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Ann Biomed Eng. 2017 Mar;45(3):811-818. doi: 10.1007/s10439-016-1730-3. Epub 2016 Sep 19.

In Vivo Contrast-Enhanced Cone Beam CT Provides Quantitative Information on Articular Cartilage and Subchondral Bone.

Author information

1
Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. katariina.myller@uef.fi.
2
Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, 70029, Kuopio, Finland. katariina.myller@uef.fi.
3
Department of Applied Physics, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
4
Diagnostic Imaging Center, Kuopio University Hospital, P.O. Box 100, 70029, Kuopio, Finland.
5
Orthopaedics and Traumatology Clinic, Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260, Helsinki, Finland.
6
Kuopio Musculoskeletal Research Unit (KMRU), Surgery, Institute of Clinical Medicine, University of Eastern Finland, 70211, Kuopio, Finland.

Abstract

In post-traumatic osteoarthritis, both articular cartilage and subchondral bone undergo characteristic pathological changes. This study investigates potential of delayed cone beam computed tomography arthrography (dCBCTa) to simultaneously detect variations in cartilage and subchondral bone. The knees of patients (n = 17) with suspected joint injuries were imaged using a clinical CBCT scanner at 5 and 45 min after the intra-articular injection of anionic contrast agent (Hexabrix™) with hydroxyapatite phantoms around the knee. Normalized attenuation (i.e., contrast agent partition, an indicator of tissue composition) in cartilage, bone mineral density (BMD) in subchondral bone plate (SBP), subchondral bone and trabecular bone, and thicknesses of SBP and cartilage were determined. Lesions of cartilage were scored using International Cartilage Repair Society (ICRS) grading. Normalized attenuation in the delayed image (t = 45 min) increased along the increase of ICRS grade (p = 0.046). Moreover, BMD was significantly higher in SBPs under damaged cartilage (ICRS = 1-2 or ICRS ≥ 3; p = 0.047 and p = 0.038, respectively) than in SBP under non-injured tissue (ICRS = 0). For the first time, dCBCTa enabled the detection of articular cartilage injuries and subchondral bone alterations simultaneously in vivo. Significant relations between ICRS grading and both cartilage and bone parameters suggest that dCBCTa has potential for quantitative imaging of the knee joint.

KEYWORDS:

Computed tomography; Contrast agent; Knee joint; Osteoarthritis; Quantitative imaging

PMID:
27646147
DOI:
10.1007/s10439-016-1730-3
[Indexed for MEDLINE]

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