Improving the quantitative classification of Erlenmeyer flask deformities
Authors
Kaggie, Joshua D.
D’Amore, Simona
Cox, Timothy M.
Deegan, Patrick
MacKay, James W.
McDonald, Scott
Publication Date
2020-07-30Journal Title
Skeletal Radiology
ISSN
0364-2348
Publisher
Springer Berlin Heidelberg
Volume
50
Issue
2
Pages
361-369
Language
en
Type
Article
This Version
VoR
Metadata
Show full item recordCitation
Adusumilli, G., Kaggie, J. D., D’Amore, S., Cox, T. M., Deegan, P., MacKay, J. W., McDonald, S., & et al. (2020). Improving the quantitative classification of Erlenmeyer flask deformities. Skeletal Radiology, 50 (2), 361-369. https://doi.org/10.1007/s00256-020-03561-2
Abstract
Abstract: The Erlenmeyer flask deformity is a common skeletal modeling deformity, but current classification systems are binary and may restrict its utility as a predictor of associated skeletal conditions. A quantifiable 3-point system of severity classification could improve its predictive potential in disease. Ratios were derived from volumes of regions of interests drawn in 50 Gaucher’s disease patients. ROIs were drawn from the distal physis to 2 cm proximal, 2 cm to 4 cm, and 4 cm to 6 cm. Width was also measured at each of these boundaries. Two readers rated these 100 femurs using a 3-point scale of severity classification. Weighted kappa indicated reliability and one-way analysis of variance characterized ratio differences across the severity scale. Accuracy analyses allowed determination of clinical cutoffs for each ratio. Pearson’s correlations assessed the associations of volume and width with a shape-based concavity metric of the femur. The volume ratio incorporating the metaphyseal region from 0 to 2 cm and the diametaphyseal region at 4–6 cm was most accurate at distinguishing femurs on the 3-point scale. Receiver operating characteristic curves for this ratio indicated areas of 0.95 to distinguish normal and mild femurs and 0.93 to distinguish mild and severe femurs. Volume was moderately associated with the degree of femur concavity. The proposed volume ratio method is an objective, proficient method at distinguishing severities of the Erlenmeyer flask deformity with the potential for automation. This may have application across diseases associated with the deformity and deficient osteoclast-mediated modeling of growing bone.
Keywords
Scientific Article, MRI, Shape analysis, Erlenmeyer flask deformity, Surface area, Sphericity, Distal femur, Clinical cutoffs
Sponsorship
Addenbrooke's Charitable Trust, Cambridge University Hospitals (MR/K015338/1)
Identifiers
s00256-020-03561-2, 3561
External DOI: https://doi.org/10.1007/s00256-020-03561-2
This record's URL: https://www.repository.cam.ac.uk/handle/1810/315406
Rights
Licence:
http://creativecommons.org/licenses/by/4.0/