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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