Standardized volumetric 3D-analysis of SPECT/CT imaging in orthopaedics: overcoming the limitations of qualitative 2D analysis
Reads0
Chats0
TLDR
A method is proposed for normalizing orthopaedic SPECT/CT data that enables standardised 3D volumetric quantitative measurements and comparison among patients, enabling more widespread clinical use of this powerful imaging tool.Abstract:
SPECT/CT combines high resolution anatomical 3D computerized tomography (CT) and single photon emission computerized tomography (SPECT) as functional imaging, which provides 3D information about biological processes into a single imaging modality. The clinical utility of SPECT/CT imaging has been recognized in a variety of medical fields and most recently in orthopaedics; however, clinical adoption has been limited due to shortcomings of analytical tools available. Specifically, SPECT analyses are mainly qualitative due to variation in overall metabolic uptake among patients. Furthermore, most analyses are done in 2D, although rich 3D data are available. Consequently, it is difficult to quantitatively compare the position, size, and intensity of SPECT uptake regions among patients, and therefore difficult to draw meaningful clinical conclusions. We propose a method for normalizing orthopaedic SPECT/CT data that enables standardised 3D volumetric quantitative measurements and comparison among patients. Our method is based on 3D localisation using clinically relevant anatomical landmarks and frames of reference, along with intensity value normalisation using clinically relevant reference regions. Using the normalised data, we describe a thresholding technique to distinguish clinically relevant hot spots from background activity. Using an exemplar comparison of two patients, we demonstrate how the normalised, 3D-rendered data can provide a richer source of clinical information and allow quantitative comparison of SPECT/CT measurements across patients. Specifically, we demonstrate how non-normalized SPECT/CT analysis can lead to different clinical conclusions than the normalized SPECT/CT analysis, and that normalized quantitative analysis can be a more accurate indicator of pathology. Conventional orthopaedic frames of reference, 3D volumetric data analysis and thresholding are used to distinguish clinically relevant hot spots from background activity. Our goal is to facilitate a standardised approach to quantitative data collection and comparison of clinical studies using SPECT/CT, enabling more widespread clinical use of this powerful imaging tool.read more
Citations
More filters
Journal ArticleDOI
Component alignment during total knee arthroplasty with use of standard or custom instrumentation: a randomized clinical trial using computed tomography for postoperative alignment measurement.
TL;DR: There were no significant improvements in clinical outcomes or knee component alignment in patients treated with patient-specific cutting blocks as compared with those treated with standard instruments.
Journal ArticleDOI
Assessment of loading history of compartments in the knee using bone SPECT/CT: a study combining alignment and 99mTc-HDP tracer uptake/distribution patterns.
Michael T. Hirschmann,Stephan Schön,Faik K. Afifi,Felix Amsler,Helmut Rasch,Niklaus F. Friederich,Markus P. Arnold +6 more
TL;DR: The intensity of SPECT/CT tracer uptake in the medial and lateral knee compartment significantly correlated with varus or valgus alignment of the knee, which is related to the degree of osteoarthritis.
Journal ArticleDOI
Maximum standardised uptake value of quantitative bone SPECT/CT in patients with medial compartment osteoarthritis of the knee
TL;DR: The SUVmax of quantitative bone SPECT/CT was highly correlated with traditional imaging parameters for medial compartment OA severity of the knee and is a promising imaging technique for the objective assessment of knee OA.
Journal ArticleDOI
4D-SPECT/CT in orthopaedics: a new method of combined quantitative volumetric 3D analysis of SPECT/CT tracer uptake and component position measurements in patients after total knee arthroplasty
TL;DR: This combined 3D-volumetric standardised method of analysing the location, size and the intensity of SPECT/CT tracer uptake regions (“hotspots”) and the determination of the TKA position was highly reliable and represents a novel promising approach to biomechanics.
Journal ArticleDOI
Three-dimensional Imaging and Scanning: Current and Future Applications for Pathology
Navid Farahani,Alex Braun,Dylan Jutt,Todd Huffman,Nicholas P. Reder,Zheng Liu,Yukako Yagi,Liron Pantanowitz +7 more
TL;DR: Current imaging methods that enable optimal 3D histopathologic reconstruction: Scanning, 3D scanning, and whole slide imaging are summarized.
References
More filters
Journal ArticleDOI
Gamma camera-mounted anatomical X-ray tomography: technology, system characteristics and first images
TL;DR: Despite limitations of the system when compared with a state of the art CT scanner, the transmission anatomical maps allow for precise anatomical localisation and for attenuation correction of the emission images.
Journal ArticleDOI
Very low-dose computed tomography for planning and outcome measurement in knee replacement: THE IMPERIAL KNEE PROTOCOL
Johann Henckel,Robin R. Richards,K. Lozhkin,Simon Harris,F. Rodriguez y Baena,A.R.W. Barrett,Justin Cobb +6 more
TL;DR: By refining the CT scanning protocol, the effective radiation dose received by the patient is reduced down to the equivalent of one long-leg standing radiograph, which will be more acceptable to obtain the three-dimensional data set produced by CT scanning.
Journal ArticleDOI
The position and orientation of total knee replacement components: A COMPARISON OF CONVENTIONAL RADIOGRAPHS, TRANSVERSE 2D-CT SLICES AND 3D-CT RECONSTRUCTION
Michael T. Hirschmann,Praveen Konala,Felix Amsler,Farhad Iranpour,Niklaus F. Friederich,Justin Cobb +5 more
TL;DR: 3D-reconstructed images are sufficiently reliable to enable reporting of the position and orientation of the components in a poorly functioning TKR with concerns over component positioning, and are recommend 3D-CT as the investigation of choice.
Journal ArticleDOI
SPECT/CT Physical Principles and Attenuation Correction
TL;DR: The ability to provide precise localization of physiologic data from nuclear medicine studies is now possible with hybrid SPECT/CT systems, and these systems provide an accurate attenuation correction of the nuclear medicine image data.
Journal ArticleDOI
Hybrid SPECT/CT: a new era for SPECT imaging?
TL;DR: In a series of 81 consecutive patients evaluated for various clinical situations, using different radiopharmaceuticals, SPECT/CT improved upon SPECT analysis alone in 41% of cases and this new technology can be routinely employed, facilitating the interpretation of SPECT imaging.