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

European Radiology Experimental

Original Article

Erik Tesselaar¹  Jörg Schilcher²  Ronald Booij³  Edwin H. G. Oei⁴  Mischa Woisetschläger⁵ 

[1] 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;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;Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden;Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands;Department of Radiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden;

关键词: Arthroplasty;    Joint prosthesis;    Osseointegration;    Osteoarthritis (hip);    Tomography (x-ray computed);   

DOI  :  10.1186/s41747-023-00335-y

 received in 2023-01-06, accepted in 2023-02-28,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSuccessful 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.MethodsTwo 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.ResultsDelineation 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.ConclusionsPCD-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.

【 授权许可】

CC BY   
© The Author(s) 2023

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