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C-arm flat-panel CT arthrography of the wrist and elbow: first experiences in human cadavers

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Abstract

Objective

To determine the optimal intra-articular iodine concentration for C-arm flat-panel computed tomography (FPCT) arthrography using advanced joint phantoms and to evaluate its application in human cadaveric wrists and elbows. Multi-detector (MD) CT served as the standard of reference.

Materials and methods

Joint phantoms and 10 human cadaveric wrist and elbow joints were scanned with C-arm FPCT (5-s, 8-s, and 20-s runs) and standard MDCT using different and optimal concentrations of iodinated contrast material. CT numbers of contrast material, tissue, and noise were measured and contrast-to-noise ratios (CNR) calculated for quantitative analysis. Image and depiction of cartilage, bone, and soft tissues were rated. Radiation doses were compared.

Results

In FPCT, iodine concentrations positively correlated with CT numbers and noise of contrast material and with radiation dose (r = 0.713–0.996, p < 0.05 each). At an iodine concentration of 45 mg/ml, CNR of cartilage and soft tissues were highest for all FPCT acquisitions and higher than in MDCT. The 20-s FPCT run performed best for image quality and depiction of anatomical structures and was rated overall equal to MDCT (p = 0.857).

Conclusion

The optimal iodine concentration for C-arm FPCT arthrography in this study is 45 mg/ml, leading to superior CNR and image quality for an optimal FPCT protocol compared with standard MDCT arthrography in human cadaveric joints.

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Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Zurich, Ramistrasse 100, 8091, Zurich, Switzerland

    Roman Guggenberger, Fabian Morsbach, Hatem Alkadhi, Thomas Pfammatter, Juerg Hodler & Gustav Andreisek

  2. Institute of Anatomy, University Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland

    Magdalena Vich

Authors
  1. Roman Guggenberger
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  2. Fabian Morsbach
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  3. Hatem Alkadhi
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  4. Magdalena Vich
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  5. Thomas Pfammatter
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  6. Juerg Hodler
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  7. Gustav Andreisek
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Correspondence to Roman Guggenberger.

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Guggenberger, R., Morsbach, F., Alkadhi, H. et al. C-arm flat-panel CT arthrography of the wrist and elbow: first experiences in human cadavers. Skeletal Radiol 42, 419–429 (2013). https://doi.org/10.1007/s00256-012-1501-7

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  • DOI: https://doi.org/10.1007/s00256-012-1501-7

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