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Does the use of 3D Endoanal Ultrasound Improve Inter-Observer Agreement Compared with 2D Ultrasound in Patients with Faecal Incontinence?

100%

Wadhawan H., Smith L., Brown S.

Polish Journal of Surgery

2010

vol. 82

issue 9

515-519

Endoanal ultrasound (EAUS) is used in the assessment of the anal sphincter in patients with faecal incontinence. However, interpretation is very operator dependent. 3D technology allows capture of the image of the whole anal canal in three dimensions and manipulation of the image by others not carrying out the scan reducing operator dependence.The aim of the study was to determine whether inter-observer agreement is better using 3D technology compared with 2D images.Material and methods. For the first part of the study inter-observer variability was compared using a small number of patients and a large number of interpreters. Study images of ten randomly selected patients undergoing endoanal ultrasound for faecal incontinence were obtained in 2D format and using 3D technology. Images were interpreted by 4 specialists (defined as personnel who regularly reported scans) and 9 non-specialists with an interest in coloproctology (1 radiologist and 8 colorectal surgeons). For the second part of the study images of forty patients were randomly selected in both formats and interpreted by only 2 specialists. Each image was graded as normal, showing internal sphincter injury, external sphincter injury or a combination.Results. There appeared to be minimal to no advantage for the 3D format over the 2D format for any of the groups in terms of inter-observer variability. For interpretation of the 10 images as expected the inter-observer agreement was low for the non-specialist group (k = 0.11 for 2D and k = 0.16 for 3D) but was surprisingly only moderate for the specialists alone (k = 0.42 for 2D and k = 0.44 for 3D). In the second part of the study there was a higher overall agreement and a slight improvement in interobserver variability with the 3D format. Agreement was moderate for 2D and substantial for 3D (k = 0.60 and k = 0.67 respectively).Conclusions. Despite the ability to view the whole anal canal in different planes, the 3D technology appears to only slightly improve inter-observer agreement and only in expert hands.

Three-dimensional analysis of airway space and mandibular morphology in Pierre Robin sequence using cone beam computed tomography.

75%

Olszewski R., Dontaine T., Odri G. A., Zech F., Bayet B., Reychler H.

Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

2018

vol. 2

issue 1

1-27

Objectives: The Pierre Robin sequence (PRS) is defined by retromicrognathia, glossoptosis, and sleep apnea and can also be associated with cleft palate. Diagnosis, management and mandibular catch-up growth are still controversial issues in PRS patients. The aim of our retrospective study was to evaluate in three dimensions (3D) the airway space and mandibular morphology in PRS compared to a normal control group patients in the pre-orthodontic period of life. The null hypothesis was that we would not find a significant difference between the PRS and control group patients in oropharyngeal airway volume measurements. Material and methods: We analyzed 9 PRS patients (mean age: 8 years-old) who underwent cleft palate surgery in the first four months of life, performed by the same surgeon using the same technique. Cone-beam computed tomography (CBCT) was performed in these patients after local ethical committee approval. The control group consisted of 15 patients (mean age: 9 years-old) with CBCT already performed for other reasons. 3D Slicer was used in both groups for semi-automatic segmentation of the airway space. Two independent observers performed semi-automatic segmentations twice in each patient with a one- week interval between the two series of measurements. Airway volume was automatically measured using 3D Slicer. We also developed a 3D cephalometric analysis with Maxilim software in order to define a 3D mandibular morphology which consisted of 25 landmarks, 4 planes, and 23 distances. Two independent observers performed the 3D cephalometric analysis twice for each patient, with a one- week interval between the two series of measurements. Results: There was no significant difference in the intra- and inter-observer measurements between the PRS and control groups for airway space volume (p<0.05). However, there was a significant difference in the shape of the mandible between the PRS group and the control group (p<0.05). Conclusions: Vertical ramus width and mandibular global anteroposterior length were significantly lower in the PRS group. Mandibular hypoplasia could be found in PRS patients not only in the horizontal dimension. Nemesis relevance: the null hypothesis was confirmed. Moreover we failed to find exactly the same control group under 9 years-old due to radioprotection restrictions of application of cone beam CT in children.

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1 Nemesis. Negative Effects in Medical Sciences Oral and Maxillofacial Surgery

1 Polish Journal of Surgery

1 2018

1 2010

1 Bayet B.

1 Brown S.

1 Dontaine T.

1 Odri G. A.

1 Olszewski R.

1 Reychler H.

1 Smith L.

1 Wadhawan H.

1 Zech F.

Search results

Does the use of 3D Endoanal Ultrasound Improve Inter-Observer Agreement Compared with 2D Ultrasound in Patients with Faecal Incontinence?

Three-dimensional analysis of airway space and mandibular morphology in Pierre Robin sequence using cone beam computed tomography.