Dutta Anika, Ferrero Andrea, Rajendran Kishore, Drake Matthew T, Ou Fang-Shu, Giri Sharmila, Fletcher Joel G, McCollough Cynthia H, Baffour Francis I
Department of Radiology, Mayo Clinic, 200 1st SW, Rochester, MN, 55905, USA.
Division of Endocrinology, Diabetes and Metabolism, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.
Skeletal Radiol. 2025 Mar;54(3):531-540. doi: 10.1007/s00256-024-04770-9. Epub 2024 Aug 9.
To determine the accuracy of photon-counting-detector CT (PCD-CT) at deriving bone morphometric indices and demonstrate utility in vivo in the distal radius.
Ten cadaver wrists were scanned using PCD-CT and high-resolution peripheral quantitative CT (HRpQCT). Correlation between PCD-CT and HRpQCT morphometric indices was determined. Agreement was assessed by Lin's concordance correlation coefficient (Lin's CCC). Wrist PCD-CTs of patients between 02/2022 and 08/2023 were also evaluated for clinical utility. Morphometric indices of the in vivo distal radii were extracted and compared between patients with or without osteoporosis.
In cadavers, strong correlation between PCD-CT and HRpQCT was observed for cortical thickness (Spearman correlation, ρ, 0.85), trabecular spacing (ρ = 0.98), and trabecular bone volume fraction (ρ = 0.68). Moderate negative correlation (ρ = - 0.49) was observed for trabecular thickness. PCD-CT shows good agreement to HRpQCT for cortical thickness, trabecular spacing, and trabecular bone volume fraction (Lin's CCC = 0.80, 0.94, and 0.86, respectively) but poor agreement (Lin's CCC = - 0.1) for trabecular thickness. In forty participants (31 adults and 9 pediatric), bone morphometrics indices for cortical thickness, trabecular thickness, trabecular spacing, and trabecular bone volume fraction were 0.99 mm (IQR, 0.89-1.06), 0.38 mm (IQR, 0.25-0.40), 0.82 mm (IQR, 0.72-1.05), and 0.28 (IQR, 0.25-0.33), respectively. Patients with osteoporosis had statistically significantly larger trabecular spacing (p = 0.025) and lower trabecular volumetric bone mineral density (p = 0.042).
This study demonstrates the agreement of PCD-CT to HRpQCT in cadavers of most cortical and bone morphometrics examined and provide in vivo quantitative metrics of bone microarchitecture from routine clinical PCD-CT images of the distal radius.
确定光子计数探测器CT（PCD-CT）在推导骨形态计量学指标方面的准确性，并证明其在桡骨远端的体内应用价值。
使用PCD-CT和高分辨率外周定量CT（HRpQCT）对10具尸体手腕进行扫描。确定PCD-CT与HRpQCT形态计量学指标之间的相关性。通过林氏一致性相关系数（Lin's CCC）评估一致性。还对2022年2月至2023年8月期间患者的手腕PCD-CT进行了临床应用评估。提取体内桡骨远端的形态计量学指标，并在有或无骨质疏松症的患者之间进行比较。
在尸体中，观察到PCD-CT与HRpQCT在皮质厚度（Spearman相关性，ρ，0.85）、小梁间距（ρ = 0.98）和小梁骨体积分数（ρ = 0.68）方面有很强的相关性。在小梁厚度方面观察到中度负相关（ρ = -0.49）。PCD-CT在皮质厚度、小梁间距和小梁骨体积分数方面与HRpQCT显示出良好的一致性（Lin's CCC分别为0.80、0.94和0.86），但在小梁厚度方面一致性较差（Lin's CCC = -0.1）。在40名参与者（31名成年人和9名儿童）中，皮质厚度、小梁厚度、小梁间距和小梁骨体积分数的骨形态计量学指标分别为0.99毫米（IQR，0.89 - 1.06）、0.38毫米（IQR，0.25 - 0.40）、0.82毫米（IQR，0.72 - 1.05）和0.28（IQR，0.25 - 0.33）。骨质疏松症患者的小梁间距在统计学上显著更大（p = 0.025），小梁体积骨密度更低（p = 0.042）。
本研究证明了PCD-CT与HRpQCT在大多数检查的皮质和骨形态计量学尸体研究中的一致性，并从桡骨远端的常规临床PCD-CT图像中提供了骨微结构的体内定量指标。
