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Dual Contrast CT Method Enables Diagnostics of Cartilage Injuries and Degeneration Using a Single CT Image

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Abstract

Cartilage injuries may be detected using contrast-enhanced computed tomography (CECT) by observing variations in distribution of anionic contrast agent within cartilage. Currently, clinical CECT enables detection of injuries and related post-traumatic degeneration based on two subsequent CT scans. The first scan allows segmentation of articular surfaces and lesions while the latter scan allows evaluation of tissue properties. Segmentation of articular surfaces from the latter scan is difficult since the contrast agent diffusion diminishes the image contrast at surfaces. We hypothesize that this can be overcome by mixing anionic contrast agent (ioxaglate) with bismuth oxide nanoparticles (BINPs) too large to diffuse into cartilage, inducing a high contrast at the surfaces. Here, a dual contrast method employing this mixture is evaluated by determining the depth-wise X-ray attenuation profiles in intact, enzymatically degraded, and mechanically injured osteochondral samples (n = 3 × 10) using a microCT immediately and at 45 min after immersion in contrast agent. BiNPs were unable to diffuse into cartilage, producing high contrast at articular surfaces. Ioxaglate enabled the detection of enzymatic and mechanical degeneration. In conclusion, the dual contrast method allowed detection of injuries and degeneration simultaneously with accurate cartilage segmentation using a single scan conducted at 45 min after contrast agent administration.

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Acknowledgments

Academy of Finland (Projects 269315, 288531, and 288531), Kuopio University Hospital (VTR 5041746, 5203101, PY 210), Magnus Ehrnrooth Foundation, Finnish Cultural Foundation, and Doctoral Programme in Science, Technology and Computing (SCITECO) of University of Eastern Finland are acknowledged for financial support. MSc (Tech) Jaakko Sarin is acknowledged for assistance with the histological analysis.

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Authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Applied Physics, University of Eastern Finland, POB 1627, 70211, Kuopio, Finland

    Annina E. A. Saukko, Juuso T. J. Honkanen, Wujun Xu, Sami P. Väänänen, Jukka S. Jurvelin, Vesa-Pekka Lehto & Juha Töyräs

  2. Diagnostic Imaging Center, Kuopio University Hospital, POB 100, 70029, Kuopio, Finland

    Annina E. A. Saukko, Juuso T. J. Honkanen & Juha Töyräs

  3. Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, POB 100, 70029, Kuopio, Finland

    Sami P. Väänänen

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  1. Annina E. A. Saukko
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Correspondence to Annina E. A. Saukko.

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Associate Editor Sean S. Kohles oversaw the review of this article.

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Saukko, A.E.A., Honkanen, J.T.J., Xu, W. et al. Dual Contrast CT Method Enables Diagnostics of Cartilage Injuries and Degeneration Using a Single CT Image. Ann Biomed Eng 45, 2857–2866 (2017). https://doi.org/10.1007/s10439-017-1916-3

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  • DOI: https://doi.org/10.1007/s10439-017-1916-3

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