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Optical Coherence Tomography - Cartilage Diagnostics by Laserlight
Sanne M. Jansen, MD, PhD; Paul Cernohorsky, MD; Daniel M. de Bruin, PhD; Simon D. Strackee, MD, PhD; Ton G. van Leeuwen, PhD
University of Amsterdam, Amsterdam, Netherlands

Discrimination of cartilage differences in patient with osteoarthritis (OA) is critical, yet challenging. There is a discrepancy between the clinical symptoms and the radiological signs of OA. The hypothesis is that standard radiology lacks in terms of imaging resolution. Optical Coherence Tomography (OCT) could be the answer to this problem. OCT uses laser light to create cross-sectional images of tissue in a microscopic resolution in real-time. Previous studies show the ability of OCT to image cartilage in-vivo. However, we need a quantitative parameter to distinguish healthy cartilage from diseased. In this study we tested the ability of OCT in the discrimination of healthy cartilage from degenerative cartilage.

We used a goat model, which was approved by the animal ethics committee. Defects of 6 x 6 mm and 3 mm in depth were created in the articular cartilage of the ankle bones. After 24 weeks of spontaneous repair, the goats were sacrificed and ankle bones were analyzed with OCT and processed in histology slides. Healthy cartilage was distinguished from diseased cartilage in the histology slides, and exact matches of OCT slides (n=50) were selected for analysis. The optical parameter ‘attenuation coefficient’, which is the decay in light intensity in function of depth, was measured for healthy and degenerative cartilage. Differences were statistically analyzes. Also, polarization microscopy was used to look at the collagen content.

Healthy cartilage had a significantly higher attenuation coefficient compared to degenerative cartilage (p=0.001). Also, healthy cartilage attenuation was higher than bone (p=0.05). With polarization microscopy higher collagen content in healthy cartilage was seen compared to degenerative cartilage and bone.

In conclusion OCT is able to discriminate between healthy and degenerative cartilage, suggestion a powerful role for OCT in clinical diagnostics of osteoarthritis.

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