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Journal of orthopaedic research : official publication of the Orthopaedic Research Society2019; 37(10); 2138-2148; doi: 10.1002/jor.24382

Contrast-Enhanced Computed Tomography Scoring System for Distinguishing Early Osteoarthritis Disease States: A Feasibility Study.

Abstract: Early detection of osteoarthritis (OA) remains a diagnostic challenge owing to insensitive diagnostic techniques currently available. Herein a new semiquantitative scoring system, based upon contrast-enhanced computed tomographic (CECT) imaging, is described for further refinement of early OA disease staging. Trochlear ridge cartilage defects were surgically created in the femoropatellar joint of an adult horse (ACUC approved protocols). Seven weeks post-surgery, CECT imaging was performed on a clinical scanner after intra-articular injection of a cationic iodinated contrast agent, CA4+, into both injured and control femoropatellar joint compartments. The femoral cartilage surface was densely biopsied, and specimens were assessed for visual (Outerbridge score), functional (equilibrium compressive modulus), and biochemical (glycosaminoglycan content) measures of cartilage quality. Cartilage CECT attenuation was compared with cartilage quality measures using receiver operating characteristic curve analysis to establish attenuation thresholds for distinguishing among cartilage quality levels. CECT imaging identifies macroscopically damaged cartilage regions and in morphologically identical tissue provides moderately sensitive and specific semiquantitative segregation of cartilage quality based upon CECT attenuation, reflecting both glycosaminoglycan content and compressive stiffness of cartilage area under the curve (AUC = 0.83 [95% confidence interval [CI]: 0.72-0.93] for distinguishing poor quality and AUC = 0.76 [95% CI: 0.65-0.90] for distinguishing healthy quality cartilage). A semiquantitative 6-point scoring system-the Osteoarthritis Attenuation and Morphological Assessment (OAMA) score-is proposed as a tool for assessing cartilage quality from CECT images. The OAMA scoring system expands the current disease staging capability of early OA by inclusion of morphological, biochemical, and biomechanical assessments. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2138-2148, 2019.
© 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
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Publication Date: 2019-06-21 PubMed ID: 31136003PubMed Central: PMC6739126DOI: 10.1002/jor.24382Google Scholar: Lookup
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  • Evaluation Study
  • Journal Article
  • Research Support
  • N.I.H.
  • Extramural
  • Research Support
  • Non-U.S. Gov't

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 introduces a new scoring system, based on contrast-enhanced computed tomographic (CECT) imaging, for early identification and staging of osteoarthritis (OA). The system, termed the Osteoarthritis Attenuation and Morphological Assessment (OAMA), proposes a more detailed and accurate method by incorporating morphological, biochemical, and biomechanical evaluations.

Research Methodology

  • The study was performed on an adult horse, on whose femoropatellar joint a cartilage defect was surgically induced, simulating early OA conditions. This was done in compliance with approved protocols.
  • The joint was injected with a cationic iodinated contrast agent, CA4+, and CECT imaging was carried out seven weeks post-surgery.
  • The femoral cartilage surface was thoroughly biopsied, and samples were evaluated based on visual (Outerbridge score), functional (equilibrium compressive modulus), and biochemical (glycosaminoglycan content) aspects to determine their quality.
  • Measurements of cartilage CECT attenuation were compared with these quality measures to set attenuation thresholds for differentiating between cartilage quality levels.

Findings

  • The CECT imaging was able to identify macroscopically damaged cartilage regions. It also proved moderately sensitive and specific for segmenting cartilage quality in morphologically identical tissue, based on CECT attenuation. This attenuation was found to be reflective of both the glycosaminoglycan content and the compressive stiffness of the cartilage area.
  • This led to the development of the OAMA score, a semiquantitative 6-point scoring system for assessing cartilage quality from CECT images. It offers a more comprehensive approach to early OA disease staging by including morphological, biochemical, and biomechanical assessments.

Significance and Implications

  • This study presents a novel approach to early detection and staging of OA, which has traditionally been a challenge due to the insensitivity of available diagnostic techniques.
  • It suggests that CECT imaging, when paired with correlated assessments of cartilage quality, can provide a robust, detailed diagnostic tool that improves upon current methods.
  • The use of the OAMA score has the potential to significantly enhance the understanding and management of OA in its early stages, allowing for more effective treatments and interventions.

Cite This Article

APA
Stewart RC, Nelson BB, Kawcak CE, Freedman JD, Snyder BD, Goodrich LR, Grinstaff MW. (2019). Contrast-Enhanced Computed Tomography Scoring System for Distinguishing Early Osteoarthritis Disease States: A Feasibility Study. J Orthop Res, 37(10), 2138-2148. https://doi.org/10.1002/jor.24382

Publication

Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
NlmUniqueID: 8404726
Country: United States
Language: English
Volume: 37
Issue: 10
Pages: 2138-2148

Researcher Affiliations

Stewart, Rachel C
  • Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts, 02215.
  • Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, Massachusetts, 02215.
Nelson, Brad B
  • Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts, 02215.
  • Department of Clinical Sciences, Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, Colorado, 80523.
Kawcak, Chris E
  • Department of Clinical Sciences, Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, Colorado, 80523.
Freedman, Jonathan D
  • Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts, 02215.
  • Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, Massachusetts, 02215.
Snyder, Brian D
  • Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, 99 Brookline Avenue, Boston, Massachusetts, 02215.
Goodrich, Laurie R
  • Department of Clinical Sciences, Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 1678 Campus Delivery, Fort Collins, Colorado, 80523.
Grinstaff, Mark W
  • Department of Biomedical Engineering, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts, 02215.
  • Department of Chemistry, Boston University, 590 Commonwealth Avenue, Boston, Massachusetts, 02215.
  • Department of Medicine, Boston University School of Medicine, 715 Albany St. E-113, Boston, Massachusetts, 02118.

MeSH Terms

  • Animals
  • Cartilage, Articular / diagnostic imaging
  • Contrast Media
  • Feasibility Studies
  • Horses
  • Osteoarthritis / diagnostic imaging
  • Severity of Illness Index
  • Tomography, X-Ray Computed

Grant Funding

  • Gail Holmes Equine Orthopedic Research Center
  • Wallace H. Coulter Foundation
  • T32 GM008541 / NIGMS NIH HHS
  • T32GM008541 / NIGMS NIH HHS

Conflict of Interest Statement

COMPETING INTERESTS. The authors have no commercial competing interests. MWG and BDS receiving laboratory funding from this work from the above sources.

References

This article includes 50 references
  1. Chronic Rheumatic Conditions, Chronic diseases and health promotionnWorld Health Organization; nhttp://www.who.int/chp/topics/rheumatic/en/. AccessednApril 7, 2019.
  2. Wright RW, Boyce RH, Michener T, Shyr Y, McCarty EC, Spindler KP. Radiographs are not useful in detecting arthroscopically confirmed mild chondral damage.. Clin Orthop Relat Res 2006 Jan;442:245-51.
    pubmed: 16394768doi: 10.1097/01.blo.0000167670.03197.c2google scholar: lookup
  3. Uzumcugil A, Bekmez S, Kaya D, Atay AO, Doral MN. Can standing knee radiographs predict chondral lesions in young- and middle-aged population?. Knee Surg Sports Traumatol Arthrosc 2014 Jun;22(6):1370-5.
    pubmed: 23689962doi: 10.1007/s00167-013-2530-zgoogle scholar: lookup
  4. McDevitt CA, Muir H. Biochemical changes in the cartilage of the knee in experimental and natural osteoarthritis in the dog.. J Bone Joint Surg Br 1976 Feb;58(1):94-101.
    pubmed: 131804doi: 10.1302/0301-620x.58b1.131804google scholar: lookup
  5. Tiderius CJ, Olsson LE, Nyquist F, Dahlberg L. Cartilage glycosaminoglycan loss in the acute phase after an anterior cruciate ligament injury: delayed gadolinium-enhanced magnetic resonance imaging of cartilage and synovial fluid analysis.. Arthritis Rheum 2005 Jan;52(1):120-7.
    pubmed: 15641092doi: 10.1002/art.20795google scholar: lookup
  6. Arokoski J, Jurvelin J, Kiviranta I, Tammi M, Helminen HJ. Softening of the lateral condyle articular cartilage in the canine knee joint after long distance (up to 40 km/day) running training lasting one year.. Int J Sports Med 1994 Jul;15(5):254-60.
    pubmed: 7960320doi: 10.1055/s-2007-1021056google scholar: lookup
  7. Setton LA, Elliott DM, Mow VC. Altered mechanics of cartilage with osteoarthritis: human osteoarthritis and an experimental model of joint degeneration.. Osteoarthritis Cartilage 1999 Jan;7(1):2-14.
    pubmed: 10367011doi: 10.1053/joca.1998.0170google scholar: lookup
  8. Petersson IF, Boegård T, Svensson B, Heinegård D, Saxne T. Changes in cartilage and bone metabolism identified by serum markers in early osteoarthritis of the knee joint.. Br J Rheumatol 1998 Jan;37(1):46-50.
    pubmed: 9487250doi: 10.1093/rheumatology/37.1.46google scholar: lookup
  9. Garnero P, Piperno M, Gineyts E, Christgau S, Delmas PD, Vignon E. Cross sectional evaluation of biochemical markers of bone, cartilage, and synovial tissue metabolism in patients with knee osteoarthritis: relations with disease activity and joint damage.. Ann Rheum Dis 2001 Jun;60(6):619-26.
    pmc: PMC1753666pubmed: 11350852doi: 10.1136/ard.60.6.619google scholar: lookup
  10. Firestein GS, Paine MM, Littman BH. Gene expression (collagenase, tissue inhibitor of metalloproteinases, complement, and HLA-DR) in rheumatoid arthritis and osteoarthritis synovium. Quantitative analysis and effect of intraarticular corticosteroids.. Arthritis Rheum 1991 Sep;34(9):1094-105.
    pubmed: 1657009doi: 10.1002/art.1780340905google scholar: lookup
  11. Aigner T, Fundel K, Saas J, Gebhard PM, Haag J, Weiss T, Zien A, Obermayr F, Zimmer R, Bartnik E. Large-scale gene expression profiling reveals major pathogenetic pathways of cartilage degeneration in osteoarthritis.. Arthritis Rheum 2006 Nov;54(11):3533-44.
    pubmed: 17075858doi: 10.1002/art.22174google scholar: lookup
  12. Mankin HJ. Biochemical and metabolic aspects of osteoarthritis.. Orthop Clin North Am 1971 Mar;2(1):19-31.
    pubmed: 4940528
  13. Mankin HJ, Lippiello L. The glycosaminoglycans of normal and arthritic cartilage.. J Clin Invest 1971 Aug;50(8):1712-9.
    pmc: PMC442071pubmed: 4255496doi: 10.1172/jci106660google scholar: lookup
  14. Appleyard RC, Burkhardt D, Ghosh P, Read R, Cake M, Swain MV, Murrell GA. Topographical analysis of the structural, biochemical and dynamic biomechanical properties of cartilage in an ovine model of osteoarthritis.. Osteoarthritis Cartilage 2003 Jan;11(1):65-77.
    pubmed: 12505489doi: 10.1053/joca.2002.0867google scholar: lookup
  15. Gomoll AH, Yoshioka H, Watanabe A, Dunn JC, Minas T. Preoperative Measurement of Cartilage Defects by MRI Underestimates Lesion Size.. Cartilage 2011 Oct;2(4):389-93.
    pmc: PMC4297136pubmed: 26069597doi: 10.1177/1947603510397534google scholar: lookup
  16. Strickland CD, Kijowski R. Morphologic imaging of articular cartilage.. Magn Reson Imaging Clin N Am 2011 May;19(2):229-48.
    pubmed: 21665089doi: 10.1016/j.mric.2011.02.009google scholar: lookup
  17. Bangerter NK, Tarbox GJ, Taylor MD, Kaggie JD. Quantitative sodium magnetic resonance imaging of cartilage, muscle, and tendon.. Quant Imaging Med Surg 2016 Dec;6(6):699-714.
    pmc: PMC5219970pubmed: 28090447doi: 10.21037/qims.2016.12.10google scholar: lookup
  18. Keenan KE, Besier TF, Pauly JM, Han E, Rosenberg J, Smith RL, Delp SL, Beaupre GS, Gold GE. Prediction of glycosaminoglycan content in human cartilage by age, T1ρ and T2 MRI.. Osteoarthritis Cartilage 2011 Feb;19(2):171-9.
    pmc: PMC3041640pubmed: 21112409doi: 10.1016/j.joca.2010.11.009google scholar: lookup
  19. Kurkijärvi JE, Nissi MJ, Kiviranta I, Jurvelin JS, Nieminen MT. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 characteristics of human knee articular cartilage: topographical variation and relationships to mechanical properties.. Magn Reson Med 2004 Jul;52(1):41-6.
    pubmed: 15236365doi: 10.1002/mrm.20104google scholar: lookup
  20. Hirvasniemi J, Kulmala KA, Lammentausta E, Ojala R, Lehenkari P, Kamel A, Jurvelin JS, Töyräs J, Nieminen MT, Saarakkala S. In vivo comparison of delayed gadolinium-enhanced MRI of cartilage and delayed quantitative CT arthrography in imaging of articular cartilage.. Osteoarthritis Cartilage 2013 Mar;21(3):434-42.
    pubmed: 23274105doi: 10.1016/j.joca.2012.12.009google scholar: lookup
  21. van Tiel J, Siebelt M, Reijman M, Bos PK, Waarsing JH, Zuurmond AM, Nasserinejad K, van Osch GJ, Verhaar JA, Krestin GP, Weinans H, Oei EH. Quantitative in vivo CT arthrography of the human osteoarthritic knee to estimate cartilage sulphated glycosaminoglycan content: correlation with ex-vivo reference standards.. Osteoarthritis Cartilage 2016 Jun;24(6):1012-20.
    pubmed: 26851449doi: 10.1016/j.joca.2016.01.137google scholar: lookup
  22. Bansal PN, Joshi NS, Entezari V, Grinstaff MW, Snyder BD. Contrast enhanced computed tomography can predict the glycosaminoglycan content and biomechanical properties of articular cartilage.. Osteoarthritis Cartilage 2010 Feb;18(2):184-91.
    pubmed: 19815108doi: 10.1016/j.joca.2009.09.003google scholar: lookup
  23. Bansal PN, Joshi NS, Entezari V, Malone BC, Stewart RC, Snyder BD, Grinstaff MW. Cationic contrast agents improve quantification of glycosaminoglycan (GAG) content by contrast enhanced CT imaging of cartilage.. J Orthop Res 2011 May;29(5):704-9.
    pubmed: 21437949doi: 10.1002/jor.21312google scholar: lookup
  24. Joshi NS, Bansal PN, Stewart RC, Snyder BD, Grinstaff MW. Effect of contrast agent charge on visualization of articular cartilage using computed tomography: exploiting electrostatic interactions for improved sensitivity.. J Am Chem Soc 2009 Sep 23;131(37):13234-5.
    pubmed: 19754183doi: 10.1021/ja9053306google scholar: lookup
  25. Bansal PN, Stewart RC, Entezari V, Snyder BD, Grinstaff MW. Contrast agent electrostatic attraction rather than repulsion to glycosaminoglycans affords a greater contrast uptake ratio and improved quantitative CT imaging in cartilage.. Osteoarthritis Cartilage 2011 Aug;19(8):970-6.
    pubmed: 21549206doi: 10.1016/j.joca.2011.04.004google scholar: lookup
  26. Lakin BA, Grasso DJ, Shah SS, Stewart RC, Bansal PN, Freedman JD, Grinstaff MW, Snyder BD. Cationic agent contrast-enhanced computed tomography imaging of cartilage correlates with the compressive modulus and coefficient of friction.. Osteoarthritis Cartilage 2013 Jan;21(1):60-8.
    pmc: PMC3878721pubmed: 23041438doi: 10.1016/j.joca.2012.09.007google scholar: lookup
  27. Stewart RC, Bansal PN, Entezari V, Lusic H, Nazarian RM, Snyder BD, Grinstaff MW. Contrast-enhanced CT with a high-affinity cationic contrast agent for imaging ex vivo bovine, intact ex vivo rabbit, and in vivo rabbit cartilage.. Radiology 2013 Jan;266(1):141-50.
    pmc: PMC3528972pubmed: 23192774doi: 10.1148/radiol.12112246google scholar: lookup
  28. Silvast TS, Jurvelin JS, Aula AS, Lammi MJ, Töyräs J. Contrast agent-enhanced computed tomography of articular cartilage: association with tissue composition and properties.. Acta Radiol 2009 Jan;50(1):78-85.
    pubmed: 19052932doi: 10.1080/02841850802572526google scholar: lookup
  29. Silvast TS, Jurvelin JS, Lammi MJ, Töyräs J. pQCT study on diffusion and equilibrium distribution of iodinated anionic contrast agent in human articular cartilage--associations to matrix composition and integrity.. Osteoarthritis Cartilage 2009 Jan;17(1):26-32.
    pubmed: 18602844doi: 10.1016/j.joca.2008.05.012google scholar: lookup
  30. Silvast TS, Kokkonen HT, Jurvelin JS, Quinn TM, Nieminen MT, Töyräs J. Diffusion and near-equilibrium distribution of MRI and CT contrast agents in articular cartilage.. Phys Med Biol 2009 Nov 21;54(22):6823-36.
    pubmed: 19864699doi: 10.1088/0031-9155/54/22/005google scholar: lookup
  31. Palmer AW, Guldberg RE, Levenston ME. Analysis of cartilage matrix fixed charge density and three-dimensional morphology via contrast-enhanced microcomputed tomography.. Proc Natl Acad Sci U S A 2006 Dec 19;103(51):19255-60.
    pmc: PMC1748213pubmed: 17158799doi: 10.1073/pnas.0606406103google scholar: lookup
  32. Entezari V, Bansal PN, Stewart RC, Lakin BA, Grinstaff MW, Snyder BD. Effect of mechanical convection on the partitioning of an anionic iodinated contrast agent in intact patellar cartilage.. J Orthop Res 2014 Oct;32(10):1333-40.
    pubmed: 24961833doi: 10.1002/jor.22662google scholar: lookup
  33. Xie L, Lin AS, Levenston ME, Guldberg RE. Quantitative assessment of articular cartilage morphology via EPIC-microCT.. Osteoarthritis Cartilage 2009 Mar;17(3):313-20.
    pmc: PMC2683349pubmed: 18789727doi: 10.1016/j.joca.2008.07.015google scholar: lookup
  34. Goodrich LR, Hidaka C, Robbins PD, Evans CH, Nixon AJ. Genetic modification of chondrocytes with insulin-like growth factor-1 enhances cartilage healing in an equine model.. J Bone Joint Surg Br 2007 May;89(5):672-85.
    pubmed: 17540757doi: 10.1302/0301-620x.89b5.18343google scholar: lookup
  35. Fortier LA, Potter HG, Rickey EJ, Schnabel LV, Foo LF, Chong LR, Stokol T, Cheetham J, Nixon AJ. Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model.. J Bone Joint Surg Am 2010 Aug 18;92(10):1927-37.
    pubmed: 20720135doi: 10.2106/jbjs.i.01284google scholar: lookup
  36. McIlwraith CW, Fortier LA, Frisbie DD, Nixon AJ. Equine Models of Articular Cartilage Repair.. Cartilage 2011 Oct;2(4):317-26.
    pmc: PMC4297134pubmed: 26069590doi: 10.1177/1947603511406531google scholar: lookup
  37. Miller RE, Grodzinsky AJ, Barrett MF, Hung HH, Frank EH, Werpy NM, McIlwraith CW, Frisbie DD. Effects of the combination of microfracture and self-assembling Peptide filling on the repair of a clinically relevant trochlear defect in an equine model.. J Bone Joint Surg Am 2014 Oct 1;96(19):1601-9.
    pmc: PMC4179451pubmed: 25274785doi: 10.2106/jbjs.m.01408google scholar: lookup
  38. Frisbie DD, Lu Y, Kawcak CE, DiCarlo EF, Binette F, McIlwraith CW. In vivo evaluation of autologous cartilage fragment-loaded scaffolds implanted into equine articular defects and compared with autologous chondrocyte implantation.. Am J Sports Med 2009 Nov;37 Suppl 1:71S-80S.
    pubmed: 19934439doi: 10.1177/0363546509348478google scholar: lookup
  39. Stewart RC, Patwa AN, Lusic H, Freedman JD, Wathier M, Snyder BD, Guermazi A, Grinstaff MW. Synthesis and Preclinical Characterization of a Cationic Iodinated Imaging Contrast Agent (CA4+) and Its Use for Quantitative Computed Tomography of Ex Vivo Human Hip Cartilage.. J Med Chem 2017 Jul 13;60(13):5543-5555.
    pmc: PMC6408935pubmed: 28616978doi: 10.1021/acs.jmedchem.7b00234google scholar: lookup
  40. Brittberg M, Winalski CS. Evaluation of cartilage injuries and repair.. J Bone Joint Surg Am 2003;85-A Suppl 2:58-69.
    pubmed: 12721346doi: 10.2106/00004623-200300002-00008google scholar: lookup
  41. OUTERBRIDGE RE. The etiology of chondromalacia patellae.. J Bone Joint Surg Br 1961 Nov;43-B:752-7.
    pubmed: 14038135doi: 10.1302/0301-620x.43b4.752google scholar: lookup
  42. Farndale RW, Buttle DJ, Barrett AJ. Improved quantitation and discrimination of sulphated glycosaminoglycans by use of dimethylmethylene blue.. Biochim Biophys Acta 1986 Sep 4;883(2):173-7.
    pubmed: 3091074doi: 10.1016/0304-4165(86)90306-5google scholar: lookup
  43. Han EH, Chen SS, Klisch SM, Sah RL. Contribution of proteoglycan osmotic swelling pressure to the compressive properties of articular cartilage.. Biophys J 2011 Aug 17;101(4):916-24.
    pmc: PMC3175069pubmed: 21843483doi: 10.1016/j.bpj.2011.07.006google scholar: lookup
  44. Strauss EJ, Goodrich LR, Chen CT, Hidaka C, Nixon AJ. Biochemical and biomechanical properties of lesion and adjacent articular cartilage after chondral defect repair in an equine model.. Am J Sports Med 2005 Nov;33(11):1647-53.
    pubmed: 16093540doi: 10.1177/0363546505275487google scholar: lookup
  45. Lahm A, Dabravolski D, Spank H, Merk H, Esser J, Kasch R. Regional differences of tibial and femoral cartilage in the chondrocyte gene expression, immunhistochemistry and composite in different stages of osteoarthritis.. Tissue Cell 2017 Apr;49(2 Pt B):249-256.
    pubmed: 28302318doi: 10.1016/j.tice.2017.02.004google scholar: lookup
  46. Kokkonen HT, Suomalainen JS, Joukainen A, Kröger H, Sirola J, Jurvelin JS, Salo J, Töyräs J. In vivo diagnostics of human knee cartilage lesions using delayed CBCT arthrography.. J Orthop Res 2014 Mar;32(3):403-12.
    pubmed: 24249683doi: 10.1002/jor.22521google scholar: lookup
  47. Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG. The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score).. Ann Rheum Dis 2008 Feb;67(2):206-11.
    pubmed: 17472995doi: 10.1136/ard.2006.066183google scholar: lookup
  48. Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, Kothari M, Lu Y, Fye K, Zhao S, Genant HK. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis.. Osteoarthritis Cartilage 2004 Mar;12(3):177-90.
    pubmed: 14972335doi: 10.1016/j.joca.2003.11.003google scholar: lookup
  49. Nelson BB. Investigation of cationic contrast-enhanced computed tomography for the evaluation of equine articular cartilage. PhD dissertation: Colorado State University, ProQuest/UMI, Fort Collins, CO, USA, 1–265, 2017.
  50. Bhattarai A, Honkanen JTJ, Myller KAH, Prakash M, Korhonen M, Saukko AEA, Virén T, Joukainen A, Patwa AN, Kröger H, Grinstaff MW, Jurvelin JS, Töyräs J. Quantitative Dual Contrast CT Technique for Evaluation of Articular Cartilage Properties.. Ann Biomed Eng 2018 Jul;46(7):1038-1046.
    pubmed: 29654384doi: 10.1007/s10439-018-2013-ygoogle scholar: lookup

Citations

This article has been cited 2 times.
  1. Fantoni S, Gabucci I, Cardarelli P, Paternò G, Taibi A, Cristofori V, Trapella C, Bazzani A, Assenza M, Zanna Bonacorsi A, Conti D, Baruffaldi F. A Cationic Contrast Agent in X-ray Imaging of Articular Cartilage: Pre-Clinical Evaluation of Diffusion and Attenuation Properties. Diagnostics (Basel) 2022 Aug 31;12(9).
    doi: 10.3390/diagnostics12092111pubmed: 36140512google scholar: lookup
  2. Gao X, Patwa AN, Deng Z, Utsunomiya H, Grinstaff MW, Ruzbarsky JJ, Snyder BD, Ravuri S, Philippon MJ, Huard J. Influence of fixation on CA4+ contrast enhanced microCT of articular cartilage and subsequent feasibility for histological evaluation. Am J Transl Res 2021;13(8):8921-8937.
    pubmed: 34540005
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