TP4.1 Comparable accuracy of three-dimensional reconstruction of MRI and CT in the evaluation of femoroacetabular morphology: a systematic review

Abstract

Abstract Purpose To compare the accuracy of three-dimensional (3D) magnetic resonance imaging (MRI) to 3D computed tomography (CT) in the assessment of bony morphology of the acetabulum and proximal femur. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Medline, Embase, Cochrane and PubMed databases were queried using keywords “hip,” “hip joint,” “MRI,” and “three dimensional imaging.” Two independent reviewers screened titles, abstracts, and full texts for inclusion. Included studies compared 3D MRI and 3D CT reconstructions of the hip to assess bone morphology. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was applied to assess for heterogeneity and risk of bias. Data collected included patient demographics, MRI and CT sequences and processing techniques, surface-surface differences and qualitative assessment of CAM morphology. Results 608 articles were identified for screening after duplicates were removed. 10 studies met the inclusion criteria, with 249 hips included. QUADAS-2 was low risk in all studies. Six studies compared surface-surface differences between 3D MRI and CT models, finding no significant differences between proximal femur and acetabulum volume. Qualitative analysis of CAM deformity in two studies, showed excellent agreement for presence and location of deformity. Segmentation and reconstruction of 3D MRI sequences ranged from no additional time compared to 3D CT, up to two hours longer. Conclusions 3D MRI compared to 3D CT was accurate in evaluating acetabulum and proximal femur osseous anatomy. Techniques for constructing 3D MRI models varied greatly and were more time consuming than 3D CT in the majority of studies.