Abstract
Introduction
Increased accuracy of pre-operative imaging in patient-specific instrumentation (PSI) can result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging or revision surgery. The benefits and drawbacks of CT vs MRI for use in PSI is a source of ongoing debate. This study reviews all currently available evidence regarding accuracy of CT vs MRI for pre-operative imaging in PSI.
Methods
The MEDLINE and EMBASE databases were searched between 1990 and 2013 to identify relevant studies. As most studies available focus on validation of a single technique rather than a direct comparison, the data from several clinical studies was assimilated to allow comparison of accuracy. Overall accuracy of each modality was calculated as proportion of outliers >3 % in the coronal plane.
Results
Seven studies matched our inclusion criteria. Outlier incidence was 12.5% (9.27–17.4%) with CT and 16.96% (1.2–44%) with MRI (p>0.05).
Conclusions
Current evidence shows comparable accuracy with both imaging modalities for PSI. Outlier incidence is slightly lower in the CT group with lower variation but this was not significant. At present there is not enough published data to convincingly conclude in favour of CT or MRI for accuracy of component alignment. It is our conclusion that CT is more favourable at present due to reduced scanning times, increased availability, and cheaper cost.
