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Tomosynthesis better than radiographs for detecting knee OA

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Researchers at Boston University School of Medicine found tomosynthesis superior to radiography at depicting osteophytes and subchondral cysts associated with knee osteoarthritis, according to a study published in the April issue of Radiology. They also discovered subjects reported more pain when osteophytes and subchondral cysts were detected using tomosynthesis than patients without lesions.

“Despite the known limitation of X-ray imaging, it is widely used to diagnose knee osteoarthritis (OA), both in terms of daily clinical practice and also for clinical research studies,” lead author Daichi Hayashi, MD, PhD, of the Quantitative Imaging Center in the department of radiology at Boston University School of Medicine (BUSM), stated in a BUSM press release.

Hayashi and colleagues studied 40 individual over 40 years old (80 knees) whether or not they had knee pain or radiographic OA and imaged their knees with radiography and tomosynthesis. Using MRI as a reference, investigators recorded osteophytes or subchondral cysts they observed in four areas of the tibiofemoral joint, according to the study abstract.

The researchers then compared radiographic and tomosynthesis results and found 171 osteophytes and 51 subchondral cysts on MRI. They discovered tomosynthesis sensitivity increased from 5% to 29% vs. radiographs for osteophyte detection. Subchondral cyst detection improved from 11% to 50% with tomosynthesis vs. radiographs. Study participants undergoing tomosynthesis for osteophytes or subchondral cysts felt more pain than those with no lesions, according to the release.

“This study shows that images obtained through tomosynthesis are significantly better than those from X-rays and could potentially be a better diagnostic tool for knee OA in patients with knee pain,” Hayashi stated in the release. “While tomosynthesis has not been widely used in imaging of bone and joints to date, the results of our study show that using tomosynthesis to detect knee OA can be effective.”

Reference:

• Hayashi D, Xu L, Roemer FW, et al. Detection of osteophytes and subchondral cysts in the knee with use of tomosynthesis. Radiology. 2012; 263(1):206-215. doi: 10.1148/radiol.12111649.

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