Extremity cone-beam CT for evaluation of medial tibiofemoral osteoarthritis: Initial experience in imaging of the weight-bearing and non-weight-bearing knee

Gaurav K. Thawait, Shadpour Demehri, Abdullah Almuhit, Wojciech Zbijweski, John Yorkston, Filippo Del Grande, Bashir Zikria, John A. Carrino, Jeffrey H. Siewerdsen

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose To investigate differences in joint space width (JSW) and meniscal extrusion (ME) between non-weight bearing (NWB) and weight bearing (WB) examinations of knee joints with medial compartment osteoarthritis (OA) using a cone-beam CT (CBCT) extremity imaging system. Materials and methods In this IRB approved prospective study, informed consent was obtained for 17 patients symptomatic for OA (11 F,6 M; 31-78 years, mean 56 years) and 18 asymptomatic controls (0 F,18 M; 29-48 years, mean 38.5 years) enrolled for CBCT exams in NWB and WB positions. Three independent observers measured medial tibiofemoral JSW and ME. Measurements were compared between NWB and WB images using paired Wilcoxon signed-rank sum test. Results OA subjects exhibited a statistically significant reduction in JSW between NWB and WB scans (average JSWNWBOA = 2.1 mm and JSWWBOA = 1.5 mm, p = 0.016) and increase in ME (average MENWBOA = 6.9 mm and MEWBOA = 8.2 mm, p = 0.018)). For non-OA subjects, the change in JSW and ME between NWB and WB exams was reduced (average JSWNWBnonOA = 3.7 mm and JSWWBnonOA = 3.4 mm; average MENWBnonOA = 2.6 mm and MEWBnonOA = 2.7 mm) and was not statistically significant. Inter-observer agreement was evaluated using Bland-Altman limits of agreement, with good agreement for all measurements (correlation coefficient 0.89-0.98). Conclusion The ability to conduct NWB and WB exams in CBCT with a dose profile that is favorable in comparison to multidetector CT (MDCT) and with image quality sufficient for morphological analysis of joint space narrowing and meniscal extrusion could provide a valuable tool for OA diagnosis and treatment assessment.

Original languageEnglish (US)
Pages (from-to)2564-2570
Number of pages7
JournalEuropean Journal of Radiology
Volume84
Issue number12
DOIs
StatePublished - 2015

Keywords

  • Cone-beam CT
  • Extremity imaging
  • Functional imaging
  • Osteoarthritis
  • Weight bearing imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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