4.6 Article

Contrast solution properties and scan parameters influence the apparent diffusivity of computed tomography contrast agents in articular cartilage

Journal

JOURNAL OF THE ROYAL SOCIETY INTERFACE
Volume 19, Issue 193, Pages -

Publisher

ROYAL SOC
DOI: 10.1098/rsif.2022.0403

Keywords

computed tomography; contrast agents; articular cartilage; diffusion; biomarker; osteoarthritis

Funding

  1. National Institute of Arthritis, Musculoskeletal and Skin Disorders (NIAMS) of the National Institutes of Health [R01AR065248, S10RR026714]
  2. Siemens Healthineers
  3. Stanford Bio-XGraduate Fellowship

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The ability to derive contrast agent (CA) diffusivity from computed tomography arthrography (CTa) scans may serve as a biomarker for early degenerative changes. Experimental and computational approaches were used to study the factors influencing CTa-derived apparent diffusivity.
The inability to detect early degenerative changes to the articular cartilage surface that commonly precede bulk osteoarthritic degradation is an obstacle to early disease detection for research or clinical diagnosis. Leveraging a known artefact that blurs tissue boundaries in clinical arthrograms, contrast agent (CA) diffusivity can be derived from computed tomography arthrography (CTa) scans. We combined experimental and computational approaches to study protocol variations that may alter the CTa-derived apparent diffusivity. In experimental studies on bovine cartilage explants, we examined how CA dilution and transport direction (absorption versus desorption) influence the apparent diffusivity of untreated and enzymatically digested cartilage. Using multiphysics simulations, we examined mechanisms underlying experimental observations and the effects of image resolution, scan interval and early scan termination. The apparent diffusivity during absorption decreased with increasing CA concentration by an amount similar to the increase induced by tissue digestion. Models indicated that osmotically-induced fluid efflux strongly contributed to the concentration effect. Simulated changes to spatial resolution, scan spacing and total scan time all influenced the apparent diffusivity, indicating the importance of consistent protocols. With careful control of imaging protocols and interpretations guided by transport models, CTa-derived diffusivity offers promise as a biomarker for early degenerative changes.

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