Dual-Energy Computed Tomography for the Detection of Bone Edema-Like Lesions in the Equine Foot: Standing Horses and Cadaveric Specimens.
Abstract: Dual-energy computed tomography (DECT) is a promising advancement for detecting bone edema-like lesions (BME). However, its application in horses remains limited. The aim of this study was to evaluate DECT virtual-non-calcium (VNCa) imaging in the equine foot and establish which confounding factors could influence its applicability in clinical practice. The DECT VNCa map of 14 standing and 5 cadaveric (recumbent) cases with foot-related lameness was scored in consensus by two readers in comparison to MRI. Overall, 17/19 cases demonstrated BME on MRI, whereas 2 did not. Agreement between DECT VNCa and MRI was found in 15/19 feet (78.9%). Disagreement in 4/19 cases with BME was due to sclerosis (1/19), mild BME extent on MRI (2/19), or scan artifacts (1/19). The extent of BME was significantly underestimated using DECT VNCa compared to MRI ( = 0.016). No significant correlation was found between sclerosis score and the BME extent underestimation on DECT ( = 0.056). Between standing and post-mortem cases, there was no significant difference in the agreement between DECT and MRI ( = 0.53) or DECT VNCa image quality ( = 0.22). In conclusion, DECT VNCa effectively identified moderate and severe BME, and its use was feasible in standing positioning. In case of sclerosis, a case-by-case assessment is recommended.
Publication Date: 2025-06-24 PubMed ID: 40711274PubMed Central: PMC12298723DOI: 10.3390/vetsci12070614Google Scholar: Lookup
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- Journal Article
Summary
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The research presents the use of Dual-energy Computed Tomography (DECT) in detecting bone edema-like lesions in horses’ feet and explores various factors that could affect its application in clinical practice. While in most cases, DECT is similar to MRI, some discrepancies were noted owing to factors like sclerosis, mild bone edema extent on MRI, and scan artifacts.
Research Objective and Methodology
- The major objective of this study was to evaluate if Dual-energy Computed Tomography (DECT) can accurately identify Bone Marrow Edema (BME) like lesions in the foot of horses. Essentially, the focus was on DECT virtual-non-calcium (VNCa) imaging in the equine foot and determining any factors that could affect its clinical implementation.
- A group of 14 standing and five cadaveric (lying down, after death) horses exhibiting foot-related lameness were studied. The DECT VNCa maps of these horses were scored by two readers and compared to MRI results.
Findings
- The research reveals that 17 out of 19 horse cases demonstrated BME when evaluated using MRI, and 2 cases did not.
- An agreement in the findings using DECT VNCa and MRI was observed in 15 out of the 19 cases, which constitutes approximately 78.9% of the cases.
- Discrepancies in the remaining 4 cases stemmed from sclerosis (hardening; in 1 case), a minor extent of BME on the MRI (in 2 cases), and scanning artifacts (in 1 case).
- A noteworthy observation made was that the extent of BME was considerably underestimated using DECT VNCa when compared to MRI. However, there was no significant correlation found between the sclerosis score and the underestimation of BME extent on DECT.
- Additionally, there was no significant difference in DECT and MRI agreement or DECT VNCa image quality between standing and post-mortem horses.
Conclusions
- Based on the study, DECT VNCa is useful for identifying moderate and severe BME and can be effectively utilized in a horse’s standing positioning.
- In cases involving sclerosis, a case-by-case evaluation is advised, as it might impact the effectiveness in diagnosing using DECT.
Cite This Article
APA
Germonpré J, Lorenz I, Vandekerckhove LMJ, Duchateau L, Diekhoff T, Vanderperren K.
(2025).
Dual-Energy Computed Tomography for the Detection of Bone Edema-Like Lesions in the Equine Foot: Standing Horses and Cadaveric Specimens.
Vet Sci, 12(7), 614.
https://doi.org/10.3390/vetsci12070614 Publication
Researcher Affiliations
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
- Pferdeklinik Bargteheide, 22941 Bargteheide, Germany.
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
- Department of Radiology, Brandenburg Medical School, 15562 Rüdersdorf, Germany.
- Department of Radiology, Immanuel Klinik Rüdersdorf, Seebad 82/83, 15562 Rüdersdorf, Germany.
- Department of Morphology, Imaging, Orthopedics, Rehabilitation, and Nutrition, Faculty of Veterinary Medicine, Ghent University, 9820 Merelbeke, Belgium.
Grant Funding
- BOF21/DOC/202 / doctoral scholarship from the Special Research Fund (BOF) of Ghent University
Conflict of Interest Statement
The authors declare no conflicts of interest. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
References
This article includes 44 references
- Dixon J, Müksch G, Witte T, Perkins J, Weller R. Standing equine computed tomography: Technique and clinical use. Yearbook of European Association of Veterinary Diagnostic Imaging Forum European Association of Veterinary Diagnostic Imaging; Cambridge, UK: 2016; pp. 31–50.
- Mageed M. Standing computed tomography of the equine limb using a multi-slice helical scanner: Technique and feasibility study. Equine Vet. Educ. 2020;34:77–83.
- Moliner L, Bolas N, Pallas E, Rodríguez-Álvarez M.J, Benlloch J.M. Development of a standing equine Leg CT (slCT). J. Instrum. 2022;17:C03003.
- Porter E.G, Werpy N.M. New concepts in standing advanced diagnostic equine imaging. Vet. Clin. N. Am. Equine Pract. 2014;30:239–268.
- Mizobe F, Nomura M, Ueno T, Yamada K. Bone marrow oedema-type signal in the proximal phalanx of Thoroughbred racehorses. J. Vet. Med. Sci. 2019;81:593–597.
- Olive J, Mair T, Charles B. Use of standing low-field magnetic resonance imaging to diagnose middle phalanx bone marrow lesions in horses. Equine Vet. Educ. 2009;21:116–123.
- Alvarez R.E, Macovski A. Energy-selective reconstructions in X-ray computerized tomography. Phys. Med. Biol. 1976;21:733–744.
- Avrin D.E, Macovski A, Zatz L.E. Clinical application of Compton and photo-electric reconstruction in computed tomography: Preliminary results. Investig. Radiol. 1978;13:217–222.
- Goo H.W, Goo J.M. Dual-Energy CT: New Horizon in Medical Imaging. Korean J. Radiol. 2017;18:555–569.
- McCollough C.H, Leng S, Yu L, Fletcher J.G. Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications. Radiology 2015;276:637–653.
- Omoumi P, Becce F, Racine D, Ott J.G, Andreisek G, Verdun F.R. Dual-energy CT: Basic principles, technical approaches, and applications in musculoskeletal imaging (Part 1). Semin. Musculoskelet. Radiol. 2015;19:431–437.
- Booz C, Nöske J, Albrecht M.H, Lenga L, Martin S.S, Bucher A.M, Huizinga N.A, Wichmann J.L, Vogl T.J, Yel I. Diagnostic accuracy of color-coded virtual noncalcium dual-energy CT for the assessment of bone marrow edema in sacral insufficiency fracture in comparison to MRI. Eur. J. Radiol. 2020;129:109046.
- Chen M, Herregods N, Jaremko J.L, Carron P, Elewaut D, Van den Bosch F, Jans L. Bone marrow edema in sacroiliitis: Detection with dual-energy CT. Eur. Radiol. 2020;30:3393–3400.
- Diekhoff T, Ziegeler K, Feist E, Kiefer T, Mews J, Hamm B, Hermann K.G. First experience with single-source dual-energy computed tomography in six patients with acute arthralgia: A feasibility experiment using joint aspiration as a reference. Skelet. Radiol. 2015;44:1573–1577.
- Mallinson P.I, Coupal T.M, McLaughlin P.D, Nicolaou S, Munk P.L, Ouellette H.A. Dual-energy CT for the musculoskeletal system. Radiology 2016;281:690–707.
- Yadav H, Khanduri S, Yadav P, Pandey S, Yadav V.K, Khan S. Diagnostic accuracy of dual energy CT in the assessment of traumatic bone marrow edema of lower limb and its correlation with MRI. Indian J. Radiol. Imaging. 2020;30:59–63.
- Yang P, Wu G, Chang X. Diagnostic accuracy of dual-energy computed tomography in bone marrow edema with vertebral compression fractures: A meta-analysis. Eur. J. Radiol. 2018;99:124–129.
- Faulkner J.E, Broeckx B.J.G, Martens A, Raes E, Haardt H, Vanderperren K. Single energy metal artifact reduction performs better than virtual monoenergetic dual-energy reconstruction in CT of the equine proximal phalanx. Vet. Radiol. Ultrasound. 2023;64:677–685.
- Germonpré J, Vandekerckhove L.M.J, Raes E, Chiers K, Jans L, Vanderperren K. Post-mortem feasibility of dual-energy computed tomography in the detection of bone edema-like lesions in the equine foot: A proof of concept. Front. Vet. Sci. 2024;10:1201017.
- Steiner J, Richter H, Kaufmann R, Ohlerth S. Characterization of Normal Bone in the Equine Distal Limb with Effective Atomic Number and Electron Density Determined with Single-Source Dual Energy and Detector-Based Spectral Computed Tomography. Animals 2024;14:1064.
- Deppe D, Ziegeler K, Hermann K.G.A, Proft F, Poddubnyy D, Radny F, Makowski M.R, Muhle M, Diekhoff T. Dual-Energy-CT for Osteitis and Fat Lesions in Axial Spondyloarthritis: How Feasible is Low-Dose Scanning?. Diagnostics 2023;13:776.
- Foti G, Serra G, Iacono V, Zorzi C. Identification of Traumatic Bone Marrow Oedema: The Pearls and Pitfalls of Dual-Energy CT (DECT) Tomography. 2021;7:424–433.
- Foti G, Faccioli N, Silva R, Oliboni E, Zorzi C, Carbognin G. Bone marrow edema around the hip in non-traumatic pain: Dual-energy CT vs. MRI. Eur. Radiol. 2020;30:4098–4106.
- Diekhoff T, Hermann K.G, Pumberger M, Hamm B, Putzier M, Fuchs M. Dual-energy CT virtual non-calcium technique for detection of bone marrow edema in patients with vertebral fractures: A prospective feasibility study on a single-source volume CT scanner. Eur. J. Radiol. 2017;87:59–65.
- Eustace S, Keogh C, Blake M, Ward R, Oder P, Dimasi M. MR imaging of bone oedema: Mechanisms and interpretation. Clin. Radiol. 2001;56:4–12.
- Mayerhoefer M.E, Breitenseher M.J, Kramer J, Aigner N, Norden C, Hofmann S. STIR vs. T1-weighted fat-suppressed gadolinium-enhanced MRI of bone marrow edema of the knee: Quantitative comparison. J. Magn. Reson. Imaging. 2005;22:788–793.
- Cao J.X, Wang Y.M, Kong X.Q, Yang C, Wang P. Good interrater reliability of a new grading system in detecting traumatic bone marrow lesions in the knee by dual energy CT virtual noncalcium images. Eur. J. Radiol. 2015;84:1109–1115.
- Diekhoff T, Hermann K.G.A, Lambert R.G. Future of low-dose computed tomography and dual-energy computed tomography in axial spondyloarthritis. Curr. Rheumatol. Rep. 2022;24:198–205.
- Guggenberger R, Gnannt R, Hodler J, Krauss B, Wanner G.A, Csuka E, Payne B, Frauenfelder T, Andreisek G, Alkadhi H. Diagnostic performance of dual-energy CT for the detection of traumatic bone marrow lesions in the ankle: Comparison with MR imaging. Radiology 2012;264:164–173.
- Vandersmissen M., Evrard L., Busoni V. Prevalence and distribution of distal phalanx STIR hypersignal on MR images of 129 equine feet [Poster presentation]; Proceedings of the European Veterinary Diagnostic Imaging (EVDI) Meeting; Basel, Switzerland. 21–24 August 2019.
- Cavallaro M, D’Angelo T, Albrecht M.H, Yel I, Martin S.S, Wichmann J.L, Lenga L, Mazziotti S, Blandino A, Ascenti G. Comprehensive comparison of dual-energy computed tomography and magnetic resonance imaging for the assessment of bone marrow edema and fracture lines in acute vertebral fractures. Eur. Radiol. 2022;32:561–571.
- Heales C.J, Summers I.R, Fulford J, Knapp K.M, Winlove C.P. Investigation of changes in bone density and chemical composition associated with bone marrow oedema-type appearances in magnetic resonance images of the equine forelimb. BMC Musculoskelet. Disord. 2019;20:330.
- Diekhoff T, Engelhard N, Fuchs M, Pumberger M, Putzier M, Mews J, Makowski M, Hamm B, Hermann K.-G.A. Single-source dual-energy computed tomography for the assessment of bone marrow oedema in vertebral compression fractures: A prospective diagnostic accuracy study. Eur. Radiol. 2019;29:31–39.
- Wang C.-K, Tsai J.-M, Chuang M.-T, Wang M.-T, Huang K.-Y, Lin R.-M. Bone marrow edema in vertebral compression fractures: Detection with dual-energy CT. Radiology 2013;269:525–533.
- Mens M.A, de Geus A, Wellenberg R.H.H, Streekstra G.J, Weil N.L, Bus S.A, Busch-Westbroek T.E, Nieuwdorp M, Maas M. Preliminary evaluation of dual-energy CT to quantitatively assess bone marrow edema in patients with diabetic foot ulcers and suspected osteomyelitis. Eur. Radiol. 2023;33:5645–5652.
- Foti G, Catania M, Caia S, Romano L, Beltramello A, Zorzi C, Carbognin G. Identification of bone marrow edema of the ankle: Diagnostic accuracy of dual-energy CT in comparison with MRI. Radiol. Medica. 2019;124:1028–1036.
- Foti G, Mantovani W, Faccioli N, Crivellari G, Romano L, Zorzi C, Carbognin G. Identification of bone marrow edema of the knee: Diagnostic accuracy of dual-energy CT in comparison with MRI. Radiol. Medica. 2021;126:405–413.
- Lu H, Li Z, Liang Z, Liu Y. Diagnostic efficacy of dual-energy CT virtual non-calcium technique in the diagnosis of bone marrow edema of sacroiliac joints in ankylosing spondylitis. J. Orthop. Surg. Res. 2025;20:28.
- Hagen F, Fritz J, Mair A, Horger M, Bongers M.N. Dual-energy computed tomography-based quantitative bone marrow imaging in non-hematooncological subjects: Associations with age, gender and other variables. J. Clin. Med. 2022;11:4094.
- Chan B.Y, Gill K.G, Rebsamen S.L, Nguyen J.C. MR imaging of pediatric bone marrow. Radiographics 2016;36:1911–1930.
- Laor T, Jaramillo D. MR imaging insights into skeletal maturation: What is normal?. Radiology 2009;250:28–38.
- Małkiewicz A, Dziedzic M. Bone marrow reconversion—Imaging of physiological changes in bone marrow. Pol. J. Radiol. 2012;77:45–50.
- D’Angelo T, Albrecht M.H, Caudo D, Mazziotti S, Vogl T.J, Wichmann J.L, Martin S, Yel I, Ascenti G, Koch V. Virtual non-calcium dual-energy CT: Clinical applications. Eur. Radiol. Exp. 2021;5:38.
- Suh C.H, Yun S.J, Jin W, Lee S.H, Park S.Y, Ryu C.W. Dual-energy CT for the diagnosis of vertebral bone marrow edema: A systematic review and meta-analysis. Eur. Radiol. 2023;33:1201–1210.
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