1
|
Schadow JE, Maxey D, Smith TO, Finnilä MAJ, Manske SL, Segal NA, Wong AKO, Davey RA, Turmezei T, Stok KS. Systematic review of computed tomography parameters used for the assessment of subchondral bone in osteoarthritis. Bone 2024; 178:116948. [PMID: 37926204 DOI: 10.1016/j.bone.2023.116948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To systematically review the published parameters for the assessment of subchondral bone in human osteoarthritis (OA) using computed tomography (CT) and gain an overview of current practices and standards. DESIGN A literature search of Medline, Embase and Cochrane Library databases was performed with search strategies tailored to each database (search from 2010 to January 2023). The search results were screened independently by two reviewers against pre-determined inclusion and exclusion criteria. Studies were deemed eligible if conducted in vivo/ex vivo in human adults (>18 years) using any type of CT to assess subchondral bone in OA. Extracted data from eligible studies were compiled in a qualitative summary and formal narrative synthesis. RESULTS This analysis included 202 studies. Four groups of CT modalities were identified to have been used for subchondral bone assessment in OA across nine anatomical locations. Subchondral bone parameters measuring similar features of OA were combined in six categories: (i) microstructure, (ii) bone adaptation, (iii) gross morphology (iv) mineralisation, (v) joint space, and (vi) mechanical properties. CONCLUSIONS Clinically meaningful parameter categories were identified as well as categories with the potential to become relevant in the clinical field. Furthermore, we stress the importance of quantification of parameters to improve their sensitivity and reliability for the evaluation of OA disease progression and the need for standardised measurement methods to improve their clinical value.
Collapse
Affiliation(s)
- Jemima E Schadow
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
| | - David Maxey
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
| | - Toby O Smith
- Warwick Medical School, University of Warwick, United Kingdom.
| | - Mikko A J Finnilä
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Sarah L Manske
- Department of Radiology, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Neil A Segal
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, United States.
| | - Andy Kin On Wong
- Joint Department of Medical Imaging, University Health Network, Toronto, Canada; Schroeder's Arthritis Institute, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
| | - Rachel A Davey
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Kathryn S Stok
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Belluzzi E, Todros S, Pozzuoli A, Ruggieri P, Carniel EL, Berardo A. Human Cartilage Biomechanics: Experimental and Theoretical Approaches towards the Identification of Mechanical Properties in Healthy and Osteoarthritic Conditions. Processes (Basel) 2023. [DOI: 10.3390/pr11041014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Articular cartilage is a complex connective tissue with the fundamental functions of load bearing, shock absorption and lubrication in joints. However, traumatic events, aging and degenerative pathologies may affect its structural integrity and function, causing pain and long-term disability. Osteoarthritis represents a health issue, which concerns an increasing number of people worldwide. Moreover, it has been observed that this pathology also affects the mechanical behavior of the articular cartilage. To better understand this correlation, the here proposed review analyzes the physiological aspects that influence cartilage microstructure and biomechanics, with a special focus on the pathological changes caused by osteoarthritis. Particularly, the experimental data on human articular cartilage are presented with reference to different techniques adopted for mechanical testing and the related theoretical mechanical models usually applied to articular cartilage are briefly discussed.
Collapse
|
4
|
Silva MO, Kirkwood N, Mulvaney P, Ellis AV, Stok KS. Evaluation of a lanthanide nanoparticle-based contrast agent for microcomputed tomography of porous channels in subchondral bone. J Orthop Res 2023; 41:447-458. [PMID: 35524421 PMCID: PMC10084061 DOI: 10.1002/jor.25361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 04/10/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023]
Abstract
Osteoarthritis (OA) is a chronic joint disease that causes disability and pain. The osteochondral interface is a gradient tissue region that plays a significant role in maintaining joint health. It has been shown that during OA, increased neoangiogenesis creates porous channels at the osteochondral interface allowing the transport of molecules related to OA. Importantly, the connection between these porous channels and the early stages of OA development is still not fully understood. Microcomputed tomography (microCT) offers the ability to image the porous channels at the osteochondral interface, however, a contrast agent is necessary to delineate the different X-ray attenuations of the tissues. In this study BaYbF5 -SiO2 nanoparticles are synthesized and optimized as a microCT contrast agent to obtain an appropriate contrast attenuation for subsequent segmentation of structures of interest, that is, porous channels, and mouse subchondral bone. For this purpose, BaYbF5 nanoparticles were synthesized and coated with a biocompatible silica shell (SiO2 ). The optimized BaYbF5 -SiO2 27 nm nanoparticles exhibited the highest average microCT attenuation among the biocompatible nanoparticles tested. The BaYbF5 -SiO2 27 nm nanoparticles increased the mean X-ray attenuation of structures of interest, for example, porous channel models and mouse subchondral bone. The BaYbF5 -SiO2 contrast attenuation was steady after diffusion into mouse subchondral bone. In this study, we obtained for the first time, the average microCT attenuation of the BaYbF5 -SiO2 nanoparticles into porous channel models and mouse subchondral bone. In conclusion, BaYbF5 -SiO2 nanoparticles are a potential contrast agent for imaging porous channels at the osteochondral interface using microCT.
Collapse
Affiliation(s)
- Mateus O Silva
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Victoria, Australia
| | - Nicholas Kirkwood
- ARC Centre of Excellence in Exciton Science, School of Chemistry, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul Mulvaney
- ARC Centre of Excellence in Exciton Science, School of Chemistry, The University of Melbourne, Parkville, Victoria, Australia
| | - Amanda V Ellis
- Department of Chemical Engineering, The University of Melbourne, Parkville, Victoria, Australia
| | - Kathryn S Stok
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
5
|
Stokolosa AM, Thomas-Colwell J, Dilley KK, Qu Y, Cullip C, Heidari AE, Huang M, Kerrigan N, Hsu K, Leonard J, Prasad KR, Wong BJ, Hill MG. Electromechanical Cornea Reshaping for Refractive Vision Therapy. ACS Biomater Sci Eng 2023; 9:595-600. [PMID: 36634100 PMCID: PMC9930080 DOI: 10.1021/acsbiomaterials.2c01177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The corneal stroma consists of orthogonally stacked collagen-fibril lamellae that determine the shape of the cornea and provide most of the refractive power of the eye. We have applied electromechanical reshaping (EMR), an electrochemical platform for remodeling cartilage and other semirigid tissues, to change the curvature of the cornea as a potential procedure for nonsurgical vision correction. EMR relies on short electrochemical pulses to electrolyze water, with subsequent diffusion of protons into the extracellular matrix of collagenous tissues; protonation of immobilized anions within this matrix disrupts the ionic-bonding network, leaving the tissue transiently responsive to mechanical remodeling. Re-equilibration to physiological pH restores the ionic matrix, resulting in persistent shape change of the tissue. Using ex vivo rabbit eyes, we demonstrate here the controlled change of corneal curvature over a wide range of refractive powers with no loss of optical transparency. Optical coherence tomography (OCT), combined with second-harmonic generation (SHG) and confocal microscopy, establish that EMR enables extremely fine control of corneal contouring while maintaining the underlying macromolecular collagen structure and stromal cellular viability, positioning electrochemical vision therapy as a potentially simple and ultralow-cost modality for correcting routine refractive errors.
Collapse
Affiliation(s)
- Anna M. Stokolosa
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | - Jack Thomas-Colwell
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | - Katelyn K. Dilley
- Beckman
Laser Institute & Medical Clinic, University
of California, Irvine, Irvine, California 92697, United States
| | - Yueqiao Qu
- Beckman
Laser Institute & Medical Clinic, University
of California, Irvine, Irvine, California 92697, United States,Department
of Biomedical Engineering, University of
California, Irvine, Irvine, California 92697, United States
| | - Charlotte Cullip
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | - Andrew E. Heidari
- Beckman
Laser Institute & Medical Clinic, University
of California, Irvine, Irvine, California 92697, United States,Department
of Biomedical Engineering, University of
California, Irvine, Irvine, California 92697, United States
| | - Michelle Huang
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | - Nathalie Kerrigan
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | - Kellie Hsu
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | - Jack Leonard
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States
| | | | - Brian J.F. Wong
- Beckman
Laser Institute & Medical Clinic, University
of California, Irvine, Irvine, California 92697, United States,Department
of Biomedical Engineering, University of
California, Irvine, Irvine, California 92697, United States,Department
of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, Irvine, Orange, California 92617, United States,
| | - Michael G. Hill
- Department
of Chemistry, Occidental College, Los Angeles, California 90041, United States,
| |
Collapse
|
6
|
Durongbhan P, Silva MO, Li Z, Ansari N, Kour RYN, Davey CE, Stok KS. A microCT imaging protocol for reproducible and efficient quantitative morphometric analysis (QMA) of joint structures of the in situ mouse tibio-femoral joint. Bone 2023; 166:116606. [PMID: 36368467 DOI: 10.1016/j.bone.2022.116606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/19/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Abstract
Micro-computed tomography (microCT) offers a three-dimensional (3D), high-resolution technique for the visualisation and analysis of bone microstructure. Using contrast-enhanced microCT, this capability has been expanded in recent studies to include cartilage morphometry and whole joint measures, known together as quantitative morphometric analysis (QMA). However, one of the main challenges in quantitative analysis of joint images is sensitivity to joint pose and alignment, which may influence measures related to both joint space and joint biomechanics. Thus, this study proposes a novel microCT imaging protocol for reproducible and efficient QMA of in situ mouse tibio-femoral joint. This work consists of two parts: an in situ diffusion kinetics study for a known cationic iodinated contrast agent (CA4+) for QMA of the cartilage, and a joint positioning and image processing workflow for whole joint QMA. In the diffusion kinetics study, 8 mice were injected at both of their tibio-femoral joints with distinct CA4+ concentrations and diffusion times. The mice were scanned at different time points after injection, and evaluated using attenuation and cartilage QMA measures. Results show that cartilage segmentation and QMA could be performed for CA4+ solution at a concentration of 48 mg/ml, and that reliable measurement and quantification of cartilage were achieved after 5 min of diffusion following contrast agent injection. We established the joint positioning and image processing workflow by developing a novel positioning device to control joint pose during scanning, and a spherical harmonics-based image processing workflow to ensure consistent alignment during image processing. Both legs of seven mice were scanned 10 times, 5 prior to receiving CA4+ and 5 after, and evaluated using whole joint QMA parameters. Joint QMA evaluation of the workflow showed excellent reproducibility; intraclass correlation coefficients ranged from 0.794 to 0.930, confirming that the imaging protocol enables reproducible and efficient QMA of joint structures in preclinical models, and that contrast agent injection did not cause significant alteration to the measured parameters.
Collapse
Affiliation(s)
- Pholpat Durongbhan
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia.
| | - Mateus O Silva
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia.
| | - Zihui Li
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia
| | - Niloufar Ansari
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia
| | - R Y Nigel Kour
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia; Department of Mechanical Engineering, The University of Melbourne, Parkville, Australia.
| | - Catherine E Davey
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia.
| | - Kathryn S Stok
- Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia.
| |
Collapse
|
7
|
Gao X, Patwa AN, Deng Z, Utsunomiya H, Grinstaff MW, Ruzbarsky JJ, Snyder BD, Ravuri S, Philippon MJ, Huard J. Influence of fixation on CA4+ contrast enhanced microCT of articular cartilage and subsequent feasibility for histological evaluation. Am J Transl Res 2021; 13:8921-8937. [PMID: 34540005 PMCID: PMC8430171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
CA4+ is a novel cationic iodinated contrast agent utilized for contrast-enhanced microCT (CECT). In this study, we compared CA4+ CECT for cartilage quantification of unfixed and neutral buffered formalin (NBF)-fixed rabbit distal femur cartilage after 8-, 24- and 30-hours of contrast agent diffusion. The stability of CA4+ binding to cartilage after PBS soak and decalcification was also investigated by CECT. We further assessed the feasibility of cartilage histology and immunohistochemistry after CA4+ CECT. Contrast-enhanced CA4+ labeled unfixed and NBF-fixed cartilage tissues facilitate articular cartilage quantification and accurate morphological assessment. The NBF fixed tissues demonstrate higher cartilage intensity and imaging characteristics distinct from subchondral bone than unfixed tissues while maintaining stable binding even after decalcification with 10% EDTA. The unfixed tissues labeled with CA4+, after CECT imaging and decalcification, are amenable to H&E, Alcian blue, and Safranin O staining, as well as Col2 immunohistochemistry. In contrast, only H&E and Alcian blue staining can be accomplished with CA4+ labeled NBF fixed cartilage, and CA4+ labeling interferes with downstream immunohistochemistry and Safranin O staining, likely due to its positive charge. In conclusion, CA4+ CECT of NBF fixed tissues provides high quality microCT cartilage images and allows for convenient quantification along with feasible downstream H&E and Alcian blue staining after decalcification. CA4+ CECT of unfixed tissues enables researchers to obtain both quantitative microCT as well as cartilage histology and immunohistochemistry data from one set of animals in a cost-, time-, and labor-efficient manner.
Collapse
Affiliation(s)
- Xueqin Gao
- Steadman Philippon Research InstituteVail, CO, USA
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at HoustonHouston, TX, USA
| | - Amit N Patwa
- Department of Biomedical Engineering, Boston UniversityBoston, MA, USA
- Current Institution, School of Science, Navrachana UniversityVadodara, Gujarat, India
| | - Zhenhan Deng
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at HoustonHouston, TX, USA
| | | | - Mark W Grinstaff
- Department of Biomedical Engineering, Boston UniversityBoston, MA, USA
| | | | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical SchoolBoston, MA, USA
| | | | | | - Johnny Huard
- Steadman Philippon Research InstituteVail, CO, USA
- Department of Orthopaedic Surgery, McGovern Medical School, University of Texas Health Science Center at HoustonHouston, TX, USA
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
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] [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.
Collapse
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
| |
Collapse
|
10
|
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.
Collapse
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
| | | | | |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Guo JB, Liang T, Che YJ, Yang HL, Luo ZP. Structure and mechanical properties of high-weight-bearing and low-weight-bearing areas of hip cartilage at the micro- and nano-levels. BMC Musculoskelet Disord 2020; 21:425. [PMID: 32616028 PMCID: PMC7333404 DOI: 10.1186/s12891-020-03468-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Articular cartilage has a high-weight-bearing area and a low-weight-bearing area, the macroscopic elastic moduli of the two regions are different. Chondrocytes are affected by the applied force at the microscopic level. Currently, the modulus of the two areas at the micro and nano levels is unknown, and studies on the relationship between macro-, micro- and nano-scale elastic moduli are limited. Such information may be important for further understanding of cartilage mechanics. Moreover, the surface morphology, proteoglycan content, and micro and nano structure of the two areas, which influences the mechanical properties of cartilage should be discussed. METHODS Safranin-O/Fast Green staining was used to evaluate the surface morphology and semi-quantify proteoglycan content of porcine femoral head cartilage between the two weight-bearing areas. The unconfined compression test was used to determine the macro elastic modulus. Atomic force microscope was used to measure the micro and nano compressive elastic modulus as well as the nano structure. Scanning electron microscope was employed to evaluate the micro structure. RESULTS No significant differences in the fibrillation index were observed between two areas (P = 0.5512). The Safranin-O index of the high-weight-bearing area was significantly higher than that of the low-weight-bearing area (P = 0.0387). The compressive elastic modulus of the high-weight-bearing area at the macro and micro level was significantly higher than that of the low-weight-bearing area (P = 0.0411 for macro-scale, and P = 0.0001 for micro-scale), while no statistically significant differences were observed in the elastic modulus of collagen fibrils at the nano level (P = 0.8544). The density of the collagen fibers was significantly lower in the high-weight-bearing area (P = 0.0177). No significant differences were observed in the structure and diameter of the collagen fibers between the two areas (P = 0.7361). CONCLUSIONS A higher proteoglycan content correlated with a higher compressive elastic modulus of the high-weight-bearing area at the micro level than that of the low-weight-bearing area, which was consistent with the trend observed from the macroscopic compressive elastic modulus. The weight-bearing level was not associated with the elastic modulus of individual collagen fibers and the diameter at the nano level. The micro structure of cartilage may influence the macro- and micro-scale elastic modulus.
Collapse
Affiliation(s)
- Jiang-Bo Guo
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.,Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Ting Liang
- Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Yan-Jun Che
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.,Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Hui-Lin Yang
- Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.,Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China
| | - Zong-Ping Luo
- Department of Orthopaedics, Orthopaedic Institute, the First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, 215006, People's Republic of China.
| |
Collapse
|
13
|
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] [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.
Collapse
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.,Address correspondence and reprint requests to: 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, , OR, Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering and Chemistry, Boston University, 590 Commonwealth Ave, Boston, MA 02215,
| | - 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,Address correspondence and reprint requests to: 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, , OR, Mark W. Grinstaff, Ph.D., Departments of Biomedical Engineering and Chemistry, Boston University, 590 Commonwealth Ave, Boston, MA 02215,
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Meng H, Quan Q, Yuan X, Zheng Y, Peng J, Guo Q, Wang A, Lu S. Diffusion of neutral solutes within human osteoarthritic cartilage: Effect of loading patterns. J Orthop Translat 2019; 22:58-66. [PMID: 32440500 PMCID: PMC7231982 DOI: 10.1016/j.jot.2019.10.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/26/2019] [Accepted: 10/28/2019] [Indexed: 11/04/2022] Open
Abstract
Objective Variation of the solute diffusion within articular cartilage is an important feature of osteoarthritis (OA) progression. For in vitro study of monitoring of the diffusion process, it is essential to simulate physiological conditions as much as possible. Our objective was to investigate the effects of loading patterns on diffusion processes of neutral solutes within osteoarthritic cartilage. Methods Osteochondral plugs were harvested from human tibial plateaus and separated into three OA stages according to modified Mankin scoring system. The samples were subjected to static or cyclic compression using a carefully designed loading device. Contrast-enhanced micro-computed tomography (CEμCT) was applied to acquire image sequences while the cartilage was being compressed. The apparent diffusion maps and diffusion coefficients were analysed, as well as histological and stereological assessments of the plugs. Results The diffusion of neutral solutes was significantly affected by the loading patterns. For OA cartilage with early and middle stages, cyclic loading accelerated contrast agent infiltration compared with static loading. However, for late-stage OA samples, no acceleration of diffusion was observed in the first 2 h because of the insufficient resilience of compressed cartilage. The accumulation of neutral solutes in an upward invasive fissure also suggested that solutes could penetrate into the fissure under cyclic loading. Conclusions To our knowledge, this is the first study to combine the cyclic compression and CEμCT scanning in the diffusion testing of human OA cartilage. This loading pattern could simulate the physiological conditions and reduce the time to reach solute equilibrium within cartilage. The diffusion data may contribute to joint drug-injection therapies for early OA. The translational potential of this article The combination of cyclic loading and CEμCT scanning enabled diffusion analysis of osteoarthritic cartilage under different compressions. A comprehensive evaluation of OA cartilage and subchondral bone may benefit from this technique. The diffusion data provide theoretical support and reference for intra-articular injection of drugs.
Collapse
Affiliation(s)
- Haoye Meng
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China.,Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China.,Beijing Key Lab of Regenerative Medicine in Orthopaedics, Beijing, China
| | - Qi Quan
- Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China
| | - Xueling Yuan
- Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China
| | - Yudong Zheng
- School of Material Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Jiang Peng
- Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China.,Beijing Key Lab of Regenerative Medicine in Orthopaedics, Beijing, China
| | - Quanyi Guo
- Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China.,Beijing Key Lab of Regenerative Medicine in Orthopaedics, Beijing, China
| | - Aiyuan Wang
- Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China.,Beijing Key Lab of Regenerative Medicine in Orthopaedics, Beijing, China
| | - Shibi Lu
- Institute of Orthopaedics, Chinese PLA General Hospital, Beijing, China.,Beijing Key Lab of Regenerative Medicine in Orthopaedics, Beijing, China
| |
Collapse
|
16
|
Zhang H, Belev G, Stewart RC, Grinstaff MW, Snyder BD, Wilson DR. Protocol development for synchrotron contrast-enhanced CT of human hip cartilage. Med Eng Phys 2019; 73:1-8. [PMID: 31526590 DOI: 10.1016/j.medengphy.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/11/2019] [Accepted: 08/21/2019] [Indexed: 11/24/2022]
Abstract
Understanding hip osteoarthritis requires new investigational tools for quantitative studies of biophysical and biomechanical properties as well as for determination of structure. Three new protocols to study pathological changes in cartilage and to measure cartilage thickness in intact human hips are described using synchrotron contrast enhanced computed tomography (sCECT) with the iodinated contrast agent CA4+. Ten human cadaver hips were prepared and injected with CA4+ using three different methods, all of which included rotation and distraction of the joint. CA4+ diffusion into cartilage was monitored using sCECT. The thickness of acetabular and femoral cartilage was also measured. Diffusion times ranged from 2 h to 75 h, depending on the injection protocol and the cartilage region. Direct single injection of the contrast through the labrum resulted in the fastest diffusion times. The iodine attenuation coefficient, which reflects the contrast agent distribution in the cartilage, ranged from 0.0142/cm to 0.1457/cm. Three injections at the head/neck conjunction area yielded the highest iodine attenuation coefficients in cartilage. The femoral cartilage in the Superior-Medial compartment was significantly thicker than in the other 3 femoral compartments, and femoral cartilage in the Superior-Anterior compartment was significantly thinner than the other 3 femoral compartments. The acetabular cartilage in the Superior compartment was significantly thicker than that in the Superior-Posterior compartment. sCECT with CA4+ allows assessment of hip cartilage thickness with 0.1 mm isotropic voxel size, sufficient for evaluating cartilage pathology and biomechanics.
Collapse
Affiliation(s)
- Honglin Zhang
- Department of Orthopaedics, University of British Columbia, Centre for Hip Health and Mobility, 2635 Laurel St, Vancouver BC V5Z 1M9, Canada
| | - George Belev
- Canadian Light Source, 44 Innovation Blvd, Saskatoon, SK S7N 2V3, Canada
| | - Rachel C Stewart
- Departments of Biomedical Engineering and Chemistry, Boston University, 403-44 Cummington Mall, Boston, MA 02215, USA
| | - Mark W Grinstaff
- Departments of Biomedical Engineering and Chemistry, Boston University, 403-44 Cummington Mall, Boston, MA 02215, USA
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., RN 115, Boston, MA 02215, USA
| | - David R Wilson
- Department of Orthopaedics, University of British Columbia, Centre for Hip Health and Mobility, 2635 Laurel St, Vancouver BC V5Z 1M9, Canada.
| |
Collapse
|
17
|
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.
Collapse
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.
| |
Collapse
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
Myller KAH, Korhonen RK, Töyräs J, Salo J, Jurvelin JS, Venäläinen MS. Computational evaluation of altered biomechanics related to articular cartilage lesions observed in vivo. J Orthop Res 2019; 37:1042-1051. [PMID: 30839123 DOI: 10.1002/jor.24273] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 02/17/2019] [Indexed: 02/04/2023]
Abstract
Chondral lesions provide a potential risk factor for development of osteoarthritis. Despite the variety of in vitro studies on lesion degeneration, in vivo studies that evaluate relation between lesion characteristics and the risk for the possible progression of OA are lacking. Here, we aimed to characterize different lesions and quantify biomechanical responses experienced by surrounding cartilage tissue. We generated computational knee joint models with nine chondral injuries based on clinical in vivo arthrographic computed tomography images. Finite element models with fibril-reinforced poro(visco)elastic cartilage and menisci were constructed to simulate physiological loading. Systematically, the lesions experienced increased peak values of maximum principal strain, maximum shear strain, and minimum principal strain in the surrounding chondral tissue (p < 0.01) compared with intact tissue. Depth, volume, and area of the lesion correlated with the maximum shear strain (p < 0.05, Spearman rank correlation coefficient ρ = 0.733-0.917). Depth and volume of the lesion correlated also with the maximum principal strain (p < 0.05, ρ = 0.767, and ρ = 0.717, respectively). However, the lesion area had non-significant correlation with this strain parameter (p = 0.06, ρ = 0.65). Potentially, the introduced approach could be developed for clinical evaluation of biomechanical risks of a chondral lesion and planning an intervention. Statement of Clinical Relevance: In this study, we computationally characterized different in vivo chondral lesions and evaluated their risk of cartilage degeneration. This information is vital in decision-making for intervention in order to prevent post-traumatic osteoarthritis. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
Collapse
Affiliation(s)
- Katariina A H Myller
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,Centre of Oncology, Kuopio University Hospital, Kuopio, Finland
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, 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
| | - Jari Salo
- Orthopaedics and Traumatology Clinic, Mehiläinen, Helsinki, Finland.,Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko S Venäläinen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Turku Centre for Biotechnology, University of Turku and Åbo Akademi University, Turku, Finland
| |
Collapse
|
20
|
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.
Collapse
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.
| |
Collapse
|
21
|
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.
Collapse
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
| |
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
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
| |
Collapse
|
24
|
Labens R, Daniel C, Hall S, Xia XR, Schwarz T. Effect of intra-articular administration of superparamagnetic iron oxide nanoparticles (SPIONs) for MRI assessment of the cartilage barrier in a large animal model. PLoS One 2017; 12:e0190216. [PMID: 29287105 PMCID: PMC5747449 DOI: 10.1371/journal.pone.0190216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/11/2017] [Indexed: 11/22/2022] Open
Abstract
Early diagnosis of cartilage disease at a time when changes are limited to depletion of extracellular matrix components represents an important diagnostic target to reduce patient morbidity. This report is to present proof of concept for nanoparticle dependent cartilage barrier imaging in a large animal model including the use of clinical magnetic resonance imaging (MRI). Conditioned (following matrix depletion) and unconditioned porcine metacarpophalangeal cartilage was evaluated on the basis of fluorophore conjugated 30 nm and 80 nm spherical gold nanoparticle permeation and multiphoton laser scanning and bright field microscopy after autometallographic particle enhancement. Consequently, conditioned and unconditioned joints underwent MRI pre- and post-injection with 12 nm superparamagnetic iron oxide nanoparticles (SPIONs) to evaluate particle permeation in the context of matrix depletion and use of a clinical 1.5 Tesla MRI scanner. To gauge the potential pro-inflammatory effect of intra-articular nanoparticle delivery co-cultures of equine synovium and cartilage tissue were exposed to an escalating dose of SPIONs and IL-6, IL-10, IFN-γ and PGE2 were assessed in culture media. The chemotactic potential of growth media samples was subsequently assessed in transwell migration assays on isolated equine neutrophils. Results demonstrate an increase in MRI signal following conditioning of porcine joints which suggests that nanoparticle dependent compositional cartilage imaging is feasible. Tissue culture and neutrophil migration assays highlight a dose dependent inflammatory response following SPION exposure which at the imaging dose investigated was not different from controls. The preliminary safety and imaging data support the continued investigation of nanoparticle dependent compositional cartilage imaging. To our knowledge, this is the first report in using SPIONs as intra-articular MRI contrast agent for studying cartilage barrier function, which could potentially lead to a new diagnostic technique for early detection of cartilage disease.
Collapse
Affiliation(s)
- Raphael Labens
- School of Animal and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia
- * E-mail:
| | - Carola Daniel
- The Roslin Institute, Easter Bush Campus, The University of Edinburgh, Midlothian, United Kingdom
| | - Sarah Hall
- Animal & Veterinary Sciences, Scotland’s Rural College, Easter Bush Campus, Midlothian, United Kingdom
| | - Xin-Rui Xia
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Tobias Schwarz
- Royal (Dick) School of Veterinary Studies, Easter Bush Campus, The University of Edinburgh, Midlothian, United Kingdom
| |
Collapse
|
25
|
Mashiatulla M, Moran MM, Chan D, Li J, Freedman JD, Snyder BD, Grinstaff MW, Plaas A, Sumner DR. Murine articular cartilage morphology and compositional quantification with high resolution cationic contrast-enhanced μCT. J Orthop Res 2017; 35:2740-2748. [PMID: 28471533 PMCID: PMC5671366 DOI: 10.1002/jor.23595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 04/24/2017] [Indexed: 02/04/2023]
Abstract
Articular cartilage lines the load-bearing surfaces of long bones and undergoes compositional and structural degeneration during osteoarthritis progression. Contrast enhanced microcomputed tomography (μCT) is being applied to a variety of preclinical models, including the mouse, to map structural and compositional properties in 3-D. The thinness (∼30-50 μm) and high cellularity of mouse articular cartilage presents a significant imaging challenge. Our group previously showed that mouse articular cartilage and proteoglycan (PG) content can be assessed by μCT with the ioxagalate-based contrast agent Hexabrix, but the voxel size used (6 μm) was deemed to be barely adequate. The objective of the present study is to assess the utility of a novel contrast agent, CA4+, to quantify mouse articular cartilage morphology and composition with high resolution μCT imaging (3 μm voxels) and to compare the sensitivity of CA4+ and Hexabrix to detect between-group differences. While both contrast agents are iodine-based, Hexabrix is anionic and CA4+ is cationic so they interact differently with negatively charged PGs. With CA4+, a strong correlation was found between non-calcified articular cartilage thickness measurements made with histology and μCT (R2 = 0.72, p < 0.001). Cartilage degeneration-as assessed by loss in volume, thickness, and PG content-was observed in 34-week-old mice when compared to both 7- and 12-week-old mice. High measurement precision was observed with CA4+, with the coefficient of variation after repositioning and re-imaging samples equaling 2.8%, 4.5%, 7.4% and 5.9% for attenuation, thickness, volume, and PG content, respectively. Use of CA4+ allowed increased sensitivity for assessing PG content compared to Hexabrix, but had no advantage for measurement of cartilage thickness or volume. This improvement in imaging should prove useful in preclinical studies of cartilage degeneration and regeneration. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2740-2748, 2017.
Collapse
Affiliation(s)
- Maleeha Mashiatulla
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, USA,Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Meghan M. Moran
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Deva Chan
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jun Li
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jonathan D. Freedman
- Department of Biomedical Engineering and Chemistry, Boston University, Boston, MA, USA
| | - Brian D. Snyder
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Mark W. Grinstaff
- Department of Biomedical Engineering and Chemistry, Boston University, Boston, MA, USA
| | - Anna Plaas
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA,Address for correspondence: D. Rick Sumner, Ph.D., Department of Cell & Molecular Medicine, Rush University Medical Center, 600 South Paulina, Suite 507, Chicago, IL 60612, Phone: 312-942-5501, ; Anna Plaas, Department of Internal Medicine, Rush University Medical Center, 1750 W. Harrison Street, Suite 1413, Chicago, IL 60612, Phone: 312-942-7194,
| | - D. Rick Sumner
- Department of Cell & Molecular Medicine, Rush University Medical Center, Chicago, IL, USA,Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, USA,Address for correspondence: D. Rick Sumner, Ph.D., Department of Cell & Molecular Medicine, Rush University Medical Center, 600 South Paulina, Suite 507, Chicago, IL 60612, Phone: 312-942-5501, ; Anna Plaas, Department of Internal Medicine, Rush University Medical Center, 1750 W. Harrison Street, Suite 1413, Chicago, IL 60612, Phone: 312-942-7194,
| |
Collapse
|
26
|
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
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
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.
Collapse
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
| |
Collapse
|
29
|
In Vivo Contrast-Enhanced Cone Beam CT Provides Quantitative Information on Articular Cartilage and Subchondral Bone. Ann Biomed Eng 2016; 45:811-818. [DOI: 10.1007/s10439-016-1730-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/07/2016] [Indexed: 12/17/2022]
|
30
|
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.
Collapse
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,
| |
Collapse
|