ACDSee-10 Gamma Correction Conventional Radiography for Demonstration and Size Measurement of Callused Trabecular Microfracture

Abstract

Presumably due to rapid, astonishing development of sophisticated modern imaging means such as MRI and MDCT the golden valued conventional radiography seemed to have become unimportantly treated and left behind in this imaging surge. Recently, however, the hitherto undervalued conventional radiographic imaging of bone trabeculae suddenly began to be afresh reappraised in the form of gamma correction radiography. The diagnostic usefulness of naïve conventional radiograph appears to be well comparable to CT and MRI. Basically, we were able to visually confirm the fineness of the image quality of normal trabeculae, for example, in the calcaneus. Morphologically, normal trabeculae were analyzed by simple comparison as they were visualized on conventional radiographs, MDCT, and 1.5 T MRI taken in middle-aged subjects. The lateral image of normal calcaneus showed very fine thready trabeculae in all three imaging modalities (Fig. 12.1). Radiograph showed fine radiopaque linear trabeculae and MDCT showed less fine bright radiopaque trabeculae, while 1.5-T T-2 WT FS MRI showed similar fine trabeculae in dark intensity. The fineness of trabeculae is practically the same in radiograph and MR although the image presentation is bright in radiograph and dark in MRI. It is to be mentioned that the difference in image quality is closely related to the version of imaging machines used. Furthermore, lately introduced upgraded ACDSee-10 gamma correction ^99mTc-HDP pinhole bone scan can very neatly image the injured trabeculae with unsuppressed high tracer uptake (Fig. 12.2) (Bahk et al. 2017). Such a distinct demonstration of CTMF naturally drew our attention. The clean imaging of 200-μm sized trabecular microfracture is an important clinical and academic development. Hence, it is fully justified to make a systematic attempt at importing ACDSee-10 gamma correction to the conventional radiograph of CTMF.