Application of digital tomosynthesis to hand radiography for arthritis assessment

Arthritis is a painful condition with enormous societal impact. Arthritis damages the articular cartilage between adjacent bones in a joint, which is seen radiographically as narrowing of the joint space width (JSW). JSW is an important arthritis outcome measure however a single radiographic image is a 2D projection of a 3D structure and diseased areas can be obscured. To quantify the JSW in three dimensions we have applied digital tomosynthesis imaging to hand radiography. A tomosynthesis algorithm, developed for use in chest radiography, was modified to provide reconstructed slices through the bones that formed joints of the hand. The methodology was tested using simulated radiographs of dry-bone specimens from 3 hand skeletons. Estimates to the JSW in 3D were made from the reconstructed slices. The algorithm produced tomographic slices through the bones of the joint with minimal loss of spatial resolution. We discovered that hand radiography is ideally suited for tomosynthesis imaging due to the small amount of scatter and lack of truncation artifacts. We have demonstrated the utility of digital tomosynthesis for use in quantifying JSW for arthritis assessment. The method shows promise for improving the assessment of disease progression.