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Table 4 Studies Directly Comparing Imaging Methods for Assessing Glenoid Bone Loss

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

Bishop et al. [42]: Cadaveric study

Radiography; 2DCT; 3DCT; MRI

7 cadavers

Observers measured bone loss using his/her usual approach (Methods not specified)

Overall agreement with gold standard (kappa score):

Assessment:

 

3DCT 0.5

Serial imaging of shoulder after osteotomies of 0 %, <12 %, 12-25 %, 25-40 %; manually measured glenoid width through bare area using a digital caliper (gold standard); 12 observers measured twice

 

CT 0.4

Outcome:

 

MRI 0.28

Reliability

 

Radiography 0.15

  

Intra-observer reliability (kappa):

  

3DCT 0.59

  

CT 0.64

  

MRI 0.51

  

Radiography 0.45

  

Note: 3DCT highest agreement & 2nd highest intra-observer reliability; radiography lowest agreement & reliability

Bois et al. [63]: Laboratory study

2DCT; 3DCT

Sawbones:1 model for anterior defect; 1 model for anteroinferior defect

2DCT & 3DCT:

2D CT methods (ICC, PE):

Assessment:

Indicators: linear width/length (W/L) ratio; defect length; quantifiers: glenoid index (injured glenoid inferior circle diameter relative to uninjured glenoid diameter)

Defect length: 0.81, 7.68

Osteotomies made at 0, 15 %, and 30 % of inferior glenoid circle diameter; gold standard measurement (3D laser scanner of model); 6 observers measured all 7 techniques

3DCT:

W/L ratio: 0.50, −16.34

Outcome:

Quantifiers: linear ratio (d/R; d = radius to defect, R = circle radius); Pico method (3 variations):

Glenoid index, 0.3, −4.13

Reliability, PE

(1) Original circle method

3D CT (ICC, PE):

 

(2) Based on contralateral normal glenoid circle with 3 points of reference

Defect length: 0.90, 0.29

 

(3) Based on remaining intact glenoid cortex

W/L ratio: 0.88, −2.41

  

Glenoid index: 0.69, 0.01 (0.85, 3.39 with other software platform)

  

Linear ratio: 0.97, 29.9

  

Pico (1): 0.98, 4.93

  

Pico (2): 0.84, 7.32

  

Pico (3): 0.86, 12.14

  

Note: Pico method (1) based on the contralateral, intact glenoid and Glenoid Index on 3DCT were most reliable & accurate; Glenoid Index on 2DCT was deemed invalid

Rerko et al. [44]: Cadaveric study

Radiography; 2DCT; 3DCT; MRI

7 cadavers

Observers measured bone loss using his/her usual approach (Methods not specified)

Accuracy (PE):

Assessment:

 

3DCT −3.3 %+/−6.6 %

Serial imaging of shoulder with osteotomies grouped as 0 %,<12 %, 12, 25 %, 25-40 %; gold standard defined as glenoid width using digital caliper; 2 radiologists & 2 orthopaedic surgeons measured twice

 

2DCT −3.7 %+/−8.0 %

Outcome:

 

MRI −2.75 %+/−10.6 %

PE, reliability

 

Radiography −6.9 % +/− 13.1 %

  

Intra-observer reliability (ICC):

  

3DCT 0.947

  

2DCT 0.927

  

MRI 0.837

  

Radiography 0.726

  

Inter-observer reliability (ICC):

  

3DCT 0.87-0.93

  

2DCT 0.82-0.89

  

MRI 0.38-0.85

  

Radiography 0.12-0.53

  1. List of Abbreviations: ICC: intraclass correlation coefficient; PE: percent error