MRI‐based synthetic CT shows equivalence to conventional CT for the morphological assessment of the hip joint

Florkow, Mateusz C.; Willemsen, Koen; Zijlstra, Frank; Foppen, Wouter; Wal, Bart C. H. van der; Zyp, Jochem R.N. van der Voort van; Viergever, Max A.; Castelein, René M.; Weinans, Harrie; Stralen, Marijn van; Sakkers, R. J. B.; Seevinck, Peter R.

doi:10.1002/jor.25127

Cited by 36 publications

(45 citation statements)

References 51 publications

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“…In in vivo hip joints, MR bone models differed on average by 0.4-0.9 mm from CT models, 27,30 with average RMSE under 1.8 mm 30 for VS-GRE Dixon images and under 0.81 mm for sCT images. 77 When considering in vivo knees, there was no difference in the width and volume of the medial tibial plateau, with highly consistent measurements between standard of care PDw MR and CT images. 89 This geometrical accuracy was influenced by the MR sequence acquired to perform the segmentation.…”

Section: Bone Geometrical Accuracymentioning

confidence: 54%

“…Other parameters that were compared include the lateral center edge and alpha angles. The intermodal agreement was good to excellent 23,43 with intermodal limits of agreements roughly within 12° 23,43,77 and bounded by the interobserver limits of agreement achieved on CT 23 …”

Section: Mri For Diagnosing Bone Pathologiesmentioning

confidence: 71%

“…To take into account soft tissue, evaluate more complex anatomies, and to make comparisons in an in vivo setting, MR segmentations were compared to CT segmentations. In in vivo hip joints, MR bone models differed on average by 0.4–0.9 mm from CT models, 27,30 with average RMSE under 1.8 mm 30 for VS‐GRE Dixon images and under 0.81 mm for sCT images 77 . When considering in vivo knees, there was no difference in the width and volume of the medial tibial plateau, with highly consistent measurements between standard of care PDw MR and CT images 89 …”

Section: Mri For Three‐dimensional Bone Modelingmentioning

confidence: 85%

See 2 more Smart Citations

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Florkow

Willemsen

Mascarenhas

et al. 2022

Magnetic Resonance Imaging

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Magnetic resonance imaging (MRI) is increasingly utilized as a radiation‐free alternative to computed tomography (CT) for the diagnosis and treatment planning of musculoskeletal pathologies. MR imaging of hard tissues such as cortical bone remains challenging due to their low proton density and short transverse relaxation times, rendering bone tissues as nonspecific low signal structures on MR images obtained from most sequences. Developments in MR image acquisition and post‐processing have opened the path for enhanced MR‐based bone visualization aiming to provide a CT‐like contrast and, as such, ease clinical interpretation. The purpose of this review is to provide an overview of studies comparing MR and CT imaging for diagnostic and treatment planning purposes in orthopedic care, with a special focus on selective bone visualization, bone segmentation, and three‐dimensional (3D) modeling. This review discusses conventional gradient‐echo derived techniques as well as dedicated short echo time acquisition techniques and post‐processing techniques, including the generation of synthetic CT, in the context of 3D and specific bone visualization. Based on the reviewed literature, it may be concluded that the recent developments in MRI‐based bone visualization are promising. MRI alone provides valuable information on both bone and soft tissues for a broad range of applications including diagnostics, 3D modeling, and treatment planning in multiple anatomical regions, including the skull, spine, shoulder, pelvis, and long bones. Level of Evidence 3 Technical Efficacy Stage 3

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Section: Bone Geometrical Accuracymentioning

confidence: 54%

Section: Mri For Diagnosing Bone Pathologiesmentioning

confidence: 71%

Section: Mri For Three‐dimensional Bone Modelingmentioning

confidence: 85%

See 1 more Smart Citation

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Florkow

Willemsen

Mascarenhas

et al. 2022

Magnetic Resonance Imaging

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“…Nevertheless, MRI is less efficient for the characterization of bone destruction compared to CT. FEA-based modeling has been reported ex vivo on vertebrae or in vivo using 15-minute acquisition time sequences, which is hardly feasible in a clinical MRI-based routine [50]. Low-TE or synthetic sequences allow good depiction of cortical bone and could be an alternative approach to CT [51]. They have been tested for the detection of bone metastasis [52], but the assessment of risk fracture with these sequences has not been reported yet.…”

Section: Local Evaluation Of Bone Metastasismentioning

confidence: 99%

Fracture Risk Evaluation of Bone Metastases: A Burning Issue

Confavreux

Follet

Mitton

et al. 2021

Cancers

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Major progress has been achieved to treat cancer patients and survival has improved considerably, even for stage-IV bone metastatic patients. Locomotive health has become a crucial issue for patient autonomy and quality of life. The centerpiece of the reflection lies in the fracture risk evaluation of bone metastasis to guide physician decision regarding physical activity, antiresorptive agent prescription, and local intervention by radiotherapy, surgery, and interventional radiology. A key mandatory step, since bone metastases may be asymptomatic and disseminated throughout the skeleton, is to identify the bone metastasis location by cartography, especially within weight-bearing bones. For every location, the fracture risk evaluation relies on qualitative approaches using imagery and scores such as Mirels and spinal instability neoplastic score (SINS). This approach, however, has important limitations and there is a need to develop new tools for bone metastatic and myeloma fracture risk evaluation. Personalized numerical simulation qCT-based imaging constitutes one of these emerging tools to assess bone tumoral strength and estimate the femoral and vertebral fracture risk. The next generation of numerical simulation and artificial intelligence will take into account multiple loadings to integrate movement and obtain conditions even closer to real-life, in order to guide patient rehabilitation and activity within a personalized-medicine approach.

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“…In the MRI-HIFU context, such sCT images could be generated from MR images acquired during the treatment session to depict the bone distribution in the treatment position. Although sCT generation has been used for orthopedic purposes [17][18][19] and HIFU treatment planning [20], its ability to reconstruct bone blastic or lytic lesions is unknown.…”

Section: Introductionmentioning

confidence: 99%

Synthetic CT for the planning of MR-HIFU treatment of bone metastases in pelvic and femoral bones: a feasibility study

et al. 2022

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Objectives Visualization of the bone distribution is an important prerequisite for MRI-guided high-intensity focused ultrasound (MRI-HIFU) treatment planning of bone metastases. In this context, we evaluated MRI-based synthetic CT (sCT) imaging for the visualization of cortical bone. Methods MR and CT images of nine patients with pelvic and femoral metastases were retrospectively analyzed in this study. The metastatic lesions were osteolytic, osteoblastic or mixed. sCT were generated from pre-treatment or treatment MR images using a UNet-like neural network. sCT was qualitatively and quantitatively compared to CT in the bone (pelvis or femur) containing the metastasis and in a region of interest placed on the metastasis itself, through mean absolute difference (MAD), mean difference (MD), Dice similarity coefficient (DSC), and root mean square surface distance (RMSD). Results The dataset consisted of 3 osteolytic, 4 osteoblastic and 2 mixed metastases. For most patients, the general morphology of the bone was well represented in the sCT images and osteolytic, osteoblastic and mixed lesions could be discriminated. Despite an average timespan between MR and CT acquisitions of 61 days, in bone, the average (± standard deviation) MAD was 116 ± 26 HU, MD − 14 ± 66 HU, DSC 0.85 ± 0.05, and RMSD 2.05 ± 0.48 mm and, in the lesion, MAD was 132 ± 62 HU, MD − 31 ± 106 HU, DSC 0.75 ± 0.2, and RMSD 2.73 ± 2.28 mm. Conclusions Synthetic CT images adequately depicted the cancellous and cortical bone distribution in the different lesion types, which shows its potential for MRI-HIFU treatment planning. Key Points • Synthetic computed tomography was able to depict bone distribution in metastatic lesions. • Synthetic computed tomography images intrinsically aligned with treatment MR images may have the potential to facilitate MR-HIFU treatment planning of bone metastases, by combining visualization of soft tissues and cancellous and cortical bone.

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MRI‐based synthetic CT shows equivalence to conventional CT for the morphological assessment of the hip joint

Cited by 36 publications

References 51 publications

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Magnetic Resonance Imaging Versus Computed Tomography for Three‐Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review

Fracture Risk Evaluation of Bone Metastases: A Burning Issue

Synthetic CT for the planning of MR-HIFU treatment of bone metastases in pelvic and femoral bones: a feasibility study

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