Tomosynthesis imaging of the wrist using a CNT x-ray source array

Inscoe, Christina R.; Billingsley, Alex J.; Puett, Connor; Feinstein, Shawn; Gunnell, Elias T.; Nissman, Daniel; Maetani, Troy; Draeger, Reid W.; Lü, Jianping; Lee, Yueh Z.; Zhou, Otto

doi:10.1117/12.2512906

Cited by 3 publications

(1 citation statement)

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“…The tomosynthesis system used 7 projection images and a 12° angular span, comparatively fewer images and less angular span than what are used in orthopedic tomosynthesis studies in humans. 22 Increasing the number of projection images or angular span may have provided additional information for specific regions of interest in equine MCPJs, but an objective comparison of different system configurations for equine imaging evaluation was outside the scope of the present study. The source array used in the present study was also originally fabricated for a dental application, with a maximum anode voltage of 70 kVp.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of tomosynthesis, computed tomography, and magnetic resonance imaging findings for metacarpophalangeal joints from equine cadavers

Stewart

Kawcak

Inscoe³

et al. 2021

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OBJECTIVE To describe the technique and assess the diagnostic potential and limitations of tomosynthesis for imaging of the metacarpophalangeal joint (MCPJ) of equine cadavers; compare the tomosynthesis appearance of pathological lesions with their conventional radiographic, CT, and MRI appearances; and evaluate all imaging findings with gross lesions of a given MCPJ. SAMPLE Distal portions of 4 forelimbs from 4 equine cadavers. PROCEDURES The MCPJs underwent radiography, tomosynthesis (with a purpose-built benchtop unit), CT, and MRI; thereafter, MCPJs were disarticulated and evaluated for the presence of gross lesions. The ability to identify pathological lesions on all images was assessed, followed by semiobjective scoring for quality of the overall image and appearance of the subchondral bone, articular cartilage, periarticular margins, and adjacent trabecular bone of the third metacarpal bone, proximal phalanx, and proximal sesamoid bones of each MCPJ. RESULTS Some pathological lesions in the subchondral bone of the third metacarpal bone were detectable with tomosynthesis but not with radiography. Overall, tomosynthesis was comparable to radiography, but volumetric imaging modalities were superior to tomosynthesis and radiography for imaging of subchondral bone, articular cartilage, periarticular margins, and adjacent bone. CONCLUSIONS AND CLINICAL RELEVANCE With regard to the diagnostic characterization of equine MCPJs, tomosynthesis may be more accurate than radiography for identification of lesions within subchondral bone because, in part, of its ability to reduce superimposition of regional anatomic features. Tomosynthesis may be useful as an adjunctive imaging technique, highlighting subtle lesions within bone, compared with standard radiographic findings.

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Section: Discussionmentioning

confidence: 99%

Comparative evaluation of tomosynthesis, computed tomography, and magnetic resonance imaging findings for metacarpophalangeal joints from equine cadavers

Stewart

Kawcak

Inscoe³

et al. 2021

ajvr

Self Cite

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Point-of-Care Tomosynthesis Imaging of the Wrist

et al. 2021

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Introduction Musculoskeletal injury to extremities is a common issue for both stateside and deployed military personnel, as well as the general public. Superposition of anatomy can make diagnosis difficult using standard clinical techniques. There is a need for increased diagnostic accuracy at the point-of-care for military personnel in both training and operational environments, as well as assessment during follow-up treatment to optimize care and expedite return to service. Orthopedic tomosynthesis is rapidly emerging as an alternative to digital radiography (DR), exhibiting an increase in sensitivity for some clinical tasks, including diagnosis and follow-up of fracture and arthritis. Commercially available digital tomosynthesis systems are large complex devices. A compact device for extremity tomosynthesis (TomoE) was previously demonstrated using carbon nanotube X-ray source array technology. The purpose of this study was to prepare and evaluate the prototype device for an Institutional Review Board-approved patient wrist imaging study and provide initial patient imaging results. Materials and Methods A benchtop device was constructed using a carbon nanotube X-ray source array and a flat panel digital detector. Twenty-one X-ray projection images of cadaveric specimens and human subjects were acquired at incident angles from −20 to +20 degrees in various clinical orientations, with entrance dose calibrated to commercial digital tomosynthesis wrist scans. The projection images were processed with an iterative reconstruction algorithm in 1 mm slices. Reconstruction slice images were evaluated by a radiologist for feature conspicuity and diagnostic accuracy. Results The TomoE image quality was found to provide more diagnostic information than DR, with reconstruction slices exhibiting delineation of joint space, visual conspicuity of trabecular bone, bone erosions, fractures, and clear depiction of normal anatomical features. The scan time was 15 seconds and the skin entrance dose was verified to be 0.2 mGy. Conclusions The TomoE device image quality has been evaluated using cadaveric specimens. Dose was calibrated for a patient imaging study. Initial patient images depict a high level of anatomical detail and an increase in diagnostic value compared to DR.

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