A1 Refereed original research article in a scientific journal
Triple Contrast CT Method Enables Simultaneous Evaluation of Articular Cartilage Composition and Segmentation
Authors: Miitu K. M. Honkanen, Annina E. A. Saukko, Mikael J. Turunen, Wujun Xu, Goran Lovric, Juuso T. J. Honkanen, Mark W. Grinstaff, Vesa-Pekka Lehto, Juha Töyräs
Publisher: SPRINGER
Publication year: 2020
Journal: Annals of Biomedical Engineering
Journal name in source: ANNALS OF BIOMEDICAL ENGINEERING
Journal acronym: ANN BIOMED ENG
Volume: 48
Issue: 2
First page : 556
Last page: 567
Number of pages: 12
ISSN: 0090-6964
eISSN: 1573-9686
DOI: https://doi.org/10.1007/s10439-019-02362-6
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/42654360
Early degenerative changes of articular cartilage are detected using contrast-enhanced computed tomography (CT) with a cationic contrast agent (CA). However, cationic CA diffusion into degenerated cartilage decreases with proteoglycan depletion and increases with elevated water content, thus hampering tissue evaluation at early diffusion time points. Furthermore, the contrast at synovial fluid-cartilage interface diminishes as a function of diffusion time hindering accurate cartilage segmentation. For the first time, we employ quantitative dual-energy CT (QDECT) imaging utilizing a mixture of three CAs (cationic CA4+ and non-ionic gadoteridol which are sensitive to proteoglycan and water contents, respectively, and bismuth nanoparticles which highlight the cartilage surface) to simultaneously segment the articulating surfaces and determine of the cartilage condition. Intact healthy, proteoglycan-depleted, and mechanically injured bovine cartilage samples (n = 27) were halved and imaged with synchrotron microCT 2-h post immersion in triple CA or in dual CA (CA4+ and gadoteridol). CA4+ and gadoteridol partitions were determined using QDECT, and pairwise evaluation of these partitions was conducted for samples immersed in dual and triple CAs. In conclusion, the triple CA method is sensitive to proteoglycan depletion while maintaining sufficient contrast at the articular surface to enable detection of cartilage lesions caused by mechanical impact.
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