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Home / Equine Research Bank / Equine Vet J / Comparison of cone-beam and fan-beam computed tomography and...
Equine veterinary journal2023; doi: 10.1111/evj.14023

Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of palmar/plantar osteochondral disease in Thoroughbred horses.

Abstract: Palmar/plantar osteochondral disease (POD) of the metacarpal/tarsal condyles is a common pathological finding in racehorses. Objective: To compare diagnoses, imaging details, and measurements of POD lesions between cone-beam computed tomography CT (CBCT), fan-beam CT (FBCT), and low-field magnetic resonance imaging (MRI) using macroscopic pathology as a gold standard. Methods: Cross-sectional study. Methods: Thirty-five cadaver limbs from 10 horses underwent CBCT, FBCT, MRI, and macroscopic examination. CT and MR images were examined for presence of POD, imaging details of POD, and measurements of POD dimensions and areas. Imaging diagnoses, details, and measurements were compared with macroscopic examination and between modalities. Results: Forty-eight POD lesions were seen over 70 condyles. Compared with macroscopic examination the sensitivity and specificity of diagnosis were 95.8% (CI95 = 88%-99%) and 63.6% (CI95 = 43%-81%) for FBCT, 85.4% (CI95 = 74%-94%) and 81.8% (CI95 = 63%-94%) for CBCT, and 69.0% (CI95 = 54%-82%) and 71.4% (CI95 = 46%-90%) for MRI. Inter-modality agreement on diagnosis was moderate between CBCT and FBCT (κ = 0.56, p < 0.001). POD was identified on CT as hypoattenuating lesions with surrounding hyperattenuation and on MRI as either T1W, T2*W, T2W, and STIR hyperintense lesions or T1W and T2*W heterogeneous hypointense lesions with surrounding hypointensity. Agreement on imaging details between CBCT and FBCT was substantial for subchondral irregularity (κ = 0.61, p < 0.001). Macroscopic POD width strongly correlated with MRI (r = 0.81, p < 0.001) and CBCT (r = 0.79, p < 0.001) and moderately correlated with FBCT (r = 0.69, p < 0.001). Macroscopic POD width was greater than all imaging modality (p < 0.001). Conclusions: Effect of motion artefact in live horse imaging could not be assessed. Conclusions: All imaging modalities were able to detect POD lesions, but underestimated lesion size. The CT systems were more sensitive, but the differing patterns of signal intensity may suggest that MRI can detect changes associated with POD pathological status or severity. The image features observed by CBCT and FBCT were similar. Unassigned: Die palmar/plantare osteochondrale Erkrankung (POD) der metakarpalen/tarsalen Kondylen ist ein häufiger pathologischer Befund bei Rennpferden. Unassigned: Vergleich von Diagnosen, Bildgebungsdetails und Messungen von POD-Läsionen zwischen Cone-Beam-Computertomographie (CBCT), Fan-Beam-CT (FBCT) und Low-Field-Magnetresonanztomographie (MRT) unter Verwendung der makroskopischen Pathologie als Goldstandard. Methods: Querschnittsstudie. Methods: Fünfunddreißig Kadavergliedmaßen von 10 Pferden wurden einer CBCT-, FBCT-, MRT- und makroskopischen Untersuchung unterzogen. CT- und MR-Bilder wurden auf das Vorhandensein von POD, bildgebende Details von POD und Messungen der POD-Abmessungen und -Flächen untersucht. Bildgebende Diagnosen, Details und Messungen wurden mit makroskopischen Untersuchungen und zwischen verschiedenen Modalitäten verglichen. Unassigned: Achtundvierzig POD-Läsionen wurden an siebzig Kondylen festgestellt. Im Vergleich zur makroskopischen Untersuchung betrugen die Sensitivität und Spezifität der Diagnose 95,8% (CI95=88-99%) und 63,6% (CI95=43-81%) für das FBCT, 85,4% (CI95=74-94%) und 81,8% (CI95=63-94%) für das CBCT und 69,0% (CI95=54-82%) und 71,4% (CI95=46-90%) für die MRT. Die Übereinstimmung zwischen CBCT und FBCT bei der Diagnose war mäßig (κ=0,56, p<0,001). Die POD wurde im CT als hypoabschwächende Läsionen mit umliegender Hyperabschwächung und im MRT entweder als T1W-, T2*W-, T2W- und STIR-hyperintense Läsionen oder als T1W- und T2*W-heterogene hypointense Läsionen mit umliegender Hypointensität identifiziert. Die Übereinstimmung der Bildgebungsdetails zwischen CBCT und FBCT war bei subchondralen Unregelmäßigkeiten erheblich (κ=0,61, p<0,001). Die makroskopische POD-Breite korrelierte stark mit MRT (r=0,81, p<0,001) und CBCT (r=0,79, p<0,001) und mäßig mit FBCT (r=0,69, p<0,001). Die makroskopische POD-Breite war größer als bei allen Bildgebungsmodalitäten (p<0,001). Unassigned: Die Auswirkungen von Bewegungsartefakten bei der Bildgebung von lebenden Pferden konnten nicht bewertet werden. Unassigned: Alle bildgebenden Verfahren waren in der Lage, POD-Läsionen zu erkennen, unterschätzten jedoch die Größe der Läsionen. Die CT-Systeme waren empfindlicher, aber die unterschiedlichen Muster der Signalintensität könnten darauf hindeuten, dass die MRT Veränderungen erkennen kann, die mit dem pathologischen Status oder Schweregrad der POD zusammenhängen. Die mit CBCT und FBCT beobachteten Bildmerkmale waren ähnlich.
© 2023 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2023-11-06 PubMed ID: 37931621DOI: 10.1111/evj.14023Google Scholar: Lookup
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Summary

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This research article looked at the effectiveness of different types of imaging for identifying palmar/plantar osteochondral disease (POD) in Thoroughbred horses, a common orthopedic condition often found in racehorses. The study compared cone-beam computed tomography (CBCT), fan-beam CT (FBCT), and low-field magnetic resonance imaging (MRI) against actual macroscopic (visible to the naked eye) findings as the standard.

Methodology

  • Thirty-five limbs from ten horse cadavers were put through three different imaging techniques – CBCT, FBCT and MRI – as well as gross macroscopic examination.
  • The images obtained from CT and MRI were analyzed for signs of POD – its presence, the imaging details, and measurements of the disease’s dimensions and area.
  • All the image findings were then compared with the macroscopic results and the different imaging modalities were compared with each other as well.

Results

  • Out of 70 condyles, 48 pod lesions were identified.
  • The specificity and sensitivity towards macroscopic findings differed among the imaging techniques. FBCT had a 95.8% sensitivity and a 63.6% specificity, whereas CBCT had an 85.4% sensitivity and 81.8% specificity. MRI had the lowest sensitivity and specificity, at 69.0% and 71.4% respectively.
  • The agreement between CBCT and FBCT in diagnosis was moderate (κ = 0.56, p < 0.001).
  • On CT images, POD was indicated by hypoattenuating lesions with surrounding hyperattenuation. In MRI, POD appeared as either T1W, T2*W, T2W, and STIR hyperintense lesions or T1W and T2*W heterogeneous hypointense lesions with surrounding hypointensity.
  • There was substantial agreement between CBCT and FBCT on imaging details for subchondral irregularity (κ = 0.61, p < 0.001).
  • The macroscopic width of the POD strongly correlated with MRI and CBCT, but was moderately correlated with FBCT.
  • However, the macroscopic width of the POD was larger than all the imaging modality, meaning all imaging techniques underestimated the size of the lesions.

Conclusion

  • How motion artifact in live horse imaging might affect the findings could not be determined in this study.
  • All imaging modalities – CBCT, FBCT and MRI were able to detect POD lesions, but underestimated the actual size of the lesions.
  • CT systems were more sensitive than MRI in detecting POD. However, the researchers suggest that the different patterns of intensity on MRI pictures suggest that MRI might be better at showing changes that correlate with the severity or pathological status of POD.
  • CBCT and FBCT showed a similarity in the type of image features they detected.

Cite This Article

APA
Lin ST, Bolas NM, Peter VG, Pokora R, Patrick H, Foote AK, Sargan DR, Murray RC. (2023). Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of palmar/plantar osteochondral disease in Thoroughbred horses. Equine Vet J. https://doi.org/10.1111/evj.14023

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Lin, Szu-Ting
  • Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Bolas, Nicholas M
  • Hallmarq Veterinary Imaging, Surrey, UK.
Peter, Vanessa G
  • Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK.
Pokora, Rachel
  • Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK.
Patrick, Hayley
  • Swayne and Partners Veterinary Surgeons, Suffolk, UK.
Foote, Alastair K
  • Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK.
Sargan, David R
  • Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Murray, Rachel C
  • Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK.

Grant Funding

  • Department of Veterinary Medicine, University of Cambridge
  • Horserace Betting Levy Board
  • Robinson College, University of Cambridge
  • Charles Slater Fund, School of Biological Sciences, University of Cambridge

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Citations

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