Li Zhengliang, Xia Jie, Wang Cong, Zhu Zhemin, Zhang Fan, Tsai Tsung-Yuan, Zhu Zhenhong, Yang Kai
School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China.
Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China.
Bioengineering (Basel). 2025 Sep 19;12(9):999. doi: 10.3390/bioengineering12090999.
Full-length radiography is essential for evaluating spinal deformities, limb length discrepancies, and preoperative planning in orthopedics, yet the measurement accuracy of different radiographic methods remains unclear. This phantom study compared the accuracy of rotational stitching, one-shot and slot-scanning full-length radiography across six radiographic systems in quantifying distances between anatomical landmarks. Measurement errors were statistically analyzed using appropriate nonparametric tests. The results demonstrated significant differences in measurement accuracy among the three methods (H (2) = 15.86, < 0.001). Slot-scanning exhibited the highest accuracy, with a mean error of -1.19 ± 10.13 mm, while both rotational stitching and one-shot imaging showed greater systematic underestimation, with mean errors of -18.95 ± 13.77 mm and -15.32 ± 12.38 mm, respectively. These negative biases (approximately 1.9 cm and 1.5 cm) are clinically meaningful because, if unrecognized, they can alter mechanical axis estimation and alignment planning in procedures such as high tibial osteotomy (HTO). Post hoc analysis confirmed the superior accuracy of slot-scanning compared to the other two methods, while no significant difference was found between rotational stitching and one-shot imaging. These findings indicate that system choice substantially impacts measurement accuracy, supporting preferential use of slot-scanning when precise quantitative assessment is required.
全长放射摄影对于评估脊柱畸形、肢体长度差异以及骨科术前规划至关重要，但不同放射摄影方法的测量准确性仍不明确。本模型研究比较了旋转拼接、单次和狭缝扫描全长放射摄影在六个放射成像系统中量化解剖标志点之间距离的准确性。使用适当的非参数检验对测量误差进行统计学分析。结果表明，三种方法在测量准确性上存在显著差异（H(2)=15.86，P<0.001）。狭缝扫描显示出最高的准确性，平均误差为-1.19±10.13毫米，而旋转拼接和单次成像均显示出更大的系统性低估，平均误差分别为-18.95±13.77毫米和-15.32±12.38毫米。这些负偏差（约1.9厘米和1.5厘米）具有临床意义，因为如果未被识别，它们可能会改变诸如高位胫骨截骨术（HTO）等手术中的机械轴估计和对线规划。事后分析证实了狭缝扫描相对于其他两种方法具有更高的准确性，而旋转拼接和单次成像之间未发现显著差异。这些发现表明，系统选择对测量准确性有重大影响，支持在需要精确定量评估时优先使用狭缝扫描。
