Abstract
Objectives: X-ray Phase Contrast Imaging (PCI) is an emerging modality whose availability in clinics for mammography and lung imaging is expected to materialize within the coming years. In this study, we evaluate the PCI performances with respect to current conventional imaging modalities in the context of osteo-articular disorders diagnosis. Materials and Methods: X-ray PCI was performed on 3 cadaveric human hands and wrists using a synchrotron beam. Conventional CT, MRI and Ultrasound were also performed on these three samples using routine procedures as well as research protocols. Six radiologists and rheumatologists independently evaluated qualitatively and semi quantitatively the images' quality. Medical interpretations were also made from the images. Results: PCI allows the simultaneous visualization of both the high absorbing and the softer tissues. The 6 reader evaluations characterized PCI as a visualization tool with improved performances for all tissue types (significant p-values) which provides sharper outlines and clearer internal structures than images obtained using conventional modalities. The PCI images contain overall more information, especially at smaller scales with for instance more visible micro-calcifications in our chondrocalcinosis case. Conclusions: Despite a reduced number of samples used, this pilot study highlights the possible medical benefits of PCI for osteo-articular disorders evaluation. Although PCI is not yet available in hospitals, the improved visualization capabilities demonstrated so far and the enhanced tissue measurement quality let suggest strong diagnosis benefits for rheumatology in case of a widespread application of PCI. Funding: Part of this study was financed by Labex PRIMES. Grenoble MRI facility IRMaGe was partly funded by the French program “Investissement d’Avenir” run by the ‘Agence Nationale pour la Recherche’; grant 'Infrastructure d’avenir en Biologie Sante' - ANR-11-INBS-0006. Declaration of Interest: The authors have no conflict of interest related to this study. Ethical Approval: Anatomical pieces were extracted from body to science donors. This donation was granted by our local ethics committee. However, due to local regulations, the anatomic pieces obtained from donors did not grant us access to the details of the patients’ medical history.
Highlights
To cite this version: Hélène Rougé-Labriet, Sébastien Bérujon, Hervé Mathieu, Sylvain Bohic, Barbara Fayard, et al
Some subtle density changes in the tissue, e.g the small features of denser material in the enthesis of the triangular ligament or a calcification in the joint (Fig. 2 inset 4), were detected by the readers in the Phase Contrast Imaging (PCI)-CT images whereas the radiologists were unable to do it with conventional imaging modalities
While X-ray PCI is already under translation from large-scale facilities to the clinics for 2D and 3D mammography, this study aimed at evaluating for the first time the potential of PCI Computed Tomography (PCI-CT) in the context of osteo-articular disorders showing slowly developing multifactorial degradations
Summary
To cite this version: Hélène Rougé-Labriet, Sébastien Bérujon, Hervé Mathieu, Sylvain Bohic, Barbara Fayard, et al. We evaluate the PCI Computed Tomography (PCI-CT) performances with respect to current conventional imaging modalities in the context of osteo-articular disorders diagnosis. The 6 reader evaluations characterized PCI-CT as a visualization tool with improved performances for all tissue types (significant p-values), which provides sharper outlines and clearer internal structures than images obtained using conventional modalities. Despite a reduced number of samples used, this pilot study highlights the possible medical benefits of PCI for osteo-articular disorders evaluation. Medical imaging plays a key role in rheumatology where it is today essential at the time of diagnosing an osteo-articular disorder. Clinical imaging modalities currently encounter limitations for the simultaneous correct depiction of the different tissues constituting a joint. Changes in the composition of a joint cartilage or soft tissues are usually rather evaluated using Magnetic Resonance Imaging (MRI). Ultrasonography (US) is still confined to a minor role in clinical routine since, albeit being fast and efficient, its low reproducibility shows problematic when diagnosing acute superficial lesions
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