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.
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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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Appendix
Appendix
Glossary of terms
- 3D
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Three-dimensional
- DCM
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Deviation color map
- CT
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Computed tomography
- RMS
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Root mean square
- POBS
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Plane of best symmetry
- ASIS
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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