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

使用 C 臂 CT 进行膝盖负重成像

• 批准号: 8902732
• 负责人: Garry E Gold
• 金额: $ 50.3万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 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/8902732
• 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; public health relevance; quantitative imaging; receptor; reconstruction; response; skeletal tissue; soft tissue; tool; treatment strategy

 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(申请人提供)：膝关节是最常见的患肢骨关节炎(OA)的关节，主要症状包括疼痛和僵硬。骨骼组织受其机械环境的调节，骨和软组织中对机械刺激做出反应的受体被认为在关节疼痛中起着主要作用。骨关节炎的发生和发展的一个可能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。改变骨骼的机械应力和代谢活动的治疗可能是缓解这些患者疼痛的有效策略。然而，临床医生无法诊断或治疗这些“病理力学”，因为他们缺乏评估承重膝关节功能和组织应力的工具。这项研究的首要目标是开发新的负重计算机断层扫描(CT)成像，以支持膝关节健康的定量测量，该测量既测量关节的形态，也测量关节的力学。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微米各向同性)、基于C臂CT的成像测试，该测试将在受试者站在完全承重的位置下测量软骨变形随时间的变化。我们假设，由于软骨材料特性的不同及其对机械负荷的反应不同，变形-负荷曲线的力学模型将提供一个敏感的和早期的OA状态的成像生物标记物。我们将优化体外身体膝关节变形-时间曲线的获取，并进行40名受试者的初步研究，以证明新的成像生物标志物在区分非OA和不同阶段的OA进展方面的潜在敏感性。我们相信，我们新的关节健康测试将能够测试针对患者的治疗策略，这些策略可能会减缓或逆转膝骨性关节炎的进展。