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Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT

BACKGROUND: Ultrasonography is a fast and patient-friendly modality to assess cartilage thickness. However, inconsistent results regarding accuracy have been reported. Therefore, we asked what are (1) the accuracy, (2) reproducibility, and (3) reliability of ultrasonographic cartilage thickness meas...

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Autores principales: Steppacher, Simon Damian, Hanke, Markus Simon, Zurmühle, Corinne Andrea, Haefeli, Pascal Cyrill, Klenke, Frank Michael, Tannast, Moritz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391750/
https://www.ncbi.nlm.nih.gov/pubmed/30813958
http://dx.doi.org/10.1186/s13018-019-1099-8
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author Steppacher, Simon Damian
Hanke, Markus Simon
Zurmühle, Corinne Andrea
Haefeli, Pascal Cyrill
Klenke, Frank Michael
Tannast, Moritz
author_facet Steppacher, Simon Damian
Hanke, Markus Simon
Zurmühle, Corinne Andrea
Haefeli, Pascal Cyrill
Klenke, Frank Michael
Tannast, Moritz
author_sort Steppacher, Simon Damian
collection PubMed
description BACKGROUND: Ultrasonography is a fast and patient-friendly modality to assess cartilage thickness. However, inconsistent results regarding accuracy have been reported. Therefore, we asked what are (1) the accuracy, (2) reproducibility, and (3) reliability of ultrasonographic cartilage thickness measurement using contrast-enhanced micro-CT for validation? METHODS: A series of 50 cartilage–bone plugs were harvested from fresh bovine and porcine joints. Ultrasonic cartilage thickness was determined using an A-mode, 20-MHz hand-held ultrasonic probe with native (1580 m/s) and adjusted speed of sound (1696 m/s). All measurements were performed by two observers at two different occasions. Angle of insonation was controlled by tilting the device and recording minimal thickness. Retrieval of exact location for measurement was facilitated by aligning the circular design of both cartilage–bone plug and ultrasonic device. There was no soft tissue interference between cartilage surface and ultrasonic probe. Ground truth measurement was performed using micro-CT with iodine contrast agent and a voxel size of 16 μm. The mean cartilage thickness was 1.383 ± 0.402 mm (range, 0.588–2.460 mm). RESULTS: Mean accuracy was 0.074 ± 0.061 mm (0.002–0.256 mm) for native and 0.093 ± 0.098 mm (0.000–0.401 mm) for adjusted speed of sound. Bland–Altman analysis showed no systematic error. High correlation was found for native and adjusted speed of sound with contrast-enhanced micro-CT (both r = 0.973; p < 0.001). A perfect agreement for reproducibility (intraclass correlation coefficient [ICC] 0.992 and 0.994) and reliability (ICC 0.993, 95% confidence interval 0.990–0.995) was found. CONCLUSIONS: Ultrasonic cartilage thickness measurement could be shown to be highly accurate, reliable, and reproducible. The A-mode ultrasonic cartilage thickness measurement is a fast and patient-friendly modality which can detect early joint degeneration and facilitate decision making in joint preserving surgery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13018-019-1099-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-63917502019-03-11 Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT Steppacher, Simon Damian Hanke, Markus Simon Zurmühle, Corinne Andrea Haefeli, Pascal Cyrill Klenke, Frank Michael Tannast, Moritz J Orthop Surg Res Research Article BACKGROUND: Ultrasonography is a fast and patient-friendly modality to assess cartilage thickness. However, inconsistent results regarding accuracy have been reported. Therefore, we asked what are (1) the accuracy, (2) reproducibility, and (3) reliability of ultrasonographic cartilage thickness measurement using contrast-enhanced micro-CT for validation? METHODS: A series of 50 cartilage–bone plugs were harvested from fresh bovine and porcine joints. Ultrasonic cartilage thickness was determined using an A-mode, 20-MHz hand-held ultrasonic probe with native (1580 m/s) and adjusted speed of sound (1696 m/s). All measurements were performed by two observers at two different occasions. Angle of insonation was controlled by tilting the device and recording minimal thickness. Retrieval of exact location for measurement was facilitated by aligning the circular design of both cartilage–bone plug and ultrasonic device. There was no soft tissue interference between cartilage surface and ultrasonic probe. Ground truth measurement was performed using micro-CT with iodine contrast agent and a voxel size of 16 μm. The mean cartilage thickness was 1.383 ± 0.402 mm (range, 0.588–2.460 mm). RESULTS: Mean accuracy was 0.074 ± 0.061 mm (0.002–0.256 mm) for native and 0.093 ± 0.098 mm (0.000–0.401 mm) for adjusted speed of sound. Bland–Altman analysis showed no systematic error. High correlation was found for native and adjusted speed of sound with contrast-enhanced micro-CT (both r = 0.973; p < 0.001). A perfect agreement for reproducibility (intraclass correlation coefficient [ICC] 0.992 and 0.994) and reliability (ICC 0.993, 95% confidence interval 0.990–0.995) was found. CONCLUSIONS: Ultrasonic cartilage thickness measurement could be shown to be highly accurate, reliable, and reproducible. The A-mode ultrasonic cartilage thickness measurement is a fast and patient-friendly modality which can detect early joint degeneration and facilitate decision making in joint preserving surgery. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13018-019-1099-8) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-27 /pmc/articles/PMC6391750/ /pubmed/30813958 http://dx.doi.org/10.1186/s13018-019-1099-8 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Steppacher, Simon Damian
Hanke, Markus Simon
Zurmühle, Corinne Andrea
Haefeli, Pascal Cyrill
Klenke, Frank Michael
Tannast, Moritz
Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT
title Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT
title_full Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT
title_fullStr Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT
title_full_unstemmed Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT
title_short Ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-CT
title_sort ultrasonic cartilage thickness measurement is accurate, reproducible, and reliable—validation study using contrast-enhanced micro-ct
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6391750/
https://www.ncbi.nlm.nih.gov/pubmed/30813958
http://dx.doi.org/10.1186/s13018-019-1099-8
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