Journal of X-Ray Science and Technology - Volume 27, issue 4

Authors: Yin, Nan | Shen, Cong | Dong, Fuwen | Wang, Jun | Guo, Youmin | Bai, Lu

Article Type: Research Article

Abstract: OBJECTIVE: Identification of interstitial lung disease (ILD) may be difficult in certain cases using pulmonary function tests (PFTs) or subjective radiological analysis. We evaluated the efficacy of quantitative computed tomography (CT) with 3-dimensional (3D) reconstruction for distinguishing ILD patients from healthy controls. MATERIALS AND METHODS: We retrospectively collected chest CT images of 102 ILD patients and 102 healthy matched controls, and measured the following parameters: lung parenchymal volume, emphysema indices low attenuation area LAA910 volume, LAA950 volume, LAA910%, and LAA950%, and mean lung density (MLD) for whole lung, left lung, right lung, and each lobe, respectively. The Mann-Whitney …U test was used to compare quantitative CT parameters between groups. Receiver operating characteristic (ROC) curves, Bayesian stepwise discriminant analysis, and deep neural network analysis were used to test the discriminative performance of quantitative CT parameters. Binary logistic regression was performed to identify ILD markers. RESULTS: Total lung volume was lower in ILD patients than controls, while emphysema and MLD values were higher (P  < 0.001) except LAA910 volume in right middle lobe. LAA910 volume, LAA950 volume, LAA910%, LAA950%, and MLD accurately distinguished ILD patients from healthy controls (AUC >0.5, P  < 0.05), and high MLD was a significant marker for ILD (OR = 1.047, P  < 0.05). CONCLUSIONS: This quantitative CT analysis can effectively identify ILD patients, providing an alternative to subjective image analysis and PFTs. Show more

Keywords: Interstitial lung diseases, computer-aided CT quantification, mean lung density

DOI: 10.3233/XST-180460

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 591-603, 2019

Authors: Lu, Bo | Deng, Heping | Chen, Baicheng | Zhao, Jian

Article Type: Research Article

Abstract: OBJECTIVE: To investigate and evaluate the accuracy of ultrasound (US) imaging for measurement of ischiofemoral space (IFS) compared with magnetic resonance imaging (MRI). METHODS: Twenty-five hips of 16 patients with hip pain and ipsilateral quadratus femoris muscle (QFM) edema were recruited to the IFI group, and 19 hips of 19 patients without hip pain and QFM edema were recruited as the control group. IFS of both groups was measured by US and MRI. The correlations and differences between US and MRI measurements were then assessed. Last, the receiver operating characteristic (ROC) data analysis was performed. RESULTS: …The US results revealed a decreased IFS in IFI hips compared with controls (P  < 0.001), suggesting that US were valuable in identifying IFI. IFS measured by US and MRI showed positive correlations in both the IFI group (r  = 0.409, P  = 0.042) and control group (r  = 0.575, P  = 0.01). There were no statistically significant differences between IFS measured by US and MRI in the control group (P  = 0.657), while IFS measurements in the IFI group performed with US were significantly greater than those with MRI (P  < 0.001). ROC curve analysis revealed that the cutoff value of IFS measured with US was 2.14 cm, with a sensitivity of 92.0% and specificity of 68.4%, while measured by MRI was 1.87 cm, with a sensitivity of 96.0% and specificity of 84.2%. CONCLUSIONS: IFS measurements obtained with US are very similar to those obtained with MRI. Therefore, US provides a low-cost and easy-to-operate alternative imaging modality to measure IFS. Show more

Keywords: Ishiofemoral, impingement, ultrasound, magnetic resonance images

DOI: 10.3233/XST-180482

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 605-614, 2019

Authors: Zhao, Xinzhuo | Qi, Shouliang | Zhang, Baihua | Ma, He | Qian, Wei | Yao, Yudong | Sun, Jianjun

Article Type: Research Article

Abstract: BACKGROUND: Deep learning has made spectacular achievements in analysing natural images, but it faces challenges for medical applications partly due to inadequate images. OBJECTIVE: Aiming to classify malignant and benign pulmonary nodules using CT images, we explore different strategies to utilize the state-of-the-art deep convolutional neural networks (CNN). METHODS: Experiments are conducted using the Lung Image Database Consortium image collection (LIDC-IDRI), which is a public database containing 1018 cases. Three strategies are implemented including to 1) modify some state-of-the-art CNN architectures, 2) integrate different CNNs and 3) adopt transfer learning. Totally, 11 deep CNN models are …compared using the same dataset. RESULTS: Study demonstrates that, for the model modification scheme, a concise CifarNet performs better than the other modified CNNs with more complex architectures, achieving an area under ROC curve of AUC = 0.90. Integrated CNN models do not significantly improve the classification performance, but the model complexity is reduced. Transfer learning outperforms the other two schemes and ResNet with fine-tuning leads to the best performance with an AUC = 0.94, as well as the sensitivity of 91% and an overall accuracy of 88%. CONCLUSIONS: Model modification, model integration, and transfer learning can play important roles to identify and generate optimal deep CNN models in classifying pulmonary nodules based on CT images efficiently. Transfer learning is preferred when applying deep learning to medical imaging applications. Show more

Keywords: Convolutional neural networks, deep learning, lung cancer, nodule classification, transfer learning

DOI: 10.3233/XST-180490

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 615-629, 2019

Authors: Isa, I.N.C | Rahmat, S.M.S. | Dom, S.M. | Kayun, Z. | Karim, M.K.A

Article Type: Research Article

Abstract:  There are several factors that may contribute to the increase in radiation dose of CT including the use of unoptimized protocols and improper scanning technique. In this study, we aim to determine significant impact on radiation dose as a result of mis-centering during CT head examination. The scanning was performed by using Toshiba Aquilion 64 slices multi-detector CT (MDCT) scanner and dose were measured by using calibrated ionization chamber. Two scanning protocols of routine CT head; 120 kVp/ 180 mAs and 100 kVp/ 142 mAs were used represent standard and low dose, respectively. As reference measurement, the dose was first …measured on standard cylindrical polymethyl methacrylate (PMMA) phantom that positioned at 104 cm from the floor (reference isocenter). The positions then were varied to simulate mis-centering by 5 cm from isocenter, superiorly and inferiorly at 109 cm, 114 cm, 119 cm, 124 cm and 99 cm, 94 cm, 89 cm, 84 cm, respectively. Scanning parameter and dose information from the console were recorded for the radiation effective dose (E) measurement. The highest mean CTDIvol value for MCS and MCI were 105.06 mGy (at +10 cm) and 105.51 mGy (at – 10 cm), respectively which differed significantly (p  < 0.05) as compared to the isocenter. There were large significant different (p  < 0.05) of mean Dose Length Product (DLP) recorded between isocenter to the MCS (85.8 mGy.cm) and MCI (93.1 mGy.cm). As the low dose protocol implemented, the volume CTDI (CTDIvol ) were significantly increase (p  < 0.05) for MCS (at +10 cm) and MCI (at – 10 cm) when compared to the isocenter. The phantom study revealed a noticeable different in radiation dose between isocenter and experimental groups due to degradation of the bowtie filter performance. It is anticipated that these noteworthy findings may emphasize the importance of accurate patient centering at the isocenter of CT gantry, so that CT optimization practice can be achieved. Show more

Keywords: Mis-centering position, CT head, radiation dose, CT dose index

DOI: 10.3233/XST-190491

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 631-639, 2019

Authors: Li, Yan | Dai, Yongliang | Duan, Xiaoyi | Zhang, Weishan | Guo, Youmin | Wang, Jiansheng

Article Type: Research Article

Abstract: BACKGROUND Quantitative measurement of bronchial morphological changes in pulmonary contusion with acute respiratory distress syndrome (ARDS) has important clinical implications. OBJECTIVE To investigate the morphological changes in bronchus before and after treatment in patients with pulmonary contusion combined with ARDS using an automated bronchial three-dimensional computed tomography (3D-CT) measurement method. METHODS The study involves a dataset of CT images of 62 patients diagnosed with pulmonary contusion combined with ARDS. The volume of pulmonary contusion lesions was calculated as a percentage of the total lung volume using the automated 3D-CT method. The bronchial luminal cross-sectional area, wall …cross-sectional area, the maximum and average wall thickness, the maximum and average luminal densities, intraluminal and extraluminal diameters, and circumferences of generations 2–4 bronchi before and after treatment were measured. Furthermore, the corresponding differences were analyzed statistically. RESULTS The luminal cross-sectional area, wall cross-sectional area, intraluminal and extraluminal diameters, and circumferences of generations 2–4 bronchi were all significantly lower before treatment than after treatment (P  < 0.05). However, the maximum and average wall thicknesses were both significantly higher before treatment than after treatment (P  < 0.05). No significant difference was found in the maximum and average luminal densities before and after treatment (P  > 0.05). The percentage of the pulmonary contusion lesion volume to the total lung volume correlated positively with the thoracic trauma severity score (r  = 0.74, P  < 0.01). CONCLUSIONS Quantitative bronchial CT image analysis enables to detect and assess bronchial morphological changes in patients diagnosed with pulmonary contusion combined with ARDS. Show more

Keywords: CT quantification for pulmonary contusion, acute respiratory distress syndrome (ARDS), pulmonary contusion combined with ARDS, Bronchial morphological changes in pulmonary contusion

DOI: 10.3233/XST-180486

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 641-654, 2019

Authors: Gul, Attia | Farrukh, Salman | Kakakhel, M. Basim | Ilyas, Nasir | Naveed, Muhammad | Haseeb, Abdul | Mirza, Sikander M.

Article Type: Research Article

Abstract:  The objective of this study is to analyze small field photon beams acquired with commonly available detectors. Beam profiles of 6 MV photons from the Siemens Primus Linear Accelerator were measured with a micro ion chamber (IC CC01, IBA) and linear diode array (LDA-99SC, IBA). Data was acquired using a water phantom for small fields (0.5×0.5 cm2 to 4×4 cm2 ) at depth of maximum dose, 5 cm and 10 cm. Profiles were also generated with EGSnrc Monte Carlo code. Measured and simulated profiles were compared in terms of percentage difference of the area under the simulated and measured profiles (PD …), ratio of the measured to simulated dose at the point of maximum deviation within the central region of profile (R ), full width half maximum (FWHM ) and penumbra. For field sizes ≥1×1 cm2 , the maximum PD is 3.17 % and 2.87 % for IC and LDA respectively, whereas R is in the range of 0.95–1.05 for IC and 0.99–1.05 for LDA. LDA measured FWHM and penumbra are also in better agreement with the simulated results. This study demonstrated that LDA can be used for acquisition of beam profiles for field size as low as 1×1 cm2 . Show more

Keywords: Small field, dosimetry, beam profiles, monte carlo, 6 MV X-ray

DOI: 10.3233/XST-190493

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 655-664, 2019

Authors: Chen, Ming | Wang, Dan | Cai, Ning | Xia, Dimeng | Zou, Jing | Yu, Hengyong

Article Type: Research Article

Abstract: Multi-source computed tomography (CT) imaging has unique technical advantages not only for dynamic objects, but also for large-size objects by designing its imaging scan mode. Using the triple-source fan-beam imaging scan mode under three circular trajectories with two different radii, we in this study developed and analyzed theoretically several exact reconstruction algorithms in terms of full-scan and short-scan for three sets of truncated projection data. This triple-source scan configuration in different radii cases is easier to be simulated by a single-source scan configuration in an industrial CT system. The proposed algorithms are based on the idea of filtering-back-projection (FBP) algorithm, …and can reconstruct the large-size objects under the same CT devices. The developed algorithms avoid data rebinning and can provide exact and fast image reconstruction. The results of the numerical simulation based data analysis verified that new algorithms were accurate and effective. Show more

Keywords: CT imaging, scanning mode, reconstruction algorithm, FBP algorithm, triple-source CT

DOI: 10.3233/XST-190494

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 665-684, 2019

Authors: Tang, Xiaoling | Chen, Ke | Han, Lin | Peng, Yulan | Li, Cheng | Lin, Jiangli

Article Type: Research Article

Abstract: BACKGROUND: Automatic detection of tumor in breast ultrasound (BUS) images is important for the subsequent image processing and has been researched for decades. However, there still lacks a robust method due to poor quality of BUS images. OBJECTIVE: To propose and test a salient object detection method for BUS images. METHODS: BUS image is preprocessed by an adaptively selective replacement and speckle reducing anisotropic diffusion (SRAD) algorithm. Then, the preprocessed image is segmented into super pixels by a simple linear iterative clustering (SLIC) algorithm to form a graph model, and the saliency of the nodes in …the graph is calculated by using the absorbed time of absorbing Markov chain (AMC). Finally, the initial saliency map is optimized by the recurrent time of ergodic Markov chain (EMC) and a distance weighting formula. RESULTS: Results of the proposed method were compared both qualitatively and quantitatively with two saliency detection models. It was observed that the proposed method outperformed the comparison models and yielded the highest Accuracy value (97.49% vs. 86.63% and 90.33%) using a dataset of 1000 BUS images. CONCLUSIONS: After the adaptively selective replacement, AMC can effectively distinguish tumors from background by random walks. Show more

Keywords: Ultrasound image, breast tumor, automatic detection, absorbing Markov chain, saliency model, adaptive selective replacement

DOI: 10.3233/XST-190533

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 685-701, 2019

Authors: Pan, Jing-Hui | Yu, Dong-Dong | Song, Qi-Bin | Ruan, Chang-Li | Fu, Jing-Guo | Wu, Bing | Ma, Guang-Dong | Wang, Lu-Zhou | Lei, Yu | Han, Guang

Article Type: Research Article

Abstract: OBJECTIVE: The skin marking method (SMM) and bow-form-ruler marking method (BFRM) are two commonly used patient marking methods in mainland China. This study aims to evaluate SMM and BFRM by comparing the inter-fraction setup errors from using these two methods together with vacuum cushion immobilization in patients underwent radiotherapy for different treatment sites. MATERIALS AND METHODS: Eighteen patients diagnosed with pelvic, abdominal and thoracic malignant tumors (with 6 patients per treatment site) were enrolled in this prospective study. All patients were immobilized with vacuum cushion. Each patient was marked by both SMM and BFRM before computed tomography (CT) …simulation. Target location was verified by cone beam CT images with displacements assessed prior to each sampled treatment session. The localization errors in three translational and three rotational directions were recorded and analyzed. RESULTS: Images from 108 fractions in 18 patients produced 324 translational and 324 rotational comparisons for SMM and BFRM. The setup errors of all treatment sites showed no difference in two marking methods in any directions (p  > 0.05). In subgroups of treatment site analysis, SMM significantly lessened the lateral and yaw setup errors compared to BFRM in the pelvic sites (0.39±1.85 mm vs –1.28±1.13 mm, p  < 0.01 and –0.19±0.59° vs –0.61±0.59°, p  < 0.05). However, in the abdominal subgroup, BFRM was superior to SMM for reduced vertical errors (0.17±2.73 mm vs 2.28±3.16 mm, p  < 0.05). For the underweight or obese patients (with Body Mass Index, BMI < 18.5 or BMI≥24), SMM resulted in less yaw errors compared to BFRM (–0.05±0.38° vs –0.43±0.48°, p  < 0.05). No significant difference between SMM and BFRM in setup errors of normal weighted patients (18.5≤BMI < 24) was observed for all three studied treatment sites. CONCLUSIONS: This study shows no significant difference in patient setup errors for various treatment sites between SMM and BFRM in general. SMM may be suitable for the pelvic tumor and patients with BMI < 18.5 or BMI≥24, while BFRM is recommended for the abdominal tumor sites. Show more

Keywords: Marking method, tumors, vacuum cushion, setup errors, cone beam computed tomography

DOI: 10.3233/XST-180467

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 703-714, 2019

Authors: Kuo, Chia-Chun | Chuang, Ho-Chiao | Yu, Hsiao-Wei | Huang, Jeng-Wei | Tien, Der-Chi | Jeng, Shiu-Chen | Chiou, Jeng-Fong

Article Type: Research Article

Abstract: PURPOSE: This study evaluates the feasibility of our previously developed Respiratory Motion Compensation System (RMCS) combined with the Phase Lead Compensator (PLC) to eliminate system delays during the compensation of respiration-induced tumor motion. The study objective is to improve the compensation effect of RMCS and the efficay of radiation therapy to reduce its side effects to the patients. MATERIAL AND METHODS: In this study, LabVIEW was used to develop the proposed software for calculating real-time adaptive control parameters, combined with PLC and RMCS for the compensation of total system delay time. Experiments of respiratory motion compensation were performed …using 6 pre-recorded human respiration patterns and 7 sets of different sine waves. During the experiments, a respiratory simulation device, Respiratory Motion Simulation System (RMSS), was placed on the RMCS, and the detected target motion signals by the Ultrasound Image Tracking Algorithm (UITA) were transmitted to the RMCS, and the compensation of respiration induced motion was started. Finally, the tracking error of the system is obtained by comparing the encoder signals bwtween RMSS and RMCS. The compensation efficacy is verified by the root mean squared error (RMSE) and the system compensation rate (CR). RESULTS: The experimental results show that the calcuated CR with the simulated respiration patterns is between 42.85% ∼3.53% and 33.76% ∼2.62% in the Right-Left (RL) and Superior-Inferior (SI), respectively, after the RMCS compensation of using the adaptive control parameters in PLC. For the compensation results of human respiration patterns, the CR is between 58.95% ∼8.56% and 62.87% ∼9.05% in RL and SI, respectively. CONCLUSIONS: During the respiratory motion compensation, the influence of the delay time of the entire system (RMCS+RMSS+UITA) on the compensation effect was improved by adding an adaptive control PLC, which reduces compensation error and helps improve efficacy of radiation therapy. Show more

Keywords: Real-time adaptive control parameters, respiratory motion compensation, ultrasound image tracking, organ motion correction

DOI: 10.3233/XST-190503

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 715-729, 2019

Authors: Kong, Que | Lu, Fengqi | Gao, Yu | Qiao, Peng | Shao, Min | Xie, Min

Article Type: Research Article

Abstract: BACKGROUND: Computed tomography (CT) is considered a standard modality for imaging the paranasal sinus (PS), but increasingly radiation dose is of concern, especially in children. Objective: This study aims to investigate the feasibility of using a 320-detector CT scanner with a 16 cm wide-detector combined with iterative reconstruction (IR) algorithm to further reduce radiation dose when scanning the PS. METHODS: A total of 90 children who underwent CT of the PS were randomly allocated into three groups namely, (1) the experimental group using low-dose wide-detector scan (n = 30, 9±4 years); (2) low-dose helical group …(n = 30, 9±4 years); and (3) pediatric conventional group (n = 30, 8±4 years). Statistical software SPSS 19.0 was used for one-way ANOVA analysis of the general data (age, BMI), image quality, and radiation dose. Multiple comparisons of data without homogeneity of variance were analyzed by Bonferroni test and Tamhane’s test. RESULTS: All patients underwent successful CT examinations. No significant differences in the general data and image quality evaluation were detected between three groups (all P values > 0.05). CTDIvol and DLP were 2.87 mGy and 32.58 mGy·cm in the experimental group, 4.92 mGy and 70.84 mGy·cm in the low-dose helical group, and 9.95 mGy and 131.83 mGy·cm in the conventional group, respectively, which were significantly different among these three groups as indicated by multiple comparisons (all P values < 0.05). In the experimental group, the effective radiation dose was 0.07 mSv, which was reduced by 76% and 56% comparing to the conventional group and the low-dose helical group, respectively. CONCLUSIONS: The 320-detector CT scanner equipped with the wide-detector combined with IR can further reduce radiation dose, while maintaining good image quality comparing to the low-dose helical or pediatric modes. Show more

Keywords: 320-detector computed tomography (CT), wide-detector, iterative reconstruction, pediatric, paranasal sinus, low dose

DOI: 10.3233/XST-180487

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 731-738, 2019

Authors: Li, Kuai | Sang, Ziru | Zhang, Xuezhu | Zhang, Mengxi | Jiang, Changhui | Zhang, Qiyang | Ge, Yongshuai | Liang, Dong | Yang, Yongfeng | Liu, Xin | Zheng, Hairong | Hu, Zhanli

Article Type: Research Article

Abstract: X-ray radiation is harmful to human health. Thus, obtaining a better reconstructed image with few projection view constraints is a major challenge in the computed tomography (CT) field to reduce radiation dose. In this study, we proposed and tested a new algorithm that combines penalized weighted least-squares using total generalized variation (PWLS-TGV) and dictionary learning (DL), named PWLS-TGV-DL to address this challenge. We first presented and tested this new algorithm and evaluated it through both data simulation and physical experiments. We then analyzed experimental data in terms of image qualitative and quantitative measures, such as the structural similarity index (SSIM) …and the root mean square error (RMSE). The experiments and data analysis indicated that applying the new algorithm to CT data recovered images more efficiently and yielded better results than the traditional CT image reconstruction approaches. Show more

Keywords: Dictionary learning, total generalized variation, regularization, CT image reconstruction, few-view

DOI: 10.3233/XST-190506

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 739-753, 2019

Authors: Tao, Wei | Xue, Boxin | Sun, Chuanyang | Yang, Dongrong | Zhang, Yuanyuan | Shan, Yuxi

Article Type: Research Article

Abstract: OBJECTIVE: To evaluate safety, efficacy, and long-term outcomes of photoselective vaporization of prostate using 120-W HPS GreenLight KTP laser and compare the results with those obtained with 2-micrometer continuous-wave (2 um CW) laser for treatment of patients with benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: One group of 216 patients diagnosed with BPH underwent 120-W KTP laser vaporization of the prostate, while another group of 198 BPH patients underwent 2 um CW laser vaporization. The relevant pre-, peri-, and post-operative parameters were compared between the two therapy groups. Functional results in terms of improvement of International Prostate Symptom Score (IPSS), …maximum flow rate (Qmax), and post-void residual (PVR) urine were assessed at 3, 6, 12, and 24 months. RESULTS: BPH was successfully treated with 120-W HPS KTP laser and 2 um CW laser in all patients. There were no significant difference between two patient groups in the baseline characteristics (such as PSA, IPSS, QoL, and Qmax). No major complications occurred intraoperatively (capsule perforation and TUR syndrome) or postoperatively (electric unbalance), and no blood transfusions were required in both groups. Average catheterization time was 1.9±1.3 days for the 120-W PVP and 2.2±1.9 days for the 2 um CW laser treatment. In addition, the hospitalization times were 3.8±1.2days (120-W PVP) and 4.8±1.5 days (2 um CW laser), respectively. The incidence of dysuria and urge incontinence was higher in the 2 um CW laser group (35/198, 24/198) than in the 120 W PVP group (15/216, 10/216). Dramatic improvement was observed in Qmax, IPSS, Qol, and PVR as compared with the respective pre-operative values. The degree of improvement during the follow-up period was comparable in both groups. No significant differences were observed in terms of re-operation rates, bladder neck stricture, and urethral stricture. CONCLUSIONS: Both 120-W HPS laser and 2 um CW laser vaporization present effective treatment options in patients with BPH, but 120-W PVP provides safer therapy with less post-operative complications within the 2-year follow-up period. Show more

Keywords: Benign prostatic hyperplasia (BPH) treatment, laser surgery, vaporization outcomes

DOI: 10.3233/XST-190507

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 755-764, 2019

Authors: Li, Shuang | Khan, Alick | Chen, Jing | Tan, Jun

Article Type: Research Article

Abstract: We report the case of a 19-year old man who presented to our institution with a history of pain of one week in the ulnar side of the left wrist and continuous pressing sensation in the palm. According to patient, there was no history of acute hand trauma. The conventional roentgenograms did not show the fracture and computerized tomographic (CT) scanning demonstrated a complete fracture of the hook of the hamate. The patient was given a surgical intervention and the hamate bone was reduced through a palmar skin incision. After surgery, the operated hand was immobilized in a wrist brace …and the patient was put on a rehabilitation protocol. At the last follow-up, the patient was able to return to normal living activities without any symptoms. We reviewed the latest articles of the past 18 years and compared the research studies related to the diagnosis and treatment of the hamate hook fracture. Our conclusion is that CT scan is the most effective diagnostic tool for detecting the hamate hook fracture. Three-dimensionally (3D) reconstructed images based of CT could provide more accurate and insight illustration for better evaluation in surgical planning. Show more

Keywords: Hamate hook fracture, open reduction and internal fixation, computed tomography, 3D reconstruction

DOI: 10.3233/XST-190497

Citation: Journal of X-Ray Science and Technology, vol. 27, no. 4, pp. 765-772, 2019