TY - JOUR

T1 - Weight-bearing cone-beam CT

T2 - the need for standardised acquisition protocols and measurements to fulfill high expectations—a review of the literature

AU - Brinch, Signe

AU - Wellenberg, Ruud H.H.

AU - Boesen, Mikael Ploug

AU - Maas, Mario

AU - Johannsen, Finn Elkjær

AU - Nybing, Janus Uhd

AU - Turmezei, Tom

AU - Streekstra, Geert J.

AU - Hansen, Philip

N1 - Correction to: Weight‑bearing cone‑beam CT: the need for standardised acquisition protocols and measurements to fulfill high expectations—a review of the literature (Skeletal Radiology, (2023), 52, 6, (1073-1088), 10.1007/s00256-022-04223-1) Publisher Copyright: © 2022, The Author(s), under exclusive licence to International Skeletal Society (ISS).

PY - 2023

Y1 - 2023

N2 - Weight bearing CT (WBCT) of the lower extremity is gaining momentum in evaluation of the foot/ankle and knee. A growing number of international studies use WBCT, which is promising for improving our understanding of anatomy and biomechanics during natural loading of the lower extremity. However, we believe there is risk of excessive enthusiasm for WBCT leading to premature application of the technique, before sufficiently robust protocols are in place e.g. standardised limb positioning and imaging planes, choice of anatomical landmarks and image slices used for individual measurements. Lack of standardisation could limit benefits from introducing WBCT in research and clinical practice because useful imaging information could become obscured. Measurements of bones and joints on WBCT are influenced by joint positioning and magnitude of loading, factors that need to be considered within a 3-D coordinate system. A proportion of WBCT studies examine inter- and intraobserver reproducibility for different radiological measurements in the knee or foot with reproducibility generally reported to be high. However, investigations of test–retest reproducibility are still lacking. Thus, the current ability to evaluate, e.g. the effects of surgery or structural disease progression, is questionable. This paper presents an overview of the relevant literature on WBCT in the lower extremity with an emphasis on factors that may affect measurement reproducibility in the foot/ankle and knee. We discuss the caveats of performing WBCT without consensus on imaging procedures and measurements.

AB - Weight bearing CT (WBCT) of the lower extremity is gaining momentum in evaluation of the foot/ankle and knee. A growing number of international studies use WBCT, which is promising for improving our understanding of anatomy and biomechanics during natural loading of the lower extremity. However, we believe there is risk of excessive enthusiasm for WBCT leading to premature application of the technique, before sufficiently robust protocols are in place e.g. standardised limb positioning and imaging planes, choice of anatomical landmarks and image slices used for individual measurements. Lack of standardisation could limit benefits from introducing WBCT in research and clinical practice because useful imaging information could become obscured. Measurements of bones and joints on WBCT are influenced by joint positioning and magnitude of loading, factors that need to be considered within a 3-D coordinate system. A proportion of WBCT studies examine inter- and intraobserver reproducibility for different radiological measurements in the knee or foot with reproducibility generally reported to be high. However, investigations of test–retest reproducibility are still lacking. Thus, the current ability to evaluate, e.g. the effects of surgery or structural disease progression, is questionable. This paper presents an overview of the relevant literature on WBCT in the lower extremity with an emphasis on factors that may affect measurement reproducibility in the foot/ankle and knee. We discuss the caveats of performing WBCT without consensus on imaging procedures and measurements.

KW - CBCT

KW - Cone beam CT

KW - Lower extremity

KW - Reproducibility

KW - Standardisation

KW - Test–retest

KW - Weight-bearing WBCT

UR - https://doi.org/10.1007/s00256-023-04357-w

U2 - 10.1007/s00256-022-04223-1

DO - 10.1007/s00256-022-04223-1

M3 - Review

C2 - 36350387

AN - SCOPUS:85141565869

VL - 52

SP - 1073

EP - 1088

JO - Skeletal Radiology

JF - Skeletal Radiology

SN - 0364-2348

ER -