1
|
Jacobson AM, Zhao X, Sommer S, Sadik F, Warden SJ, Newman C, Siegmund T, Allen MR, Surowiec RK. A comprehensive set of ultrashort echo time magnetic resonance imaging biomarkers to assess cortical bone health: A feasibility study at clinical field strength. Bone 2024; 181:117031. [PMID: 38311304 PMCID: PMC10923147 DOI: 10.1016/j.bone.2024.117031] [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: 11/29/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Conventional bone imaging methods primarily use X-ray techniques to assess bone mineral density (BMD), focusing exclusively on the mineral phase. This approach lacks information about the organic phase and bone water content, resulting in an incomplete evaluation of bone health. Recent research highlights the potential of ultrashort echo time magnetic resonance imaging (UTE MRI) to measure cortical porosity and estimate BMD based on signal intensity. UTE MRI also provides insights into bone water distribution and matrix organization, enabling a comprehensive bone assessment with a single imaging technique. Our study aimed to establish quantifiable UTE MRI-based biomarkers at clinical field strength to estimate BMD and microarchitecture while quantifying bound water content and matrix organization. METHODS Femoral bones from 11 cadaveric specimens (n = 4 males 67-92 yrs of age, n = 7 females 70-95 yrs of age) underwent dual-echo UTE MRI (3.0 T, 0.45 mm resolution) with different echo times and high resolution peripheral quantitative computed tomography (HR-pQCT) imaging (60.7 μm voxel size). Following registration, a 4.5 mm HR-pQCT region of interest was divided into four quadrants and used across the multi-modal images. Statistical analysis involved Pearson correlation between UTE MRI porosity index and a signal-intensity technique used to estimate BMD with corresponding HR-pQCT measures. UTE MRI was used to calculate T1 relaxation time and a novel bound water index (BWI), compared across subregions using repeated measures ANOVA. RESULTS The UTE MRI-derived porosity index and signal-intensity-based estimated BMD correlated with the HR-pQCT variables (porosity: r = 0.73, p = 0.006; BMD: r = 0.79, p = 0.002). However, these correlations varied in strength when we examined each of the four quadrants (subregions, r = 0.11-0.71). T1 relaxometry and the BWI exhibited variations across the four subregions, though these differences were not statistically significant. Notably, we observed a strong negative correlation between T1 relaxation time and the BWI (r = -0.87, p = 0.0006). CONCLUSION UTE MRI shows promise for being an innocuous method for estimating cortical porosity and BMD parameters while also giving insight into bone hydration and matrix organization. This method offers the potential to equip clinicians with a more comprehensive array of imaging biomarkers to assess bone health without the need for invasive or ionizing procedures.
Collapse
Affiliation(s)
- Andrea M Jacobson
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Dept. of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Xuandong Zhao
- Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Stefan Sommer
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland; Advanced Clinical Imaging Technology (ACIT), Siemens Healthineers International AG, Zurich, Switzerland.
| | - Farhan Sadik
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA.
| | - Stuart J Warden
- Department of Physical Therapy, School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN, USA.
| | - Christopher Newman
- Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Thomas Siegmund
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, USA.
| | - Matthew R Allen
- Dept. of Anatomy, Physiology, and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Rachel K Surowiec
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA; Dept. of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.
| |
Collapse
|
2
|
Surowiec RK, Ram S, Idiyatullin D, Goulet R, Schlecht SH, Galban CJ, Kozloff KM. In vivo quantitative imaging biomarkers of bone quality and mineral density using multi-band-SWIFT magnetic resonance imaging. Bone 2021; 143:115615. [PMID: 32853850 PMCID: PMC7770067 DOI: 10.1016/j.bone.2020.115615] [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] [Received: 06/23/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/29/2022]
Abstract
Bone is a composite biomaterial of mineral crystals, organic matrix, and water. Each contributes to bone quality and strength and may change independently, or together, with disease progression and treatment. Even so, there is a near ubiquitous reliance on ionizing x-ray-based approaches to measure bone mineral density (BMD) which is unable to fully characterize bone strength and may not adequately predict fracture risk. Characterization of treatment efficacy in bone diseases of altered remodeling is complicated by the lack of imaging modality able to safely monitor material-level and biochemical changes in vivo. To improve upon the current state of bone imaging, we tested the efficacy of Multi Band SWeep Imaging with Fourier Transformation (MB-SWIFT) magnetic resonance imaging (MRI) as a readout of bone derangement in an estrogen deficient ovariectomized (OVX) rat model during growth. MB-SWIFT MRI-derived BMD correlated significantly with BMD measured using micro-computed tomography (μCT). In this rodent model, growth appeared to overcome estrogen deficiency as bone mass continued to increase longitudinally over the duration of the study. Nonetheless, after 10 weeks of intervention, MB-SWIFT detected significant changes consistent with estrogen deficiency in cortical water, cortical matrix organization (T1), and marrow fat. Findings point to MB-SWIFT's ability to quantify BMD in good agreement with μCT while providing additive quantitative outcomes about bone quality in a manner consistent with estrogen deficiency. These results indicate MB-SWIFT as a non-ionizing imaging strategy with value for bone imaging and may be a promising technique to progress to the clinic for monitoring and clinical management of patients with bone diseases such as osteoporosis.
Collapse
Affiliation(s)
- Rachel K Surowiec
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Sundaresh Ram
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Djaudat Idiyatullin
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Robert Goulet
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Stephen H Schlecht
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Craig J Galban
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Kenneth M Kozloff
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA; Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
3
|
Ho KY, Cummins A, Khuu C, Parker S, Shepherd S. Comparisons of patellar bone mineral density between individuals with and without patellofemoral pain. Knee 2020; 27:846-853. [PMID: 32359941 DOI: 10.1016/j.knee.2020.04.009] [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: 10/18/2019] [Revised: 02/12/2020] [Accepted: 04/10/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although bone stress injuries have been reported in individuals with patellofemoral pain (PFP), especially within the lateral patella, it remains unclear whether persons with PFP exhibit altered patellar regional bone mineral density (BMD). The primary purpose of this study was to compare BMD of the patella (lateral, medial, and total regions) between individuals with and without PFP using quantitative computed tomography (QCT). The secondary aim was to examine the associations between patellar regional BMD and patellofemoral joint (PFJ) alignment. METHODS Ten individuals with retropatellar pain and 10 sex, age, weight, height, and activity matched pain-free controls underwent a QCT scan to obtain patellar BMD. To quantify PFJ alignment, patellar lateral displacement was measured using bisect-offset (BSO) index and patellar mediolateral tilt was quantified using patellar tilt angle (PTA). A two-factor repeated-measures ANOVA was used to compare BMD across the three patellar regions and between the two groups. Pearson correlation coefficient analyses were used to evaluate the associations between BMD and PFJ alignment of all participants. RESULTS There was no difference in BMD between the two groups. However, BMD was highest within the lateral patella and was lowest within the medial patella across both groups. There were significantly moderate to large correlations between BSO index/PTA and BMD within lateral, medial, and total regions. CONCLUSIONS While individuals with PFP and pain-free controls have similar patellar BMD, the lateral patella exhibits the highest BMD. Additionally, higher patellar regional BMD is related to increased patellar lateral displacement and lateral tilt.
Collapse
Affiliation(s)
- Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, United States..
| | - Allina Cummins
- Department of Physical Therapy, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, United States
| | - Chris Khuu
- Department of Physical Therapy, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, United States
| | - Shane Parker
- Department of Physical Therapy, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, United States
| | - Steven Shepherd
- Department of Physical Therapy, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Las Vegas, NV 89154, United States
| |
Collapse
|
4
|
Chang R, Ma X, Jiang Y, Huang D, Chen X, Zhang M, Hao D. Percentage fat fraction in magnetic resonance imaging: upgrading the osteoporosis-detecting parameter. BMC Med Imaging 2020; 20:30. [PMID: 32183731 PMCID: PMC7079407 DOI: 10.1186/s12880-020-00423-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 02/10/2020] [Indexed: 02/05/2023] Open
Abstract
Background Osteoporosis (OP) is a systemic metabolic bone disorder identified as an essential health issue worldwide. Orthopedic imaging approaches were commonly used with some limitations. Thus, our study aimed to investigate the diagnostic value of magnetic resonance spectroscopy (1-H MRS) and m-Dixon-Quant in OP. Methods A total of 76 subjects were enrolled in the study and bone mineral density (BMD) was measured using quantitative computed tomography (QCT). Then, the subjects were divided into three groups according to BMD: normal control group, osteopenia group and OP group. The following parameters were recorded for each patient: gender, age, height, body weight, waist circumference, and hip circumference. Further, the fat fraction percentage (FF%) values were determined by 1-H MRS and m-Dixon-Quant methods. Results In both 1-H MRS and magnetic resonance Imaging (MRI) m-Dixon-Quant, the FF% exhibited a negative correlation with BMD (P < 0.05). The FF% value of the OP group was significantly higher than that of the control group (P < 0.05). In addition, the FF% value in the m-Dixon scans was positively related to age, while BMD showed a negative linear relationship with age (P < 0.0001). Further, females had a significantly higher FF% value compared to males (P < 0.01), and height was correlated with BMD (P < 0.05) but not with FF% (P > 0.05). Conclusions MRI investigations especially FF% value in the m-Dixon-Quant imaging system is correlated with OP. Its diagnostic value remains to be demonstrated on a large prospective cohort of patients. Besides, parameters such as age, gender, and height are important factors for predicting and diagnosing OP.
Collapse
Affiliation(s)
- Rong Chang
- Department of Medical Imaging, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Xiaowen Ma
- Department of Medical Imaging, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Yonghong Jiang
- Department of Medical Imaging, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Dageng Huang
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Xiujin Chen
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital, Medical College Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Dingjun Hao
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China.
| |
Collapse
|
5
|
Alcântara ACS, Assis I, Prada D, Mehle K, Schwan S, Costa-Paiva L, Skaf MS, Wrobel LC, Sollero P. Patient-Specific Bone Multiscale Modelling, Fracture Simulation and Risk Analysis-A Survey. MATERIALS (BASEL, SWITZERLAND) 2019; 13:E106. [PMID: 31878356 PMCID: PMC6981613 DOI: 10.3390/ma13010106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 12/26/2022]
Abstract
This paper provides a starting point for researchers and practitioners from biology, medicine, physics and engineering who can benefit from an up-to-date literature survey on patient-specific bone fracture modelling, simulation and risk analysis. This survey hints at a framework for devising realistic patient-specific bone fracture simulations. This paper has 18 sections: Section 1 presents the main interested parties; Section 2 explains the organzation of the text; Section 3 motivates further work on patient-specific bone fracture simulation; Section 4 motivates this survey; Section 5 concerns the collection of bibliographical references; Section 6 motivates the physico-mathematical approach to bone fracture; Section 7 presents the modelling of bone as a continuum; Section 8 categorizes the surveyed literature into a continuum mechanics framework; Section 9 concerns the computational modelling of bone geometry; Section 10 concerns the estimation of bone mechanical properties; Section 11 concerns the selection of boundary conditions representative of bone trauma; Section 12 concerns bone fracture simulation; Section 13 presents the multiscale structure of bone; Section 14 concerns the multiscale mathematical modelling of bone; Section 15 concerns the experimental validation of bone fracture simulations; Section 16 concerns bone fracture risk assessment. Lastly, glossaries for symbols, acronyms, and physico-mathematical terms are provided.
Collapse
Affiliation(s)
- Amadeus C. S. Alcântara
- Department of Computational Mechanics, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil; (A.C.S.A.); (D.P.)
| | - Israel Assis
- Department of Integrated Systems, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil;
| | - Daniel Prada
- Department of Computational Mechanics, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil; (A.C.S.A.); (D.P.)
| | - Konrad Mehle
- Department of Engineering and Natural Sciences, University of Applied Sciences Merseburg, 06217 Merseburg, Germany;
| | - Stefan Schwan
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, 06120 Halle/Saale, Germany;
| | - Lúcia Costa-Paiva
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-887, Brazil;
| | - Munir S. Skaf
- Institute of Chemistry and Center for Computing in Engineering and Sciences, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil;
| | - Luiz C. Wrobel
- Institute of Materials and Manufacturing, Brunel University London, Uxbridge UB8 3PH, UK;
- Department of Civil and Environmental Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro 22451-900, Brazil
| | - Paulo Sollero
- Department of Computational Mechanics, School of Mechanical Engineering, University of Campinas—UNICAMP, Campinas, Sao Paulo 13083-860, Brazil; (A.C.S.A.); (D.P.)
| |
Collapse
|
6
|
Herrington L, Alarifi S, Jones R. Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction. Am J Sports Med 2017; 45:2812-2816. [PMID: 28749699 DOI: 10.1177/0363546517716632] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patellofemoral joint pain and degeneration are common in patients who undergo anterior cruciate ligament reconstruction (ACLR). The presence of patellofemoral joint pain significantly affects the patient's ability to continue sport participation and may even affect participation in activities of daily living. The mechanisms behind patellofemoral joint pain and degeneration are unclear, but previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear whether this process occurs after ACLR. PURPOSE To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to the noninjured knee and matched control knees. STUDY DESIGN Controlled laboratory study. METHODS Thirty-four elite sports practitioners who had undergone ACLR and 34 age- and sex-matched controls participated in the study. The participants' running gait was assessed via 3D motion capture, and knee loads and forces were calculated by use of inverse dynamics. RESULTS A significance difference was found in knee extensor moment, knee flexion angles, patellofemoral contact force (about 23% greater), and patellofemoral contact pressure (about 27% greater) between the ACLR and the noninjured limb ( P ≤ .04) and between the ACLR and the control limb ( P ≤ .04); no significant differences were found between the noninjured and control limbs ( P ≥ .44). CONCLUSION Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared with the noninjured and control knees. CLINICAL RELEVANCE Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.
Collapse
Affiliation(s)
- Lee Herrington
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Saud Alarifi
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| | - Richard Jones
- Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK
| |
Collapse
|
7
|
Ho KY, Kulig K. Changes in water content in response to an acute bout of eccentric loading in a patellar tendon with a history of tendinopathy: A case report. Physiother Theory Pract 2016; 32:566-70. [PMID: 27472664 DOI: 10.1080/09593985.2016.1206646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This case-based report assessed resting water content and exercise-driven water exchange within a tendon with a history of tendinopathy and compared the response to that of a healthy uninvolved tendon. DESIGN Case Report. SETTING University imaging center. PARTICIPANT The participant was a 27-year-old female basketball player 39 months following knee trauma. Patellar tendinopathy developed 12 months after the injury episode and was treated with eccentric exercises. Eighteen months from the beginning of the first eccentric training bout, the participant reported full resolution of symptoms and returned to her pre-injury sport participation without symptoms. INTERVENTION Eccentric decline squat exercise. MAIN OUTCOME MEASURES Tendon water content obtained from magnetic resonance imaging (MRI). RESULTS MRI acquired 39 months post-injury demonstrated increased resting water content of the involved tendon (involved: 91.1% vs. uninvolved: 84.6%). Immediately after the eccentric squat maneuver, water content decreased on both involved and uninvolved tendons (involved: 89.5% vs. uninvolved: 83.3%). CONCLUSIONS Elevated resting water content of the involved tendon found in this report may be indicative of reduced tendon stiffness. A similar amount of water content reduction was observed on both sides following mechanical loading, suggesting that the involved tendon may respond to the eccentric exercise similarly to the uninvolved tendon. Future investigations are needed to study the relationships among tendon water exchanges, mechanical properties, patient symptoms, and tissue injuries.
Collapse
Affiliation(s)
- Kai-Yu Ho
- a Department of Physical Therapy , University of Nevada , Las Vegas, Las Vegas , NV , USA
| | - Kornelia Kulig
- b Division of Biokinesiology and Physical Therapy , University of Southern California , Los Angeles , CA , USA
| |
Collapse
|
8
|
Dhainaut A, Hoff M, Syversen U, Haugeberg G. Technologies for assessment of bone reflecting bone strength and bone mineral density in elderly women: an update. ACTA ACUST UNITED AC 2016; 12:209-16. [PMID: 26900798 DOI: 10.2217/whe.15.94] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Reduced bone mineral density is a strong risk factor for fracture. The WHO's definition of osteoporosis is based on bone mineral density measurements assessed by dual x-ray absorptiometry. Several on other techniques than dual x-ray absorptiometry have been developed for quantitative assessment of bone, for example, quantitative ultrasound and digital x-ray radiogrammetry. Some of these techniques may also capture other bone properties than bone mass that contribute to bone strength, for example, bone porosity and microarchitecture. In this article we give an update on technologies which are available for evaluation primarily of bone mass and bone density, but also describe methods which currently are validated or are under development for quantitative assessment of other bone properties.
Collapse
Affiliation(s)
- Alvilde Dhainaut
- Department of Neuroscience (INM) Norwegian University of Science & Technology (NTNU), Trondheim, Norway.,Department of Public Health & General Practice (ISM), Norwegian University of Science & Technology, Trondheim Norway
| | - Mari Hoff
- Department of Public Health & General Practice (ISM), Norwegian University of Science & Technology, Trondheim Norway.,Department of Rheumatology, St Olav's Hospital, Trondheim, Norway
| | - Unni Syversen
- Department of Cancer Research & Molecular Medicine (IKM), NTNU, Trondheim, Norway.,Department of Endocrinology, St. Olav's Hospital, Norway
| | - Glenn Haugeberg
- Department of Neuroscience (INM) Norwegian University of Science & Technology (NTNU), Trondheim, Norway.,Department of Rheumatology, Hospital of Southern Norway, Kristiansand S, Norway
| |
Collapse
|
9
|
Goodsitt MM, Shenoy A, Shen J, Howard D, Schipper MJ, Wilderman S, Christodoulou E, Chun SY, Dewaraja YK. Evaluation of dual energy quantitative CT for determining the spatial distributions of red marrow and bone for dosimetry in internal emitter radiation therapy. Med Phys 2014; 41:051901. [PMID: 24784380 DOI: 10.1118/1.4870378] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate a three-equation three-unknown dual-energy quantitative CT (DEQCT) technique for determining region specific variations in bone spongiosa composition for improved red marrow dose estimation in radionuclide therapy. METHODS The DEQCT method was applied to 80/140 kVp images of patient-simulating lumbar sectional body phantoms of three sizes (small, medium, and large). External calibration rods of bone, red marrow, and fat-simulating materials were placed beneath the body phantoms. Similar internal calibration inserts were placed at vertebral locations within the body phantoms. Six test inserts of known volume fractions of bone, fat, and red marrow were also scanned. External-to-internal calibration correction factors were derived. The effects of body phantom size, radiation dose, spongiosa region segmentation granularity [single (∼17 × 17 mm) region of interest (ROI), 2 × 2, and 3 × 3 segmentation of that single ROI], and calibration method on the accuracy of the calculated volume fractions of red marrow (cellularity) and trabecular bone were evaluated. RESULTS For standard low dose DEQCT x-ray technique factors and the internal calibration method, the RMS errors of the estimated volume fractions of red marrow of the test inserts were 1.2-1.3 times greater in the medium body than in the small body phantom and 1.3-1.5 times greater in the large body than in the small body phantom. RMS errors of the calculated volume fractions of red marrow within 2 × 2 segmented subregions of the ROIs were 1.6-1.9 times greater than for no segmentation, and RMS errors for 3 × 3 segmented subregions were 2.3-2.7 times greater than those for no segmentation. Increasing the dose by a factor of 2 reduced the RMS errors of all constituent volume fractions by an average factor of 1.40 ± 0.29 for all segmentation schemes and body phantom sizes; increasing the dose by a factor of 4 reduced those RMS errors by an average factor of 1.71 ± 0.25. Results for external calibrations exhibited much larger RMS errors than size matched internal calibration. Use of an average body size external-to-internal calibration correction factor reduced the errors to closer to those for internal calibration. RMS errors of less than 30% or about 0.01 for the bone and 0.1 for the red marrow volume fractions would likely be satisfactory for human studies. Such accuracies were achieved for 3 × 3 segmentation of 5 mm slice images for: (a) internal calibration with 4 times dose for all size body phantoms, (b) internal calibration with 2 times dose for the small and medium size body phantoms, and (c) corrected external calibration with 4 times dose and all size body phantoms. CONCLUSIONS Phantom studies are promising and demonstrate the potential to use dual energy quantitative CT to estimate the spatial distributions of red marrow and bone within the vertebral spongiosa.
Collapse
Affiliation(s)
- Mitchell M Goodsitt
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| | - Apeksha Shenoy
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| | - Jincheng Shen
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, Michigan 48109
| | - David Howard
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| | - Matthew J Schipper
- Department of Radiation Oncology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| | - Scott Wilderman
- Department of Nuclear Engineering, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| | - Emmanuel Christodoulou
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| | - Se Young Chun
- Ulsan National Institute of Science and Technology (UNIST), School of Electrical and Computer Engineering, Ulsan 689-798, Republic of Korea
| | - Yuni K Dewaraja
- Department of Radiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109
| |
Collapse
|
10
|
Armstrong J, da Costa RC, Martin-Vaquero P. Cervical vertebral trabecular bone mineral density in Great Danes with and without osseous-associated cervical spondylomyelopathy. J Vet Intern Med 2014; 28:1799-804. [PMID: 25312453 PMCID: PMC4330089 DOI: 10.1111/jvim.12444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/18/2014] [Accepted: 07/30/2014] [Indexed: 12/14/2022] Open
Abstract
Background Great Danes (GDs) with osseous‐associated cervical spondylomyelopathy (CSM) have osteoarthritis (OA) of the cervical vertebrae. OA is often associated with increases in bone mineral density (BMD) in people and dogs. Hypothesis/Objectives To compare the trabecular BMD of the cervical vertebrae between clinically normal (control) GDs and GDs with osseous‐associated CSM by using computed tomography (CT). We hypothesized that the vertebral trabecular BMD of CSM‐affected GDs would be higher than that of control GDs. Animals Client‐owned GDs: 12 controls, 10 CSM affected. Methods Prospective study. CT of the cervical vertebral column was obtained alongside a calibration phantom. By placing a circular region of interest at the articular process joints, vertebral body, pedicles, and within each rod of the calibration phantom, trabecular BMD was measured in Hounsfield units, which were converted to diphosphate equivalent densities. Trabecular BMD measurements were compared between CSM‐affected and control dogs, and between males and females within the control group. Results Differences between CSM‐affected and control dogs were not significant for the articular processes (mean = −39; P = .37; 95% CI: −102 to 24), vertebral bodies (mean = −62; P = .08; 95% CI: −129 to 6), or pedicles (mean = −36; P = .51; 95% CI: −105 to 33). Differences between female and male were not significant. Conclusions and Clinical Importance This study revealed no difference in BMD between control and CSM‐affected GDs. Based on our findings no association was detected between cervical OA and BMD in GDs with CSM.
Collapse
Affiliation(s)
- J Armstrong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | | | | |
Collapse
|
11
|
Gudur MSR, Rao RR, Peterson AW, Caldwell DJ, Stegemann JP, Deng CX. Noninvasive quantification of in vitro osteoblastic differentiation in 3D engineered tissue constructs using spectral ultrasound imaging. PLoS One 2014; 9:e85749. [PMID: 24465680 PMCID: PMC3899074 DOI: 10.1371/journal.pone.0085749] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 12/01/2013] [Indexed: 11/29/2022] Open
Abstract
Non-destructive monitoring of engineered tissues is needed for translation of these products from the lab to the clinic. In this study, non-invasive, high resolution spectral ultrasound imaging (SUSI) was used to monitor the differentiation of MC3T3 pre-osteoblasts seeded within collagen hydrogels. SUSI was used to measure the diameter, concentration and acoustic attenuation of scatterers within such constructs cultured in either control or osteogenic medium over 21 days. Conventional biochemical assays were used on parallel samples to determine DNA content and calcium deposition. Construct volume and morphology were accurately imaged using ultrasound. Cell diameter was estimated to be approximately 12.5–15.5 µm using SUSI, which corresponded well to measurements of fluorescently stained cells. The total number of cells per construct assessed by quantitation of DNA content decreased from 5.6±2.4×104 at day 1 to 0.9±0.2×104 at day 21. SUSI estimation of the equivalent number of acoustic scatters showed a similar decreasing trend, except at day 21 in the osteogenic samples, which showed a marked increase in both scatterer number and acoustic impedance, suggestive of mineral deposition by the differentiating MC3T3 cells. Estimation of calcium content by SUSI was 41.7±11.4 µg/ml, which agreed well with the biochemical measurement of 38.7±16.7 µg/ml. Color coded maps of parameter values were overlaid on B-mode images to show spatiotemporal changes in cell diameter and calcium deposition. This study demonstrates the use of non-destructive ultrasound imaging to provide quantitative information on the number and differentiated state of cells embedded within 3D engineered constructs, and therefore presents a valuable tool for longitudinal monitoring of engineered tissue development.
Collapse
Affiliation(s)
- Madhu Sudhan Reddy Gudur
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Rameshwar R. Rao
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Alexis W. Peterson
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - David J. Caldwell
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jan P. Stegemann
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail: (JPS); (CXD)
| | - Cheri X. Deng
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail: (JPS); (CXD)
| |
Collapse
|
12
|
Ho KY, Hu HH, Colletti PM, Powers CM. Running-induced patellofemoral pain fluctuates with changes in patella water content. Eur J Sport Sci 2013; 14:628-34. [PMID: 24283889 DOI: 10.1080/17461391.2013.862872] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although increased bone water content resulting from repetitive patellofemoral joint loading has been suggested to be a possible mechanism underlying patellofemoral pain (PFP), there is little data to support this mechanism. The purpose of the current study was to determine whether running results in increases in patella water content and pain and whether 48 hours of rest reduces patella water content and pain to pre-running levels. Ten female runners with a diagnosis of PFP (mean age 25.1 years) participated. Patella water content was quantified using a chemical-shift-encoded water-fat magnetic resonance imaging (MRI) protocol. The visual analog scale (VAS) was used to quantify subjects' pain levels. MRI and pain data were obtained prior to running, immediately following a 40-minute running session, and 48 hours post-running. Pain and patella water content were compared among the 3 time points using one-way ANOVA's with repeated measures. Immediately post-running, persons with PFP reported significant increases in pain and exhibited elevated patella water content. Pain and patella water content decreased to pre-running levels following 48 hours of rest. Our findings suggest that transient changes in patella water content associated with running may, in part, contribute to patellofemoral symptoms.
Collapse
Affiliation(s)
- Kai-Yu Ho
- a Department of Physical Therapy , University of Nevada , Las Vegas , Nevada , USA
| | | | | | | |
Collapse
|
13
|
Ho KY, Keyak JH, Powers CM. Comparison of patella bone strain between females with and without patellofemoral pain: a finite element analysis study. J Biomech 2013; 47:230-6. [PMID: 24188973 DOI: 10.1016/j.jbiomech.2013.09.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 08/27/2013] [Accepted: 09/10/2013] [Indexed: 11/27/2022]
Abstract
Elevated bone principal strain (an indicator of potential bone injury) resulting from reduced cartilage thickness has been suggested to contribute to patellofemoral symptoms. However, research linking patella bone strain, articular cartilage thickness, and patellofemoral pain (PFP) remains limited. The primary purpose was to determine whether females with PFP exhibit elevated patella bone strain when compared to pain-free controls. A secondary objective was to determine the influence of patella cartilage thickness on patella bone strain. Ten females with PFP and 10 gender, age, and activity-matched pain-free controls participated. Patella bone strain fields were quantified utilizing subject-specific finite element (FE) models of the patellofemoral joint (PFJ). Input parameters for the FE model included (1) PFJ geometry, (2) elastic moduli of the patella bone, (3) weight-bearing PFJ kinematics, and (4) quadriceps muscle forces. Using quasi-static simulations, peak and average minimum principal strains as well as peak and average maximum principal strains were quantified. Cartilage thickness was quantified by computing the perpendicular distance between opposing voxels defining the cartilage edges on axial plane magnetic resonance images. Compared to the pain-free controls, individuals with PFP exhibited increased peak and average minimum and maximum principal strain magnitudes in the patella. Additionally, patella cartilage thickness was negatively associated with peak minimum principal patella strain and peak maximum principal patella strain. The elevated bone strain magnitudes resulting from reduced cartilage thickness may contribute to patellofemoral symptoms and bone injury in persons with PFP.
Collapse
Affiliation(s)
- Kai-Yu Ho
- Department of Physical Therapy, University of Nevada, Las Vegas, NV, USA
| | - Joyce H Keyak
- Department of Radiological Sciences, University of California, Irvine, CA, USA; Department of Mechanical and Aerospace Engineering, University of California, Irvine, CA, USA
| | - Christopher M Powers
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|