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ConeBeam scanner (CBCT) is a widely technique used for dental and maxillofacial imaging. Patients can be set up in a sitting or a laying position in the, Newtom 5G CBCT allowing for an analysis of the limbs distal joints. Our hypothesis is that the cone-beam scanner could detect and characterize chondral lesions the cartilage similarly to a multidetector CT (MDCT). 100 patients over 18 years requiring arthroscanner of the wrist, ankle, elbow or knee will be enrolled The primary endpoint based on the ability of cone-beam scanner to detect cartilage lesions. Secondary endpoints will concern the depiction of the joint lesions, quality of the images, tolerability of the exams and inter- intra-operator reproducibility. After arthrography, patients will have a MDCT considered as the reference exam, and a CBCT on a randomized order. Exams will be anonymized and read twice by two trained radiologists with 3-6 week intervals. The inter-observer agreement for the diagnosis of cartilage lesion type between the two techniques will be evaluated by a kappa coefficient. The evaluation of diagnostic performance will be achieved by studying the sensitivity, specificity, negative predictive value and positive predictive value, and its likelihood ratio. Kappa test will be performed to evaluate the consistency of the depiction of the lesions. A Student t test will be performed for paired data if distributions are normal, a Wilcoxon test if not. To assess patient's tolerance, the percentages of (painful, not painful) will be calculated for each technique and will be compared using the Chi2 test (or Fisher's exact test if the chi can not apply).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CBCT prior to MDCT | Experimental | To avoid systematic bias in performance or image quality due to dilution of the contrast enhancement within the joint, the order of the CBCT and the MDCT will be randomized. This arm is composed of patients who will have the CBCT performed prior to the MDCT. |
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| MDCT prior to CBCT | Experimental | To avoid systematic bias in performance or image quality due to dilution of the contrast enhancement within the joint, the order of the CBCT and the MDCT will be randomized. This arm is composed of patients who will have the MDCT performed prior to the CBCT. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CBCT prior to MDCT | Device | Cone-beam scanner is performed immediately after arthrography, then multidetector scanner is performed. |
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| Measure | Description | Time Frame |
|---|---|---|
| cartilage damage thickness | 0- normal, 1- Linear cartilage tear, 2- focal ulceration of less than 50% of the cartilage thickness, 3-: - focal ulceration of greater than 50% of the cartilage thickness, 4- Full thickness ulceration of the cartilage | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Measure | Description | Time Frame |
|---|---|---|
| cartilage damage measurements | Quantitative assessment of each location of cartilage damage by maximal diameter in two orthogonal planes tangential to the surface | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Image quality (for CBCT and MDCT) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jean-Baptiste PIALAT, MD | Hospices Civils de Lyon- Hôpital Edouard Herriot | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civils de Lyon- hôpital Edouard Herriot- service de radiologie pavillon B | Lyon | 69003 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30467778 | Result | Debeaupte M, Hermann R, Pialat JB, Martinon A, Truy E, Ltaief Boudrigua A. Cone beam versus multi-detector computed tomography for detecting hearing loss. Eur Arch Otorhinolaryngol. 2019 Feb;276(2):315-321. doi: 10.1007/s00405-018-5214-y. Epub 2018 Nov 23. |
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| MDCT prior to CBCT | Device | Multidetector scanner is performed immediately after arthrography, then Cone-beam scanner is performed. |
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0 - Insufficient, 1 - Poor, 2 - Average, 3 - Good, 4 - Excellent |
| participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Tolerability of the exam (for CBCT and MDCT) | Perfect, tolerable, hardly tolerable, intolerable | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Duration of the exam (for CBCT and MDCT) | Perfect, tolerable, hardly tolerable, intolerable | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Subchondral bone lesion (for CBCT and MDCT) | No subchondral bone lesion, subchondral bone thickening, subchondral cyst <3mm diameter, subchondral cyst 3 to 5 mm diameter, subchondral cyst >5mm diameter | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Lesion of intrinsic ligament (for CBCT and MDCT) | Yes / No | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Osteochondroma (for CBCT and MDCT) | Each osteochondroma is located (anterior/posterior Medial/ lateral recess, and diameter is measured.: >3mm, 3 to 5 mm, >5mm | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |
| Meniscal lesion (for arthrography CBCT and MDCT of the knee) | No lesion, longitudinal tear, radial tear, complex tear, displaced tear, bucket handle tear | participants will be followed for the duration of the arthrography CT , an expected average of 2 hours |