Abstract: Cationic agent contrast-enhanced computed tomography (cationic CECT) characterizes articular cartilage ex vivo, however, its capacity to detect post-traumatic injury is unknown. The study objectives were to correlate cationic CECT attenuation with biochemical, mechanical and histological properties of cartilage and morphologic computed tomography (CT) measures of bone, and to determine the ability of cationic CECT to distinguish subtly damaged from normal cartilage in an in vivo equine model. Mechanical impact injury was initiated in equine femoropatellar joints in vivo to establish subtle cartilage degeneration with site-matched controls. Cationic CECT was performed in vivo (clinical) and postmortem (microCT). Articular cartilage was characterized by glycosaminoglycan (GAG) content, biochemical moduli and histological scores. Bone was characterized by volume density (BV/TV) and trabecular number (Tb.N.), thickness (Tb.Th.) and spacing (Tb.Sp.). Cationic CECT attenuation (microCT) of cartilage correlated with GAG (r = 0.74, P < 0.0001), compressive modulus (E) (r = 0.79, P < 0.0001) and safranin-O histological score (r = -0.66, P < 0.0001) of cartilage, and correlated with BV/TV (r = 0.37, P = 0.0005), Tb.N. (r = 0.39, P = 0.0003), Tb.Th. (r = 0.28, P = 0.0095) and Tb.Sp. (r = -0.44, P < 0.0001) of bone. Mean [95% CI] cationic CECT attenuation at the impact site (2215 [1987, 2443] Hounsfield Units [HUs]) was lower than site-matched controls (2836 [2490, 3182] HUs, P = 0.036). Clinical cationic CECT attenuation correlated with GAG (r = 0.23, P = 0.049), E (r = 0.26, P = 0.025) and safranin-O histology score (r = -0.32, P = 0.0046). Cationic CECT (microCT) reflects articular cartilage properties enabling segregation of subtly degenerated from healthy tissue and also reflects bone morphometric properties on CT. Cationic CECT is capable of characterizing articular cartilage in clinical scanners.
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The research paper discusses how cationic contrast-enhanced computed tomography (CECT) can be used to detect subtle degeneration in equine articular cartilage following a mechanical impact injury.
Research Objectives
The primary objectives of the study were two-fold. First, the researchers wanted to correlate the results from cationic CECT with the biochemical, mechanical, and histological properties of the cartilage, as well as morphologic measurements of the bone acquired from CT scans. Second, they needed to ascertain if cationic CECT can distinguish between subtly damaged and normal cartilage in an in vivo equine model.
Methodology
The study used a mechanical impact injury on equine femoropatellar joints to induce subtle degeneration in the cartilage. The cartilage’s health was analyzed through its glycosaminoglycan (GAG) content, biochemical moduli, and histological scores.
They also characterized bone health using volume density (BV/TV) and parameters like trabecular number (Tb.N.), thickness (Tb.Th.), and spacing (Tb.Sp.).
Cationic CECT was performed both clinically (in vivo) and postmortem (microCT).
Findings
A strong correlation was found between the attenuation seen in cationic CECT and GAG content, the compressive modulus (E), and safranin-O histological scores of cartilage. Attenuation also demonstrated correlation with BV/TV, Tb.N., Tb.Th., and Tb.Sp. of bone.
Hounsfield Units (HUs), which measure radiodensity in CT scans, were lower at the impact site when compared to control sites, indicating potential damage or degeneration.
Even clinical cationic CECT attenuation correlated with GAG, E, and safranin-O histology score revealing its effectiveness in clinical setups to identify cartilage conditions.
Conclusion
The findings demonstrated that cationic CECT is capable of reflecting articular cartilage properties, distinguishing between subtly degenerated and healthy tissues, as well as reflecting bone morphometric properties.
Therefore, cationic CECT can be seen as a potential tool for characterizing articular cartilage in clinical scanners, enhancing diagnosis, and treatment of related conditions.
Cite This Article
APA
Nelson BB, Mäkelä JTA, Lawson TB, Patwa AN, Barrett MF, McIlwraith CW, Hurtig MB, Snyder BD, Moorman VJ, Grinstaff MW, Goodrich LR, Kawcak CE.
(2019).
Evaluation of equine articular cartilage degeneration after mechanical impact injury using cationic contrast-enhanced computed tomography.
Osteoarthritis Cartilage, 27(8), 1219-1228.
https://doi.org/10.1016/j.joca.2019.04.015
Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA.
Mäkelä, J T A
Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Chemistry, Boston University, Boston, MA, USA.
Lawson, T B
Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Mechanical Engineering, Boston University, Boston, MA, USA.
Patwa, A N
Department of Chemistry, Boston University, Boston, MA, USA; SLSE (Chemistry), Navrachana University, Vadodara, Gujarat, India.
Barrett, M F
Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA.
McIlwraith, C W
Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA.
Hurtig, M B
Department of Clinical Studies, University of Guelph, Ontario, Canada.
Snyder, B D
Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Moorman, V J
Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA.
Grinstaff, M W
Department of Chemistry, Boston University, Boston, MA, USA; Department of Mechanical Engineering, Boston University, Boston, MA, USA; Departments of Biomedical Engineering, and Medicine, Boston University, Boston, MA, USA.
Goodrich, L R
Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA.
Kawcak, C E
Equine Orthopaedic Research Center, Colorado State University, Fort Collins, CO, USA. Electronic address: ckawcak@colostate.edu.
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.
Freedman JD, Ellis DJ, Lusic H, Varma G, Grant AK, Lakin BA, Snyder BD, Grinstaff MW. dGEMRIC and CECT Comparison of Cationic and Anionic Contrast Agents in Cadaveric Human Metacarpal Cartilage. J Orthop Res 2020 Apr;38(4):719-725.