Pathological changes in bone microarchitecture are associated with a broad range of musculoskeletal (MSK) diseases, including osteoporosis (OP) and osteoarthritis (OA). OP and OA carry significant healthcare burden, with an estimated 10 million US adults suffering from OP and 27 million afflicted by OA. This motivates quantitative assessment of bone microstructure on clinical imaging systems. Quantitative metrics of bone microarchitecture remain, however, underutilized in OP and OA because of limited spatial resolution of current orthopedic imaging modalities. Application of extremity CBCT in quantitative imaging of bone microstructure is likely to have high impact in OA and OP because (a) OA occurs primarily in the extremities, and (b) in OP, morphological measurements in distal extremities were shown to be indicative of fracture risk, including of hip fractures. Again, the spatial resolution of current extremity CBCT (?0.25 mm) is insufficient to fully resolve the ?0.1 mm trabeculae, limiting the performance in assessment of bone quality. We intend to address this specific issue through the development of a novel sensor that promises to provide the necessary resolution without compromising detector sensitivity. Efficacy of such a detector will be demonstrated through CBCT scanning and comparing results to those obtained using the current state-of-the-art system.
The imaging platform resulting from integration of the proposed sensor into large area CMOS readout will provide the unique ability to monitor bone microarchitecture in humans in vivo with sufficient detection efficiency to support imaging in highly attenuating body sites, including major joints of the extremities, hip and spine. Future applications of this technology will extend beyond extremity CBCT to 2D and 3D fluoro visualization of stents, breast CBCT for better visualization of micro-calcifications, dental, maxillofacial and ENT including temporal bone and inner/middle ear imaging, to name a few.
