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Photon-counting spectral computed tomography (PCSCT) can acquire data in multiple energy bins with the potential to increase contrast, especially for soft tissues. Our objectives were to assess the value of PCSST to characterise cartilage and to extract quantitative measures of subchondral bone integrity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Seven excised human knees (3 males and 4 females; 4 normal and 3 with osteoarthritis; age 80.6 \u00b1 14 years, mean \u00b1 standard deviation) were scanned using a clinical PCSCT prototype scanner. Tomographic image reconstruction was performed after Compton\/photoelectric decomposition. Virtual monoenergetic images were generated from 40 keV to 110 keV every 10 keV (cubic voxel size 250 \u00d7 250 \u00d7 250 \u03bcm<jats:sup>3<\/jats:sup>). After selecting an optimal virtual monoenergetic image, we analysed the grey level histograms of different tissues and extracted quantitative measurements on bone cysts.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The optimal monoenergetic images were obtained for 60 keV and 70 keV. Visual inspection revealed that these images provide sufficient spatial resolution and soft-tissue contrast to characterise surfaces, disruption, calcification of cartilage, bone osteophytes, and bone cysts. Analysis of attenuation <jats:italic>versus<\/jats:italic> energy revealed different energy fingerprint according to tissues. The volumes and numbers of bone cyst were quantified.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Virtual monoenergetic images may provide direct visualisation of both cartilage and bone details. Thus, unenhanced PCSCT appears to be a new modality for characterising the knee joint with the potential to increase the diagnostic capability of computed tomography for joint diseases and osteoarthritis.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s41747-021-00261-x","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T02:02:27Z","timestamp":1645495347000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Virtual monoenergetic images from photon-counting spectral computed tomography to assess knee osteoarthritis"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9088-1582","authenticated-orcid":false,"given":"Christine","family":"Chappard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Abascal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Olivier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salim","family":"Si-Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loic","family":"Boussel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Baptiste","family":"Piala","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Douek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francoise","family":"Peyrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,22]]},"reference":[{"key":"261_CR1","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1002\/art.34453","volume":"64","author":"RF Loeser","year":"2012","unstructured":"Loeser RF, Goldring SR, Scanzello CR, Goldring MB (2012) Osteoarthritis: a disease of the joint as an organ. 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