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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

  

Outcome:

  

Reliability

  

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)

  

MRI:

  

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

  

Correlation:

  

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

Outcome:

  

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):

  

0.60-0.84

  

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

Outcome:

  

Reliability

  

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

  

Outcome:

  
  

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
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BMC Musculoskeletal Disorders

ISSN: 1471-2474

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