title_full An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.
title_fullStr An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.
title_full_unstemmed An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.
title_short An exploratory study of the impact of CT slice thickness and inter-rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy.
title_sort exploratory study of the impact of ct slice thickness and inter rater variability on anatomical accuracy of malunited distal radius models and surgical guides for corrective osteotomy
url https://doi.org/10.1371/journal.pone.0311805
work_keys_str_mv AT emiliagryska anexploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT perfredrikson anexploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT katleenlibberecht anexploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT charlottestorswinkels anexploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT peteraxelsson anexploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT andersbjorkman anexploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT emiliagryska exploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT perfredrikson exploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT katleenlibberecht exploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT charlottestorswinkels exploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT peteraxelsson exploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy
AT andersbjorkman exploratorystudyoftheimpactofctslicethicknessandinterratervariabilityonanatomicalaccuracyofmaluniteddistalradiusmodelsandsurgicalguidesforcorrectiveosteotomy