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（由申请人提供）：下肢骨关节炎（OA）最常累及的关节是膝关节，其主要症状包括疼痛和僵硬。骨骼组织受其机械环境的调节，并且骨和软组织内对机械刺激作出反应的受体被认为在关节疼痛中起主要作用。OA发病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。改变骨中的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。然而，临床医生无法诊断或治疗这些“病理力学”，因为他们缺乏评估负重膝关节功能和组织应力的工具。本研究的总体目标是开发新型承重计算机断层扫描（CT）成像，以支持膝关节健康的定量测量，该测量同时测量关节的形态和力学。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）的、基于C形臂CT的成像测试，该测试将测量软骨变形作为受试者站在完全负重位置时时间的函数。我们假设，由于软骨材料特性的差异及其对机械载荷的反应，变形-载荷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关节中变形-时间曲线的采集，并进行40例受试者的初步研究，以证明新成像生物标志物区分非OA和OA进展不同阶段的潜在灵敏度。我们相信，我们新的关节健康测试将能够测试患者特定的治疗策略，这些策略可能会减缓或逆转膝关节OA的进展。