BEAMS Department, Université Libre de Bruxelles, Bruxelles, Belgium.
Witapp srl, Florence, Italy.
Knee. 2021 Dec;33:275-281. doi: 10.1016/j.knee.2021.10.016. Epub 2021 Oct 29.
Proper use of three-dimensional (3D) models generated from medical imaging data in clinical preoperative planning, training and consultation is based on the preliminary proved accuracy of the replication of the patient anatomy. Therefore, this study investigated the dimensional accuracy of 3D reconstructions of the knee joint generated from computed tomography scans via automatic segmentation by comparing them with 3D models generated through manual segmentation.
Three unpaired, fresh-frozen right legs were investigated. Three-dimensional models of the femur and the tibia of each leg were manually segmented using a commercial software and compared in terms of geometrical accuracy with the 3D models automatically segmented using proprietary software. Bony landmarks were identified and used to calculate clinically relevant distances: femoral epicondylar distance; posterior femoral epicondylar distance; femoral trochlear groove length; tibial knee center tubercle distance (TKCTD). Pearson's correlation coefficient and Bland and Altman plots were used to evaluate the level of agreement between measured distances.
Differences between parameters measured on 3D models manually and automatically segmented were below 1 mm (range: -0.06 to 0.72 mm), except for TKCTD (between 1.00 and 1.40 mm in two specimens). In addition, there was a significant strong correlation between measurements.
The results obtained are comparable to those reported in previous studies where accuracy of bone 3D reconstruction was investigated. Automatic segmentation techniques can be used to quickly reconstruct reliable 3D models of bone anatomy and these results may contribute to enhance the spread of this technology in preoperative and operative settings, where it has shown considerable potential.
在临床术前规划、培训和咨询中，正确使用基于患者解剖结构复制精度的医学影像数据生成的三维（3D）模型，因此，本研究通过比较自动分割和手动分割生成的膝关节 3D 模型，调查了从计算机断层扫描自动分割生成的膝关节 3D 重建的尺寸精度。
本研究调查了 3 个未配对的新鲜冷冻右腿。使用商业软件对每条腿的股骨和胫骨的 3D 模型进行手动分割，并与使用专有软件自动分割的 3D 模型进行几何精度比较。确定了骨性标志点，并计算了临床相关的距离：股骨髁上距离；股骨后髁上距离；股骨滑车沟长度；胫骨膝关节中心结节距离（TKCTD）。使用 Pearson 相关系数和 Bland 和 Altman 图评估测量距离的一致性水平。
手动和自动分割 3D 模型测量的参数之间的差异小于 1mm（范围：-0.06 至 0.72mm），除了 TKCTD（在两个标本中为 1.00 至 1.40mm）。此外，测量值之间存在显著的强相关性。
获得的结果与先前研究中报道的骨 3D 重建精度相当。自动分割技术可用于快速重建可靠的骨骼解剖 3D 模型，这些结果可能有助于在术前和手术环境中推广这项技术，在这些环境中，它显示出了相当大的潜力。
