Dr. Fernando J. Quevedo-González Profile

Dr. Fernando J. Quevedo-González

at Hospital for Special Surgery

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Publications (3)

Proceedings Article | 2 April 2024 Paper

Quantitative trabecular bone morphometry using photon-counting CT

G. Shi, A. Sivakumar, E. Abadi, C. McCabe, F. Quevedo Gonzalez, R. Breighner, J. Carrino, J. Siewerdsen, W. Zbijewski

Proceedings Volume 12930, 1293004 (2024) https://doi.org/10.1117/12.3006949

KEYWORDS: Bone, Voxels, Spatial resolution, Image segmentation, Image resolution, In vivo imaging, X-ray computed tomography, Computed tomography, Spine, Head

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The recently introduced Photon Counting CT (PCCT) offers major advances in spatial resolution and material discrimination compared to conventional multi-detector CT. We investigate whether these new capabilities may enable accurate in vivo quantification of the trabecular microstructure of human bone. Human femoral bone was imaged using reference HR-pQCT (isotropic 60 μm voxels) and PCCT operated in a High Resolution mode (HR, 80 μm in-plane voxel size. 200 μm slice thickness) and in a Calcium-selective mode (CA, isotropic 390 μm voxels). 468 spherical Regions-of-Interest (ROIs) of 5 mm diameter were placed at corresponding locations in the HR-pQCT and PCCT volumes. The bone voxels of HR-pQCT and CA PCCT ROIs were segmented (binarized) using global Otsu thresholding; local Bernsen segmentation was used for HR PCCT. Trabecular thickness (TbTh), spacing (TbSp), number (TbN), and bone volume fraction (BV/TV) were measured in the binarized ROIs. The performance of PCCT morphometrics was evaluated in terms of correlation coefficient and numerical agreement with HR-pQCT. For ROIs with mean TbTh⪆250 μm (approaching the nominal resolution of HR PCCT), the average trabecular measurements obtained from HR PCCT achieved excellent correlations with the reference HR-pQCT: 0.88 for BvTv, 0.89 for TbTh, 0.81 for TbSp and 0.78 for TbN. For ROIs with mean TbTh of 200 μm – 250 μm, the correlations were slightly worse, ranging from 0.61 for TbTh to 0.84 for BvTv. The spatial resolution of CA PCCT in its current implementation is insufficient for microarchitectural measurements, but the material discrimination capability appears to enable accurate estimation of BvTv (correlation of 0.89 to HR-pQCT). The results suggest that the introduction of PCCT may enable microstructural evaluation of the trabecular bone of the lumbar spine and hip, which are inaccessible to current in vivo high-resolution bone imaging technologies. The findings of this work will inform the development of clinical indications for PCCT trabecular bone assessment.

Proceedings Article | 19 April 2023 Presentation + Paper

Effects of non-stationary blur on texture biomarkers of bone using ultra-high resolution CT

G. Shi, F. Quevedo Gonzalez, R. Breighneer, J. Carrino, J. Siewerdsen, W. Zbijewski

Proceedings Volume 12468, 1246813 (2023) https://doi.org/10.1117/12.2654304

KEYWORDS: Bone, Modulation transfer functions, X-ray computed tomography, Radiomics, Spatial resolution, Reproducibility, Principal component analysis, Current controlled current source, Head, Cooccurrence matrices

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Purpose: To advance the development of radiomic models of bone quality using the recently introduced Ultra-High Resolution CT (UHR CT), we investigate inter-scan reproducibility of trabecular bone texture features to spatially-variant azimuthal and radial blurs associated with focal spot elongation and gantry rotation. Methods: The UHR CT system features 250x250 μm detector pixels and an x-ray source with a 0.4x0.5 mm focal spot. Visualization of details down to ~150 μm has been reported for this device. A cadaveric femur was imaged on UHR CT at three radial locations within the field-of-view: 0 cm (isocenter), 9 cm from the isocenter, and 18 cm from the isocenter; we expect the non-stationary blurs to worsen with increasing radial displacement. Gray level cooccurrence (GLCM) and gray level run length (GLRLM) texture features were extracted from 237 trabecular regions of interest (ROIs, 5 cm diameter) placed at corresponding locations in the femoral head in scans obtained at the different shifts. We evaluated concordance correlation coefficient (CCC) between texture features at 0 cm (reference) and at 9 cm and 18 cm. We also investigated whether the spatially-variant blurs affect K-means clustering of trabecular bone ROIs based on their texture features. Results: The average CCCs (against the 0 cm reference) for GLCM and GLRM features were ~0.7 at 9 cm. At 18 cm, the average CCCs were reduced to ~0.17 for GLCM and ~0.26 for GLRM. The non-stationary blurs are incorporated in radiomic features of cancellous bone, leading to inconsistencies in clustering of trabecular ROIs between different radial locations: an intersection-over-union overlap of corresponding (most similar) clusters between 0 cm and 9 cm shift was >70%, but dropped to <60% for the majority of corresponding clusters between 0 cm and 18 cm shift. Conclusion: Non-stationary CT system blurs reduce inter-scan reproducibility of texture features of trabecular bone in UHR CT, especially for locations <15 cm from the isocenter. Radiomic models of bone quality derived from UHR CT measurements at isocenter might need to be revised before application in peripheral body sites such as the hips.

Proceedings Article | 15 March 2019 Presentation + Paper

Quantitative evaluation of bone microstructure using high-resolution extremity cone-beam CT with a CMOS detector

S. Subramanian, M. Brehler, Q. Cao, F. Quevedo Gonzalez, R. Breighner, J. Carrino, T. Wright, J. Yorkston, J. Siewerdsen, W. Zbijewski

Proceedings Volume 10953, 1095317 (2019) https://doi.org/10.1117/12.2515504

KEYWORDS: Bone, Image segmentation, Spatial resolution, Imaging systems, CMOS sensors, Sensors, Prototyping, Scintillators, X-ray detectors, Scanners

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Purpose: A high-resolution cone-beam CT (CBCT) system for extremity imaging has been developed using a custom complementary metal–oxide–semiconductor (CMOS) x-ray detector. The system has spatial resolution capability beyond that of recently introduced clinical orthopedic CBCT. We evaluate performance of this new scanner in quantifying trabecular microstructure in subchondral bone of the knee. Methods: The high-resolution scanner uses the same mechanical platform as the commercially available Carestream OnSight 3D extremity CBCT, but replaces the conventional amorphous silicon flat-panel detector (a-Si:H FPD with 0.137 mm pixels and a ~0.7 mm thick scintillator) with a Dalsa Xineos3030 CMOS detector (0.1 mm pixels and a custom 0.4 mm scintillator). The CMOS system demonstrates ~40% improved spatial resolution (FWHM of a ~0.1 mm tungsten wire) and ~4x faster scan time than FPD-based extremity CBCT (FPD-CBCT). To investigate potential benefits of this enhanced spatial resolution in quantitative assessment of bone microstructure, 26 trabecular core samples were obtained from four cadaveric tibias and imaged using FPD-CBCT (75 μm voxels), CMOS-CBCT (75 μm voxels), and reference micro-CT (μCT, 15 μm voxels). CBCT bone segmentations were obtained using local Bernsen’s thresholding combined with global histogram-based pre-thresholding; μCT segmentation involved Otsu’s method. Measurements of trabecular thickness (Tb.Th), spacing (Tb.Sp), number (Tb.N) and bone volume (BV/TV) were performed in registered regions of interest in the segmented CBCT and μCT reconstructions. Results: CMOS-CBCT achieved noticeably improved delineation of trabecular detail compared to FPD-CBCT. Correlations with reference μCT for metrics of bone microstructure were better for CMOS-CBCT than FPD-CBCT, in particular for Tb.Th (increase in Pearson correlation from 0.84 with FPD-CBCT to 0.96 with CMOS-CBCT) and Tb.Sp (increase from 0.80 to 0.85). This improved quantitative performance of CMOS-CBCT is accompanied by a reduction in scan time, from ~60 sec for a clinical high resolution protocol on FPD-CBCT to ~17 sec for CMOS-CBCT. Conclusion: The CMOS-based extremity CBCT prototype achieves improved performance in quantification of bone microstructure, while retaining other diagnostic capabilities of its FPD-based precursor, including weight-bearing imaging. The new system offers a promising platform for quantitative imaging of skeletal health in osteoporosis and osteoarthritis.

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