MR/CT image fusion of the spine after spondylodesis: a feasibility study.
The objective of this study is to evaluate feasibility, accuracy and time requirements of MR/CT image fusion of the lumbar spine after spondylodesis. Sagittal MR and CT images derived from standard imaging protocols (sagittal T2-weighted MR/sagittal reformatted multi-planar-reformation of the CT) of the lumbar spine with correct (n = 5) and incorrect (n = 5) implant position were fused by two readers (R1, R2) using OsiriX in two sessions placing one (session 1) or two (session 2) reference point(s) on the dorsal tip(s) of the cranial and caudal endplates from the second lumbar to the first sacral vertebra. R1 was an experienced musculoskeletal radiologist; R2 a spine surgeon, both had received a short training on the software tool. Fusion times and fusion accuracy, defined as the largest deviation between MR and CT in the median sagittal plane on the ventral tip of the cranial end plate of the most cranial vertebra visible on the CT, were measured in both sessions. Correct or incorrect implant position was evaluated upon the fused images for all patients by an experienced senior staff musculoskeletal radiologist. Mean fusion time (session 1/session 2; in seconds) was 100.4/95 (R1) and 104.2/119.8 (R2). Mean fusion deviation (session 1/session 2; in mm) was 1.24/2.20 (R1) and 0.79/1.62 (R2). The correct/incorrect implant position was identified correctly in all cases. In conclusion, MR/CT image fusion of the spine with metallic implants is feasible, fast, accurate and easy to implement in daily routine work.
Karlo
C A
CA
Department of Radiology, University Hospital Balgrist, Forchstrasse 340, 8008 Zurich, Switzerland. christoph.karlo@usz.ch
Steurer-Dober
I
I
Leonardi
M
M
Pfirrmann
C W A
CW
Zanetti
M
M
Hodler
J
J
D005240:Feasibility Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D013123:Spinal Fusion / Q000379:methods*; D013131:Spine / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods*
Eur J Surg Oncol. 2009 Jun;35(6):666-72
19056201
Clin Orthop Relat Res. 2008 Oct;466(10):2533-41
18648902
Comput Med Imaging Graph. 2004 Jan-Mar;28(1-2):21-31
15127746
J Magn Reson Imaging. 2008 Sep;28(3):705-13
18777555
Radiology. 1994 May;191(2):371-7
8153308
J Thorac Imaging. 2007 Feb;22(1):101-6
17325581
J Nucl Med. 1993 Jul;34(7):1190-7
8315501
Rev Stomatol Chir Maxillofac. 2008 Feb;109(1):53-5
18093626
Med Image Anal. 2003 Sep;7(3):377-89
12946476
Eur J Radiol. 2007 May;62(2):192-8
17229539
Biomed Tech (Berl). 2004 Mar;49(3):49-55
15106898
J Digit Imaging. 2004 Sep;17(3):205-16
15534753
J Digit Imaging. 2005 Dec;18(4):270-9
15988626
JACC Cardiovasc Imaging. 2008 Jan;1(1):73-82
19356409
J Cardiovasc Magn Reson. 2006;8(5):685-92
16891227
Acta Neurochir (Wien). 2009 Mar;151(3):231-8; discussion 238
19240972
Appl Radiat Isot. 2008 Dec;66(12):1948-53
18656372
J Nucl Med. 2007 May;48(5):696-703
17475956
Radiographics. 2006 Jan-Feb;26(1):299-308
16418259
Radiology. 2005 Nov;237(2):465-73
16244254
Eur J Radiol. 2010 Feb;73(2):224-9
19097718
Eur J Nucl Med Mol Imaging. 2007 Jul;34(7):1097-106
17245532