Pub Date : 2024-02-01DOI: 10.1016/j.ostima.2024.100174
M Fagan , R Fajardo , C Grozier , TR Jildeh , M Lissy , MS Harkey
Introduction
Osteoarthritis (OA) commonly occurs following anterior cruciate ligament reconstruction (ACLR), affecting over 50 % of patients within 10–15 years post-ACLR. The Hoffa-synovitis of the infrapatellar fat pad (IPFP) has been implicated as a major contributor to OA pathogenesis. While MRI is typically used to evaluate the IPFP, it is cost-prohibitive for routine screening. This study aimed to validate ultrasound as an alternative for detecting IPFP Hoffa-synovitis in participants post-ACLR.
Methods
In this cross-sectional study, 15 participants (18–35 years, 1–5 years post-ACLR) underwent two imaging sessions separated by one week. First, a standardized bilateral anterior knee ultrasound assessment was used to examine IPFP echo-intensity. Second, MRI scans of both knees were graded by a board-certified musculoskeletal radiologist for Hoffa-synovitis according to the Anterior Cruciate Ligament Osteoarthritis Score grading system. IPFP echo-intensity were quantified on each ultrasound image, and a limb symmetry index (LSI) was calculated to assess between-limb differences. We used an independent t-test and Cohen's d effect sizes to compare IPFP echo-intensity LSI between people with and without MRI-confirmed Hoffa-synovitis.
Results
Four of the 15 participants (27 %) exhibited MRI-confirmed Hoffa-synovitis. Significantly higher IPFP echo-intensity LSI values were found in participants with Hoffa-synovitis (32.1 ± 12.1 %) compared to those without (10.5 ± 10.4 %), confirming the ultrasound's ability to distinguish between the two groups (t = -3.44; p = 0.004; d = 2.01).
Discussion
Ultrasound detects bilateral IPFP signal intensity alterations in participants post-ACLR with MRI-confirmed Hoffa-synovitis. This work should be seen as a proof-of-concept, and further validation in a larger, more diverse sample is essential for verifying these results.
{"title":"Ultrasound assessment of the infrapatellar fat pad can detect Hoffa-synovitis in patients following anterior cruciate ligament reconstruction: A pilot study","authors":"M Fagan , R Fajardo , C Grozier , TR Jildeh , M Lissy , MS Harkey","doi":"10.1016/j.ostima.2024.100174","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100174","url":null,"abstract":"<div><h3>Introduction</h3><p>Osteoarthritis (OA) commonly occurs following anterior cruciate ligament reconstruction (ACLR), affecting over 50 % of patients within 10–15 years post-ACLR. The Hoffa-synovitis of the infrapatellar fat pad (IPFP) has been implicated as a major contributor to OA pathogenesis. While MRI is typically used to evaluate the IPFP, it is cost-prohibitive for routine screening. This study aimed to validate ultrasound as an alternative for detecting IPFP Hoffa-synovitis in participants post-ACLR.</p></div><div><h3>Methods</h3><p>In this cross-sectional study, 15 participants (18–35 years, 1–5 years post-ACLR) underwent two imaging sessions separated by one week. First, a standardized bilateral anterior knee ultrasound assessment was used to examine IPFP echo-intensity. Second, MRI scans of both knees were graded by a board-certified musculoskeletal radiologist for Hoffa-synovitis according to the Anterior Cruciate Ligament Osteoarthritis Score grading system. IPFP echo-intensity were quantified on each ultrasound image, and a limb symmetry index (LSI) was calculated to assess between-limb differences. We used an independent <em>t</em>-test and Cohen's <em>d</em> effect sizes to compare IPFP echo-intensity LSI between people with and without MRI-confirmed Hoffa-synovitis.</p></div><div><h3>Results</h3><p>Four of the 15 participants (27 %) exhibited MRI-confirmed Hoffa-synovitis. Significantly higher IPFP echo-intensity LSI values were found in participants with Hoffa-synovitis (32.1 ± 12.1 %) compared to those without (10.5 ± 10.4 %), confirming the ultrasound's ability to distinguish between the two groups (<em>t</em> = -3.44; <em>p</em> = 0.004; <em>d</em> = 2.01).</p></div><div><h3>Discussion</h3><p>Ultrasound detects bilateral IPFP signal intensity alterations in participants post-ACLR with MRI-confirmed Hoffa-synovitis. This work should be seen as a proof-of-concept, and further validation in a larger, more diverse sample is essential for verifying these results.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 1","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000023/pdfft?md5=ac7cc014c454e5cf1160d3e6e643fba5&pid=1-s2.0-S2772654124000023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139675819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-26DOI: 10.1016/j.ostima.2024.100173
Hayden F. Atkinson , Trevor B. Birmingham , Codie A. Primeau , Anthony A. Gatti , Rebecca F. Moyer , Jaques S. Milner , David W. Holdsworth , J. Robert Giffin
Objectives
The objectives of this study were: 1) to evaluate the effect of a functional loading stimulus on MRI-acquired T2 relaxation time (T2) and thickness of knee articular cartilage, and 2) to compare the response between patients at risk for knee OA and healthy controls.
Design
A total of 32 participants (16 healthy controls [24.7 ± 3.0 years], and 16 at-risk participants [37.5 ± 12.2]) underwent 3T MRI T2 mapping scans immediately before and after a standardized 25-minute functional loading stimulus on a computerized treadmill that included a variety of challenging walking conditions. Groups were defined using the Osteoarthritis Initiative Control (healthy) and Incidence Cohort (at-risk) Criteria. We analyzed changes in T2 between groups in the superficial and deep layers of tibiofemoral, patellar, and trochlear cartilage, and for tibiofemoral cartilage thickness using multivariate linear mixed-effects models.
Results
T2 was shorter in the superficial cartilage layers in both groups. The mean combined change (95 % confidence interval) in T2 of the superficial layer was -3.80 ms (-4.87; -2.73) for at-risk participants and -3.89 ms (-4.96; -2.82) for healthy controls. The between-group difference in change was 0.09 ms (-1.04; 1.22). There was a decrease in articular cartilage thickness in the lateral compartment for healthy controls (-0.14 mm [-0.24; -0.04]), otherwise there were no changes detected.
Conclusions
Consistently shorter T2 was observed in the articular cartilage of patients at risk for knee OA and in healthy controls, after a challenging walking test, but with no concurrent change in cartilage thickness, suggesting a similar articular cartilage response to functional loading.
{"title":"Effect of functional knee loading on articular cartilage MRI T2 relaxation time and thickness in patients at risk for knee osteoarthritis","authors":"Hayden F. Atkinson , Trevor B. Birmingham , Codie A. Primeau , Anthony A. Gatti , Rebecca F. Moyer , Jaques S. Milner , David W. Holdsworth , J. Robert Giffin","doi":"10.1016/j.ostima.2024.100173","DOIUrl":"10.1016/j.ostima.2024.100173","url":null,"abstract":"<div><h3>Objectives</h3><p>The objectives of this study were: 1) to evaluate the effect of a functional loading stimulus on MRI-acquired T2 relaxation time (T2) and thickness of knee articular cartilage, and 2) to compare the response between patients at risk for knee OA and healthy controls.</p></div><div><h3>Design</h3><p>A total of 32 participants (16 healthy controls [24.7 ± 3.0 years], and 16 at-risk participants [37.5 ± 12.2]) underwent 3T MRI T2 mapping scans immediately before and after a standardized 25-minute functional loading stimulus on a computerized treadmill that included a variety of challenging walking conditions. Groups were defined using the Osteoarthritis Initiative Control (healthy) and Incidence Cohort (at-risk) Criteria. We analyzed changes in T2 between groups in the superficial and deep layers of tibiofemoral, patellar, and trochlear cartilage, and for tibiofemoral cartilage thickness using multivariate linear mixed-effects models.</p></div><div><h3>Results</h3><p>T2 was shorter in the superficial cartilage layers in both groups. The mean combined change (95 % confidence interval) in T2 of the superficial layer was -3.80 ms (-4.87; -2.73) for at-risk participants and -3.89 ms (-4.96; -2.82) for healthy controls. The between-group difference in change was 0.09 ms (-1.04; 1.22). There was a decrease in articular cartilage thickness in the lateral compartment for healthy controls (-0.14 mm [-0.24; -0.04]), otherwise there were no changes detected.</p></div><div><h3>Conclusions</h3><p>Consistently shorter T2 was observed in the articular cartilage of patients at risk for knee OA and in healthy controls, after a challenging walking test, but with no concurrent change in cartilage thickness, suggesting a similar articular cartilage response to functional loading.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 1","pages":"Article 100173"},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000011/pdfft?md5=09a9c3b0461d441578786f1cf5cca52e&pid=1-s2.0-S2772654124000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139633062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/S2772-6541(24)00053-9
{"title":"Welcome to the 18th IWOAI","authors":"","doi":"10.1016/S2772-6541(24)00053-9","DOIUrl":"https://doi.org/10.1016/S2772-6541(24)00053-9","url":null,"abstract":"","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000539/pdfft?md5=895c995a7c683ddf6aa75fef814dc90a&pid=1-s2.0-S2772654124000539-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100216
N. Hendriks , F. Boel , H. Ahedi , V. Arbabi , N.K. Arden , M.A. van den Berg , C.G. Boer , M.M.A. van Buuren , F.M. Cicuttini , T.F. Cootes , K.M. Crossley , D.T. Felson , W.P. Gielis , J.J. Heerey , G. Jones , S. Kluzek , N.E. Lane , C. Lindner , J.A. Lynch , J.B.J. van Meurs , R. Agricola
INTRODUCTION
The center of rotation (CoR) on 2D hip radiographs is important for the calculation of different angles, for determining the presence of hip dysplasia. The hip joint CoR can be found as the center of a circle fitted to the femoral head. Since the acetabulum and femoral head are concentric, realistically their CoR projects on the hip joint CoR. The two methods to determine the CoR have surprisingly never been compared head-to-head.
OBJECTIVE
To determine and compare the CoR obtained from the convexity of the femoral head to the CoR obtained from the concave of the acetabulum in hips free of OA.
METHODS
Data from the Worldwide Collaboration on Osteoarthritis prediCtion for the Hip (World COACH) was used. Participants with no signs of OA in the standardized anteroposterior radiographs of the hip joints were selected (KL/croft grade = 0). The contour of the femoral head and acetabulum were outlined with points automatically placed using Bonefinder and the CoR based on the convexity of the femoral head and the acetabulum were calculated for each hip. With the x-, and y-coordinates of the CoRs of both methods, the directional distance between the points was calculated. Using the CoRs of both methods the LCEA and WCEA were calculated. In sensitivity analysis, the (mild) dysplasia (WCEA and LCEA<25°) cases, based on the femoral head method, were excluded.
RESULTS
The mean age of the participants (n = 13,683) was 59.0 ± 8.2 years, mean BMI 28.2 ± 4.8 kg/m2, and 61% was female. The mean radius of the circle fit of the femur was 27.25 mm (SD = 2.79). The mean radius of the circle fit based on the acetabulum was 34.17 mm (SD = 4.15). The mean difference between the x-coordinates of both methods was 1.76 mm (SD = 0.98), the mean difference between the y-coordinates of both methods was -2.66 mm (SD = 3.02), with a mean directional distance of 3.89 mm (SD = 2.27). Based on the CoR using the femoral head method the mean LCEA = 34.80° (SD = 5.89), mean WCEA = 29.67° (SD = 6.29), based on the CoR using the acetabulum method the mean LCEA = 30.41° (SD = 6.65), mean WCEA = 25.11° (SD = 6.80). After exclusion of the (mild) dysplasia cases the mean difference between the x-coordinates of both methods was 1.68 mm (SD = 0.84), the mean difference between the y-coordinates of both methods was -2.62 mm (SD = 2.81), with a mean directional distance of 3.71 mm (SD = 2.08). In Table 1, the number of participants with (mild) dysplastic hips are shown based on the different CoRs.
CONCLUSION
Based on the mean difference in x-, and y-coordinates per hip, the CoR based on the femoral head method is placed 1.76 mm more medially and 2.66 mm towards cranial direction compared to the CoR using the concave of the acetabulum, with a mean directional distance of 3.89 mm. The CoR determination is independent of the presence of (mild) dysplasia. However, amon
简介:二维髋关节X光片上的旋转中心(CoR)对于计算不同角度、确定是否存在髋关节发育不良非常重要。髋关节的旋转中心可以通过一个与股骨头相匹配的圆的中心来确定。由于髋臼和股骨头是同心的,因此现实中它们的CoR投影在髋关节CoR上。目标确定并比较在无 OA 的髋关节中,通过股骨头凸面获得的 CoR 与通过髋臼凹面获得的 CoR。方法使用髋关节骨性关节炎预后全球合作组织(World COACH)的数据。研究人员选择了在髋关节标准前后位X光片上无OA迹象的参与者(KL/croft分级=0)。用 Bonefinder 自动定位点勾勒出股骨头和髋臼的轮廓,并根据股骨头和髋臼的凸度计算出每个髋关节的 CoR。利用这两种方法计算出的 CoR 的 x 坐标和 y 坐标,计算出各点之间的方向距离。利用两种方法的 CoRs 计算出低密度EA 和中密度EA。在敏感性分析中,根据股骨头方法排除了(轻度)发育不良(WCEA 和 LCEA<25°)病例。结果参与者(n = 13,683)的平均年龄为 59.0 ± 8.2 岁,平均体重指数为 28.2 ± 4.8 kg/m2,61% 为女性。股骨圆拟合半径的平均值为 27.25 毫米(SD = 2.79)。基于髋臼的圆拟合半径的平均值为 34.17 毫米(标准差 = 4.15)。两种方法的 x 坐标之间的平均差值为 1.76 mm(SD = 0.98),两种方法的 y 坐标之间的平均差值为 -2.66 mm(SD = 3.02),平均方向距离为 3.89 mm(SD = 2.27)。根据使用股骨头方法得出的CoR,平均LCEA=34.80°(SD=5.89),平均WCEA=29.67°(SD=6.29);根据使用髋臼方法得出的CoR,平均LCEA=30.41°(SD=6.65),平均WCEA=25.11°(SD=6.80)。排除(轻度)发育不良病例后,两种方法的 x 坐标平均差值为 1.68 mm(SD = 0.84),两种方法的 y 坐标平均差值为 -2.62 mm(SD = 2.81),平均方向距离为 3.71 mm(SD = 2.08)。结论根据每个髋关节 x 坐标和 y 坐标的平均差异,与使用髋臼凹面的 CoR 相比,使用股骨头方法的 CoR 更偏向内侧 1.76 mm,偏向头颅方向 2.66 mm,平均方向距离为 3.89 mm。CoR的确定与是否存在(轻度)发育不良无关。然而,在(轻度)发育不良的髋关节中,不同方法对发育不良分类的差异要比非发育不良髋关节大得多。目前的方法不能互换使用。
{"title":"HEAD-TO-HEAD COMPARISON BETWEEN THE CENTER OF ROTATION BASED ON THE SPHERICAL FEMORAL HEAD AND THE HEMISPHERICAL ACETABULUM","authors":"N. Hendriks , F. Boel , H. Ahedi , V. Arbabi , N.K. Arden , M.A. van den Berg , C.G. Boer , M.M.A. van Buuren , F.M. Cicuttini , T.F. Cootes , K.M. Crossley , D.T. Felson , W.P. Gielis , J.J. Heerey , G. Jones , S. Kluzek , N.E. Lane , C. Lindner , J.A. Lynch , J.B.J. van Meurs , R. Agricola","doi":"10.1016/j.ostima.2024.100216","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100216","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>The center of rotation (CoR) on 2D hip radiographs is important for the calculation of different angles, for determining the presence of hip dysplasia. The hip joint CoR can be found as the center of a circle fitted to the femoral head. Since the acetabulum and femoral head are concentric, realistically their CoR projects on the hip joint CoR. The two methods to determine the CoR have surprisingly never been compared head-to-head.</p></div><div><h3>OBJECTIVE</h3><p>To determine and compare the CoR obtained from the convexity of the femoral head to the CoR obtained from the concave of the acetabulum in hips free of OA.</p></div><div><h3>METHODS</h3><p>Data from the Worldwide Collaboration on Osteoarthritis prediCtion for the Hip (World COACH) was used. Participants with no signs of OA in the standardized anteroposterior radiographs of the hip joints were selected (KL/croft grade = 0). The contour of the femoral head and acetabulum were outlined with points automatically placed using Bonefinder and the CoR based on the convexity of the femoral head and the acetabulum were calculated for each hip. With the x-, and y-coordinates of the CoRs of both methods, the directional distance between the points was calculated. Using the CoRs of both methods the LCEA and WCEA were calculated. In sensitivity analysis, the (mild) dysplasia (WCEA and LCEA<25°) cases, based on the femoral head method, were excluded.</p></div><div><h3>RESULTS</h3><p>The mean age of the participants (n = 13,683) was 59.0 ± 8.2 years, mean BMI 28.2 ± 4.8 kg/m2, and 61% was female. The mean radius of the circle fit of the femur was 27.25 mm (SD = 2.79). The mean radius of the circle fit based on the acetabulum was 34.17 mm (SD = 4.15). The mean difference between the x-coordinates of both methods was 1.76 mm (SD = 0.98), the mean difference between the y-coordinates of both methods was -2.66 mm (SD = 3.02), with a mean directional distance of 3.89 mm (SD = 2.27). Based on the CoR using the femoral head method the mean LCEA = 34.80° (SD = 5.89), mean WCEA = 29.67° (SD = 6.29), based on the CoR using the acetabulum method the mean LCEA = 30.41° (SD = 6.65), mean WCEA = 25.11° (SD = 6.80). After exclusion of the (mild) dysplasia cases the mean difference between the x-coordinates of both methods was 1.68 mm (SD = 0.84), the mean difference between the y-coordinates of both methods was -2.62 mm (SD = 2.81), with a mean directional distance of 3.71 mm (SD = 2.08). In Table 1, the number of participants with (mild) dysplastic hips are shown based on the different CoRs.</p></div><div><h3>CONCLUSION</h3><p>Based on the mean difference in x-, and y-coordinates per hip, the CoR based on the femoral head method is placed 1.76 mm more medially and 2.66 mm towards cranial direction compared to the CoR using the concave of the acetabulum, with a mean directional distance of 3.89 mm. The CoR determination is independent of the presence of (mild) dysplasia. However, amon","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000448/pdfft?md5=227b0ebdb0f588849ec70f9e2dd213c2&pid=1-s2.0-S2772654124000448-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100188
K. Moradi , S. Mohammadi , B. Mohajer , F.W. Roemer , S. Momtazmanesh , Q. Hathaway , H.A. Ibad , D.J. Hunter , A. Guermazi , S. Demehri
INTRODUCTION
Bone marrow lesions (BMLs) are a risk factor for incident knee OA and deep-learning (DL) methods can help in automated segmentation and risk prediction.
OBJECTIVE
To develop and validate a DL model for quantifying tibiofemoral BML volume from MRIs in knees without radiographic OA and assess the association between longitudinal changes and knee OA incidence.
METHODS
The DL model segmented tibiofemoral joint into 10 subregions (akin to MRI Osteoarthritis Knee Score (MOAKS) system) and measured BML volume in each subregion. Baseline and 4th-year follow-up MRIs from 4700 participants (9400 knees) of the OAI cohort were analyzed. Knees without OA at baseline (KLG<2) were categorized into three groups based on 4-year BML volume changes: BML-free, regressing BML, and progressive BML. Over a 9-year period, the risk of radiographic and symptomatic knee OA incidence was compared among these groups.
RESULTS
We included 3869 non-OA knees from 2430 participants (age mean ± SD: 59.5±9.0, female/male:1.3). At the 4th-year follow-up, 2216 remained BML-free, 1106 showed an increase, and 547 showed a decrease in BML volume. Knees with progressive BML had a higher risk of radiographic knee OA incidence compared to BML-free (HR:3.01, P<0.001) and regressing BML (HR:2.00, P<0.001) knees. They also had a higher risk for symptomatic OA incidence compared to BML-free knees (HR:1.25, P:0.001). Larger volume changes in BML progression were associated with a higher risk of knee OA incidence (radiographic HR:1.95, symptomatic HR:1.70, P-values<0.001). In all subchondral plates, especially the medial femur and tibia, BML progression was associated with a higher risk of developing both radiographic and symptomatic knee OA compared to BML-free plates.
CONCLUSION
Progressive BMLs, according to the subregion and volume changes extent, are associated with an increased risk of OA incidence compared to BML-free or regressing BML knees, emphasizing the importance of monitoring BML volume changes in evaluating early interventions to prevent OA incidence.
{"title":"PROGRESSION OF BONE MARROW LESION VOLUME IS ASSOCIATED WITH AN INCREASED RISK OF RADIOGRAPHIC AND SYMTOMATIC KNEE OSTEOARTHRITIS: A PROSPECTIVE ANALYSIS OF KNEE MRIS FROM OSTEOARTHRITIS INITIATIVE COHORT","authors":"K. Moradi , S. Mohammadi , B. Mohajer , F.W. Roemer , S. Momtazmanesh , Q. Hathaway , H.A. Ibad , D.J. Hunter , A. Guermazi , S. Demehri","doi":"10.1016/j.ostima.2024.100188","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100188","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Bone marrow lesions (BMLs) are a risk factor for incident knee OA and deep-learning (DL) methods can help in automated segmentation and risk prediction.</p></div><div><h3>OBJECTIVE</h3><p>To develop and validate a DL model for quantifying tibiofemoral BML volume from MRIs in knees without radiographic OA and assess the association between longitudinal changes and knee OA incidence.</p></div><div><h3>METHODS</h3><p>The DL model segmented tibiofemoral joint into 10 subregions (akin to MRI Osteoarthritis Knee Score (MOAKS) system) and measured BML volume in each subregion. Baseline and 4<sup>th</sup>-year follow-up MRIs from 4700 participants (9400 knees) of the OAI cohort were analyzed. Knees without OA at baseline (KLG<2) were categorized into three groups based on 4-year BML volume changes: BML-free, regressing BML, and progressive BML. Over a 9-year period, the risk of radiographic and symptomatic knee OA incidence was compared among these groups.</p></div><div><h3>RESULTS</h3><p>We included 3869 non-OA knees from 2430 participants (age mean ± SD: 59.5±9.0, female/male:1.3). At the 4<sup>th</sup>-year follow-up, 2216 remained BML-free, 1106 showed an increase, and 547 showed a decrease in BML volume. Knees with progressive BML had a higher risk of radiographic knee OA incidence compared to BML-free (HR:3.01, P<0.001) and regressing BML (HR:2.00, P<0.001) knees. They also had a higher risk for symptomatic OA incidence compared to BML-free knees (HR:1.25, P:0.001). Larger volume changes in BML progression were associated with a higher risk of knee OA incidence (radiographic HR:1.95, symptomatic HR:1.70, P-values<0.001). In all subchondral plates, especially the medial femur and tibia, BML progression was associated with a higher risk of developing both radiographic and symptomatic knee OA compared to BML-free plates.</p></div><div><h3>CONCLUSION</h3><p>Progressive BMLs, according to the subregion and volume changes extent, are associated with an increased risk of OA incidence compared to BML-free or regressing BML knees, emphasizing the importance of monitoring BML volume changes in evaluating early interventions to prevent OA incidence.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100188"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000163/pdfft?md5=faee3b96e63e5da066e94bc85850ed02&pid=1-s2.0-S2772654124000163-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100206
M.P. Jansen , T.D. Turmezei , K. Dattani , D.A. Kessler , S.C. Mastbergen , M. Kloppenburg , F.J. Blanco , I.K. Haugen , F. Berenbaum , W. Wirth , F. Eckstein , F.W. Roemer , J.W. Mackay
INTRODUCTION
Most participants of the IMI-APPROACH knee OA cohort displayed cartilage damage, based on quantitative (segmentation-based) MRI morphometry and MOAKS scoring, predominantly in the medial tibiofemoral compartment. Cartilage surface mapping (CaSM) is a quantitative 3D analytic method that, unconstrained by subregional boundaries, can demonstrate visually how cartilage thickness varies across a joint.
OBJECTIVE
The purpose of this cross-sectional study was to evaluate cartilage thickness distribution in knee OA patients using CaSM, and to analyze how it varies amongst demographic, radiographic, and MRI structural pathology strata.
METHODS
The cohort included 297 participants with clinical knee OA. 1.5T or 3T MRI 3D gradient echo sequences were acquired at baseline and follow-up, with only baseline being used in the current analysis. Semi-automatic segmentation of the femoral and tibial cartilage was performed using Stradview. Segmentations were registered to canonical surfaces using wxRegSurf and analyzed in MATLAB. The relationship between demographic and structural pathology strata on the cartilage thickness distribution was analyzed using statistical parametric mapping (SPM). SPM allows for vertex-wise comparisons and delivers multiple-comparison-corrected F-test statistics, using the Surfstat MATLAB package. p<0.05 was used as the threshold for statistical significance. Sex, age, and BMI were examined (demographic factors). Presence of radiographic OA (ROA; KLG≥2) and degree of medial/lateral JSN were studied as radiographic factors, and MOAKS BMLs and meniscal extrusion (scored on intermediate-weighted fat-suppressed sequences) as MRI structural pathology features, in individual models. Analysis differentiating patients with and without ROA was performed in addition.
RESULTS
287 patients could be analyzed (age 66.4±7.1, BMI 28.0±5.2, 78% female, 55% ROA). Male patients had significantly thicker cartilage across the entire joint, especially the tibiae and trochlea (Figure 1). Age showed a pronounced effect in the trochlea and (central) medial and lateral tibia, with older patients having thinner cartilage (independent of radiographic status); BMI was not significantly associated with cartilage thickness in any region (Figure 1). Patients with ROA showed significantly thinner cartilage in the tibiae and medial femur than those without ROA, but thicker cartilage in the trochlea and lateral femur (Figure 1). Patients with JSN showed opposite effects depending on direction: those with medial JSN displayed significantly thinner cartilage in the medial, and those with lateral JSN in the lateral compartment (Figure 2). Meniscal extrusion results were very similar to JSN results (Figure 2). Presence of BMLs in any subregion of a compartment (lateral/medial FT and PF) was associated with thinner cartilage throughout that entire compartment (Figure 3
{"title":"DISTRIBUTION IN KNEE OSTEOARTHRITIS - IMPACT OF DEMOGRAPHIC, RADIOGRAPHIC & MRI STRUCTURAL PATHOLOGY STRATA: DATA FROM THE IMI-APPROACH COHORT","authors":"M.P. Jansen , T.D. Turmezei , K. Dattani , D.A. Kessler , S.C. Mastbergen , M. Kloppenburg , F.J. Blanco , I.K. Haugen , F. Berenbaum , W. Wirth , F. Eckstein , F.W. Roemer , J.W. Mackay","doi":"10.1016/j.ostima.2024.100206","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100206","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Most participants of the IMI-APPROACH knee OA cohort displayed cartilage damage, based on quantitative (segmentation-based) MRI morphometry and MOAKS scoring, predominantly in the medial tibiofemoral compartment. Cartilage surface mapping (CaSM) is a quantitative 3D analytic method that, unconstrained by subregional boundaries, can demonstrate visually how cartilage thickness varies across a joint.</p></div><div><h3>OBJECTIVE</h3><p>The purpose of this cross-sectional study was to evaluate cartilage thickness distribution in knee OA patients using CaSM, and to analyze how it varies amongst demographic, radiographic, and MRI structural pathology strata.</p></div><div><h3>METHODS</h3><p>The cohort included 297 participants with clinical knee OA. 1.5T or 3T MRI 3D gradient echo sequences were acquired at baseline and follow-up, with only baseline being used in the current analysis. Semi-automatic segmentation of the femoral and tibial cartilage was performed using Stradview. Segmentations were registered to canonical surfaces using wxRegSurf and analyzed in MATLAB. The relationship between demographic and structural pathology strata on the cartilage thickness distribution was analyzed using statistical parametric mapping (SPM). SPM allows for vertex-wise comparisons and delivers multiple-comparison-corrected F-test statistics, using the Surfstat MATLAB package. p<0.05 was used as the threshold for statistical significance. Sex, age, and BMI were examined (demographic factors). Presence of radiographic OA (ROA; KLG≥2) and degree of medial/lateral JSN were studied as radiographic factors, and MOAKS BMLs and meniscal extrusion (scored on intermediate-weighted fat-suppressed sequences) as MRI structural pathology features, in individual models. Analysis differentiating patients with and without ROA was performed in addition.</p></div><div><h3>RESULTS</h3><p>287 patients could be analyzed (age 66.4±7.1, BMI 28.0±5.2, 78% female, 55% ROA). Male patients had significantly thicker cartilage across the entire joint, especially the tibiae and trochlea (Figure 1). Age showed a pronounced effect in the trochlea and (central) medial and lateral tibia, with older patients having thinner cartilage (independent of radiographic status); BMI was not significantly associated with cartilage thickness in any region (Figure 1). Patients with ROA showed significantly thinner cartilage in the tibiae and medial femur than those without ROA, but thicker cartilage in the trochlea and lateral femur (Figure 1). Patients with JSN showed opposite effects depending on direction: those with medial JSN displayed significantly thinner cartilage in the medial, and those with lateral JSN in the lateral compartment (Figure 2). Meniscal extrusion results were very similar to JSN results (Figure 2). Presence of BMLs in any subregion of a compartment (lateral/medial FT and PF) was associated with thinner cartilage throughout that entire compartment (Figure 3","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000345/pdfft?md5=b3dc03396a970cc39c0d291ae5297a3a&pid=1-s2.0-S2772654124000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100209
J.G. Raya , A. Duarte , R. Kijowski , S. Krasnokutsky-Samuels , J. Samuels , A. Ruiz
INTRODUCTION
Assessment of disease progression in patients with incipient OA remains a major challenge. Quantitative imaging biomarkers have the advantage of being sensitive to changes in cartilage composition, which represent an early feature of the disease. Several MRI parameters have shown sensitive to PG content, but only T2 being partially sensitive to collagen. Diffusion tensor imaging (DTI) was introduced as a biomarker specific for PG content (MD) and collagen structure (FA) and has demonstrated to be a promising biomarker to diagnose OA.
OBJECTIVE
To validate DTI and T2 of articular cartilage at 3T as biomarkers for OA progression in a population at early stages of the disease and high likelihood of short-term progression.
METHODS
Study design. We recruited 60 subjects (m/f=23/37, age=61±8 y, BMl=30.7±6.4 kg/cm2) with unilateral knee OA (symptomatic with KL≥2) and incipient OA in the contralateral knee (KL=1, no history of injury). We focused on the KL=1 knees since they were at an early stage of disease and had high likelihood of progression according to the OAI dataset. At baseline all subjects underwent a clinical assessment, provided x-rays of the bilateral knees, and MRI of the KL=1 knee. Forty subjects returned for 3-years follow-up evaluation, which included clinical assessment and x-rays of the bilateral knees to capture clinical endpoint for progression. Medial and lateral JSW was measured at each time point in the KL=1 knees. JSN was calculated in the lateral and medial compartments. A JSN >0.7 mm was considered progression.
MRI. The 3T protocol included a radial imaging spin-echo diffusion (RAISED) sequence for DTI measure (TE/TR=35/1500 ms, 105 spokes/image, 6 directions, b-values=0, 300 s/mm2, resolution 0.6 × 0.6 × 3 mm3), and a multi echo T2-weighted sequence for T2 calculation (TE=10.5 to 126 ms, train length 12, echo train 10.5 ms, TR=4.3s, resolution 0.6 × 0.6 × 3 mm3). Diffusion-weighted images were reconstructed using a non-linear motion correction. Cartilage regions (TrF, LF, MF, MT, LT, and P) were segmented. T2 and DTI parameter maps of mean diffusivity (MD) and fractional anisotropy (FA) were calculated averaged over every region.
Statistics. Pearson or Spearman coefficients were used to evaluate the association between baseline MRI parameters and biological variables (age, sex, and BMI), and 3-year radiographic progression (JSN, change in KL). Partial correlations were performed to correct for biological variables. Group differences between progressors and non-progressors were assessed using either a two-sided unpaired t-test or Wilcoxon test depending on normality of the data (K-S test). Finally, a stepwise forward algorithm was used including both biological variables and [DTI and T2] to identify the op
{"title":"DTI AS A BIOMARKER TO PREDICT PROGRESSION IN EARLY OA","authors":"J.G. Raya , A. Duarte , R. Kijowski , S. Krasnokutsky-Samuels , J. Samuels , A. Ruiz","doi":"10.1016/j.ostima.2024.100209","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100209","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Assessment of disease progression in patients with incipient OA remains a major challenge. Quantitative imaging biomarkers have the advantage of being sensitive to changes in cartilage composition, which represent an early feature of the disease. Several MRI parameters have shown sensitive to PG content, but only T<sub>2</sub> being partially sensitive to collagen. Diffusion tensor imaging (DTI) was introduced as a biomarker specific for PG content (MD) and collagen structure (FA) and has demonstrated to be a promising biomarker to diagnose OA.</p></div><div><h3>OBJECTIVE</h3><p>To validate DTI and T<sub>2</sub> of articular cartilage at 3T as biomarkers for OA progression in a population at early stages of the disease and high likelihood of short-term progression.</p></div><div><h3>METHODS</h3><p><u>Study design</u>. We recruited 60 subjects (m/f=23/37, age=61±8 y, BMl=30.7±6.4 kg/cm<sup>2</sup>) with unilateral knee OA (symptomatic with KL≥2) and incipient OA in the contralateral knee (KL=1, no history of injury). We focused on the KL=1 knees since they were at an early stage of disease and had high likelihood of progression according to the OAI dataset. At baseline all subjects underwent a clinical assessment, provided x-rays of the bilateral knees, and MRI of the KL=1 knee. Forty subjects returned for 3-years follow-up evaluation, which included clinical assessment and x-rays of the bilateral knees to capture clinical endpoint for progression. Medial and lateral JSW was measured at each time point in the KL=1 knees. JSN was calculated in the lateral and medial compartments. A JSN >0.7 mm was considered progression.</p><p><u>MRI.</u> The 3T protocol included a radial imaging spin-echo diffusion (RAISED) sequence for DTI measure (TE/TR=35/1500 ms, 105 spokes/image, 6 directions, b-values=0, 300 s/mm<sup>2</sup>, resolution 0.6 × 0.6 × 3 mm<sup>3</sup>), and a multi echo T<sub>2</sub>-weighted sequence for T<sub>2</sub> calculation (TE=10.5 to 126 ms, train length 12, echo train 10.5 ms, TR=4.3s, resolution 0.6 × 0.6 × 3 mm<sup>3</sup>). Diffusion-weighted images were reconstructed using a non-linear motion correction. Cartilage regions (TrF, LF, MF, MT, LT, and P) were segmented. T<sub>2</sub> and DTI parameter maps of mean diffusivity (MD) and fractional anisotropy (FA) were calculated averaged over every region.</p><p><u>Statistics.</u> Pearson or Spearman coefficients were used to evaluate the association between baseline MRI parameters and biological variables (age, sex, and BMI), and 3-year radiographic progression (JSN, change in KL). Partial correlations were performed to correct for biological variables. Group differences between progressors and non-progressors were assessed using either a two-sided unpaired t-test or Wilcoxon test depending on normality of the data (K-S test). Finally, a stepwise forward algorithm was used including both biological variables and [DTI and T<sub>2</sub>] to identify the op","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000370/pdfft?md5=2d557e7440cc33b0c3c7cfa1434934e9&pid=1-s2.0-S2772654124000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100200
N.A. Segal , J.A. Lynch
INTRODUCTION
MRI and CT can provide valuable 3D information on joint structures but are generally acquired in a non-functional position. The Multicenter Osteoarthritis Study (MOST) will address this serious limitation through using low-dose weight-bearing CT (WBCT) to obtain 3D images of the bilateral hips, knees, ankles/feet in a standing position, while also maintaining continuity with previous MOST exams by acquiring both 3D WBCT and knee radiographs using the Synaflexer frame used for all previous MOST knee x-rays. This imaging protocol takes about the same time as PA and lateral knee x-rays, while providing a wealth of additional information that will enable future opportunities to investigate novel questions about OA using 3D imaging of all the joints in the lower limb kinetic chain in a functionally loaded position.
OBJECTIVE
To standardize the 3D lower limb joints (hips, knees, feet/ankles) imaging procedures using WBCT and knee radiographs using the Planmed XFI scanner.
METHODS
The XFI permits efficient scans (46sec per scan for the hips, knees, and feet/ankles respectively) with excellent image quality (least artifact among WBCT scanners and resolution 150–300µm), with effective algorithms for correction of participant motion and metal artifacts, thereby minimizing the need to repeat scans. The gantry diameter of 85cm permits larger bodies or people with knee flexion contractures to be scanned and has a 43.2 × 43.2cm flat panel detector with pixel size 148µm and source distance of 80cm, providing superior imaging capabilities. Average effective radiation doses are acceptable (20µSv, 26.5µSv, and 629µSv for 3D WBCT of the feet/ankles, knees, and hips and 7µSv total for bilateral knee and hand radiographs), automatic exposure control (AEC) optimizes image quality vs. radiation dose.
RESULTS
Participants stand on a platform facing the vertical table, with their feet pressed against the Perspex Synaflexor frame with aluminum beads to position their feet in 5 degrees external rotation (10° between medial sides of feet) and their great toes at the edge of the positioner closest to the table. They stand with equal weight on each foot and with their patellae and front of their thighs pressed against the vertical table, holding handholds and with a Velcro strap around the table and their thighs for safety during the standing scan. The XFI and participant position is adjusted so that: the coronal laser passes through the greater trochanters, posterior to the knees and through the midfoot; the sagittal laser passes in the center between the lower limbs and the axial laser is positioned for each joint of interest. For an average size adult, 3D images of the hip are acquired at 120 kV, 450 mAs, bowtie filter on and using AEC, and knees, feet/ankles at 96 kV, 180 mAs. To scan the hips, the gantry is lowered until the axial laser is at the level 2 inches above t
引言MRI 和 CT 可以提供关节结构的宝贵三维信息,但通常是在非功能性体位下获取的。多中心骨关节炎研究(MOST)将通过使用低剂量负重 CT(WBCT)获取双侧髋关节、膝关节、踝关节/足部的站立位三维图像来解决这一严重的局限性,同时还将通过使用以往所有 MOST 膝关节 X 光片所使用的 Synaflexer 架获取三维 WBCT 和膝关节 X 光片来保持与以往 MOST 检查的连续性。该成像方案所需的时间与 PA 和膝关节侧位 X 光片差不多,但却能提供大量的额外信息,从而为将来利用功能负荷位置下肢运动链中所有关节的三维成像研究有关 OA 的新问题提供机会。方法XFI可进行高效扫描(髋关节、膝关节和足/踝关节的每次扫描时间分别为46秒),图像质量极佳(在WBCT扫描仪中伪影最少,分辨率为150-300µm),并采用有效算法对参与者的运动和金属伪影进行校正,从而最大限度地减少重复扫描的需要。该扫描仪的龙门直径为 85 厘米,可对较大的身体或膝关节屈曲挛缩者进行扫描,其平板探测器尺寸为 43.2 × 43.2 厘米,像素大小为 148 微米,光源距离为 80 厘米,具有卓越的成像能力。平均有效辐射剂量是可接受的(脚/踝、膝和髋关节的 3D WBCT 分别为 20µSv、26.5µSv 和 629µSv,双侧膝关节和手部射线照片的总剂量为 7µSv),自动曝光控制 (AEC) 优化了图像质量与辐射剂量的关系。结果参试者站在一个平台上,面向垂直的工作台,双脚紧贴带有铝珠的 Perspex Synaflexor 框架,双脚外旋 5 度(双脚内侧之间为 10°),大脚趾位于最靠近工作台的定位器边缘。在站立扫描过程中,他们每只脚的重量相等,髌骨和大腿前部紧贴垂直台面,手持支架,台面和大腿上有尼龙搭扣带,以确保安全。调整 XFI 和参与者的位置,使冠状激光穿过大转子、膝盖后方和中足;矢状激光穿过下肢之间的中心;轴向激光定位到每个感兴趣的关节。对于普通体型的成年人,髋关节的三维图像是在 120 kV、450 mAs、弓形滤波器开启并使用 AEC 的情况下采集的,膝关节、脚/踝关节的三维图像是在 96 kV、180 mAs 的情况下采集的。扫描髋部时,将龙门架降低,直到轴向激光位于大转子上方 2 英寸处。扫描图像用于确认是否包含髋部感兴趣区、准直曝光和设置 AEC。完成髋部扫描后,降低龙门架,直到轴向激光穿过腘窝皱襞。膝关节图像采集完成后,降低龙门架,直到轴向激光穿过第五跖骨,脚/踝关节三维图像采集完成。旋转龙门架,使受试者靠在与 X 射线探测器成 80° 角的 Synaflexor 框架上。该框架由 90° Synaflexor 框架改装而成,以考虑到 XFI 的水平光束角度。对于需要 10° 光束角以优化固定屈曲 X 光中胫骨内侧平台 (MTP) 成像的膝关节,无需进行额外调整。对于需要 5° 或 15° X 光束角的膝关节,在获取站立双侧固定屈曲 PA X 光片时,在改良型 Synaflexor 架的底部放置一个 5° 楔形,以实现光束与 MTP 之间的等效相对角度(图)。随后,分别采集左膝和右膝的侧视放射线照片。参试者感兴趣的腿放置在探测器旁边并与之平行,大脚趾尖与垂直的 Perspex 片接触,对侧脚趾与脚跟后部持平,从而使膝关节的屈曲角度达到 40-50 度。
{"title":"PROTOCOL FOR ACQUISITION OF 3D IMAGING OF BILATERAL FOOT, ANKLE, KNEE, AND HIP JOINTS WITH WEIGHT-BEARING CT (WBCT)","authors":"N.A. Segal , J.A. Lynch","doi":"10.1016/j.ostima.2024.100200","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100200","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>MRI and CT can provide valuable 3D information on joint structures but are generally acquired in a non-functional position. The Multicenter Osteoarthritis Study (MOST) will address this serious limitation through using low-dose weight-bearing CT (WBCT) to obtain 3D images of the bilateral hips, knees, ankles/feet in a standing position, while also maintaining continuity with previous MOST exams by acquiring both 3D WBCT and knee radiographs using the Synaflexer frame used for all previous MOST knee x-rays. This imaging protocol takes about the same time as PA and lateral knee x-rays, while providing a wealth of additional information that will enable future opportunities to investigate novel questions about OA using 3D imaging of all the joints in the lower limb kinetic chain in a functionally loaded position.</p></div><div><h3>OBJECTIVE</h3><p>To standardize the 3D lower limb joints (hips, knees, feet/ankles) imaging procedures using WBCT and knee radiographs using the Planmed XFI scanner.</p></div><div><h3>METHODS</h3><p>The XFI permits efficient scans (46sec per scan for the hips, knees, and feet/ankles respectively) with excellent image quality (least artifact among WBCT scanners and resolution 150–300µm), with effective algorithms for correction of participant motion and metal artifacts, thereby minimizing the need to repeat scans. The gantry diameter of 85cm permits larger bodies or people with knee flexion contractures to be scanned and has a 43.2 × 43.2cm flat panel detector with pixel size 148µm and source distance of 80cm, providing superior imaging capabilities. Average effective radiation doses are acceptable (20µSv, 26.5µSv, and 629µSv for 3D WBCT of the feet/ankles, knees, and hips and 7µSv total for bilateral knee and hand radiographs), automatic exposure control (AEC) optimizes image quality vs. radiation dose.</p></div><div><h3>RESULTS</h3><p>Participants stand on a platform facing the vertical table, with their feet pressed against the Perspex Synaflexor frame with aluminum beads to position their feet in 5 degrees external rotation (10° between medial sides of feet) and their great toes at the edge of the positioner closest to the table. They stand with equal weight on each foot and with their patellae and front of their thighs pressed against the vertical table, holding handholds and with a Velcro strap around the table and their thighs for safety during the standing scan. The XFI and participant position is adjusted so that: the coronal laser passes through the greater trochanters, posterior to the knees and through the midfoot; the sagittal laser passes in the center between the lower limbs and the axial laser is positioned for each joint of interest. For an average size adult, 3D images of the hip are acquired at 120 kV, 450 mAs, bowtie filter on and using AEC, and knees, feet/ankles at 96 kV, 180 mAs. To scan the hips, the gantry is lowered until the axial laser is at the level 2 inches above t","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277265412400028X/pdfft?md5=b1164690ab7719afdf46cd5261234fc0&pid=1-s2.0-S277265412400028X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100217
V. Janacova , V. Juras , P. Szomolanyi , S. Trattnig
INTRODUCTION
Non-invasive monitoring of VC using segmentation of MRI images has become vital part of clinical trials and longitudinal OA studies. Many parts of protocol such as MR sequence parameters, MR hardware or time between follow-ups are fixed to ensure that the observed change in VC caused by degenerative/regenerative processes and not by other confounders. Consistent patient positioning during follow-up visits improves the overall precision, however due to various reasons, such as pain, same positioning might not be possible.
OBJECTIVE
Objective of this study was to assess an effect of the patient positioning on the femoral VC.
METHODS
The left knees of eight healthy volunteers (4 male, 4 female, mean age: 35.5 ± 10.2 years) were scanned on 3T Siemens PrismaFit (Siemens Healthineers AG, Forchheim, Germany). The 3D DESS (TE=5ms, TR=14.1ms, 160 slices, 0.6x0.6x0.6mm3, flip angle=25°, acquisition=5:58min) was used. Each volunteer's patella center was marked with a black line, and two additional lines spaced 1cm apart were drawn on each side. A dedicated 15-channel knee coil was positioned to align these lines with the scanner laser, resulting in five different knee positions: neutral, two medial rotations, and two lateral rotations. Knee rotation angles were measured using RadiAnt DICOM Viewer (Medixant, Poznań, Poland) (Fig. 1). Images were segmented automatically using MR ChondralHealth version 3.1 research application software (Siemens Healthineers AG, Forchheim, Germany), then manually edited if needed. Voxel volume times number of voxels yielded the VC for nine femoral cartilage regions: medial anterior (MaF)/central (McF)/posterior (MpF); trochlear lateral (TL)/central (TC)/medial (TM) and lateral anterior (LaF)/central (LcF)/posterior (LpF). The correlation between knee rotation angle and VC was assessed using Spearman's correlation coefficient.
While there are observable correlations between knee rotation angle and femoral VC in healthy individuals, these correlations are generally weak and vary across different cartilage regions. Volume of trochlear cartilage is essentially unaffected by knee positioning, while the posterior condyle region exhibit weak negative correlation, implying the false VC decrease. Further quantification of the effect using linear mixed effects models is planned in the future. While the impact of positioning on VC is negligible, if the anticipated change in VC is expected to be small in longitudinal studies, it's crucial to validate the intended segmentation method in comparable situations.
{"title":"EFFECT OF KNEE POSITIONING DURING MRI SCAN ON SEGMENTED CARTILAGE VOLUME","authors":"V. Janacova , V. Juras , P. Szomolanyi , S. Trattnig","doi":"10.1016/j.ostima.2024.100217","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100217","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Non-invasive monitoring of VC using segmentation of MRI images has become vital part of clinical trials and longitudinal OA studies. Many parts of protocol such as MR sequence parameters, MR hardware or time between follow-ups are fixed to ensure that the observed change in VC caused by degenerative/regenerative processes and not by other confounders. Consistent patient positioning during follow-up visits improves the overall precision, however due to various reasons, such as pain, same positioning might not be possible.</p></div><div><h3>OBJECTIVE</h3><p>Objective of this study was to assess an effect of the patient positioning on the femoral VC.</p></div><div><h3>METHODS</h3><p>The left knees of eight healthy volunteers (4 male, 4 female, mean age: 35.5 ± 10.2 years) were scanned on 3T Siemens PrismaFit (Siemens Healthineers AG, Forchheim, Germany). The 3D DESS (TE=5ms, TR=14.1ms, 160 slices, 0.6x0.6x0.6mm3, flip angle=25°, acquisition=5:58min) was used. Each volunteer's patella center was marked with a black line, and two additional lines spaced 1cm apart were drawn on each side. A dedicated 15-channel knee coil was positioned to align these lines with the scanner laser, resulting in five different knee positions: neutral, two medial rotations, and two lateral rotations. Knee rotation angles were measured using RadiAnt DICOM Viewer (Medixant, Poznań, Poland) (Fig. 1). Images were segmented automatically using MR ChondralHealth version 3.1 research application software (Siemens Healthineers AG, Forchheim, Germany), then manually edited if needed. Voxel volume times number of voxels yielded the VC for nine femoral cartilage regions: medial anterior (MaF)/central (McF)/posterior (MpF); trochlear lateral (TL)/central (TC)/medial (TM) and lateral anterior (LaF)/central (LcF)/posterior (LpF). The correlation between knee rotation angle and VC was assessed using Spearman's correlation coefficient.</p></div><div><h3>RESULTS</h3><p>Observed correlations were as follows: MaF = -0.06, McF = -0.18, MpF = -0.3, TL = 0.07, TC = 0.05, TM = 0.01, LaF = 0.15, LcF = -0.12, LpF = -0.2.</p></div><div><h3>CONCLUSION</h3><p>While there are observable correlations between knee rotation angle and femoral VC in healthy individuals, these correlations are generally weak and vary across different cartilage regions. Volume of trochlear cartilage is essentially unaffected by knee positioning, while the posterior condyle region exhibit weak negative correlation, implying the false VC decrease. Further quantification of the effect using linear mixed effects models is planned in the future. While the impact of positioning on VC is negligible, if the anticipated change in VC is expected to be small in longitudinal studies, it's crucial to validate the intended segmentation method in comparable situations.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277265412400045X/pdfft?md5=4f5086fb89466aacaf637bf2ddcdadc3&pid=1-s2.0-S277265412400045X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100193
M.A. Kamphuis , E.H.G. Oei , J. Runhaar , D. Hanff , S.M.A. Bierma-Zeinstra , S. Klein , J. Hirvasniemi
INTRODUCTION
Exploring ways to improve methodologies for model training in MRI-based segmentation tasks is important for enhancing segmentation accuracy. Accurate automated segmentations are essential for applications including the extraction of imaging biomarkers. Leveraging advanced deep learning techniques, such as nnU-Net, holds promise for achieving precise segmentations. Additionally, incorporating multiple image outputs from Dixon MRI into these methodologies could improve segmentation performance.
OBJECTIVE
The aim of the study was to investigate whether the accuracy of an automated deep learning segmentation model for the hip joint could be improved by combining information from multiple image outputs from a Dixon sequence.
METHODS
Manual segmentations of 20 participants (40 hips) of the Generation R study, comprising individuals who were 19 years old (11 males, 9 females), were used to train an nnU-Net. The segmented regions included the femoral bone, acetabular bone, femoral cartilage, and acetabular cartilage in both the left and right hip. The 2D and 3D configurations of the nnU-Net were trained using 5-fold cross-validation and an ensemble of the 2D-3D configurations was used in the analyses. The input consisted of 1) water-only images from the Lava Flex sequence, with an in-plane resolution of 0.89 × 0.89 mm2 and a slice thickness of 1.2 mm, 2) a combination of in-phase and water-only images, as well as 3) a combination of water-only and fat-only images from the same sequence, allowing for comparison between the methodologies. The combination of water-only and in-phase images was chosen for potentially increasing segmentation accuracy, following visual inspection. Additionally, the water-only and fat-only combination aimed to assess if segmentation results could be enhanced by offering additional tissue contrast. Evaluation was performed on a hold-out test set consisting of 10 manually segmented hips, using the Dice similarity coefficient (DSC) and mean surface distance (MSD).
RESULTS
The mean ±SD DSC for the segmentation of bone and cartilage in the hip using the 1) water-only vs 2) in-phase and water-only combination vs. 3) combination of fat-only and water-only images were as follows: femoral bone 1) 0.961±0.013 vs. 2) 0.967±0.004 vs. 3) 0.950±0.036, acetabular bone 1) 0.886±0.027 vs. 2) 0.893±0.021 vs. 3) 0.896±0.016, femoral cartilage 1) 0.762±0.018 vs. 2) 0.763±0.020 vs. 3) 0.752±0.023, and acetabular cartilage 1) 0.760±0.028 vs. 2) 0.768±0.022 vs. 3) 0.768±0.022. The MSDs were: femoral bone 1) 0.412± 0.105 mm vs. 2) 0.341±0.047 mm vs. 3) 0.297±5.59 mm, acetabular bone 1) 0.602±0.109 mm vs. 2) 0.567±0.097 mm vs. 3) 0.651±0.077 mm, femoral cartilage 1) 0.276±0.033 mm vs. 2) 0.271±0.034 mm vs. 3) 0.295±0.033 mm, and acetabular cartilage 1) 0.313±0.078 mm vs. 2) 0.282±0.049 mm vs. 3) 0.281±0.046 mm.
CONCLUSION<
引言 在基于核磁共振成像的分割任务中,探索如何改进模型训练方法对于提高分割准确性非常重要。准确的自动分割对于提取成像生物标记物等应用至关重要。利用先进的深度学习技术(如 nnU-Net)有望实现精确的分割。此外,将 Dixon 核磁共振成像的多个图像输出纳入这些方法可提高分割性能。研究的目的是探讨是否可以通过结合 Dixon 序列的多个图像输出信息来提高髋关节自动深度学习分割模型的准确性。分割区域包括左右髋部的股骨头、髋臼骨、股软骨和髋臼软骨。nnU-Net 的 2D 和 3D 配置通过 5 倍交叉验证进行了训练,在分析中使用了 2D-3D 配置的集合。输入包括:1)来自 Lava Flex 序列的纯水图像(平面内分辨率为 0.89 × 0.89 mm2,切片厚度为 1.2 mm);2)同相图像和纯水图像的组合;以及 3)来自同一序列的纯水图像和纯脂肪图像的组合,以便在不同方法之间进行比较。经目测,选择纯水图像和同相图像的组合可能会提高分割的准确性。此外,纯水和纯脂肪组合旨在评估是否可以通过提供额外的组织对比度来增强分割结果。使用 Dice 相似性系数(DSC)和平均表面距离(MSD)对由 10 个人工分割的髋关节组成的暂留测试集进行了评估。结果使用 1) 纯水 vs 2) 同相和纯水组合 vs 3) 纯脂肪和纯水组合分割髋关节骨骼和软骨的平均 ±SD DSC。股骨头 1) 0.961±0.013 vs. 2) 0.967±0.004 vs. 3) 0.950±0.036;髋臼骨 1) 0.886±0.027 vs. 2) 0.893±0.021 vs. 3) 0.896±0.016;股骨头软骨 1) 0.762±0.013 vs. 2) 0.762±0.014 vs. 3) 0.950±0.036。0.762±0.018 vs. 2) 0.763±0.020 vs. 3) 0.752±0.023,髋臼软骨 1)0.760±0.028 vs. 2) 0.768±0.022 vs. 3) 0.768±0.022。MSD为:股骨头 1) 0.412±0.105 mm vs. 2) 0.341±0.047 mm vs. 3) 0.297±5.59 mm,髋臼骨 1) 0.602±0.109 mm vs. 2) 0.567±0.097 mm vs. 3) 0.651±0.077 mm,股骨头软骨 1)0.276±0.033 mm vs. 2) 0.271±0.034 mm vs. 3) 0.295±0.033 mm,髋臼软骨 1)结果表明,结合同相图像和纯水图像进行模型训练可提高分割质量。具体来说,DSCs 提高了,MSD 减少了,这表明边界的重叠和对齐得到了改善。这些结果凸显了在核磁共振成像中使用组合图像输出来提高髋关节分割准确性的功效。
{"title":"ENHANCING MODEL PERFORMANCE IN HIP JOINT SEGMENTATION BY LEVERAGING MULTIPLE IMAGE OUTPUTS FROM DIXON MRI","authors":"M.A. Kamphuis , E.H.G. Oei , J. Runhaar , D. Hanff , S.M.A. Bierma-Zeinstra , S. Klein , J. Hirvasniemi","doi":"10.1016/j.ostima.2024.100193","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100193","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Exploring ways to improve methodologies for model training in MRI-based segmentation tasks is important for enhancing segmentation accuracy. Accurate automated segmentations are essential for applications including the extraction of imaging biomarkers. Leveraging advanced deep learning techniques, such as nnU-Net, holds promise for achieving precise segmentations. Additionally, incorporating multiple image outputs from Dixon MRI into these methodologies could improve segmentation performance.</p></div><div><h3>OBJECTIVE</h3><p>The aim of the study was to investigate whether the accuracy of an automated deep learning segmentation model for the hip joint could be improved by combining information from multiple image outputs from a Dixon sequence.</p></div><div><h3>METHODS</h3><p>Manual segmentations of 20 participants (40 hips) of the Generation R study, comprising individuals who were 19 years old (11 males, 9 females), were used to train an nnU-Net. The segmented regions included the femoral bone, acetabular bone, femoral cartilage, and acetabular cartilage in both the left and right hip. The 2D and 3D configurations of the nnU-Net were trained using 5-fold cross-validation and an ensemble of the 2D-3D configurations was used in the analyses. The input consisted of 1) water-only images from the Lava Flex sequence, with an in-plane resolution of 0.89 × 0.89 mm<sup>2</sup> and a slice thickness of 1.2 mm, 2) a combination of in-phase and water-only images, as well as 3) a combination of water-only and fat-only images from the same sequence, allowing for comparison between the methodologies. The combination of water-only and in-phase images was chosen for potentially increasing segmentation accuracy, following visual inspection. Additionally, the water-only and fat-only combination aimed to assess if segmentation results could be enhanced by offering additional tissue contrast. Evaluation was performed on a hold-out test set consisting of 10 manually segmented hips, using the Dice similarity coefficient (DSC) and mean surface distance (MSD).</p></div><div><h3>RESULTS</h3><p>The mean ±SD DSC for the segmentation of bone and cartilage in the hip using the 1) water-only vs 2) in-phase and water-only combination vs. 3) combination of fat-only and water-only images were as follows: femoral bone 1) 0.961±0.013 vs. 2) 0.967±0.004 vs. 3) 0.950±0.036, acetabular bone 1) 0.886±0.027 vs. 2) 0.893±0.021 vs. 3) 0.896±0.016, femoral cartilage 1) 0.762±0.018 vs. 2) 0.763±0.020 vs. 3) 0.752±0.023, and acetabular cartilage 1) 0.760±0.028 vs. 2) 0.768±0.022 vs. 3) 0.768±0.022. The MSDs were: femoral bone 1) 0.412± 0.105 mm vs. 2) 0.341±0.047 mm vs. 3) 0.297±5.59 mm, acetabular bone 1) 0.602±0.109 mm vs. 2) 0.567±0.097 mm vs. 3) 0.651±0.077 mm, femoral cartilage 1) 0.276±0.033 mm vs. 2) 0.271±0.034 mm vs. 3) 0.295±0.033 mm, and acetabular cartilage 1) 0.313±0.078 mm vs. 2) 0.282±0.049 mm vs. 3) 0.281±0.046 mm.</p></div><div><h3>CONCLUSION<","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000217/pdfft?md5=e1f4286e8a8e3a3f941cc6b986a250cd&pid=1-s2.0-S2772654124000217-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}