High-Resolution Peripheral Quantitative Computed Tomography for Bone Evaluation in Inflammatory Rheumatic Disease

Frontiers in Medicine

article

Rasmus Klose-Jensen¹  Sarah L. Manske³  Justin J. Tse³  Kresten Krarup Keller⁵  Cheryl Barnabe³  Andrew J. Burghardt⁷  Stephanie Finzel⁸  Lai-Shan Tam^1,10  Ellen-Margrethe Hauge¹  Kathryn S. Stok^1,11 

[1] Department of Rheumatology, Aarhus University Hospital;Department of Clinical Medicine, Faculty of Health, Aarhus University;Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary;Department of Radiology, Cumming School of Medicine, University of Calgary;Diagnostic Centre, Silkeborg Regional Hospital;Department of Medicine, Cumming School of Medicine, University of Calgary;Department of Radiology and Biomedical Imaging, University of California, United States;Department of Rheumatology and Clinical Immunology, Medical Centre - University of Freiburg;Faculty of Medicine, University of Freiburg;Department of Medicine and Therapeutics, The Chinese University of Hong Kong;Department of Biomedical Engineering, The University of Melbourne

关键词: HR-pQCT (high-resolution peripheral quantitative computed tomography);    arthritis;    joint space;    erosions;    osteophytes;    bone mineral density;    bone microstructure;   

DOI  :  10.3389/fmed.2020.00337

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

High resolution peripheral quantitative computed tomography (HR-pQCT) is a 3-dimensional imaging modality with superior sensitivity for bone changes and abnormalities. Recent advances have led to increased use of HR-pQCT in inflammatory arthritis to report quantitative volumetric measures of bone density, microstructure, local anabolic (e.g., osteophytes, enthesiophytes) and catabolic (e.g., erosions) bone changes and joint space width. These features may be useful for monitoring disease progression, response to therapy, and are responsive to differentiating between those with inflammatory arthritis conditions and healthy controls. We reviewed 69 publications utilizing HR-pQCT imaging of the metacarpophalangeal (MCP) and/or wrist joints to investigate arthritis conditions. Erosions are a marker of early inflammatory arthritis progression, and recent work has focused on improvement and application of techniques to sensitively identify erosions, as well as quantifying erosion volume changes longitudinally using manual, semi-automated and automated methods. As a research tool, HR-pQCT may be used to detect treatment effects through changes in erosion volume in as little as 3 months. Studies with 1-year follow-up have demonstrated progression or repair of erosions depending on the treatment strategy applied. HR-pQCT presents several advantages. Combined with advances in image processing and image registration, individual changes can be monitored with high sensitivity and reliability. Thus, a major strength of HR-pQCT is its applicability in instances where subtle changes are anticipated, such as early erosive progression in the presence of subclinical inflammation. HR-pQCT imaging results could ultimately impact decision making to uptake aggressive treatment strategies and prevent progression of joint damage. There are several potential areas where HR-pQCT evaluation of inflammatory arthritis still requires development. As a highly sensitive imaging technique, one of the major challenges has been motion artifacts; motion compensation algorithms should be implemented for HR-pQCT. New research developments will improve the current disadvantages including, wider availability of scanners, the field of view, as well as the versatility for measuring tissues other than only bone. The challenge remains to disseminate these analysis approaches for broader clinical use and in research.

【 授权许可】

CC BY