Characterization of heterotopic ossification using radiographic imaging: Evidence for a paradigm shift

R. Cameron Brownley, Shailesh Agarwal, Shawn Loder, Oluwatobi Eboda, John Li, Joshua Peterson, Charles Hwang, Christopher Breuler, Vesa Kaartinen, Bin Zhou, Yuji Mishina, Benjamin Levi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Heterotopic ossification (HO) is the growth of extra-skeletal bone which occurs following trauma, burns, and in patients with genetic bone morphogenetic protein (BMP) receptor mutations. The clinical and laboratory evaluation of HO is dependent on radiographic imaging to identify and characterize these lesions. Here we show that despite its inadequacies, plain film radiography and single modality microCT continue to serve as a primary method of HO imaging in nearly 30% of published in vivo literature. Furthermore, we demonstrate that detailed microCT analysis is superior to plain film and single modality microCT radiography specifically in the evaluation of HO formed through three representative models due to its ability to 1) define structural relationships between growing extra-skeletal bone and normal, anatomic bone, 2) provide accurate quantification and growth rate based on volume of the space-occupying lesion, thereby facilitating assessments of therapeutic intervention, 3) identify HO at earlier times allowing for evaluation of early intervention, and 4) characterization of metrics of bone physiology including porosity, tissue mineral density, and cortical and trabecular volume. Examination of our trauma model using microCT demonstrated two separate areas of HO based on anatomic location and relationship with surrounding, normal bone structures. Additionally, microCT allows HO growth rate to be evaluated to characterize HO progression. Taken together, these data demonstrate the need for a paradigm shift in the evaluation of HO towards microCT as a standard tool for imaging.

Original languageEnglish (US)
Article numbere0141432
JournalPLoS One
Volume10
Issue number11
DOIs
StatePublished - Nov 6 2015

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Heterotopic Ossification
bone formation
X-Ray Microtomography
Bone
image analysis
Imaging techniques
Radiography
bones
Bone and Bones
Bone Morphogenetic Protein Receptors
Motion Pictures
radiography
Physiology
lesions (animal)
Density (specific gravity)
Minerals
Growth
Porosity
bone morphogenetic proteins
Tissue

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Brownley, R. C., Agarwal, S., Loder, S., Eboda, O., Li, J., Peterson, J., ... Levi, B. (2015). Characterization of heterotopic ossification using radiographic imaging: Evidence for a paradigm shift. PLoS One, 10(11), [e0141432]. https://doi.org/10.1371/journal.pone.0141432

Characterization of heterotopic ossification using radiographic imaging : Evidence for a paradigm shift. / Brownley, R. Cameron; Agarwal, Shailesh; Loder, Shawn; Eboda, Oluwatobi; Li, John; Peterson, Joshua; Hwang, Charles; Breuler, Christopher; Kaartinen, Vesa; Zhou, Bin; Mishina, Yuji; Levi, Benjamin.

In: PLoS One, Vol. 10, No. 11, e0141432, 06.11.2015.

Research output: Contribution to journalArticle

Brownley, RC, Agarwal, S, Loder, S, Eboda, O, Li, J, Peterson, J, Hwang, C, Breuler, C, Kaartinen, V, Zhou, B, Mishina, Y & Levi, B 2015, 'Characterization of heterotopic ossification using radiographic imaging: Evidence for a paradigm shift', PLoS One, vol. 10, no. 11, e0141432. https://doi.org/10.1371/journal.pone.0141432
Brownley, R. Cameron ; Agarwal, Shailesh ; Loder, Shawn ; Eboda, Oluwatobi ; Li, John ; Peterson, Joshua ; Hwang, Charles ; Breuler, Christopher ; Kaartinen, Vesa ; Zhou, Bin ; Mishina, Yuji ; Levi, Benjamin. / Characterization of heterotopic ossification using radiographic imaging : Evidence for a paradigm shift. In: PLoS One. 2015 ; Vol. 10, No. 11.
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