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J Orthop Res. 2019 Sep 19. doi: 10.1002/jor.24479. [Epub ahead of print]

Synchrotron MicroCT Reveals the Potential of the Dual Contrast Technique for Quantitative Assessment of Human Articular Cartilage Composition.

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Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.
Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.
Department of Medical Physics, Turku University Hospital, Turku, Finland.
SIB Labs, University of Eastern Finland, Kuopio, Finland.
A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.
Centre d'lmagerie BioMédicale, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Swiss Light Source, Paul Scherrer Institute, Villigen, Switzerland.
Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland.
Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts.
School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Queensland, Australia.


Dual contrast micro computed tomography (CT) shows potential for detecting articular cartilage degeneration. However, the performance of conventional CT systems is limited by beam hardening, low image resolution (full-body CT), and long acquisition times (conventional microCT). Therefore, to reveal the full potential of the dual contrast technique for imaging cartilage composition we employ the technique using synchrotron microCT. We hypothesize that the above-mentioned limitations are overcome with synchrotron microCT utilizing monochromatic X-ray beam and fast image acquisition. Human osteochondral samples (n = 41, four cadavers) were immersed in a contrast agent solution containing two agents (cationic CA4+ and non-ionic gadoteridol) and imaged with synchrotron microCT at an early diffusion time point (2 h) and at diffusion equilibrium (72 h) using two monochromatic X-ray energies (32 and 34 keV). The dual contrast technique enabled simultaneous determination of CA4+ (i.e., proteoglycan content) and gadoteridol (i.e., water content) partitions within cartilage. Cartilage proteoglycan content and biomechanical properties correlated significantly (0.327 < r < 0.736, p < 0.05) with CA4+ partition in superficial and middle zones at both diffusion time points. Normalization of the CA4+ partition with gadoteridol partition within the cartilage significantly (p < 0.05) improved the detection sensitivity for human osteoarthritic cartilage proteoglycan content, biomechanical properties, and overall condition (Mankin, Osteoarthritis Research Society International, and International Cartilage Repair Society grading systems). The dual energy technique combined with the dual contrast agent enables assessment of human articular cartilage proteoglycan content and biomechanical properties based on CA4+ partition determined using synchrotron microCT. Additionally, the dual contrast technique is not limited by the beam hardening artifact of conventional CT systems. © 2019 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society. J Orthop Res.


CA4+; CECT; cationic contrast agent; contrast-enhanced computed tomography; dual contrast agent


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