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Quantitative analysis of regional specific pelvic symmetry

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Abstract

Understanding bilateral pelvic symmetry can be useful for analyzing complex pelvis anatomy and simplifying difficult procedures for pelvic fractures. This paper aims to quantify the degree of regional pelvic symmetry using computer-based methods. CT scans of 30 intact pelvises were digitized into 3D models and regions were defined: the ilium, acetabulum, pubis, and ischium. The right hemipelvis was aligned with the left, and deviations between the two models were quantified using method 1 (global registration) and method 2 (local registration). Symmetry was evaluated using the root mean square (RMS) of the deviations and the percentage of points within preset thresholds of ± 2 mm and ± 1 mm. The results showed that > 86% of points are within the ± 2 mm deviation threshold and average RMS are < 1.33 mm. For all regions, method 2 showed lower deviations than method 1. The pubis and ischium regions showed a large difference in symmetry between the two methods indicating high local symmetry, but a degree of global asymmetry. Conversely, the acetabular and iliac regions showed similar levels of symmetry with the two methods. When evaluated locally, the pelvic regions can be considered highly symmetric; the acetabulum is highly symmetric globally as well. These findings can be used in future studies to assess the feasibility of patient-specific implants using the mirrored contralateral hemipelvis as a template for unilateral pelvic fracture fixation.

Graphical abstract

The left image shows the “cut planes” used to define four pelvic regions: the ilium, acetabulum, pubis, and ischium. The right image shows a deviation color map (DCM) used to quantify bilateral pelvic symmetry. The scale and color illustrate the degree of deviation of the left hemipelvis with the right hemipelvis with the units in millimeters (mm).

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Acknowledgments

The authors would like to thank Irina Ilic, Sarah McClelland, and Samantha Polege for their assistance in digitization of pelvic models.

Funding

This work was funded by the Natural Sciences and Engineering Research Council of Canada (NSERC).

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Authors and Affiliations

  1. Department of Civil and Environmental Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, T6G 2R3, Canada

    David Xinzheyang Li

  2. Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB, T6G 2R3, Canada

    Maha S. Ead, Kajsa K. Duke & Lindsey Westover

  3. Department of Radiology & Diagnostic Imaging, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2R3, Canada

    Jacob L. Jaremko

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  1. David Xinzheyang Li
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  2. Maha S. Ead
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  4. Jacob L. Jaremko
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  5. Lindsey Westover
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Correspondence to David Xinzheyang Li.

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Ethics approval and a waiver of consent were obtained from the Health Research Ethics Board at the University of Alberta.

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Appendix

Appendix

Fig. 10
figure 10

DCM of the acetabular region for subject S22 (outliers with higher than average difference in deviation parameter between methods 1 and 2). (a) Method 1—global registration; (b) method 2—local registration. The color scale represents the deviation (mm) between the two models

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Glossary of terms

3D

Three-dimensional

DCM

Deviation color map

CT

Computed tomography

RMS

Root mean square

POBS

Plane of best symmetry

ASIS

Anterior superior iliac spine

PSIS

Posterior superior iliac spine

AIIS

Anterior inferior iliac spine

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Li, D.X., Ead, M.S., Duke, K.K. et al. Quantitative analysis of regional specific pelvic symmetry. Med Biol Eng Comput 59, 369–381 (2021). https://doi.org/10.1007/s11517-020-02296-5

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  • DOI: https://doi.org/10.1007/s11517-020-02296-5

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