Improved visualization of the bone-implant interface and osseointegration in ex vivo acetabular cup implants using photon-counting detector CT.

Autor: Woisetschläger M; Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. mischa.woisetschlager@liu.se.; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden. mischa.woisetschlager@liu.se., Booij R; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., Tesselaar E; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.; Department of Medical Radiation Physics, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden., Oei EHG; Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., Schilcher J; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.; Department of Orthopedics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.; Wallenberg Center for Molecular Medicine, Linköping University, Linköping, Sweden.
Jazyk: angličtina
Zdroj: European radiology experimental [Eur Radiol Exp] 2023 May 01; Vol. 7 (1), pp. 19. Date of Electronic Publication: 2023 May 01.
DOI: 10.1186/s41747-023-00335-y
Abstrakt: Background: Successful osseointegration of joint replacement implants is required for long-term implant survival. Accurate assessment of osseointegration could enable clinical discrimination of failed implants from other sources of pain avoiding unnecessary surgeries. Photon-counting detector computed tomography (PCD-CT) provides improvements in image resolution compared to conventional energy-integrating detector CT (EID-CT), possibly allowing better visualization of bone-implant-interfaces and osseointegration. The aim of this study was to assess the quality of visualization of bone-implant-interfaces and osseointegration in acetabular cup implants, using PCD-CT compared with EID-CT.
Methods: Two acetabular implants (one cemented, one uncemented) retrieved during revision surgery were scanned using PCD-CT and EID-CT at equal radiation dose. Images were reconstructed using different reconstruction kernels and iterative strengths. Delineation of the bone-implant and bone-cement-interface as an indicator of osseointegration was scored subjectively for image quality by four radiologists on a Likert scale and assessed quantitatively.
Results: Delineation of bone-implant and bone-cement-interfaces was better with PCD-CT compared with EID-CT (p ≤ 0.030). The highest ratings were given for PCD-CT at sharper kernels for the cemented cup (PCD-CT, median 5, interquartile range 4.25-5.00 versus EID-CT, 3, 2.00-3.75, p < 0.001) and the uncemented cup (5, 4.00-5.00 versus 2, 2-2, respectively, p < 0.001). The bone-implant-interface was 35-42% sharper and the bone-cement-interface was 28-43% sharper with PCD-CT compared with EID-CT, depending on the reconstruction kernel.
Conclusions: PCD-CT might enable a more accurate assessment of osseointegration of orthopedic joint replacement implants.
Key Points: • The bone-implant interface ex vivo showed superior visualization using photon-counting detector computed tomography (PCD-CT) compared to energy-integrating detector computed tomography. • Harder reconstruction kernels in PCD-CT provide sharper images with lower noise levels. • These improvements in imaging might make it possible to visualize osseointegration in vivo.
(© 2023. The Author(s).)
Databáze: MEDLINE
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