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Table 2 Studies Assessing Glenoid Surface Area Loss with CT and MRI

From: Imaging methods for quantifying glenoid and Hill-Sachs bone loss in traumatic instability of the shoulder: a scoping review

Study Modality Details Quantification Technique Findings
Barchilon et al. [20]: Prospective case series 2DCT; 3DCT 13 patients Best-fit circle surface area: Method 1 with method 2:
Assessment: Approximation based on intact posteroinferior edge of ipsilateral glenoid R2 = 0.91
2DCT & 3DCT using 3 methods (1) Software directly measured area of circle and area of missing area using 2DCT (gold standard) Method 1 with method 3:
Outcome: (2) Mathematical formula to calculate % surface area loss using 2DCT based on circle radius & defect depth with software R2 = 0.60
Intra-method comparison (3) Manually measured defect depth & circle radius using 3DCT & femoral head gauge; formula to calculate % surface area Note: BCSA methods can be applied without computer software
Hantes et al. [65]: Cadaveric study 3DCT 14 cadavers Best-fit circle surface area: Reliability:
Assessment: Sugaya Method Coefficient of variation 2.2-2.5 %
CT scan following 3 serial osteotomy’s; 1 observer measured 5 times for 2 glenoids   
Huijsmans et al. [21]: Cadaveric study 3DCT; MRI 14 cadavers Best-fit circle surface area: Difference with digital picture:
Assessment: Circle approximated based on ipsilateral glenoid; software used CT −0.81 % to −1.21 %
Digital picture, CT, & MRI before/after osteotomy (random size) on anterior glenoid; 2 observers measured 3 times   MRI 0.61 % to 0.74 % (non-significant)
Outcome:   CT:
Reliability   Inter-observer r2 = 0.94
   Intra-observer r2 = 0.97 (observer 1) and 0.90 (observer 2)
   Inter-observer r2 = 0.87
   Intra-observer r2 = 0.93 (observer 1) and r2 = 0.92 (observer 2)
   Digital image:
   Inter-observer r2 = 0.97
Lee et al. [52]: Prospective case series 2DCT; MRI 65 patients 1) Best-fit circle surface area (Pico method) Inter-observer ICC:
Assessment: 2) Best-fit circle width method 0.95 for best-fit circle width
CT (bilateral) & MRI followed by arthroscopy; 1 observer measured CT once; 3 observers measured MRI once; 1 observer measured MRI 3 times Arthroscopy with bare-area technique (used as gold standard) 0.90 for area (Pico method)
Outcome:   Intra-observer reliability ICC:
Reliability   0.98 width
   0.97 area
   CT & MRI 0.83
   CT & arthroscopy 0.91
   MRI & arthroscopy 0.84
Magarelli et al. [32]: Prospective case series 2DCT 40 patients Best-fit circle surface area method: Intra-observer reliability:
Assessment: Pico method based on contralateral glenoid ICC 0.94
Bilateral CT; 1 observer measured 3 times; 1observer measured once   SEM 1.1 %.
Outcome:   Inter-observer reliability:
Reliability   ICC 0.90
   SEM 1.0 %.
   Note: No comparison to other methods
Magarelli et al. [57]: Prospective cohort study 2DCT; 3DCT 100 patients Best-fit circle surface area: Mean difference:
Assessment: Pico method based on contralateral glenoid 0.62 %+/−1.96 %
Bilateral CT; 2 observers measured once   Note: No reliability measurement
Agreement between 2D & 3D CT   
Nofsinger et al. [35]: Retrospective case series 3DCT 23 patients Best-fit circle surface area: Normal shoulder:
Assessment: Anatomic Glenoid Index: circle matched to postero-inferior glenoid of contralateral glenoid; software measured area of circle Circle fit true glenoid closely −100.5 %, SD 2.2 %.
Bilateral pre-op CT followed by surgical repair (12 Bankart, 11   Mean AGI for Bankart group:
Latarjet); 3 blinded observers measured once (A1); circle manually adjusted to fit defect & area again calculated by software (A2); area loss = A2/A1 x 100 92.1 %+/−5.2 %
Outcome:   Mean AGI for Latarjet:
Surgical decision based on size >25 % at arthroscopy; reliability   89.6 %+/−4.7 %
   Inter-rater reliability (Pearson correlation coefficient):
   Note: Did not have the power to separate the two surgical groups
Park et al. [60]: Retrospective case series 2DCTA 30 patients Best-fit circle surface area: Intra-observer reliability:
Assessment: Pico method based on ipsilateral glenoid ICC 0.96-1.00;
CTA taken pre-op, at 3 months, and 1 year after bony Bankart repair; 1 observer measured 6 times   Positive relationship between number of dislocations & defect size
Sugaya et al. [11]: Case–control study 3DCT 100 patients, 10 healthy volunteers Best-fit circle surface: Normal glenoid did not differ significantly from contralateral glenoid; inferior portion of glenoid approximates a true circle; did not compare measurements to arthroscopic measurements; no reliability measurements
Assessment: Sugaya Method with bone fragment manually outlined Note: Technique would not work in case of attritional bone loss without a Bankart fragment
Bilateral CT; defects categorized as: small (<5 %), medium (5-20 %), or large (>20 %); patients also had arthroscopy: 1 observer measured once   
   Comparison to normal glenoid   
  1. List of Abbreviations: ICC: intraclass correlation coefficient; PE: percent error; SEM: standard error of measurement; R2: coefficient of determination; AGI: anatomic glenoid index