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Ditton DM, Marchus CR, Bozeman AL, Martes AC, Brumley MR, Schiele NR. Visualization of rat tendon in three dimensions using micro-Computed Tomography. MethodsX 2024; 12:102565. [PMID: 38292310 PMCID: PMC10825692 DOI: 10.1016/j.mex.2024.102565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
Micro-computed tomography (CT) is an X-ray-based imaging modality that produces three-dimensional (3D), high-resolution images of whole-mount tissues, but is typically limited to dense tissues, such as bone. The X-rays readily pass-through tendons, rendering them transparent. Contrast-enhancing chemical stains have been explored, but their use to improve contrast in different tendon types and across developmental stages for micro-CT imaging has not been systematically evaluated. Therefore, we investigated how phosphotungstic acid (PTA) staining and tissue hydration impacts tendon contrast for micro-CT imaging. We showed that PTA staining increased X-ray absorption of tendon to enhance tissue contrast and obtain 3D micro-CT images of immature (postnatal day 21) and sexually mature (postnatal day 50) rat tendons within the tail and hindlimb. Further, we demonstrated that tissue hydration state following PTA staining significantly impacts soft tissue contrast. Using this method, we also found that tail tendon fascicles appear to cross between fascicle bundles. Ultimately, contrast-enhanced 3D micro-CT imaging will lead to better understanding of tendon structure, and relationships between the bone and soft tissues.•Simple tissue fixation and staining technique enhances soft tissue contrast for tendon visualization using micro-CT.•3D tendon visualization in situ advances understanding of musculoskeletal tissue structure and organization.
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Affiliation(s)
- Destinee M. Ditton
- Chemical & Biological Engineering, University of Idaho, 875 Perimeter Dr. MS 0904, Moscow, ID 83844, USA
| | - Colin R. Marchus
- Chemical & Biological Engineering, University of Idaho, 875 Perimeter Dr. MS 0904, Moscow, ID 83844, USA
| | - Aimee L. Bozeman
- Psychology, Idaho State University, 921 S 8th Avenue Stop 8087, Pocatello, ID 83209, USA
| | - Alleyna C. Martes
- Psychology, Idaho State University, 921 S 8th Avenue Stop 8087, Pocatello, ID 83209, USA
| | - Michele R. Brumley
- Psychology, Idaho State University, 921 S 8th Avenue Stop 8087, Pocatello, ID 83209, USA
| | - Nathan R. Schiele
- Chemical & Biological Engineering, University of Idaho, 875 Perimeter Dr. MS 0904, Moscow, ID 83844, USA
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2
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Orava H, Paakkari P, Jäntti J, Honkanen MKM, Honkanen JTJ, Virén T, Joenathan A, Tanska P, Korhonen RK, Grinstaff MW, Töyräs J, Mäkelä JTA. Triple contrast computed tomography reveals site-specific biomechanical differences in the human knee joint-A proof of concept study. J Orthop Res 2024; 42:415-424. [PMID: 37593815 DOI: 10.1002/jor.25683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/05/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
Cartilage and synovial fluid are challenging to observe separately in native computed tomography (CT). We report the use of triple contrast agent (bismuth nanoparticles [BiNPs], CA4+, and gadoteridol) to image and segment cartilage in cadaveric knee joints with a clinical CT scanner. We hypothesize that BiNPs will remain in synovial fluid while the CA4+ and gadoteridol will diffuse into cartilage, allowing (1) segmentation of cartilage, and (2) evaluation of cartilage biomechanical properties based on contrast agent concentrations. To investigate these hypotheses, triple contrast agent was injected into both knee joints of a cadaver (N = 1), imaged with a clinical CT at multiple timepoints during the contrast agent diffusion. Knee joints were extracted, imaged with micro-CT (µCT), and biomechanical properties of the cartilage surface were determined by stress-relaxation mapping. Cartilage was segmented and contrast agent concentrations (CA4+ and gadoteridol) were compared with the biomechanical properties at multiple locations (n = 185). Spearman's correlation between cartilage thickness from clinical CT and reference µCT images verifies successful and reliable segmentation. CA4+ concentration is significantly higher in femoral than in tibial cartilage at 60 min and further timepoints, which corresponds to the higher Young's modulus observed in femoral cartilage. In this pilot study, we show that (1) large BiNPs do not diffuse into cartilage, facilitating straightforward segmentation of human knee joint cartilage in a clinical setting, and (2) CA4+ concentration in cartilage reflects the biomechanical differences between femoral and tibial cartilage. Thus, the triple contrast agent CT shows potential in cartilage morphology and condition estimation in clinical CT.
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Affiliation(s)
- Heta Orava
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Petri Paakkari
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Jiri Jäntti
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Miitu K M Honkanen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | | | - Tuomas Virén
- Center of Oncology, Kuopio University Hospital, Kuopio, Finland
| | - Anisha Joenathan
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts, USA
| | - Petri Tanska
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Rami K Korhonen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts, USA
| | - Juha Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | - Janne T A Mäkelä
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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3
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Zhang C, Vedadghavami A, He T, Charles JF, Bajpayee AG. Cationic Carrier Mediated Delivery of Anionic Contrast Agents in Low Doses Enable Enhanced Computed Tomography Imaging of Cartilage for Early Osteoarthritis Diagnosis. ACS NANO 2023; 17:6649-6663. [PMID: 36989423 PMCID: PMC10629240 DOI: 10.1021/acsnano.2c12376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/23/2023] [Indexed: 06/03/2023]
Abstract
Cartilage tissue exhibits early degenerative changes with onset of osteoarthritis (OA). Early diagnosis is critical as there is only a narrow time window during which therapeutic intervention can reverse disease progression. Computed tomography (CT) has been considered for cartilage imaging as a tool for early OA diagnosis by introducing radio-opaque contrast agents like ioxaglate (IOX) into the joint. IOX, however, is anionic and thus repelled by negatively charged cartilage glycosaminoglycans (GAGs) that hinders its intra-tissue penetration and partitioning, resulting in poor CT attenuation. This is further complicated by its short intra-tissue residence time owing to rapid clearance from joints, which necessitates high doses causing toxicity concerns. Here we engineer optimally charged cationic contrast agents based on cartilage negative fixed charge density by conjugating cartilage targeting a cationic peptide carrier (CPC) and multi-arm avidin nanoconstruct (mAv) to IOX, such that they can penetrate through the full thickness of cartilage within 6 h using electrostatic interactions and elicit similar CT signal with about 40× lower dose compared to anionic IOX. Their partitioning and distribution correlate strongly with spatial GAG distribution within healthy and early- to late-stage arthritic bovine cartilage tissues at 50-100× lower doses than other cationic contrast agents used in the current literature. The use of contrast agents at low concentrations also allowed for delineation of cartilage from subchondral bone as well as other soft tissues in rat tibial joints. These contrast agents are safe to use at current doses, making CT a viable imaging modality for early detection of OA and staging of its severity.
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Affiliation(s)
- Chenzhen Zhang
- Department
of Bioengineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Armin Vedadghavami
- Department
of Bioengineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Tengfei He
- Department
of Bioengineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
| | - Julia F. Charles
- Department
of Orthopaedic Surgery, Brigham and Women’s
Hospital, 60 Fenwood Road, Boston, Massachusetts 02115, United States
| | - Ambika G. Bajpayee
- Department
of Bioengineering, Northeastern University, 360 Huntington Avenue, Boston, Massachusetts 02115, United States
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4
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Honkanen MKM, Mohammadi A, Te Moller NCR, Ebrahimi M, Xu W, Plomp S, Pouran B, Lehto VP, Brommer H, van Weeren PR, Korhonen RK, Töyräs J, Mäkelä JTA. Dual-contrast micro-CT enables cartilage lesion detection and tissue condition evaluation ex vivo. Equine Vet J 2023; 55:315-324. [PMID: 35353399 PMCID: PMC10084070 DOI: 10.1111/evj.13573] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 03/10/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Post-traumatic osteoarthritis is a frequent joint disease in the horse. Currently, equine medicine lacks effective methods to diagnose the severity of chondral defects after an injury. OBJECTIVES To investigate the capability of dual-contrast-enhanced computed tomography (dual-CECT) for detection of chondral lesions and evaluation of the severity of articular cartilage degeneration in the equine carpus ex vivo. STUDY DESIGN Pre-clinical experimental study. METHODS In nine Shetland ponies, blunt and sharp grooves were randomly created (in vivo) in the cartilage of radiocarpal and middle carpal joints. The contralateral joint served as control. The ponies were subjected to an 8-week exercise protocol and euthanised 39 weeks after surgery. CECT scanning (ex vivo) of the joints was performed using a micro-CT scanner 1 hour after an intra-articular injection of a dual-contrast agent. The dual-contrast agent consisted of ioxaglate (negatively charged, q = -1) and bismuth nanoparticles (BiNPs, q = 0, diameter ≈ 0.2 µm). CECT results were compared to histological cartilage proteoglycan content maps acquired using digital densitometry. RESULTS BiNPs enabled prolonged visual detection of both groove types as they are too large to diffuse into the cartilage. Furthermore, proportional ioxaglate diffusion inside the tissue allowed differentiation between the lesion and ungrooved articular cartilage (3 mm from the lesion and contralateral joint). The mean ioxaglate partition in the lesion was 19 percentage points higher (P < 0.001) when compared with the contralateral joint. The digital densitometry and the dual-contrast CECT findings showed good subjective visual agreement. MAIN LIMITATIONS Ex vivo study protocol and a low number of investigated joints. CONCLUSIONS The dual-CECT methodology, used in this study for the first time to image whole equine joints, is capable of effective lesion detection and simultaneous evaluation of the condition of the articular cartilage.
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Affiliation(s)
- Miitu K M Honkanen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Ali Mohammadi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Nikae C R Te Moller
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Mohammadhossein Ebrahimi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Wujun Xu
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Saskia Plomp
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Behdad Pouran
- Department of Orthopedics, University Medical Center Utrecht, The Netherlands
| | - Vesa-Pekka Lehto
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P René van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia.,Science Service Center, Kuopio University Hospital, Kuopio, Finland
| | - Janne T A Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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5
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Chan DD, Mashiatulla M, Li J, Ross RD, Pendyala M, Patwa A, Grinstaff MW, Plaas A, Sumner DR. Contrast-enhanced micro-computed tomography of compartment and time-dependent changes in femoral cartilage and subchondral plate in a murine model of osteoarthritis. Anat Rec (Hoboken) 2023; 306:92-109. [PMID: 35751529 PMCID: PMC10084428 DOI: 10.1002/ar.25027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 01/29/2023]
Abstract
A lack of understanding of the mechanisms underlying osteoarthritis (OA) progression limits the development of effective long-term treatments. Quantitatively tracking spatiotemporal patterns of cartilage and bone degeneration is critical for assessment of more appropriately targeted OA therapies. In this study, we use contrast-enhanced micro-computed tomography (μCT) to establish a timeline of subchondral plate (SCP) and cartilage changes in the murine femur after destabilization of the medial meniscus (DMM). We performed DMM or sham surgery in 10-12-week-old male C57Bl/6J mice. Femora were imaged using μCT after 0, 2, 4, or 8 weeks. Cartilage-optimized scans were performed after immersion in contrast agent CA4+. Bone mineral density distribution (BMDD), cartilage attenuation, SCP, and cartilage thickness and volume were measured, including lateral and medial femoral condyle and patellar groove compartments. As early as 2 weeks post-DMM, cartilage thickness significantly increased and cartilage attenuation, SCP volume, and BMDD mean significantly decreased. Trends in cartilage and SCP metrics within each joint compartment reflected those seen in global measurements, and both BMDD and SCP thickness were consistently greater in the lateral and medial condyles than the patellar groove. Sham surgery also resulted in significant changes to SCP and cartilage metrics, highlighting a potential limitation of using surgical models to study tissue morphology or composition changes during OA progression. Contrast-enhanced μCT analysis is an effective tool to monitor changes in morphology and composition of cartilage, and when combined with bone-optimized μCT, can be used to assess the progression of degenerative changes after joint injury.
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Affiliation(s)
- Deva D Chan
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, USA.,Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Maleeha Mashiatulla
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, Illinois, USA
| | - Jun Li
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Ryan D Ross
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, Illinois, USA
| | - Meghana Pendyala
- Department of Biomedical Engineering, Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York, USA
| | - Amit Patwa
- Department of Biomedical Engineering Department of Chemistry, Boston University, Boston, Massachusetts, USA.,Department of Chemistry, Boston University, Boston, Massachusetts, USA.,Division of Chemistry, Navrachana University, Vadodara, Gujarat, India
| | - Mark W Grinstaff
- Department of Biomedical Engineering Department of Chemistry, Boston University, Boston, Massachusetts, USA.,Department of Chemistry, Boston University, Boston, Massachusetts, USA
| | - Anna Plaas
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - D Rick Sumner
- Department of Anatomy and Cell Biology, Rush University Medical Center, Chicago, Illinois, USA
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6
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Bhattarai A, Lok JGT, Sun H, Vardhanabhuti V. Computed Tomography of Cartilage: An Exploration of Novel Cationic Bismuth Contrast Agent. Ann Biomed Eng 2022; 51:977-986. [PMID: 36446911 DOI: 10.1007/s10439-022-03110-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/16/2022] [Indexed: 12/02/2022]
Abstract
Accurate diagnosis of minor cartilage injuries with delayed contrast-enhanced computed tomography (CECT) is challenging as poor diffusion and toxicity issues limit the usage of common CT contrast agents. Hence, the design of safe contrast agents with physiochemical properties suitable for fast, deep cartilage imaging is imminent. Herein, a novel cationic bismuth contrast agent (Bi-DOTAPXD) based on dodecane tetraacetic acid (DOTA) was synthesized and examined for CECT of cartilage. The complex was designed to improve diagnosis by utilising a net-positive charge for enhanced permeability through cartilage, inherent low-toxicity and high X-ray attenuation of bismuth. Osteochondral plugs (n = 12), excised from visually intact porcine articular cartilage were immersed in Bi-DOTAPXD (8 mg/mL) and Gd-DOTAPXD (10 mg/mL) contrast agents and scanned with a high-resolution microcomputed tomography scanner at multiple time-points. The mean Bi-DOTAPXD and Gd-DOTAPXD partitions at 45-min time-point were 85.7 ± 35.1 and 69.8 ± 30.2%, and the partitions correlated with the histopathological analysis of cartilage proteoglycan (PG) content (r) at 0.657 and 0.632, respectively. The time diffusion constants (τ) for Bi-DOTAPXD and Gd-DOTA were 121 and 159 min, respectively. Diffusion Bi-DOTAPXD and Gd-DOTAPXD reflected inter-sample variation in cartilage PG content. Cationic Bi-DOTAPXD may have the potential as a CT agent for the diagnosis of cartilage.
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7
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Maes A, Pestiaux C, Marino A, Balcaen T, Leyssens L, Vangrunderbeeck S, Pyka G, De Borggraeve WM, Bertrand L, Beauloye C, Horman S, Wevers M, Kerckhofs G. Cryogenic contrast-enhanced microCT enables nondestructive 3D quantitative histopathology of soft biological tissues. Nat Commun 2022; 13:6207. [PMID: 36266273 PMCID: PMC9584947 DOI: 10.1038/s41467-022-34048-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 10/12/2022] [Indexed: 12/24/2022] Open
Abstract
Biological tissues comprise a spatially complex structure, composition and organization at the microscale, named the microstructure. Given the close structure-function relationships in tissues, structural characterization is essential to fully understand the functioning of healthy and pathological tissues, as well as the impact of possible treatments. Here, we present a nondestructive imaging approach to perform quantitative 3D histo(patho)logy of biological tissues, termed Cryogenic Contrast-Enhanced MicroCT (cryo-CECT). By combining sample staining, using an X-ray contrast-enhancing staining agent, with freezing the sample at the optimal freezing rate, cryo-CECT enables 3D visualization and structural analysis of individual tissue constituents, such as muscle and collagen fibers. We applied cryo-CECT on murine hearts subjected to pressure overload following transverse aortic constriction surgery. Cryo-CECT allowed to analyze, in an unprecedented manner, the orientation and diameter of the individual muscle fibers in the entire heart, as well as the 3D localization of fibrotic regions within the myocardial layers. We foresee further applications of cryo-CECT in the optimization of tissue/food preservation and donor banking, showing that cryo-CECT also has clinical and industrial potential.
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Affiliation(s)
- Arne Maes
- Department of Materials Engineering, KU Leuven, Heverlee, Belgium
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Camille Pestiaux
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Alice Marino
- Pole of Cardiovascular Research, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Tim Balcaen
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
- Molecular Design and Synthesis, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Lisa Leyssens
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Sarah Vangrunderbeeck
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
- Molecular Design and Synthesis, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Grzegorz Pyka
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Wim M De Borggraeve
- Molecular Design and Synthesis, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Luc Bertrand
- Pole of Cardiovascular Research, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | | | - Sandrine Horman
- Pole of Cardiovascular Research, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium
| | - Martine Wevers
- Department of Materials Engineering, KU Leuven, Heverlee, Belgium
| | - Greet Kerckhofs
- Department of Materials Engineering, KU Leuven, Heverlee, Belgium.
- Biomechanics lab, Institute of Mechanics, Materials and Civil Engineering, UCLouvain, Louvain-la-Neuve, Belgium.
- Pole of Morphology, Institute of Experimental and Clinical Research, UCLouvain, Brussels, Belgium.
- Prometheus, Division for Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.
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8
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A Cationic Contrast Agent in X-ray Imaging of Articular Cartilage: Pre-Clinical Evaluation of Diffusion and Attenuation Properties. Diagnostics (Basel) 2022; 12:diagnostics12092111. [PMID: 36140512 PMCID: PMC9497730 DOI: 10.3390/diagnostics12092111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was the preliminary assessment of a new cationic contrast agent, the CA4+, via the analysis of spatial distribution in cartilage of ex vivo bovine samples, at micrometer and millimeter scale. Osteochondral plugs (n = 18) extracted from bovine stifle joints (n = 2) were immersed in CA4+ solution up to 26 h. Planar images were acquired at different time points, using a microCT apparatus. The CA4+ distribution in cartilage and saturation time were evaluated. Tibial plates from bovine stifle joints (n = 3) were imaged with CT, before and after 24 h-CA4+ bath immersion, at different concentrations. Afterward, potential CA4+ washout from cartilage was investigated. From microCT acquisitions, the CA4+ distribution differentiated into three distinct layers inside the cartilage, reflecting the spatial distribution of proteoglycans. After 24 h of diffusion, the iodine concentration reached in cartilage was approximately seven times that of the CA4+ bath. The resulting saturation time was 1.9 ± 0.9 h and 2.6 ± 2.9 h for femoral and tibial samples, respectively. Analysis of clinical CT acquisitions confirmed overall contrast enhancement of cartilage after 24 h immersion, observed for each CA4+ concentration. Distinct contrast enhancement was reached in different cartilage regions, depending on tissue’s local features. Incomplete but remarkable washout of cartilage was observed. CA4+ significantly improved cartilage visualization and its qualitative analysis.
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9
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Hall ME, Wang AS, Gold GE, Levenston ME. Contrast solution properties and scan parameters influence the apparent diffusivity of computed tomography contrast agents in articular cartilage. J R Soc Interface 2022; 19:20220403. [PMID: 35919981 PMCID: PMC9346352 DOI: 10.1098/rsif.2022.0403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022] Open
Abstract
The inability to detect early degenerative changes to the articular cartilage surface that commonly precede bulk osteoarthritic degradation is an obstacle to early disease detection for research or clinical diagnosis. Leveraging a known artefact that blurs tissue boundaries in clinical arthrograms, contrast agent (CA) diffusivity can be derived from computed tomography arthrography (CTa) scans. We combined experimental and computational approaches to study protocol variations that may alter the CTa-derived apparent diffusivity. In experimental studies on bovine cartilage explants, we examined how CA dilution and transport direction (absorption versus desorption) influence the apparent diffusivity of untreated and enzymatically digested cartilage. Using multiphysics simulations, we examined mechanisms underlying experimental observations and the effects of image resolution, scan interval and early scan termination. The apparent diffusivity during absorption decreased with increasing CA concentration by an amount similar to the increase induced by tissue digestion. Models indicated that osmotically-induced fluid efflux strongly contributed to the concentration effect. Simulated changes to spatial resolution, scan spacing and total scan time all influenced the apparent diffusivity, indicating the importance of consistent protocols. With careful control of imaging protocols and interpretations guided by transport models, CTa-derived diffusivity offers promise as a biomarker for early degenerative changes.
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Affiliation(s)
- Mary E. Hall
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Adam S. Wang
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Marc E. Levenston
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
- Department of Radiology, Stanford University, Stanford, CA, USA
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10
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Fowkes MM, Das Neves Borges P, Cacho-Nerin F, Brennan PE, Vincent TL, Lim NH. Imaging articular cartilage in osteoarthritis using targeted peptide radiocontrast agents. PLoS One 2022; 17:e0268223. [PMID: 35536857 PMCID: PMC9089912 DOI: 10.1371/journal.pone.0268223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Established MRI and emerging X-ray contrast agents for non-invasive imaging of articular cartilage rely on non-selective electrostatic interactions with negatively charged proteoglycans. These contrast agents have limited prognostic utility in diseases such as osteoarthritis (OA) due to the characteristic high turnover of proteoglycans. To overcome this limitation, we developed a radiocontrast agent that targets the type II collagen macromolecule in cartilage and used it to monitor disease progression in a murine model of OA. Methods To confer radiopacity to cartilage contrast agents, the naturally occurring tyrosine derivative 3,5-diiodo-L-tyrosine (DIT) was introduced into a selective peptide for type II collagen. Synthetic DIT peptide derivatives were synthesised by Fmoc-based solid-phase peptide synthesis and binding to ex vivo mouse tibial cartilage evaluated by high-resolution micro-CT. Di-Iodotyrosinated Peptide Imaging of Cartilage (DIPIC) was performed ex vivo and in vivo 4, 8 and 12 weeks in mice after induction of OA by destabilisation of the medial meniscus (DMM). Finally, human osteochondral plugs were imaged ex vivo using DIPIC. Results Fifteen DIT peptides were synthesised and tested, yielding seven leads with varying cartilage binding strengths. DIPIC visualised ex vivo murine articular cartilage comparably to the ex vivo contrast agent phosphotungstic acid. Intra-articular injection of contrast agent followed by in vivo DIPIC enabled delineation of damaged murine articular cartilage. Finally, the translational potential of the contrast agent was confirmed by visualisation of ex vivo human cartilage explants. Conclusion DIPIC has reduction and refinement implications in OA animal research and potential clinical translation to imaging human disease.
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Affiliation(s)
- Milan M. Fowkes
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Patricia Das Neves Borges
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Fernando Cacho-Nerin
- Diamond Light Source Ltd, Diamond House, Harwell Science and Innovation Campus, Didcot, United Kingdom
| | - Paul E. Brennan
- Target Discovery Institute, Nuffield Department of Medicine Research Building, University of Oxford, Oxford, United Kingdom
| | - Tonia L. Vincent
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Ngee H. Lim
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
- * E-mail:
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11
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Saukko AEA, Nykänen O, Sarin JK, Nissi MJ, Te Moller NCR, Weinans H, Mancini IAD, Visser J, Brommer H, van Weeren PR, Malda J, Grinstaff MW, Töyräs J. Dual-contrast computed tomography enables detection of equine posttraumatic osteoarthritis in vitro. J Orthop Res 2022; 40:703-711. [PMID: 33982283 DOI: 10.1002/jor.25066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/26/2021] [Indexed: 02/04/2023]
Abstract
To prevent the progression of posttraumatic osteoarthritis, assessment of cartilage composition is critical for effective treatment planning. Posttraumatic changes include proteoglycan (PG) loss and elevated water content. Quantitative dual-energy computed tomography (QDECT) provides a means to diagnose these changes. Here, we determine the potential of QDECT to evaluate tissue quality surrounding cartilage lesions in an equine model, hypothesizing that QDECT allows detection of posttraumatic degeneration by providing quantitative information on PG and water contents based on the partitions of cationic and nonionic agents in a contrast mixture. Posttraumatic osteoarthritic samples were obtained from a cartilage repair study in which full-thickness chondral defects were created surgically in both stifles of seven Shetland ponies. Control samples were collected from three nonoperated ponies. The experimental (n = 14) and control samples (n = 6) were immersed in the contrast agent mixture and the distributions of the agents were determined at various diffusion time points. As a reference, equilibrium moduli, dynamic moduli, and PG content were measured. Significant differences (p < 0.05) in partitions between the experimental and control samples were demonstrated with cationic contrast agent at 30 min, 60 min, and 20 h, and with non-ionic agent at 60 and 120 min. Significant Spearman's rank correlations were obtained at 20 and 24 h (ρ = 0.482-0.693) between the partition of cationic contrast agent, cartilage biomechanical properties, and PG content. QDECT enables evaluation of posttraumatic changes surrounding a lesion and quantification of PG content, thus advancing the diagnostics of the extent and severity of cartilage injuries.
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Affiliation(s)
- Annina E A Saukko
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Olli Nykänen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Research Unit of Medical Imaging Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaakko K Sarin
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Mikko J Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Research Unit of Medical Imaging Physics and Technology, University of Oulu, Oulu, Finland
| | - Nikae C R Te Moller
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Harrie Weinans
- Department of Biomechanical Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands.,Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Irina A D Mancini
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jetze Visser
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Harold Brommer
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - P Réné van Weeren
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Jos Malda
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.,Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts, USA
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia.,Science Service Center, Kuopio University Hospital, Kuopio, Finland
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12
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Hall ME, Black MS, Gold GE, Levenston ME. Validation of watershed-based segmentation of the cartilage surface from sequential CT arthrography scans. Quant Imaging Med Surg 2022; 12:1-14. [PMID: 34993056 PMCID: PMC8666781 DOI: 10.21037/qims-20-1062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study investigated the utility of a 2-dimensional watershed algorithm for identifying the cartilage surface in computed tomography (CT) arthrograms of the knee up to 33 minutes after an intra-articular iohexol injection as boundary blurring increased. METHODS A 2D watershed algorithm was applied to CT arthrograms of 3 bovine stifle joints taken 3, 8, 18, and 33 minutes after iohexol injection and used to segment tibial cartilage. Thickness measurements were compared to a reference standard thickness measurement and the 3-minute time point scan. RESULTS 77.2% of cartilage thickness measurements were within 0.2 mm (1 voxel) of the thickness calculated in the reference scan at the 3-minute time point. 42% fewer voxels could be segmented from the 33-minute scan than the 3-minute scan due to diffusion of the contrast agent out of the joint space and into the cartilage, leading to blurring of the cartilage boundary. The traced watershed lines were closer to the location of the cartilage surface in areas where tissues were in direct contact with each other (cartilage-cartilage or cartilage-meniscus contact). CONCLUSIONS The use of watershed dam lines to guide cartilage segmentation shows promise for identifying cartilage boundaries from CT arthrograms in areas where soft tissues are in direct contact with each other.
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Affiliation(s)
- Mary E. Hall
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
| | - Marianne S. Black
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Marc E. Levenston
- Department of Mechanical Engineering, Stanford University, Stanford, CA, USA
- Department of Radiology, Stanford University, Stanford, CA, USA
- Department of Bioengineering, Stanford University, Stanford, CA, USA
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13
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Nelson BB, Mäkelä JTA, Lawson TB, Patwa AN, Snyder BD, McIlwraith CW, Grinstaff MW, Goodrich LR, Kawcak CE. Cationic contrast-enhanced computed tomography distinguishes between reparative, degenerative, and healthy equine articular cartilage. J Orthop Res 2021; 39:1647-1657. [PMID: 33104251 DOI: 10.1002/jor.24894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/21/2020] [Accepted: 10/21/2020] [Indexed: 02/04/2023]
Abstract
Cationic contrast-enhanced computed tomography (CECT) is a quantitative imaging technique that characterizes articular cartilage, though its efficacy in differentiating repair tissue from other disease states is undetermined. We hypothesized that cationic CECT attenuation will distinguish between reparative, degenerative, and healthy equine articular cartilage and will reflect biochemical, mechanical, and histologic properties. Chondral defects were created in vivo on equine femoropatellar joint surfaces. Within defects, calcified cartilage was retained (Repair 1) or removed (Repair 2). At sacrifice, plugs were collected from within defects, and at locations bordering (adjacent site) and remote to defects along with site-matched controls. Articular cartilage was analyzed via CECT using CA4+ to assess glycosaminoglycan (GAG) content, compressive modulus (E eq ), and International Cartilage Repair Society (ICRS) II histologic score. Comparisons of variables were made between sites using mixed model analysis and between variables with correlations. Cationic CECT attenuation was significantly lower in Repair 1 (1478 ± 333 Hounsfield units [HUs]), Repair 2 (1229 ± 191 HUs), and adjacent (2139 ± 336 HUs) sites when compared with site-matched controls (2587 ± 298, 2505 ± 184, and 2563 ± 538 HUs, respectively; all p < .0001). Cationic CECT attenuation was significantly higher at remote sites (2928 ± 420 HUs) compared with Repair 1, Repair 2, and adjacent sites (all p < .0001). Cationic CECT attenuation correlated with ICRS II score (r = .79), GAG (r = .76), and E eq (r = .71; all p < .0001). Cationic CECT distinguishes between reparative, degenerative, and healthy articular cartilage and highly correlates with biochemical, mechanical, and histological tissue properties.
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Affiliation(s)
- Brad B Nelson
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - Janne T A Mäkelä
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Departments of Chemistry, Boston University, Boston, Massachusetts, USA.,Department Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Taylor B Lawson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA.,Departments of Chemistry, Boston University, Boston, Massachusetts, USA.,Department Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Amit N Patwa
- Departments of Chemistry, Boston University, Boston, Massachusetts, USA.,Department Biomedical Engineering, Boston University, Boston, Massachusetts, USA.,Deparment of Chemistry, School of Science, Navrachana University, Vadodara, Gujarat, India
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - C Wayne McIlwraith
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - Mark W Grinstaff
- Departments of Chemistry, Boston University, Boston, Massachusetts, USA.,Department Biomedical Engineering, Boston University, Boston, Massachusetts, USA
| | - Laurie R Goodrich
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - Chris E Kawcak
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
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14
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Bhattarai A, Mäkelä JTA, Pouran B, Kröger H, Weinans H, Grinstaff MW, Töyräs J, Turunen MJ. Effects of human articular cartilage constituents on simultaneous diffusion of cationic and nonionic contrast agents. J Orthop Res 2021; 39:771-779. [PMID: 32767676 PMCID: PMC8048551 DOI: 10.1002/jor.24824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/03/2020] [Accepted: 08/05/2020] [Indexed: 02/04/2023]
Abstract
Contrast-enhanced computed tomography is an emerging diagnostic technique for osteoarthritis. However, the effects of increased water content, as well as decreased collagen and proteoglycan concentrations due to cartilage degeneration, on the diffusion of cationic and nonionic agents, are not fully understood. We hypothesize that for a cationic agent, these variations increase the diffusion rate while decreasing partition, whereas, for a nonionic agent, these changes increase both the rate of diffusion and partition. Thus, we examine the diffusion of cationic and nonionic contrast agents within degraded tissue in time- and depth-dependent manners. Osteochondral plugs (N = 15, d = 8 mm) were extracted from human cadaver knee joints, immersed in a mixture of cationic CA4+ and nonionic gadoteridol contrast agents, and imaged at multiple time-points, using the dual-contrast method. Water content, and collagen and proteoglycan concentrations were determined using lyophilization, infrared spectroscopy, and digital densitometry, respectively. Superficial to mid (0%-60% depth) cartilage CA4+ partitions correlated with water content (R < -0.521, P < .05), whereas in deeper (40%-100%) cartilage, CA4+ correlated only with proteoglycans (R > 0.671, P < .01). Gadoteridol partition correlated inversely with collagen concentration (0%-100%, R < -0.514, P < .05). Cartilage degeneration substantially increased the time for CA4+ compared with healthy tissue (248 ± 171 vs 175 ± 95 minute) to reach the bone-cartilage interface, whereas for gadoteridol the time (111 ± 63 vs 179 ± 163 minute) decreased. The work clarifies the diffusion mechanisms of two different contrast agents and presents depth and time-dependent effects resulting from articular cartilage constituents. The results will inform the development of new contrast agents and optimal timing between agent administration and joint imaging.
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Affiliation(s)
- Abhisek Bhattarai
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | | | - Behdad Pouran
- Department of OrthopaedicsUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Heikki Kröger
- Department of Orthopedics, Traumatology and Hand SurgeryKuopio University HospitalKuopioFinland
| | - Harrie Weinans
- Department of OrthopaedicsUniversity Medical Center UtrechtUtrechtThe Netherlands
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials EngineeringDelft University of Technology (TU Delft)DelftThe Netherlands
| | - Mark W. Grinstaff
- Departments of Biomedical Engineering, Chemistry, and MedicineBoston UniversityBostonMassachusetts
| | - Juha Töyräs
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
- School of Information Technology and Electrical EngineeringThe University of QueenslandBrisbaneAustralia
| | - Mikael J. Turunen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- SIB LabsUniversity of Eastern FinlandKuopioFinland
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15
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Nelson BB, Stewart RC, Kawcak CE, Freedman JD, Patwa AN, Snyder BD, Goodrich LR, Grinstaff MW. Quantitative Evaluation of Equine Articular Cartilage Using Cationic Contrast-Enhanced Computed Tomography. Cartilage 2021; 12:211-221. [PMID: 33722083 PMCID: PMC7970376 DOI: 10.1177/1947603518812562] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To investigate the diffusion trajectory of a cationic contrast medium (CA4+) into equine articular cartilage, and to assess normal and degenerative equine articular cartilage using cationic contrast-enhanced computed tomography (CECT). DESIGN In the first experiment (Exp1), equine osteochondral specimens were serially imaged with cationic CECT to establish the diffusion time constant and time to reach equilibrium in healthy articular cartilage. In a separate experiment (Exp2), articular cartilage defects were created on the femoral trochlea (defect joint) in a juvenile horse, while the opposite joint was a sham-operated control. After 7 weeks, osteochondral biopsies were collected throughout the articular surfaces of both joints. Biopsies were analyzed for cationic CECT attenuation, glycosaminoglycan (GAG) content, mechanical stiffness (Eeq), and histology. Imaging, biochemical and mechanical data were compared between defect and control joints. RESULTS Exp1: The mean diffusion time constant was longer for medial condyle cartilage (3.05 ± 0.1 hours) than lateral condyle cartilage (1.54 ± 0.3 hours, P = 0.04). Exp2: Cationic CECT attenuation was lower in the defect joint than the control joint (P = 0.005) and also varied by anatomic location (P = 0.045). Mean cationic CECT attenuation from the lateral trochlear ridge was lower in the defect joint than in the control joint (2223 ± 329 HU and 2667 ± 540 HU, respectively; P = 0.02). Cationic CECT attenuation was strongly correlated with both GAG (ρ = 0.79, P < 0.0001) and Eeq (ρ = 0.61, P < 0.0001). CONCLUSIONS The equilibration time of CA4+ into equine articular cartilage is affected by tissue volume. Quantitative cationic CECT imaging reflects the biochemical, biomechanical and histological state of normal and degenerative equine articular cartilage.
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Affiliation(s)
| | | | | | - Jonathan D. Freedman
- Plastic and Reconstructive Surgery, School of Surgery, University of Colorado, Aurora, CO, USA
| | | | - Brian D. Snyder
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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16
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Quantitative dual contrast photon-counting computed tomography for assessment of articular cartilage health. Sci Rep 2021; 11:5556. [PMID: 33692379 PMCID: PMC7946949 DOI: 10.1038/s41598-021-84800-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 02/09/2021] [Indexed: 01/31/2023] Open
Abstract
Photon-counting detector computed tomography (PCD-CT) is a modern spectral imaging technique utilizing photon-counting detectors (PCDs). PCDs detect individual photons and classify them into fixed energy bins, thus enabling energy selective imaging, contrary to energy integrating detectors that detects and sums the total energy from all photons during acquisition. The structure and composition of the articular cartilage cannot be detected with native CT imaging but can be assessed using contrast-enhancement. Spectral imaging allows simultaneous decomposition of multiple contrast agents, which can be used to target and highlight discrete cartilage properties. Here we report, for the first time, the use of PCD-CT to quantify a cationic iodinated CA4+ (targeting proteoglycans) and a non-ionic gadolinium-based gadoteridol (reflecting water content) contrast agents inside human osteochondral tissue (n = 53). We performed PCD-CT scanning at diffusion equilibrium and compared the results against reference data of biomechanical and optical density measurements, and Mankin scoring. PCD-CT enables simultaneous quantification of the two contrast agent concentrations inside cartilage and the results correlate with the structural and functional reference parameters. With improved soft tissue contrast and assessment of proteoglycan and water contents, PCD-CT with the dual contrast agent method is of potential use for the detection and monitoring of osteoarthritis.
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17
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Lawson TB, Mäkelä JTA, Klein T, Snyder BD, Grinstaff MW. Nanotechnology and osteoarthritis; part 1: Clinical landscape and opportunities for advanced diagnostics. J Orthop Res 2021; 39:465-472. [PMID: 32827322 DOI: 10.1002/jor.24817] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/12/2020] [Accepted: 07/27/2020] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is a disease of the entire joint, often triggered by cartilage injury, mediated by a cascade of inflammatory pathways involving a complex interplay among metabolic, genetic, and enzymatic factors that alter the biochemical composition, microstructure, and biomechanical performance. Clinically, OA is characterized by degradation of the articular cartilage, thickening of the subchondral bone, inflammation of the synovium, and degeneration of ligaments that in aggregate reduce joint function and diminish quality of life. OA is the most prevalent joint disease, affecting 140 million people worldwide; these numbers are only expected to increase, concomitant with societal and financial burden of care. We present a two-part review encompassing the applications of nanotechnology to the diagnosis and treatment of OA. Herein, part 1 focuses on OA treatment options and advancements in nanotechnology for the diagnosis of OA and imaging of articular cartilage, while part 2 (10.1002/jor.24842) summarizes recent advances in drug delivery, tissue scaffolds, and gene therapy for the treatment of OA. Specifically, part 1 begins with a concise review of the clinical landscape of OA, along with current diagnosis and treatments. We next review nanoparticle contrast agents for minimally invasive detection, diagnosis, and monitoring of OA via magnetic resonace imaging, computed tomography, and photoacoustic imaging techniques as well as for probes for cell tracking. We conclude by identifying opportunities for nanomedicine advances, and future prospects for imaging and diagnostics.
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Affiliation(s)
- Taylor B Lawson
- Departments of Biomedical Engineering, Mechanical Engineering, Chemistry, and Medicine Boston University, Boston, Massachusetts
- Orthopaedics Research Department, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Janne T A Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Travis Klein
- School of Mechanical, Medical and Process Engineering, Center for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia
| | - Brian D Snyder
- Orthopaedics Research Department, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Mechanical Engineering, Chemistry, and Medicine Boston University, Boston, Massachusetts
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18
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Xiao S, Chen L. The emerging landscape of nanotheranostic-based diagnosis and therapy for osteoarthritis. J Control Release 2020; 328:817-833. [PMID: 33176171 DOI: 10.1016/j.jconrel.2020.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 02/06/2023]
Abstract
Osteoarthritis (OA) is a common degenerative disease involving numerous joint tissues and cells, with a growing rate in prevalence that ultimately results in a negative social impact. Early diagnosis, OA progression monitoring and effective treatment are of significant importance in halting OA process. However, traditional imaging techniques lack sensitivity and specificity, which lead to a delay in timely clinical intervention. Additionally, current treatments only slow the progression of OA but have not meet the largely medical need for disease-modifying therapy. In order to overcome the above-mentioned problems and improve clinical efficacy, nanotheranostics has been proposed on OA remedy, which has confirmed success in animal models. In this review, different imaging targets-based nanoprobe for early and timely OA diagnosis is first discussed. Second, therapeutic strategies delivered by nanosystem are summarized as much as possible. Their advantages and the potential for clinical translation are detailed discussed. Third, nanomedicine simultaneously combined with the imaging for OA treatment is introduced. Nanotheranostics dynamically tracked the OA treatment outcomes to timely and individually adjust therapy. Finally, future prospects and challenges of nanotechnology-based OA diagnosis, imaging and treatment are concluded and predicted. It is believed that nanoprobe and nanomedicine will become prospective in OA therapeutic revolution.
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Affiliation(s)
- Shuyi Xiao
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China; Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China
| | - Liang Chen
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China.
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19
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Bhattarai A, Pouran B, Mäkelä JTA, Shaikh R, Honkanen MKM, Prakash M, Kröger H, Grinstaff MW, Weinans H, Jurvelin JS, Töyräs J. Dual contrast in computed tomography allows earlier characterization of articular cartilage over single contrast. J Orthop Res 2020; 38:2230-2238. [PMID: 32525582 DOI: 10.1002/jor.24774] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 02/04/2023]
Abstract
Cationic computed tomography contrast agents are more sensitive for detecting cartilage degeneration than anionic or non-ionic agents. However, osteoarthritis-related loss of proteoglycans and increase in water content contrarily affect the diffusion of cationic contrast agents, limiting their sensitivity. The quantitative dual-energy computed tomography technique allows the simultaneous determination of the partitions of iodine-based cationic (CA4+) and gadolinium-based non-ionic (gadoteridol) agents in cartilage at diffusion equilibrium. Normalizing the cationic agent partition at diffusion equilibrium with that of the non-ionic agent improves diagnostic sensitivity. We hypothesize that this sensitivity improvement is also prominent during early diffusion time points and that the technique is applicable during contrast agent diffusion. To investigate the validity of this hypothesis, osteochondral plugs (d = 8 mm, N = 33), extracted from human cadaver (n = 4) knee joints, were immersed in a contrast agent bath (a mixture of CA4+ and gadoteridol) and imaged using the technique at multiple time points until diffusion equilibrium. Biomechanical testing and histological analysis were conducted for reference. Quantitative dual-energy computed tomography technique enabled earlier determination of cartilage proteoglycan content over single contrast. The correlation coefficient between human articular cartilage proteoglycan content and CA4+ partition increased with the contrast agent diffusion time. Gadoteridol normalized CA4+ partition correlated significantly (P < .05) with Mankin score at all time points and with proteoglycan content after 4 hours. The technique is applicable during diffusion, and normalization with gadoteridol partition improves the sensitivity of the CA4+ contrast agent.
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Affiliation(s)
- Abhisek Bhattarai
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Behdad Pouran
- Department of Orthopaedic, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Janne T A Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Rubina Shaikh
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miitu K M Honkanen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Mithilesh Prakash
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Kröger
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts
| | - Harrie Weinans
- Department of Orthopaedic, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands.,Department of Rheumatology, University Medical Center, Utrecht, The Netherlands
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
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20
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Newton MD, Junginger L, Maerz T. Automated MicroCT-based bone and articular cartilage analysis using iterative shape averaging and atlas-based registration. Bone 2020; 137:115417. [PMID: 32416288 DOI: 10.1016/j.bone.2020.115417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 05/02/2020] [Accepted: 05/12/2020] [Indexed: 01/09/2023]
Abstract
Micro-computed tomography (μCT) and contrast-enhanced μCT are important tools for preclinical analysis of bone and articular cartilage (AC). Quantitative data from these modalities is highly dependent on the accuracy of tissue segmentations, which are often obtained via time-consuming manual contouring and are prone to inter- and intra-observer variability. Automated segmentation strategies could mitigate these issues, but few such approaches have been described in the context of μCT. Here, we validated a fully-automated strategy for bone and AC segmentation based on registration of an average tissue atlas. Femora from healthy and arthritic rats underwent μCT scanning, and epiphyseal trabecular bone and AC volumes were manually contoured by an expert. Average tissue atlases composed of 1, 3, 5, 10 and 20 pre-contoured training images (n = 10 atlases/group) were generated using iterative shape averaging and registered onto unknown images via affine and non-rigid registration. Atlas-based and expert-defined volumes for bone and AC were compared in terms of shape-based similarity metrics, as well as morphometric and densitometric parameters. Our results demonstrate that atlas-based registrations were capable of highly accurate and consistent segmentation. Atlases built from as few as 3 training images had no incidence of mal-registration and exhibited improved incidence of accurate registration, and higher sensitivity and specificity compared to atlases built from only one training image. Atlas-based segmentation of bone and AC from μCT images is a robust and accurate alternative to manual tissue segmentation, enabling faster, more consistent segmentation of pre-clinical datasets.
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Affiliation(s)
- Michael D Newton
- Orthopaedic Research Laboratories, Beaumont Health, Royal Oak, MI, United States of America
| | - Lucas Junginger
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, United States of America
| | - Tristan Maerz
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, United States of America.
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21
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Freedman JD, Ellis DJ, Lusic H, Varma GV, Grant AK, Lakin BA, Snyder BD, Grinstaff MW. dGEMRIC and CECT Comparison of Cationic and Anionic Contrast Agents in Cadaveric Human Metacarpal Cartilage. J Orthop Res 2020; 38:719-725. [PMID: 31687789 PMCID: PMC7071952 DOI: 10.1002/jor.24511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/31/2019] [Indexed: 02/04/2023]
Abstract
Magnetic resonance imaging (MRI) and computed tomography (CT) are widely used to image cartilage and their diagnostic capability is enhanced in the presence of contrast agents. The aim of the study is to directly compare the performance between commercial anionic MRI (Gd(DTPA), Gd2-) and CT (Ioxaglate, Iox1-) contrast agents with novel cationic MRI (Gd(DTPA)Lys2 , Gd4+) and CT (CA4+) contrast agents for assessment of cartilage mechanical and biochemical properties using the ex vivo human osteoarthritis metacarpal cartilage model. First, indentation testing was conducted to obtain the compressive modulus of the human fifth metacarpals. The samples were then immersed in the anionic and cationic contrast agents prior to delayed gadolinium-enhanced MRI of cartilage and CT scanning, respectively. The cartilage glycosaminoglycan (GAG) content and distribution were determined using the 1,9-dimethylmethylene blue assay and Safranin-O histology. Cationic agents significantly accumulate in cartilage compared with anionic agents. Significant positive correlations (p < 0.05) exist between imaging results of cationic agents and GAG content (Gd4+: R2 = 0.43; CA4+: R2 = 0.67) and indentation equilibrium modulus (Gd4+: R2 = 0.48; CA4+: R2 = 0.77). Significant negative correlations are observed between anionic MRI relaxation times, but not contrast-enhanced computed tomography attenuation and cartilage GAG content (Gd2-: R2 = 0.56, p < 0.05; Iox1-: R2 = 0.31, p > 0.05) and indentation equilibrium modulus (Gd2-: R2 = 0.38, p < 0.05; Iox1-: R2 = 0.17, p > 0.05). MRI or CT with cationic contrast agents provides greater sensitivity than their anionic analogs at assessing the biochemical and biomechanical properties of ex vivo human metacarpal cartilage. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:719-725, 2020.
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Affiliation(s)
- Jonathan D. Freedman
- Department of Pharmacology, Boston University, Boston, MA
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Daniel J. Ellis
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Hrvoje Lusic
- Department of Chemistry, Boston University, Boston, MA
| | - Gopal V. Varma
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Aaron K. Grant
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Benjamin A. Lakin
- Department of Biomedical Engineering, Boston University, Boston, MA
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Brian D. Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, MA
| | - Mark W. Grinstaff
- Department of Pharmacology, Boston University, Boston, MA
- Department of Chemistry, Boston University, Boston, MA
- Department of Biomedical Engineering, Boston University, Boston, MA
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22
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Honkanen MKM, Saukko AEA, Turunen MJ, Shaikh R, Prakash M, Lovric G, Joukainen A, Kröger H, Grinstaff MW, Töyräs J. Synchrotron MicroCT Reveals the Potential of the Dual Contrast Technique for Quantitative Assessment of Human Articular Cartilage Composition. J Orthop Res 2020; 38:563-573. [PMID: 31535728 PMCID: PMC7065106 DOI: 10.1002/jor.24479] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/13/2019] [Indexed: 02/04/2023]
Abstract
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 38:563-573, 2020.
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Affiliation(s)
- Miitu K. M. Honkanen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Annina E. A. Saukko
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Department of Medical PhysicsTurku University HospitalTurkuFinland
| | - Mikael J. Turunen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- SIB LabsUniversity of Eastern FinlandKuopioFinland
| | - Rubina Shaikh
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Mithilesh Prakash
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
- A.I. Virtanen Institute for Molecular SciencesUniversity of Eastern FinlandKuopioFinland
| | - Goran Lovric
- Centre d'lmagerie BioMédicaleÉcole Polytechnique Fédérale de LausanneLausanneSwitzerland
- Swiss Light SourcePaul Scherrer InstituteVilligenSwitzerland
| | - Antti Joukainen
- Department of Orthopedics, Traumatology and Hand SurgeryKuopio University HospitalKuopioFinland
| | - Heikki Kröger
- Department of Orthopedics, Traumatology and Hand SurgeryKuopio University HospitalKuopioFinland
| | - Mark W. Grinstaff
- Departments of Biomedical Engineering, Chemistry, and MedicineBoston UniversityBostonMassachusetts
| | - Juha Töyräs
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
- School of Information Technology and Electrical EngineeringThe University of QueenslandBrisbaneQueenslandAustralia
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23
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Algotsson J, Jönsson P, Forsman J, Topgaard D, Söderman O. Intermolecular interactions play a role in the distribution and transport of charged contrast agents in a cartilage model. PLoS One 2019; 14:e0215047. [PMID: 31581235 PMCID: PMC6776344 DOI: 10.1371/journal.pone.0215047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/05/2019] [Indexed: 11/18/2022] Open
Abstract
The transport and distribution of charged molecules in polyelectrolyte solutions are of both fundamental and practical importance. A practical example, which is the specific subject addressed in the present paper, is the transport and distribution of charged species into cartilage. The charged species could be a contrast agent or a drug molecule involved in diagnosis or treatment of the widespread degenerative disease osteoarthritis, which leads to degradation of articular cartilage. Associated scientific issues include the rate of transport and the equilibrium concentrations of the charged species in the cartilage and the synovial fluid. To address these questions, we present results from magnetic resonance micro-imaging experiments on a model system of articular cartilage. The experiments yield temporally and spatially resolved data on the transport of a negatively charged contrast agent (charge = -2), used in medical examinations of cartilage, into a polyelectrolyte solution, which is designed to capture the electrostatic interactions in cartilage. Also presented is a theoretical analysis of the transport where the relevant differential equations are solved using finite element techniques as well as treated with approximate analytical expressions. In the analysis, non-ideal effects are included in the treatment of the mobile species in the system. This is made possible by using results from previous Monte Carlo simulations. The results demonstrate the importance of taking non-idealities into account when data from measurements of transport of charged solutes in a system with fixed charges from biological polyelectrolytes are analyzed.
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Affiliation(s)
- Jenny Algotsson
- Division of Physical Chemistry, Lund University, Lund, Sweden
| | - Peter Jönsson
- Division of Physical Chemistry, Lund University, Lund, Sweden
| | - Jan Forsman
- Division of Theoretical Chemistry, Lund University, Lund, Sweden
| | - Daniel Topgaard
- Division of Physical Chemistry, Lund University, Lund, Sweden
| | - Olle Söderman
- Division of Physical Chemistry, Lund University, Lund, Sweden
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24
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Stewart RC, Nelson BB, Kawcak CE, Freedman JD, Snyder BD, Goodrich LR, Grinstaff MW. Contrast-Enhanced Computed Tomography Scoring System for Distinguishing Early Osteoarthritis Disease States: A Feasibility Study. J Orthop Res 2019; 37:2138-2148. [PMID: 31136003 PMCID: PMC6739126 DOI: 10.1002/jor.24382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/14/2019] [Indexed: 02/04/2023]
Abstract
Early detection of osteoarthritis (OA) remains a diagnostic challenge owing to insensitive diagnostic techniques currently available. Herein a new semiquantitative scoring system, based upon contrast-enhanced computed tomographic (CECT) imaging, is described for further refinement of early OA disease staging. Trochlear ridge cartilage defects were surgically created in the femoropatellar joint of an adult horse (ACUC approved protocols). Seven weeks post-surgery, CECT imaging was performed on a clinical scanner after intra-articular injection of a cationic iodinated contrast agent, CA4+, into both injured and control femoropatellar joint compartments. The femoral cartilage surface was densely biopsied, and specimens were assessed for visual (Outerbridge score), functional (equilibrium compressive modulus), and biochemical (glycosaminoglycan content) measures of cartilage quality. Cartilage CECT attenuation was compared with cartilage quality measures using receiver operating characteristic curve analysis to establish attenuation thresholds for distinguishing among cartilage quality levels. CECT imaging identifies macroscopically damaged cartilage regions and in morphologically identical tissue provides moderately sensitive and specific semiquantitative segregation of cartilage quality based upon CECT attenuation, reflecting both glycosaminoglycan content and compressive stiffness of cartilage area under the curve (AUC = 0.83 [95% confidence interval [CI]: 0.72-0.93] for distinguishing poor quality and AUC = 0.76 [95% CI: 0.65-0.90] for distinguishing healthy quality cartilage). A semiquantitative 6-point scoring system-the Osteoarthritis Attenuation and Morphological Assessment (OAMA) score-is proposed as a tool for assessing cartilage quality from CECT images. The OAMA scoring system expands the current disease staging capability of early OA by inclusion of morphological, biochemical, and biomechanical assessments. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2138-2148, 2019.
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Affiliation(s)
- Rachel C. Stewart
- Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, MA 02215,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, MA 02215
| | - Brad B. Nelson
- Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, MA 02215,Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, CO 80523
| | - Chris E. Kawcak
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, CO 80523
| | - Jonathan D. Freedman
- Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, MA 02215,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, MA 02215
| | - Brian D. Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, MA 02215,Address correspondence and reprint requests to: Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, 590 Commonwealth Ave, Boston MA 02215, Phone: 617-358-3429, ; Brian D. Snyder, M.D., Ph.D., Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 1 Overland Street, RN 115, Boston MA 02215,
| | - Laurie R. Goodrich
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, CO 80523
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, MA 02215,Department of Chemistry, Boston University, 590 Commonwealth Avenue, Boston, MA 02215,Department of Medicine, Boston University School of Medicine, 715 Albany St. E-113, Boston, MA 02118,Address correspondence and reprint requests to: Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, 590 Commonwealth Ave, Boston MA 02215, Phone: 617-358-3429, ; Brian D. Snyder, M.D., Ph.D., Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 1 Overland Street, RN 115, Boston MA 02215,
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25
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Triple Contrast CT Method Enables Simultaneous Evaluation of Articular Cartilage Composition and Segmentation. Ann Biomed Eng 2019; 48:556-567. [PMID: 31576504 PMCID: PMC6949199 DOI: 10.1007/s10439-019-02362-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 09/11/2019] [Indexed: 12/16/2022]
Abstract
Early degenerative changes of articular cartilage are detected using contrast-enhanced computed tomography (CT) with a cationic contrast agent (CA). However, cationic CA diffusion into degenerated cartilage decreases with proteoglycan depletion and increases with elevated water content, thus hampering tissue evaluation at early diffusion time points. Furthermore, the contrast at synovial fluid-cartilage interface diminishes as a function of diffusion time hindering accurate cartilage segmentation. For the first time, we employ quantitative dual-energy CT (QDECT) imaging utilizing a mixture of three CAs (cationic CA4+ and non-ionic gadoteridol which are sensitive to proteoglycan and water contents, respectively, and bismuth nanoparticles which highlight the cartilage surface) to simultaneously segment the articulating surfaces and determine of the cartilage condition. Intact healthy, proteoglycan-depleted, and mechanically injured bovine cartilage samples (n = 27) were halved and imaged with synchrotron microCT 2-h post immersion in triple CA or in dual CA (CA4+ and gadoteridol). CA4+ and gadoteridol partitions were determined using QDECT, and pairwise evaluation of these partitions was conducted for samples immersed in dual and triple CAs. In conclusion, the triple CA method is sensitive to proteoglycan depletion while maintaining sufficient contrast at the articular surface to enable detection of cartilage lesions caused by mechanical impact.
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26
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Nelson BB, Mäkelä JTA, Lawson TB, Patwa AN, Barrett MF, McIlwraith CW, Hurtig MB, Snyder BD, Moorman VJ, Grinstaff MW, Goodrich LR, Kawcak CE. Evaluation of equine articular cartilage degeneration after mechanical impact injury using cationic contrast-enhanced computed tomography. Osteoarthritis Cartilage 2019; 27:1219-1228. [PMID: 31075424 DOI: 10.1016/j.joca.2019.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/13/2019] [Accepted: 04/16/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Cationic agent contrast-enhanced computed tomography (cationic CECT) characterizes articular cartilage ex vivo, however, its capacity to detect post-traumatic injury is unknown. The study objectives were to correlate cationic CECT attenuation with biochemical, mechanical and histological properties of cartilage and morphologic computed tomography (CT) measures of bone, and to determine the ability of cationic CECT to distinguish subtly damaged from normal cartilage in an in vivo equine model. DESIGN Mechanical impact injury was initiated in equine femoropatellar joints in vivo to establish subtle cartilage degeneration with site-matched controls. Cationic CECT was performed in vivo (clinical) and postmortem (microCT). Articular cartilage was characterized by glycosaminoglycan (GAG) content, biochemical moduli and histological scores. Bone was characterized by volume density (BV/TV) and trabecular number (Tb.N.), thickness (Tb.Th.) and spacing (Tb.Sp.). RESULTS Cationic CECT attenuation (microCT) of cartilage correlated with GAG (r = 0.74, P < 0.0001), compressive modulus (Eeq) (r = 0.79, P < 0.0001) and safranin-O histological score (r = -0.66, P < 0.0001) of cartilage, and correlated with BV/TV (r = 0.37, P = 0.0005), Tb.N. (r = 0.39, P = 0.0003), Tb.Th. (r = 0.28, P = 0.0095) and Tb.Sp. (r = -0.44, P < 0.0001) of bone. Mean [95% CI] cationic CECT attenuation at the impact site (2215 [1987, 2443] Hounsfield Units [HUs]) was lower than site-matched controls (2836 [2490, 3182] HUs, P = 0.036). Clinical cationic CECT attenuation correlated with GAG (r = 0.23, P = 0.049), Eeq (r = 0.26, P = 0.025) and safranin-O histology score (r = -0.32, P = 0.0046). CONCLUSIONS Cationic CECT (microCT) reflects articular cartilage properties enabling segregation of subtly degenerated from healthy tissue and also reflects bone morphometric properties on CT. Cationic CECT is capable of characterizing articular cartilage in clinical scanners.
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Affiliation(s)
- B B Nelson
- Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA
| | - J T A Mäkelä
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Chemistry, Boston University, Boston, MA, USA
| | - T B Lawson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Mechanical Engineering, Boston University, Boston, MA, USA
| | - A N Patwa
- Department of Chemistry, Boston University, Boston, MA, USA; SLSE (Chemistry), Navrachana University, Vadodara, Gujarat, India
| | - M F Barrett
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - C W McIlwraith
- Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA
| | - M B Hurtig
- Department of Clinical Studies, University of Guelph, Ontario, Canada
| | - B D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - V J Moorman
- Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA
| | - M W Grinstaff
- Department of Chemistry, Boston University, Boston, MA, USA; Department of Mechanical Engineering, Boston University, Boston, MA, USA; Departments of Biomedical Engineering, and Medicine, Boston University, Boston, MA, USA
| | - L R Goodrich
- Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA
| | - C E Kawcak
- Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA.
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27
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Simultaneous Quantitation of Cationic and Non-ionic Contrast Agents in Articular Cartilage Using Synchrotron MicroCT Imaging. Sci Rep 2019; 9:7118. [PMID: 31068614 PMCID: PMC6506503 DOI: 10.1038/s41598-019-43276-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 04/15/2019] [Indexed: 01/15/2023] Open
Abstract
Early diagnosis of acute cartilage injuries enables monitoring of disease progression and improved treatment option planning to prevent post-traumatic osteoarthritis. In contrast-enhanced computed tomography (CECT), the changes in cationic agent diffusion within the tissue reflect cartilage degeneration. The diffusion in degenerated cartilage depends on proteoglycan (PG) content and water content, but each having an opposite effect on diffusion, thus compromising the diagnostic sensitivity. To overcome this limitation, we propose the simultaneous imaging of cationic (sensitive to PG and water contents) and non-ionic (sensitive to water content) agents. In this study, quantitative dual-energy CT (QDECT) imaging of two agents is reported for the first time at clinically feasible imaging time points. Furthermore, this is the first time synchrotron microCT with monochromatic X-rays is employed in cartilage CECT. Imaging was conducted at 1 and 2 h post contrast agent immersion. Intact, PG-depleted, and mechanically injured + PG-depleted cartilage samples (n = 33) were imaged in a mixture of cationic (iodine-based CA4+) and non-ionic (gadolinium-based gadoteridol) agents. Concurrent evaluation of CA4+ and gadoteridol partitions in cartilage is accomplished using QDECT. Subsequent normalization of the CA4+ partition with that of the gadoteridol affords CA4+ attenuations that significantly correlate with PG content – a key marker of OA.
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28
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Honkanen MKM, Matikka H, Honkanen JTJ, Bhattarai A, Grinstaff MW, Joukainen A, Kröger H, Jurvelin JS, Töyräs J. Imaging of proteoglycan and water contents in human articular cartilage with full-body CT using dual contrast technique. J Orthop Res 2019; 37:1059-1070. [PMID: 30816584 PMCID: PMC6594070 DOI: 10.1002/jor.24256] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/12/2019] [Indexed: 02/04/2023]
Abstract
Assessment of cartilage composition via tomographic imaging is critical after cartilage injury to prevent post-traumatic osteoarthritis. Diffusion of cationic contrast agents in cartilage is affected by proteoglycan loss and elevated water content. These changes have opposite effects on diffusion and, thereby, reduce the diagnostic accuracy of cationic agents. Here, we apply, for the first time, a clinical full-body CT for dual contrast imaging of articular cartilage. We hypothesize that full-body CT can simultaneously determine the diffusion and partitioning of cationic and non-ionic contrast agents and that normalization of the cationic agent partition with that of the non-ionic agent minimizes the effect of water content and tissue permeability, especially at early diffusion time points. Cylindrical (d = 8 mm) human osteochondral samples (n = 45; four cadavers) of a variable degenerative state were immersed in a mixture of cationic iodinated CA4+ and non-charged gadoteridol contrast agents and imaged with a full-body CT scanner at various time points. Determination of contrast agents' distributions within cartilage was possible at all phases of diffusion. At early time points, gadoteridol, and CA4+ distributed throughout cartilage with lower concentrations in the deep cartilage. At ≥24 h, the gadoteridol concentration remained nearly constant, while the CA4+ concentration increased toward deep cartilage. Normalization of the CA4+ partition with that of gadoteridol significantly (p < 0.05) enhanced correlation with proteoglycan content and Mankin score at the early time points. To conclude, the dual contrast technique was found advantageous over single contrast imaging enabling more sensitive diagnosis of cartilage degeneration. © 2019 The Authors. Journal of Orthopaedic Research Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-12, 2019.
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Affiliation(s)
- Miitu K. M. Honkanen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland,Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Hanna Matikka
- Department of Clinical RadiologyDiagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | | | - Abhisek Bhattarai
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland,Diagnostic Imaging CenterKuopio University HospitalKuopioFinland
| | - Mark W. Grinstaff
- Departments of Biomedical Engineering, Chemistry, and MedicineBoston UniversityBostonMassachusetts
| | - Antti Joukainen
- Department of Orthopedics, Traumatology and Hand SurgeryKuopio University HospitalKuopioFinland
| | - Heikki Kröger
- Department of Orthopedics, Traumatology and Hand SurgeryKuopio University HospitalKuopioFinland
| | - Jukka S. Jurvelin
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Juha Töyräs
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland,Diagnostic Imaging CenterKuopio University HospitalKuopioFinland,School of Information Technology and Electrical EngineeringThe University of QueenslandBrisbaneAustralia
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29
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Contrast-Enhanced MicroCT for Virtual 3D Anatomical Pathology of Biological Tissues: A Literature Review. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:8617406. [PMID: 30944550 PMCID: PMC6421764 DOI: 10.1155/2019/8617406] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/07/2019] [Indexed: 11/17/2022]
Abstract
To date, the combination of histological sectioning, staining, and microscopic assessment of the 2D sections is still the golden standard for structural and compositional analysis of biological tissues. X-ray microfocus computed tomography (microCT) is an emerging 3D imaging technique with high potential for 3D structural analysis of biological tissues with a complex and heterogeneous 3D structure, such as the trabecular bone. However, its use has been mostly limited to mineralized tissues because of the inherently low X-ray absorption of soft tissues. To achieve sufficient X-ray attenuation, chemical compounds containing high atomic number elements that bind to soft tissues have been recently adopted as contrast agents (CAs) for contrast-enhanced microCT (CE-CT); this novel technique is very promising for quantitative "virtual" 3D anatomical pathology of both mineralized and soft biological tissues. In this paper, we provided a review of the advances in CE-CT since the very first reports on the technology to date. Perfusion CAs for in vivo imaging have not been discussed, as the focus of this review was on CAs that bind to the tissue of interest and that are, thus, used for ex vivo imaging of biological tissues. As CE-CT has mostly been applied for the characterization of musculoskeletal tissues, we have put specific emphasis on these tissues. Advantages and limitations of multiple CAs for different musculoskeletal tissues have been highlighted, and their reproducibility has been discussed. Additionally, the advantages of the "full" 3D CE-CT information have been pinpointed, and its importance for more detailed structural, spatial, and functional characterization of the tissues of interest has been shown. Finally, the remaining challenges that are still hampering a broader adoption of CE-CT have been highlighted, and suggestions have been made to move the field of CE-CT imaging one step further towards a standard accepted tool for quantitative virtual 3D anatomical pathology.
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30
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Cope P, Ourradi K, Li Y, Sharif M. Models of osteoarthritis: the good, the bad and the promising. Osteoarthritis Cartilage 2019; 27:230-239. [PMID: 30391394 PMCID: PMC6350005 DOI: 10.1016/j.joca.2018.09.016] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/30/2018] [Accepted: 09/13/2018] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a chronic degenerative disease of diarthrodial joints most commonly affecting people over the age of forty. The causes of OA are still unknown and there is much debate in the literature as to the exact sequence of events that trigger the onset of the heterogeneous disease we recognise as OA. There is currently no consensus model for OA that naturally reflects human disease. Existing ex-vivo models do not incorporate the important inter-tissue communication between joint components required for disease progression and differences in size, anatomy, histology and biomechanics between different animal models makes translation to the human model very difficult. This narrative review highlights the advantages and disadvantages of the current models used to study OA. It discusses the challenges of producing a more reliable OA-model and proposes a direction for the development of a consensus model that reflects the natural environment of human OA. We suggest that a human osteochondral plug-based model may overcome many of the fundamental limitations associated with animal and in-vitro models based on isolated cells. Such a model will also provide a platform for the development and testing of targeted treatment and validation of novel OA markers directly on human tissues.
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Affiliation(s)
| | | | | | - M. Sharif
- Address correspondence and reprint requests to: M. Sharif, Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning and Research Building level 2, Southmead Hospital, Bristol, BS10 5NB, UK. Tel: 44-117-414-7926.
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31
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Dourthe B, Nickmanesh R, Wilson DR, D'Agostino P, Patwa AN, Grinstaff MW, Snyder BD, Vereecke E. Assessment of healthy trapeziometacarpal cartilage properties using indentation testing and contrast-enhanced computed tomography. Clin Biomech (Bristol, Avon) 2019; 61:181-189. [PMID: 30594765 DOI: 10.1016/j.clinbiomech.2018.12.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 10/05/2018] [Accepted: 12/18/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The trapeziometacarpal joint is a common site for osteoarthritis development in the hand. When osteoarthritis is present, it results in significant functional disabilities due to the broad range of activities performed by this joint. However, our understanding of osteoarthritis initiation and progression at this joint is limited because of the current lack of knowledge regarding the properties and structure of the corresponding cartilage layers. The objective of this study is to assess the morphological and mechanical properties of trapeziometacarpal cartilage via the combination of indentation testing and contrast-enhanced computed tomography. Such research may lead to the development of medical imaging-based approaches to measure cartilage properties in vivo. METHODS Intact first metacarpals and trapezia were extracted from 16 fresh-frozen human cadaver hands. For each specimen, load-displacement behavior was measured at 9 testing sites using a standardized indentation testing device to calculate the normal force and Young's modulus of the cartilage sub-regions. The specimens were then immersed in CA4+ contrast agent solution for 48 h and subsequently scanned with a resolution of 41 μm in a HR-pQCT scanner to measure cartilage thickness and attenuation. Finally, correlations between compressive Young's modulus and contrast-enhanced computed tomography attenuation of the cartilage were assessed. FINDINGS No significant difference was found in cartilage thickness between the trapezium and first metacarpal, but the comparison between articular regions showed thinner cartilage around the volar aspect of both the first metacarpal and the trapezium. The first metacarpal cartilage was stiffer than the trapezial cartilage. A significant positive correlation was observed between Young's modulus and mean contrast-enhanced CT attenuations in superficial and full-depth cartilage in both the first metacarpal and the trapezium cartilage. INTERPRETATION The quantitative measurements of trapeziometacarpal thickness and stiffness as well as a correlation between Young's modulus and contrast-enhanced computed tomography attenuation provides a method for the non-destructive in vivo assessment of cartilage properties, a greater understanding of thumb cartilage behavior, and a dataset for the development of more accurate computer models.
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Affiliation(s)
- Benjamin Dourthe
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Kulak, Kortrijk, Belgium.
| | - Reza Nickmanesh
- Centre for Hip Health and Mobility (CHHM), Vancouver, BC, Canada
| | - David R Wilson
- Centre for Hip Health and Mobility (CHHM), Vancouver, BC, Canada; Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada.
| | - Priscilla D'Agostino
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Kulak, Kortrijk, Belgium; Louise Hand Clinic, Brussels, Belgium; Europe Clinic, St.-Elisabeth Clinic, Brussels, Belgium
| | - Amit N Patwa
- Departments of Chemistry and Biomedical Engineering, Boston University, Boston, MA, USA.
| | - Mark W Grinstaff
- Departments of Chemistry and Biomedical Engineering, Boston University, Boston, MA, USA.
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | - Evie Vereecke
- Muscles & Movement, Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven Kulak, Kortrijk, Belgium.
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32
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Nickmanesh R, Stewart RC, Snyder BD, Grinstaff MW, Masri BA, Wilson DR. Contrast-enhanced computed tomography (CECT) attenuation is associated with stiffness of intact knee cartilage. J Orthop Res 2018; 36:2641-2647. [PMID: 29667235 DOI: 10.1002/jor.24022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 01/24/2018] [Indexed: 02/04/2023]
Abstract
Contrast-enhanced computed tomography (CECT) using charged contrast-agents enables quantification of cartilage glycosaminoglycan content. Since glycosaminoglycan content is a key determinant of cartilage compressive stiffness, CECT measurements have the potential to non-invasively assess cartilage stiffness. The objective of this study was to determine whether CECT attenuation, using a cationic contrast-agent (CA4+), correlates with the stiffness of intact cartilage. Six fresh femoral and six fresh tibial compartments with intact cartilage were obtained from patients undergoing total knee replacement surgery. The instantaneous stiffness was determined for 25-50 points on the surface of each compartment using an established indentation technique. The samples were then immersed in CA4+ solution for 48 h, scanned in a micro-CT scanner, and the average CECT attenuation at each indentation site was found for the superficial cartilage. A significant (p < 0.01) and positive correlation was observed between stiffness and CECT attenuation for sites from each individual cartilage surface, with correlation coefficients ranging from r = 0.37-0.57 and r = 0.48-0.69 (p < 0.01) for the tibia and femur, respectively. When data for each type of cartilage surface were pooled together, the correlation coefficients were r = 0.73 for femoral condyle data points and r = 0.49 for tibial plateau data points. CECT provided a map of cartilage stiffness across each surface, which allows regions of low stiffness to be identified. These findings support continued evaluation and development of quantitative imaging techniques to assess the functional properties of cartilage. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2641-2647, 2018.
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Affiliation(s)
- Reza Nickmanesh
- University of British Columbia, Department of Orthopaedics, Vancouver, BC, Canada.,Center for Hip Health and Mobility, Vancouver, BC, Canada
| | - Rachel C Stewart
- Boston University, Departments of Chemistry and Biomedical Engineering, Boston, MA, USA.,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Brian D Snyder
- Boston University, Departments of Chemistry and Biomedical Engineering, Boston, MA, USA.,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Mark W Grinstaff
- Boston University, Departments of Chemistry and Biomedical Engineering, Boston, MA, USA.,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Bassam A Masri
- University of British Columbia, Department of Orthopaedics, Vancouver, BC, Canada.,Center for Hip Health and Mobility, Vancouver, BC, Canada
| | - David R Wilson
- University of British Columbia, Department of Orthopaedics, Vancouver, BC, Canada.,Center for Hip Health and Mobility, Vancouver, BC, Canada
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33
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Newton MD, Hartner SE, Gawronski K, Davenport EJ, Timmons SC, Baker KC, Maerz T. Nondestructive, indirect assessment of the biomechanical properties of the rat intervertebral disc using contrast-enhanced μCT. J Orthop Res 2018; 36:2030-2038. [PMID: 29314237 DOI: 10.1002/jor.23850] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 12/24/2017] [Indexed: 02/04/2023]
Abstract
Mechanical characterization of the intervertebral disc involves labor-intensive and destructive experimental methodology. Contrast-enhanced micro-computed tomography is a nondestructive imaging modality for high-resolution visualization and glycosaminoglycan quantification of cartilaginous tissues. The purpose of this study was to determine whether anionic and cationic contrast-enhanced micro-computed tomography of the intervertebral disc can be used to indirectly assess disc mechanical properties in an ex vivo model of disc degeneration. L3/L4 motion segments were dissected from female Lewis rats. To deplete glycosaminoglycan, samples were treated with 0 U/ml (Control) or 5 U/ml papain. Contrast-enhanced micro-computed tomography was performed following incubation in 40% Hexabrix (anionic) or 30 mg I/ml CA4+ (cationic) for 24 h (n = 10/contrast agent/digestion group). Motion segments underwent cyclic mechanical testing to determine compressive and tensile modulus, stiffness, and hysteresis. Glycosaminoglycan content was determined using the dimethylmethylene blue assay. Correlations between glycosaminoglycan content, contrast-enhanced micro-computed tomography attenuation, and mechanical properties were assessed via the Pearson correlation. The predictive accuracy of attenuation on compressive properties was assessed via repeated random sub-sampling cross validation. Papain digestion produced significant decreases in glycosaminoglycan content and corresponding differences in attenuation and mechanical properties. Attenuation correlated significantly to glycosaminoglycan content and to all compressive mechanical properties using both Hexabrix and CA4+ . Predictive linear regression models demonstrated a predictive accuracy of attenuation on compressive modulus and stiffness of 79.8-86.0%. Contrast-enhanced micro-computed tomography was highly predictive of compressive mechanical properties in an ex vivo simulation of disc degeneration and may represent an effective modality for indirectly assessing disc compressive properties. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:2030-2038, 2018.
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Affiliation(s)
- Michael D Newton
- Orthopaedic Research Laboratory, Beaumont Health, Royal Oak, Michigan
| | | | - Karissa Gawronski
- Orthopaedic Research Laboratory, Beaumont Health, Royal Oak, Michigan
| | - Erik J Davenport
- Department of Natural Sciences, Lawrence Technological University, Southfield, Michigan
| | - Shannon C Timmons
- Department of Natural Sciences, Lawrence Technological University, Southfield, Michigan
| | - Kevin C Baker
- Orthopaedic Research Laboratory, Beaumont Health, Royal Oak, Michigan.,Department of Orthopaedic Surgery, Oakland University - William Beaumont School of Medicine, Rochester, Michigan
| | - Tristan Maerz
- Orthopaedic Research Laboratory, Beaumont Health, Royal Oak, Michigan.,Department of Orthopaedic Surgery, Oakland University - William Beaumont School of Medicine, Rochester, Michigan.,Department of Orthopaedic Surgery, University of Michigan, 109 Zina Pitcher Place, 48109, Ann Arbor, Michigan
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34
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Bhattarai A, Honkanen JTJ, Myller KAH, Prakash M, Korhonen M, Saukko AEA, Virén T, Joukainen A, Patwa AN, Kröger H, Grinstaff MW, Jurvelin JS, Töyräs J. Quantitative Dual Contrast CT Technique for Evaluation of Articular Cartilage Properties. Ann Biomed Eng 2018; 46:1038-1046. [DOI: 10.1007/s10439-018-2013-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/21/2018] [Indexed: 12/12/2022]
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35
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Nelson BB, Kawcak CE, Barrett MF, McIlwraith CW, Grinstaff MW, Goodrich LR. Recent advances in articular cartilage evaluation using computed tomography and magnetic resonance imaging. Equine Vet J 2018; 50:564-579. [DOI: 10.1111/evj.12808] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/09/2018] [Indexed: 12/18/2022]
Affiliation(s)
- B. B. Nelson
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - C. E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. F. Barrett
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
- Department of Environmental and Radiological Health Sciences Colorado State University Fort Collins Colorado USA
| | - C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. W. Grinstaff
- Departments of Biomedical Engineering, Chemistry and Medicine Boston University Boston Massachusetts USA
| | - L. R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
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36
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Huang L, Liu Y, Ding Y, Wu X, Zhang N, Lai Q, Zeng X, Wan Z, Dai M, Zhang B. Quantitative evaluation of lumbar intervertebral disc degeneration by axial T2* mapping. Medicine (Baltimore) 2017; 96:e9393. [PMID: 29390547 PMCID: PMC5758249 DOI: 10.1097/md.0000000000009393] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
To quantitatively evaluate the clinical value and demonstrate the potential benefits of biochemical axial T2* mapping-based grading of early stages of degenerative disc disease (DDD) using 3.0-T magnetic resonance imaging (MRI) in a clinical setting.Fifty patients with low back pain and 20 healthy volunteers (control) underwent standard MRI protocols including axial T2* mapping. All the intervertebral discs (IVDs) were classified morphologically. Lumbar IVDs were graded using Pfirrmann score (I to IV). The T2* values of the anterior annulus fibrosus (AF), posterior AF, and nucleus pulposus (NP) of each lumbar IVD were measured. The differences between groups were analyzed regarding specific T2* pattern at different regions of interest.The T2* values of the NP and posterior AF in the patient group were significantly lower than those in the control group (P < .01). The T2* value of the anterior AF was not significantly different between the patients and the controls (P > .05). The mean T2*values of the lumbar IVD in the patient group were significantly lower, especially the posterior AF, followed by the NP, and finally, the anterior AF. In the anterior AF, comparison of grade I with grade III and grade I with grade IV showed statistically significant differences (P = .07 and P = .08, respectively). Similarly, in the NP, comparison of grade I with grade III, grade I with grade IV, grade II with grade III, and grade II with grade IV showed statistically significant differences (P < .001). In the posterior AF, comparison of grade II with grade IV showed a statistically significant difference (P = .032). T2 values decreased linearly with increasing degeneration based on the Pfirrmann scoring system (ρ < -0.5, P < .001).Changes in the T2* value can signify early degenerative IVD diseases. Hence, T2* mapping can be used as a diagnostic tool for quantitative assessment of IVD degeneration.
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Affiliation(s)
- Leitao Huang
- Department of Orthopedics Surgery, the First Affiliated Hospital of Nanchang University
- Artificial Joints Engineering and Technology Research Center of Jiangxi
| | - Yuan Liu
- Department of Orthopedics Surgery, the First Affiliated Hospital of Nanchang University
- Artificial Joints Engineering and Technology Research Center of Jiangxi
| | - Yi Ding
- Department of Spine Surgery of Ganzhou People's Hospital, Ganzhou Jiangxi
| | - Xia Wu
- Department of Thoracic and Cardiovascular Surgery
| | - Ning Zhang
- Department of Radiology, the First Affiliated Hospital of Nanchang University,Nanchang Jiangxi, China
| | - Qi Lai
- Department of Orthopedics Surgery, the First Affiliated Hospital of Nanchang University
- Artificial Joints Engineering and Technology Research Center of Jiangxi
| | - Xianjun Zeng
- Department of Radiology, the First Affiliated Hospital of Nanchang University,Nanchang Jiangxi, China
| | - Zongmiao Wan
- Department of Orthopedics Surgery, the First Affiliated Hospital of Nanchang University
- Artificial Joints Engineering and Technology Research Center of Jiangxi
| | - Min Dai
- Department of Orthopedics Surgery, the First Affiliated Hospital of Nanchang University
- Artificial Joints Engineering and Technology Research Center of Jiangxi
| | - Bin Zhang
- Department of Orthopedics Surgery, the First Affiliated Hospital of Nanchang University
- Artificial Joints Engineering and Technology Research Center of Jiangxi
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37
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Stewart RC, Honkanen JT, Kokkonen HT, Tiitu V, Saarakkala S, Joukainen A, Snyder BD, Jurvelin JS, Grinstaff MW, Töyräs J. Contrast-Enhanced Computed Tomography Enables Quantitative Evaluation of Tissue Properties at Intrajoint Regions in Cadaveric Knee Cartilage. Cartilage 2017; 8:391-399. [PMID: 28934883 PMCID: PMC5613888 DOI: 10.1177/1947603516665443] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective The aim of this study was to investigate whether the concentration of the anionic contrast agent ioxaglate, as quantitated by contrast-enhanced computed tomography (CECT) using a clinical cone-beam CT (CBCT) instrument, reflects biochemical, histological, and biomechanical characteristics of articular cartilage imaged in an ex vivo, intact human knee joint. Design An osteoarthritic human cadaveric knee joint (91 years old) was injected with ioxaglate (36 mg I/mL) and imaged using CBCT over 61 hours of ioxaglate diffusion into cartilage. Following imaging, the joint surfaces were excised, rinsed to remove contrast agent, and compressive stiffness (equilibrium and instantaneous compressive moduli) was measured via indentation testing ( n = 17 sites). Each site was sectioned for histology and assessed for glycosaminoglycan content using digital densitometry of Safranin-O stained sections, Fourier transform infrared spectroscopy for collagen content, and morphology using both the Mankin and OARSI semiquantitative scoring systems. Water content was determined using mass change after lyophilization. Results CECT attenuation at all imaging time points, including those <1 hour of ioxaglate exposure, correlated significantly ( P < 0.05) with cartilage water and glycosaminoglycan contents, Mankin score, and both equilibrium and instantaneous compressive moduli. Early time points (<30 minutes) also correlated ( P < 0.05) with collagen content and OARSI score. Differences in cartilage quality between intrajoint regions were distinguishable at diffusion equilibrium and after brief ioxaglate exposure. Conclusions CECT with ioxaglate affords biochemical and biomechanical measurements of cartilage health and performance even after short, clinically relevant exposure times, and may be useful in the clinic as a means for detecting early signs of cartilage pathology.
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Affiliation(s)
- Rachel C. Stewart
- Department of Biomedical Engineering, Boston University, Boston, MA, USA,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Juuso T.J. Honkanen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland,Juuso T. J. Honkanen, Department of Applied Physics, University of Eastern Finland, POB 1627, 70211 Kuopio, Finland.
| | - Harri T. Kokkonen
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Virpi Tiitu
- Institute of Biomedicine, Anatomy, University of Eastern Finland, Kuopio, Finland
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Antti Joukainen
- Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Brian D. Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Jukka S. Jurvelin
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, MA, USA,Department of Chemistry, Boston University, Boston, MA, USA
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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38
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Stewart RC, Patwa AN, Lusic H, Freedman JD, Wathier M, Snyder BD, Guermazi A, Grinstaff MW. Synthesis and Preclinical Characterization of a Cationic Iodinated Imaging Contrast Agent (CA4+) and Its Use for Quantitative Computed Tomography of Ex Vivo Human Hip Cartilage. J Med Chem 2017; 60:5543-5555. [PMID: 28616978 PMCID: PMC6408935 DOI: 10.1021/acs.jmedchem.7b00234] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Contrast agents that go beyond qualitative visualization and enable quantitative assessments of functional tissue performance represent the next generation of clinically useful imaging tools. An optimized and efficient large-scale synthesis of a cationic iodinated contrast agent (CA4+) is described for imaging articular cartilage. Contrast-enhanced CT (CECT) using CA4+ reveals significantly greater agent uptake of CA4+ in articular cartilage compared to that of similar anionic or nonionic agents, and CA4+ uptake follows Donnan equilibrium theory. The CA4+ CECT attenuation obtained from imaging ex vivo human hip cartilage correlates with the glycosaminoglycan content, equilibrium modulus, and coefficient of friction, which are key indicators of cartilage functional performance and osteoarthritis stage. Finally, preliminary toxicity studies in a rat model show no adverse events, and a pharmacokinetics study documents a peak plasma concentration 30 min after dosing, with the agent no longer present in vivo at 96 h via excretion in the urine.
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Affiliation(s)
- Rachel C. Stewart
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, 590 Commonwealth Ave., Boston, Massachusetts 02215, United States
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts 02215, United States
| | - Amit N. Patwa
- Ionic Pharmaceuticals, Boston, Massachusetts 02445, United States
| | - Hrvoje Lusic
- Ionic Pharmaceuticals, Boston, Massachusetts 02445, United States
| | - Jonathan D. Freedman
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts 02215, United States
- Ionic Pharmaceuticals, Boston, Massachusetts 02445, United States
| | - Michel Wathier
- Ionic Pharmaceuticals, Boston, Massachusetts 02445, United States
| | - Brian D. Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts 02215, United States
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, Massachusetts 02118, United States
| | - Mark W. Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, 590 Commonwealth Ave., Boston, Massachusetts 02215, United States
- Ionic Pharmaceuticals, Boston, Massachusetts 02445, United States
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39
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Lakin BA, Snyder BD, Grinstaff MW. Assessing Cartilage Biomechanical Properties: Techniques for Evaluating the Functional Performance of Cartilage in Health and Disease. Annu Rev Biomed Eng 2017; 19:27-55. [DOI: 10.1146/annurev-bioeng-071516-044525] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Benjamin A. Lakin
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
| | - Brian D. Snyder
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215
- Orthopedic Center, Children's Hospital, Boston, Massachusetts 02115
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
- Department of Chemistry, Boston University, Boston, Massachusetts 02215
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40
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Newton MD, Hartner SE, Timmons S, Delaney ND, Pirrone MG, Baker KC, Maerz T. Contrast-enhanced μCT of the intervertebral disc: A comparison of anionic and cationic contrast agents for biochemical and morphological characterization. J Orthop Res 2017; 35:1067-1075. [PMID: 27415967 DOI: 10.1002/jor.23364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 07/02/2016] [Indexed: 02/04/2023]
Abstract
The objective of this study was to quantify and compare the contrast-enhancing properties of the anionic contrast agent ioxaglate/Hexabrix, and cationic contrast agent CA4+ for biochemical and morphological characterization of the intervertebral disc (IVD) via μCT. Optimal contrast agent concentrations were determined by incubating rat lumbar IVDs in dilutions of Hexabrix-320 (20%, 30%, 40%, and 50%) and CA4+ (10, 20, 30, and 40 mg I/ml). μCT imaging was performed at 70 kVp, 114 μA, and 250 ms integration time, 12 μm voxel size. The kinetics of contrast enhancement were quantified with cumulative incubations for 0.5, 1, 2, 12, 16, 20, and 24 h using both agents. Agreement in morphological quantification was assessed via serial scans of the same IVDs. Correlation of attenuation to glycosaminoglycan (GAG) content was determined by enzymatic digestion of IVDs, subsequent μCT imaging, and GAG quantification via dimethylmethylene blue assay. Forty percent Hexabrix and 30 mg I/ml CA4+ were chosen as optimal concentrations. Hexabrix enabled greater delineation of the IVD from surrounding tissues, and CA4+ had the lowest uptake in surrounding soft tissue. Twenty-four hour incubation was sufficient for >99% equilibration of both agents. A high level of agreement was observed in the quantification of IVD volume (ICC = 0.951, r = 0.997) and height (ICC = 0.947, r = 0.991). Both agents exhibited strong linear correlations between μCT attenuation and GAG content (Hexabrix: r = -0.940; CA4+ : r = 0.887). Both agents enable biochemical and morphological quantification of the IVD via contrast-enhanced μCT and are effective tools for preclinical characterization. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1067-1075, 2017.
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Affiliation(s)
- Michael D Newton
- Orthopaedic Research Laboratory, Beaumont Health, 3811W Thirteen Mile Road, Royal Oak, Michigan, 48073
| | - Samantha E Hartner
- Orthopaedic Research Laboratory, Beaumont Health, 3811W Thirteen Mile Road, Royal Oak, Michigan, 48073
| | - Shannon Timmons
- Department of Natural Sciences, Lawrence Technological University, Southfield, Michigan
| | - Nathan D Delaney
- Department of Natural Sciences, Lawrence Technological University, Southfield, Michigan
| | - Michael G Pirrone
- Department of Natural Sciences, Lawrence Technological University, Southfield, Michigan
| | - Kevin C Baker
- Orthopaedic Research Laboratory, Beaumont Health, 3811W Thirteen Mile Road, Royal Oak, Michigan, 48073.,Department of Orthopaedic Surgery, Oakland University-William Beaumont School of Medicine, Rochester, Michigan
| | - Tristan Maerz
- Orthopaedic Research Laboratory, Beaumont Health, 3811W Thirteen Mile Road, Royal Oak, Michigan, 48073.,Department of Orthopaedic Surgery, Oakland University-William Beaumont School of Medicine, Rochester, Michigan
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41
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Oh DJ, Lakin BA, Stewart RC, Wiewiorski M, Freedman JD, Grinstaff MW, Snyder BD. Contrast-enhanced CT imaging as a non-destructive tool for ex vivo examination of the biochemical content and structure of the human meniscus. J Orthop Res 2017; 35:1018-1028. [PMID: 27302693 DOI: 10.1002/jor.23337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 06/05/2016] [Indexed: 02/04/2023]
Abstract
The biochemical and histopathological techniques used to investigate meniscal content and structure are destructive and time-consuming. Therefore, this study evaluated whether contrast-enhanced computed tomography (CECT) attenuation and contrast agent flux using the iodinated contrast agents CA4+ and ioxaglate correlate with the glycosaminoglycan (GAG) content/distribution and water content in human menisci. The optimal ioxaglate and CA4+ contrast agent concentrations for mapping meniscal GAG distribution were qualitatively determined by comparison of CECT color maps with Safranin-O stained histological sections. The associations between CECT attenuation and GAG content, CECT attenuation and water content, and flux and water content at various time points were determined using both contrast agents. Depth-wise analyses were also performed through each of the native surfaces to examine differences in contrast agent diffusion kinetics and equilibrium partitioning. The optimal concentrations for GAG depiction for ioxaglate and CA4+ were ≥80 and 12 mgI/ml, respectively. Using these concentrations, weak to moderate associations were found between ioxaglate attenuation and GAG content at all diffusion time points (1-48 h), while strong and significant associations were observed between CA4+ attenuation and GAG content as early as 7 h (R2 ≥ 0.67), being strongest at the equilibrium time point (48 h, R2 = 0.81). CECT attenuation for both agents did not significantly correlate with water content, but CA4+ flux correlated with water content (R2 = 0.56-0.64). CECT is a promising, non-destructive imaging technique for ex vivo assessment of meniscal GAG concentration and water content compared to traditional biochemical and histopathological methods. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1018-1028, 2017.
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Affiliation(s)
- Daniel J Oh
- Harvard-MIT Health Sciences and Technology Program, Harvard Medical School, Cambridge, Massachusetts.,Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts, 02215
| | - Benjamin A Lakin
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts, 02215.,Department of Biomedical Engineering, Boston University, 590 Commonwealth Ave, Boston, Massachusetts, 02215
| | - Rachel C Stewart
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts, 02215.,Department of Biomedical Engineering, Boston University, 590 Commonwealth Ave, Boston, Massachusetts, 02215
| | - Martin Wiewiorski
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts, 02215.,Department of Orthopaedic and Trauma, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Jonathan D Freedman
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts, 02215.,Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, Massachusetts
| | - Mark W Grinstaff
- Department of Biomedical Engineering, Boston University, 590 Commonwealth Ave, Boston, Massachusetts, 02215.,Department of Chemistry, Boston University, Boston, Massachusetts
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Overland Street, RN 115, Boston, Massachusetts, 02215.,Children's Hospital, Boston, Massachusetts
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Honkanen JTJ, Turunen MJ, Freedman JD, Saarakkala S, Grinstaff MW, Ylärinne JH, Jurvelin JS, Töyräs J. Cationic Contrast Agent Diffusion Differs Between Cartilage and Meniscus. Ann Biomed Eng 2016; 44:2913-2921. [PMID: 27129372 PMCID: PMC5042996 DOI: 10.1007/s10439-016-1629-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 04/22/2016] [Indexed: 12/31/2022]
Abstract
Contrast enhanced computed tomography (CECT) is a non-destructive imaging technique used for the assessment of composition and structure of articular cartilage and meniscus. Due to structural and compositional differences between these tissues, diffusion and distribution of contrast agents may differ in cartilage and meniscus. The aim of this study is to determine the diffusion kinematics of a novel iodine based cationic contrast agent (CA(2+)) in cartilage and meniscus. Cylindrical cartilage and meniscus samples (d = 6 mm, h ≈ 2 mm) were harvested from healthy bovine knee joints (n = 10), immersed in isotonic cationic contrast agent (20 mgI/mL), and imaged using a micro-CT scanner at 26 time points up to 48 h. Subsequently, normalized X-ray attenuation and contrast agent diffusion flux, as well as water, collagen and proteoglycan (PG) contents in the tissues were determined. The contrast agent distributions within cartilage and meniscus were different. In addition, the normalized attenuation and diffusion flux were higher (p < 0.05) in cartilage. Based on these results, diffusion kinematics vary between cartilage and meniscus. These tissue specific variations can affect the interpretation of CECT images and should be considered when cartilage and meniscus are assessed simultaneously.
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Affiliation(s)
- Juuso T. J. Honkanen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211 Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Mikael J. Turunen
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211 Kuopio, Finland
| | - Jonathan D. Freedman
- Department of Pharmacology, Boston University School of Medicine, Boston, MA USA
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, MA USA
- Department of Chemistry, Boston University, Boston, MA USA
| | - Janne H. Ylärinne
- Department of Integrative Medical Biology, University of Umea, Umeå, Sweden
| | - Jukka S. Jurvelin
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211 Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, POB 1627, 70211 Kuopio, Finland
- Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
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43
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Lakin BA, Patel H, Holland C, Freedman JD, Shelofsky JS, Snyder BD, Stok KS, Grinstaff MW. Contrast-enhanced CT using a cationic contrast agent enables non-destructive assessment of the biochemical and biomechanical properties of mouse tibial plateau cartilage. J Orthop Res 2016; 34:1130-8. [PMID: 26697956 PMCID: PMC5556386 DOI: 10.1002/jor.23141] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 12/21/2015] [Indexed: 02/04/2023]
Abstract
Mouse models of osteoarthritis (OA) are commonly used to study the disease's pathogenesis and efficacy of potential treatments. However, measuring the biochemical and mechanical properties of articular cartilage in these models currently requires destructive and time-consuming histology and mechanical testing. Therefore, we examined the feasibility of using contrast-enhanced CT (CECT) to rapidly and non-destructively image and assess the glycosaminoglycan (GAG) content. Using three ex vivo C57BL/6 mouse tibial plateaus, we determined the time required for the cationic contrast agent CA4+ to equilibrate in the cartilage. The whole-joint coefficient of friction (μ) of 10 mouse knees (some digested with Chondroitenase ABC to introduce variation in GAG) was evaluated using a modified Stanton pendulum. For both the medial and lateral tibial plateau cartilage of these knees, linear regression was used to compare the equilibrium CECT attenuations to μ, as well as each side's indentation equilibrium modulus (E) and Safranin-O determined GAG content. CA4+ equilibrated in the cartilage in 30.9 ± 0.95 min (mean ± SD, tau value of 6.17 ± 0.19 min). The mean medial and lateral CECT attenuation was correlated with μ (R(2) = 0.69, p < 0.05), and the individual medial and lateral CECT attenuations correlated with their respective GAG contents (R(2) ≥ 0.63, p < 0.05) and E (R(2) ≥ 0.63, p < 0.05). In conclusion, CECT using CA4+ is a simple, non-destructive technique for three-dimensional imaging of ex vivo mouse cartilage, and significant correlations between CECT attenuation and GAG, E, and μ are observed. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1130-1138, 2016.
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Affiliation(s)
- Benjamin A. Lakin
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department of Biomedical Engineering, Boston University, Boston, MA
| | - Harsh Patel
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department of Biomedical Engineering, Boston University, Boston, MA
| | - Conor Holland
- Department of Biomedical Engineering, Boston University, Boston, MA
| | - Jonathan D. Freedman
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA
| | - Joshua S. Shelofsky
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department of Biomedical Engineering, Boston University, Boston, MA
| | - Brian D. Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,Department of Orthopaedic Surgery, Children’s Hospital, Boston, MA,Address correspondence and reprint requests to: Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering and Chemistry, Boston University, 590 Commonwealth Ave, Boston MA 02215, OR Brian D. Snyder, M.D., PhD., Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, 1 Overland Street, RN 115, Boston MA 02215, OR Kathryn S. Stok, Ph.D., Institute for Biomechanics, ETH Zurich, Leopold-Ruzicka-Weg 4, Zurich, 8093, Switzerland,
| | - Kathryn S. Stok
- Institute for Biomechanics, ETH Zürich, Zürich, Switzerland,Scanco Medical AG, Brüttisellen, Switzerland,Address correspondence and reprint requests to: Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering and Chemistry, Boston University, 590 Commonwealth Ave, Boston MA 02215, OR Brian D. Snyder, M.D., PhD., Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, 1 Overland Street, RN 115, Boston MA 02215, OR Kathryn S. Stok, Ph.D., Institute for Biomechanics, ETH Zurich, Leopold-Ruzicka-Weg 4, Zurich, 8093, Switzerland,
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, MA,Department of Chemistry, Boston University, Boston, MA,Address correspondence and reprint requests to: Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering and Chemistry, Boston University, 590 Commonwealth Ave, Boston MA 02215, OR Brian D. Snyder, M.D., PhD., Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, 1 Overland Street, RN 115, Boston MA 02215, OR Kathryn S. Stok, Ph.D., Institute for Biomechanics, ETH Zurich, Leopold-Ruzicka-Weg 4, Zurich, 8093, Switzerland,
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44
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Lin KH, Wu Q, Leib DJ, Tang SY. A novel technique for the contrast-enhanced microCT imaging of murine intervertebral discs. J Mech Behav Biomed Mater 2016; 63:66-74. [PMID: 27341292 DOI: 10.1016/j.jmbbm.2016.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 10/21/2022]
Abstract
Disc degeneration is one of the leading factors that contribute to low back pain. Thus, the further understanding of the mechanisms contributing to degeneration of the intervertebral disc degeneration is critical for the development of therapies and strategies for treating low back pain. Rodent models are attractive for conducting mechanistic studies particularly because of the availability of genetically modified animals. However, current imaging technologies such as magnetic resonance imaging, do not have the ability to resolve spatial features at the tens- to single- micrometer scale. We propose here a contrast-enhanced microCT technique to conduct high-resolution imaging of the rodent intervertebral discs at 10µm spatial resolution. Based on the iodinated-hydrophilic contrast agent Ioversol, we are able to conduct high resolution imaging on rat and mouse intervertebral discs. Leveraging the hydrophilic characteristic of the contrast agent, we are able to discriminate the annulus fibrosus from the water-rich nucleus pulposus. Moreover, this technique allows for the quantitative measurement of disc morphologies and volumes, and we demonstrate the versatility of this technique on cultured live intervertebral discs. Coupled with our semi-automated segmentation technique, we are able to quantify the intervertebral disc volumes with a high degree of reproducibility. The contrast-enhanced microCT images were qualitatively and quantitatively indistinguishable from the traditional histological assessment of the same sample. Furthermore, stereological measures compared well between histology and microCT images. Taken together, the results reveal that rat and mouse intervertebral discs can be imaged longitudinally in vitro at high resolutions, with no adverse effects on viability and features of the intervertebral disc.
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Affiliation(s)
- Kevin H Lin
- Department of Biology, Washington University in St. Louis, St. Louis, MO, United States
| | - Qi Wu
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Daniel J Leib
- Department of Orthopaedic Surgery, Washington University in St. Louis, United States
| | - Simon Y Tang
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States; Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States; Department of Orthopaedic Surgery, Washington University in St. Louis, United States.
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45
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van Tiel J, Siebelt M, Reijman M, Bos PK, Waarsing JH, Zuurmond AM, Nasserinejad K, van Osch GJVM, Verhaar JAN, Krestin GP, Weinans H, Oei EHG. Quantitative in vivo CT arthrography of the human osteoarthritic knee to estimate cartilage sulphated glycosaminoglycan content: correlation with ex-vivo reference standards. Osteoarthritis Cartilage 2016; 24:1012-20. [PMID: 26851449 DOI: 10.1016/j.joca.2016.01.137] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 12/24/2015] [Accepted: 01/19/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Recently, computed tomography arthrography (CTa) was introduced as quantitative imaging biomarker to estimate cartilage sulphated glycosaminoglycan (sGAG) content in human cadaveric knees. Our aim was to assess the correlation between in vivo CTa in human osteoarthritis (OA) knees and ex vivo reference standards for sGAG and collagen content. DESIGN In this prospective observational study 11 knee OA patients underwent CTa before total knee replacement (TKR). Cartilage X-ray attenuation was determined in six cartilage regions. Femoral and tibial cartilage specimens harvested during TKR were re-scanned using equilibrium partitioning of an ionic contrast agent with micro-CT (EPIC-μCT), which served as reference standard for sGAG. Next, cartilage sGAG and collagen content were determined using dimethylmethylene blue (DMMB) and hydroxyproline assays. The correlation between CTa X-ray attenuation, EPIC-μCT X-ray attenuation, sGAG content and collagen content was assessed. RESULTS CTa X-ray attenuation correlated well with EPIC-μCT (r = 0.76, 95% credibility interval (95%CI) 0.64 to 0.85). CTa correlated moderately with the DMMB assay (sGAG content) (r = -0.66, 95%CI -0.87 to -0.49) and to lesser extent with the hydroxyproline assay (collagen content) (r = -0.56, 95%CI -0.70 to -0.36). CONCLUSIONS Outcomes of in vivo CTa in human OA knees correlate well with sGAG content. Outcomes of CTa also slightly correlate with cartilage collagen content. Since outcomes of CTa are mainly sGAG dependent and despite the fact that further validation using hyaline cartilage of other joints with different biochemical composition should be conducted, CTa may be suitable as quantitative imaging biomarker to estimate cartilage sGAG content in future clinical OA research.
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Affiliation(s)
- J van Tiel
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - M Siebelt
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - M Reijman
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - P K Bos
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - J H Waarsing
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | | | - K Nasserinejad
- Department of Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - G J V M van Osch
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Otorhinolaryngology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.
| | - J A N Verhaar
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - G P Krestin
- Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
| | - H Weinans
- Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands; Department of Orthopedics and Department of Rheumatology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - E H G Oei
- Department of Radiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
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Arbabi V, Pouran B, Weinans H, Zadpoor AA. Multiphasic modeling of charged solute transport across articular cartilage: Application of multi-zone finite-bath model. J Biomech 2016; 49:1510-1517. [DOI: 10.1016/j.jbiomech.2016.03.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 01/14/2023]
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47
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Cooper BG, Stewart RC, Burstein D, Snyder BD, Grinstaff MW. A Tissue-Penetrating Double Network Restores the Mechanical Properties of Degenerated Articular Cartilage. Angew Chem Int Ed Engl 2016; 55:4226-30. [PMID: 26934682 PMCID: PMC5726259 DOI: 10.1002/anie.201511767] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 01/28/2016] [Indexed: 12/20/2022]
Abstract
Incorporation of an interpenetrating polymer network into an existing single polymer network enables augmentation of the original substrate's mechanical properties, and translation of this concept from purely synthetic materials to natural-synthetic hybrid systems provides the opportunity to reinforce mechanical properties of bulk biological substrates. In many disease states, the mechanical properties of bodily tissues deteriorate rendering them prone to further material failure. Herein, a tissue-supplementing technique is described in which an interpenetrating biomimetic hydrogel is polymerized in situ throughout cartilage tissue. The treatment restores the inferior compressive properties of osteoarthritic cartilage to that of healthy cartilage, preferentially localizing to weaker regions of tissue. Furthermore, the treatment technique preserves cartilage under harsh articulation conditions, showing promise as a materials-based treatment for early-stage osteoarthritis.
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Affiliation(s)
- Benjamin G Cooper
- Departments of Chemistry and Biomedical Engineering, Boston University, Boston, MA, 02215, USA
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Rachel C Stewart
- Departments of Chemistry and Biomedical Engineering, Boston University, Boston, MA, 02215, USA
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Deborah Burstein
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Brian D Snyder
- Departments of Chemistry and Biomedical Engineering, Boston University, Boston, MA, 02215, USA
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
- Department of Orthopedic Surgery, Boston Children's Hospital, Boston, MA, 02215, USA
| | - Mark W Grinstaff
- Departments of Chemistry and Biomedical Engineering, Boston University, Boston, MA, 02215, USA.
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48
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Cooper BG, Stewart RC, Burstein D, Snyder BD, Grinstaff MW. A Tissue‐Penetrating Double Network Restores the Mechanical Properties of Degenerated Articular Cartilage. Angew Chem Int Ed Engl 2016. [DOI: 10.1002/ange.201511767] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Benjamin G. Cooper
- Departments of Chemistry and Biomedical Engineering Boston University Boston MA 02215 USA
- Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA 02215 USA
| | - Rachel C. Stewart
- Departments of Chemistry and Biomedical Engineering Boston University Boston MA 02215 USA
- Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA 02215 USA
| | - Deborah Burstein
- Department of Radiology Beth Israel Deaconess Medical Center Boston MA 02215 USA
| | - Brian D. Snyder
- Departments of Chemistry and Biomedical Engineering Boston University Boston MA 02215 USA
- Center for Advanced Orthopaedic Studies Beth Israel Deaconess Medical Center Boston MA 02215 USA
- Department of Orthopedic Surgery Boston Children's Hospital Boston MA 02215 USA
| | - Mark W. Grinstaff
- Departments of Chemistry and Biomedical Engineering Boston University Boston MA 02215 USA
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Novakofski KD, Pownder SL, Koff MF, Williams RM, Potter HG, Fortier LA. High-Resolution Methods for Diagnosing Cartilage Damage In Vivo. Cartilage 2016; 7:39-51. [PMID: 26958316 PMCID: PMC4749750 DOI: 10.1177/1947603515602307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Advances in current clinical modalities, including magnetic resonance imaging and computed tomography, allow for earlier diagnoses of cartilage damage that could mitigate progression to osteoarthritis. However, current imaging modalities do not detect submicrometer damage. Developments in in vivo or arthroscopic techniques, including optical coherence tomography, ultrasonography, bioelectricity including streaming potential measurement, noninvasive electroarthrography, and multiphoton microscopy can detect damage at an earlier time point, but they are limited by a lack of penetration and the ability to assess an entire joint. This article reviews current advancements in clinical and developing modalities that can aid in the early diagnosis of cartilage injury and facilitate studies of interventional therapeutics.
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Affiliation(s)
| | | | - Matthew F. Koff
- MRI Laboratory, Hospital for Special Surgery, New York, NY, USA
| | | | | | - Lisa A. Fortier
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA,Lisa A. Fortier, Department of Clinical Sciences, Cornell University, VMC C3-181, Ithaca, NY 14853, USA. Email
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Lakin BA, Ellis DJ, Shelofsky JS, Freedman JD, Grinstaff MW, Snyder BD. Contrast-enhanced CT facilitates rapid, non-destructive assessment of cartilage and bone properties of the human metacarpal. Osteoarthritis Cartilage 2015; 23:2158-2166. [PMID: 26067518 PMCID: PMC4841831 DOI: 10.1016/j.joca.2015.05.033] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/14/2015] [Accepted: 05/26/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this work is to establish the human metacarpal as a new whole joint surface early-stage osteoarthritis (OA) model that enables comparisons of articular cartilage and subchondral bone through high resolution contrast-enhanced CT (CECT) imaging, mechanical testing, and biochemical analysis. DESIGN The fourth metacarpal was obtained from 12 human cadaveric donors and baseline μCT imaging was followed by indentation testing. The samples were then immersed in anionic (Ioxaglate) and cationic (CA4+) iodinated contrast agent solutions followed by CECT. Cartilage GAG content and distribution was measured using the 1,9 dimethylmethylene blue (DMMB) assay and Safranin-O histology staining. Linear regression was performed to compare cartilage and subchondral bone properties. RESULTS Strong and significant positive correlations were observed between CA4+ CECT attenuation and both GAG content (R(2) = 0.86) and equilibrium modulus (R(2) = 0.84), while correlations using Ioxaglate were insignificant (R(2) ≤ 0.24, P > 0.05). Subchondral bone plate (SBP) thickness negatively and significantly correlated with SBP mineral density (R(2) = 0.49). Cartilage GAG content significantly correlated with several trabecular bone properties, including positive correlations with bone volume fraction (%BV/TV, R(2) = 0.67), trabecular number (Tb.N, R(2) = 0.60), and trabecular thickness (R(2) = 0.42), and negative relationships with structural model index (SMI, R(2) = 0.78) and trabecular spacing (Tb.Sp, R(2) = 0.56). Similarly, equilibrium modulus correlated positively with %BV/TV (R(2) = 0.50), Tb.N (R(2) = 0.59) and negatively with Tb.Sp (R(2) = 0.55) and SMI (R(2) = 0.60). CONCLUSION This study establishes the human metacarpal as a new early-stage OA model suitable for rapid, high resolution CECT imaging, mechanical testing, and biochemical analysis of the cartilage and subchondral bone, and for examining their inter-relationships.
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Affiliation(s)
- B A Lakin
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - D J Ellis
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - J S Shelofsky
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - J D Freedman
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Pharmacology and Experimental Therapeutics, Boston University, Boston, MA, USA
| | - M W Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, MA, USA; Department of Chemistry, Boston University, Boston, MA, USA.
| | - B D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA.
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