Research Methods
What is High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT)?
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High-Resolution peripheral Quantitative Computed Tomography (HR-pQCT) is an x-ray-based 3D imaging modality for imaging peripheral skeletal sites at a high spatial resolution.
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HR-pQCT:
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is used for imaging proximal interphalangeal joints, the metacarpophalangeal joints, the distal radius and tibia
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produces images with an isotropic voxel size of 82 µm3 (Scanco XtremeCTI) or 60 µm3 (Scanco XtremeCTII).
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allows for the measurement of bone microarchitecture and bone mineral density.
Many published studies using HR-pQCT have focused on technical aspects and validation, but recently, there has been a large increase in the number of studies demonstrating the clinical utility of HR-pQCT in assessing arthritis.
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What are the benefits?
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i. Research benefits
HR-pQCT imaging has a very high resolution, scan time is short, and low radiation exposure. It is a very sensitive tool for evaluating bone mineral density and microstructure, and has been applied for evaluating periosteal bone growth and erosion. Progression of erosions has even been shown after three-months follow-up. It has an excellent perspective for monitoring progression in patients with inflammatory arthritis.
ii. Potential clinical benefits
Moving forward, HR-pQCT may be a reliable candidate for individual disease monitoring of RA. The perspective is that relevant immunosuppressive treatment can be initiated at an earlier stage to improve the prognosis for those patients at risk of developing severe bone destruction and disability (and omitted or stopped in those patients not at risk). This would help avoid excessive health cost and patient adverse events.
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