Effect of external fixation rod coupling in computed tomography

Carlos Andres Peña-Solórzano, Matthew R. Dimmock, David W. Albrecht, David M. Paganin, Richard B. Bassed, Mitzi Klein, Peter C. Harris

Research output: Contribution to journalArticleResearchpeer-review

Abstract

External fixation is a common tool in the treatment of complex fractures, correction of limb deformity, and salvage arthrodesis. These devices typically incorporate radio-opaque metal rods/struts connected at varying distances and orientations between rings. Whilst the predominant imaging modality is plain film radiology, computed tomography (CT) may be performed in order for the surgeon to make a more confident clinical decision (e.g. timing of frame removal, assessment of degree of arthrodesis). We used a fractured sheep leg to systematically assess CT imaging performance with a Discovery CT750 HD CT scanner (GE Healthcare) to show how rod coupling in both traditional Ilizarov and hexapod frames distorts images. We also investigated the role of dual-energy CT (DECT) and metal artefact reduction software (MARS) on the visualisation of the fractured leg. Whilst mechanical reasons predominantly dictate the rod/strut configurations when building a circular frame, rod coupling in CT can be minimised. Firstly, ideally, all or all but one rod can be removed during imaging resulting in no rod coupling. If this is not possible, strategies for configuring the rods to minimise the effect of the rod coupling on the region of interest are demonstrated, e.g., in the case of a four-rod construct, switching the two anterior rods to a more central single one will achieve this goal without particularly jeopardising mechanical strength for a short period. It is also shown that the addition of DECT and MARS results in a reduction of artefacts, but also affects tissue and bone differentiation.

Original languageEnglish
Pages (from-to)137-149
Number of pages13
JournalStrategies in Trauma and Limb Reconstruction
Volume13
Issue number3
DOIs
Publication statusPublished - 1 Nov 2018

Keywords

  • Computed tomography
  • Dual-energy CT
  • Metal artefact reduction
  • Metal artefacts
  • Rod coupling

Cite this

Peña-Solórzano, Carlos Andres ; Dimmock, Matthew R. ; Albrecht, David W. ; Paganin, David M. ; Bassed, Richard B. ; Klein, Mitzi ; Harris, Peter C. / Effect of external fixation rod coupling in computed tomography. In: Strategies in Trauma and Limb Reconstruction. 2018 ; Vol. 13, No. 3. pp. 137-149.
@article{6cbb59fff680438aa1795b8d2dbf8971,
title = "Effect of external fixation rod coupling in computed tomography",
abstract = "External fixation is a common tool in the treatment of complex fractures, correction of limb deformity, and salvage arthrodesis. These devices typically incorporate radio-opaque metal rods/struts connected at varying distances and orientations between rings. Whilst the predominant imaging modality is plain film radiology, computed tomography (CT) may be performed in order for the surgeon to make a more confident clinical decision (e.g. timing of frame removal, assessment of degree of arthrodesis). We used a fractured sheep leg to systematically assess CT imaging performance with a Discovery CT750 HD CT scanner (GE Healthcare) to show how rod coupling in both traditional Ilizarov and hexapod frames distorts images. We also investigated the role of dual-energy CT (DECT) and metal artefact reduction software (MARS) on the visualisation of the fractured leg. Whilst mechanical reasons predominantly dictate the rod/strut configurations when building a circular frame, rod coupling in CT can be minimised. Firstly, ideally, all or all but one rod can be removed during imaging resulting in no rod coupling. If this is not possible, strategies for configuring the rods to minimise the effect of the rod coupling on the region of interest are demonstrated, e.g., in the case of a four-rod construct, switching the two anterior rods to a more central single one will achieve this goal without particularly jeopardising mechanical strength for a short period. It is also shown that the addition of DECT and MARS results in a reduction of artefacts, but also affects tissue and bone differentiation.",
keywords = "Computed tomography, Dual-energy CT, Metal artefact reduction, Metal artefacts, Rod coupling",
author = "Pe{\~n}a-Sol{\'o}rzano, {Carlos Andres} and Dimmock, {Matthew R.} and Albrecht, {David W.} and Paganin, {David M.} and Bassed, {Richard B.} and Mitzi Klein and Harris, {Peter C.}",
year = "2018",
month = "11",
day = "1",
doi = "10.1007/s11751-018-0318-x",
language = "English",
volume = "13",
pages = "137--149",
journal = "Strategies in Trauma and Limb Reconstruction",
issn = "1828-8936",
publisher = "Springer",
number = "3",

}

Effect of external fixation rod coupling in computed tomography. / Peña-Solórzano, Carlos Andres; Dimmock, Matthew R.; Albrecht, David W.; Paganin, David M.; Bassed, Richard B.; Klein, Mitzi; Harris, Peter C.

In: Strategies in Trauma and Limb Reconstruction, Vol. 13, No. 3, 01.11.2018, p. 137-149.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Effect of external fixation rod coupling in computed tomography

AU - Peña-Solórzano, Carlos Andres

AU - Dimmock, Matthew R.

AU - Albrecht, David W.

AU - Paganin, David M.

AU - Bassed, Richard B.

AU - Klein, Mitzi

AU - Harris, Peter C.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - External fixation is a common tool in the treatment of complex fractures, correction of limb deformity, and salvage arthrodesis. These devices typically incorporate radio-opaque metal rods/struts connected at varying distances and orientations between rings. Whilst the predominant imaging modality is plain film radiology, computed tomography (CT) may be performed in order for the surgeon to make a more confident clinical decision (e.g. timing of frame removal, assessment of degree of arthrodesis). We used a fractured sheep leg to systematically assess CT imaging performance with a Discovery CT750 HD CT scanner (GE Healthcare) to show how rod coupling in both traditional Ilizarov and hexapod frames distorts images. We also investigated the role of dual-energy CT (DECT) and metal artefact reduction software (MARS) on the visualisation of the fractured leg. Whilst mechanical reasons predominantly dictate the rod/strut configurations when building a circular frame, rod coupling in CT can be minimised. Firstly, ideally, all or all but one rod can be removed during imaging resulting in no rod coupling. If this is not possible, strategies for configuring the rods to minimise the effect of the rod coupling on the region of interest are demonstrated, e.g., in the case of a four-rod construct, switching the two anterior rods to a more central single one will achieve this goal without particularly jeopardising mechanical strength for a short period. It is also shown that the addition of DECT and MARS results in a reduction of artefacts, but also affects tissue and bone differentiation.

AB - External fixation is a common tool in the treatment of complex fractures, correction of limb deformity, and salvage arthrodesis. These devices typically incorporate radio-opaque metal rods/struts connected at varying distances and orientations between rings. Whilst the predominant imaging modality is plain film radiology, computed tomography (CT) may be performed in order for the surgeon to make a more confident clinical decision (e.g. timing of frame removal, assessment of degree of arthrodesis). We used a fractured sheep leg to systematically assess CT imaging performance with a Discovery CT750 HD CT scanner (GE Healthcare) to show how rod coupling in both traditional Ilizarov and hexapod frames distorts images. We also investigated the role of dual-energy CT (DECT) and metal artefact reduction software (MARS) on the visualisation of the fractured leg. Whilst mechanical reasons predominantly dictate the rod/strut configurations when building a circular frame, rod coupling in CT can be minimised. Firstly, ideally, all or all but one rod can be removed during imaging resulting in no rod coupling. If this is not possible, strategies for configuring the rods to minimise the effect of the rod coupling on the region of interest are demonstrated, e.g., in the case of a four-rod construct, switching the two anterior rods to a more central single one will achieve this goal without particularly jeopardising mechanical strength for a short period. It is also shown that the addition of DECT and MARS results in a reduction of artefacts, but also affects tissue and bone differentiation.

KW - Computed tomography

KW - Dual-energy CT

KW - Metal artefact reduction

KW - Metal artefacts

KW - Rod coupling

UR - http://www.scopus.com/inward/record.url?scp=85053463001&partnerID=8YFLogxK

U2 - 10.1007/s11751-018-0318-x

DO - 10.1007/s11751-018-0318-x

M3 - Article

VL - 13

SP - 137

EP - 149

JO - Strategies in Trauma and Limb Reconstruction

JF - Strategies in Trauma and Limb Reconstruction

SN - 1828-8936

IS - 3

ER -