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（由适用提供）：下肢骨关节炎（OA）最常实施的关节是膝盖，主要症状包括疼痛和僵硬。骨骼组织受其机械环境的调节，并且骨骼和软组织中的接收器对机械刺激的反应被认为在关节疼痛中起主要作用。 OA发作和进展的一个潜在途径是由于关节运动异常引起的，导致关节应力升高和软骨损伤。改变骨骼机械应力和代谢活性的治疗可能是减轻这些患者疼痛的有效策略。但是，临床医生无法诊断或治疗这些“病理力学”，因为他们缺乏评估重量膝关节功能和组织应激的工具。这项研究的总体目的是开发新型的重量计算机断层扫描（CT）成像，以支持对膝关节健康的定量度量，以测量关节的形态和机械。作为实现这一目标的第一步，我们将研究并优化一个新的，非常高的分辨率（210 µM各向同性），基于C-ARM CT的成像测试，该测试将根据时间的时间来测量软骨变形，而受试者站在完全体重的位置。我们假设，由于软骨材料特性的差异及其对机械载荷的响应，变形 - 负载曲线的机械模型将提供OA状态的敏感和早期成像生物标志物。我们将优化离体尸体膝盖中变形时间曲线的获取，并进行40个受试者的初步研究，以证明新成像生物标志物的潜在灵敏度，以区分OA进展的非OA和不同阶段。我们认为，我们的新联合健康测试将实现患者特异性治疗策略的测试，这些治疗策略可能会减慢或扭转膝盖OA的进展。