Ultrasonic and skinfold caliper measures of subcutaneous adipose tissue thickness in elderly men and women

Ultrasonic and skinfold caliper measures of subcutaneous adipose tissue were taken in a sample of elderly men and women, 65 to 99 years of age with an A-mode Ithaco Body Composition Meter and a Holtain skinfold caliper. For most of the measurements, standard deviations for the ultrasonic measurements were three or more times larger than corresponding caliper measurements. Also, mean absolute interobserver errors for the ultrasonic measurements were considerably larger than those for skinfold calipers. At best, the interobserver reliability for the ultrasound machine was 68% while the poorest reliability for the skinfold caliper was 88%. In the form tested, the Ithaco Body Composition Meter is not as accurate for measuring subcutaneous adipose tissue thickness in the elderly as a Holtain skinfold caliper.     

Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers

Gerodontology 2010; doi: 10.1111/j.1741‐2358.2009.00353.x
Reliability and comparison of two facial measurements to detect changes of occlusal vertical dimension in complete denture wearers Background: Facial measurements are frequently used to determine OVD. However, the reliability of neither the method nor the chosen landmarks has been cleared yet. Objective: This study compares the reliability of two facial measurements, subnasal (SN) to chin (C) and tip of the nose (TN) to C, for determining occlusal vertical dimension (OVD). Materials and methods: Thirty edentulous subjects with adequate neuromuscular co‐ordination, without signs and symptoms of temporomandibular disorders and who had been wearing complete dentures for at least 5 years were enrolled. A modified central bearing device was used to alter the OVD and facial measurements were made with a digital caliper. Student’s t‐test was used to compare the two measurements. Interobserver and intraobserver reliability were evaluated with Spearman’s rho correlation test. Results: TN–C distance had an improved correlation with the changes in intraoral alterations than SN–C distance. While the means of the changes in facial measurements were in good agreement with the intraoral alterations, the ranges were wide. Both interobserver and intraobserver reliability of the measurements were high. Conclusion: While facial measurement is not a good predictor of OVD, TN–C distance appears to be more reliable than SN–C distance.     

Intra and Interobserver Reliability and Agreement of Semiquantitative Vertebral Fracture Assessment on Chest Computed Tomography

Objectives

To evaluate the reliability of semiquantitative Vertebral Fracture Assessment (VFA) on chest Computed Tomography (CT).

Methods

Four observers performed VFA twice upon sagittal reconstructions of 50 routine clinical chest CTs. Intra- and interobserver agreement (absolute agreement or 95% Limits of Agreement) and reliability (Cohen''s kappa or intraclass correlation coefficient(ICC)) were calculated for the visual VFA measures (fracture present, worst fracture grade, cumulative fracture grade on patient level) and for percentage height loss of each fractured vertebra compared to the adjacent vertebrae.

Results

Observers classified 24–38% patients as having at least one vertebral fracture, giving rise to kappa''s of 0.73–0.84 (intraobserver) and 0.56–0.81 (interobserver). For worst fracture grade we found good intraobserver (76–88%) and interobserver (74–88%) agreement, and excellent reliability with square-weighted kappa''s of 0.84–0.90 (intraobserver) and 0.84–0.94 (interobserver). For cumulative fracture grade the 95% Limits of Agreement were maximally ±1,99 (intraobserver) and ±2,69 (interobserver) and the reliability (ICC) varied from 0.84–0.94 (intraobserver) and 0.74–0.94 (interobserver). For percentage height-loss on a vertebral level the 95% Limits of Agreement were maximally ±11,75% (intraobserver) and ±12,53% (interobserver). The ICC was 0.59–0.90 (intraobserver) and 0.53–0–82 (interobserver). Further investigation is needed to evaluate the prognostic value of this approach.

Conclusion

In conclusion, these results demonstrate acceptable reproducibility of VFA on CT.     

Intra- and interobserver error in craniometry: A cautionary tale

This study investigates intra- and interobserver measurement error in craniometry. Data consists of 72 craniometric measurements taken on a series of 28 Sadlermuit Eskimo crania. Utermohle measured the series twice; Zegura measured it once. Statistical procedures used to demonstrate measurement imprecision include the mean difference, the method error statistic, two-way anova without replication, the t-test for paired comparisons, Fisher's distribution-free sign test, and the t-test for independent samples. The results indicate less intraobserver repeatability than expected as well as an alarming lack of interobserver reproducibility for many of these craniometric measurements. We hope these results will serve as a caution against the widespread belief that craniometric measurements are always produced with a high degree of precision by experienced craniometrists. In addition, these results suggest that investigators employing craniometric measurements to study population affinities, functional morphology, forensics, fossil primates, and human microevolution might profit from conducting a measurement error analysis as an important baseline for the interpretation of the biological significance of their results.     

The use of sequential MR image sets for determining tibiofemoral motion: reliability of coordinate systems and accuracy of motion tracking algorithm

The use of magnetic resonance imaging has been proposed by many investigators for establishment of joint reference systems and kinematic tracking of musculoskeletal joints. In this study, the intraobserver and interobserver reliability of a strategy to establish anatomic reference systems using manually selected fiducial points were quantified for seven sets of MR images of the human knee joint. The standard error of the measurement of the intraobserver and interobserver errors were less than 2.6 degrees, and 1.2 mm for relative tibiofemoral orientation and displacement, respectively. An automated motion tracking algorithm was also validated with a controlled motion experiment in a cadaveric knee joint. The controlled displacements and rotations prescribed in our motion tracking validation were highly correlated to those predicted (Pearson's correlation = 0.99, RMS errors = 0.39 mm, 0.38 degree). Finally, the system for anatomic reference system definition and motion tracking was demonstrated with a set of MR images of in vivo passive flexion in the human knee.     

正常大鼠脑CT灌注成像的可重复性研究

目的:评价多层螺旋CT灌注成像对正常大鼠脑血流动力学观测结果的可重复性.方法:分别对10只健康Wistar大鼠间隔2d进行CT灌注扫描,两组原始灌注数据由2名放射科医师分别进行5次后处理得出CBF、CBV和MTT值.分析观察者内和观察者间观测结果的可重复性,以及对同一组研究对象间隔2d两次检查结果的一致性.结果:多层螺旋CT对Wistar大鼠脑所采集的灌注原始数据在观察者内和观察者间观测结果均无统计学差别(P＞0.05),并具有很好的线性(CBF和CBV值)或等级(MTT值)正相关(P＜0.01).对同一组研究对象间隔2d的两次CT灌注成像结果也存在同样好的重复性.结论:多层螺旋CT灌注成像对于Wistar大鼠脑部血流动力学观测具有很高的精密度和准确性,完全适于小型动物模型脑部血流动力学的研究.     

Determination of Trantinterol Enantiomers in Human Plasma by High‐Performance Liquid Chromatography – Tandem Mass Spectrometry Using Vancomycin Chiral Stationary Phase and Solid Phase Extraction and Stereoselective Pharmacokinetic Application

A sensitive and enantioselective vancomycin chiral stationary phase high‐performance liquid chromatography–tandem mass spectrometry method was developed for the determination of trantinterol enantiomers in human plasma. Baseline resolution was achieved using the vancomycin chiral stationary phase known as Chirobiotic V with polar ionic mobile phase consisting of acetonitrile–methanol (60:40, v/v) containing 0.01% ammonia and 0.02% acetic acid at a flow rate of 1.0 mL/min. Waters Oasis HLB C18 solid phase extraction cartridges were used in the sample preparation of trantinterol samples from plasma. The detection was performed on a triple‐quadrupole tandem mass spectrometer by multiple reaction monitoring mode via electrospray ionization. The calibration curve was linear in a concentration range from 0.0606 to 30.3 ng/mL in plasma, with the lower limit of quantification of 0.0606 ng/mL. The intra‐ and interday precision (relative standard deviation) values were within 9.7% and the accuracy (relative error) was from ?6.6 to 7.2% at all quality control levels. The method was successfully applied to a study of stereoselective pharmacokinetics in human. Chirality 27:327–331, 2015.© 2015 Wiley Periodicals, Inc.     

DNA barcoding of stylommatophoran land snails: a test of existing sequences

DNA barcoding has attracted attention because it is a potentially simple and universal method for taxonomic assignment. One anticipated problem in applying the method to stylommatophoran land snails is that they frequently exhibit extreme divergence of mitochondrial DNA sequences, sometimes reaching 30% within species. We therefore trialled the utility of barcodes in identifying land snails, by analysing the stylommatophoran cytochrome oxidase subunit I sequences from GenBank. Two alignments of 381 and 228 base pairs were used to determine potential error rates among a test data set of 97 or 127 species, respectively. Identification success rates using neighbour‐joining phylogenies were 92% for the longer sequence and 82% for the shorter sequence, indicating that a high degree of mitochondrial variation may actually be an advantage when using phylogeny‐based methods for barcoding. There was, however, a large overlap between intra‐ and interspecific variation, with assignment failure (per cent of samples not placed with correct species) particularly associated with a low degree of mitochondrial variation (Kimura 2‐parameter distance < 0.05) and a small GenBank sample size (< 25 per species). Thus, while the optimum intra/interspecific threshold value was 4%, this was associated with an overall error of 32% for the longer sequences and 44% for the shorter sequences. The high error rate necessitates that barcoding of land snails is a potentially useful method to discriminate species of land snail, but only when a baseline has first been established using conventional taxonomy and sample DNA sequences. There is no evidence for a barcoding gap, ruling out species discovery based on a threshold value alone.     

Representativity and reproducibility of DNA malignancy grading in different carcinomas

The reproducibility of the determination of the "DNA malignancy grade" (DNA-MG) was tested in 56 carcinomas of the colon, breast and lung while its representativity was tested on 195 slides from 65 tumors of the colon, breast and lung. DNA measurements were performed on Feulgen-stained smears with the TAS Plus TV-based image analysis system combined with an automated microscope. The variance of the DNA values of tumor cells around the 2c peak, the "2c deviation index" (2cDI), was taken as a basis for the computation of the DNA-MG, which ranges on a continuous scale from 0.01 to 3.00. The representativity, analyzed by comparison of the DNA-MGs measured in three different areas of the same tumor greater than or equal to 1.5 cm apart from each other, yielded an 81% agreement. No significant differences between DNA-MGs of these areas were found. The intraobserver and interobserver reproducibilities of the DNA grading system, investigated by repeated DNA measurements, were 83.9% and 82.2%, respectively. In comparison, histopathologic grading of the 27 breast cancers studied yielded 65% intraobserver and 57% interobserver reproducibilities and 66% representativity.     

Paradoxical bilateral asymmetry in bone size and bone mass in the hand

Among 227 chronic renal disease patients, micrometer caliper radiogrammetric measurements of the second metacarpal at midshaft showed the right metacarpal to be larger (with greater bone area) and with a greater cortical area than the left second metacarpal, both in 208 right-handed individuals and in 19 left-handed individuals. This direction of asymmetry was individually characteristic of the majority of individuals, whether right-handed, left-handed or ambidextrous.     

Reproducibility of diagnostic criteria associated with atypical breast cytology

Objective

The aim of this project was to assess the interobserver and intraobserver variability when identifying cytological criteria, which were found to have a statistically significant association with C3 within a workplace environment.

Methods

Sixty C3 cases with known endpoints of malignant, benign proliferative or benign non‐proliferative diagnoses were blindly and independently screened by seven experienced cytologists to identify previously reported statistically significant criteria associated with the C3 category. The criteria included the presence of myoepithelial cells or bare bipolar nuclei, cohesiveness, cystic background, papillary fragments with fibrovascular cores and tubular structures. Kappa statistics were used to measure interobserver variability. Two cytologists repeated the process 6 months later to obtain intraobserver data.

Results

The interobserver agreement was poor for all criteria except tubules which performed badly. The intraobserver variability for the two cytologists showed that one cytologist achieved moderate intraobserver agreement for all the criteria except cohesion which was poor, whilst the second cytologist showed poor agreement for all criteria. The reasons for the variability are multifactorial and include threshold effects where criteria lack good definition or error in identifying the criteria.

Conclusion

Interobserver and intraobserver variability remains a significant challenge for cytologists. Despite attempts to define significant criteria associated with C3, good reproducibility could not be achieved. The C3 category is imprecise and highlights the inadequacy of the current classification reporting categories for breast FNA. The impending review of reporting breast cytology by the International Academy of Cytology is timely and appropriate.     

Validation of Morphometric Analyses of Small-Intestinal Biopsy Readouts in Celiac Disease

Background

Assessment of the gluten-induced small-intestinal mucosal injury remains the cornerstone of celiac disease diagnosis. Usually the injury is evaluated using grouped classifications (e.g. Marsh groups), but this is often too imprecise and ignores minor but significant changes in the mucosa. Consequently, there is a need for validated continuous variables in everyday practice and in academic and pharmacological research.

Methods

We studied the performance of our standard operating procedure (SOP) on 93 selected biopsy specimens from adult celiac disease patients and non-celiac disease controls. The specimens, which comprised different grades of gluten-induced mucosal injury, were evaluated by morphometric measurements. Specimens with tangential cutting resulting from poorly oriented biopsies were included. Two accredited evaluators performed the measurements in blinded fashion. The intraobserver and interobserver variations for villus height and crypt depth ratio (VH:CrD) and densities of intraepithelial lymphocytes (IELs) were analyzed by the Bland-Altman method and intraclass correlation.

Results

Unevaluable biopsies according to our SOP were correctly identified. The intraobserver analysis of VH:CrD showed a mean difference of 0.087 with limits of agreement from −0.398 to 0.224; the standard deviation (SD) was 0.159. The mean difference in interobserver analysis was 0.070, limits of agreement −0.516 to 0.375, and SD 0.227. The intraclass correlation coefficient in intraobserver variation was 0.983 and that in interobserver variation 0.978. CD3⁺ IEL density countings in the paraffin-embedded and frozen biopsies showed SDs of 17.1% and 16.5%; the intraclass correlation coefficients were 0.961 and 0.956, respectively.

Conclusions

Using our SOP, quantitative, reliable and reproducible morphometric results can be obtained on duodenal biopsy specimens with different grades of gluten-induced injury. Clinically significant changes were defined according to the error margins (2SD) of the analyses in VH:CrD as 0.4 and in CD3⁺-stained IELs as 30%.     

A re‐evaluation of the impact of radiographic orientation on the identification and interpretation of Harris lines

The identification of Harris lines through radiographic analysis has been well‐established since their discovery in the late nineteenth century. Most commonly associated with stress, the study of Harris lines has been fraught with inconsistent identification standards, high levels of intra‐ and interobserver error, and the inevitability of skeletal remodelling. Despite these methodological challenges, the use of Harris lines remains an important contributor to studies of health in archaeological populations. This research explores the radiographic process, specifically orientation and how Harris lines are initially captured for study. Using the Black Friars (13th–mid 17th centuries) skeletal sample from Denmark, 157 individuals (134 adults; 23 subadults) were radiographically analyzed in both an anterior–posterior (A–P) and medial–lateral (M–L) view for the left and right radii and tibiae. Based on the current methodological standards within the literature, it was hypothesized that the A–P view would provide the best resolution and visualization of Harris lines. The results, however, show that the number of lines visible in the M–L view were significantly higher than those visible in the A–P view; inferring that the M–L view is superior for the study of Harris lines. Am J Phys Anthropol 156:141–147, 2015 © 2014 Wiley Periodicals, Inc.     

Three‐dimensional environments preserve extracellular matrix compartments of ovarian follicles and increase FSH‐dependent growth

In this study we performed a systematic comparative analysis of two culture environments—flat/adhesive liquid and three‐dimensional collagen gel—upon in vitro ovarian follicle development. We paid particular attention to the effects of in vitro environments upon the preservation of follicular structure and of peri‐ and intra‐follicular extracellular matrix. We show that flat/adhesive environment leads to an obvious distortion of follicle morphology, marked extracellular matrix modifications and high rates of spontaneous, i.e., FSH‐independent, follicle disruption. In contrast, three‐dimensional collagen gel environments are able to maintain follicular structure with an in vivo‐like basal lamina architecture, minimizing spontaneous disruption. Follicle distortions found in flat/adhesive culture systems include a pronounced flattening, causing the follicle horizontal diameters not to adequately reflect follicle volume. Our volume data, based on three‐axis follicle diameter measurements, indicate that three‐dimensional collagen gel environments increase follicle growth, particularly in response to FSH. This study demonstrates that preservation of both peri‐ and intra‐follicular extracellular matrix compartments during the in vitro growth and differentiation of ovarian follicles is highly desirable, and is now possible through the use of appropriate three‐dimensional collagen gel culture environments. This system allows a better understanding of the specific roles played by each of the follicle compartments during development. Mol. Reprod. Dev. 54:163–172, 1999. © 1999 Wiley‐Liss, Inc.     

Ovarian self‐incompatibility in Narcissus papyraceus (Amaryllidaceae) is the result of a pre‐zygotic response

Ovarian self‐incompatibility, including pre‐ and post‐zygotic reactions, is a complex mechanism for which we still lack many details relating to its function and significance. The joint presence of ovarian self‐incompatibility with style polymorphism is a rare combination that is found in the genus Narcissus. Usually, style polymorphic species have heteromorphic (diallelic and linked to style length locus) incompatibility, which prevents fertilization between individuals of the same morph, thereby helping to maintain equal proportions of floral morphs in populations. However, when present, self‐incompatibility in Narcissus is not linked to style polymorphism and cross‐fertilization within each morph is possible. Hence, self‐incompatibility in Narcissus is of particular interest when attempting to unravel the nature of the rejection reaction and aiming to assess possible cryptic differences in the fertilization process in intra‐ and inter‐morph crosses, which might ultimately explain the wide variation of morph‐ratio in the field. We examined the breeding system of Narcissus papyraceus, a style‐dimorphic species that has biased morph ratios in most of its populations. We studied pollen‐tube growth in the pistil and ovule fate after experimentally controlled hand pollinations. The growth of pollen tubes in self‐ and intra‐ and inter‐morph crosses was similar up to the point of micropyle penetration in both morphs but, subsequently, a pre‐zygotic failure appeared to affect male and female gametophytes in selfed pistils. A high proportion of ovules from self‐pollinated flowers showed signs of collapse and self‐pollen tubes were blocked or behaved abnormally before entering the embryo sac. Self‐incompatibility was stronger in the long‐styled morph than in the short‐styled morph. We did not find any conclusive sign of differential functioning between intra‐ and inter‐morph cross‐pollinations in any morph. These results enable us to rule out the possible effects of pollen–pistil interactions in N. papyraceus as a cause of morph‐ratio biases and confirm the exceptional nature of the self‐incompatibility mechanism in this polymorphic species. © 2015 The Linnean Society of London, Botanical Journal of the Linnean Society, 2015, 177 , 629–643.     

Stable Individual Profiles of Daily Timing of Migratory Restlessness in European Quail

Temporal characteristics of migratory behavior in birds are usually studied at the species and population levels, and rarely at the individual level. Variations among species and populations of the seasonal onset of migratory behavior have been widely investigated, but very little is known about its daily organization or whether birds are conservative in their behavior. The determination of intra‐ and inter‐individual variability is important for the study of genetic variations and can reveal the existence of different adaptation capacities within populations. This laboratory study analyzed intra‐ and inter‐individual variability of daily initiation and time course of nocturnal restlessness in partial‐migrant European quail (Coturnix coturnix coturnix). Thirty‐five quail were selected randomly from a captive stock, and their spring activity was recorded under natural daylenghs. Eighteen of the thirty‐five quail presented behavioral profiles of migrant birds. Migrant birds initiated their nocturnal activity punctually, and the time courses of the nocturnal activity of 88% of them revealed intra‐individual stability over six consecutive nights. All birds initiated their nocturnal activity after sunset and civil twilight, and they were more active at the beginning than the middle or end of the night, suggesting that their drive to migrate could be synchronized with particular skylight conditions. For the first time, stable individual profiles in the daily time course of migratory restlessness are shown. These results support previous findings concerning biological rhythms of quail and raise questions concerning the timing of migratory behavior.     

Precision (Repeatability and Reproducibility) and Agreement of Corneal Power Measurements Obtained by Topcon KR-1W and iTrace

Purpose

To evaluate the repeatability and reproducibility of corneal power measurements obtained by Topcon KR-1W and iTrace, and assess the agreement with measurements obtained by Allegro Topolyzer and IOLMaster.

Methods

The right eyes of 100 normal subjects were prospectively scanned 3 times using all the 4 devices. Another observer performed additional 3 consecutive scans using the Topcon KR-1W and iTrace in the same session. About one week later, the first observer repeated the measurements using the Topcon KR-1W and iTrace. The steep keratometry (Ks), flat keratometry (Kf), mean keratometry (Km), J0 and J45 were analyzed. Repeatability and reproducibility of measurements were evaluated by the within-subject standard deviation (Sw), coefficient of variation (CoV), test-retest repeatability (2.77Sw), and intraclass correlation coefficient (ICC). Agreements between devices were assessed using Bland-Altman analysis and 95% limits of agreement (LoA).

Results

Intraobserver repeatability and interobserver and intersession reproducibility of the Ks, Kf and Km showed a CoV of no more than 0.5%, a 2.77Sw of 0.70 D or less, and an ICC of no less than 0.99. However, J0 and J45 showed poor intraobserver repeatability and interobserver and intersession reproducibility (all ICCs not greater than 0.446). Statistically significant differences existed between Topcon KR-1W and IOLMaster, Topcon KR-1W and iTrace, Topcon KR-1W and Topolyzer, iTrace and Topolyzer, iTrace and IOLMaster for Ks, Kf and Km measurements (all P < 0.05). The mean differences between Topcon KR-1W, iTrace, and the other 2 devices were small. The 95% LoA were approximately 1.0 D to 1.5 D for all measurements.

Conclusions

The Ks, Kf and Km obtained by Topcon KR-1W and iTrace showed excellent intraobserver repeatability and interobserver and intersession reproducibility in normal eyes. The agreement between Topcon KR-1W and Topolyzer, Topcon KR-1W and IOLMaster, iTrace and Topolyzer, iTrace and IOLMaster, Topcon KR-1W and iTrace were not so good, they should not be interchangeable in clinical application. Given that the intraobserver repeatability and interobserver and intersession reproducibility of corneal astigmatism measurements obtained by Topcon KR-1W and iTrace were poor, it should be cautious that Topcon KR-1W and iTrace were applied for the preparation of toric lens implantation.     

Sexing potential of fragmentary and pathological metacarpals

The use of metacarpal dimensions for determining skeletal sex is investigated. Previous studies on sexual dimorphism in the metacarpals (Scheuer and Elkington [1993]; J. Forensic Sci. 38:769–778; Falsetti [1995]; J. Forensic Sci. 40:774–776; Smith [1996]; J. Forensic Sci. 41:469–477) used multiple variables, which limits the application potential of the methodology. Using six measurements for each metacarpal, I generated 35 linear discriminant functions based on expected taphonomic or pathological preservation scenarios. The number of variables per function ranged from 2–5. Normal, jackknifed, and cross-validation classification matrices indicated a sex prediction accuracy in the 79–85% range. MC4 produced the most consistent functions. Overall accuracy in the validation samples ranged from 75–90%. ANOVA and MANOVA analyses indicated that population effects are insignificant, which may allow for the application of the functions without knowledge of the ancestral background of the individual. This, combined with the variety of preservation scenarios considered, provides accurate sex estimators for incomplete individuals. However, the population specificity of the insignificant population group effects remains untested. Am J Phys Anthropol 109:245–252, 1999. © 1999 Wiley-Liss, Inc.     

运用CT三维重建测量重度先天性脊柱侧凸Cobb角的临床应用

目的:评价在CT三维重建上测量重度先天性脊柱侧凸Cobb角度的可重复性和可靠性。方法:收集在我院诊治的重度先天性脊柱侧凸病人的CT三维重建和脊柱全长X线片,共计67例。由五名不同测量者对CT三维重建脊柱畸形冠状面主弯Cobb角测量两次,两次间隔在三周以上,并测量脊柱全长X线片脊柱畸形冠状面主弯Cobb角一次,运用组内相关系数分析测量结果之间的可重复性和可靠性。结果:同一测量者两次测量结果之间的差值平均为4.5°。同一测量者两次测量结果之间的组内相关系数为0.969,不同测量者之间测量结果的组内相关系数为0.913。取五名测量者在CT三维重建上第一次测量的Cobb角度,其平均值为(110.5±23.5)°,五名测量者在X线片上测量结果的平均值为(103.1±22.0)°,对两组数据进行Mann-Whitney非参数检验差异有统计学意义(Z=-2.86,P=0.004)。结论:在CT三维重建上测量重度先天性脊柱侧凸的Cobb角,可以减小测量的误差,提高测量的可重复性和可靠性,是一种相对准确的测量方法。     

Comparison of 2.5D and 3D Quantification of Femoral Head Coverage in Normal Control Subjects and Patients with Hip Dysplasia

Hip dysplasia is characterized by insufficient femoral head coverage (FHC). Quantification of FHC is of importance as the underlying goal of the surgery to treat hip dysplasia is to restore a normal acetabular morphology and thereby to improve FHC. Unlike a pure 2D X-ray radiograph-based measurement method or a pure 3D CT-based measurement method, previously we presented a 2.5D method to quantify FHC from a single anteriorposterior (AP) pelvic radiograph. In this study, we first quantified and compared 3D FHC between a normal control group and a patient group using a CT-based measurement method. Taking the CT-based 3D measurements of FHC as the gold standard, we further quantified the bias, precision and correlation between the 2.5D measurements and the 3D measurements on both the control group and the patient group. Based on digitally reconstructed radiographs (DRRs), we investigated the influence of the pelvic tilt on the 2.5D measurements of FHC. The intraclass correlation coefficients (ICCs) for absolute agreement was used to quantify interobserver reliability and intraobserver reproducibility of the 2.5D measurement technique. The Pearson correlation coefficient, r, was used to determine the strength of the linear association between the 2.5D and the 3D measurements. Student’s t-test was used to determine whether the differences between different measurements were statistically significant. Our experimental results demonstrated that both the interobserver reliability and the intraobserver reproducibility of the 2.5D measurement technique were very good (ICCs > 0.8). Regression analysis indicated that the correlation was very strong between the 2.5D and the 3D measurements (r = 0.89, p < 0.001). Student’s t-test showed that there were no statistically significant differences between the 2.5D and the 3D measurements of FHC on the patient group (p > 0.05). The results of this study provided convincing evidence demonstrating the validity of the 2.5D measurements of FHC from a single AP pelvic radiograph and proved that it could serve as a surrogate for 3D CT-based measurements. Thus it may be possible to use this method to avoid a CT scan for the purpose of estimating 3D FHC in diagnosis and post-operative treatment evaluation of patients with hip dysplasia.