Quantitative high resolution cone beam CT for assessment of bone and joint health

用于评估骨和关节健康的定量高分辨率锥形束 CT

• 批准号: 8751463
• 负责人: Wojciech Bartosz Zbijewski
• 金额: $ 46.96万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8751463
• 关键词: Accounting; Adult; Affect; Algorithms; American; Architecture; Area; Biological Markers; Biological Models; Biopsy Specimen; Bone Density; Bone plates; Cadaver; Calibration; Cartilage; Clinical; Clinical Research; Cone; Degenerative polyarthritis; Development; Diagnosis; Diagnostic; Diagnostic radiologic examination; Disease; Dose; Early Diagnosis; Early treatment; Electronics; Evaluation; Future; Geometry; Health; Human; Image; Imagery; Imaging technology; Industry; Institution; Investigational Therapies; Joints; Knee; Lead; Limb structure; Logistics; Magnetic Resonance Imaging; Measurement; Measures; Metric; Modeling; Monte Carlo Method; Morphology; Motion; Musculoskeletal; Noise; Osteoporosis; Pathogenesis; Patients; Performance; Pilot Projects; Porosity; Protocols documentation; Radiation; Reproducibility; Research; Resolution; Rheumatoid Arthritis; Scanning; Source; Spottings; Staging; Support System; System; Systems Analysis; Techniques; Tendon structure; Testing; Thick; Time; Translating; Translations; Universities; Weight-Bearing state; Width; advanced system; base; bone; bone health; cone-beam computed tomography; detector; diagnosis evaluation; disability; effective therapy; follow-up; image reconstruction; imaging modality; improved; in vivo; in vivo imaging; innovative technologies; interest; model development; morphometry; musculoskeletal imaging; novel; novel diagnostics; novel strategies; object motion; prevent; prototype; public health relevance; reconstruction; soft tissue; tool; treatment response; ultra high resolution

PROJECT SUMMARY / ABSTRACT Osteoarthritis (OA) is the most common degenerative joint disease, afflicting ~30 million US adults and currently lacking effective treatment. OA diagnosis with radiography and MRI relies predominantly on biomarkers of late disease, and capability for early detection of OA could enable therapies preventing irreversible cartilage loss. Changes in subchondral bone (SB) architecture and bone mineral density (BMD) have been identified as possible biomarkers of early disease and a target for therapy. However, this potential advance in OA diagnosis and treatment is hampered by the lack of imaging technology that combines the high level of spatial resolution required to characterize trabecular architecture (<0.2 mm) with a high degree of quantitative accuracy enabling reliable BMD measurement and the ability to image large joints in vivo. Dedicated extremity cone-beam CT (CBCT) is a recent advance providing the capability for weight-bearing imaging, reduced dose, and superior spatial resolution (~0.3 mm) compared to conventional CT, as demonstrated in clinical studies using a system developed at our institution. We hypothesize that an advanced system for extremity CBCT utilizing a novel CMOS detector, model-based image reconstruction, and patient-specific scatter correction will provide simultaneous in-vivo assessment of SB architecture, BMD, and joint space morphology for early diagnosis and evaluation of treatment response in OA. The development and clinical translation of the system supporting this hypothesis involve the following Specific Aims: 1) Develop an advanced extremity CBCT configuration for in-vivo assessment of bone health employing a fast, low-noise, high-resolution CMOS detector within a system optimized for OA imaging tasks and compatible with rapid translation to the extremity CBCT clinical prototype; 2) Enhance spatial resolution in CBCT beyond conventional limits with model-based reconstruction incorporating a model of system blur, fiducial-free rigid motion correction, and a volume-of-interest, multi-resolution object representation to yield minimum resolvable detail size of ~0.1 mm to facilitate accurate SB morphometry; 3) Improve quantitative accuracy and soft tissue contrast (e.g., cartilage and tendons) using a patient-specific scatter correction with Monte Carlo calculation accelerated with iterative de-noising (anticipated correction time ~2 min/scan) and by developing a novel, automatic BMD calibration system integrated with the scanner enclosure to yield BMD accuracy better than 3%; and 4) Integrate the systems from Aims 1-3 onto a clinical platform for extremity CBCT and evaluate the system in a clinical pilot study to assess potential diagnostic performance and reproducibility of the SB architecture and BMD measurement. The project will advance the resolution and quantitative accuracy of CBCT translated to pilot studies pertinent to the early detection and staging of OA, with potential application in other areas of bone health e.g. rheumatoid arthritis or osteoporosis. The research is conducted in an academic-industry consortium between Johns Hopkins University and Carestream Health.

项目摘要 /摘要 骨关节炎（OA）是最常见的退行性关节疾病，遭受了约3000万美国成年人和 目前缺乏有效的治疗方法。 OA射线照相诊断和MRI诊断主要依赖 晚期疾病的生物标志物，以及早期检测到OA的能力，可以防止疗法 不可逆的软骨损失。软骨下骨（SB）结构和骨矿物质密度（BMD）的变化 已被确定为早期疾病的可能生物标志物和治疗靶标。但是，这种潜力 OA诊断和治疗方面的进步会因缺乏成像技术而受到阻碍 表征小梁建筑（<0.2 mm）所需的空间分辨率水平 定量精度可实现可靠的BMD测量以及在体内成像大关节的能力。 专用末端锥形束CT（CBCT）是最近的预付款，提供了重量的能力 与常规CT相比 在临床研究中使用我们机构开发的系统证明。我们假设一个高级 使用新颖的CMO探测器，基于模型的图像重建和 患者特定的散射校正将同时提供SB结构的体内评估， BMD和联合空间形态，用于早期诊断和评估OA治疗反应。这 支持该假设的系统的开发和临床翻译涉及以下特定 目的：1）开发高级肢体CBCT配置，用于使用骨骼健康的体内评估 在针对OA成像任务优化的系统中，快速，低噪声，高分辨率的CMO探测器和 与末端CBCT临床原型兼容； 2）增强空间分辨率 CBCT超出了常规限制，基于模型的重建结合了系统模型的模型， 无基质的刚性运动校正和利益量的多分辨率对象表示 最小可分离的细节尺寸约为0.1毫米，以促进准确的SB形态测定法； 3）提高定量 使用患者特异性散射校正与精度和软组织对比度（例如软骨和肌腱） 蒙特卡洛计算随迭代降低（预期的校正时间〜2分钟/扫描）和通过 开发一个与扫描仪外壳集成的新型自动BMD校准系统，以产生BMD 准确性高于3％； 4）将AIMS 1-3的系统集成到临床平台上的极端平台 CBCT并评估临床试点研究中的系统，以评估潜在的诊断性能和 SB体系结构和BMD测量的可重复性。该项目将推进决议，并 CBCT的定量准确性转化为与OA的早期检测和分期有关的试验研究 在骨骼健康的其他领域的潜在应用，例如类风湿关节炎或骨质疏松症。研究 在约翰·霍普金斯大学和凯特雷姆健康之间的学术行业联盟中进行。