October 27, 2024
Actual research: CT next to the stall? That day may come
Nellie Carlson/Paulik Report Photo
© Copyright 2024 Paulick Report/Blenheim Publishing. Reprinted with permission.
Over the past few years, equine veterinary imaging has grown exponentially. Computed tomography (CT) and magnetic resonance imaging (MRI) were once rare and expensive luxuries for veterinarians seeking to diagnose horses, and were only available in a few parts of the country. Recently, an increasing number of referral clinics have introduced machines that bring advanced image processing closer to more people and horses. Some of these new machines are faster and do not require the horse to be fully anesthetized to obtain images.
Dr. Chris Kawcak expects the next wave to be more availability of CT in the form of stall-side machines.
CT uses X-rays to take three-dimensional images of the body, often viewing “slices” of parts of the body that include bones and some soft tissues in more detail than an X-ray. (In contrast, MRI also produces a series of three-dimensional images, but is more often used to study soft tissue than bone.) CT can characterize the shape of bones that radiographs cannot do well. It also detects small changes in bone surfaces faster than radiographic images. The level of detail can make all the difference as veterinarians and researchers strive to intervene before subclinical injuries in racehorses become serious.
Kokak, a professor of orthopedic surgery at Colorado State University, has spent the past 30 years studying both CT and MRI, looking for ways the technology can be used to help racehorses.
Even before the first CT robot arrived at the University of Pennsylvania, Kokak was working on a small, portable CT machine that could take images in 30 seconds. Many technologies are introduced into the world of equine veterinary medicine through human medical companies, and even when companies partner with scientists to conduct research, it is difficult to bring machines or drugs to market. It is not uncommon for people to hesitate when they realize that the scale is relatively small. There is a market for it. This happened at the stall-side CT in Kokak, but he says it’s now back on track.
“We are currently in the process of designing three beta units that will be distributed to equine clinics for further testing and optimization in preparation for commercial units,” said Kawcak.
This is still far from an agreement. Getting a product like this into the hands of veterinarians, researchers, and technology companies requires not only making sure it works, but making sure the price is affordable for doctors and that technical support is strong. That means that the image may actually be useful.
“Sometimes the science behind it is the easiest part,” he said.
While radiologists prefer ultra-high-resolution images from huge machines, Kokak says the stall-side version he’s working on uses artificial intelligence before being read based on the data the machine captures. He said it will sharpen images and provide the quality that experts desire. From small machines preferred by veterinarians in the field. It’s not like adding a filter to your photo before posting it to Instagram. The data comes from what the CT sees.
“The data is real, and the research groups we work with (one at Johns Hopkins University, one at the University of Chicago) are both radiation physicists, so we can take the CT signals and make them more suitable. We know how to optimize for it. Read it and interpret it,” Kokak said.
Of course, for any technology like this to advance, there needs to be a lot of research to verify that everything works. Kocak said the Grayson Jockey Club Research Foundation was instrumental in this process, helping to fund research he conducted from 2018 to 2022 that showed the potential of the machine.
More interesting research is planned for the future – Kocak is collaborating with a group at Johns Hopkins to develop predictive imaging biomarkers for horse bulbar bone density and joint shape using CT scanners. , said they are trying to predict whether a horse has a higher-than-average risk. Fracture of the condyle or sesamoid bone.
“There’s some pretty strong evidence at this point that it might be possible, but ultimately we won’t know until a year from now,” he said.
Collaborating with Johns Hopkins University on racehorse research may seem strange, but Kokak said it’s not.
“They really like animal research for animals. When I first started working with them, I was impressed by that. They understand horse problems and have developed things that help animals. “We were very excited to try to deploy it,” Kokak said.
While much of veterinary medicine comes from the human world, it is also true that it can go in the opposite direction. This is called translational medicine and is based on the idea that many things, such as imaging, biomarkers, treatments, and therapies, can be defined in one species and successfully applied to another. Johns Hopkins University is interested in this racehorse project because they know that osteoarthritis in humans occurs similarly to in athletic horses, and bone density and shape also play a role in the risk of injury. I’m interested in whether this could be a factor.
“Some people have argued, or want to argue, that this is essentially going to be a scanning method or an investigative method,” he said, adding that advanced imaging procedures like CT can be used regularly, preventatively, and For those wondering if it can be done, Koukak said. “I think it’s probably true, or at least that’s the hope, that we can better monitor horses in training to identify problems early.”
This can be a double-edged sword. Veterinarians caution that the ability to take more detailed images and the ability to interpret what is seen during the examination along with the images must always be combined with the clinician in the field. Mr Kokak pointed out that horses undergo CT scans to qualify for the Melbourne Cup, sometimes resulting in controversial injuries. Because CT cannot always definitively declare whether a finding is problematic or not, people sometimes end up taking a gamble and injuring their horse rather than risk injury. Given advances in PET imaging and data aggregation and analysis in racehorse management, CT results represent another and very important piece of the puzzle for identifying horses at risk of injury. There is no doubt that it will be.
“The more information we have, the better we understand what these things actually mean and identify which horses are considered safe to continue and others need to take a step back.” We will be able to do it,” Kokak said.
Grayson Jockey Club Research Foundation
The Grayson Jockey Club Research Foundation has traditionally been the nation’s largest source of private funding for equine medical research benefiting horses of all breeds. Since 1940, Grayson has provided nearly $42.3 million to undertake more than 437 projects at 48 universities. Additional information about the Foundation can be found at grayson-jockeyclub.org.
