Biomechanics Section, Mechanical Engineering, KU Leuven, Leuven, Belgium.
AO Research Institute Davos, Davos, Switzerland.
Calcif Tissue Int. 2021 Mar;108(3):314-323. doi: 10.1007/s00223-020-00773-5. Epub 2021 Jan 16.
Obtaining high-resolution scans of bones and joints for clinical applications is challenging. HR-pQCT is considered the best technology to acquire high-resolution images of the peripheral skeleton in vivo, but a breakthrough for widespread clinical applications is still lacking. Recently, we showed on trapezia that CBCT is a promising alternative providing a larger FOV at a shorter scanning time. The goals of this study were to evaluate the accuracy of CBCT in quantifying trabecular bone microstructural and predicted mechanical parameters of the distal radius, the most often investigated skeletal site with HR-pQCT, and to compare it with HR-pQCT. Nineteen radii were scanned with four scanners: (1) HR-pQCT (XtremeCT, Scanco Medical AG, @ (voxel size) 82 μm), (2) HR-pQCT (XtremeCT-II, Scanco, @60.7 μm), (3) CBCT (NewTom 5G, Cefla, @75 μm) reconstructed and segmented using in-house developed software and (4) microCT (VivaCT40, Scanco, @19 μm-gold standard). The following parameters were evaluated: predicted stiffness, strength, bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), separation (Tb.Sp) and number (Tb.N). The overall accuracy of CBCT with in-house optimized algorithms in quantifying bone microstructural parameters was comparable (R = 0.79) to XtremeCT (R = 0.76) and slightly worse than XtremeCT-II (R = 0.86) which were both processed with the standard manufacturer's technique. CBCT had higher accuracy for BV/TV and Tb.Th but lower for Tb.Sp and Tb.N compared to XtremeCT. Regarding the mechanical parameters, all scanners had high accuracy (R [Formula: see text] 0.96). While HR-pQCT is optimized for research, the fast scanning time and good accuracy renders CBCT a promising technique for high-resolution clinical scanning.
获得骨骼和关节的高分辨率扫描用于临床应用具有挑战性。HR-pQCT 被认为是获取活体外周骨骼高分辨率图像的最佳技术，但仍缺乏广泛临床应用的突破。最近，我们在腕骨上表明，CBCT 是一种很有前途的替代方法，可在更短的扫描时间内提供更大的视野。这项研究的目的是评估 CBCT 定量测量桡骨远端小梁骨微观结构和预测力学参数的准确性，桡骨远端是 HR-pQCT 最常研究的骨骼部位，并将其与 HR-pQCT 进行比较。使用四种扫描仪对 19 根桡骨进行了扫描：(1) HR-pQCT (XtremeCT，Scanco Medical AG，@ 82 μm 体素大小)，(2) HR-pQCT (XtremeCT-II，Scanco，@60.7 μm)，(3) CBCT (NewTom 5G，Cefla，@75 μm) 使用内部开发的软件进行重建和分割，(4) microCT (VivaCT40，Scanco，@19 μm-金标准)。评估了以下参数：预测刚度、强度、骨体积分数 (BV/TV) 和小梁厚度 (Tb.Th)、分离度 (Tb.Sp) 和数量 (Tb.N)。使用内部优化算法的 CBCT 在定量评估骨微观结构参数方面的整体准确性与 XtremeCT (R=0.79) 相当(R=0.76)，略低于 XtremeCT-II (R=0.86)，后者均采用制造商的标准技术进行处理。CBCT 在 BV/TV 和 Tb.Th 方面具有更高的准确性，但在 Tb.Sp 和 Tb.N 方面准确性较低。关于力学参数，所有扫描仪都具有很高的准确性(R [公式：见正文] 0.96)。虽然 HR-pQCT 是为研究而优化的，但快速的扫描时间和良好的准确性使 CBCT 成为高分辨率临床扫描的一种很有前途的技术。
