Division of Radiology, Department of Diagnosis, Geneva University Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland.
Tomography. 2023 Nov 29;9(6):2134-2147. doi: 10.3390/tomography9060167.
Osteoarthritis (OA) is a prevalent disease and the leading cause of pain, disability, and quality of life deterioration. Our study sought to evaluate the image quality and dose of cone-beam computed tomography arthrography (CBCT-A) and compare them to digital radiography (DR) for OA diagnoses. Overall, 32 cases of CBCT-A and DR with OA met the inclusion criteria and were prospectively analyzed. The Kellgren and Lawrence classification (KLC) stage, sclerosis, osteophytes, erosions, and mean joint width (MJW) were compared between CBCT-A and DR. Image quality was excellent in all CBCT-A cases, with excellent inter-observer agreement. OA under-classification was noticed with DR for MJW ( = 0.02), osteophyte detection (<0.0001), and KLC ( < 0.0001). The Hounsfield Unit (HU) values obtained for the cone-beam computed tomography CBCT did not correspond to the values for multi-detector computed tomography (MDCT), with a greater mean deviation obtained with the MDCT HU for Modeled Based Iterative Reconstruction 1st (MBIR1) than for the 2nd generation (MBIR2). CBCT-A has been found to be more reliable for OA diagnosis than DR as revealed by our results using a three-point rating scale for the qualitative image analysis, with higher quality and an acceptable dose. Moreover, the use of this imaging technique permits the preoperative assessment of extremities in an OA diagnosis, with the upright position and bone microarchitecture analysis being two other advantages of CBCT-A.
骨关节炎（OA）是一种常见疾病，也是疼痛、残疾和生活质量恶化的主要原因。我们的研究旨在评估锥形束 CT 关节造影（CBCT-A）的图像质量和剂量，并将其与数字射线照相术（DR）进行比较，以诊断 OA。共有 32 例符合纳入标准的 OA 患者进行了前瞻性分析，这些患者均接受了 CBCT-A 和 DR 检查。对 CBCT-A 和 DR 检查的 Kellgren 和 Lawrence 分级（KLC）分期、硬化、骨赘、侵蚀和平均关节宽度（MJW）进行了比较。所有 CBCT-A 病例的图像质量均为优秀，观察者间的一致性也很好。DR 对 MJW（=0.02）、骨赘检测（<0.0001）和 KLC（<0.0001）的 OA 分类不足。锥形束 CT 获得的 Hounsfield 单位（HU）值与多排 CT（MDCT）的 HU 值不对应，MBIR1 的 MDCT HU 值的平均偏差大于 MBIR2。我们的结果使用三点评分量表对定性图像分析进行了评估，发现 CBCT-A 比 DR 更可靠地诊断 OA，因为 CBCT-A 的图像质量更高，且剂量可接受。此外，这种成像技术可用于 OA 诊断中四肢的术前评估，直立位和骨微结构分析是 CBCT-A 的另外两个优点。
