The UK’s National Institute for Health and Clinical Excellence (NICE) has published diagnostic guidance encouraging the use of the EOS 2D/3D imaging system in specialist research settings to collect evidence about potentially important clinical benefits associated with 3D reconstruction, single image weight‐bearing whole‐body imaging and simultaneous postero‐anterior (PA) and lateral imaging.
In the guidance, NICE recognises that EOS is an important emerging technology with potentially important clinical benefits such as significant imaging improvements that could result in better clinical decision‐making. NICE recognises that there is evidence for people with spinal deformities (scoliosis) to receive substantially less radiation dose and for clinicians and organisations to increase patient throughput, although no substantial health economic benefit could be obtained from radiation dose reduction on the scoliotic population.
The NICE Committee considered that the EOS system could provide positive health outcome benefits resulting in better decisions about orthopaedic surgery, in particular for the management of spinal pathologies, principally scoliosis, but also including other conditions such as progressive kyphosis and osteoporotic fractures in adults, as well as conditions that particularly affect the hip and knee (notably hip and knee replacement planning).
Professor Lazennec, from Paris’ leading hospital, Pitié‐Salpétrière, said “Hip and knee prothestic surgery planning as done until now is biased by projection and by patient position. EOS provides the ability of seeing and measuring our patients in 3D, weight bearing and globally, and allows me to plan adequately my surgeries respecting my patient specific anatomy. I am happy that my patients can benefit from this technology today.
“Full data sets demonstrating the potential benefits required for cost‐efficacy analysis to NICE standards will require time to establish.”
“NICE has kindly offered to work with EOS to co‐develop its specialist research programme. However full data sets demonstrating the potential benefits required for cost‐efficacy analysis to NICE standards will require time to establish as they involve the outcome of pre‐operative planning through to complex therapies and surgeries such as scoliosis surgery and hip and knee replacements. Until such data are available, NICE is not yet able to recommend the system for routine use in the NHS.
Marie Meynadier, EOS Imaging CEO said, “The EOS 2D/3D imaging system is routinely used in clinical settings across the world. It is also subject to an extensive programme of research associating radiologists and orthopaedic surgeons. We will provide data to NICE as they are established to determine when a cost‐effectiveness review based on this evidence would be appropriate.”
At a leading institution for scoliosis, Dr Hubert Labelle, Head of Orthopedics at St Justine Hospital, Montreal, Canada, said “Orthopedic surgery is a series of precise gestures in a 3D universe, performed on 3D patients. We need to take this into account when we plan our surgeries. We also have results from a preliminary study showing that 3D could be key to the prognosis of scoliosis. In other words, 3D parameters measured at the very first patient visit could give us an indication of the foreseeable progression of the pathology, and help us define the best course of action. Scoliosis therapies are very invasive and we need tools that can help us define the best for our patients. This is why we are using EOS, together with the dose reduction benefit to the patient.”
Source: EOS Imaging