Stereological Estimation of Bone Cyst Volume Using Computed Tomography Images: A Comparison with the Planimetry Technique
Abstract views: 172 / PDF downloads: 142
DOI:
https://doi.org/10.58600/eurjther-28-4-0084Keywords:
Bone cyst, computed tomography, planimetry, stereologyAbstract
Objective: The exact volume of the bone cyst is fundamental for evaluation, treatment, and surgical management of the pathology related to any bone. The aim of this study was to introduce the stereological point-counting technique in bone cyst volume measurements on computed tomography images and to compare it with the planimetry technique.
Methods: A total of 30 bone cyst volumes were estimated on CT images using stereological point-counting and the planimetry technique, which is based on the Cavalieri principle. The planimetric measurements were regarded as reference values. The stereological and planimetric volume estimations were performed by two independent observers twice. The estimation results of the two volumetric techniques were compared with the Wilcoxon signed-rank test. Intra-observer and inter-observer reliability of each volumetric technique was assessed.
Results: For each bone cyst, 7-11 systematically sampled CT slices enabled reliable cyst volume estimations with a low coefficient of error (0.39%-3.12%). There was no significant difference between point counting and planimetry methods regarding volume measurements in both sessions (p>0.05), and these methods correlated well with each other. There was a significant inter-and intra-observer agreement for each volumetric method (ICC=0.9984 to 0.9988). The stereological approach was observed to take less time than the planimetric approach (mean 01:43±0.44 vs. 03.33±1:47 minutes)
Conclusion: The stereological point-counting method can be well pertained to CT images for the reliable and reproducible assessment of bone cyst volume. Application of the point-counting method for volume estimation of bone cysts with different morphological features provides a great advantage in terms of both time-saving, applicability, and practicality in comparison with the planimetry technique.
Metrics
References
Ruggieri P. Simple Bone Cyst (Unicameral Bone Cyst). In: Picci P, Manfrini M, Fabbri N, Gambarotti M, Vanel D, (editors). Atlas of Musculoskeletal Tumors and Tumorlike Lesions the Rizzoli Case Archive. Cham: Springer; 2014. pp. 41–44.
Mascard E, Gomez-Brouchet A, Lambot K. Bone cysts: unicameral and aneurysmal bone cyst. Orthop Traumatol Surg Res. 2015;101(1Suppl):119-127.
Biermann JS. Common benign lesions of bone in children and adolescents. J Pediatr Orthop. 2002; 22(2): 268–273.
Rosenblatt J, Koder A. Understanding Unicameral and Aneurysmal Bone Cysts. Pediatr Rev. 2019;40(2):51-59.
Noordin S, Allana S, Umer M, Jamil M, Hilal K, Uddin N. Unicameral bone cysts: Current concepts. Ann Med Surg (Lond). 2018; 34: 43-49.
Acar N, Karakasli A, Karaarslan A, Mas NN, Hapa O. The reliability of Cavalier’s principle of stereological method in determining volumes of enchondromas using the computerized tomography tools. J Orthop Surg (Hong Kong). 2017;25(1):2309499016684503.
Say F, Gölpınar M, Kılınç CY, Şahin B. The estimation of bone cyst volume using the Cavalieri principle on computed tomography images. J Orthop Surg (Hong Kong). 2018;26(2):2309499018772373.
Karaca O, Buyukmert A, Tepe N, Ozcan E, Kus I. Volume estimation of brain ventricles using Cavalieri’s principle and Atlas-based methods in Alzheimer disease: Consistency between methods. J Clin Neurosci. 2020; 78: 333-338.
Ekinci N, Acer N, Akkaya A, Sankur S, Kabadayi T et al. Volumetric evaluation of the relations among the cerebrum, cerebellum and
brain stem in young subjects: a combination of stereology and magnetic resonance imaging. Surg Radiol Anat. 2008;30(6):489-94.
Manios GE, Mazonakis M, Voulgaris C, Karantanas A, Damilakis J. Abdominal fat volume estimation by stereology on CT: a comparison with manual planimetry. Eur Radiol. 2016;26(3):706-13.
Mazonakis M, Damilakis J, Maris T, Prassopoulos P, Gourtsoyiannis N. Comparison of two volumetric techniques for estimating liver volume using magnetic resonance imaging. J Magn Reson Imaging. 2002;15:557–563.
Mazonakis M, Karampekios S, Damilakis J, Voloudaki A, Gourtsoyiannis N. Stereological estimation of total intracranial volume on CT images. Eur Radiol. 2004;14(7):1285-1290.
Bontzos G, Mazonakis M, Papadaki E, Maris TG, Blazaki S, et al. Ex vivo orbital volumetry using stereology and CT imaging: A comparison with manual planimetry. Eur Radiol. 2019;29(3):1365-1374.
Gundersen HJ, Jensen EB. The efficiency of systematic sampling in stereology and its prediction. J Microsc. 1987;147(Pt 3):229-63.
Göbel V, Jürgens H, Etspüler G, Kemperdick H, Jungblut RM, Stienen U, et al. Prognostic significance of tumor volume in localized Ewing’s sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol. 1987;113(2):187-91.
Glowacki M, Ignys-O’Byrne A, Ignys I, Mankowski P, Melzer P. Evaluation of volume and solitary bone cyst remodeling using conventional radiological examination. Skeletal Radiol. 2010;39(3):251-259.
Docquier PL, Paul L, Menten R, Cartiaux O, Francq B, Banse X. Measurement of bone cyst fluid volume using k-means clustering. Magn Reson Imaging. 2009;27(10):1430-9.
Mazonakis M, Stratakis J, Damilakis J. Efficient stereological approaches for the volumetry of a normal or enlarged spleen from MDCT images. Eur Radiol. 2015;25(6):1761-1767.
Acer N, Uğurlu N, Uysal DD, Unur E, Turgut M, Camurdanoğlu M. Comparison of two volumetric techniques for estimating volume of intracerebral ventricles using magnetic resonance imaging: a stereological study. Anat Sci Int. 2010;85(3):131-39.
Acer N, Sahin B, Ucar T, Usanmaz M. Unbiased estimation of the eyeball volume using the Cavalieri principle on computed tomography images. J Craniofac Surg. 2009;20(1):233-7.
Sahin B, Ergur H. Assessment of the optimum section thickness for the estimation of liver volume using magnetic resonance images: a stereological gold-standard study. Eur J Radiol. 2006;57(1):96-101.
Acer N, Sahin B, Baş O, Ertekin T, Usanmaz M. Comparison of three methods for the estimation of total intracranial volume: stereologic, planimetric, and anthropometric approaches. Ann Plast Surg. 2007;58(1):48‐53.
Acer N, Sahin B, Usanmaz M, Tatoğlu H, Irmak Z. Comparison of point counting and planimetry methods for the assessment of cerebellar volume in human using magnetic resonance imaging: a stereological study. Surg Radiol Anat. 2008;30(4):335-9.
Mazonakis M, Damilakis J, Varveris H. Bladder and rectum volume estimations using CT and stereology. Comput Med Imaging Graph. 1998; 22(3):195-201.
Pretell-Mazzini J, Murphy RF, Kushare I, Dormans JP. Unicameral bone cysts: general characteristics and management controversies. J Am Acad Orthop Surg Glob Res Rev. 2014;22(5):295-303.
Mascard E, Gomez-Brouchet A, Lambot K. Bone cysts: unicameral and aneurysmal bone cyst. Orthop Traumatol Surg Res. 015;101(1Suppl):S119-27.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.