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Thesis Format

Integrated Article

Degree

Master of Science

Program

Medical Biophysics

Supervisor

Fenster, Aaron

2nd Supervisor

Appleton, Tom

Co-Supervisor

Abstract

Arthritis is the most common chronic health condition in Canada, with the most common form being osteoarthritis (OA). There is a great clinical need for an objective imaging-based point-of-care tool to assess OA status, progression, and response to treatment. This thesis aims to validate a handheld mechanical three-dimensional (3D) ultrasound (US) device against the current clinical standard of magnetic resonance imaging (MRI) for quantifying femoral articular cartilage (FAC) volume. Knee images of 25 healthy volunteers were acquired using 3D US and 3.0 Tesla MRI scans. Two raters manually segmented the trochlear FAC during separate sessions to assess intra- and inter-rater reliabilities. The results demonstrated that 3D US has excellent reliability and strong concurrent validity with MRI for measuring healthy FAC volume. 3D US is a promising, inexpensive, and widely accessible imaging modality that will enable clinicians and researchers to obtain additional information without added complexity or discomfort to patients.

Summary for Lay Audience

Arthritis is the most common disease in Canada, affecting around 21% of the population. There are over 100 different types of arthritis, with the most common type being osteoarthritis (OA). Medical imaging systems such as x-ray imaging and magnetic resonance imaging (MRI) are utilized to diagnose and monitor OA by taking pictures of joints such as the knee. Structures within the knee joint are observed to assess disease progression and response to treatment. While x-ray imaging is excellent at visualizing bone, it cannot visualize soft tissues such as cartilage, ligaments, and fat. It is challenging to use x-ray imaging to assess cartilage abnormalities caused by OA. MRI is excellent at visualizing soft tissues, but MRI systems are expensive to operate and have long waitlists and imaging times. Furthermore, neither x-ray imaging nor MRI can be used to acquire images at the patient’s bedside. There is a tremendous clinical need for an imaging system that can assess knee cartilage at the patient’s bedside without the limitations of x-ray and MRI. This work aimed to use 3D ultrasound (US) imaging to meet this clinical need and compare it against MRI for measuring knee cartilage volume.

Knee images of 25 healthy volunteers were acquired using MRI and 3D US. Two raters traced the cartilage from MRI and 3D US images to measure the cartilage volume. The cartilage was traced multiple times to assess the reliability of each rater. The cartilage volumes were compared between MRI and 3D US to evaluate the performance of 3D US against the current clinical standard of MRI. The results demonstrated that clinicians and researchers could use 3D US to measure knee cartilage volume at the patient’s bedside with excellent reliability and strong agreement with MRI. 3D US is a promising, inexpensive, and widely accessible imaging modality that will enable clinicians and researchers to measure knee cartilage volume without the limitations of x-ray and MRI.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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