Computed tomography topographic mapping of subchondral density (CT-TOMASD) in osteoarthritic and normal knees: methodological development and preliminary.

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Computed tomography topographic mapping of subchondral density (CT-TOMASD) in osteoarthritic and normal knees: methodological development and preliminary findings J.D. Johnston, B.A. Masri, D.R. Wilson Osteoarthritis and Cartilage Volume 17, Issue 10, Pages 1319-1326 (October 2009) DOI: 10.1016/j.joca.2009.04.013 Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 1 Methodological sequence for CT-TOMASD analyses of proximal tibiae consists of converting CT grayscale intensity to BMD using a QCT reference phantom (A), followed by semi-automatic tibial segmentation in the sagittal plane (B). Peripheral and inner boundary points are manually selected (C) to define the medial and lateral plateaus; with the proximal tibia reorientated relative to ‘best-fit’ planes passing through plateau boundary points (D). A surface projection image processing algorithm is performed to map 3D subchondral density in relation to depth (measured from the subchondral surface) directly at the joint surface (E). CT-TOMASD regional analyses are performed, including the max BMD contained within a 10mm diameter core and the average BMD contained within the anterior, central and posterior compartments of each plateau (F). Osteoarthritis and Cartilage 2009 17, 1319-1326DOI: (10.1016/j.joca.2009.04.013) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 2 CT-TOMASD topographic density maps of proximal tibial subchondral bone using the surface projection image processing technique, assessed across a depth of 2.5mm from the subchondral surface. Results are displayed for two cases of late OA (valgus-aligned lateral OA1, varus-aligned medial OA2), one case of early OA (neutral-aligned lateral OA3), and five asymptomatic subjects displaying no radiographic evidence of OA. All knees are displayed as left knees for comparative purposes. Osteoarthritis and Cartilage 2009 17, 1319-1326DOI: (10.1016/j.joca.2009.04.013) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions

Fig. 3 CT-TOMASD topographic density maps of proximal tibial subchondral bone using the surface projection image processing technique, assessed across a depth of 5.0mm from the subchondral surface. Results are displayed for two cases of late OA (valgus-aligned lateral OA1, varus-aligned medial OA2), one case of early OA (neutral-aligned lateral OA3), and five asymptomatic subjects displaying no radiographic evidence of OA. All knees are displayed as left knees for comparative purposes. Osteoarthritis and Cartilage 2009 17, 1319-1326DOI: (10.1016/j.joca.2009.04.013) Copyright © 2009 Osteoarthritis Research Society International Terms and Conditions