University of Twente Student Theses


Automatic motion analysis of the wrist using 4DCT Development of an automatic tool for the diagnosis of scapholunate ligament injuries

Haenen, Maranda (2023) Automatic motion analysis of the wrist using 4DCT Development of an automatic tool for the diagnosis of scapholunate ligament injuries.

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Abstract:Objective: The scapho-lunate-interosseous-ligament (SLIL), a C-shape ligament connecting the scaphoid and the lunate, is the primary stabiliser of the wrist and is most commonly injured. A SLIL tear disturbs wrist kinematics and causes carpal instability. Early-stage diagnosis is essential for early treatment, preventing irreversible damage and improving prognosis. Arthroscopy, the current golden standard for diagnosing SLIL injury, is invasive, associated with complications and does not allow for kinematic assessment. Four-Dimensional Computed Tomography (4DCT) is a promising new imaging modality allowing for non-invasive wrist kinematic quantification. Due to the large amount of data, analysis of 4DCT scans should be automatic. Therefore, this thesis aims to further develop the algorithm for automated motion analysis of the wrist in 4DCT scans. Methods: During scan acquisition, the patient was asked to perform two movements in seven seconds; radial-ulnar-deviation (RUD) flexion-extension (FE). One 4DCT scan consists of one static scan of the wrist and 144 dynamic scans. The automatic motion analysis consists of segmentation, registration and extraction of motion parameters. These parameters are the scapholunate angle (SLA, capitolunate angle (CLA), radiolunate angle (RLA), radioscaphoid angle (RSA) and radiocapitate angle (RCA). The robustness and reliability of the algorithms to extract these carpal angles were assessed. Motion analysis was performed on 45 healthy wrists to establish reference values. Finally, motion analysis was performed on both wrists of one patient with a confirmed SLIL injury to assess the feasibility is this approach in diagnosing SLIL injury. Results: In healthy wrists, a slight increase in carpal angles (RLA, RSA, SLA and CLA) was seen whilst the wrist was moving from extension to flexion. An increase was seen in RLA, RSA and RSA and a decrease in CLA whilst the wrist was moving from ulnar to radial deviation. The analysis of one SLIL-injured wrist showed that the SLA and CLA during FE and RUD, RSA during RUD and RLA during FE are best used to discriminate injured from uninjured wrists in patients with a total SLIL rupture. Conclusion: In this thesis, the algorithm for automatic motion analysis of the wrist using 4DCT was further developed. The algorithm was successfully performed on healthy wrists and one SLIL-injured wrist. This showed the ability of the algorithm to differentiate motion parameters between injured and uninjured wrists, indicating the potential of 4DCT scans for diagnosing SLIL injury. Further studies should aim to analyse more 4DCT data obtained from SLIL-injured wrists.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
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