Poster Presentation 33rd ASM of the Australian & New Zealand Bone & Mineral Society 2023

A systematic review of parameters used for the assessment of subchondral bone in osteoarthritis (OA) with computed tomography (CT) (#218)

Jemima E. Schadow 1 , David Maxey 2 , Toby O. Smith 3 , Mikko A.J. Finnilä 4 , Sarah L. Manske 5 , Neil A. Segal 6 , Andy Kin On Wong 7 8 , Rachel A. Davey 9 , Tom Turmezei 2 10 , Kathryn S. Stok 1
  1. Department of Biomedical Engineering, The University of Melbourne, Parkville, Australia
  2. Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Noriwch, United Kingdom
  3. Warwick Medical School, University of Warwick, Coventry, United Kingdom
  4. Research Unit of Health Science and Technology, University of Oulu, Oulu, Finland
  5. Department of Radiology, University of Calgary, Calgary, Canada
  6. Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, United States
  7. Joint Department of Medical Imaging, University Health Network, Toronto, Canada
  8. Schroeder's Arthritis Institute & Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
  9. Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia
  10. Norwich Medical School, University of East Anglia, Norwich, United Kingdom

Introduction

Bone is critically involved in OA pathology with features such as sclerosis and osteophytes appearing early in disease development [1]. The imaging modalities of choice for OA assessment are radiography and magnetic resonance imaging. However, there are significant advantages to CT imaging compared to these modalities. Primarily, CT is capable of high-resolution three-dimensional image reconstruction allowing standardised bone structure analysis. Therefore, the objective of this systematic review was to gain an overview of published CT parameters for the assessment of subchondral bone in OA, and current practices and standards.

Methods

Search strategies were run in Medline, Embase, and Cochrane Library databases (2010-January 2023) and results were independently screened by two reviewers. Pre-determined inclusion/ exclusion criteria deemed studies conducted with CT in vivo/ex vivo in human adults (>18 years) to assess subchondral bone in OA eligible. Data was extracted from included studies and analysed in a qualitative summary and formal narrative synthesis.

Results

Of all search results, 202 studies were deemed eligible. The CT modalities used were summarised in four groups: micro-/nano-CT, conventional clinical-type CT, quantitative CT, and cone-beam CT (Fig. 1a). Nine anatomical locations were found to be of interest for OA assessment (Fig. 1b). Six parameter categories were identified that combine measurements of related osseous features: microstructure, bone adaptation, gross morphology, mineralisation, joint space, and mechanical properties (Fig. 1c).

Conclusions

CT techniques are increasingly popular for OA assessment and clinically meaningful CT measurements as well as parameters with the potential to perform in the clinical field. Quantification is crucial for their sensitivity and reproducibility. Finally, consistent reporting and standardised measurement protocols enhance the value of parameters in future OA research and clinical practice.

 

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Figure 1 | Overview of a) use frequency of CT groups, b) investigation frequency of anatomical locations, and c) reporting frequency of parameter categories.

  1. 1. Altman, R., et al., Arthritis & Rheumatism. 29(8):1039-1049, 1986.