Periprosthetic Hip Lucency

Purpose	Measure periprosthetic lucency in the hip
Tag(s)	#THA
Panel	Musculoskeletal
Define-AI ID	18050010
Originator	Munib Sana
Panel Chair	Jay Patti
Panel Reviewers	Musculoskeletal Panel
License	Creative Commons 4.0
Status	Published

Value Proposition

There are 400,000 total hip arthroplasties (THAs) performed annually. Every patient has annual follow-up exams, which can add up to about 100 reads per day for a musculoskeletal radiologist who works with arthroplasty surgeons. Aseptic loosening and adverse local tissue reaction complicate a significant number of THAs and necessitate revision arthroplasty. These are indolent processes that, if not detected early, can lead to osteolysis or extensive tissue necrosis. Findings are not readily apparent on x-ray and require comparison with multiple prior exams to see progression of abnormality over time. AI meeting this use case would help to reduce the false negative rate, patient risk, and medical legal risk for the radiologists. High-risk patients could be screened for elevated serum cobalt levels and sent to MRI for further evaluation. Delay in diagnosis could delay treatment for years.

Narrative(s)

A 65-year-old patient presents for annual follow-up THA x-ray. An algorithm evaluates the image and compares this exam with multiple prior exams, if accessible. The algorithm measures periprosthetic lucency. If the measurement is greater than 2 mm, the radiologist is alerted. Otherwise, the measurement displays when called.

Workflow Description

The current image and prior hip x-rays are analyzed by an AI engine. The engine measures periprosthetic lucency between the current image and images at least 5 years old or initial post-op film if THA was performed less than 5 years ago.

Procedures(s): X-ray, Hip

View(s): {AP, Frog-leg lateral, Cross-table lateral}

 

Sex at Birth: {Male, Female}

 

Osteolysis Location: {Gruen Zone 1, Gruen Zone 7, Gruen Zone 8, Gruen Zone 14}

 

Interval Between Imaging (years): [0,20]

 

Comorbidities: {Calcar resorption, osteoporosis, subsidence, lucency}

Inputs

DICOM Study

Procedure	XRAY, Hip
Views	AP, frog-leg lateral, cross-table lateral
Data Type	DICOM
Modality	XRAY
Body Region	Pelvis
Anatomic Focus	Hip

Primary Outputs

Periprosthetic Lucency

RadElement ID	RDE313
Definition	Measure periprosthetic lucency. Alert if greater than 2 mm.
Data Type	Numeric
Value Set
Units	mm

Secondary Outputs

Total Hip Arthroplasty Status

RadElement ID	RDE213
Definition	Status of the total hip arthroplasty
Data Type	Categorical
Value Set	0–Normal 1–Abnormal 2–Indeterminate
Units	N/A

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