Title
Quantitative in vivo CT arthrography of the human osteoarthritic knee to estimate cartilage sulphated glycosaminoglycan content: Correlation with ex-vivo reference standards
Author
van Tiel, J.
Siebelt, M.
Reijman, M.
Bos, P.K.
Waarsing, J.H.
Zuurmond, A.M.
Nasserinejad, K.
van Osch, G.J.V.M.
Verhaar, J.A.N.
Krestin, G.P.
Weinans, H.
Oei, E.H.G.
Publication year
2016
Abstract
Objective. Recently, computed tomography arthrography (CTa) was introduced as quantitative imaging biomarker to estimate cartilage sulphated glycosaminoglycan (sGAG) content in human cadaveric knees. Our aim was to assess the correlation between in vivo CTa in human osteoarthritis (OA) knees and ex vivo reference standards for sGAG and collagen content. Design. In this prospective observational study 11 knee OA patients underwent CTa before total knee replacement (TKR). Cartilage X-ray attenuation was determined in six cartilage regions. Femoral and tibial cartilage specimens harvested during TKR were re-scanned using equilibrium partitioning of an ionic contrast agent with micro-CT (EPIC-μCT), which served as reference standard for sGAG. Next, cartilage sGAG and collagen content were determined using dimethylmethylene blue (DMMB) and hydroxyproline assays. The correlation between CTa X-ray attenuation, EPIC-μCT X-ray attenuation, sGAG content and collagen content was assessed. Results. CTa X-ray attenuation correlated well with EPIC-μCT (r = 0.76, 95% credibility interval (95%CI) 0.64 to 0.85). CTa correlated moderately with the DMMB assay (sGAG content) (r = −0.66, 95%CI −0.87 to −0.49) and to lesser extent with the hydroxyproline assay (collagen content) (r = −0.56, 95%CI −0.70 to −0.36). Conclusions. Outcomes of in vivo CTa in human OA knees correlate well with sGAG content. Outcomes of CTa also slightly correlate with cartilage collagen content. Since outcomes of CTa are mainly sGAG dependent and despite the fact that further validation using hyaline cartilage of other joints with different biochemical composition should be conducted, CTa may be suitable as quantitative imaging biomarker to estimate cartilage sGAG content in future clinical OA research.
Subject
Life
MHR - Metabolic Health Research
ELSS - Earth, Life and Social Sciences
Biomedical Innovation
Biology
Healthy Living
CT arthrography
Sulphated glycosaminoglycan content
Knee osteoarthritis
Articular cartilage
Clinical research
Translational study
To reference this document use:
http://resolver.tudelft.nl/uuid:3892fbd3-a555-4ed9-9188-673a4279a6f0
DOI
https://doi.org/10.1016/j.joca.2016.01.137
TNO identifier
573416
ISSN
1063-4584
Source
Osteoarthritis and Cartilage, 24 (6), 1012-1020
Document type
article