Acetabular cartilage thickness: accuracy of three-dimensional reconstructions from multidetector CT arthrograms in a cadaver study.

PURPOSE To prospectively quantify the accuracy of hip cartilage thickness estimated from three-dimensional (3D) surfaces, generated by segmenting multidetector computed tomographic (CT) arthrograms by using direct physical measurements of cartilage thickness as the reference standard. MATERIALS AND METHODS Four fresh-frozen cadaver hip joints from two male donors, ages 43 and 46 years, were obtained; institutional review board approval for cadaver research was also obtained. Sixteen holes were drilled perpendicular to the cartilage of four cadaveric acetabula (two specimens). Hip capsules were surgically closed, injected with contrast material, and scanned by using multidetector CT. After scanning, 5.3-mmcores were harvested concentrically at each drill hole and cartilage thickness was measured with a microscope. Cartilage was reconstructed in 3D by using commercial software. Segmentations were repeated by two authors. Reconstructed cartilage thickness was determined by using a published algorithm. Bland-Altman plots and linear regression were used to assess accuracy. Repeatability was quantified by using the coefficient of variation, intraclass correlation coefficient (ICC), repeatability coefficient, and percentage variability. RESULTS Cartilage was reconstructed to a bias of -0.13 mm and a repeatability coefficient of + or - 0.46 mm. Regression of the scatterplots indicated a tendency for multidetector CT to overestimate thickness. Intra- and interobserver repeatability were very good. For intraobserver correlation, the coefficient of variation was 14.80%, the ICC was 0.88, the repeatability coefficient was 0.55 mm, and the percentage variability was 11.77%. For interobserver correlation, the coefficient of variation was 13.47%, the ICC was 0.90, the repeatability coefficient was 0.52 mm, and the percentage variability was 11.63%. CONCLUSION Assuming that an accuracy of approximately + or - 0.5 mm is sufficient, reconstructions of cartilage geometry from multidetector CT arthrographic data could be used as a preoperative surgical planning tool.

[1]  Jean-Denis Laredo,et al.  Comparison of MR-arthrography and CT-arthrography in hyaline cartilage-thickness measurement in radiographically normal cadaver hips with anatomy as gold standard. , 2009, Osteoarthritis and cartilage.

[2]  F Eckstein,et al.  In vivo reproducibility of three-dimensional cartilage volume and thickness measurements with MR imaging. , 1998, AJR. American journal of roentgenology.

[3]  R W Mann,et al.  Influence of cartilage geometry on the pressure distribution in the human hip joint. , 1979, Science.

[4]  W. Kalender,et al.  Accuracy limits for the determination of cortical width and density: the influence of object size and CT imaging parameters. , 1999, Physics in medicine and biology.

[5]  F Eckstein,et al.  Non-invasive determination of cartilage thickness throughout joint surfaces using magnetic resonance imaging. , 1997, Journal of biomechanics.

[6]  V C Mow,et al.  Quantitation of articular surface topography and cartilage thickness in knee joints using stereophotogrammetry. , 1991, Journal of biomechanics.

[7]  T. Stammberger,et al.  Determination of 3D cartilage thickness data from MR imaging: Computational method and reproducibility in the living , 1999, Magnetic resonance in medicine.

[8]  T Stammberger,et al.  Interobserver reproducibility of quantitative cartilage measurements: comparison of B-spline snakes and manual segmentation. , 1999, Magnetic resonance imaging.

[9]  F. J. Dzida,et al.  Comparative study of the intrinsic mechanical properties of the human acetabular and femoral head cartilage , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[10]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[11]  Jennifer N. Jackson,et al.  Magnetic Resonance Arthrography versus Arthroscopy in the Evaluation of Articular Hip Pathology , 2004, Clinical orthopaedics and related research.

[12]  E. Zaragoza,et al.  Magnetic resonance imaging with gadolinium arthrography to assess acetabular cartilage delamination. A report of four cases. , 2004, The Journal of bone and joint surgery. American volume.

[13]  Douglas G. Altman,et al.  Measurement in Medicine: The Analysis of Method Comparison Studies , 1983 .

[14]  R. Ganz,et al.  Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. , 2005, Radiology.

[15]  F Eckstein,et al.  Quantitative analysis of incongruity, contact areas and cartilage thickness in the human hip joint. , 1997, Acta anatomica.

[16]  H. Genant,et al.  Accuracy of CT-based thickness measurement of thin structures: modeling of limited spatial resolution in all three dimensions. , 2002, Medical physics.

[17]  A. Kassarjian.  Hip MR arthrography and femoroacetabular impingement. , 2006, Seminars in Musculoskeletal Radiology.

[18]  J. Weiss,et al.  Subject-specific finite element model of the pelvis: development, validation and sensitivity studies. , 2005, Journal of biomechanical engineering.

[19]  A. Cotten,et al.  Comparison of double-contrast CT arthrography image quality with nonionic contrast agents: isotonic dimeric iodixanol 270 mg I/mL and monomeric iohexol 300 mg I/mL. , 2000, Investigative radiology.

[20]  Eric Vicaut,et al.  Hyaline cartilage thickness in radiographically normal cadaveric hips: comparison of spiral CT arthrographic and macroscopic measurements. , 2007, Radiology.

[21]  B B Seedhom,et al.  Thickness of human articular cartilage in joints of the lower limb , 1999, Annals of the rheumatic diseases.

[22]  M. Demirtas,et al.  An overview of MR arthrography with emphasis on the current technique and applicational hints and tips , 2006 .

[23]  Hideki Yoshikawa,et al.  Three-dimensional distribution of acetabular cartilage thickness in patients with hip dysplasia: a fully automated computational analysis of MR imaging. , 2004, Osteoarthritis and cartilage.

[24]  J. Jurvelin,et al.  pQCT study on diffusion and equilibrium distribution of iodinated anionic contrast agent in human articular cartilage--associations to matrix composition and integrity. , 2009, Osteoarthritis and cartilage.

[25]  A. Haims,et al.  MR arthrography of the hip. , 1998, Radiologic clinics of North America.

[26]  T P Andriacchi,et al.  Methods for evaluating the progression of osteoarthritis. , 2000, Journal of rehabilitation research and development.

[27]  H J Kurrat,et al.  The thickness of the cartilage in the hip joint. , 1978, Journal of anatomy.

[28]  Hideki Yoshikawa,et al.  Fat-suppressed 3D spoiled gradient-echo MRI and MDCT arthrography of articular cartilage in patients with hip dysplasia. , 2005, AJR. American journal of roentgenology.

[29]  C. Pfirrmann,et al.  Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. , 2006, Radiology.

[30]  M. Schweitzer,et al.  Special focus session. MR arthrography. , 2002, Radiographics : a review publication of the Radiological Society of North America, Inc.

[31]  F Menschik,et al.  The hip joint as a conchoid shape. , 1999, Journal of biomechanics.

[32]  C. Petersilge.  Current concepts of MR arthrography of the hip. , 1997, Seminars in ultrasound, CT, and MR.

[33]  Felix Eckstein,et al.  Accuracy and precision of quantitative assessment of cartilage morphology by magnetic resonance imaging at 3.0T. , 2005, Arthritis and rheumatism.

[34]  G A Ateshian,et al.  Knee cartilage topography, thickness, and contact areas from MRI: in-vitro calibration and in-vivo measurements. , 1999, Osteoarthritis and cartilage.

[35]  G. Wang,et al.  Stair-step artifacts in three-dimensional helical CT: an experimental study. , 1994, Radiology.

[36]  P. Grenier,et al.  MR arthrography of the hip: normal intra-articular structures and common disorders , 2000, European Radiology.

[37]  C J Taylor,et al.  The use of active shape models for making thickness measurements of articular cartilage from MR images , 1997, Magnetic resonance in medicine.

[38]  K. Kopecky,et al.  Musculoskeletal imaging with multislice CT. , 2001, AJR. American journal of roentgenology.

[39]  W. Mccarthy,et al.  The Analysis of Pixel Intensity (Myocardial Signal Density) Data: The Quantification of Myocardial Perfusion by Imaging Methods. , 2007 .

[40]  N. Sugano,et al.  Articular Cartilage Abnormalities in Dysplastic Hips Without Joint Space Narrowing , 2001, Clinical orthopaedics and related research.

[41]  M. Demirtas,et al.  An overview of MR arthrography with emphasis on the current technique and applicational hints and tips. , 2006, European journal of radiology.

[42]  Thomas D Brown,et al.  Cartilage thickness in cadaveric ankles: measurement with double-contrast multi-detector row CT arthrography versus MR imaging. , 2004, Radiology.

[43]  W Herzog,et al.  Joint contact mechanics in the early stages of osteoarthritis. , 2000, Medical engineering & physics.

[44]  Benjamin J Ellis,et al.  Cartilage thickness: factors influencing multidetector CT measurements in a phantom study. , 2008, Radiology.

[45]  M. Hochberg,et al.  Reliability of a quantification imaging system using magnetic resonance images to measure cartilage thickness and volume in human normal and osteoarthritic knees. , 2003, Osteoarthritis and cartilage.

[46]  C. McGibbon,et al.  Accuracy of cartilage and subchondral bone spatial thickness distribution from MRI , 2003, Journal of magnetic resonance imaging : JMRI.

[47]  B. Daenen,et al.  Evaluation of patellar cartilage surface lesions: comparison of CT arthrography and fat-suppressed FLASH 3D MR imaging , 1998, European Radiology.

[48]  F Eckstein,et al.  The distribution of cartilage thickness within the joints of the lower limb of elderly individuals , 1998, Journal of anatomy.

[49]  M J Lammi,et al.  Contrast agent-enhanced computed tomography of articular cartilage: Association with tissue composition and properties , 2009, Acta radiologica.

[50]  P. D. Rushfeldt,et al.  Improved techniques for measuring in vitro the geometry and pressure distribution in the human acetabulum--I. Ultrasonic measurement of acetabular surfaces, sphericity and cartilage thickness. , 1981, Journal of biomechanics.

[51]  Professor Dr. Dietrich Tönnis.  Congenital Dysplasia and Dislocation of the Hip in Children and Adults , 1987, Springer Berlin Heidelberg.

[52]  Cheryl A. Petersilge,et al.  MR arthrography for evaluation of the acetabular labrum , 2001, Skeletal Radiology.

[53]  I. Mechlenburg.  Evaluation of Bernese periacetabular osteotomy , 2008, Acta orthopaedica. Supplementum.