BoneView Measurement
The measurements functionality of BoneView (BoneMetrics) is a radiological fully automated image processing software device intended to analyze standard radiographs using machine learning techniques to measure different angles and length for the following anatomical areas:
- Pelvis: ≥ 10 years old, Frontal (weight-bearing)
- Hip: ≥ 10 years old, False Profile
- Hip (for congenital hip dislocation): < 1 year old, Frontal
- Leg: ≥ 3 years old, Frontal + Lateral
- Knee: ≥ 15 years old, Lateral
- Foot: ≥ 10 years old, Lateral (weight-bearing) + Frontal (weight-bearing) + Méary's view
- Spine : ≥ 3 years old, Frontal + Lateral
- Shoulder: ≥ 10 years old, neutral rotation
It also supports in the detection of the following pathologies: Spine deformities, scoliosis, pelvic obliquity, leg length discrepancy, femoral coverage, acetabular impingement, hip dysplasia, hip arthritis, genu varum, genu valgum, patella alta/baja.1
Application visual output
Pelvis & hip measurements
Hip measurements for congenital hip
Leg measurements
Leg lateral
Knee measurements
Shoulder measurements
Foot frontal view measurements
Foot lateral view
Foot Méary's view measurements
Frontal spine measurements
Lateral spine
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- CR / DX / DR Exams
- A Body part algorithm will define which images can be processed.
Pelvis & hip measurements
- Pelvic obliquity - Difference of height between the horizontal lines passing through the highest point of each acetabulum.
- Acetabular roof angle – angle defined by 1) line connecting the medial edge of the acetabulum roof and the lateral edge of the acetabulum roof and 2) horizontal axis.
- Lateral center-edge angle – defined by 1) line connecting the center of the head of the femur and the lateral edge of the acetabulum and 2) vertical axis.
- Femoral neck-shaft angle (CCD) – angle defined by 1) line connecting the center of the head of the femur and the center of the neck of the femur and 2) line connecting the center of the distal diaphysis of the femur and the center of the proximal diaphysis of the femur.
- Vertical-center-anterior angle (VCA) – angle defined by 1) line connecting the center of the femoral head and the anterior-most aspect of the acetabulum and 2) vertical axis.
Hip measurements for congenital hip dislocation
- Sharp angle – angle defined by 1) horizontal plane of the pelvis defined by a line connecting both triradiate cartilages (Hilgenreiner line) and 2) line that extends through to the lateral aspect of the acetabular roof.
- Hilgenreiner-Perkins Quadrant
- Hilgenreiner's Line: A horizontal line drawn at the level of the triradiate cartilages, connecting the Y-shaped cartilages of both hips. This line serves as the base and divides the pelvis horizontally.
- Perkins' Line: A vertical line drawn perpendicular to Hilgenreiner's line, originating at the outer edge of the acetabulum on each side. This line divides the acetabulum into anterior and posterior segment.
Leg measurement
- Pelvic obliquity - Difference of height between the horizontal lines passing through the highest point of each acetabulum.
- Hip-Knee-Ankle angle (HKA) – angle defined by 1) line connecting the center of the femoral head and the center of the femoral notch and 2) line connecting the center of the tibial spines (at the height of the plateau) and the center of the distal tibia.
- Femur length – length defined by the different between 1) the center of the femoral head and 2) the center of the femoral notch.
- Tibia length – length defined by the different between 1) the center of the tibial spines (at the height of the plateau) and 2) the center of the distal tibia.
- Leg length – length defined by the different between 1) the center of the femoral head and 2) the center of the distal tibia.
Leg measurement lateral
- Pelvic tilt– angle defined by 1) line connecting the center of the upper surface of the 1st sacral vertebra to center of the femoral heads and 2) vertical line passing through the center of the femoral head.
- Pelvic Incidence - angle defined by 1) line perpendicular to the upper surface the 1st sacral vertebra passing though its center and 2) line connecting the center mentioned before passing through center of the femoral heads.
- Sacral Slope - angle defined by 1) horizontal line passing through the posterior edge of the 1st sacral vertebra and 2) line connecting the 1st anterior edge of the sacral plateau to the horizontal line passing through the upper surface of the 1st sacral vertebra.
- Flessum/Recurvatum angle - angle defined by 1) line connecting the center of the femoral head and the center of the femoral notch and 2) line connecting the center of the tibial spines (at the height of the plateau) and the center of the distal tibia.
Knee measurement
- Caton-Deschamps Index- ratio defined by 1) distance between the most inferior aspect of the patellar articular surface and the anterior angle of the tibial plateau and 2) distance between the most superior aspect of the patellar articular surface and the most inferior aspect of the patellar articular surface.
- Insall-Salvati Index – ratio defined by 1) distance between the anterior tibial tuberosity and the anterior inferior patella edge and 2) distance between the anterior inferior patella edge and the most superior aspect of the patellar articular surface.
Shoulder measurements
- Critical Shoulder Angle (CSA) – angle defined by 1) glenoid inclination line drawn from the inferior aspect of the glenoid to the superior aspect and 2) lateral acromion line drawn from the inferior point of the glenoid to the lateral edge of the acromion.
Foot (frontal view) measurement
- Hallux Valgus angle – angle defined by 1) line connecting the center of the base of the 1st metatarsal and the center of the head of the 1st metatarsal and 2) line connecting the center of the base of the 1st phalanx and the center of the head of the 1st phalanx.
- 1st-2nd intermetatarsal angle – angle defined by 1) line connecting the center of the base of the 1st metatarsal and the center of the head of the 1st metatarsal and 2) line connecting the center of the base of the 2nd metatarsal and the center of the head of the 2nd metatarsal.
- 1st-5th intermetatarsal angle – angle defined by 1) line connecting the center of the base of the 1st metatarsal and the center of the head of the 1st metatarsal and 2) line connecting the center of the base of the 5th metatarsal and the center of the head of the 5th metatarsal.
Foot (lateral view) measurement
- Talus-1st metatarsal angle – angle defined by 1) line connecting the center of the talus neck and the center of the talus head and 2) line connecting the center of the base of the 1st metatarsal and the center of the head of the 1st metatarsal.
- Medial arch angle – angle defined by 1) line connecting the most sloping point of the calcaneus and the lower point of the talo-navicular joint and 2) line connecting the lower point of the talo-navicular joint and the inferior point of the medial sesamoid.
- Calcaneal inclination angle – angle defined by 1) line connecting the most sloping point of the calcaneus and most sloping point of the calcaneocuboidal line and 2) horizontal axis.
Foot (Méary's view) measurements
- Meary's Hindfoot Angle – angle defined by 1) line connecting the center of the foot support and the tibiotalar joint center and 2) tibial axis.
Frontal Spine measurement
- Pelvic obliquity – Difference of height between the horizontal lines passing through the highest point of each acetabulum.
- Cobb angle – angle defined by 1) line formed by the superior endplate of the upper end vertebra and 2) line formed by the inferior endplate of the lower end vertebra.
- BoneView Bone Measurement function can measure up to three different Cobb angle values for a patient. If the AI detects only two Cobb angles, it will display only those two angles in the results.
- If a Cobb angle is detected, the value of this angle is displayed in the results
- If no Cobb angles are detected, then the value “<7°” is displayed
- If two Cobb angles are already detected, then only a third Cobb angle with value >10° will be displayed
- BoneView’s Bone Measurement functionality can be configured as follows when there are multiple Cobb angles in the same image:
- default configuration : possibility of sharing one common vertebrae maximum
- opt-in configuration : impossiblility of sharing any common vertebrae
- BoneView Bone Measurement function can measure up to three different Cobb angle values for a patient. If the AI detects only two Cobb angles, it will display only those two angles in the results.
- Coronal Balance (CLS) – length defined by vertical line descending from the center of 7th cervical vertebra to the center of sacral plateau.
- Risser Sign - assessment of skeletal maturity based on the degree of ossification and fusion of the iliac crest apophysis. It is classified from 0 to 5, where 0 indicates no ossification and 5 indicates complete fusion.
Lateral Spine measurement
- Spino-Sacral angle – angle defined by 1) line connecting the center of the 7th cervical vertebra to the middle of the 1st sacral vertebra and 2) line from the 1st sacral vertebra.
- Sagittal Vertical axis – horizontal distance between 1) the vertical line descending from the center of the 7th cervical vertebra and 2) horizontal line passing through the posterior-superior corner of the 1st sacral vertebra.
- Thoracic Kyphosis – angle defined by 1) line through the upper surface of the 4th thoracic vertebra and 2) line through the lower surface of the 12th thoracic vertebra.
- Lumbar Lordosis – angle defined by 1) line through the upper surface of the 1st lumbar vertebra and 2) line through the upper surface of the sacrum.
- T1 tilt – angle defined by 1) line connecting the center of the 1st thoracic vertebra to the center of the femoral head and 2) vertical line passing through the center of the femoral head.
- T9 tilt – angle defined by 1) line connecting the center of the 9th thoracic vertebra to the center of the femoral head and 2) vertical line passing through the center of the femoral head.
- Pelvic tilt – angle defined by 1) line connecting the center of the upper surface of the 1st sacral vertebra to center of the femoral heads and 2) vertical line passing through the center of the femoral head.
- Pelvic incidence – angle defined by 1) line perpendicular to the upper surface the 1st sacral vertebra passing though its center and 2) line connecting the center mentioned before passing through center of the femoral heads.
- Sacral Scope – angle defined by 1) horizontal line passing through the posterior edge of the 1st sacral vertebra and 2) line connecting the 1st anterior edge of the sacral plateau to the horizontal line passing through the upper surface of the 1st sacral vertebra.
EU risk class and CE marking
CE marking as of 2023. EU MDR class IIa
Reimbursement status
None
Contraindications
- BoneView is not intended to be used for X-ray radiographs from the skull and cervical spine regions.
- BoneView is not intended to be used on other exam modalities than X-rays.
- BoneView is not intended to be used on lossy exams.
Target Population
The intended patients are persons admitted to a hospital/health institution for X-rays examination: while patients don't directly interact with BoneView, the results from the X-ray radiograph they just underwent are processed via BoneView and will be used by the clinicians in their diagnosis.
Limitations
- BoneView Measurement function (BoneMetrics) only provides preliminary data, the final diagnosis shall rely upon the physician’s expertise.
- BoneView Measurement function (BoneMetrics) is intended for use as a concurrent reading aid during the interpretations of radiographs.
- Particular attention needs to be provided to the exam where:
- BoneView Measurement function (BoneMetrics) has not received or analyzed all the images
- BoneView Measurement function (BoneMetrics) did not provide results on all the images
- BoneView Measurement function (BoneMetrics) is providing results on stiched images (i.e. for spine) but is not stitching the images, it needs to be performed by the radiographers prior to be sent to the PACS
- The results from BoneView Measurement function (BoneMetrics) are different images from the original images
- In the case of an update of the PACS or RIS solution, Gleamer shall be contacted to ensure the continued compatibility of BoneView Measurement function (BoneMetrics) with the updated software
1.
Instructions for Use BoneView Detection, software version 2.5.x, dated 2024-04
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