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Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI
To determine the diagnostic yield of cone beam computed tomography (CBCT) compared with 3 T magnetic resonance imaging (MRI) for the evaluation of subchondral insufficiency fractures of the knee. Consecutive patients with subchondral insufficiency fractures of the knee examined by 3 T MRI and CBCT o...
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| Published in: | Scientific reports 2024-07, Vol.14 (1), p.15278-9, Article 15278 |
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| description | To determine the diagnostic yield of cone beam computed tomography (CBCT) compared with 3 T magnetic resonance imaging (MRI) for the evaluation of subchondral insufficiency fractures of the knee. Consecutive patients with subchondral insufficiency fractures of the knee examined by 3 T MRI and CBCT of the femoral condyles were reviewed. Two experienced raters graded the lesion severity on 3 T MRI and CBCT images: grade 1: no signs of a subchondral bone lesion; grade 2: subchondral trabecular fracture or cystic changes, but without infraction of the subchondral bone plate; grade 3: collapse of the subchondral bone plate. Ratings were repeated after six weeks to determine reliability. In addition, the bone lesion size was measured as elliptical area (mm
2
) and compared between CBCT and T1-weighted MRI sequences. Among 30 patients included (43.3% women; mean age: 60.9 ± 12.8 years; body mass index (BMI) 29.0 ± 12.8 kg/m
2
), the medial femoral condyle was affected in 21/30 patients (70%). The grading of subchondral lesions between MRI and CBCT did not match in 12 cases (40%). Based on MRI images, an underestimation (i.e., undergrading) compared with CBCT was observed in nine cases (30%), whereas overgrading occurred in three cases (10%). Compared to CBCT, routine T1-weighted 3 T sequences significantly overestimated osseus defect zones in sagittal (84.7 ± 68.9 mm
2
vs. 35.9 ± 38.2 mm
2
, p |
| doi_str_mv | 10.1038/s41598-024-64591-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_b3a07e9d923c40b8a701b3342de0b0b7</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_b3a07e9d923c40b8a701b3342de0b0b7</doaj_id><sourcerecordid>3075701401</sourcerecordid><originalsourceid>FETCH-LOGICAL-c422t-9f47973be146a114b8f3e32a9fe6c25f1e07f3e9ae05ac2e38a7da207d5583443</originalsourceid><addsrcrecordid>eNp9ks1u1DAURiMEolXpC7BAkdiwSfFvEq9QVRU6UhESgrV149xkMiT2YDsjdcG740lKaVngjS37-NjX_rLsNSUXlPD6fRBUqrogTBSlkIoW1bPslBEhC8YZe_5ofJKdh7AjqUmmBFUvsxNeq5LSkp1mvy7bA9gIPYbcdblxFvMGYUqjaT9HbPPoJtd72G_v8s75HA8wzhAHZ498mBuzdbb1MOaDDXPXDWZAaxLrwcTZr9q4xfyHRVys4Bdr_vnr5lX2ooMx4Pl9f5Z9_3j97eqmuP3yaXN1eVsYwVgsVCcqVfEGqSiBUtHUHUfOQHVYGiY7iqRKMwqQSDAMeQ1VC4xUrZQ1F4KfZZvV2zrY6b0fJvB32sGglwnnew0-DmZE3XAgFapWMW4EaZKJ0IZzwVokDWmq5PqwuvZzM2Fr0MZU_RPp0xU7bHXvDppSxphkNBne3Ru8-zljiHoagsFxBItuDpqTSqZTBTmib_9Bd272Nr3VQkki0wcniq2U8S4Ej93DbSjRx7ToNS06pUUvadHHOt48ruNhy59sJICvQEhLtkf_9-z_aH8DoL3L_g</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3075505322</pqid></control><display><type>article</type><title>Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI</title><source>PubMed (Medline)</source><source>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</source><source>Free Full-Text Journals in Chemistry</source><source>Springer Nature - nature.com Journals - Fully Open Access</source><creator>Delsmann, Maximilian M. ; Delsmann, Julian ; Jandl, Nico Maximilian ; Maas, Kai-Jonathan ; Beil, Frank Timo ; Amling, Michael ; Henes, Frank Oliver ; Rolvien, Tim ; Spink, Clemens</creator><creatorcontrib>Delsmann, Maximilian M. ; Delsmann, Julian ; Jandl, Nico Maximilian ; Maas, Kai-Jonathan ; Beil, Frank Timo ; Amling, Michael ; Henes, Frank Oliver ; Rolvien, Tim ; Spink, Clemens</creatorcontrib><description>To determine the diagnostic yield of cone beam computed tomography (CBCT) compared with 3 T magnetic resonance imaging (MRI) for the evaluation of subchondral insufficiency fractures of the knee. Consecutive patients with subchondral insufficiency fractures of the knee examined by 3 T MRI and CBCT of the femoral condyles were reviewed. Two experienced raters graded the lesion severity on 3 T MRI and CBCT images: grade 1: no signs of a subchondral bone lesion; grade 2: subchondral trabecular fracture or cystic changes, but without infraction of the subchondral bone plate; grade 3: collapse of the subchondral bone plate. Ratings were repeated after six weeks to determine reliability. In addition, the bone lesion size was measured as elliptical area (mm
2
) and compared between CBCT and T1-weighted MRI sequences. Among 30 patients included (43.3% women; mean age: 60.9 ± 12.8 years; body mass index (BMI) 29.0 ± 12.8 kg/m
2
), the medial femoral condyle was affected in 21/30 patients (70%). The grading of subchondral lesions between MRI and CBCT did not match in 12 cases (40%). Based on MRI images, an underestimation (i.e., undergrading) compared with CBCT was observed in nine cases (30%), whereas overgrading occurred in three cases (10%). Compared to CBCT, routine T1-weighted 3 T sequences significantly overestimated osseus defect zones in sagittal (84.7 ± 68.9 mm
2
vs. 35.9 ± 38.2 mm
2
, p < 0.01, Cohen’s
d
= 1.14) and coronal orientation (53.1 ± 24.0 mm
2
vs
.
22.0 ± 15.2 mm
2
, p < 0.01, Cohen’s
d
= 1.23). The reproducibility of the grading determined by intra- and inter-rater agreement was very high in MRI (intra-class correlation coefficient (ICC) 0.78 and 0.90, respectively) and CBCT (ICC 0.96 and 0.96, respectively). In patients with subchondral insufficiency fractures of the knee, the use of CBCT revealed discrepancies in lesion grading compared with MRI. These findings are clinically relevant, as precise determination of subchondral bone plate integrity may influence the decision about conservative or surgical treatment. CBCT represents our imaging modality of choice for grading the lesion and assessing subchondral bone plate integrity. MRI remains the gold standard modality to detect especially early stages.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/s41598-024-64591-7</identifier><identifier>PMID: 38961162</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308 ; 692/699/578 ; Aged ; Ahlbäck ; Body mass index ; Bone imaging ; Bone lesions ; Cancellous bone ; Collapse ; Computed tomography ; Cone-Beam Computed Tomography - methods ; Correlation coefficient ; Female ; Femur ; Fractures ; Fractures, Stress - diagnostic imaging ; Humanities and Social Sciences ; Humans ; Insufficiency fracture ; Knee ; Knee Joint - diagnostic imaging ; Knee Joint - pathology ; Lesions ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; multidisciplinary ; Osteonecrosis ; Reproducibility of Results ; Science ; Science (multidisciplinary) ; SPONK ; Subchondral bone ; Subchondral bone plate ; Tomography</subject><ispartof>Scientific reports, 2024-07, Vol.14 (1), p.15278-9, Article 15278</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c422t-9f47973be146a114b8f3e32a9fe6c25f1e07f3e9ae05ac2e38a7da207d5583443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/3075505322/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/3075505322?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38961162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Delsmann, Maximilian M.</creatorcontrib><creatorcontrib>Delsmann, Julian</creatorcontrib><creatorcontrib>Jandl, Nico Maximilian</creatorcontrib><creatorcontrib>Maas, Kai-Jonathan</creatorcontrib><creatorcontrib>Beil, Frank Timo</creatorcontrib><creatorcontrib>Amling, Michael</creatorcontrib><creatorcontrib>Henes, Frank Oliver</creatorcontrib><creatorcontrib>Rolvien, Tim</creatorcontrib><creatorcontrib>Spink, Clemens</creatorcontrib><title>Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>To determine the diagnostic yield of cone beam computed tomography (CBCT) compared with 3 T magnetic resonance imaging (MRI) for the evaluation of subchondral insufficiency fractures of the knee. Consecutive patients with subchondral insufficiency fractures of the knee examined by 3 T MRI and CBCT of the femoral condyles were reviewed. Two experienced raters graded the lesion severity on 3 T MRI and CBCT images: grade 1: no signs of a subchondral bone lesion; grade 2: subchondral trabecular fracture or cystic changes, but without infraction of the subchondral bone plate; grade 3: collapse of the subchondral bone plate. Ratings were repeated after six weeks to determine reliability. In addition, the bone lesion size was measured as elliptical area (mm
2
) and compared between CBCT and T1-weighted MRI sequences. Among 30 patients included (43.3% women; mean age: 60.9 ± 12.8 years; body mass index (BMI) 29.0 ± 12.8 kg/m
2
), the medial femoral condyle was affected in 21/30 patients (70%). The grading of subchondral lesions between MRI and CBCT did not match in 12 cases (40%). Based on MRI images, an underestimation (i.e., undergrading) compared with CBCT was observed in nine cases (30%), whereas overgrading occurred in three cases (10%). Compared to CBCT, routine T1-weighted 3 T sequences significantly overestimated osseus defect zones in sagittal (84.7 ± 68.9 mm
2
vs. 35.9 ± 38.2 mm
2
, p < 0.01, Cohen’s
d
= 1.14) and coronal orientation (53.1 ± 24.0 mm
2
vs
.
22.0 ± 15.2 mm
2
, p < 0.01, Cohen’s
d
= 1.23). The reproducibility of the grading determined by intra- and inter-rater agreement was very high in MRI (intra-class correlation coefficient (ICC) 0.78 and 0.90, respectively) and CBCT (ICC 0.96 and 0.96, respectively). In patients with subchondral insufficiency fractures of the knee, the use of CBCT revealed discrepancies in lesion grading compared with MRI. These findings are clinically relevant, as precise determination of subchondral bone plate integrity may influence the decision about conservative or surgical treatment. CBCT represents our imaging modality of choice for grading the lesion and assessing subchondral bone plate integrity. MRI remains the gold standard modality to detect especially early stages.</description><subject>692/308</subject><subject>692/699/578</subject><subject>Aged</subject><subject>Ahlbäck</subject><subject>Body mass index</subject><subject>Bone imaging</subject><subject>Bone lesions</subject><subject>Cancellous bone</subject><subject>Collapse</subject><subject>Computed tomography</subject><subject>Cone-Beam Computed Tomography - methods</subject><subject>Correlation coefficient</subject><subject>Female</subject><subject>Femur</subject><subject>Fractures</subject><subject>Fractures, Stress - diagnostic imaging</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Insufficiency fracture</subject><subject>Knee</subject><subject>Knee Joint - diagnostic imaging</subject><subject>Knee Joint - pathology</subject><subject>Lesions</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Osteonecrosis</subject><subject>Reproducibility of Results</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>SPONK</subject><subject>Subchondral bone</subject><subject>Subchondral bone plate</subject><subject>Tomography</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks1u1DAURiMEolXpC7BAkdiwSfFvEq9QVRU6UhESgrV149xkMiT2YDsjdcG740lKaVngjS37-NjX_rLsNSUXlPD6fRBUqrogTBSlkIoW1bPslBEhC8YZe_5ofJKdh7AjqUmmBFUvsxNeq5LSkp1mvy7bA9gIPYbcdblxFvMGYUqjaT9HbPPoJtd72G_v8s75HA8wzhAHZ498mBuzdbb1MOaDDXPXDWZAaxLrwcTZr9q4xfyHRVys4Bdr_vnr5lX2ooMx4Pl9f5Z9_3j97eqmuP3yaXN1eVsYwVgsVCcqVfEGqSiBUtHUHUfOQHVYGiY7iqRKMwqQSDAMeQ1VC4xUrZQ1F4KfZZvV2zrY6b0fJvB32sGglwnnew0-DmZE3XAgFapWMW4EaZKJ0IZzwVokDWmq5PqwuvZzM2Fr0MZU_RPp0xU7bHXvDppSxphkNBne3Ru8-zljiHoagsFxBItuDpqTSqZTBTmib_9Bd272Nr3VQkki0wcniq2U8S4Ej93DbSjRx7ToNS06pUUvadHHOt48ruNhy59sJICvQEhLtkf_9-z_aH8DoL3L_g</recordid><startdate>20240703</startdate><enddate>20240703</enddate><creator>Delsmann, Maximilian M.</creator><creator>Delsmann, Julian</creator><creator>Jandl, Nico Maximilian</creator><creator>Maas, Kai-Jonathan</creator><creator>Beil, Frank Timo</creator><creator>Amling, Michael</creator><creator>Henes, Frank Oliver</creator><creator>Rolvien, Tim</creator><creator>Spink, Clemens</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><general>Nature Portfolio</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88I</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20240703</creationdate><title>Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI</title><author>Delsmann, Maximilian M. ; Delsmann, Julian ; Jandl, Nico Maximilian ; Maas, Kai-Jonathan ; Beil, Frank Timo ; Amling, Michael ; Henes, Frank Oliver ; Rolvien, Tim ; Spink, Clemens</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-9f47973be146a114b8f3e32a9fe6c25f1e07f3e9ae05ac2e38a7da207d5583443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>692/308</topic><topic>692/699/578</topic><topic>Aged</topic><topic>Ahlbäck</topic><topic>Body mass index</topic><topic>Bone imaging</topic><topic>Bone lesions</topic><topic>Cancellous bone</topic><topic>Collapse</topic><topic>Computed tomography</topic><topic>Cone-Beam Computed Tomography - methods</topic><topic>Correlation coefficient</topic><topic>Female</topic><topic>Femur</topic><topic>Fractures</topic><topic>Fractures, Stress - diagnostic imaging</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Insufficiency fracture</topic><topic>Knee</topic><topic>Knee Joint - diagnostic imaging</topic><topic>Knee Joint - pathology</topic><topic>Lesions</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Osteonecrosis</topic><topic>Reproducibility of Results</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>SPONK</topic><topic>Subchondral bone</topic><topic>Subchondral bone plate</topic><topic>Tomography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Delsmann, Maximilian M.</creatorcontrib><creatorcontrib>Delsmann, Julian</creatorcontrib><creatorcontrib>Jandl, Nico Maximilian</creatorcontrib><creatorcontrib>Maas, Kai-Jonathan</creatorcontrib><creatorcontrib>Beil, Frank Timo</creatorcontrib><creatorcontrib>Amling, Michael</creatorcontrib><creatorcontrib>Henes, Frank Oliver</creatorcontrib><creatorcontrib>Rolvien, Tim</creatorcontrib><creatorcontrib>Spink, Clemens</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health and Medical</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>ProQuest Biological Science Journals</collection><collection>Publicly Available Content Database (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Delsmann, Maximilian M.</au><au>Delsmann, Julian</au><au>Jandl, Nico Maximilian</au><au>Maas, Kai-Jonathan</au><au>Beil, Frank Timo</au><au>Amling, Michael</au><au>Henes, Frank Oliver</au><au>Rolvien, Tim</au><au>Spink, Clemens</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2024-07-03</date><risdate>2024</risdate><volume>14</volume><issue>1</issue><spage>15278</spage><epage>9</epage><pages>15278-9</pages><artnum>15278</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>To determine the diagnostic yield of cone beam computed tomography (CBCT) compared with 3 T magnetic resonance imaging (MRI) for the evaluation of subchondral insufficiency fractures of the knee. Consecutive patients with subchondral insufficiency fractures of the knee examined by 3 T MRI and CBCT of the femoral condyles were reviewed. Two experienced raters graded the lesion severity on 3 T MRI and CBCT images: grade 1: no signs of a subchondral bone lesion; grade 2: subchondral trabecular fracture or cystic changes, but without infraction of the subchondral bone plate; grade 3: collapse of the subchondral bone plate. Ratings were repeated after six weeks to determine reliability. In addition, the bone lesion size was measured as elliptical area (mm
2
) and compared between CBCT and T1-weighted MRI sequences. Among 30 patients included (43.3% women; mean age: 60.9 ± 12.8 years; body mass index (BMI) 29.0 ± 12.8 kg/m
2
), the medial femoral condyle was affected in 21/30 patients (70%). The grading of subchondral lesions between MRI and CBCT did not match in 12 cases (40%). Based on MRI images, an underestimation (i.e., undergrading) compared with CBCT was observed in nine cases (30%), whereas overgrading occurred in three cases (10%). Compared to CBCT, routine T1-weighted 3 T sequences significantly overestimated osseus defect zones in sagittal (84.7 ± 68.9 mm
2
vs. 35.9 ± 38.2 mm
2
, p < 0.01, Cohen’s
d
= 1.14) and coronal orientation (53.1 ± 24.0 mm
2
vs
.
22.0 ± 15.2 mm
2
, p < 0.01, Cohen’s
d
= 1.23). The reproducibility of the grading determined by intra- and inter-rater agreement was very high in MRI (intra-class correlation coefficient (ICC) 0.78 and 0.90, respectively) and CBCT (ICC 0.96 and 0.96, respectively). In patients with subchondral insufficiency fractures of the knee, the use of CBCT revealed discrepancies in lesion grading compared with MRI. These findings are clinically relevant, as precise determination of subchondral bone plate integrity may influence the decision about conservative or surgical treatment. CBCT represents our imaging modality of choice for grading the lesion and assessing subchondral bone plate integrity. MRI remains the gold standard modality to detect especially early stages.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>38961162</pmid><doi>10.1038/s41598-024-64591-7</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 2045-2322 2045-2322 |
| language | eng |
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| subjects | 692/308 692/699/578 Aged Ahlbäck Body mass index Bone imaging Bone lesions Cancellous bone Collapse Computed tomography Cone-Beam Computed Tomography - methods Correlation coefficient Female Femur Fractures Fractures, Stress - diagnostic imaging Humanities and Social Sciences Humans Insufficiency fracture Knee Knee Joint - diagnostic imaging Knee Joint - pathology Lesions Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Middle Aged multidisciplinary Osteonecrosis Reproducibility of Results Science Science (multidisciplinary) SPONK Subchondral bone Subchondral bone plate Tomography |
| title | Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T11%3A30%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Advantages%20of%20cone%20beam%20computed%20tomography%20for%20evaluation%20of%20subchondral%20insufficiency%20fractures%20of%20the%20knee%20compared%20to%20MRI&rft.jtitle=Scientific%20reports&rft.au=Delsmann,%20Maximilian%20M.&rft.date=2024-07-03&rft.volume=14&rft.issue=1&rft.spage=15278&rft.epage=9&rft.pages=15278-9&rft.artnum=15278&rft.issn=2045-2322&rft.eissn=2045-2322&rft_id=info:doi/10.1038/s41598-024-64591-7&rft_dat=%3Cproquest_doaj_%3E3075701401%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c422t-9f47973be146a114b8f3e32a9fe6c25f1e07f3e9ae05ac2e38a7da207d5583443%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=3075505322&rft_id=info:pmid/38961162&rfr_iscdi=true |