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The Need for a Standardized Acquisition Protocol for Whole Leg Radiography

Nguyen, Huu Chien (2019) The Need for a Standardized Acquisition Protocol for Whole Leg Radiography.

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Abstract:The purpose of this project is to find the effect of knee flexion, leg rotation and position of the X-ray source on the measured hip knee ankle angle (HKAA). Also, goniometric measurements are performed on the human leg regarding the angular relations between the feet and the knee. These results are used to create a standard whole leg radiograph (WLR) acquisition protocol in favour of the reproducibility. An in vitro experiment was designed using sawbones of the whole leg and foot, which were fixated with an Ilizarov frameset in different knee flexion angles and HKAA’s. This model was placed on a rotary table, which induced leg rotation accurate to the degree. The X-ray source position was varied between three different heights when making the WLR’s. Geometrical measurements of the lower limb were performed on 67 CT scans. Angles between the Akagi line and the transmalleolar line, the 1st metatarsal line and the 5th metatarsal line were measured. The HKAA is underestimated with approximately 1 degree per 20 degrees of external leg rotation when the leg is in full extension (p = 0.000). However, when 5 degrees of flexion is added, the HKAA is overestimated with 0.8 degree per 20 degrees of external rotation (p = 0.000). When the leg is in 15 degrees flexion, the HKAA is overestimated with 4 degrees per 20 degrees of external rotation (p = 0.000). Leg rotation alone (P = 0.001) shows a significant effect on the measured HKAA however, flexion alone does not (P = 0.348). The height of the X-ray beam source does not affect the measured HKAA. The geometrical measurements on the CT scans were conducted on 134 legs and resulted in the mean angles of 25.69° between the Akagi line and the transmalleolar line, -1.17° between the Akagi line and the 1st metatarsal line and 16.06° between the Akagi line and the 5th metatarsal line. In conclusion, with this project aimed on researching different possible affecters of the measured HKAA on a WLR. On top of that geometrical measurements were performed on human legs using CT scans and a feasibility research was conducted in the radiography room among the X-ray technicians. The results were used to design a WLR acquisition protocol with the aim on standardized radiographs. This protocol is implemented and steps are taken for future research studying the reproducibility of the protocol.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/79783
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