Beyaz Salih, Kurtuldu Hüseyin
Department of Orthopedics and Traumatology, Başkent University Adana Dr. Turgut Noyan Research and Application Center, Adana, Turkey.
Jt Dis Relat Surg. 2020;31(1):2-7. doi: 10.5606/ehc.2020.71292.
This study aims to introduce a new low-cost universal laser aiming device (LAD) that can be used in existing C-arm fluoroscopy devices, independent of brand and model, and to determine whether this new universal LAD improves technician accuracy in locating the desired region at the midpoint of the fluoroscopic image.
A low-priced universal LAD that is compatible with existing 12-inch C-arm fluoroscopy devices was designed. Eight radiology technicians with varied levels of experience in C-arm fluoroscopy participated in the study. A 12 mm cortical screw with a diameter of 3.5 mm was placed on proximal, diaphyseal, and distal points of femur, tibia, and humerus bones in the anteroposterior plane on L3 vertebrae and the left pubis arm in the pelvis bone model. Technicians were asked to align each screw in the image center 10 times from a distance of 30 cm in the anterolateral plane, first without the LAD and then with the LAD. The distance of the screw head to the center point was measured from the 3,520 images with the help of medical viewer software based on the X- and Y-axis.
Each fluoroscopic image was divided into 48 equal parts and the length of a part was taken as one unit for distance measurements. The compliance between technicians without the LAD was 0.347 (95% confidence interval [CI]: 0.208-0.47, p=0.001) and with the LAD was 0.687 (95% CI: 0.621-0.741, p=0.001). The distance between the screw head and the center of the image without the LAD was 19.0±9.8 for technicians with more than 10 years of experience and 28.0±12.9 for those with less than 10 years of experience. This difference was statistically significant (p=0.001). When the LAD was used, the difference between the less experienced (3.1±1.5) and more experienced (3.3±2.0) technicians was statistically reduced, along with the distance (p=0.033).
The use of the LAD with C-arm fluoroscopy appears to be successful in helping technicians capture the desired point in the center of the fluoroscopic image. The use of the LAD reduces the experience gap between technicians.
本研究旨在介绍一种新型低成本通用激光瞄准装置（LAD），该装置可用于现有的C形臂荧光透视设备，不受品牌和型号限制，并确定这种新型通用LAD是否能提高技术人员在荧光透视图像中点处定位所需区域的准确性。
设计了一种与现有的12英寸C形臂荧光透视设备兼容的低价通用LAD。八名在C形臂荧光透视方面经验水平各异的放射科技术人员参与了研究。在L3椎体的前后平面以及骨盆骨模型中的左耻骨臂上，将一根直径为3.5mm的12mm皮质螺钉放置在股骨、胫骨和肱骨的近端、骨干和远端点上。要求技术人员在距前外侧平面30cm处，先不使用LAD，然后使用LAD，将每个螺钉在图像中心对齐10次。借助基于X轴和Y轴的医学观察软件，从3520张图像中测量螺钉头部到中心点的距离。
每张荧光透视图像被分成48等份，将一份的长度作为距离测量的一个单位。不使用LAD时技术人员的符合度为0.347（95%置信区间[CI]：0.208 - 0.47，p = 0.001），使用LAD时为0.687（95%CI：0.621 - 0.741，p = 0.001）。经验超过10年的技术人员在不使用LAD时，螺钉头部与图像中心的距离为19.0±9.8，经验不足10年的技术人员为28.0±12.9。这种差异具有统计学意义（p = 0.001）。当使用LAD时，经验较少（3.1±1.5）和经验较多（3.3±2.0）的技术人员之间的差异以及距离在统计学上均有所减小（p = 0.033）。
在C形臂荧光透视中使用LAD似乎成功地帮助技术人员在荧光透视图像中心捕获所需点。LAD的使用缩小了技术人员之间的经验差距。
