ABSTRACT
Objective To establish a clinical score system of giant cell tumors (GCT) according to its morphological features presented on three-dimensional (3D) computed tomographic imaging. Methods Sixteen patients with GCT around knee were included from January 2006 to March 2009. Of the tumors, 9 were located in the distal part of femur, and 7 were in proximal part of tibia. Each patient was exposed to spiral CT preoperatively. Then these primitive CT dates were inputted into digital Orthopedics clinical research platform. With 3D surfaces reconstruction and volume rendering, we reconstructed 3D morphology of GCT. The measurement index included pathological fracture, the degree of involvement of cortical bone, the volume of tumor, the distance between tumor and joint surface and the percentage of involvement areas of articular surface. On account of previous literature and above data, clinical score system of GCT was established. Its feasibility was testified by clinical data. Results A new clinical score system of GCT was established. It was named Hu-Chen Giant Cell Tumor Scale. Full score of the system was 12. In the 16 patients, 5patients whose points was more than 9 elevated by Hu-Chen Giant Cell Tumor Scale preoperatively were treated by wide excision and prosthetic replacement. The postoperative average MSTS score of 5 patients was 27, and there were no recurrence. The 5 patients whose points was 6-8 elevated by Hu-Chen Scale were treated by intralesional excision and structured allograft. The postoperative average MSTS score of the patients was 29, and 1 case underwent recurrence whose points was 8. The 6 patients whose points were less than 6 elevated by Hu-Chen Scale were treated by intralesional excision and morsellized allograft. The postoperative average MSTS score of the patients was 27, and there were no recurrence. Conclusion Hu-Chen Giant Cell Tumor Scale established based on digital techniques includes lots of factors which determined surgical strategy. The grating system is an effectively, reliable method in treatment of GCT.
ABSTRACT
Objective To discuss the measurement of bone tumor volume on the basis of three dimensional images segmentation technology. Methods Twenty patients with lacunar bone tumor from Tianjin hospital and Tongji hospital were included in the study from January 2010 to August 2010. There were 11 males and 9 females. Each patient was exposed to spiral CT preoperatively. Then these primitive CT dates were imported into digital orthopedics clinical research platform (SuperImage orthopedics edition 1.1, Cybermed Ltd). The volume and maximum diameter of bone tumor were measured before operation by three-dimensional reconstruction technology. The actual tumor volume was measured during the operation. The tumor volume was also calculated from plain X-rays and CT scans as ellipsoidal or cylindrical depending on the tumor configuration and presence or absence of a soft tissue component. Results The tumor volume was measured to be (14.92±7.34) mm3, (16.65±6.95) mm3 and (34.29±15.70) mm3 using three-dimensional reconstruction technology, intraoperative elevation, and traditional radiograph measurement separately. It was found that there was no difference regarding the outcomes of measurement between three-dimensional reconstruction technology and gross intraoperative measurement. But obvious difference was detected between gross intraoperative measurement and traditional radiograph measurement. Coefficient of correlation between diameter and volume of bone tumor was 0.325 (P=0.162). Conclusion Digital measurement is a precise, efficient,convenient and repeatable method for bone tumor measurement.
ABSTRACT
OBJETIVO: Comparar os tempos de geração e digitação de laudos radiológicos entre um sistema eletrônico baseado na tecnologia de voz sobre o protocolo de internet (VoIP) e o sistema tradicional, em que o radiologista escreve o laudo à mão. MATERIAIS E MÉTODOS: Foi necessário modelar, construir e implantar o sistema eletrônico proposto, capaz de gravar o laudo em formato de áudio digital, e compará-lo com o tradicional já existente. Por meio de formulários, radiologistas e digitadores anotaram os tempos de geração e digitação dos laudos nos dois sistemas. RESULTADOS: Comparadas as médias dos tempos entre os sistemas, o eletrônico apresentou redução de 20 por cento (p = 0,0410) do tempo médio de geração do laudo em comparação com o sistema tradicional. O tradicional foi mais eficiente em relação ao tempo de digitação, uma vez que a média de tempo do eletrônico foi três vezes maior (p < 0,0001). CONCLUSÃO: Os resultados mostraram diferença estatisticamente significante entre os sistemas comparados, sendo que o eletrônico foi mais eficiente do que o tradicional em relação ao tempo de geração dos laudos, porém, em relação ao tempo de digitação, o tradicional apresentou melhores resultados.
OBJECTIVE: To compare the time required for generation and typing of radiology reports by means of an electronic system based on the technology of voice over internet protocol (VoIP) and the traditional system, in which the report is handwritten by the radiologist. MATERIALS AND METHODS: It was necessary to model, build and deploy the proposed electronic system, capable of recording the reports in a digital audio format and comparing it with the traditional method. Radiologists and transcriptionists recorded the reports generation and typing times for both systems, using appropriate forms. RESULTS: When the mean times between both systems were compared, those from the electronic system presented a reduction of 20 percent (p = 0.0410) in the report generation time as compared with the traditional method. On the other hand, the traditional method was more efficient with respect to typing time, as the mean typing time with the electronic system was three times longer (p < 0.0001). CONCLUSION: The results demonstrated a statistically significant difference between the compared systems, with the electronic system being more efficient than the traditional one with respect to report generation time, while the traditional method presented better results with respect to typing time.