Thesis Format
Monograph
Degree
Master of Science
Program
Medical Biophysics
Collaborative Specialization
Musculoskeletal Health Research
Supervisor
Lalone, Emily
2nd Supervisor
Fenster, Aaron
Co-Supervisor
Abstract
Osteoarthritis (OA) is a common joint disease, which frequently affects the first carpometacarpal (CMC1) joint in the thumb. Detection of early features of OA, including inflammation and vascular changes, can lead to improved disease assessment, diagnosis, and treatment. Current clinical imaging modalities, x-ray and magnetic resonance imaging, are limited by their soft tissue contrast, and accessibility, respectively. There is a clinical need for point-of-care imaging tools to improve OA care. This thesis reports on an investigation of the use of three-dimensional (3D) Doppler ultrasound (US) blood flow imaging and an assessment of the reliability of 3D US joint blood flow measures in CMC1 OA patients. Five healthy volunteers had 3D US imaging of their thumbs submerged in a water solution at increasing temperatures. Increased blood flow was observed with increased temperature, which informed future scanning with the 3D US system. Eighteen CMC1 OA patients had 3D US scans with blood flow detection and visualization of the thumb repeated twice to assess test-retest reliability. 3D joint blood flow volumes were determined from the 3D US images. The results showed that 3D US measures of inflammation and joint blood flow have excellent reliability. The development of 3D US scanning systems with Doppler imaging capability and quantitative measures of early features of OA provides tools to clinicians and researchers to further understand the disease and improve patient care.
Summary for Lay Audience
Osteoarthritis (OA) is a common joint disease that causes pain and disability. The joint at the base of the thumb is a common site of OA. Thumb pain and loss of function can greatly impact the ability to do daily activities and quality of life. This makes it important to detect early features of the disease for earlier treatment. Joint inflammation is a feature of OA that can present before advanced joint degeneration happens. This inflammation contributes to changes in blood flow and the blood vessels within the joint. Current clinical imaging techniques are limited by access, cost, and the ability to detect soft tissues involved in joint inflammation. There is a clinical need for accessible imaging techniques to examine joint inflammation and blood flow. This work investigates the use of three-dimensional (3D) ultrasound (US) for joint blood flow imaging and determines the reliability of the 3D US blood flow measures in the thumb joint.
The thumb joint of healthy volunteers was scanned with 3D ultrasound Doppler imaging at different temperatures. These 3D US images showed the blood flow around the joint and this was measured as blood flow volumes. The blood flow volumes of the healthy volunteers increased with increased temperature. This showed that higher temperatures can be used for better visualization of blood flow with US. 3D US blood flow imaging was then looked at in patients with thumb OA. Eighteen patients had 3D US scans of the basal thumb joint. These images were taken twice to assess the consistency and reliability of the technique. Blood flow volumes were measured in the affected joint for both sets of 3D US images. This work showed excellent reliability for joint blood flow measures and demonstrated the novel technique of assessing 3D joint blood flow with Doppler US in OA patients. The development of this US system can help to better understand the disease and improve imaging, diagnosis, and disease monitoring.
Recommended Citation
Hutter, Megan, "Three-Dimensional Ultrasound Imaging For Blood Flow Assessment In First Carpometacarpal Osteoarthritis" (2024). Electronic Thesis and Dissertation Repository. 10844.
https://ir.lib.uwo.ca/etd/10844