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Semin Musculoskelet Radiol 2023; 27(04): 397-410
DOI: 10.1055/s-0043-1768451
Review Article

Computed Tomography Bone Imaging: Pushing the Boundaries in Clinical Practice

Romain Gillet 
1   Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
2   Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
3   Université de Lorraine, INSERM, IADI, Nancy, France
,
Fatma Boubaker
1   Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
,
Gabriela Hossu
2   Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
3   Université de Lorraine, INSERM, IADI, Nancy, France
,
Anthony Thay
4   Canon Medical Systems France, Suresnes, France
,
Pierre Gillet
5   Université de Lorraine, CNRS, IMoPA, Nancy, France
,
Alain Blum
1   Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
2   Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
3   Université de Lorraine, INSERM, IADI, Nancy, France
,
Pedro Augusto Gondim Teixeira
1   Guilloz Imaging Department, Central Hospital, University Hospital Center of Nancy, Nancy, France
2   Université de Lorraine, CIC, Innovation Technologique, University Hospital Center of Nancy, Nancy, France
3   Université de Lorraine, INSERM, IADI, Nancy, France
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Abstract

Bone microarchitecture has several clinical implications over and above estimating bone strength. Computed tomography (CT) analysis mainly uses high-resolution peripheral quantitative CT and micro-CT, research imaging techniques, most often limited to peripheral skeleton assessment. Ultra-high-resolution (UHR) CT and photon-counting detector CT, two commercially available techniques, provide images that can approach the spatial resolution of the trabeculae, bringing bone microarchitecture analysis into clinical practice and improving depiction of bone vascularization, tumor matrix, and cortical and periosteal bone. This review presents bone microarchitecture anatomy, principles of analysis, reference measurements, and an update on the performance and potential clinical applications of these new CT techniques. We also share our clinical experience and technical considerations using an UHR-CT device.

Keywords

bone microstructure - ultra-high-resolution CT - bone imaging - photon-counting detector CT - spatial resolution


Publication History

Article published online:
25 September 2023

© 2023. Thieme. All rights reserved.

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