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.

项目概要/摘要 骨关节炎 (OA) 是最常见的退行性关节疾病，困扰着大约 3000 万美国成年人和 目前缺乏有效的治疗方法。 OA 诊断主要依赖于放射线照相和 MRI 晚期疾病的生物标志物以及早期检测 OA 的能力可以使治疗预防 不可逆转的软骨损失。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点。然而，这种潜力 由于缺乏结合高通量成像技术的成像技术，OA 诊断和治疗的进展受到阻碍。 表征小梁结构（<0.2毫米）所需的空间分辨率水平具有高度 定量精度可实现可靠的 BMD 测量和体内大关节成像的能力。 专用四肢锥形束 CT (CBCT) 是一项最新进展，提供负重能力 与传统 CT 相比，成像、剂量减少和卓越的空间分辨率 (~0.3 mm) 使用我们机构开发的系统在临床研究中得到证明。我们假设一个先进的 利用新型 CMOS 探测器、基于模型的图像重建和 患者特异性散射校正将同时提供 SB 架构的体内评估， BMD 和关节间隙形态用于 OA 的早期诊断和治疗反应评估。这 支持该假设的系统的开发和临床转化涉及以下具体内容 目标：1) 开发一种先进的四肢 CBCT 配置，用于骨健康的体内评估 系统内的快速、低噪声、高分辨率 CMOS 探测器，针对 OA 成像任务进行了优化 兼容快速转化为肢体CBCT临床原型； 2）增强空间分辨率 CBCT 超越传统限制，基于模型的重建结合了系统模糊模型， 无基准刚性运动校正，以及感兴趣体积、多分辨率对象表示以产生 最小可分辨细节尺寸约为 0.1 毫米，以促进准确的 SB 形态测量； 3）提高定量 使用患者特定的散射校正来提高准确性和软组织对比度（例如软骨和肌腱） 蒙特卡洛计算通过迭代去噪加速（预期校正时间约为 2 分钟/扫描）并通过 开发一种与扫描仪外壳集成的新型自动 BMD 校准系统，以产生 BMD 准确度优于3%； 4) 将目标 1-3 的系统集成到四肢临床平台上 CBCT 并在临床试点研究中评估该系统，以评估潜在的诊断性能和 SB 架构和 BMD 测量的可重复性。该项目将推进该决议并 CBCT 的定量准确性转化为与 OA 早期检测和分期相关的试点研究， 在骨骼健康的其他领域具有潜在的应用，例如类风湿性关节炎或骨质疏松症。研究 该研究由约翰·霍普金斯大学和 Carestream Health 之间的学术产业联盟进行。