Operator variability in scan positioning is a major component of HR-pQCT precision error and is reduced by standardized training
| Autor: | Sundeep Khosla, Dennis M. Black, Andrew J. Burghardt, Kyle K. Nishiyama, Elizabeth Shane, CM Chan, Thomas Lang, Ali Ghasem-Zadeh, Steven K. Boyd, Eric S. Orwoll, Mary L. Bouxsein, Serena Bonaretti, A Yu, S. Majumdar, Heather A. McKay, Stephanie Boutroy, Nicolas Vilayphiou, Roland Chapurlat, Danmei Liu |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Scanner Inservice Training Endocrinology Diabetes and Metabolism Clinical Sciences Biomedical Engineering 030209 endocrinology & metabolism Bioengineering Article 03 medical and health sciences Endocrinology & Metabolism 0302 clinical medicine Software Operator (computer programming) Software Design medicine 80 and over Humans Computer vision Quantitative computed tomography Projection (set theory) Multicenter studies Tomography Aged Aged 80 and over Reproducibility Observational error HR-pQCT medicine.diagnostic_test Tibia business.industry Reproducibility of Results Precision Standardization X-Ray Computed Operator reproducibility Radius 030104 developmental biology Public Health and Health Services Osteoporosis Biomedical Imaging Female Artificial intelligence Clinical Competence Anatomic Landmarks business Tomography X-Ray Computed |
| Zdroj: | Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol 28, iss 1 |
| Popis: | In this study, we determined that operator positioning precision contributes significant measurement error in high-resolution peripheral quantitative computed tomography (HR-pQCT). Moreover, we developed software to quantify intra- and inter-operator variability and demonstrated that standard positioning training (now available as a web-based application) can significantly reduce inter-operator variability. HR-pQCT is increasingly used to assess bone quality, fracture risk, and anti-fracture interventions. The contribution of the operator has not been adequately accounted in measurement precision. Operators acquire a 2D projection (“scout view image”) and define the region to be scanned by positioning a “reference line” on a standard anatomical landmark. In this study, we (i) evaluated the contribution of positioning variability to in vivo measurement precision, (ii) measured intra- and inter-operator positioning variability, and (iii) tested if custom training software led to superior reproducibility in new operators compared to experienced operators. To evaluate the operator in vivo measurement precision, we compared precision errors calculated in 64 co-registered and non-co-registered scan-rescan images. To quantify operator variability, we developed software that simulates the positioning process of the scanner’s software. Eight experienced operators positioned reference lines on scout view images designed to test intra- and inter-operator reproducibility. Finally, we developed modules for training and evaluation of reference line positioning. We enrolled six new operators to participate in a common training, followed by the same reproducibility experiments performed by the experienced group. In vivo precision errors were up to threefold greater (Tt.BMD and Ct.Th) when variability in scan positioning was included. The inter-operator precision errors were significantly greater than the short-term intra-operator precision (p |
| Databáze: | OpenAIRE |
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