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Three-dimensional, computed tomography preoperative planning has been increasingly adopted among shoulder arthroplasty surgeons. Prior studies have not examined outcomes in patients undergoing reverse total shoulder arthroplasty in which the surgeon implanted prostheses that deviated from the preoperative plan compared to patients in which the surgeon followed the preoperative plan. The hypothesis of this study was that clinical outcomes would not be different between patients in which the surgeon utilized components that deviated from those predicted in the preoperative plan and patients in which the surgeon followed the preoperative plan. A retrospective review of patients that had preoperative planning for reverse total shoulder arthroplasty from April 2017 through February 2022 was performed. Patients were stratified into two groups: patients in which the surgeon utilized components that deviated from those anticipated by the preoperative plan (changed group), and patients in which the surgeon utilized all of the components anticipated by the preoperative plan (as planned group). Patient-reported outcomes including the Western Ontario Osteoarthritis Index, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Shoulder Activity Level were recorded preoperatively, at one year, and at two years. Preoperative and one-year postoperative range of motion was recorded. One hundred and eighty-nine patients were included in this study. One hundred forty-seven patients had intraoperative changes to their preoperative plan and 42 patients underwent reverse total arthroplasty without changes to their preoperative plan. There was no difference determined between any patient-reported outcome score at the one- and two-year postoperative time points between the as planned group and the changed group. No differences were found in range of motion between groups. Patients initially planned to undergo anatomic total shoulder arthroplasty that were intraoperatively converted to a reverse total shoulder arthroplasty had equivalent outcomes compared to those that had 1) other intraoperative deviations or 2) had no changes to their original preoperative plan. Patients undergoing reverse total shoulder arthroplasty that had an intraoperative deviation to the components utilized in the preoperative plan had equivalent 1) patient-reported outcomes at one and two years after surgery and 2) range of motion one year after surgery compared to those that did not change from the preoperative plan. This study suggests it is safe to make intraoperative changes to the components utilized in the preoperative plan without concern for inferior postoperative outcomes when performing reverse total shoulder arthroplasty. [ABSTRACT FROM AUTHOR]

Acromion and scapular spine fractures (ASFs) following reverse total shoulder arthroplasty (RSA) have been reported at a rate of 3.9%. The location of the fracture has been shown to be an important factor in determining the outcomes of nonoperative treatment, with medial fractures having worse outcomes than lateral fractures. As the debate between operative and nonoperative treatment continues, a more precise understanding of the location of the fracture is necessary for effective management. The purpose of this study was to use 3-dimensional computed tomography (CT) reconstruction to characterize the exact location of ASFs after RSA. A retrospective review of 2 separate institutional shoulder and elbow repositories was performed. Patients with post-RSA ASFs documented by post-fracture CT scans were included. The query identified 48 patients who sustained postoperative ASFs after RSA between July 2008 and September 2021. CT scans of patients with ASFs were segmented using Mimics software. Eight patients were excluded because of poor image quality. Each bone model was manipulated using 3-Matic Medical software to align the individual scapula with an idealized bone model to create a view of scapular fracture locations on a normalized bone model. This model was used to classify the fractures using the modified Levy classification. The study cohort consisted of 40 patients with a diagnosis of postoperative ASF after RSA. The median age at the time of surgery was 76 years (interquartile range, 73-79 years). The cohort comprised 32 women (80%) and 8 men (20%), with a median body mass index of 27.8. Only 10 patients (25%) had a previous diagnosis of osteoporosis and 6 (13%) had a diagnosis of inflammatory arthritis; 53% of patients underwent RSA owing to rotator cuff tear arthropathy. The distribution of fracture locations was similar within the cohort. However, lateral fractures were slightly more prevalent. The most common fracture location was the type I zone, with 12 fracture lines (29%). There were 11 fracture lines (26%) in the type IIa zone, 10 (23%) in the type IIb zone, 0 in the type IIc zone, and 9 (21%) in the type III zone. ASFs after RSA occur in 4 predictable clusters. No fractures appeared to distinctly cluster in the type IIc zone, which may not represent a true fracture zone. Understanding the distribution of these fractures will help to enable the future design of implants and devices to stabilize the fractures that require fixation. [ABSTRACT FROM AUTHOR]

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Bronchoscopic lung volume reduction (BLVR) is a feasible, safe, effective and minimally invasive technique to significantly improve the quality of life of advanced severe chronic obstructive pulmonary disease (COPD). In this study, three‐dimensional computed tomography (3D‐CT) automatic analysis software combined with pulmonary function test (PFT) was used to retrospectively evaluate the postoperative efficacy of BLVR patients. The purpose is to evaluate the improvement of lung function of local lung tissue after operation, maximize the benefits of patients, and facilitate BLVR in the treatment of patients with advanced COPD. All the reported cases of advanced COPD patients treated with BLVR with one‐way valve were collected and analysed from 2017 to 2020. Three‐dimensional‐CT image analysis software system was used to analyse the distribution of low‐density areas <950 Hounsfield units in both lungs pre‐ and post‐ BLVR. Meanwhile, all patients performed standard PFT pre‐ and post‐operation for retrospective analysis. We reported six patients that underwent unilateral BLVR with 1 to 3 valves according to the range of emphysema. All patients showed a median increase in forced expiratory volume in 1 second (FEV1) of 34%, compared with baseline values. Hyperinflation was reduced by 16.6% (range, 4.9%‐47.2%). The volumetric measurements showed a significant reduction in the treated lobe volume among these patients. Meanwhile, the targeted lobe volume changes were inversely correlated with change in FEV1/FEV1% in patients with heterogeneous emphysematous. We confirm that 3D‐CT analysis can quantify the changes of lung volume, ventilation and perfusion, to accurately evaluate the distribution and improvement of emphysema and rely less on the observer. [ABSTRACT FROM AUTHOR]

Three-dimensional computed tomography preoperative planning has become adopted among shoulder arthroplasty surgeons. Prior studies have not examined outcomes in patients in whom the surgeon implanted prostheses that deviated from the preoperative plan compared with patients in whom the surgeon followed the preoperative plan. The hypothesis of this study was that clinical and radiographic outcomes would be equivalent between patients undergoing anatomic total shoulder arthroplasty that had a deviation in the components predicted in the preoperative plan and patients who did not have a change in the components predicted in the preoperative plan. A retrospective review of patients who had preoperative planning for anatomic total shoulder arthroplasty from March 2017 through October 2022 was performed. Patients were stratified into 2 groups: patients in whom the surgeon used components that deviated from those anticipated by the preoperative plan (changed group), and patients in whom the surgeon used all of the components anticipated by the preoperative plan (planned group). Patient-determined outcomes including the Western Ontario Osteoarthritis Index, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test (SST), and Shoulder Activity Level were recorded preoperatively, at 1 year, and at 2 years. Preoperative and 1-year postoperative range of motion was recorded. Radiographic parameters to assess restoration of proximal humeral anatomy included humeral head height, humeral neck angle, humeral centering on the glenoid, and postoperative restoration of the anatomic center of rotation. A total of 159 patients had intraoperative changes to their preoperative plan, and 136 patients underwent arthroplasty without changes to their preoperative plan. The planned group had higher scores than the group that had a deviation in the preoperative plan for every patient-determined outcome metric at every postoperative time point with statistically significant improvements found in the SST and Single Assessment Numeric Evaluation at 1-year and the SST and American Shoulder and Elbow Surgeons score at 2-year follow-up. No differences were found in range of motion metrics between the groups. Patients who did not have a deviation in their preoperative plan had more optimal restoration of their postoperative radiographic center of rotation than patients who did have a deviation in their preoperative plan. Patients who have intraoperative changes to their preoperative plan have (1) inferior postoperative patient-determined outcome scores at 1 and 2 years after surgery and (2) a larger deviation in the postoperative radiographic restoration of the humeral center of rotation than patients who did not have intraoperative changes from the initial plan. [ABSTRACT FROM AUTHOR]

To describe various important soil processes like the release of greenhouse gases or the proliferation of microorganisms, it is necessary to assess quantitatively how the geometry and in particular the connectivity of the air‐filled pore space of a soil evolves as it is progressively dried. The availability of X‐ray computed microtomography (μCT) images of soil samples now allows this information to be obtained directly, without having to rely on the interpretation of macroscopic measurements using capillary theory, as used to be the case. In this general context, we present different methods to describe quantitatively the configuration of the air‐filled pore space in 3D μCT images of 20 separate samples of a loamy soil equilibrated at different matric potentials. Even though measures using μCT on such multi‐scale materials strongly depend on image resolution, our results show that in general, soil samples most often behave as expected, for example, connectivity increases with higher negative matric potential, while tortuosity decreases. However, simple correlations could not be found between the evolution of quantitative descriptors of the pore space at the different matric potentials and routinely measured macroscopic soil parameters. A statistical analysis of all soil samples concurrently confirmed this lack of correspondence. [ABSTRACT FROM AUTHOR]

Abstract Background The 3D computed tomography produces detailed images of the digit bones in addition to the angiograph render volume 3D of the CT shows the relation between the arteries, bones, and tissues of the digit. Therefore, the present study used those imaging techniques to provide a complete description of the digit bones and arteries’ origin, distribution, and course and their relations with surrounding structures in the Dromedary Camel. Which would serve as a guide for surgeons and students in distinguishing normal digit structures. The study used eight hind limbs of four adult camels of both sexes (two males and two females), aged 9–15 years (Mean ± SD, 11.80 ± 2.59 years). The samples were injected with latex with lead oxide were undergone 3D render volume CT (128-slice multi-detector CT scanning protocol) and angiography x-rays. Results The blood vessels and correlated structures such as bones, tendons, and ligaments were examined using 3D CT in all directions, which was easier to view than angiography and dissected specimens. The arterial supply to the camel’s hind foot was the A. digitalis plantaris communis III. The angiography render volume 3D of CT explained the blood supply of the bones and joints of digital regions and showed a good visualization of the many digit arteries. The metatarsals, the phalanges, and the sesamoid bones were visualized. A. plantaris medialis superficialis, A. digitalis plantaris communis III, A. digitalis plantaris communis II and IV, A. interdigitalis, rami articularis medialis and lateralis to the fetlock joint, ramus medialis and ramus lateralis of the A. digitalis plantaris communis III, A. digitalis plantaris propriae III et IV abaxialis, A. digitalis plantaris propriae III et IV axialis, Ramus phalangis axialis and abaxialis of the first phalanx, Ramus phalangis axialis and abaxialis of the second and third phalanges, and A. metatarsae plantaris III were visualized. The study discovered new blood vessel sources in dromedary camels, such as the ramus articularis to the fetlock and the ramus plantaris phalangis abaxialis proximalis and distalis of the first phalanx. Conclusions The digital circulation angiography investigates the circulatory pattern of the camel hind digit, which can assist clinicians in diagnosing digit region affections. 3D CT explained improved visualization of bones and arteries, including many small branches in relation to surrounding structures, in some views better than others.

Background: The 3D computed tomography produces detailed images of the digit bones in addition to the angiograph render volume 3D of the CT shows the relation between the arteries, bones, and tissues of the digit. Therefore, the present study used those imaging techniques to provide a complete description of the digit bones and arteries' origin, distribution, and course and their relations with surrounding structures in the Dromedary Camel. Which would serve as a guide for surgeons and students in distinguishing normal digit structures. The study used eight hind limbs of four adult camels of both sexes (two males and two females), aged 9–15 years (Mean ± SD, 11.80 ± 2.59 years). The samples were injected with latex with lead oxide were undergone 3D render volume CT (128-slice multi-detector CT scanning protocol) and angiography x-rays. Results: The blood vessels and correlated structures such as bones, tendons, and ligaments were examined using 3D CT in all directions, which was easier to view than angiography and dissected specimens. The arterial supply to the camel's hind foot was the A. digitalis plantaris communis III. The angiography render volume 3D of CT explained the blood supply of the bones and joints of digital regions and showed a good visualization of the many digit arteries. The metatarsals, the phalanges, and the sesamoid bones were visualized. A. plantaris medialis superficialis, A. digitalis plantaris communis III, A. digitalis plantaris communis II and IV, A. interdigitalis, rami articularis medialis and lateralis to the fetlock joint, ramus medialis and ramus lateralis of the A. digitalis plantaris communis III, A. digitalis plantaris propriae III et IV abaxialis, A. digitalis plantaris propriae III et IV axialis, Ramus phalangis axialis and abaxialis of the first phalanx, Ramus phalangis axialis and abaxialis of the second and third phalanges, and A. metatarsae plantaris III were visualized. The study discovered new blood vessel sources in dromedary camels, such as the ramus articularis to the fetlock and the ramus plantaris phalangis abaxialis proximalis and distalis of the first phalanx. Conclusions: The digital circulation angiography investigates the circulatory pattern of the camel hind digit, which can assist clinicians in diagnosing digit region affections. 3D CT explained improved visualization of bones and arteries, including many small branches in relation to surrounding structures, in some views better than others. [ABSTRACT FROM AUTHOR]

Introduction: Osteochondroma of the coronoid process also known as Jacob’s disease, has rarely been reported in the literature and it posses a challenge as diagnosis may be overlooked in favour of other causes of limited mouth opening. Case Report: This is a case report of an adult male patient who presented with restricted mouth opening in whom radiological imaging, especially 3D computed tomography, played a role in establishing the diagnosis of Jacob’s disease. Conclusion: An osteochondroma of the coronoid process of the mandible (Jacob’s disease) is a rare cause of restricted mouth opening and its diagnosis can be overlooked in favour of TMJ ankylosis. The CT scan plays an important role in diagnosis and in planning for surgery.

BackgroundTo compare the application of the emerging 3D printing technology and 3D-CT in segmentectomy. And to explore the advantages of 3D printing technology in thoracoscopic segmentectomy.MethodsWe collected the clinical data of 118 patients undergoing thoracoscopic segmentectomy from January 2019 to April 2021 at the Thoracic Surgery Department, the Dianjiang People's Hospital of Chongqing and Southwest Hospital. Among them, 61 patients were in the 3D printing group and 57 patients were in the 3D-CT group respectively. The perioperative data of these two groups of patients were analyzed respectively.ResultsThere were no significant differences between the two groups in age, gender, tumor diameter, pathology, the preoperative complications of diabetes and heart disease. However, the patients with the complications of hypertension in the 3D printing group are significantly more than the 3D-CT group (P = 0.003). Compared with the 3D-CT group, patients in the 3D printing group had significantly shorter operation time (162.7 ± 47.0 vs. 190.3 ± 56.9 min, P = 0.006), less intraoperative fluid input (1,158.5 ± 290.2 vs. 1,433.2 ± 653.3, P = 0.013), and less total intraoperative fluid output, including intraoperative blood loss, urine excretion, and other fluid loss. In addition, there were no statistically significant differences in intraoperative blood loss, 24 h pleural fluid volume, 48 h pleural fluid volume, postoperative chest tube duration, postoperative hospital stay and complications between the two groups of patients (P > 0.05).ConclusionsIn thoracoscopic segmentectomy, the application of 3D printing technology shortens the operation time, reduces intraoperative fluid input and output, guides the operation more safely and effectively, and has better clinical application value.

Purpose: Defining normal anthropometric ranges of proximal femur and femoral head for each age group in children/adolescents is a necessity when differentiating normal anatomical variants from pathological deformities. Aim of this study is to define a set of normal anthropometric parameters based on 3D-CT measurements in normal asymptomatic children/adolescents and analyse the variations arising depending on age, side, and/or gender. Methods: Morphology of the proximal femur was retrospectively assessed in 170 hips (85 children, < 15 years). Measurements included covered femoral head volume (CFHV), femoral head diameter (FHD), femoral head extrusion index (FHEI), coronal alpha angle (CAA), lateral centre-edge angle (LCEA), anterior (AOS) and posterior head-neck offset (POS) and femoral neck-shaft angle (FNSA). Correlation analyses as well as inter- and intra-rater reliability were performed. Results: CFHV, LCEA, FHD and AOS/POS increased with age and FHEI, CAA, and FNSA decreased with age. None of the measurements correlated with the side. AOS showed a poor correlation with gender. Rapid growth phases were observed at the age of 1, 7 and 11. The inter- and intra-rater reliability was high (range ICC 0.8–0.99 Cronbach alpha 0.86–0.99). Conclusion: This data delivers a description of growth phases as well as gender and age-correlated reference values of the proximal femoral morphology that could be used by paediatricians and orthopaedic/paediatric surgeons to early diagnose proximal femur deformities and provide guidance in the planning of possible operations. [ABSTRACT FROM AUTHOR]

Hemihypertrophy or hemihyperplasia is a condition in which there is asymmetrical overgrowth of the cranium, face, trunk, and limbs on one side of the body. It is characterized by hyperplasia of tissues rather than a hypertrophy. It is more commonly seen in females than in males and usually has the right side of the face involved. It may be an isolated finding or may be associated with a variety of syndromes. We report here a case of isolated non-syndromic right facial hemihypertrophy associated with diffuse warty pigmentation on the right side of the face, which is rarely reported. The clinical features, various radiological and imaging findings, and differential diagnoses to be considered are discussed in this case report. [ABSTRACT FROM AUTHOR]

Objective: By assessing the normal dimensions and the relationship between the aortic root and leaflets in Chinese population, the objective of this three-dimensional computed tomography (3DCT)-based study was to establish a matching reference for leaflets and aortic root for aortic valve (AV) repair.Method: Electrocardiogram-gated multi-detector CT was performed on 168 Chinese participants with a normal aortic valve. Measurements of the aortic annuli and leaflets were obtained. The correlations between and the ratios of the specific root and leaflet measurements were analyzed. The references for the leaflet and root dimensions were suggested based on geometric height (gH) using a linear regression equation. The utility of the ratios was tested with CT images of 15 patients who underwent aortic valve repair.Result: The mean annulus diameter (AD), sino-tubular junction (STJ) diameter, geometric height (gH), effective height (eH), free margin length (FML), commissural height (ComH), inter-commissural distance (ICD), and coaptation height (CH) were 22.4 ± 1.7 mm, 27.3 ± 2, 0.4 mm, 15.5 ± 1.7 mm, 8.9 ± 1.2 mm, 32.0 ± 3.4 mm, 17.9 ± 1.9 mm, 23.1 ± 2.3 mm, and 3.1 ± 0.6 mm, respectively. The gH/AD, FML/ICD, and eH/ComH ratios were 0.69 ± 0.07, 1.38 ± 0.08, and 0.50 ± 0.07, respectively. The gH correlated with all other leaflet and root measurements (P < 0.01), whereas the FML demonstrated a better correlation with ICD compared with gH (R2 = 0.75, and R2 = 0.37, respectively). The FML/ICD and eH/ComH ratios might be used to assess leaflet-root mismatch and post-repair leaflet billowing.Conclusion: The normal aortic valve measurements based on 3DCT revealed a specific relationship between the root and leaflets; and this will guide the development of an objective method of aortic valve repair.

Introduction: Osteochondroma of the coronoid process also known as Jacob's disease, has rarely been reported in the literature and it posses a challenge as diagnosis may be overlooked in favour of other causes of limited mouth opening. Case Report: This is a case report of an adult male patient who presented with restricted mouth opening in whom radiological imaging, especially 3D computed tomography, played a role in establishing the diagnosis of Jacob's disease. Conclusion: An osteochondroma of the coronoid process of the mandible (Jacob's disease) is a rare cause of restricted mouth opening and its diagnosis can be overlooked in favour of TMJ ankylosis. The CT scan plays an important role in diagnosis and in planning for surgery. [ABSTRACT FROM AUTHOR]

Talocalcaneal coalitions can be difficult to detect on plain radiographs, despite obvious clinical findings. The purpose of this study is two-fold: (1) to delineate the benefits of thin-cut computed tomography (CT) and 3D reconstructions and (2) to develop a classification scheme for talocalcaneal coalitions that will provide valuable information for surgical planning.From 2005 to 2009, 54 feet (35 patients) with a talocalcaneal coalition were evaluated with thin-cut (1 mm) CT, using multi-planar 2D and 3D reconstructions. The talocalcaneal coalitions were classified into five types based on the cartilaginous or bony nature, location, and facet joint orientation.Bilateral coalitions were found in 22/35 patients. Types I and II were fibrocartilaginous coalitions, which was the most common type, comprising 40.7 and 16.7% of the coalitions, respectively. Of the patients, 14.8% had a shingled Type III coalition, while 11.1% of the feet examined had a complete bony coalition (Type IV). Small peripheral posterior bony coalitions (Type V), which are heretofore not described, were found in 16.7% of feet.CT scans can provide valuable information regarding the bony or cartilaginous nature of coalitions, as well as the facet orientation, which is helpful in diagnosis and treatment. In this study, the 2D and 3D reconstructions revealed previously unreported peripheral posterior bony coalitions (Type V), as well as coalitions that are in the same plane as the standard CT cuts or Harris view radiographs (Type I). The CT scan also improved the crucial pre-operative planning of the resection in the more complex vertical and combined horizontal and vertical fibrocartilaginous coalitions (Type I and II). Additionally, the complete bony coalitions (Type IV) can be sized accurately, which is helpful in decision-making on the resectability of the coalition.

Introduction: Diagnosis of odontogenic cysts despite their benign nature is a critical and challenging problem. Aim: The aim of this article is to demonstrate a different diagnostic approach in case of very large odontogenic cyst. Materials and Methods: This study was executed on one male patient aged of 38 using 3D computed tomography and contrast material inside the lesion. Differential diagnosis made by the residents was compared to the histopathological examination as the gold standard for identifying the nature of the cysts. Results: This diagnostic approach using 3D computed tomography combined with contrast material injected inside the lesion shows the real borders of the cyst of the maxilla and helps oral surgeon in planning the volume of the surgical intervention. Conclusion: Precise diagnose ensure the possibility of doing the optimal surgical intervention- a precondition for best wound healing.

Understanding intertrochanteric fracture distribution is an important topic in orthopedics due to its high morbidity and mortality. The intertrochanteric fracture can contain high-dimensional information including complicated 3D fracture lines, which often make it difficult to visualize or to obtain valuable statistics for clinical diagnosis and prognosis applications. This paper proposed a map projection technique to map the high-dimensional information into a 2D parametric space. This method can preserve the 3D proximal femur surface and structure while visualizing the entire fracture line with a single plot/view. Using this method and a standardization technique, a total of 100 patients with different ages and genders are studied based on the original radiographs acquired by CT scan. The comparison shows that the proposed map projection representation is more efficient and rich in information visualization than the conventional heat map technique. Using the proposed method, a fracture probability can be obtained at any location in the 2D parametric space, from which the most probable fracture region can be accurately identified. The study shows that age and gender have significant influences on intertrochanteric fracture frequency and fracture line distribution. Graphical abstract Generation of 2D parametric map for intertrochanteric fracture probability visualization. [ABSTRACT FROM AUTHOR]

Abstract The requirements of low resistivity and small magnetic permeability in the high-frequency signal delivery applications have driven the development of Ni-free surface finishes, such as Au/Pd (EPIG) or Au/Pd/Au (IGEPIG), over the Cu conducting lines. The compatibility of these newly developed surface finish techniques with microelectronic packages and their long-term, high temperature reliability still require investigations in the current state. We conducted a solderability evaluation on the Au/Pd/Cu and Au/Pd/Au/Cu multilayers and found no noticeable differences of the intermetallic compound species (i.e., (Cu,Pd) 6 Sn 5 and Cu 3 Sn) in the joint interfaces between the two examined cases. However, numerous bump voids might be formed in the vicinity of the solder/Cu interface of the EPIG case, degrading the shear resistance of solder joints. The formation mechanism of the bump voids and the evolution kinetics were proposed in this study. Highlights • A comparative study between Au/Pd/Cu (EPIG) and Au/Pd/Au/Cu (IGEPIG). • Au nanolayer (10 nm) inhibited the bump void formation. • Bump voids merged as larger ones upon soldering. • Bump voids degraded the LSBS resistance of solder joints. • IGEPIG surface finish possesses better solderability than EPIG. [ABSTRACT FROM AUTHOR]

3D computed tomography (CT) visualizations of volumetric data have become an important aspect of diagnostic imaging. The utility of 3D CT has been well described for the imaging of a number of renal pathologies. Recently, a new 3D visualization technique known as cinematic rendering (CR) has become available and provides photorealistic images derived from standard CT acquisitions by use of a complex global lighting model. Herein, we describe a number of normal variant and pathologic conditions of the kidney visualized with CR. We provide comparisons of findings with CR to traditional methods of 3D imaging and comment on the potential applications of this new method of 3D CT rendering. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to correlate highly accurate CT measurements of pre-revision total knee arthroplasty (TKA) implant position with findings of retrieval analysis post-revision, to understand the clinical relevance of TKA orientation.Methods: This study involved 53 retrieved TKA implants with pre-revision 3D-CT scans used to determine coronal (varus-valgus), sagittal (tibial slope) and rotational (internal rotation-external rotation) TKA orientation as well as tibiofemoral leg axis. Differences between femoral and tibial angles to describe the "relative rotational mismatch" were also calculated. All tibial inserts were forensically analyzed using the Hood score. Statistical analysis was performed to investigate correlations between TKA component orientation and surface damage (p < 0.05).Results: Femoral components were found to have axial rotations mainly within ± 3° (68%), whilst 45% of the tibial components and 66% of the relative rotational mismatches were > 3° and < - 3°, respectively. The majority of femoral and tibial components (87% in both cases), as well as the femorotibial angle (70%), showed coronal orientations within ± 3°. The 64% of the tibial components showed posterior tibial slopes out of both the 0°-3° and 5°-7° ranges. There was a significant correlation between tibial slope and damage score on polyethylene tibial inserts (r = 0.2856; p = 0.0382) as well as a significant correlation between implants' position in the axial plane and damage score on polyethylene tibial inserts (r = 0.6537, p = 0.0240).Conclusions: This is the first study to use accurate measurements from pre-revision 3DCT to compare tibial and femoral orientation in all three planes with retrieval findings in total knee replacements. A significant correlation between implant position and polyethylene surface damage was found. These results showed the importance of optimizing component position to minimize polyethylene damage. Further analysis involving more accurate polyethylene wear measurements are fundamental to fully understand the role of components' orientation in TKAs. [ABSTRACT FROM AUTHOR]

ABSTRACT: One of the most important characteristic of knee osteoarthritis (OA) is the joint space (JS) width narrowing. Measurements are usually performed on two dimensional (2D) X‐rays. We propose and validate a new method to assess the 3D joint space at the medial knee compartment using high resolution peripheral computed tomography images. A semi‐automated method was developed to obtain a distance 3D map between femur an tibia with the following parameters: volume, minimum, maximum, mean, standard deviation, median, asymmetry, and entropy. We analyzed 71 knee specimens (mean age: 85 years), radiographs were performed for the Kellgren Lawrence (KL) score grading. In a subgroup of 41 specimens, the histopathological Outerbridge and meniscal classifications were performed and then cores were harvested from the tibial plateau in three different positions (posterior, central, and peripheral) and imaged at 10 µm of resolution to measure the cartilage thickness. Minimum, maximum, mean, and median were statistically lower and entropy higher between knee specimens classified as KL = 0 and KL = 3–4. Gr1 and 2 were statistically different from Gr3‐4 for minimum, asymmetry, entropy using the Outerbridge classification and Gr1 was statistically different from Gr3–4 using the meniscal classification. Asymmetry, minimum, mean, median and entropy were significantly correlated with cartilage thickness. Parameters extracted from a 3D map of the medial joint space indicate local variations of JS and are related to local measurements of tibial cartilage thickness, and could be consequently useful to identify early OA. © 2018 The Authors. Journal of Orthopaedic Research® Published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res 36:2380–2391, 2018. [ABSTRACT FROM AUTHOR]

Background: Suboptimal total knee arthroplasty (TKA) position of both femoral and tibial components is thought to be linked with poor clinical outcomes, polyethylene wear and the "unexplained" painful knee arthroplasty. The aim of this study was to better understand the effect of implant orientation on knee implant performance.Methods: We analyzed 30 retrieved contemporary TKA implants. Implant positioning measurements in the coronal plane were made prior to revision using a diagnostic algorithm, based on 3D computed tomography (CT) images. Each retrieved polyethylene component was imaged using a micro-CT scanner and a high resolution computational 3D model of each component was digitally reconstructed. The difference in thickness between medial and lateral components was calculated. Statistical analysis was performed to investigate the association between component positioning and damage patterns.Results: We found a significant correlation between both the tibiofemoral and femoral angles and difference in thickness between polyethylene compartments: varus angulations were strongly associated with thinner medial compartments, whilst valgus angulations were associated with thinner lateral compartments. Moreover, suboptimal tibiofemoral orientations and tibial component angulations were associated to greater differences in thickness between polyethylene compartments.Conclusion: Our study is the first to compare accurate 3D CT measurements of prerevision TKA positioning in the coronal plane with postrevision retrieval analysis from innovative, accurate and highly reliable micro-CT-based method. Our results demonstrate the impact of component positioning on polyethylene damage and helps understanding of the in vivo performance of these implants.Level Of Evidence: III. [ABSTRACT FROM AUTHOR]

We propose a scaled gradient projection algorithm for the reconstruction of 3D X-ray tomographic images from limited data. The problem arises from the discretization of an ill-posed integral problem and, due to the incompleteness of the data, has infinite possible solutions. Hence, by following a regularization approach, we formulate the reconstruction problem as the nonnegatively constrained minimization of an objective function given by the sum of a fit-to-data term and a smoothed differentiable Total Variation function. The problem is challenging for its very large size and because a good reconstruction is required in a very short time. For these reasons, we propose to use a gradient projection method, accelerated by exploiting a scaling strategy for defining gradient-based descent directions and generalized Barzilai-Borwein rules for the choice of the step-lengths. The numerical results on a 3D phantom are very promising since they show the ability of the scaling strategy to accelerate the convergence in the first iterations. [ABSTRACT FROM AUTHOR]

Background: We hypothesized that there is a correlation between the distal femoral rotation and proximal tibial joint line obliquity in nonarthritic knees. This has significance for kinematic knee arthroplasty, in which the target knee alignment desired approximates the knee before disease.Methods: Fifty computed tomography scans of nonarthritic knees were evaluated using three-dimensional image processing software. Four distal femoral rotational axes were determined in the axial plane: the transepicondylar axis (TEA), transcondylar axis (TCA), posterior condylar axis (PCA), and a line perpendicular to Whiteside's anterior-posterior axis. Then, angles were measured relative to the TEA. Tibial joint line obliquity was measured as the angle between the proximal tibial plane and a line perpendicular to the axis of the tibia.Results: There was a strong positive correlation between PCA-TEA and tibial joint line obliquity (r = 0.68, P < .001) as well as TCA-TEA and tibial joint line obliquity (r = 0.69, P < .001). In addition, the tibial joint line obliquity and TCA-TEA angles were similar, 3.7° ± 2.2° (mean ± standard deviation) and 3.5° ± 1.7°, respectively (mean difference, 0.2° ± 0.2°; P = .369).Conclusion: Both PCA-TEA and TCA-TEA strongly correlated with proximal tibial joint line obliquity indicating a relationship between distal femoral rotational geometry and proximal tibial inclination. These findings could imply that the native knee in flexion attempts to balance the collateral ligaments toward a rectangular flexion space. A higher tibial varus inclination is matched with a more internally rotated distal femur relative to the TEA. [ABSTRACT FROM AUTHOR]

[Display omitted] • Sodium metasilicate was used as a complementary silica source in two-part geopolymer foams. • Sodium metasilicate acted as a stabilizing agent in H 2 O 2 –geopolymer foam. • H 2 O 2 should be limited to a SiO 2 /Al 2 O 3 ratio up to 2.5 for curing at 50 °C. • SiO 2 /Al 2 O 3 = 2.5 and H 2 O 2 = 6.0% were most conducive to the porous structure. • Produced geopolymer foams can be used as lightweight insulating cores. The synergistic effects of the SiO 2 /Al 2 O 3 ratio (2.0, 2.5, and 3.0) and H 2 O 2 content (1.5%, 3.0%, and 6.0%) were evaluated in metakaolin-based geopolymer foams using sodium metasilicate pentahydrate as a complementary silica source. Sodium metasilicate helped to stabilize the pores in foams with SiO 2 /Al 2 O 3 molar ratios of up to 2.5 cured at 50 °C without stabilizing additives. The optimum porous system for insulation cores was obtained using a SiO 2 /Al 2 O 3 ratio of 2.5 and H 2 O 2 content of 6%. Furthermore, a SiO 2 /Al 2 O 3 molar ratio of 3.0 reduced pore formation as the increased geopolymerization and viscosity served as a barrier to bubble diffusion. [ABSTRACT FROM AUTHOR]

Lung cancer is a potentially fatal disease worldwide, and improving the accuracy of early lung cancer diagnosis plays a key role in improving the prognosis of patients. In recent years, as Deep Learning (DL) is increasingly applied in the field of Pulmonary Nodule Detection (PND), computer-aided systems for PND based on DL have made significant contributions. However, due to the stringent requirement for high sensitivity, many computer-aided PND systems inevitably have high false positive rate. Reducing the false positive rate continue to face challenge due to the variable morphology of pulmonary nodules. In this study, a novel MultiLayer Perceptron (MLP)-based False Positive Reduction network, Wave-Involution MLP (WINMLP), is proposed to reduce the false positive rate from a new perspective. We design a Progressive Multi-Scale Fusion block based on the novel Involution to fuse global features preferably. Moreover, inspired by Quantum theory, we design a CT-WaveMLP backbone, which transforms CT images into Wave functions and enhances feature extraction capability. We performed experiments on LUNA V2 dataset and the results show WINMLP achieves the average CPM of 0.861, which has a better performance compared with existing excellent methods. • Proposed method is crucial for early diagnosis of lung cancer. • We are the first to use VisionMLP and Involution in this field. • Our proposed method is elegant, innovative and high-performance. • Rigorous experiments have confirmed the marked superiority of our method. [ABSTRACT FROM AUTHOR]

Temporomandibular joint (TMJ) ankylosis involves fusion of the mandibular condyle with the base of the skull. It results in functional, esthetic, and psychosocial limitations, if it affects children at an early age. Hence, it is important to recognize and diagnose the pathology and provide immediate treatment alternatives to improve the patient condition. In this case report, we highlight the diagnostic perspective of TMJ ankylosis in children, and the use of 3D computed tomography as an effective diagnostic aid.

Background: The posterior tibial slope (PTS) is an important consideration in knee arthroplasty. However, there is still no consensus for the optimal slope. The objectives of this study were (1) to reliably determine the native PTS in this population using 3-dimensional computed tomography scans and (2) to determine the normal reference range for PTS in this population.Methods: One hundred computed tomography scans of disease-free knees were analyzed. A 3-dimensional reconstructed image of the tibia was generated and aligned to its anatomic axis in the coronal and sagittal planes. The tibia was then rotationally aligned to the tibial plateau (tibial centroid axis) and PTS was measured from best-fit planes on the surface of the proximal tibia and individually for the medial and lateral plateaus. This was then repeated with the tibia rotationally aligned to the ankle (transmalleolar axis).Results: When rotationally aligned to the tibial plateau, the mean PTS, medial PTS, and lateral PTS were 11.2° ± 3.0 (range, 4.7°-17.7°), 11.3° ± 3.2 (range, 2.7°-19.7°), and 10.9° ± 3.7 (range, 3.5°-19.4°), respectively. When rotationally aligned to the ankle, the mean PTS, medial PTS, and lateral PTS were 11.4° ± 3.0 (range, 5.3°-19.3°), 13.9° ± 3.7 (range, 3.1°-24.4°), and 9.7° ± 3.6 (range, 0.8°-17.7°), respectively.Conclusion: The PTS in the normal Asian knee is on average 11° (mean) with a reference range of 5°-17° (mean ± 2 standard deviation). This has implications to surgery and implant design. [ABSTRACT FROM AUTHOR]

Background: Plain radiography, 2-dimensional (2D) magnetic resonance imaging (MRI), and computed tomography (CT) do not precisely display morphology and acetabular coverage in developmental dysplasia of the hip or pincer-type femoroacetabular impingement. Pelvic position and pelvic tilt affect assessment of the acetabular parameters, leading to misinterpretation.Objective: We tested a 3-dimensional (3D) CT evaluation script to calculate the crossover sign (COS), acetabular coverage and morphology.Methods: To test the method, we constructed a phantom pelvic model, in which the acetabulum was mounted at different coverages of the femoral head, and simulated a COS and the acetabular morphology. Additionally we examined the reliability and objectivity of this method in ten patients with CT scans of the pelvis for conditions unrelated to hip disorders.Results: We obtained an average accuracy of the 3D CT evaluation script of -0.37∘ (range -3.84 to 3.88; SD ± 1.43) for morphology, and 0.002% (range -7.28% to 6.90%; SD ± 1.60%) for coverage of the femoral head. Significant correlation between the expected and calculated COS (p= 0.01) was found.Conclusions: Our 3D CT evaluation script permits precise evaluation of the acetabular coverage profile, the presence or absence of a COS and acetabular morphology, independent of patient positioning or pelvic tilt. [ABSTRACT FROM AUTHOR]

Iterative reconstruction methods in Computed Tomography (CT) are known to provide better image quality than analytical methods but they are not still applied in many fields because of their computational cost. In the last years, Graphical Processor Units (GPU) have emerged as powerful devices in order to parallelize calculations, but the efficiency of their use is conditionned on applying algorithms that can be massively parallelizable. Moreover, in non-destructive testing (NDT) applications, a segmentation of the reconstructed volume is often needed in order to have an accurate diagnosis on the material health, but performing a segmentation after the reconstruction introduces uncertainties in the diagnosis from both the reconstruction and the segmentation algorithms. In this paper, we propose an iterative reconstruction method for 3D CT that performs a joint reconstruction and segmentation of the controlled object in NDT for industrial applications. The method is based on a 3D Gauss-Markov-Potts prior model in Bayesian framework, which has shown its effective use in many image restoration and super-resolution problems. First, we briefly describe this model, before deriving the expression of the joint posterior distribution of all the unknowns. Next, an effective maximization of this distribution is presented. We use a ray-driven projector and a voxel-driven backprojector implemented on GPU. The algorithm is developed so it can be massively parallelized. Finally, we present our results on simulated and real phantoms. In addition, we investigate further reconstruction quality indicators in order to compare our results with other methods. [ABSTRACT FROM AUTHOR]

In the present article, the effective thermal conductivity (ETC) of 10 ppi open-cell ceramic foams is measured at temperatures ranging from 22 °C to 750 °C using the transient plane source (TPS) technique. The detailed morphology of the foam structures is reconstructed from 3D CT-scan images and their structural analysis is carried out using a volume image processing tool. The experimental results are compared with the predictions of directional ETC, obtained using a simplified 1D homogeneous model that considers coupled conduction–radiation heat transfer. The parameters, required by the model, are evaluated based only upon the information that could be extracted from 3D CT-scan images under certain simplifying assumptions. It can be concluded that the predictions of ETC for the present ceramic foam samples clearly correlate with the geometric parameters obtained from their structural analysis. It is also observed that the estimated microscopic porosity of the foam, which is not captured by 3D CT-scan images, has considerable influence on the reconstructed foam structure and hence on the predicted ETC. The predictions of ETC in the measured direction, obtained after the proposed directional averaging, compare extremely well with TPS measurements for the complete range of investigated temperatures. This suggests that the measurements of ETC, obtained employing TPS technique, are the directionally averaged representations of ETC in three perpendicular directions. The present investigation also clearly demonstrates the potential of the simplified modeling approach for characterizing even the directional ETC of open-cell ceramic foams, based primarily on their structural information. [ABSTRACT FROM AUTHOR]

The combination of electrochemical and 3D computed tomography (CT) investigations offers the possibility of verifying electrochemical measurements non-destructively. Determining the steel surfaces damaged by pitting corrosion allows developing specimens having damage pattern corresponding to practice. Corrosion phenomena like decoupled pitting corrosion cannot be verified by electrochemical measurements only, but with the combination of those two kinds of investigations it is possible. Another advantage is the minimization of the number of samples. The classical experimental procedure requires the destruction of samples after each damage step. This can be avoided by the use of 3D computed tomography. As long as the corrosion phenomena are completely within the examination zone shown by the 3D computed tomography, the electrochemical measurements can be calculated on an area basis to get the specific corrosion rate or polarization resistance. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study was to confirm volume stability of biphasic calcium phosphate ( BCP) through the changes of grafted volume over the time by 3 D CT analyzing software program. Patients and Methods Fifteen patients, 16 sinuses who were scheduled a staged implantation through sinus floor elevation ( SFE)-lateral window technique from 2009 to 2011 were included in the study. Of the 15 patients, eight were male and seven were female (mean age 50.1). For sinus floor augmentation, BCP with local blood was packed loosely into the maxillary sinus and the grafted site was covered with a collagen membrane. For the evaluation of volume change, 3 D CBCT scans were taken five times at pre-operatively ( To), post-op 1 week ( T1), 1 month ( T2), 3 months ( T3), and 6 months ( T4). 3D image processing software ( On Demand3 DTM software) was used for this study. The time sequential change was statistically evaluated. Result 84.32% grafted BCP is maintained until post-op 6 month ( T4), and the average volume loss is 207.7 mm3 (about 0.21 cc). Statistically, a significant volume change (decreasing) was observed in three groups ( T2- T1, T3- T2, T4- T3). Conclusion Biphasic calcium phosphate, as a synthetic material, has high volume stability and is a predictable graft material for the successful SFE. Although some limitations of the 3 D analyzing software program, it is a fast, simple, relatively accurate and promising approach to quantifying long-term changes in the grafted area. [ABSTRACT FROM AUTHOR]

Background Discrete radiographic thresholds of scapular fracture deformity proposed as a guide for when to utilize operative treatment are a matter of debate. The purpose of the present study was to determine how many patients would have received operative treatment according to these criteria and how many actually received operative treatment. Methods Three hundred and thirty patients with an extra-articular fracture of the scapula at two level 1 trauma centers were retrospectively analyzed. Glenopolar angle, translation, angulation and medial/lateral displacement were measured on computed tomogaphy scans or radiographs to determine the theoretical operative treatment recommendation according to Cole’s criteria. Results Sixty-two patients (19%) had one or more radiographic indications for operative treatment, half of them had more than 20 mm of lateral displacement, and one fourth of them had substantial translation. No patients had operative treatment of the scapular body. Two patients had operative treatment of an acromion fracture, neither of which met radiographic criteria for surgery. Conclusions At least in our centres, there is a striking discrepancy between theoretical and actual recommendations for surgery. There is clearly a need for more research to determine whether patients are being undertreated or whether the guidelines are too stringent. [ABSTRACT FROM AUTHOR]

Background There is no consensus on the operative treatment of glenoid fractures. The purpose of this study was to see whether there was a difference between how patients with a glenoid fracture would receive treatment according to theoretical operative indications based on the measurement of computed tomography (CT) scans and radiographs and the treatment they actually received in our institutions. Methods A total of 457 patients with a scapular fracture were treated in two level 1 trauma centres between January 2002 and August 2011. Ninety-eight patients with a glenoid fracture were retrospectively analyzed. Intra-articular gap, medial or lateral (M/L) displacement, angular deformity, and glenopolar angle (GPA) were measured on CT scans or radiographs to determine theoretical indications for operative treatment. Results Twenty-four patients (25%) actually had operative treatment, while 35 patients (36%) fulfilled at least one theoretical criterion to proceed with operative treatment with a medium correlation between theoretical indications for surgery and the actual operative treatment. All the patients with a theoretical indication for surgery had an intra-articular gap with a step-off of >4 mm. A bony Bankart lesion with shoulder dislocation and injury in sports was retained in the best multivariable model as indications for the actual surgery. Conclusion Theoretical guidelines for surgery on glenoid fractures may not have much influence on the current treatment. Level of evidence Therapeutic, level III. [ABSTRACT FROM AUTHOR]

Objective Non-invasive and reproducible size measurements that correlate well with computed tomography (CT) are desirable in the management of small abdominal aortic aneurysms (AAA). Three dimensional ultrasound (3D-US) technology may reduce inaccuracy because of variations in orientation of the image planes and axis. This study aimed to determine any differences in paired size estimation associated with three 3D-US derived methods using 3D-CT as the gold standard. When CTA was not available, the patients were enrolled anyway to assess 3D-US reproducibility in terms of agreement between two physicians. Methods In the period from 1 March 2013 to 27 February 2014, consecutive patients with a small AAA, <5.5 cm for men and <5.2 cm for women, underwent 3D-US examination and three AAA size measures were obtained: dual plane diameter, diameter perpendicular to the residual sac's centreline and a partial volume. Result In all, 122 consecutive US examinations were performed. Patients were excluded because of inadequate AAA size ( n = 11) and for technical reasons ( n = 11). Thus, 100 patients (F/M; 20/80) with a median maximum AAA diameter of 46 (range 31–55) mm were analysed. The mean US dual plane diameter and the 3D-US centreline diameter were 2.6 mm and 1.8 mm smaller than the mean 3D-CT centreline diameter, respectively ( p = .003). The inter-observer reproducibility coefficient was 3.7 mm for the US dual plane diameter and 3.2 mm for the 3D-US centreline diameter ( p = 0.222). For the partial volume, the reproducibility was 8–12%, corresponding to a diameter variability of ±3 mm. The median time used for post-processing of the 3D-US acquisition was 72 (range 46–108) seconds per examination. Conclusion 3D-US demonstrated an acceptable reproducibility and a good agreement with 3D-CT, and has the potential to improve future AAA management through more reliable ultrasound guided size estimates. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the anatomy of the sphenoid ostium (SO), which has so far only been investigated with the aid of two-dimensional computed tomography (CT) or using a cadaver, from a new point of view through the use of 3D CT for the first time. Methods: We have evaluated 50 patients who had CT angiography done for different reasons. The sphenoid sinus types and the SO were evaluated three dimensionally. The average diameters of the sphenoid ostia, and their distances to the midline, as well as to each other and the choana have been measured. In addition, the SO were categorized according to their shapes. Results: The average age of the patients was 48.5. No SO was found in seven cases (14 %). The average distance of the SO to the midline was 2.78 mm on the right side and 2.77 on the left. Four different shapes of SO were determined; round, oval, irregular and linear. The average distance of the right and left SO to the choana was 15.22 ± 0.95 and 14.87 ± 1.11 mm, respectively. No statistically significant difference was found between the male and female sexes with regard to the calculated diameters and shapes of the SO ( p > 0.05). Conclusion: The anatomy of the sphenoid sinus and the SO varies widely from individual to individual. We have demonstrated in our study that these anatomic variations could be evaluated pre-operatively. Using this imaging technique, surgeons can make a pre-operative 3D evaluation of the sphenoid ostium, encountered in the surgery and thus achieve better orientation. [ABSTRACT FROM AUTHOR]

Background The accuracy of reproducing a surgical plan during shoulder arthroplasty is improved by computer assistance. Intraoperative navigation, however, is challenged by increased surgical time and additional technically difficult steps. Patient-matched instrumentation has the potential to reproduce a similar degree of accuracy without the need for additional surgical steps. The purpose of this study was to examine the accuracy of patient-specific planning and a patient-specific drill guide for glenoid baseplate placement in reverse shoulder arthroplasty. Methods A patient-specific glenoid baseplate drill guide for reverse shoulder arthroplasty was produced for 14 cadaveric shoulders based on a plan developed by a virtual preoperative 3-dimensional planning system using thin-cut computed tomography images. Using this patient-specific guide, high-volume shoulder surgeons exposed the glenoid through a deltopectoral approach and drilled the bicortical pathway defined by the guide. The trajectory of the drill path was compared with the virtual preoperative planned position using similar thin-cut computed tomography images to define accuracy. Results The drill pathway defined by the patient-matched guide was found to be highly accurate when compared with the preoperative surgical plan. The translational accuracy was 1.2 ± 0.7 mm. The accuracy of inferior tilt was 1.2° ± 1.2°. The accuracy of glenoid version was 2.6° ± 1.7°. Conclusion The use of patient-specific glenoid baseplate guides is highly accurate in reproducing a virtual 3-dimensional preoperative plan. This technique delivers the accuracy observed using computerized navigation without any additional surgical steps or technical challenges. [ABSTRACT FROM AUTHOR]

In the last decade, the advances in imaging technologies have intensified the use of multislice computed tomography (MSCT) for anthropological purposes. The published literature has proved it to be a suitable tool for establishing sexually dimorphic characteristics in different anatomical areas. In this context, the main purpose of the present study was to explore the accuracy of traditional morphometric method when applied to data acquired in three-dimensional (3D) reconstructed os coxae of living Spanish population, to develop a series of statistically robust patterns for sex assessment and to test their validity in innominate remains. For this purpose, 150 volume-rendered innominate CT scans were selected to examine nine interlandmark linear distances by means of descriptive statistics and discriminant function analyses (DFA) employing the jackknife procedure for cross-validations. Five measurements were sexually dimorphic. Acetabular diameter was the single most accurate predictor. This, combined with innominate height and innominate breadth, contributed very significantly to sex estimation. Overall, classification accuracies were 89.3-95.3 % (89.3-94.7 % after cross-validation), with a sex-bias lower than 5 %. The second validation approach performed on a sample of 96 individuals from another contemporary Spanish reference collection comprising dry bones showed the high percentage of accurate classification (83.3-95.8 %). In conclusion, the assessment of sex using cross-sectional MSCT images of the os coxae is possible and the discriminant functions obtained on Spanish living individuals can also be effective for estimating sex from skeletal remains. [ABSTRACT FROM AUTHOR]