New 3D imaging analysis technique could lead to improved arthritis treatment

sc604 — Mon, 18 Jun 2018 09:00:00 +0000

̽��ֱ��technique, which detects tiny changes in arthritic joints, could enable greater understanding of how osteoarthritis develops and allow the effectiveness of new treatments to be assessed more accurately, without the need for invasive tissue sampling. ̽��ֱ��results are published in the journal Scientific Reports.

Osteoarthritis is the most common form of arthritis in the UK. It develops when the articular cartilage that coats the ends of bones, and allows them to glide smoothly over each other at joints, is worn down, resulting in painful, immobile joints. Currently there is no recognised cure and the only definitive treatment is surgery for artificial joint replacement.

Osteoarthritis is normally identified on an x-ray by a narrowing of the space between the bones of the joint due to a loss of cartilage. However, x-rays do not have enough sensitivity to detect subtle changes in the joint over time.

“In addition to their lack of sensitivity, two-dimensional x-rays rely on humans to interpret them,” said lead author Dr Tom Turmezei from Cambridge’s Department of Engineering. “Our ability to detect structural changes to identify disease early, monitor progression and predict treatment response is frustratingly limited by this.”

̽��ֱ��technique developed by Turmezei and his colleagues uses images from a standard computerised tomography (CT) scan, which isn’t normally used to monitor joints, but produces detailed images in three dimensions.

̽��ֱ��semi-automated technique, called joint space mapping (JSM), analyses the CT images to identify changes in the space between the bones of the joint in question, a recognised surrogate marker for osteoarthritis. After developing the algorithm with tests on human hip joints from bodies that had been donated for medical research, they found that it exceeded the current ‘gold standard’ of joint imaging with x-rays in terms of sensitivity, showing that it was at least twice as good at detecting small structural changes. Colour-coded images produced using the JSM algorithm illustrate the parts of the joint where the space between bones is wider or narrower.

“Using this technique, we’ll hopefully be able to identify osteoarthritis earlier, and look at potential treatments before it becomes debilitating,” said Turmezei, who is now a consultant at the Norfolk and Norwich ̽��ֱ�� Hospital’s Department of Radiology. “It could be used to screen at-risk populations, such as those with known arthritis, previous joint injury, or elite athletes who are at risk of developing arthritis due to the continued strain placed on their joints.”

While CT scanning is regularly used in the clinic to diagnose and monitor a range of health conditions, CT of joints has not yet been approved for use in research trials. According to the researchers, the success of the JSM algorithm demonstrates that 3D imaging techniques have the potential to be more effective than 2D imaging. In addition, CT can now be used with very low doses of radiation, meaning that it can be safely used more frequently for the purposes of ongoing monitoring.

“We’ve shown that this technique could be a valuable tool for the analysis of arthritis, in both clinical and research settings,” said Turmezei. “When combined with 3D statistical analysis, it could be also be used to speed up the development of new treatments.”

Tom Turmezei acknowledges the Wellcome Trust for research funding. Ken Poole acknowledges the support of the Cambridge NIHR Biomedical Research Centre.

Reference
T.D. Turmezei et al. ‘A new quantitative 3D approach to imaging of structural joint disease.’ Scientific Reports (2018). DOI: 10.1038/s41598-018-27486-y

An algorithm to monitor the joints of patients with arthritis, which could change the way that the severity of the condition is assessed, has been developed by a team of engineers, physicians and radiologists led by the ̽��ֱ�� of Cambridge.

Using this technique, we’ll hopefully be able to identify osteoarthritis earlier, and look at potential treatments before it becomes debilitating.

Tom Turmezei

Hip, knee and ankle joints analysed by the JSM algorithm

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Yes

New imaging technology predicts fracture risk

bjb42 — Wed, 27 Oct 2010 00:00:00 +0000

̽��ֱ��method, developed by Dr Graham Treece of the Department of Engineering and Dr Ken Poole of the Department of Medicine, uses CT imaging to accurately measure the thickness of the cortical bone - the hard outer layer of compact bone which surrounds the spongy trabecular bone. ̽��ֱ��thickness of cortical bone is a key indicator of the risk of fracture.

This work is expected to lead to advances in the treatment and management of osteoporosis, a condition that affects one in two women and one in five men over the age of 50 in the UK.

Osteoporosis results in a decline in bone strength and thinning of the cortical bone, so that often the remaining bone is no thicker than an eggshell by the time an individual is in their 80s. At certain key points, this thinning can lead to bones that are so weak that a stumble, trip or fall can lead to a fracture.

Currently, the key technology used to assess a patient's risk of fracture is a bone mineral density test, which uses dual-energy x-ray absorptiometry (DXA) to estimate mineral levels contained in bone. An alternative is multi-detector computed tomography (MDCT), which provides more comprehensive 3D imaging of bone structure, but not at a sufficient enough resolution to provide accurate sub-millimetre measurement.

̽��ֱ��method developed by Drs Treece and Poole increases the accuracy of cortical bone measurements to the extent that clinicians can map changes in thickness over time, and produces accurate measurements of thicknesses as low as 0.3 mm.

Utilising data from a CT scan and a mathematical model of the scanning process, thousands of cortical bone measurements are obtained. This produces 3D thickness maps, which allows the identification of dangerously thin areas, Successive imaging allows maps to be produced depicting changes in the cortical bone over time in all areas of the skeleton so that the progress of osteoporosis treatments can be monitored.

"Osteoporosis is a condition which will become more and more common as the population ages," said Dr Andrew Walsh of Cambridge Enterprise, the ̽��ֱ��'s commercialisation group. "This exciting technology has the potential to improve the treatment of patients suffering from osteoporosis as well as to support the development of new drugs."

Dr Poole presented this work at the Annual Meeting of the American Society for Bone and Mineral Research, held recently in Toronto.

It will be further demonstrated at the annual meeting of the Radiological Society of North America, to be held in Chicago this November.

A new method for identifying which bones have a high risk of fracture, and for monitoring the effectiveness of new bone-strengthening drugs and techniques, has been developed by scientists at the ̽��ֱ�� of Cambridge.

Osteoporosis is a condition which will become more and more common as the population ages.

Dr Andrew Walsh, Cambridge Enterprise

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Yes

̽��ֱ�� of Cambridge - Graham Treece

New 3D imaging analysis technique could lead to improved arthritis treatment

New imaging technology predicts fracture risk