An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography

Background: The treatment of ankle osteoarthritis (OA) varies depending on the severity and distribution of the associated joint degeneration. Disease staging is typically based on subjective grading of appearance on conventional plain radiographs, with reported subpar reproducibility and reliabilit...

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Main Authors: Tutku E. Tazegul BBME, Donald D. Anderson PhD, Nacime S. Barbachan Mansur MD, PhD, Rogerio Marcio Kajimura Chinelati MD, Caleb Iehl BS, Christian VandeLune BS, Samuel Ahrenholz BS, Matthieu Lalevee MD, MSc, Cesar de Cesar Netto MD, PhD
Format: Article
Language:English
Published: SAGE Publishing 2022-08-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/24730114221116805
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author Tutku E. Tazegul BBME
Donald D. Anderson PhD
Nacime S. Barbachan Mansur MD, PhD
Rogerio Marcio Kajimura Chinelati MD
Caleb Iehl BS
Christian VandeLune BS
Samuel Ahrenholz BS
Matthieu Lalevee MD, MSc
Cesar de Cesar Netto MD, PhD
author_facet Tutku E. Tazegul BBME
Donald D. Anderson PhD
Nacime S. Barbachan Mansur MD, PhD
Rogerio Marcio Kajimura Chinelati MD
Caleb Iehl BS
Christian VandeLune BS
Samuel Ahrenholz BS
Matthieu Lalevee MD, MSc
Cesar de Cesar Netto MD, PhD
author_sort Tutku E. Tazegul BBME
collection DOAJ
description Background: The treatment of ankle osteoarthritis (OA) varies depending on the severity and distribution of the associated joint degeneration. Disease staging is typically based on subjective grading of appearance on conventional plain radiographs, with reported subpar reproducibility and reliability. The purpose of this study was to develop and describe computational methods to objectively quantify radiographic changes associated with ankle OA apparent on low-dose weightbearing CT (WBCT). Methods: Two patients with ankle OA and 1 healthy control who had all undergone WBCT of the foot and ankle were analyzed. The severity of OA in the ankle of each patient was scored using the Kellgren-Lawrence (KL) classification using plain radiographs. For each ankle, a volume of interest (VOI) was centered on the tibiotalar joint. Initial computation analysis used WBCT image intensity (Hounsfield units [HU]) profiles along lines perpendicular to the subchondral bone/cartilage interface of the distal tibia extending across the entire VOI. Graphical plots of the HU distributions were generated and recorded for each line. These plots were then used to calculate the joint space width (JSW) and HU contrast. Results: The average JSW was 3.89 mm for the control ankle, 3.06 mm for mild arthritis (KL 2), and 1.57 mm for severe arthritis (KL 4). The average HU contrast was 72.31 for control, 62.69 for mild arthritis, and 33.98 for severe arthritis. The use of 4 projections at different locations throughout the joint allowed us to visualize specifically which quadrants have reduced joint space width and contrast. Conclusion: In this technique report, we describe a novel methodology for objective quantitative assessment of OA using JSW and HU contrast. Clinical Relevance: Objective, software-based measurements are generally more reliable than subjective qualitative evaluations. This method may offer a starting point for the development of a more robust OA classification system or deeper understanding of the pathogenesis and response to ankle OA treatment.
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spelling doaj.art-94ad5571d0b147ecadcb2f9a68f6cded2022-12-22T02:15:44ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142022-08-01710.1177/24730114221116805An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed TomographyTutku E. Tazegul BBME0Donald D. Anderson PhD1Nacime S. Barbachan Mansur MD, PhD2Rogerio Marcio Kajimura Chinelati MD3Caleb Iehl BS4Christian VandeLune BS5Samuel Ahrenholz BS6Matthieu Lalevee MD, MSc7Cesar de Cesar Netto MD, PhD8Department of Orthopaedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Orthopaedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Orthopedics and Traumatology, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, BrazilDepartment of Radiology, Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Orthopaedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Orthopaedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Orthopaedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USADepartment of Orthopedic Surgery, Rouen University Hospital, Rouen, FranceDepartment of Orthopaedics and Rehabilitation, Carver College of Medicine, University of Iowa, Iowa City, IA, USABackground: The treatment of ankle osteoarthritis (OA) varies depending on the severity and distribution of the associated joint degeneration. Disease staging is typically based on subjective grading of appearance on conventional plain radiographs, with reported subpar reproducibility and reliability. The purpose of this study was to develop and describe computational methods to objectively quantify radiographic changes associated with ankle OA apparent on low-dose weightbearing CT (WBCT). Methods: Two patients with ankle OA and 1 healthy control who had all undergone WBCT of the foot and ankle were analyzed. The severity of OA in the ankle of each patient was scored using the Kellgren-Lawrence (KL) classification using plain radiographs. For each ankle, a volume of interest (VOI) was centered on the tibiotalar joint. Initial computation analysis used WBCT image intensity (Hounsfield units [HU]) profiles along lines perpendicular to the subchondral bone/cartilage interface of the distal tibia extending across the entire VOI. Graphical plots of the HU distributions were generated and recorded for each line. These plots were then used to calculate the joint space width (JSW) and HU contrast. Results: The average JSW was 3.89 mm for the control ankle, 3.06 mm for mild arthritis (KL 2), and 1.57 mm for severe arthritis (KL 4). The average HU contrast was 72.31 for control, 62.69 for mild arthritis, and 33.98 for severe arthritis. The use of 4 projections at different locations throughout the joint allowed us to visualize specifically which quadrants have reduced joint space width and contrast. Conclusion: In this technique report, we describe a novel methodology for objective quantitative assessment of OA using JSW and HU contrast. Clinical Relevance: Objective, software-based measurements are generally more reliable than subjective qualitative evaluations. This method may offer a starting point for the development of a more robust OA classification system or deeper understanding of the pathogenesis and response to ankle OA treatment.https://doi.org/10.1177/24730114221116805
spellingShingle Tutku E. Tazegul BBME
Donald D. Anderson PhD
Nacime S. Barbachan Mansur MD, PhD
Rogerio Marcio Kajimura Chinelati MD
Caleb Iehl BS
Christian VandeLune BS
Samuel Ahrenholz BS
Matthieu Lalevee MD, MSc
Cesar de Cesar Netto MD, PhD
An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography
Foot & Ankle Orthopaedics
title An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography
title_full An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography
title_fullStr An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography
title_full_unstemmed An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography
title_short An Objective Computational Method to Quantify Ankle Osteoarthritis From Low-Dose Weightbearing Computed Tomography
title_sort objective computational method to quantify ankle osteoarthritis from low dose weightbearing computed tomography
url https://doi.org/10.1177/24730114221116805
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