Accuracy and Precision of Three-Dimensional Low Dose CT Compared to Standard RSA in Acetabular Cups: An Experimental Study

Cyrus Brodén, Henrik Olivecrona, Gerald Q Maguire Jr, Marilyn E Noz, Michael P Zeleznik, Olof Sköldenberg, Cyrus Brodén, Henrik Olivecrona, Gerald Q Maguire Jr, Marilyn E Noz, Michael P Zeleznik, Olof Sköldenberg

Abstract

Background and Purpose. The gold standard for detection of implant wear and migration is currently radiostereometry (RSA). The purpose of this study is to compare a three-dimensional computed tomography technique (3D CT) to standard RSA as an alternative technique for measuring migration of acetabular cups in total hip arthroplasty. Materials and Methods. With tantalum beads, we marked one cemented and one uncemented cup and mounted these on a similarly marked pelvic model. A comparison was made between 3D CT and standard RSA for measuring migration. Twelve repeated stereoradiographs and CT scans with double examinations in each position and gradual migration of the implants were made. Precision and accuracy of the 3D CT were calculated. Results. The accuracy of the 3D CT ranged between 0.07 and 0.32 mm for translations and 0.21 and 0.82° for rotation. The precision ranged between 0.01 and 0.09 mm for translations and 0.06 and 0.29° for rotations, respectively. For standard RSA, the precision ranged between 0.04 and 0.09 mm for translations and 0.08 and 0.32° for rotations, respectively. There was no significant difference in precision between 3D CT and standard RSA. The effective radiation dose of the 3D CT method, comparable to RSA, was estimated to be 0.33 mSv. Interpretation. Low dose 3D CT is a comparable method to standard RSA in an experimental setting.

Figures

Figure 1
Figure 1
Pelvic model with jig holding the cemented cup in place for the examinations. The jig allows precise translations in x-, y-, and z-axis by 1.0 mm increments and rotations in 1.0° increments about the x-axis.
Figure 2
Figure 2
Volume fusion of the transformed and reference volume. In this experiment the relative movement of the cup is zero. The overlapping pattern between the two examinations indicates that the surface representations are closer than the smallest voxel elements and that visually the precision of this method is good.

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