Technology and Health Care

The use of 3D ultrasound imaging to follow the progression of scoliosis, i.e., a 3D deformation of the spine, is described. Unlike other current examination modalities, in particular based on X-ray, its non-detrimental effect enables it to be used frequently to follow the progression of scoliosis which sometimes may develop rapidly. Furthermore, 3D ultrasound imaging provides information in 3D directly in contrast to projection methods.

This paper describes a feasibility study of an ultrasound system to provide a 3D image of the human spine, and presents a framework of procedures to perform this task. The framework consist of an ultrasound image acquisition procedure to image a large part of the human spine by means of a freehand 3D ultrasound system and a volume reconstruction procedure which was performed in four stages: bin-filling, hole-filling, volume segment alignment, and volume segment compounding.

The overall results of the procedures in this framework show that imaging of the human spine using ultrasound is feasible. Vertebral parts such as the transverse processes, laminae, superior articular processes, and spinous process of the vertebrae appear as clouds of voxels having intensities higher than the surrounding voxels. In sagittal slices, a string of transverse processes appears representing the curvature of the spine. In the bin-filling stage the estimated mean absolute noise level of a single measurement of a single voxel was determined. Our comparative study for the hole-filling methods based on rank sum statistics proved that the pixel nearest neighbour (PNN) method with variable radius and with the proposed olympic operation is the best method. Its mean absolute grey value error was less in magnitude than the noise level of a single measurement.

The current study evaluated whether 3-D fluoroscopic imaging is capable of adequate visualisation, reduction and effective guidance of implant placement during a minimally-invasive screw-fixation (MISF) procedure in the treatment of proximal phalanx fractures. A comparison with conventional intraoperative 2-D imaging was performed in a cadaveric model. Conventional 2-D and 3-D imaging series were performed following the creation of proximal phalanx fractures, reduction and fixation, pre- and post-operatively. For both imaging modalities, attention was paid to A) correct reduction, B) screw-placement and, if present, C) intra-articular offset of fracture edges.

The results revealed no related overall advantage of the 3-D imaging system over normal 2-D fluoroscopy at the proximal phalanx region. The authors conclude that, given the cost of 3-D imaging technology, as well as the increased time required for image acquisition, its routine use in the treatment of phalanx fracture cases is not justifiable at present.

Correct use of medical equipment within the clinical environment is of prime importance. This includes awareness of the safety issues regarding equipment, particular when it is an electrically powered device. Incidents can occur in the clinic in which a medical device is suspected of contributing to patient or staff injury. It is important that one can identify in advance any potential hazards which may arise with electrical equipment due to technical or environmental factors. This paper gives an overview of electrical safety.