SYSTEMATIC REVIEW OF COMPUTED TOMOGRAPHY PARAMETERS USED FOR THE ASSESSMENT OF SUBCHONDRAL BONE IN OSTEOARTHRITIS

Abstract

Radiography and MRI are currently regarded as the imaging modalities of choice for OA assessment. However, computed tomography (CT) has several distinct advantages over these modalities, principally the capability of delivering higher resolution 3-D image reconstructions over a wider range of biological scales, in particular with respect to mineralized tissues. This enables greater standardization in analysis of bone structures compared to other imaging modalities. Considering the growing understanding of the importance of bone in OA pathology, we deem it an important juncture to recognize the full scope that CT holds in the imaging assessment of OA. To systematically review the published parameters for the assessment of subchondral bone in human OA using CT and gain an overview of current practices and standards. Medline, Embase and Cochrane Library databases were search with respective search strategies (search from 2010 to January 2023). Based on pre-determined inclusion and exclusion criteria, search results were screened independently by two reviewers. Eligible studies were conducted in vivo / ex vivo in human adults (>18 years) using CT to assess subchondral bone in any joint with OA. Data was extracted from eligible studies and compiled in a qualitative summary and formal narrative synthesis. The literature search resulted in 202 included studies. Subchondral bone across nine anatomical locations were assessed using four broad groupings of CT modality: conventional clinical-type CT; quantitative CT for human use; micro-/nano-CT; and cone-beam CT. Six categories were identified for bone parameters measuring features of OA: (i) microstructure, (ii) bone adaptation, (iii) gross morphology (iv) mineralization, (v) joint space, and (vi) mechanical properties. From long-standing roots, CT techniques have been continuing to gain popularity in OA research. We highlight clinically meaningful CT measurements for the assessment of subchondral bone in OA as well as parameters with the potential to perform in this role. We discuss the importance of quantification of parameters to improve their sensitivity and reproducibility. Finally, we emphasize a need for consistency and standardization of measurement protocols to optimize the value of these parameters in future OA research and clinical practice. None None None CORRESPONDENCE ADDRESS: [email protected]