Weight-Bearing Imaging of the Knee Using C-Arm CT

使用 C 臂 CT 进行膝盖负重成像

基本信息

批准号：
9042244
负责人：
Garry E Gold
金额：
$ 47.57万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-04-01 至 2019-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9042244
关键词：
3-Dimensional Accounting Activities of Daily Living Adult Affect Aging Algorithms Arthralgia Arthritis Arthrography Behavior Biochemical Markers Biomechanics Bone Tissue Cadaver Cardiology Cartilage Collaborations Data Degenerative polyarthritis Development Devices Diagnosis Diagnostic radiologic examination Dose Elements Ensure Environment Evaluation Geometry Goals Health Health Care Costs Human Image Image Analysis Imaging Techniques Inpatients Intervention Joints Knee Knee Osteoarthritis Knee joint Length Letters Limb structure Lower Extremity Magnetic Resonance Imaging Measurement Measures Mechanical Stimulation Mechanical Stress Mechanics Meniscus structure of joint Metabolic Modeling Morphologic artifacts Morphology Motion Muscle Myocardium Operative Surgical Procedures Pain Pathway interactions Patients Pattern Physics Physiological Pilot Projects Play Population Positioning Attribute Property Protocols documentation Radiology Specialty Reporting Research Resolution Risk Role Scanning Staging Stress Stress Tests Symptoms System Technology Tendon structure Testing Thick Time Tissues United States Universities Weight-Bearing state Work X-Ray Computed Tomography arm articular cartilage base bone cost data acquisition design experience functional decline functional disability high risk imaging biomarker imaging platform imaging system in vivo insight joint stress kinematics knee replacement arthroplasty new technology novel novel strategies pathomechanics quantitative imaging receptor reconstruction response skeletal tissue soft tissue tool treatment strategy

项目摘要

DESCRIPTION (provided by applicant): The joint most often implicated in lower extremity osteoarthritis (OA) is the knee, where major symptoms include pain and stiffness. Skeletal tissues are regulated by their mechanical environment and receptors within bone and soft tissue that respond to mechanical stimulation are believed to play a major role in joint pain. One potential pathway for the onset and progression of OA is due to abnormal joint kinematics, resulting in elevated joint stress and cartilage damage. Treatments that alter mechanical stresses and metabolic activity in bone may be an effective strategy to alleviate pain in these patients. However, clinicians are unable to diagnose or treat these `pathomechanics' as they lack the tools to assess weight-bearing knee function and tissue stress. The overarching goal of this research is to develop novel weight-bearing computed tomography (CT) imaging to support a quantitative measure of knee joint health that measures both morphology and mechanics of the joint. As a first step towards this goal, we will research and optimize a new, very high resolution (210 µm isotropic), C-arm CT-based imaging test that will measure cartilage deformation as a function of time with the subject standing in a fully weight-bearing position. We hypothesize that a mechanical model of the deformation-load curve will provide a sensitive and early imaging biomarker of OA status due to differences in cartilage material properties and their response to mechanical loading. We will optimize the acquisition of the deformation-time curve in ex vivo cadaver knees, and conduct a 40-subject preliminary study to demonstrate the potential sensitivity of the new imaging biomarker to distinguish between non-OA and different stages of OA progression. We believe that our new joint health test will enable testing of patient-specific treatment strategies that may slow or reverse the progression of knee OA.

描述（由申请人提供）：最常与下肢骨关节炎（OA）相关的关节是膝盖，其主要症状包括疼痛和僵硬骨骼组织受到其机械环境以及骨骼和软组织内对机械反应的受体的调节。刺激被认为在关节疼痛中起着重要作用。 OA 发生和进展的一个潜在途径是由于关节运动学异常，导致关节应力升高和软骨损伤，从而改变机械应力。骨骼的代谢活动可能是减轻这些患者疼痛的有效策略，但是，坚持者无法诊断或治疗这些“病理力学”，因为他们缺乏评估膝关节负重功能和组织应力的工具。这项研究旨在开发新型负重计算机断层扫描 (CT) 成像，以支持膝关节健康状况的测量，从而测量关节的定量形态和力学。作为实现这一目标的第一步，我们将研究和优化一种新的、非常高分辨率（210 µm 各向同性），基于 C 型臂 CT 的成像测试，将在受试者处于完全负重位置时测量软骨变形随时间的变化，我们发现变形-负载曲线的机械模型将提供敏感的结果。由于软骨材料特性及其对机械负荷的反应的差异，我们将优化离体尸体膝盖变形时间曲线的采集，并进行 40 名受试者的初步研究。证明新的成像生物标志物区分非 OA 和 OA 进展的不同阶段的潜在敏感性我们相信，我们的新关节健康测试将能够测试可能减缓或逆转膝关节 OA 进展的患者特异性治疗策略。