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Imaging Research

Medical imaging plays a vital role in orthopaedic and sports medicine for diagnosis, treatment, and postoperative evaluation of injury and disease. The objectives of the SPRI Imaging Research department are to:

  • Develop orthopaedic and sports medicine imaging protocols for diagnosis and treatment evaluation
  • Apply cutting-edge imaging techniques to musculoskeletal-specific applications
  • Advance a better understanding of the relationship between non-invasive quantitative imaging measurements and pathology
  • Publish findings in peer-reviewed imaging journals with high impact factors and strong clinical readership

Since 2008, Imaging Research has worked alongside the other SPRI departments to evaluate and develop diagnosis and treatment techniques with direct clinical impact. All clinical magnetic resonance imaging (MRI) scans in the Steadman Clinic are incorporated into the SPRI clinical data registry, providing a vast dataset for clinical studies. In addition, study-specific imaging is performed on asymptomatic volunteers and cadaver specimens as appropriate to optimize MRI protocols before they are used for clinical scans.

Imaging Research has also developed strong collaborative relationships with industry partners to facilitate the translation from research to clinical practice. This includes Siemens Medical Solutions USA and Siemens Healthineers in Germany, in which new MRI protocols are developed and validated in conjunction with SPRI. For complex image processing tasks the Imaging Research department collaborates with the talented medical imaging team at the Commonwealth Scientific and Industrial Research Organisation (CSIRO) and University of Queensland in Australia.

As part of the Institute’s strategic alliance and research collaboration with Siemens Medical Solutions USA, SPRI has upgraded its previous Verio 3.0 Tesla (T) MRI technology with the Siemens flagship clinical Skyra-fit 3.0 T MRI system. This technology provides the researchers at SPRI, as well as the doctors and patients at The Steadman Clinic better access to advanced medical imaging, including quieter scan options, improved speed and resolution, and access to the most up-to-date imaging techniques. Patients are now able to get a more comprehensive picture of possible injury within a joint or body part, receive a more accurate diagnosis, get more focused treatment, and learn how well they respond to that treatment. The Institute’s agreement with Siemens also allows Imaging Research to test and validate new imaging techniques developed specifically for the type of clinical research being conducted at the Institute. This allows us to utilize cutting-edge techniques in our research and to influence the development of new clinical imaging applications.

Current collaborative projects with CSIRO and the University of Queensland focus on 3D modeling and analysis of structures including the knee meniscus and cruciate ligaments, hip labrum, as well as articular cartilage and bony morphology of the hip, knee, and shoulder. An important component of Imaging Research’s collaboration with the University of Queensland and CSIRO is in the area of automatic segmentation of various tissues. This work will greatly improve the efficiency and reproducibility of image segmentation, needed for the routine clinical applicability of quantitative imaging and other applications that currently require time-consuming manual segmentation.

Current research projects include:

  • Evaluating quantitative mapping techniques, which measure small changes in joint tissue properties (water and chemical content, collagen fiber organization), for early detection of joint disease such as osteoarthritis prior to the later stage advanced disruption of joint tissues.
  • Comparing MRI and computed tomography (CT) results for orthopaedic/sports medicine imaging applications with the goal of reducing the need for CT and patient exposure to ionizing radiation.
  • Auto-segmentation to allow efficient, reproducible clinical use of techniques that currently require time-intensive manual processing.

In summary, the highlights of Imaging Research during 2015 and early 2016 included: 1) 11 published papers in peer-reviewed journals and three podium presentations at international conferences, 2) Continued collaboration with an MRI industry leader Siemens and the researchers at CSIRO/University of Queensland to develop and validate novel and clinically important imaging sequences and software, 3) Upgrade to the Skyra-fit 3.0 T MRI system. Imaging Research will continue to take advantage of its strong collaborations and advanced imaging technology to perform state-of-the-art research and apply cutting-edge imaging tools to improving patient outcomes.

List of Publications

For up-to-date publication updates see: http://www.ncbi.nlm.nih.gov/pubmed/?term=charles+p+ho

2020:

Lockard CA, Stake IK, Brady AW, DeClercq MG, Tanghe KK, Douglass BW, Nott E, Ho CP, Clanton TO. Accuracy of MRI-Based Talar Cartilage Thickness Measurement and Talus Bone and Cartilage Modeling: Comparison with Ground-Truth Laser Scan Measurements. CARTILAGE. 2020. doi: 10.1177/1947603520976774

2019:

Lockard CA, Chang A, Clanton TO, Ho CP. T2* mapping and subregion analysis of the tibialis posterior tendon using 3 Tesla magnetic resonance imaging. Br J Radiol. 2019;92(1104):20190221. doi:10.1259/bjr.20190221

Schon JM, Brady AW, Krob JJ, et al. Defining the three most responsive and specific CT measurements of ankle syndesmotic malreduction. Knee Surg Sports Traumatol Arthrosc. 2019;27(9):2863-2876. doi:10.1007/s00167-019-05457-8

Wilson KJ, Fripp J, Lockard CA, et al. Quantitative mapping of acute and chronic PCL pathology with 3 T MRI: a prospectively enrolled patient cohort. J Exp Orthop. 2019;6(1):22. doi:10.1186/s40634-019-0188-2

Lockard CA, Chang A, Shin RC, Clanton TO, Ho CP. Regional variation of ankle and hindfoot cartilage T2 mapping values at 3 T: A feasibility study. Eur J Radiol. 2019;113:209-216. doi:10.1016/j.ejrad.2019.02.011

2018:

LaPrade RF, Cram TR, Mitchell JJ, et al. Axial-Oblique Versus Standard Axial 3-T Magnetic Resonance Imaging for the Detection of Trochlear Cartilage Lesions: A Prospective Study. Orthop J Sports Med. 2018;6(10):2325967118801009. doi:10.1177/2325967118801009

Lockard CA, Wilson KJ, Ho CP, Shin RC, Katthagen JC, Millett PJ. Quantitative mapping of glenohumeral cartilage in asymptomatic subjects using 3 T magnetic resonance imaging. Skeletal Radiol. 2018;47(5):671-682. doi:10.1007/s00256-017-2829-9

Schlegel TF, Abrams JS, Bushnell BD, Brock JL, Ho CP. Radiologic and clinical evaluation of a bioabsorbable collagen implant to treat partial-thickness tears: a prospective multicenter study. J Shoulder Elbow Surg. 2018;27(2):242-251. doi:10.1016/j.jse.2017.08.023

2017:

Millett PJ, Espinoza C, Horan MP, et al. Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years. Arch Orthop Trauma Surg. 2017;137(10):1399-1408. doi:10.1007/s00402-017-2750-7

Paproki A, Engstrom C, Strudwick M, et al. Automated T2-mapping of the Menisci From Magnetic Resonance Images in Patients with Acute Knee Injury. Acad Radiol. 2017;24(10):1295-1304. doi:10.1016/j.acra.2017.03.025

Neubert A, Wilson KJ, Engstrom C, et al. Comparison of 3D bone models of the knee joint derived from CT and 3T MR imaging. Eur J Radiol. 2017;93:178-184. doi:10.1016/j.ejrad.2017.05.042

Aga C, Wilson KJ, Johansen S, Dornan G, La Prade RF, Engebretsen L. Tunnel widening in single- versus double-bundle anterior cruciate ligament reconstructed knees. Knee Surg Sports Traumatol Arthrosc. 2017;25(4):1316-1327. doi:10.1007/s00167-016-4204-0

Wilson KJ, Surowiec RK, Johnson NS, Lockard CA, Clanton TO, Ho CP. T2* Mapping of Peroneal Tendons Using Clinically Relevant Subregions in an Asymptomatic Population. Foot Ankle Int. 2017;38(6):677-683. doi:10.1177/1071100717693208

2016:

Chandra SS, Surowiec R, Ho C, et al. Automated analysis of hip joint cartilage combining MR T2 and three-dimensional fast-spin-echo images. Magn Reson Med. 2016;75(1):403-413. doi:10.1002/mrm.25598

Wilson KJ, Surowiec RK, Ho CP, et al. Quantifiable Imaging Biomarkers for Evaluation of the Posterior Cruciate Ligament Using 3-T Magnetic Resonance Imaging: A Feasibility Study. Orthopaedic Journal of Sports Medicine. 2016;4(4):232596711663904. doi:10.1177/2325967116639044

Ganal E, Ho CP, Wilson KJ, et al. Quantitative MRI characterization of arthroscopically verified supraspinatus pathology: comparison of tendon tears, tendinosis and asymptomatic supraspinatus tendons with T2 mapping. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2216-2224. doi:10.1007/s00167-015-3547-2

Spiegl UJ, Horan MP, Smith SW, Ho CP, Millett PJ. The critical shoulder angle is associated with rotator cuff tears and shoulder osteoarthritis and is better assessed with radiographs over MRI. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2244-2251. doi:10.1007/s00167-015-3587-7

Ho CP, Surowiec RK, Frisbie DD, et al. Prospective In Vivo Comparison of Damaged and Healthy-Appearing Articular Cartilage Specimens in Patients With Femoroacetabular Impingement: Comparison of T2 Mapping, Histologic Endpoints, and Arthroscopic Grading. Arthroscopy. 2016;32(8):1601-1611. doi:10.1016/j.arthro.2016.01.066

Ho CP, Ommen ND, Bhatia S, et al. Predictive Value of 3-T Magnetic Resonance Imaging in Diagnosing Grade 3 and 4 Chondral Lesions in the Hip. Arthroscopy. 2016;32(9):1808-1813. doi:10.1016/j.arthro.2016.03.014

2015:

Xue N, Doellinger M, Fripp J, Ho CP, Surowiec RK, Schwarz R. Automatic model-based semantic registration of multimodal MRI knee data. J Magn Reson Imaging. 2015;41(3):633-644. doi:10.1002/jmri.24609

Ho CP, James EW, Surowiec RK, et al. Systematic technique-dependent differences in CT versus MRI measurement of the tibial tubercle-trochlear groove distance. Am J Sports Med. 2015;43(3):675-682. doi:10.1177/0363546514563690

LaPrade RF, Ho CP, James E, Crespo B, LaPrade CM, Matheny LM. Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology. Knee Surg Sports Traumatol Arthrosc. 2015;23(1):152-157. doi:10.1007/s00167-014-3395-5

Xue N, Doellinger M, Ho CP, Surowiec RK, Schwarz R. Automatic detection of anatomical landmarks on the knee joint using MRI data. J Magn Reson Imaging. 2015;41(1):183-192. doi:10.1002/jmri.24516

Xue N, Doellinger M, Fripp J, Ho CP, Surowiec RK, Schwarz R. Automatic model-based semantic registration of multimodal MRI knee data: Automatic Semantic Registration. J Magn Reson Imaging. 2015;41(3):633-644. doi:10.1002/jmri.24609

Ferro FP, Ho CP, Dornan GJ, Surowiec RK, Philippon MJ. Comparison of T2 Values in the Lateral and Medial Portions of the Weight-Bearing Cartilage of the Hip for Patients With Symptomatic Femoroacetabular Impingement and Asymptomatic Volunteers. Arthroscopy. 2015;31(8):1497-1506. doi:10.1016/j.arthro.2015.02.045

Ferro FP, Ho CP, Briggs KK, Philippon MJ. Patient-centered outcomes after hip arthroscopy for femoroacetabular impingement and labral tears are not different in patients with normal, high, or low femoral version. Arthroscopy. 2015;31(3):454-459. doi:10.1016/j.arthro.2014.10.008

Spiegl UJ, Petri M, Smith SW, Ho CP, Millett PJ. Association between scapula bony morphology and snapping scapula syndrome. Journal of Shoulder and Elbow Surgery. 2015;24(8):1289-1295. doi:10.1016/j.jse.2014.12.034

Gatlin CC, Matheny LM, Ho CP, Johnson NS, Clanton TO. Diagnostic Accuracy of 3.0 Tesla Magnetic Resonance Imaging for the Detection of Articular Cartilage Lesions of the Talus. Foot Ankle Int. 2015;36(3):288-292. doi:10.1177/1071100714553469

2014:

Surowiec RK, Lucas EP, Wilson KJ, Saroki AJ, Ho CP. Clinically Relevant Subregions of Articular Cartilage of the Hip for Analysis and Reporting Quantitative Magnetic Resonance Imaging: A Technical Note. CARTILAGE. 2014;5(1):11-15. doi:10.1177/1947603513514082

Surowiec RK, Lucas EP, Fitzcharles EK, et al. T2 values of articular cartilage in clinically relevant subregions of the asymptomatic knee. Knee Surg Sports Traumatol Arthrosc. 2014;22(6):1404-1414. doi:10.1007/s00167-013-2779-2

Surowiec RK, Lucas EP, Ho CP. Quantitative MRI in the evaluation of articular cartilage health: reproducibility and variability with a focus on T2 mapping. Knee Surg Sports Traumatol Arthrosc. 2014;22(6):1385-1395. doi:10.1007/s00167-013-2714-6

Ho CP, Surowiec RK, Ferro FP, et al. Subregional Anatomical Distribution of T2 Values of Articular Cartilage in Asymptomatic Hips. CARTILAGE. 2014;5(3):154-164. doi:10.1177/1947603514529587

Laprade RF, Surowiec RK, Sochanska AN, et al. Epidemiology, identification, treatment and return to play of musculoskeletal-based ice hockey injuries. Br J Sports Med. 2014;48(1):4-10. doi:10.1136/bjsports-2013-093020

Clanton TO, Ho CP, Williams BT, et al. Magnetic resonance imaging characterization of individual ankle syndesmosis structures in asymptomatic and surgically treated cohorts. Knee Surg Sports Traumatol Arthrosc. 2016;24(7):2089-2102. doi:10.1007/s00167-014-3399-1

Anz AW, Lucas EP, Fitzcharles EK, Surowiec RK, Millett PJ, Ho CP. MRI T2 mapping of the asymptomatic supraspinatus tendon by age and imaging plane using clinically relevant subregions. Eur J Radiol. 2014;83(5):801-805. doi:10.1016/j.ejrad.2014.02.002

Devitt BM, Philippon MJ, Goljan P, Peixoto LP, Briggs KK, Ho CP. Preoperative diagnosis of pathologic conditions of the ligamentum teres: is MRI a valuable imaging modality? Arthroscopy. 2014;30(5):568-574. doi:10.1016/j.arthro.2014.01.001

2013:

Clanton TO, Chacko AK, Matheny LM, Hartline BE, Ho CP. Magnetic resonance imaging findings of snowboarding osteochondral injuries to the middle talocalcaneal articulation. Sports Health. 2013;5(5):470-475. doi:10.1177/1941738113497671

Ejnisman L, Philippon MJ, Lertwanich P, et al. Relationship between femoral anteversion and findings in hips with femoroacetabular impingement. Orthopedics. 2013;36(3):e293-300. doi:10.3928/01477447-20130222-17

2012:

Register B, Pennock AT, Ho CP, Strickland CD, Lawand A, Philippon MJ. Prevalence of Abnormal Hip Findings in Asymptomatic Participants: A Prospective, Blinded Study. Am J Sports Med. 2012;40(12):2720-2724. doi:10.1177/0363546512462124

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