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Home / Equine Research Bank / Front Vet Sci / Visualization of anatomical structures in the fetlock region...
Frontiers in veterinary science2024; 10; 1278148; doi: 10.3389/fvets.2023.1278148

Visualization of anatomical structures in the fetlock region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography.

Abstract: Cone-beam computed tomography (CBCT) is regarded as a convenient and suitable alternative to conventional computed tomography. However, in the horse, the quality of obtained data sets needs to be evaluated. Therefore, the aim of this study was to compare the visibility and accessibility of clinically relevant anatomical structures displayed in CBCT and conventional multidetector computed tomography (MDCT). Unassigned: Twenty-nine limbs from horses euthanized for reasons unrelated to this study were used. Native and intraarticular contrast scans of the fetlock (CBCT vs. MDCT) were performed. The visibility and accessibility of selected anatomical structures were blindly scored by three independent experienced observers using a scoring system previously reported and adapted to the fetlock joint. Unassigned: Only minor differences between CBCT and MDCT were identified concerning the diagnostic quality of images for osseous structures. Soft tissue structures were better evaluated on MDCT images. In CBCT as well as in MDCT articular cartilage could only be visualized after intraarticular injection of contrast medium. Unassigned: Cone beam computed tomography of the fetlock is a useful and reliable diagnostic tool when evaluating osseous structures and delineating articular cartilage with contrast medium. However, this modality is limited for assessing soft tissues structures.
Copyright © 2024 Bierau, Cruz, Koch, Manso-Diaz, Büttner, Staszyk and Röcken.
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Publication Date: 2024-01-05 PubMed ID: 38260210PubMed Central: PMC10802162DOI: 10.3389/fvets.2023.1278148Google 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.

Overview

  • This study compares cone-beam computed tomography (CBCT) with conventional multidetector computed tomography (MDCT) in visualizing anatomical structures in the fetlock region of horses.
  • The main focus is on evaluating the quality and clinical usefulness of CBCT images relative to MDCT images for both bony and soft tissue structures.

Background and Purpose

  • Cone-beam computed tomography (CBCT) is an emerging imaging technique offering convenience and potential advantages over traditional CT methods.
  • In equine medicine, accurate imaging of the fetlock (horse’s ankle joint) is crucial, particularly for diagnosing joint and bone conditions.
  • Although CBCT shows promise, its image quality and ability to display important anatomical details in horses needed evaluation in comparison to the established MDCT.
  • The study’s goal was to assess visibility (how clearly structures can be seen) and accessibility (ease of assessing structures) for clinically relevant features using both scanning methods.

Methods

  • Sample: 29 limbs from horses euthanized for unrelated reasons were used to avoid ethical concerns around live subjects.
  • Imaging: Each fetlock underwent scanning with both CBCT and MDCT. Two types of scans were performed:
    • Native scans – without any contrast agent.
    • Intraarticular contrast-enhanced scans – contrast medium injected into the joint to improve visualization of cartilages and joint spaces.
  • Evaluation: Three expert observers independently and blindly scored the images without knowing which technique was used for which image, to prevent bias.
  • Scoring used a previously developed system tailored for the fetlock region to quantitatively measure diagnostic quality and clarity of depicted anatomical details.

Key Findings

  • Bone Structures:
    • CBCT and MDCT provided similar high-quality visualization of bones (osseous structures).
    • Only minor differences were found, indicating CBCT can reliably depict bone anatomy in the fetlock.
  • Soft Tissue Structures:
    • MDCT images were superior in visualizing soft tissue components such as ligaments and tendons.
    • CBCT showed limitations when assessing soft tissues, resulting in lower clarity and less diagnostic usefulness for these structures.
  • Articular Cartilage:
    • Neither imaging modality could clearly visualize articular cartilage on native scans.
    • After injecting intraarticular contrast medium, both CBCT and MDCT successfully delineated the cartilage surfaces.

Conclusions and Clinical Relevance

  • CBCT is a valuable and reliable imaging tool for assessing bone structures in the horse’s fetlock, offering a convenient alternative to MDCT.
  • The addition of intraarticular contrast improves CBCT’s ability to visualize cartilage, expanding its diagnostic capabilities.
  • Limitations remain with CBCT in evaluating soft tissue anatomy; MDCT remains the preferred method when detailed soft tissue analysis is required.
  • This information supports veterinarians in selecting appropriate imaging techniques based on the specific clinical question and anatomical features involved.

Cite This Article

APA
Bierau J, Cruz AM, Koch C, Manso-Diaz G, Büttner K, Staszyk C, Röcken M. (2024). Visualization of anatomical structures in the fetlock region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography. Front Vet Sci, 10, 1278148. https://doi.org/10.3389/fvets.2023.1278148

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 10
Pages: 1278148
PII: 1278148

Researcher Affiliations

Bierau, Jonathan
  • Equine Clinic (Surgery, Orthopedics), Justus-Liebig-University Giessen, Giessen, Germany.
Cruz, Antonio M
  • Equine Clinic (Surgery, Orthopedics), Justus-Liebig-University Giessen, Giessen, Germany.
Koch, Christoph
  • Department of Clinical Veterinary Medicine, Vetsuisse Faculty, Swiss Institute of Equine Medicine (ISME), University of Bern, Bern, Switzerland.
Manso-Diaz, Gabriel
  • Faculty of Veterinary Medicine, Department of Animal Medicine and Surgery, Universidad Complutense de Madrid, Madrid, Spain.
Büttner, Kathrin
  • Unit for Biomathematics and Data Processing, Justus-Liebig-University Giessen, Giessen, Germany.
Staszyk, Carsten
  • Institute of Veterinary-Anatomy, -Histology, and -Embryology, Faculty of Veterinary Medicine, Justus-Liebig-University Giessen, Giessen, Germany.
Röcken, Michael
  • Equine Clinic (Surgery, Orthopedics), Justus-Liebig-University Giessen, Giessen, Germany.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

This article includes 35 references
  1. Pool RR, Meagher DM. Pathologic findings and pathogenesis of racetrack injuries.. Vet Clin N Am Equine Pract (1990) 6:1–30.
    doi: 10.1016/s0749-0739(17)30555-2pubmed: 2187565google scholar: lookup
  2. Bramlage LR. Part I: operative orthopedics of the fetlock joint of the horse: traumatic and developmental diseases of the equine fetlock joint.. Proc Am Ass Equine Pract (2009) 55:96–143.
  3. Neundorf RH. Macroscopic and Histologic Correlates of Fetlock Joint Osteoarthritis in Fifty Thoroughbred Racehorses.. University of Guelph (2008).
  4. Kraft SL, Gavin P. Physical principles and technical considerations for equine computed tomography and magnetic resonance imaging.. Vet Clin N Am Equine Pract (2001) 17:115–30.
    doi: 10.1016/s0749-0739(17)30078-0pubmed: 11488039google scholar: lookup
  5. Schön S, Fürst AE, Ohlerth S, Kircher PR, Roos M, Jackson MA. Computed tomographic versus radiographic assessment of the visibility and features of subchondral cystic lesions in equine limbs.. PHK (2017) 33:256–62.
    doi: 10.21836/PEM20170306google scholar: lookup
  6. Stewart HL, Siewerdsen JH, Nelson BB, Kawcak CE. Use of cone-beam computed tomography for advanced imaging of the equine patient.. Equine Vet J (2021) 53:872–85.
    doi: 10.1111/evj.13473pubmed: 34053096google scholar: lookup
  7. Hu H. Multi-slice helical CT: scan and reconstruction.. Med Phys (1999) 26:5–18.
    doi: 10.1118/1.598470pubmed: 9949393google scholar: lookup
  8. Kyriakou Y, Struffert T, Dörfler A, Kalender WA. Basic principles of flat detector computed tomography (FD-CT).. Radiologe (2009) 49:811–9.
    doi: 10.1007/s00117-009-1860-9pubmed: 19701623google scholar: lookup
  9. Lechuga L, Weidlich GA. Cone Beam CT vs. Fan Beam CT: a comparison of image quality and dose delivered between two differing CT imaging modalities.. Cureus (2016) 8:e778.
    doi: 10.7759/cureus.778pmc: PMC5063198pubmed: 27752404google scholar: lookup
  10. Scarfe WC, Farman AG. What is cone-beam CT and how does it work?. Dent Clin N Am (2008) 52:707–30.
    doi: 10.1016/j.cden.2008.05.005pubmed: 18805225google scholar: lookup
  11. Vallance SA, Bell RJW, Spriet M, Kass PH, Puchalski SM. Comparisons of computed tomography, contrast enhanced computed tomography and standing low-field magnetic resonance imaging in horses with lameness localised to the foot. Part 1: anatomic visualisation scores.. Equine Vet J (2012) 44:51–6.
    doi: 10.1111/j.2042-3306.2011.00372.xpubmed: 21623900google scholar: lookup
  12. Razi T, Niknami M, Alavi GF. Relationship between Hounsfield unit in CT scan and gray scale in CBCT.. J Dent Res Dent Clin Dent Prosp (2014) 8:107–10.
    doi: 10.5681/joddd.2014.019pmc: PMC4120902pubmed: 25093055google scholar: lookup
  13. Molteni R. Prospects and challenges of rendering tissue density in Hounsfield units for cone beam computed tomography.. Oral Surg Oral Med Oral Pathol Oral Radiol (2013) 116:105–19.
    doi: 10.1016/j.oooo.2013.04.013pubmed: 23768878google scholar: lookup
  14. Demehri S, Muhit A, Zbijewski W, Stayman JW, Yorkston J, Packard N. Assessment of image quality in soft tissue and bone visualization tasks for a dedicated extremity cone-beam CT system.. Eur Radiol (2015) 25:1742–51.
    doi: 10.1007/s00330-014-3546-6pubmed: 25599933google scholar: lookup
  15. Vanderperren K, Saunders JH. Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 1: soft tissues.. Vet J (2009) 181:111–22.
    doi: 10.1016/j.tvjl.2008.03.005pubmed: 18445536google scholar: lookup
  16. Tofts PS, Gore JC. Some sources of artefact in computed tomography.. Phys Med Biol (1980) 25:117–27.
    doi: 10.1088/0031-9155/25/1/011pubmed: 7360783google scholar: lookup
  17. Kyriakou Y, Kolditz D, Langner O, Krause J, Kalender W. Digitale Volumentomografie (DVT) und Mehrschicht-Spiral-CT (MSCT): eine objektive Untersuchung von Dosis und Bildqualität.. RöFo (2011) 183:144–53.
    doi: 10.1055/s-0029-1245709pubmed: 20922645google scholar: lookup
  18. Schulze R, Heil U, Gross D, Bruellmann DD, Dranischnikow E, Schwanecke U. Artefacts in CBCT: a review.. Dentomaxillofac Radiol (2011) 40:265–73.
    doi: 10.1259/dmfr/30642039pmc: PMC3520262pubmed: 21697151google scholar: lookup
  19. Puchalski SM, Galuppo LD, Hornof WJ, Wisner ER. Intraarterial contrast-enhanced computed tomography of the equine distal extremity.. Vet Radiol Ultrasound (2007) 48:21–9.
    doi: 10.1111/j.1740-8261.2007.00198.xpubmed: 17236355google scholar: lookup
  20. Rasmussen L, Saunders JH, van der Veen H, Raes E, van Veggel E, Vanderperren K. Contrast-enhanced computed tomography features of oblique and straight distal sesamoidean ligament injury in thirty-one horses.. VDT (2018) 87:245–54.
    doi: 10.21825/vdt.v87i5.16057google scholar: lookup
  21. Bergman EHJ, Puchalski SM, van der Veen H, Wiemer P. Computed tomography and computed tomography arthrography of the equine stifle: technique and preliminary results in 16 clinical cases.. (2007) p. 46–55.
  22. Terabe M, Ichikawa H, Kato T, Koshida K. Artifacts caused by insufficient contrast medium filling during C-arm cone-beam CT scans: a phantom study.. Radiol Phys Technol (2014) 7:25–34.
    doi: 10.1007/s12194-013-0227-0pubmed: 23775309google scholar: lookup
  23. Vanderperren K, Ghaye B, Snaps FR, Saunders JH. Evaluation of computed tomographic anatomy of the equine metacarpophalangeal joint.. Am J Vet Res (2008) 69:631–8.
    doi: 10.2460/ajvr.69.5.631pubmed: 18447794google scholar: lookup
  24. Robinson PJ. Radiology's Achilles' heel: error and variation in the interpretation of the Röntgen image.. Br J Radiol (1997) 70:1085–98.
    doi: 10.1259/bjr.70.839.9536897pubmed: 9536897google scholar: lookup
  25. Lin S-T, 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.
    doi: 10.1016/j.jevs.2023.104252pubmed: 36796738google scholar: lookup
  26. van Zadelhoff C, Liuti T, Dixon PM, Reardon RJM. Multidetector CT and cone-beam CT have substantial agreement in detecting dental and sinus abnormalities in equine cadaver heads.. Vet Radiol Ultrasound (2021) 62:413–20.
    doi: 10.1111/vru.12978pubmed: 33987964google scholar: lookup
  27. 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) 53:510–23.
    doi: 10.1111/evj.13414pubmed: 33368443google scholar: lookup
  28. Brown KA, Davidson EJ, Johnson AL, Wulster KB, Ortved K. Inflammatory cytokines in horses with cervical articular process joint osteoarthritis on standing cone beam computed tomography.. Equine Vet J (2021) 53:944–54.
    doi: 10.1111/evj.13392pubmed: 33222300google scholar: lookup
  29. Kemp P, van Stralen J, de Graaf P, Berkhout E, van Horssen P, Merkus P. Cone-beam CT compared to multi-slice CT for the diagnostic analysis of conductive hearing loss: a feasibility study.. J Int Adv Otol (2020) 16:222–226.
    doi: 10.5152/iao.2020.5883pmc: PMC7419106pubmed: 32784161google scholar: lookup
  30. Redfors YD, Gröndahl HG, Hellgren J, Lindfors N, Nilsson I, Möller C. Otosclerosis: anatomy and pathology in the temporal bone assessed by multi-slice and cone-beam CT.. Otol Neurotol (2012) 33:922–7.
    doi: 10.1097/MAO.0b013e318259b38cpubmed: 22771999google scholar: lookup
  31. Pauwels FE, van der Vekens E, Christan Y, Koch C, Schweizer D. Feasibility, indications, and radiographically confirmed diagnoses of standing extremity cone beam computed tomography in the horse.. Vet Surg (2021) 50:365–74.
    doi: 10.1111/vsu.13560pubmed: 33421172google scholar: lookup
  32. Koch C, Pauwels F, Schweizer-Gorgas D. Technical set-up and case illustrations of orthopaedic cone beam computed tomography in the standing horse.. Equine Vet Educ (2021) 33:255–62.
    doi: 10.1111/eve.13290google scholar: lookup
  33. Bregger MDK, Koch C, Zimmermann R, Sangiorgio D, Schweizer-Gorgas D. Cone-beam computed tomography of the head in standing equids.. BMC Vet Res (2019) 15:289.
    doi: 10.1186/s12917-019-2045-zpmc: PMC6693248pubmed: 31409395google scholar: lookup
  34. Veldhoen S, Schöllchen M, Hanken H, Precht C, Henes FO, Schön G. Performance of cone-beam computed tomography and multidetector computed tomography in diagnostic imaging of the midface: a comparative study on phantom and cadaver head scans.. Eur Radiol (2017) 27:790–800.
    doi: 10.1007/s00330-016-4387-2pubmed: 27169574google scholar: lookup
  35. Shweel M, Amer MI, El-shamanhory AF. A comparative study of cone-beam CT and multidetector CT in the preoperative assessment of odontogenic cysts and tumors.. Egypt J Radiol Nuclear Med (2013) 44:23–32.
    doi: 10.1016/j.ejrnm.2012.12.002google scholar: lookup

Citations

This article has been cited 2 times.
  1. Gaida JL, Steinberg T, Stieger-Vanegas SM, Merle R, Lischer CJ. Equine Standing Multidetector Computed Tomography of the Distal Thoracic Limb and Tarsus Has a Lower Cumulative Radiation Dose than Digital Radiography.. Vet Radiol Ultrasound 2025 Jul;66(4):e70049.
    doi: 10.1111/vru.70049pubmed: 40420323google scholar: lookup
  2. 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
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