title: Advanced Knee Structure Analysis (AKSA): a comparison of bone mineral density and trabecular texture measurements using computed tomography and high-resolution peripheral quantitative computed tomography of human knee cadavers.
abstract: A change of loading conditions in the knee causes changes in the subchondral bone and may be a cause of osteoarthritis (OA). However, quantification of trabecular architecture in vivo is difficult due to the limiting spatial resolution of the imaging equipment; one approach is the use of texture parameters. In previous studies, we have used digital models to simulate changes of subchondral bone architecture under OA progression. One major result was that, using computed tomography (CT) images, subchondral bone mineral density (BMD) in combination with anisotropy and global homogeneity could characterize this progression. The primary goal of this study was a comparison of BMD, entropy, anisotropy, variogram slope, and local and global inhomogeneity measurements between high-resolution peripheral quantitative CT (HR-pQCT) and CT using human cadaveric knees. The secondary goal was the verification of the spatial resolution dependence of texture parameters observed in the earlier simulations, two important prerequisites for the interpretation of in vivo measurements in OA patients.
  
  
  
  The applicability of texture analysis to characterize bone architecture in clinical CT examinations was investigated and compared to results obtained from HR-pQCT. Fifty-seven human knee cadavers (OA status unknown) were examined with both imaging modalities. Three-dimensional (3D) segmentation and registration processes, together with automatic positioning of 3D analysis volumes of interest (VOIs), ensured the measurement of BMD and texture parameters at the same anatomical locations in CT and HR-pQCT datasets.
  
  
  
  According to the calculation of dice ratios (>0.978), the accuracy of VOI locations between methods was excellent. Entropy, anisotropy, and global inhomogeneity showed significant and high linear correlation between both methods (0.68 < R2< 1.00). The resolution dependence of these parameters simulated earlier was confirmed by the in vitro measurements.
  
  
  
  The high correlation of HR-pQCT- and CT-based measurements of entropy, global inhomogeneity, and anisotropy suggests interchangeability between devices regarding the quantification of texture. The agreement of the experimentally determined resolution dependence of global inhomogeneity and anisotropy with earlier simulations is an important milestone towards their use to quantify subchondral bone structure. However, an in vivo study is still required to establish their clinical relevance.
authors.affiliation: Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr. 91, 91052, Erlangen, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Lowitz
authors.affiliation: Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr. 91, 91052, Erlangen, Germany.
authors.forename: Oleg
authors.initials: O
authors.lastname: Museyko
authors.affiliation: AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.|Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Bousson
authors.affiliation: AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.|Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Chappard
authors.affiliation: AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.|Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France.
authors.forename: Liess
authors.initials: L
authors.lastname: Laouisset
authors.affiliation: AP-HP, Hôpital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, F-75475, Paris, Cedex 10, France.|Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire B2OA, CNRS UMR 7052, 75010, Paris, France.
authors.forename: Jean-Denis
authors.initials: JD
authors.lastname: Laredo
authors.affiliation: Institute of Medical Physics, University of Erlangen-Nürnberg, Henkestr. 91, 91052, Erlangen, Germany. klaus.engelke@imp.uni-erlangen.de.
authors.forename: Klaus
authors.identifier: 0000-0001-9875-4123
authors.initials: K
authors.lastname: Engelke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D002102:Cadaver; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Computed tomography; High-resolution peripheral quantitative computed tomography; Knee OA; Subchondral bone; Texture