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LetterLetter

High-resolution Peripheral Quantitative Computed Tomography Imaging Protocol for Metacarpophalangeal Joints in Inflammatory Arthritis: The SPECTRA Collaboration

CHERYL BARNABE and LYNNE FEEHAN
The Journal of Rheumatology July 2012, 39 (7) 1494-1495; DOI: https://doi.org/10.3899/jrheum.120218
CHERYL BARNABE
MD, MSc, FRCPC
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  • For correspondence: ccbarnab{at}ucalgary.ca
LYNNE FEEHAN
BScPT, MSc, PhD
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  • 3-D reconstruction of the second, third, and fourth metacarpophalangeal joints using high-resolution peripheral quantitative computed tomography.
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    Figure 1.

    3-D reconstruction of the second, third, and fourth metacarpophalangeal joints using high-resolution peripheral quantitative computed tomography.

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    Table 1.

    Image acquisition protocol for metacarpophalangeal joint analysis in inflammatory arthritis using high-resolution peripheral quantitative computed tomography.

    Acquisition parametersManufacturer recommends standard clinical acquisition measures (82 μm, 60 kVp, 900 μA, 100 ms) with daily quality-control calibrations.
    Patient positioningOptimal immobilization necessary to acquire high-quality images suitable for analysis.
    Image quality for analysisUse the manufacturer’s grading scale and include images graded 1–3.
    Scout viewThe minimal length of the scout view should include imaging of the 2nd and 3rd MCP joint spaces, with at least 3 mm on either side of the joint space to ensure adequate assessment of joint positioning and land marking.
    JointsAt a minimum both the 2nd and 3rd MCP should be imaged.
    HandIf only unilateral images are acquired, then the dominant hand should be scanned unless the person has had a fracture in that arm in the last year and/or they have had any surgery in the area to be scanned.
    PositionThe MCP are to be positioned between 0° and 15° of flexion, consistent with current clinical radiographic imaging positioning of the MCP joints.
    Reference lineThe initial reference line for the scout view should be the midpoint of the concave articular surface of the base of the 2nd or 3rd proximal phalanx, whichever is the most distal. The scan should start at a minimum 2 mm distal to this line and should include a minimun of 2 stacks (∼220 slices) to ensure that both the 2nd and 3rd MCP joint spaces are contained fully within the first 110 slices, in an effort to avoid any potential effect of stack artifact or discontinuity in the joint space. If a 3rd stack (∼330 slices) can also be done, the scan start location can be located more distally if needed, but it should still be ensured that the 2nd and 3rd MCP joint spaces are fully contained within 1 stack.
    Reproducibility/precisionInvestigators should report a measure of reliability (e.g., RMSCV, LSC) for their evaluations.
    • MCP: metacarpophalangeal; RMSCV: root square mean coefficient of variance; LSC: least significant change.

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The Journal of Rheumatology
Vol. 39, Issue 7
1 Jul 2012
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High-resolution Peripheral Quantitative Computed Tomography Imaging Protocol for Metacarpophalangeal Joints in Inflammatory Arthritis: The SPECTRA Collaboration
CHERYL BARNABE, LYNNE FEEHAN
The Journal of Rheumatology Jul 2012, 39 (7) 1494-1495; DOI: 10.3899/jrheum.120218

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High-resolution Peripheral Quantitative Computed Tomography Imaging Protocol for Metacarpophalangeal Joints in Inflammatory Arthritis: The SPECTRA Collaboration
CHERYL BARNABE, LYNNE FEEHAN
The Journal of Rheumatology Jul 2012, 39 (7) 1494-1495; DOI: 10.3899/jrheum.120218
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