Dual-Energy Cone-Beam Tomographic Imaging and Analysis for Rheumatoid Arthritis

类风湿性关节炎的双能锥形束断层扫描成像与分析

• 批准号: 8636994
• 负责人: JEFFREY H SIEWERDSEN
• 金额: $ 17.21万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8636994
• 关键词: Address; American; Architecture; Arthritis; Biological Assay; Biological Markers; Biometry; Bone Marrow; Cadaver; Cartilage; Clinic; Clinical; Clinical Trials; Cone; Data Set; Development; Diagnosis; Diagnostic Imaging; Diagnostic radiologic examination; Discrimination; Disease; Disease Progression; Dose; Early Diagnosis; Edema; Engineering; Enrollment; Evaluation; Face; Future; Gadolinium; Goals; Gold; Health; Image; Image Analysis; Imagery; Imaging Techniques; Individual; Institution; Iodine; Joints; Laboratories; Ligaments; Limb structure; Magnetic Resonance Imaging; Measurement; Measures; Metric; Modality; Morphology; Musculoskeletal; Orthopedics; Pain; Pathogenesis; Pathology; Patients; Performance; Pharmacotherapy; Physical Function; Pilot Projects; Play; Radiology Specialty; Relative (related person); Reproducibility; Research; Research Personnel; Resolution; Rheumatism; Rheumatoid Arthritis; Rheumatology; Role; Sensitivity and Specificity; Site; Surrogate Endpoint; Swelling; Synovial Membrane; Synovitis; System; Techniques; Technology; Tendon structure; Testing; Three-Dimensional Image; Three-dimensional analysis; Time; Tissues; Transcend; Translations; Ultrasonography; X-Ray Computed Tomography; arthritis therapy; base; bone; bone imaging; clinical remission; cohort; cone-beam computed tomography; cost; design; detector; gadolinium oxide; improved; interest; millimeter; new technology; novel; prospective; prototype; public health relevance; reconstruction; response; rheumatologist; shape analysis; soft tissue; substantia spongiosa; tool; treatment response

DESCRIPTION (provided by applicant): The last decade brought a revolution in rheumatoid arthritis (RA) therapies and an immediate need for reliable measurement of disease progression and response. Despite the strides in diagnostic imaging capabilities, conventional approaches in MRI, ultrasound, radiography, and CT face a variety of limitations that do not permit widespread application to RA assessment - e.g., limited spatial and contrast resolution, quantitation, reproducibility, and cost / accessibility. An emerging advance in CT promises to transcend the conventional limitations of this modality in rheumatology - high-resolution cone-beam CT (CBCT) with dual-energy (DE) material decomposition. We have recently developed a novel platform for CBCT dedicated to extremity imaging, demonstrating spatial and contrast resolution beyond the limits of conventional CT at reduced dose. Specifically, the system provides isotropic, sub-millimeter spatial resolution and soft-tissue contrast including synovial tissues, cartilage, tendons, and ligaments through DE decomposition. The resulting technology could provide a powerful addition to the rheumatologist's arsenal through access to high-quality imaging with cost, workflow, and site considerations appropriate to rheumatology clinical settings. We hypothesize that high- quality DE-CBCT combined with advanced, fully 3D image analysis will provide reliable visualization and quantitative metrics of RA. We will address this hypothesis through the following Specific Aims: 1.) Optimization of DE-CBCT image quality in rheumatological imaging tasks, including non-contrast exams (endogenous soft-tissues) and contrast-enhanced exams (exogenous Gd or iodine); 2.) Development of quantitative image-based metrics that leverage the superior spatial and contrast resolution of DE-CBCT for measurement of early-intermediate RA findings following the current gold standard in image-based assessment [the RA MRI score (RAMRIS)] - namely, synovial membrane volume (SMv), bone marrow edema volume (BMEv), and erosion volume (Ev) - as well as novel metrics of fully 3D intra-articular and subchondral morphology that have been identified as potential new correlates of rheumatic disease; and 3.) Translation to a pilot study in 20 RA patients on the prototype scanner to evaluate the reproducibility of DE-CBCT and associated image-based metrics (test-retest within a 1-week interval analyzed in paired t-tests) and the validity of DE-CBCT metrics relative to RAMRIS (sensitivity / specificity in scoring of RA pathology). An interdisciplinary team combining expertise in engineering, radiology, rheumatology, and biostatistics is assembled to accomplish these goals. Successful completion of the research will identify optimal imaging techniques for DE-CBCT of RA, develop quantitative image-based metrics of early, intermediate, and late RA disease (with applicability to MRI and DE-CT), and provide essential quantitation of reproducibility and validity of DE-CBCT in RA assessment as a first step toward applying DE-CBCT for quantitative measurement of RA progression and therapy response.

描述（由申请人提供）：最后十年带来了类风湿关节炎（RA）疗法的革命，并立即需要可靠地测量疾病进展和反应。尽管诊断成像能力取得了进步，但MRI，超声，放射线照相和CT的常规方法仍面临多种局限性，这些局限性不允许广泛应用RA评估，例如，有限的空间和造影分辨率和对比度解决，定量，可重复性和成本 /可及性。 CT中的新出现有望超越这种形式的风湿病学 - 高分辨率锥束CT（CBCT），并具有双能量（DE）材料分解。我们最近开发了一个专门用于肢体成像的CBCT的新型平台，表明了在减少剂量时传统CT限制的空间和对比度分辨率。具体而言，该系统通过DE分解提供了各向同性，亚毫米空间分辨率和软组织对比度，包括滑膜组织，软骨，肌腱和韧带。最终的技术可以通过使用适合风湿病学临床环境的成本，工作流程和现场注意事项的高质量成像来为风湿病学家的武器库提供有力的补充。我们假设高质量的DE-CBCT与先进的完全3D图像分析相结合，将提供可靠的可视化和RA的定量指标。我们将通过以下特定目的解决这一假设：1。）在流变学成像任务中对DE-CBCT图像质量的优化，包括非对比度考试（内源性软，无与伦比）和对比度增强的考试（外源GD或iodine）； 2.) Development of quantitative image-based metrics that leverage the superior spatial and contrast resolution of DE-CBCT for measurement of early-intermediate RA findings following the current gold standard in image-based assessment [the RA MRI score (RAMRIS)] - namely, synovial membrane volume (SMv), bone marrow edema volume (BMEv), and erosion volume (Ev) - as well as novel metrics of fully 3D关节内和软骨下形态已被确定为风湿病的潜在新相关性；和3.）将20名RA患者的试点研究转换为原型扫描仪，以评​​估DE-CBCT和相关的基于图像的基于图像的度量的可重复性（在成对的t检验中分析的1周间隔内测试 - 重测）和与RAMRIS相对于RAMRIS的DE-CBCT度量的有效性（敏感性 /特异性）（敏感性 /特异性）。跨学科团队组合了工程，放射学，风湿病学和生物统计学方面的专业知识，以实现这些目标。该研究的成功完成将确定RA的DE-CBCT的最佳成像技术，开发基于定量的RA疾病的基于定量图像的指标（对MRI和DE-CT的适用性），并为DE-CBCT在RA评估中的重复性和有效性提供了必不可少的定量，以将DE-CBCT评估作为对De-CBCT进行DEATITATITION RA PROGERSENT RA PROGERSENT和RA PROCERSENT的第一步。

项目成果

Extremity cone-beam CT for evaluation of medial tibiofemoral osteoarthritis: Initial experience in imaging of the weight-bearing and non-weight-bearing knee.

• DOI: 10.1016/j.ejrad.2015.09.003
• 发表时间: 2015-12
• 期刊: European journal of radiology
• 影响因子: 3.3
• 作者: Thawait GK;Demehri S;AlMuhit A;Zbijweski W;Yorkston J;Del Grande F;Zikria B;Carrino JA;Siewerdsen JH
• 通讯作者: Siewerdsen JH