Skip to main content

Advertisement

SpringerLink
Log in

Interchangeability of CT and 3D “pseudo-CT” MRI for preoperative planning in patients with femoroacetabular impingement

  • Scientific Article
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Objective

To determine whether a 3D magnetic resonance imaging (MRI) sequence with postprocessing applied to simulate computed tomography (CT) (“pseudo-CT”) images can be used instead of CT to measure acetabular version and alpha angles and to plan for surgery in patients with femoroacetabular impingement (FAI).

Materials and methods

Four readers retrospectively measured acetabular version and alpha angles on MRI and CT images of 40 hips from 20 consecutive patients (9 female patients, 11 male patients; mean age, 26.0 ± 6.5 years) with FAI. 3D models created from MRI and CT images were assessed by 2 orthopedic surgeons to determine the need for femoroplasty and/or acetabuloplasty. Interchangeability of MRI with CT was tested by comparing agreement between 2 readers using CT (intramodality) with agreement between 1 reader using CT and 1 using MRI (intermodality).

Results

Intramodality and intermodality agreement values were nearly identical for acetabular version and alpha angle measurements and for surgical planning. Increases in inter-reader disagreement for acetabular version angle, alpha angle, and surgical planning when MRI was substituted for CT were − 2.1% (95% confidence interval [CI], − 7.7 to + 3.5%; p = 0.459), − 0.6% (95% CI, − 8.6 to + 7.3%; p = 0.878), and 0% (95% CI, − 15.1 to + 15.1%; p = 1.0), respectively, when an agreement criterion ≤ 5° was used for angle measurements.

Conclusion

Pseudo-CT MRI was interchangeable with CT for measuring acetabular version and highly favorable for interchangeability for measuring alpha angle and for surgical planning, suggesting that MRI could replace CT in assessing patients with FAI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Bredella MA, Ulbrich EJ, Stoller DW, Anderson SE. Femoroacetabular impingement. Magn Reson Imaging Clin N Am. 2013;21(1):45–64.

    Article  Google Scholar 

  2. Ghaffari A, Davis I, Storey T, Moser M. Current concepts of femoroacetabular impingement. Radiol Clin N Am. 2018;56(6):965–82.

    Article  Google Scholar 

  3. Leunig M, Beaule PE, Ganz R. The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res. 2009;467(3):616–22.

    Article  Google Scholar 

  4. Genovese E, Spiga S, Vinci V, et al. Femoroacetabular impingement: role of imaging. Musculoskelet Surg. 2013;97(Suppl 2):S117–26.

    Article  Google Scholar 

  5. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–20.

    Google Scholar 

  6. Riley GM, McWalter EJ, Stevens KJ, Safran MR, Lattanzi R, Gold GE. MRI of the hip for the evaluation of femoroacetabular impingement; past, present, and future. J Magn Reson Imaging. 2015;41(3):558–72.

    Article  Google Scholar 

  7. Heyworth BE, Dolan MM, Nguyen JT, Chen NC, Kelly BT. Preoperative three-dimensional CT predicts intraoperative findings in hip arthroscopy. Clin Orthop Relat Res. 2012;470(7):1950–7.

    Article  Google Scholar 

  8. Beaule PE, Zaragoza E, Motamedi K, Copelan N, Dorey FJ. Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res. 2005;23(6):1286–92.

    Article  Google Scholar 

  9. Yaddanapudi K, Subhas N, Polster J, Goodwin R, Rosneck J. Acetabular version measurements in native hips: comparison between MRI and 2D CT. Skelet Radiol. 2014;43(12):1795–6.

    Google Scholar 

  10. Gyftopoulos S, Yemin A, Mulholland T, et al. 3DMR osseous reconstructions of the shoulder using a gradient-echo based two-point Dixon reconstruction: a feasibility study. Skelet Radiol. 2013;42(3):347–52.

    Article  Google Scholar 

  11. Gyftopoulos S, Beltran LS, Yemin A, et al. Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study. Skelet Radiol. 2014;43(2):213–8.

    Article  Google Scholar 

  12. Samim M, Eftekhary N, Vigdorchik JM, et al. 3D-MRI versus 3D-CT in the evaluation of osseous anatomy in femoroacetabular impingement using Dixon 3D FLASH sequence. Skelet Radiol. 2019;48(3):429–36.

    Article  Google Scholar 

  13. Obuchowski NA, Subhas N, Schoenhagen P. Testing for interchangeability of imaging tests. Acad Radiol. 2014;21(11):1483–9.

    Article  Google Scholar 

  14. Yan K, Xi Y, Sasiponganan C, Zerr J, Wells JE, Chhabra A. Does 3DMR provide equivalent information as 3DCT for the pre-operative evaluation of adult hip pain conditions of femoroacetabular impingement and hip dysplasia? Br J Radiol. 2018;91(1092):20180474.

    Article  Google Scholar 

  15. Rathnayaka K, Momot KI, Noser H, et al. Quantification of the accuracy of MRI generated 3D models of long bones compared to CT generated 3D models. Med Eng Phys. 2012;34(3):357–63.

    Article  Google Scholar 

  16. Sutter R, Dietrich TJ, Zingg PO, Pfirrmann CW. Femoral antetorsion: comparing asymptomatic volunteers and patients with femoroacetabular impingement. Radiology. 2012;263(2):475–83.

    Article  Google Scholar 

  17. Fritz B, Bensler S, Leunig M, Zingg PO, Pfirrmann CWA, Sutter R. MRI assessment of supra- and Infratrochanteric femoral torsion: association with femoroacetabular impingement and hip dysplasia. AJR Am J Roentgenol. 2018;211(1):155–61.

    Article  Google Scholar 

Download references

Acknowledgments

We acknowledge Kavitha Yaddanapudi, MD, and Soterios Gyftopoulos, MD, MSc, for their help with study design and critical revision of the manuscript. We acknowledge Megan Griffiths, ELS, for help with manuscript editing.

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Albair Guirguis, Joshua Polster, Wadih Karim & Naveen Subhas

  2. Department of Quantitative Sciences, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Nancy Obuchowski

  3. Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    James Rosneck & Ryan Goodwin

Authors
  1. Albair Guirguis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joshua Polster
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wadih Karim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nancy Obuchowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. James Rosneck
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ryan Goodwin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Naveen Subhas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Naveen Subhas.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guirguis, A., Polster, J., Karim, W. et al. Interchangeability of CT and 3D “pseudo-CT” MRI for preoperative planning in patients with femoroacetabular impingement. Skeletal Radiol 49, 1073–1080 (2020). https://doi.org/10.1007/s00256-020-03385-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00256-020-03385-0

Keywords

Search

Navigation