'Direct DICOM slice landmarking' a novel research technique to quantify skeletal changes in orthognathic surgery

The limitations of the current methods of quantifying the surgical movements of facial bones inspired this study. The aim of this study was the assessment of the accuracy and reproducibility of directly landmarking of 3D DICOM images (Digital Imaging and Communications in Medicine) to quantify the changes in the jaw bones following surgery. The study was carried out on plastic skull to simulate the surgical movements of the jaw bones. Cone beam CT scans were taken at 3mm, 6mm, and 9mm maxillary advancement; together with a 2mm, 4mm, 6mm and 8mm “down graft” which in total generated 12 different positions of the maxilla for the analysis. The movements of the maxilla were calculated using two methods, the standard approach where distances between surface landmarks on the jaw bones were measured and the novel approach where measurements were taken directly from the internal structures of the corresponding 3D DICOME slices. A one sample t-test showed that there was no statistically significant difference between the two methods of measurements for the y and z directions, however, the x direction showed a significant difference. The mean difference between the two absolute measurements were 0.34±0.20mm, 0.22±0.16mm, 0.18±0.13mm in the y, z and x directions respectively. In conclusion, the direct landmarking of 3D DICOM image slices is a reliable, reproducible and informative method for assessment of the 3D skeletal changes. The method has a clear clinical application which includes the analysis of the jaw movements “orthognathic surgery” for the correction of facial deformities

Readability of the 100 Most-Cited Neuroimaging Papers Assessed by Common Readability Formulae

Background: From time to time, neuroimaging research findings receive press coverage and attention by the general public. Scientific articles therefore should be written in a readable manner to facilitate knowledge translation and dissemination. However, no published readability report on neuroimaging articles like those published in education, medical and marketing journals is available. As a start, this study therefore aimed to evaluate the readability of the most-cited neuroimaging articles.Methods: The 100 most-cited articles in neuroimaging identified in a recent study by Kim et al. (2016) were evaluated. Headings, mathematical equations, tables, figures, footnotes, appendices, and reference lists were trimmed from the articles. The rest was processed for number of characters, words and sentences. Five readability indices that indicate the school grade appropriate for that reading difficulty (Automated Readability Index, Coleman-Liau Index, Flesch-Kincaid Grade Level, Gunning Fog index and Simple Measure of Gobbledygook index) were computed. An average reading grade level (AGL) was calculated by taking the mean of these five indices. The Flesch Reading Ease (FRE) score was also computed. The readability of the trimmed abstracts and full texts was evaluated against number of authors, country of corresponding author, total citation count, normalized citation count, article type, publication year, impact factor of the year published and type of journal.Results: Mean AGL ± standard deviation (SD) of the trimmed abstracts and full texts were 17.15 ± 2.81 (college graduate level) and 14.22 ± 1.66 (college level) respectively. Mean FRE score ± SD of the abstracts and full texts were 15.70 ± 14.11 (college graduate level) and 32.11 ± 8.56 (college level) respectively. Both items indicated that the full texts were significantly more readable than the abstracts (p < 0.001). Abstract readability was not associated with any factors under investigation. ANCOVAs showed that review/meta-analysis (mean AGL ± SD: 16.0 ± 1.4) and higher impact factor significantly associated with lower readability of the trimmed full texts surveyed.Conclusion: Concerning the 100 most-cited articles in neuroimaging, the full text appears to be more readable than the abstracts. Experimental articles and methodology papers were more readable than reviews/meta-analyses. Articles published in journals with higher impact factors were less readable

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Bland-Altman plot showing the difference against mean in y (vertical) direction.

<p>Bland-Altman plot showing the difference against mean in y (vertical) direction.</p

Results of the pilot study of a repeated measurements on clinical cases (Paired sample t-test).

<p>Results of the pilot study of a repeated measurements on clinical cases (Paired sample t-test).</p