Clinical Applications to Orthopaedics by New X-ray Technology

Product catalog summary

Introduction
This report, presented at the 83rd Annual Meeting of the Japanese Orthopaedic Association, explores the clinical applications of new X-ray technologies in orthopaedics, focusing on Shimadzu's advancements in tomosynthesis, slot radiography, and dual energy subtraction using direct conversion flat panel detectors (FPD).

Flat Panel Detectors (FPD)
FPDs provide high-quality, distortion-free images with a large field of view. They utilize direct conversion methods for sharper images and superior resolution compared to indirect conversion detectors. The Shimadzu SONIALVISION safire enhances image clarity and reduces metal artifacts through its direct-conversion FPD.

Tomosynthesis
Tomosynthesis offers high-resolution images on arbitrary parallel cross-sections, minimizing metal artifacts and allowing imaging in various postures. It is particularly beneficial for observing bone structures and detecting bone erosion in conditions like rheumatoid arthritis. Although it requires approximately twice the exposure dose of plain radiography, it offers significant advantages in image clarity and flexibility.

Slot Radiography
This technique employs slot-shaped X-rays for seamless long-view imaging, such as the entire spine. It supports imaging in both supine and standing positions with minimal distortion, allowing accurate measurements. The X-ray dose is significantly lower than conventional radiography.

Dual Energy Subtraction (D.E.)
D.E. involves imaging at different voltages to separate bone and soft tissue images, enhancing the visibility of structures like lung nodules. In orthopaedics, it aids in evaluating artificial joints by clearly showing polyethylene surfaces that are indistinct in conventional images.

Clinical Applications and Case Studies
Tomosynthesis is effective in evaluating bone union and minimizing metal artifacts in post-surgical assessments. It provides clear images for conditions like osteosarcoma and rheumatoid arthritis, facilitating better diagnosis and treatment planning.

Conclusion
The report underscores the utility and feasibility of tomosynthesis, slot radiography, and dual energy subtraction in orthopaedics. These technologies offer improved imaging capabilities, reduced artifacts, and enhanced diagnostic accuracy, promising further advancements in the field.

Tomosynthesis in Orthopaedics
Tomosynthesis provides high-resolution images similar to CT scans but with less radiation exposure. It is particularly useful for evaluating femur osteotomy, assessing bone ingrowth on implants, identifying necrotic lesions in avascular necrosis, and detecting bone destruction in rheumatoid arthritis.

Slot Radiography
Slot radiography allows for seamless imaging of the spine or lower extremities, primarily used for evaluating limb alignment post-surgery and assessing scoliosis with lower distortion compared to conventional images.

Conclusions
Tomosynthesis is effective for routine orthopaedic care due to its detailed observations of bone structures and minimal interference from metal artifacts. Its low radiation dose and flexibility in patient positioning make it a valuable tool for orthopaedic surgeons. Slot radiography offers rapid and accurate imaging for evaluating limb alignment and spinal conditions.

About the Author
The document includes brief biographies of professionals involved in the development and application of these technologies, highlighting their academic and professional backgrounds in orthopaedic surgery and medical imaging.

Catalog excerpts

Clinical Applications to Orthopaedics by New X-ray Technology-1

Evening Seminar at the 83rd Annual Meeting of the Japanese Orthopaedic Association Clinical Applications Slot Radiography and Dual Energy Subtraction — Imaging technique and clinical application to orthopaedics Takatoshi AOKI Associate Professor, Department of Radiology, University of Occupational and Environmental Health Utility of Tomosynthesis and Slot Radiography Hiroyuki TSUCHIYA Professor and Chairman, Department of Restorative Medicine of Neuro-Musculoskeletal System (Orthopaedic Surgery) Kanazawa University Graduate School of Medical Science Shimadzu Corporation

Open the catalog to page 1

Clinical Applications to Orthopaedics by New X-ray Technology-2

Special Report Clinical Applications to Orthopaedics by New X-ray Technology At the 83 rd Annual Meeting of the Japanese Orthopaedic Association held between Thursday, 27 May, and Sunday, 30 May, Shimadzu co-hosted Evening Seminar on the theme of“Clinical Applications to Orthopaedics by New X-ray Technology”on 29 May. The Seminar was chaired by Akinori SAKAI, M.D., Associate Professor, Department of Orthopaedic Surgery, University of Occupational and Environmental Health. Lectures were given by Takatoshi AOKI, M.D., Associate Professor, Department of Radiology, University of Occupational and...

Open the catalog to page 2

Clinical Applications to Orthopaedics by New X-ray Technology-3

Special Report Clinical Applications to Orthopaedics by New X-ray Technology Based on image reconstruction for cone-beam CT, with correction for differences between rotation and parallel motion, and three-dimensional filtered back projection to remedy artifacts due to angular restrictions. /Parallel-plane scanning's Tomosynthesis data Tomosynthesis is a technology that obtains images on arbitrary parallel cross-sections through image recon- struction of multiple projected images taken by a single exposure. The image reconstruction is based on image reconstruction for cone-beam CT, with additional...

Open the catalog to page 3

Clinical Applications to Orthopaedics by New X-ray Technology-4

Special Report Clinical Applications to Orthopaedics by New X-ray Technology 2006 Guideline for Medical Exposure (Plain Radiography) (A) Head (frontal) Tomosynthesis Tomosynthesis Entrance Radiography B/A Surface Dose Conditions (B) Rev. 3 . 80 Cervical vertebra (lateral) Knee joint Utility of Tomosynthesis and Slot Radiography to Orthopaedics Fig. 6　Comparison of 2006 Guideline for Medical Exposure (Plain Radiography) and Tomosynthesis Entrance Surface Dose Professor and Chairman, Department of Restorative Medicine of Neuro-Musculoskeletal System (Orthopaedic Surgery), Kanazawa University Graduate...

Open the catalog to page 4

Clinical Applications to Orthopaedics by New X-ray Technology-5

Special Report Clinical Applications to Orthopaedics by New X-ray Technology Plain radiography Tomosynthesis Plain radiography Permits easy evaluation of the bone union and metal plate by 2D image Focusing on the bone union provides clear observations (Useful for evaluation of callus formation) Data analysis provides 3-D represen- tation but the image close to metal implant is easily affected by metal Fig. 3 Images of Proximal Femur Checking bone formation (post-operative) Plain radiography Make montage image from acetabular roof Fig. 5 Evaluation of the boundary conditions of femur osteotomy...

Open the catalog to page 5

Clinical Applications to Orthopaedics by New X-ray Technology-6

Special Report Clinical Applications to Orthopaedics by New X-ray Technology After corrective surgery on both legs (left), scoliosis (center, right) Fig. 10　 valuation of Alignment of Lower Limbs by E Slot Radiography Utility of Slot Radiography Slot radiography offered by SONIALVISION safire can easily take seamless slot images to produce frontal or lateral images of the spine or lower extremities more rapidly than conventional CR (Fig. 9 ). At this hospital, slot radiography is mainly used to evaluate alignment of the lower limbs after artificial joint implant surgery or for scoliosis. Fig....

Open the catalog to page 6