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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

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

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

References

This article includes 32 references
  1. Barr E, Pinchbeck G, Clegg P, Boyde A, Riggs C. Post mortem evaluation of palmar osteochondral disease (traumatic osteochondrosis) of the metacarpo/metatarsophalangeal joint in Thoroughbred racehorses.. Equine Vet J 2009;41:366-371.
  2. Tranquille C, Parkin T, Murray R. Magnetic resonance imaging-detected adaptation and pathology in the distal condyles of the third metacarpus, associated with lateral condylar fracture in Thoroughbred racehorses.. Equine Vet J 2012;44:699-706.
  3. Cianci JM, Wulster KB, Richardson DW, Stefanovski D, Ortved KF. Computed tomographic assessment of fracture characteristics and subchondral bone injury in Thoroughbred racehorses with lateral condylar fractures and their relationship to outcome.. Vet Surg 2022;51:426-437.
  4. Pinchbeck G, Clegg P, Boyde A, Riggs C. Pathological and clinical features associated with palmar/plantar osteochondral disease of the metacarpo/metatarsophalangeal joint in Thoroughbred racehorses.. Equine Vet J 2013;45:587-592.
  5. Norrdin R, Kawcak C, Capwell B, McIlwraith C. Subchondral bone failure in an equine model of overload arthrosis.. Bone 1998;22:133-139.
  6. Pool R. Pathologic manifestations of joint disease in the athletic horse.. Joint Dis Horse 1996;1:87-104.
  7. Richardson DW. The metacarpophalangeal joint.. Diagnosis and management of lameness in the horse. Missouri: Elsevier; 2003. p. 348-362.
  8. Kawcak CE, McIlwraith CW, Norrdin RW, Park RD, Steyn PS. Clinical effects of exercise on subchondral bone of carpal and metacarpophalangeal joints in horses.. Am J Vet Res 2000;61:1252-1258.
  9. Pinilla M, Tranquille C, Blunden A, Chang Y, Parkin T, Murray R. Histological features of the distal third metacarpal bone in Thoroughbred racehorses, with and without lateral condylar fractures.. J Comp Pathol 2017;157:1-10.
  10. O'Brien T, Hornof W, Meagher D. Radiographic detection and characterization of palmar lesions in the equine fetlock joint.. J Am Vet Med Assoc 1981;178:231-237.
  11. Vanderperren K, Saunders JH. Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 2: the bony disorders.. Vet J 2009;181:123-136.
  12. Davis A, Fan X, Shen L, Robinson P, Riggs C. Improved radiological diagnosis of palmar osteochondral disease in the Thoroughbred racehorse.. Equine Vet J 2017;49:454-460.
  13. Byron C, Goetz T. Arthroscopic debridement of a palmar third metacarpal condyle subchondral bone injury in a Standardbred.. Equine Vet Educ 2007;19:344-347.
  14. Curtiss AL, Ortved KF, Dallap-Schaer B, Gouzeev S, Stefanovski D, Richardson DW. Validation of standing cone beam computed tomography for diagnosing subchondral fetlock pathology in the Thoroughbred racehorse.. Equine Vet J 2021;53:510-523.
  15. Zubrod CJ, Schneider RK, Tucker RL, Gavin PR, Ragle CA, Farnsworth KD. Use of magnetic resonance imaging for identifying subchondral bone damage in horses: 11 cases (1999-2003).. J Am Vet Med Assoc 2004;224:411-418.
  16. Powell S. Low-field standing magnetic resonance imaging findings of the metacarpo/metatarsophalangeal joint of racing Thoroughbreds with lameness localised to the region: a retrospective study of 131 horses.. Equine Vet J 2012;44:169-177.
  17. Beltran J, Shankman S. Magnetic resonance imaging of bone marrow disorders of the knee.. Magn Reson Imaging Clin N Am 1994;2:463-473.
  18. Yao L, Lee J. Occult intraosseous fracture: detection with MR imaging.. Radiology 1988;167:749-751.
  19. Vellet AD, Marks P, Fowler P, Munro T. Occult posttraumatic osteochondral lesions of the knee: prevalence, classification, and short-term sequelae evaluated with MR imaging.. Radiology 1991;178:271-276.
  20. Powell S. The fetlock region.. Equine MRI. West Sussex: John Wiley & Sons; 2010. p. 315-359.
  21. Mageed M. Standing computed tomography of the equine limb using a multi-slice helical scanner: technique and feasibility study.. Equine Vet Educ 2022;34:77-83.
  22. Olive J, D'Anjou MA, Alexander K, Laverty S, Theoret C. Comparison of magnetic resonance imaging, computed tomography, and radiography for assessment of noncartilaginous changes in equine metacarpophalangeal osteoarthritis.. Vet Radiol Ultrasound 2010;51:267-279.
  23. Lin ST, Bolas NM, Sargan DR, Restif O, Peter VG, Pokora R. Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of proximal phalanx dorsoproximal osteochondral defects.. Equine Vet J 2023.
    doi: 10.1111/evj.13973google scholar: lookup
  24. Lin ST, Peter VG, Schiavo S, Pokora R, Patrick H, Bolas N. Identification of heterotopic mineralization and adjacent pathology in the equine fetlock region by low-field magnetic resonance imaging, cone-beam and fan-beam computed tomography.. J Equine Vet 2023;126:104252.
  25. Moore D, Notz W, Flinger M. Scatterplots and correlation.. The basic practice of statistics. 6th ed. New York, NY: WH Freeman and Company; 2013.
  26. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic.. Fam Med 2005;37:360-363.
  27. Goldman LW. Principles of CT: radiation dose and image quality.. J Nucl Med Technol 2007;35:213-225.
  28. Murray R, Werpy N. Image interpretation and artefacts.. Equine MRI. West Sussex: John Wiley & Sons; 2010. p. 101-145.
  29. Saini A, Saifuddin A. MRI of osteonecrosis.. Clin Radiol 2004;59:1079-1093.
  30. Miracle A, Mukherji S. Conebeam CT of the head and neck, part 1: physical principles.. Am J Neuroradiol 2009;30:1088-1095.
  31. Gonzalez LM, Schramme MC, Robertson ID, Thrall DE, Redding RW. MRI features of metacarpo (tarso) phalangeal region lameness in 40 horses.. Vet Radiol Ultrasound 2010;51:404-414.
  32. Muir P, Peterson A, Sample S, Scollay M, Markel M, Kalscheur V. Exercise-induced metacarpophalangeal joint adaptation in the Thoroughbred racehorse.. J Anat 2008;213:706-717.

Citations

This article has been cited 4 times.
  1. Irandoust S, Whitton C, Henak C, Muir P. Tuning and validation of a virtual mechanical testing pipeline for condylar stress fracture risk assessment in Thoroughbred racehorses. R Soc Open Sci 2025 May;12(5):241935.
    doi: 10.1098/rsos.241935pubmed: 40370600google scholar: lookup
  2. Ciamillo SA, Bills KW, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF. Effect of high-speed exercise on subchondral bone in the metacarpo-/metatarsophalangeal joints of 2-year-old Thoroughbred racehorses in their first year of training. Equine Vet J 2026 Jan;58(1):40-48.
    doi: 10.1111/evj.14524pubmed: 40323137google scholar: lookup
  3. Nagy A, Dyson SJ. Combined standing low-field magnetic resonance imaging and fan-beam computed tomographic diagnosis of fetlock region pain in 27 sports horses. Equine Vet J 2025 Sep;57(5):1313-1327.
    doi: 10.1111/evj.14504pubmed: 40123444google scholar: lookup
  4. Nagy A, Dyson S. Magnetic Resonance Imaging, Computed Tomographic and Radiographic Findings in the Metacarpophalangeal Joints of 31 Warmblood Showjumpers in Full Work and Competing Regularly. Animals (Basel) 2024 May 9;14(10).
    doi: 10.3390/ani14101417pubmed: 38791635google scholar: lookup
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