Mp50-02 Radiographic Calibration for Pubic Diastasis Assessment in Bladder Exstrophy-Epispadias Complex: A Phantom Study

You have accessJournal of UrologyPediatrics III (MP50)1 May 2024MP50-02 RADIOGRAPHIC CALIBRATION FOR PUBIC DIASTASIS ASSESSMENT IN BLADDER EXSTROPHY-EPISPADIAS COMPLEX: A PHANTOM STUDY Susan J. Back, Dana A. Weiss, Brian Marshall, Erfan Akbari, Melrita Mackey, Eatrice Hinton, B. David Horn, Martin Kidd, and Michael Francavilla Susan J. BackSusan J. Back , Dana A. WeissDana A. Weiss , Brian MarshallBrian Marshall , Erfan AkbariErfan Akbari , Melrita MackeyMelrita Mackey , Eatrice HintonEatrice Hinton , B. David HornB. David Horn , Martin KiddMartin Kidd , and Michael FrancavillaMichael Francavilla View All Author Informationhttps://doi.org/10.1097/01.JU.0001008684.57262.97.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Assessment of pubic diastasis and its change is important for surgical planning and follow up in patients with bladder exstrophy-epispadias complex. Using radiography to follow diastasis is possible but may be affected by patient and technical imaging factors including body size and imaging protocol. We aimed to use imaging phantoms to assess the effect of radiographic calibration (RC) on measurements of pubic diastasis and an internal anatomic ratio as a child grows. METHODS: Radiographic images were obtained of three different sizes of computed tomography phantoms (older child, child and infant) using three imaging techniques that include the osseous pelvis in children: abdomen, pelvis and a thoracoabdominal "babygram" technique for infants. Linear measurements were made between radiographic markers placed to simulate the anterior pubic diastasis (APD) and posterior sacral width (PSW). A ratio was also created between these distances (APD/PSW). Measurements with and without image calibration were made by two pediatric radiologists using rulers placed at the time of image acquisition. RESULTS: There was excellent interrater agreement for radiographic measurements, ICC=1. APD were more affected by magnification than PSW measures: APD uncalibrated mean±SD: 73±46.8 and calibrated mean±SD: 60.4±37.2 (p=0.04); PSW uncalibrated mean±SD: 67.2±42.6 and calibrated mean±SD: 64.4±40.7 (p=0.65). There was a significant difference in simulated APD between thoracoabdominal and abdomen (p=0.04) as well as pelvic (p=0.04) techniques which resolved with calibration, each p=0.6. The ratio between the simulated APD and PSW also differed by phantom size (infant uncalibrated 0.27±0.0016 vs calibrated 0.24±0.0016; child uncalibrated 0.27±0.0019 vs calibrated 0.24±0.0019; older child uncalibrated 0.28±0.0014 vs calibrated 0.23±0.0019 (all p<0.01)) and imaging technique (p values 0.01 to 0.03) with or without calibration. However, the numerical differences of the ratio may not be clinically significant. CONCLUSIONS: Image calibration results in more uniform measurements that are more accurate than uncalibrated ones across patient size and imaging techniques. Until there is a better understanding of how these measurements relate to clinical care, image calibration is beneficial. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e830 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Susan J. Back More articles by this author Dana A. Weiss More articles by this author Brian Marshall More articles by this author Erfan Akbari More articles by this author Melrita Mackey More articles by this author Eatrice Hinton More articles by this author B. David Horn More articles by this author Martin Kidd More articles by this author Michael Francavilla More articles by this author Expand All Advertisement PDF downloadLoading ...