20:50 PM

3D imaging enhances accuracy of musculoskeletal diagnosis, surgery

Hollis G. Potter, MD, chairman, Department of Radiology and Imaging at HSS, and others, discuss recent advancements in 3D imaging that have allowed radiologists and orthopedic surgeons to work increasingly in tandem to better treat patients with musculoskeletal conditions.

Although CT has been the primary type of orthopedic 3D imaging, MRI has begun to emerge as another important imaging modality within the specialty. According to Dr. Potter, MRI 3D imaging was made especially relevant through the incorporation of parallel imaging, which shortened scan acquisition time. “We are now working on things like deep learning de-noising algorithms, which use artificial intelligence to take some of the noise away from MRI images and further shorten scan time,” she explained.

Aside from CT and MRI, other scanning modalities also incorporate 3D imaging, such as the whole-body surface photographic system made by 3dMD, which Dr. Potter explained is especially efficacious for patients with scoliosis. The photographic system tracks changes in the spinal curvature without use of an x-ray and provides an option for reducing the burden of ionizing radiation, which is particularly important for pediatric patients, she noted.

In the context of orthopedic oncology surgery, determining the size of the tumor mass can be as important as determining what structures and tissue the mass may encroach upon. For example, Dr. Potter cited a tumor surgeon who needs to know whether a tumor in the thigh might be right up against the sciatic nerve. “Going into surgery, the surgeon wants to know exactly what he or she is going to encounter when they open the patient up, so 3D imaging can be helpful in assessing tumor encroachment on vital neurovascular structures or muscle.”

Forward looking to the future era for imaging, Dr. Potter noted techniques like preoperative virtual arthroscopy and preoperative operative planning may remove a lot of the guesswork of surgery. “The concept of using fiducial markers in the operating room, potentially with robotic-assisted surgery, is going to streamline things and decrease anesthesia time, decrease operative time and overall improve operative recovery and the surgical outcome.”

Read the full article at Healio.com/news/orthopedics.