Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization
Purpose: To assess the accuracy and reliability of using cone beam computed tomography (CBCT) compared to X-ray six weeks after injury for predicting scaphoid union. Materials and methods: Overall; 52 patients with scaphoid fractures between April 2018 and March 2019 were prospectively included in t...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-01-01
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| Series: | European Journal of Radiology Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S235204772030040X |
| _version_ | 1818844582978256896 |
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| author | Lucia Calisto Farracho Berenice Moutinot Angeliki Neroladaki Marion Hamard Karel Gorican Pierre Alexandre Poletti Jean Yves Beaulieu Cindy Bouvet Sana Boudabbous |
| author_facet | Lucia Calisto Farracho Berenice Moutinot Angeliki Neroladaki Marion Hamard Karel Gorican Pierre Alexandre Poletti Jean Yves Beaulieu Cindy Bouvet Sana Boudabbous |
| author_sort | Lucia Calisto Farracho |
| collection | DOAJ |
| description | Purpose: To assess the accuracy and reliability of using cone beam computed tomography (CBCT) compared to X-ray six weeks after injury for predicting scaphoid union. Materials and methods: Overall; 52 patients with scaphoid fractures between April 2018 and March 2019 were prospectively included in this study. The mean age was 34.52 (13–88) years, and the gender ratio male/female 43/9. Of the fractures, 26 had occurred on the right side, and 26 on the left side. In total, 28 % of patients were manual workers. All patients underwent X-ray and CBCT six weeks after injury. Four readers, two radiologists, and two hand surgeons analyzed the findings using double-blinded X-ray and CBCT and categorized fractures as consolidated based on a 50 % visibility threshold concerning trabecular bridges. Proximal pole sclerosis, communition, cyst formation, and humpback deformity were similarly analyzed for all cases. Agreement between readers was calculated using Kappa, and sensitivity, specificity, and accuracy using RStudio software. The gold standard was the radiologic and clinical follow-up for all patients at two months. Results: Inter-reader agreement between the four readers was moderate concerning X-ray (0.543) but substantial concerning CBCT (0.641). It was almost perfect between seniors regarding CBCT (Kappa = 0.862). Sensitivity, specificity, and accuracy were 0.75–0.78, 0.4, and 0.61–0.64, respectively, for two readers regarding CBCT. The X-ray values were 0.65–0.71, 0.35–0.4, and 0.53–0.59, respectively. Conclusion: CBCT proves more accurate and reliable than X-ray for diagnosing scaphoid union at an early follow-up and prevents longer immobilization and interruption of activity or work. |
| first_indexed | 2024-12-19T05:16:04Z |
| format | Article |
| id | doaj.art-6038c4a3ac72402da123c7f127e426d2 |
| institution | Directory Open Access Journal |
| issn | 2352-0477 |
| language | English |
| last_indexed | 2024-12-19T05:16:04Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Journal of Radiology Open |
| spelling | doaj.art-6038c4a3ac72402da123c7f127e426d22022-12-21T20:34:40ZengElsevierEuropean Journal of Radiology Open2352-04772020-01-017100251Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilizationLucia Calisto Farracho0Berenice Moutinot1Angeliki Neroladaki2Marion Hamard3Karel Gorican4Pierre Alexandre Poletti5Jean Yves Beaulieu6Cindy Bouvet7Sana Boudabbous8Division of Radiology, Department of Diagnosis, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, SwitzerlandHand Surgery Unit, Orthopedic and Traumatology Division, Surgery Department, HUG, SwitzerlandDivision of Radiology, Department of Diagnosis, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, SwitzerlandDivision of Radiology, Department of Diagnosis, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, SwitzerlandDivision of Radiology, Department of Diagnosis, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, SwitzerlandDivision of Radiology, Department of Diagnosis, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, SwitzerlandHand Surgery Unit, Orthopedic and Traumatology Division, Surgery Department, HUG, SwitzerlandHand Surgery Unit, Orthopedic and Traumatology Division, Surgery Department, HUG, SwitzerlandDivision of Radiology, Department of Diagnosis, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211, Geneva 14, Switzerland; Correspondent author.Purpose: To assess the accuracy and reliability of using cone beam computed tomography (CBCT) compared to X-ray six weeks after injury for predicting scaphoid union. Materials and methods: Overall; 52 patients with scaphoid fractures between April 2018 and March 2019 were prospectively included in this study. The mean age was 34.52 (13–88) years, and the gender ratio male/female 43/9. Of the fractures, 26 had occurred on the right side, and 26 on the left side. In total, 28 % of patients were manual workers. All patients underwent X-ray and CBCT six weeks after injury. Four readers, two radiologists, and two hand surgeons analyzed the findings using double-blinded X-ray and CBCT and categorized fractures as consolidated based on a 50 % visibility threshold concerning trabecular bridges. Proximal pole sclerosis, communition, cyst formation, and humpback deformity were similarly analyzed for all cases. Agreement between readers was calculated using Kappa, and sensitivity, specificity, and accuracy using RStudio software. The gold standard was the radiologic and clinical follow-up for all patients at two months. Results: Inter-reader agreement between the four readers was moderate concerning X-ray (0.543) but substantial concerning CBCT (0.641). It was almost perfect between seniors regarding CBCT (Kappa = 0.862). Sensitivity, specificity, and accuracy were 0.75–0.78, 0.4, and 0.61–0.64, respectively, for two readers regarding CBCT. The X-ray values were 0.65–0.71, 0.35–0.4, and 0.53–0.59, respectively. Conclusion: CBCT proves more accurate and reliable than X-ray for diagnosing scaphoid union at an early follow-up and prevents longer immobilization and interruption of activity or work.http://www.sciencedirect.com/science/article/pii/S235204772030040XScaphoid healingCBCTX-raysImmobilisation |
| spellingShingle | Lucia Calisto Farracho Berenice Moutinot Angeliki Neroladaki Marion Hamard Karel Gorican Pierre Alexandre Poletti Jean Yves Beaulieu Cindy Bouvet Sana Boudabbous Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization European Journal of Radiology Open Scaphoid healing CBCT X-rays Immobilisation |
| title | Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization |
| title_full | Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization |
| title_fullStr | Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization |
| title_full_unstemmed | Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization |
| title_short | Determining diagnosis of scaphoid healing: Comparison of cone beam CT and X-ray after six weeks of immobilization |
| title_sort | determining diagnosis of scaphoid healing comparison of cone beam ct and x ray after six weeks of immobilization |
| topic | Scaphoid healing CBCT X-rays Immobilisation |
| url | http://www.sciencedirect.com/science/article/pii/S235204772030040X |
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