Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

Peltola, Erno; Koskinen, Seppo

doi:10.1007/s00256-015-2173-x

Cited by 40 publications

(31 citation statements)

References 15 publications

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“…Owing to its easy visualization of changes in HU values, CT color mapping has been applied clinically to assess bone remodeling, bone or soft tissue structure, and osseointegration to implant surfaces. [ 14 , 15 , 17 , 21 , 22 ] In the present study, the assessment of bone ongrowth on the surface of Ti-coated PEEK cages by CT color mapping had adequate inter- and intraobserver reliability. Moreover, even if the HU values decreased in a rectangular ROI in total, color mapping could easily detect bone ongrowth on the surface of the cage frame where the local increase in HU values occurred (Fig.…”

Section: Discussionmentioning

confidence: 59%

Computed tomography color mapping for evaluation of bone ongrowth on the surface of a titanium-coated polyetheretherketone cage in vivo

Makino¹,

Kaito²,

Sakai³

et al. 2018

Medicine

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Bone ongrowth on the surfaces of titanium (Ti)-coated polyetheretherketone (PEEK) materials has been demonstrated in animal models; however, whether this occurs on the surfaces of Ti-coated PEEK cages in lumbar interbody fusion has not been demonstrated clinically in vivo. This prospective observational study was aimed to develop and validate a computed tomography (CT) color mapping based on Hounsfield unit (HU) values for evaluation of bone ongrowth on the surfaces of the Ti-coated PEEK cage after posterior lumbar interbody fusion (PLIF).Twenty-four consecutive patients (11 men and 13 women; mean age, 67.0 years; range, 20–82 years) who underwent single- or 2-level PLIF since March 2015 were included. Two Ti-coated PEEK cages were inserted in all PLIF segments. From reconstructed sagittal planes from postoperative CT scans (within 1 week and 6 months postoperatively), bone ongrowth on the surfaces of cage frames was evaluated by CT color mapping. Inter- and intraobserver reliability of the assessment of bone ongrowth by CT color mapping was evaluated by Cohen's kappa coefficient. The relation between CT color mapping and HU values on the surfaces of cage frames was also analyzed.A total of 248 surfaces of cage frames were evaluated. Bone ongrowth was observed in 134 of 248 surfaces (54.0%) by CT color mapping. Intraobserver reliability for the evaluation of bone ongrowth was kappa = 0.831, and interobserver reliability was kappa = 0.713. The HU values in the local regions of interest (ROIs) on the surfaces of cage frames where the postoperative bone ongrowth existed on CT color mapping increased significantly postoperatively (P < .001), and the median postoperative change rate of the HU values in the local ROIs was 22.4%.The assessment of bone ongrowth on the surfaces of Ti-coated PEEK cages by CT color mapping had adequate inter- and intraobserver reliability, which was useful especially in detecting local increase in HU values on the surfaces of the cages. This method is an easy and visually comprehensible method for the assessment of bone ongrowth in the bone-implant interface.

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Section: Discussionmentioning

confidence: 59%

Computed tomography color mapping for evaluation of bone ongrowth on the surface of a titanium-coated polyetheretherketone cage in vivo

Makino¹,

Kaito²,

Sakai³

et al. 2018

Medicine

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“…Unfortunately, the thinner ligaments such as tibial collateral ligaments and patellar retinaculum were only poorly visualized. Peltola et al 60 performed a similar study in traumatic knee injuries and compared three different DECT analyses (monochromatic spectral images, bone removal images, and collagen-specific color mapping) in a single-source General Electric DECT scanner in complete ACL and posterior cruciate ligament tears. They also noted that the color mapping was least useful and that in most cases, monochromatic spectral images were superior, although, in some cases, bone removal was best.…”

Section: Tip 8: Collagen Analysismentioning

confidence: 99%

Top-Ten Tips for Dual-Energy CT in MSK Radiology

Walstra

Hickle

Duggan

et al. 2019

Semin Musculoskelet Radiol

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Dual-energy computed tomography (DECT) has the potential to detect musculoskeletal pathology with greater sensitivity than conventional CT alone at no additional radiation dose to the patient. It therefore has the potential to reduce the need for further diagnostic imaging or procedures (e.g., joint aspirations in the case of gout or magnetic resonance imaging to confirm undisplaced fractures).DECT is a well-established technique for the detection of gout arthropathy. Multiple newer applications have shown clinical potential including bone marrow edema detection and metal artifact reduction. Collagen analysis, bone marrow lesion detection, and iodine mapping in CT arthrography are areas of possible future application and development.This article outlines 10 tips on the use of DECT imaging of the musculoskeletal system, explaining the technique and indications with practical suggestions to help guide the radiologist.

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“…Although still at the research stage of development, several studies showed promising results for the evaluation of ligaments, in particular for evaluation of anterior cruciate liga-ment injuries. 73 Although MRI remains the gold standard for imaging cartilaginous structures, DECT may be an acceptable alternative technique when MRI is contraindicated or unavailable.…”

Section: Imaging Of Cartilaginous Structuresmentioning

confidence: 99%

Musculoskeletal Imaging: Current Practice and Future Directions

Farrell

Adams

Walsh

et al. 2018

Semin Musculoskelet Radiol

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Musculoskeletal (MSK) radiology plays a crucial role in the diagnosis and management of MSK disorders and has rapidly expanded in tandem with advances in technology and improved access to imaging. Although anatomical imaging remains the mainstay of MSK radiology, significant progress has been made in functional and molecular imaging as well as in hybrid imaging with an expanding armament of technologies becoming available or in development. A vast array of research is occurring in MSK imaging, and this review article highlights some of the most promising current and future clinical applications in development in each of the major imaging modalities. Identifying the clinical utility of these technologies in an era of rising health care costs is an important challenge for MSK radiologists.

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Dual-energy computed tomography of cruciate ligament injuries in acute knee trauma

Abstract: DECT is a usable method to evaluate ACL in acute knee trauma patients with rather good sensitivity and high specificity. GSI is generally a better evaluation protocol than bone removal or collagen-specific color mapping in the evaluation of cruciate ligaments and popliteus tendon.

Cited by 40 publications

References 15 publications

Computed tomography color mapping for evaluation of bone ongrowth on the surface of a titanium-coated polyetheretherketone cage in vivo

Computed tomography color mapping for evaluation of bone ongrowth on the surface of a titanium-coated polyetheretherketone cage in vivo

Top-Ten Tips for Dual-Energy CT in MSK Radiology

Musculoskeletal Imaging: Current Practice and Future Directions

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