Pub Date : 2024-01-01DOI: 10.1016/j.ostima.2024.100186
I. Zorgno , O. Bitoun , F.W. Roemer , A. Guermazi , C.K. Kwoh , T. Neogi , S.C. Mastbergen , M. Kloppenburg , F.J. Blanco , I.K. Haugen , F. Berenbaum , M.P. Jansen , M. Jarraya
INTRODUCTION
Lower muscle volume and higher intra- and inter-muscular fat content has previously been associated with structural outcomes of knee osteoarthritis (OA) and physical performance (extensor strength). Neuropathic-like pain (NP-L) was associated with less structural damage of knee OA but greater physical function impairment compared to patients without. Measurements of fat have not been studied among patients with knee OA and different pain phenotypes (NP-L versus non-NP-L).
OBJECTIVE
To compare CT-based measures of thigh muscle fat content between knee OA participants with and without an NP-L phenotype.
METHODS
We studied participants from the IMI-APPROACH study who had CT and pain measures assessed. The pain-DETECT questionnaire was used to define different NP pain categories: NP-L was defined as a score ≥19, and non-NP-L as a score ≤12. For these analyses, we focused on the group with NP-L versus non-NP-L pain. For each participant, an index knee with OA was selected based on ACR clinical criteria as applied in the IMI-APPROACH cohort. NP-L patients were matched for SF-36 and KOOS scores with non-NP-L participants. We used a manual segmentation method for bilateral thigh muscle segmentations from whole-body CTs. The axial slice corresponding to 33% distal length of the femur bone was selected. The cross-sectional area (CSA) of the thigh muscles (quadriceps, flexors, adductors, and sartorius) were calculated and summed to represent the total thigh muscle CSA, as shown in figure 1. Hounsfield unit thresholding was applied to estimate the adipose component within the muscle. CT-based markers of muscle quality included CSA of intramuscular adipose tissue (Intra-MAT), intermuscular adipose tissue (Inter-MAT), subcutaneous adipose tissue (SAT), and the total thigh muscle (Muscle). Normality was determined by Shapiro-Wilk test. We evaluated the difference in CSAs between NP-L and matched non-NP-L using the Wilcoxon rank sum test (if at least one of the distributions was non-normal), or the Student's t-test (if both distributions were normal).
RESULTS
Twenty-one participants with NP-L and 22 participants with non-NP-L phenotypes were included. Mean age was 65.1 (NP-L) versus 66.2 (non-NP-L). Among patients with NP-L, 86% were female versus 68% females for non-NP-L. Mean BMI was 31 for those with NP-L and 28.5 for those with non-NP-L. The KOOS score for NP-L was 51.3 and 52.8 for those with non-NP-L pain. As shown in Figure 2, participants with NP-L had a statistically higher Inter-MAT CSA (p-value = 0.03) and SAT CSA (p-value <0.001), when compared to patients with non-NP-L. Intra-MAT CSA was higher among those with NP-L versus non-NP-L however without reaching statistical significance. The ratios of Inter-MAT CSA / Muscle CSA and (Intra-MAT + Inter-MAT) CSA / Muscle CSA, were statistically higher among those with N
{"title":"COMPARISON OF CT-BASED FAT CONTENT IN THIGH MUSCLES BETWEEN KNEE OSTEARTHRITIS PATIENTS WITH AND WITHOUT NEUROPATHIC-LIKE PAIN PHENOTYPE","authors":"I. Zorgno , O. Bitoun , F.W. Roemer , A. Guermazi , C.K. Kwoh , T. Neogi , S.C. Mastbergen , M. Kloppenburg , F.J. Blanco , I.K. Haugen , F. Berenbaum , M.P. Jansen , M. Jarraya","doi":"10.1016/j.ostima.2024.100186","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100186","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Lower muscle volume and higher intra- and inter-muscular fat content has previously been associated with structural outcomes of knee osteoarthritis (OA) and physical performance (extensor strength). Neuropathic-like pain (NP-L) was associated with less structural damage of knee OA but greater physical function impairment compared to patients without. Measurements of fat have not been studied among patients with knee OA and different pain phenotypes (NP-L versus non-NP-L).</p></div><div><h3>OBJECTIVE</h3><p>To compare CT-based measures of thigh muscle fat content between knee OA participants with and without an NP-L phenotype.</p></div><div><h3>METHODS</h3><p>We studied participants from the IMI-APPROACH study who had CT and pain measures assessed. The pain-DETECT questionnaire was used to define different NP pain categories: NP-L was defined as a score ≥19, and non-NP-L as a score ≤12. For these analyses, we focused on the group with NP-L versus non-NP-L pain. For each participant, an index knee with OA was selected based on ACR clinical criteria as applied in the IMI-APPROACH cohort. NP-L patients were matched for SF-36 and KOOS scores with non-NP-L participants. We used a manual segmentation method for bilateral thigh muscle segmentations from whole-body CTs. The axial slice corresponding to 33% distal length of the femur bone was selected. The cross-sectional area (CSA) of the thigh muscles (quadriceps, flexors, adductors, and sartorius) were calculated and summed to represent the total thigh muscle CSA, as shown in <strong>figure 1</strong>. Hounsfield unit thresholding was applied to estimate the adipose component within the muscle. CT-based markers of muscle quality included CSA of intramuscular adipose tissue (Intra-MAT), intermuscular adipose tissue (Inter-MAT), subcutaneous adipose tissue (SAT), and the total thigh muscle (Muscle). Normality was determined by Shapiro-Wilk test. We evaluated the difference in CSAs between NP-L and matched non-NP-L using the Wilcoxon rank sum test (if at least one of the distributions was non-normal), or the Student's t-test (if both distributions were normal).</p></div><div><h3>RESULTS</h3><p>Twenty-one participants with NP-L and 22 participants with non-NP-L phenotypes were included. Mean age was 65.1 (NP-L) versus 66.2 (non-NP-L). Among patients with NP-L, 86% were female versus 68% females for non-NP-L. Mean BMI was 31 for those with NP-L and 28.5 for those with non-NP-L. The KOOS score for NP-L was 51.3 and 52.8 for those with non-NP-L pain. As shown in <strong>Figure 2</strong>, participants with NP-L had a statistically higher Inter-MAT CSA (p-value = 0.03) and SAT CSA (p-value <0.001), when compared to patients with non-NP-L. Intra-MAT CSA was higher among those with NP-L versus non-NP-L however without reaching statistical significance. The ratios of Inter-MAT CSA / Muscle CSA and (Intra-MAT + Inter-MAT) CSA / Muscle CSA, were statistically higher among those with N","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100186"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277265412400014X/pdfft?md5=93c92834b934777437a9f8f22c93782f&pid=1-s2.0-S277265412400014X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433935","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.2024.100207
F. Boel, J. Wortel, M.M.A. van Buuren, F. Rivadeneira, J.B.J. van Meurs, J. Runhaar, S.M.A. Bierma-Zeinstra, R. Agricola
INTRODUCTION
Large cohort studies on hip OA usually obtain anteroposterior (AP) pelvic radiographs. Nevertheless, the image quality of a hip dual-energy x-ray absorptiometry (DXA) has increased significantly with new-generation scanners using narrow-angle fan-beam technology. Therefore, DXA images are increasingly used to study hip morphology, especially in large population studies. One of the main advantages of hip DXA images is the lower radiation burden of 0.36-70 µSv compared to hip or pelvic radiographs with an effective dose of 600-700 µSv. However, the image acquisition method is different between radiographs and DXA images. Therefore, whether hip morphology measurements are consistent between DXA images and radiographs is unknown.
OBJECTIVE
We investigated the agreement and reliability of the measurements performed on DXA and radiographs.
METHODS
We included 750 hips from 411 participants from the Rotterdam study, a population-based cohort study, who received a hip DXA and pelvic radiograph on the same day. The participants had a median age of 67.3 years (range 52.2 – 90.6), 45.5% were male, with a median BMI of 26.2 kg/m2 (range 16.9 – 39.5). The acetabular depth-width ratio (ADR), modified acetabular index (mAI), alpha angle (AA), Wiberg and lateral center edge angle (WCEA, LCEA), extrusion index (EI) and triangular index ratio (TIR) were automatically determined on both imaging modalities, based on 38 landmark points. The intraobserver and intermethod agreement were studied using Bland-Altman methods, and the reliability was assessed using ICCs or concordance correlation coefficients (CCC) for non-normal distributed variables. Intraobserver reliability was tested with a 2-way random-effects model, single rater, absolute agreement ICC. Intermethod reliability was tested with a 2-ways mixed-effects model, single rater, absolute agreement ICC.
RESULTS
The mean values of each measurement on both DXA and pelvic radiograph, as well as the intraobserver and intermethod mean difference with limits of agreement (95% CIs) from the Bland-Altman methods, are summarized in Table 1. The limits of agreement for the intraobserver agreement within each imaging modality consistently demonstrated equal or narrower limits of agreement compared to the intermethod agreement.
Table 2 shows the intraobserver and intermethod reliability for all measurements. The intraobserver reliability was better than the intermethod reliability. However, the intermethod reliability was overall good.
CONCLUSION
DXA images and pelvic radiographs can both reliably be used to study hip morphology. Due to the lower radiation burden, DXA images can be an excellent alternative to pelvic radiographs for research purposes.
{"title":"DXA IMAGES ARE A RELIABLE ALTERNATIVE TO PELVIC RADIOGRAPHS FOR PERFORMING HIP MORPHOLOGY MEASUREMENTS","authors":"F. Boel, J. Wortel, M.M.A. van Buuren, F. Rivadeneira, J.B.J. van Meurs, J. Runhaar, S.M.A. Bierma-Zeinstra, R. Agricola","doi":"10.1016/j.ostima.2024.100207","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100207","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Large cohort studies on hip OA usually obtain anteroposterior (AP) pelvic radiographs. Nevertheless, the image quality of a hip dual-energy x-ray absorptiometry (DXA) has increased significantly with new-generation scanners using narrow-angle fan-beam technology. Therefore, DXA images are increasingly used to study hip morphology, especially in large population studies. One of the main advantages of hip DXA images is the lower radiation burden of 0.36-70 µSv compared to hip or pelvic radiographs with an effective dose of 600-700 µSv. However, the image acquisition method is different between radiographs and DXA images. Therefore, whether hip morphology measurements are consistent between DXA images and radiographs is unknown.</p></div><div><h3>OBJECTIVE</h3><p>We investigated the agreement and reliability of the measurements performed on DXA and radiographs.</p></div><div><h3>METHODS</h3><p>We included 750 hips from 411 participants from the Rotterdam study, a population-based cohort study, who received a hip DXA and pelvic radiograph on the same day. The participants had a median age of 67.3 years (range 52.2 – 90.6), 45.5% were male, with a median BMI of 26.2 kg/m<sup>2</sup> (range 16.9 – 39.5). The acetabular depth-width ratio (ADR), modified acetabular index (mAI), alpha angle (AA), Wiberg and lateral center edge angle (WCEA, LCEA), extrusion index (EI) and triangular index ratio (TIR) were automatically determined on both imaging modalities, based on 38 landmark points. The intraobserver and intermethod agreement were studied using Bland-Altman methods, and the reliability was assessed using ICCs or concordance correlation coefficients (CCC) for non-normal distributed variables. Intraobserver reliability was tested with a 2-way random-effects model, single rater, absolute agreement ICC. Intermethod reliability was tested with a 2-ways mixed-effects model, single rater, absolute agreement ICC.</p></div><div><h3>RESULTS</h3><p>The mean values of each measurement on both DXA and pelvic radiograph, as well as the intraobserver and intermethod mean difference with limits of agreement (95% CIs) from the Bland-Altman methods, are summarized in Table 1. The limits of agreement for the intraobserver agreement within each imaging modality consistently demonstrated equal or narrower limits of agreement compared to the intermethod agreement.</p><p>Table 2 shows the intraobserver and intermethod reliability for all measurements. The intraobserver reliability was better than the intermethod reliability. However, the intermethod reliability was overall good.</p></div><div><h3>CONCLUSION</h3><p>DXA images and pelvic radiographs can both reliably be used to study hip morphology. Due to the lower radiation burden, DXA images can be an excellent alternative to pelvic radiographs for research purposes.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000357/pdfft?md5=fdda28aed18d43a87c64bc8719e388dc&pid=1-s2.0-S2772654124000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434948","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.2024.100189
A.E. Heald , Y.N. Yum , Y. Ahn , J. Myung , J.E. Collins , A. Guermazi , D.W. Kim
INTRODUCTION
ICM-203, a recombinant AAV vector designed to express a truncated form of human Nkx3.2, a transcription factor which plays an important role in both chondrocyte and synoviocyte activity, is in clinical development as a potential DMOAD.
OBJECTIVE
An objective of this first-in-human phase 1/2a study is to assess the biological activity of ICM-203 by correlating changes in structural MRI findings with changes in measures of pain and function.
METHODS
In this double-blind, placebo-controlled, dose escalation study, subjects with KLG 2 or KLG 3 knee OA and minimum JSW > 1mm receive a single intra-articular (IA) injection of ICM-203 or placebo in a 3:1 ratio, with planned dose escalation of ICM-203 from 6 × 1012 vector genomes (vg) to 2 × 1013 vg and then 6 × 1013 vg. The primary efficacy endpoints are changes in knee pain as assessed on a numerical rating scale (NRS); changes in knee function as measured using the Knee Injury and Osteoarthritis Outcome Score (KOOS) activities of daily living (ADL) subscore, as well as structural knee changes, including changes in MRI OA Knee Score (MOAKS). Here, blinded efficacy data from 8 subjects in the low-dose cohort treated with ICM-203 (n=6) or placebo (n=2) are reported.
RESULTS
The low-dose cohort consisted of females aged 56 to 73 years, all with KLG 3 knee OA. Knee pain (NRS) decreased in 6 of 8 subjects and knee function (KOOS ADL) improved in 4 of 8 subjects between Day 1 and Week 52. Cartilage thickness was preserved or improved in 5 of 8 subjects and BM lesions improved in 3 of 8 subjects at Week 52. Osteophytes were unchanged in 7 of 8 subjects and only worsened minimally in 1 of 8 subjects at Week 52. Synovitis (Hoffa + effusion) improved at Week 52 in 2 of 2 subjects with more severe inflammation (synovitis score >4) at baseline. Evaluation of changes between baseline and Week 24 and baseline and Week 52 show that a decrease in the number of subregions with BM lesions was correlated with decrease in knee pain (NRS) and improvement in knee function (KOOS ADL).
CONCLUSION
IA injections of ICM-203 6 × 1012 vg may demonstrate potential as a DMOAD, between delaying structural joint damage, alleviating synovial inflammation, and ameliorating OA symptoms. Decrease in the number of subregions with BM lesions correlated with decrease in pain and improvement in function. Investigation of higher doses is underway.
{"title":"INTERIM REVIEW OF EFFICACY FROM A FIRST-IN-HUMAN PHASE 1/2A CLINICAL STUDY OF ICM-203, AN INTRA-ARTICULAR, AAV GENE THERAPY FOR OSTEOARTHRITIS","authors":"A.E. Heald , Y.N. Yum , Y. Ahn , J. Myung , J.E. Collins , A. Guermazi , D.W. Kim","doi":"10.1016/j.ostima.2024.100189","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100189","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>ICM-203, a recombinant AAV vector designed to express a truncated form of human Nkx3.2, a transcription factor which plays an important role in both chondrocyte and synoviocyte activity, is in clinical development as a potential DMOAD.</p></div><div><h3>OBJECTIVE</h3><p>An objective of this first-in-human phase 1/2a study is to assess the biological activity of ICM-203 by correlating changes in structural MRI findings with changes in measures of pain and function.</p></div><div><h3>METHODS</h3><p>In this double-blind, placebo-controlled, dose escalation study, subjects with KLG 2 or KLG 3 knee OA and minimum JSW > 1mm receive a single intra-articular (IA) injection of ICM-203 or placebo in a 3:1 ratio, with planned dose escalation of ICM-203 from 6 × 10<sup>12</sup> vector genomes (vg) to 2 × 10<sup>13</sup> vg and then 6 × 10<sup>13</sup> vg. The primary efficacy endpoints are changes in knee pain as assessed on a numerical rating scale (NRS); changes in knee function as measured using the Knee Injury and Osteoarthritis Outcome Score (KOOS) activities of daily living (ADL) subscore, as well as structural knee changes, including changes in MRI OA Knee Score (MOAKS). Here, blinded efficacy data from 8 subjects in the low-dose cohort treated with ICM-203 (n=6) or placebo (n=2) are reported.<figure><img></figure></p></div><div><h3>RESULTS</h3><p>The low-dose cohort consisted of females aged 56 to 73 years, all with KLG 3 knee OA. Knee pain (NRS) decreased in 6 of 8 subjects and knee function (KOOS ADL) improved in 4 of 8 subjects between Day 1 and Week 52. Cartilage thickness was preserved or improved in 5 of 8 subjects and BM lesions improved in 3 of 8 subjects at Week 52. Osteophytes were unchanged in 7 of 8 subjects and only worsened minimally in 1 of 8 subjects at Week 52. Synovitis (Hoffa + effusion) improved at Week 52 in 2 of 2 subjects with more severe inflammation (synovitis score >4) at baseline. Evaluation of changes between baseline and Week 24 and baseline and Week 52 show that a decrease in the number of subregions with BM lesions was correlated with decrease in knee pain (NRS) and improvement in knee function (KOOS ADL).</p></div><div><h3>CONCLUSION</h3><p>IA injections of ICM-203 6 × 10<sup>12</sup> vg may demonstrate potential as a DMOAD, between delaying structural joint damage, alleviating synovial inflammation, and ameliorating OA symptoms. Decrease in the number of subregions with BM lesions correlated with decrease in pain and improvement in function. Investigation of higher doses is underway.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000175/pdfft?md5=7e422fb5b0021b97c4f0d4657ea48204&pid=1-s2.0-S2772654124000175-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434954","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.2024.100197
J. Duryea , J.B. Driban , C.B. Eaton , L.F. Schaefer , M.B. Roberts , J.A. Cauley , T.E. McAlindon , S.E. Smith
INTRODUCTION
Metacarpal cortical thickness (MCT), a surrogate for bone density, has been well studied in people with rheumatoid arthritis but much less so for hand OA (HOA).
OBJECTIVE
To investigate the association of MCT with radiographic HOA severity.
METHODS
We performed a software measurement of MTC on the dominant hand radiograph of 3,575 participants from the OAI at the baseline and 48-month visits. Spearman's rank correlation coefficients (rho) were calculated for the association of baseline MTC and 2 measures of baseline HOA severity: the sum of Kellgren and Lawrence (KL) grade and total number of joints with radiographic HOA. Longitudinally, logistic regression with odds ratios were used to assess the relationship of MTC loss to new finger joint radiographic OA and an increase in KL grades. The results were stratified by gender and into two age groups: 45-60 years and > 60 years.
RESULTS
The baseline results are in Table 1, and the longitudinal results are in Table 2. For women, we found a weak correlation between baseline MTC and ROA for ages 45-60 years; the correlation was higher for the > 60 years age group. For MTC change, we found higher odds ratios in women for the 45-60 year group than for the > 60 year group. No significant correlations were seen between MCT and HOA for men either cross-sectionally or longitudinally.
CONCLUSION
We found significant associations between MCT and ROA status in women for both baseline and 48-month change but not for men. The consideration of differences between men and women may have implications for understanding the structural nature of HOA. It may be important in developing targeted interventions to manage symptoms and improve outcomes for affected individuals.
引言类风湿性关节炎患者的掌骨皮质厚度（MCT）是骨密度的替代指标，对其研究较多，但对手部 OA（HOA）研究较少。我们计算了基线 MTC 与 2 个基线 HOA 严重程度测量值（Kellgren 和 Lawrence (KL) 等级总和以及有放射学 HOA 的关节总数）之间的斯皮尔曼等级相关系数 (rho)。在纵向上，使用带有几率比的逻辑回归来评估 MTC 损失与新的手指关节影像学 OA 和 KL 等级增加之间的关系。结果基线结果见表 1，纵向结果见表 2。就女性而言，我们发现 45-60 岁年龄组的基线 MTC 与 ROA 之间存在微弱的相关性；60 岁年龄组的相关性更高。在 MTC 变化方面，我们发现 45-60 岁年龄组女性的几率比 60 岁年龄组更高。结论我们发现，无论是基线还是 48 个月的变化，女性的 MCT 与 ROA 状态之间都存在明显的相关性，但男性则没有。考虑男女之间的差异可能会对理解 HOA 的结构性质产生影响。这对于制定有针对性的干预措施以控制症状和改善受影响个体的预后可能非常重要。
{"title":"ASSOCIATION OF METACARPAL CORTICAL THICKNESS WITH HAND OA","authors":"J. Duryea , J.B. Driban , C.B. Eaton , L.F. Schaefer , M.B. Roberts , J.A. Cauley , T.E. McAlindon , S.E. Smith","doi":"10.1016/j.ostima.2024.100197","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100197","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Metacarpal cortical thickness (MCT), a surrogate for bone density, has been well studied in people with rheumatoid arthritis but much less so for hand OA (HOA).</p></div><div><h3>OBJECTIVE</h3><p>To investigate the association of MCT with radiographic HOA severity.</p></div><div><h3>METHODS</h3><p>We performed a software measurement of MTC on the dominant hand radiograph of 3,575 participants from the OAI at the baseline and 48-month visits. Spearman's rank correlation coefficients (rho) were calculated for the association of baseline MTC and 2 measures of baseline HOA severity: the sum of Kellgren and Lawrence (KL) grade and total number of joints with radiographic HOA. Longitudinally, logistic regression with odds ratios were used to assess the relationship of MTC loss to new finger joint radiographic OA and an increase in KL grades. The results were stratified by gender and into two age groups: 45-60 years and > 60 years.</p></div><div><h3>RESULTS</h3><p>The baseline results are in Table 1, and the longitudinal results are in Table 2. For women, we found a weak correlation between baseline MTC and ROA for ages 45-60 years; the correlation was higher for the > 60 years age group. For MTC change, we found higher odds ratios in women for the 45-60 year group than for the > 60 year group. No significant correlations were seen between MCT and HOA for men either cross-sectionally or longitudinally.</p></div><div><h3>CONCLUSION</h3><p>We found significant associations between MCT and ROA status in women for both baseline and 48-month change but not for men. The consideration of differences between men and women may have implications for understanding the structural nature of HOA. It may be important in developing targeted interventions to manage symptoms and improve outcomes for affected individuals.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000254/pdfft?md5=194df4066d91c153c191b112812aa420&pid=1-s2.0-S2772654124000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434949","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.2024.100208
J. Runhaar , B.L. van Meer , V. Smit , M. Minnaard , E. Oei , M. Reijman , D.E. Meuffels
INTRODUCTION
With an annual incidence rate of 2-5% in high-risk populations, the use of established knee OA as an outcome challenges the feasibility of preventive OA research. Therefore, valid surrogate outcomes, for which short-term changes capture long-term OA incidence, are urgently needed.
OBJECTIVE
To assess the association of 2-year's semi-quantitative scores for BMLs, cartilage defects, osteophytes, meniscus pathologies, meniscus extrusion, and effusion/synovitis worsening on MRI and 11-year's incidence of radiographic OA, among subjects with an ACL-rupture.
METHODS
154 individuals (18-45 years) with an ACL-rupture confirmed by physical examination and MRI, free of radiographic features of knee OA (KLG = 0), were enrolled in the study within 6 months of their injury. At baseline and at two years, multi-sequential MRIs were obtained (sag. and cor. proton density–weighted turbo spin echo (slice thickness, 3 mm; TR/TE 2700/27 ms), cor. T2-weighted TSE with fat saturation (slice thickness, 3 mm; TR/TE 5030/71 ms), axial PD (TR/TE 3500/25 ms) and T2-weighted (TR/TE 3500/74 ms) TSE dual echo (slice thickness, 3 mm), and sag. T2-weighted 3-dimensional DESS (slice thickness, 1.5 mm; TR/TE 21.35/7.97 ms) and scored using MOAKS. After 11 years, weight-bearing semi-flexed AP-radiographs were obtained and scored for radiographic OA incidence (KLG ≥2). Two-year's worsening of BMLs, cartilage defects, osteophytes (all in PF, medial and lateral TF compartments), medial and lateral meniscus pathology and meniscus extrusion, and of effusion/synovitis were determined, using established criteria. Features showing worsening in ≥10% of the knees were related to OA incidence after 11 years, using logistic regression analysis.
RESULTS
Follow-up data after 11.7 ± 0.7 years was available for 99 individuals (baseline age 27.8 ± 7.2 years, 68% men). Over the first two years, 48 individuals (48%) underwent ACL-reconstruction surgery. After 11 years, 41 individuals (41%) developed radiographic OA in their injured knee. Worsening of lateral cartilage defects (23%), medial (24%) and lateral (28%) meniscus pathology, and medial meniscus extrusion (17%) reached the pre-defined threshold of ≥10% within two years. Despite increased post-test probabilities for meniscus pathology, two-year's worsening of selected features was not significantly associated to long-term radiographic knee OA incidence (see Table).
CONCLUSION
Most knee OA MRI features showed little progression (<10%) over two years, across compartments, in ACL-injured knees. Lateral TF cartilage defects, meniscus pathology, and medial meniscus extrusion showed high progression rates (18-26%), but these changes showed no statistical significance association to radiographic knee OA incidence after 11 years. Of the assessed features, only progression of meniscus pathology seemed to have potential as
简介：在高风险人群中，膝关节 OA 的年发病率为 2%-5%，使用已确诊的膝关节 OA 作为结果对预防性 OA 研究的可行性提出了挑战。目的评估膝关节前交叉韧带断裂受试者两年内BMLs、软骨缺损、骨质增生、半月板病变、半月板挤压、MRI上渗出/滑膜炎恶化的半定量评分与11年放射学OA发病率的相关性。方法 154 名经体格检查和核磁共振成像确认为前交叉韧带断裂的患者（18-45 岁）在受伤后 6 个月内被纳入研究，他们没有膝关节 OA 的影像学特征（KLG = 0）。在基线和两年后，进行多序列核磁共振成像（矢状和冠状质子密度加权涡轮自旋回波（切片厚度，3 毫米；TR/TE 2700/27 毫秒）、冠状质子密度加权 T2-SE 加脂回波（切片厚度，3 毫米；TR/TE 2700/27 毫秒））。T2加权TSE与脂肪饱和（切片厚度，3毫米；TR/TE 5030/71毫秒），轴向PD（TR/TE 3500/25毫秒）和T2加权（TR/TE 3500/74毫秒）TSE双回波（切片厚度，3毫米），以及下垂。T2- 加权三维 DESS（切片厚度 1.5 毫米；TR/TE 21.35/7.97 毫秒），并使用 MOAKS 进行评分。11 年后，获得负重半屈曲 AP 光片，并对放射学 OA 发生率（KLG ≥2）进行评分。根据既定标准，确定两年内BML、软骨缺损、骨质增生（均位于PF、内侧和外侧TF区）、内侧和外侧半月板病变和半月板挤压以及渗出/滑膜炎的恶化情况。采用逻辑回归分析法，将≥10% 的膝关节出现恶化的特征与 11 年后的 OA 发生率相关联。结果99 人（基线年龄为 27.8 ± 7.2 岁，68% 为男性）获得了 11.7 ± 0.7 年的随访数据。在最初的两年中，48人（48%）接受了前交叉韧带重建手术。11 年后，41 人（41%）的受伤膝关节出现了影像学上的 OA。外侧软骨缺损（23%）、内侧半月板病变（24%）和外侧半月板病变（28%）以及内侧半月板挤压（17%）的恶化程度在两年内达到了预先设定的≥10%的阈值。尽管半月板病变的检测后概率增加，但所选特征的两年恶化与膝关节OA的长期影像学发病率并无显著关联（见表）。外侧TF软骨缺损、半月板病变和内侧半月板挤压显示出较高的进展率（18%-26%），但这些变化与11年后膝关节放射学OA发病率没有统计学意义。在评估的特征中，只有半月板病变的进展似乎有可能成为膝关节OA长期放射学发病率的替代结果，这一点应在更大的样本中得到证实。
{"title":"TWO-YEAR'S WORSENING OF SEMI-QUANTITATIVE MRI FEATURES AS SURROGATE OUTCOMES FOR LONG-TERM INCIDENT RADIOGRAPHIC KNEE OSTEOARTHRITIS AFTER ACL-RUPTURE","authors":"J. Runhaar , B.L. van Meer , V. Smit , M. Minnaard , E. Oei , M. Reijman , D.E. Meuffels","doi":"10.1016/j.ostima.2024.100208","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100208","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>With an annual incidence rate of 2-5% in high-risk populations, the use of established knee OA as an outcome challenges the feasibility of preventive OA research. Therefore, valid surrogate outcomes, for which short-term changes capture long-term OA incidence, are urgently needed.</p></div><div><h3>OBJECTIVE</h3><p>To assess the association of 2-year's semi-quantitative scores for BMLs, cartilage defects, osteophytes, meniscus pathologies, meniscus extrusion, and effusion/synovitis worsening on MRI and 11-year's incidence of radiographic OA, among subjects with an ACL-rupture.</p></div><div><h3>METHODS</h3><p>154 individuals (18-45 years) with an ACL-rupture confirmed by physical examination and MRI, free of radiographic features of knee OA (KLG = 0), were enrolled in the study within 6 months of their injury. At baseline and at two years, multi-sequential MRIs were obtained (sag. and cor. proton density–weighted turbo spin echo (slice thickness, 3 mm; TR/TE 2700/27 ms), cor. T2-weighted TSE with fat saturation (slice thickness, 3 mm; TR/TE 5030/71 ms), axial PD (TR/TE 3500/25 ms) and T2-weighted (TR/TE 3500/74 ms) TSE dual echo (slice thickness, 3 mm), and sag. T2-weighted 3-dimensional DESS (slice thickness, 1.5 mm; TR/TE 21.35/7.97 ms) and scored using MOAKS. After 11 years, weight-bearing semi-flexed AP-radiographs were obtained and scored for radiographic OA incidence (KLG ≥2). Two-year's worsening of BMLs, cartilage defects, osteophytes (all in PF, medial and lateral TF compartments), medial and lateral meniscus pathology and meniscus extrusion, and of effusion/synovitis were determined, using established criteria. Features showing worsening in ≥10% of the knees were related to OA incidence after 11 years, using logistic regression analysis.</p></div><div><h3>RESULTS</h3><p>Follow-up data after 11.7 ± 0.7 years was available for 99 individuals (baseline age 27.8 ± 7.2 years, 68% men). Over the first two years, 48 individuals (48%) underwent ACL-reconstruction surgery. After 11 years, 41 individuals (41%) developed radiographic OA in their injured knee. Worsening of lateral cartilage defects (23%), medial (24%) and lateral (28%) meniscus pathology, and medial meniscus extrusion (17%) reached the pre-defined threshold of ≥10% within two years. Despite increased post-test probabilities for meniscus pathology, two-year's worsening of selected features was not significantly associated to long-term radiographic knee OA incidence (see Table).</p></div><div><h3>CONCLUSION</h3><p>Most knee OA MRI features showed little progression (<10%) over two years, across compartments, in ACL-injured knees. Lateral TF cartilage defects, meniscus pathology, and medial meniscus extrusion showed high progression rates (18-26%), but these changes showed no statistical significance association to radiographic knee OA incidence after 11 years. Of the assessed features, only progression of meniscus pathology seemed to have potential as ","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000369/pdfft?md5=16e2c3e2bf4778c7ea00be9ae86380c8&pid=1-s2.0-S2772654124000369-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434958","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.2024.100199
W. Wirth , S. Herger , S. Maschek , A. Wisser , F. Eckstein , A. Mündermann
INTRODUCTION
Cartilage T2 is commonly measured by multi-echo spin-echo (MESE) MRI. MESE, however, requires long acquisition times to obtain sufficient in-plane resolution for laminar T2 analysis and does not fully cover the deep cartilage lamina [1]. Quantitative DESS (qDESS) retains both acquired echoes so that both cartilage morphology and cartilage T2 can be extracted simultaneously from a single acquisition with relatively short acquisition time [2, 3]. The qDESS thus reduces patient burden and analysis time. The MechSens trial [4] investigated the impact of unilateral anterior cruciate ligament (ACL) injury on femorotibial (FTJ) cartilage 2–10 years after injury and is the first clinical study to use qDESS MRI. Based on manual segmentations, deep layer FTJ T2 was longer in ACL than in contra-lateral (CL) non-ACL and in healthy control knees, whereas no differences in superficial layer T2 or cartilage thickness were observed.
OBJECTIVE
To technically validate an image analysis technique based on convolutional neural networks (CNN) for automated laminar cartilage T2 analysis for qDESS vs. manual segmentations, and to test whether between-knee and -group differences in deep cartilage T2 can be replicated in ACL-injured vs. control knees.
METHODS
Of 85 participants from two age groups (20–30y & 40–60y) 37 had a unilateral ACL-injury (2–10y prior to baseline: ACL20-30: n=23, ACL40-60, n=14). 48 healthy controls had no history of knee injury (HEA20-30, n=24, HEA40-60, n=24). Coronal qDESS MRIs were acquired using a 3T Siemens Prisma in both knees (resolution: 0.31mm x 0.31mm x 1.5mm, repetition time: 17ms, echo times: 4.85/12.15ms, flip angle: 15°). Manual segmentation of weight-bearing FTJ cartilages was performed with expert quality control. Automated cartilage segmentation was based on a 2D U-Net image analysis workflow. Two U-Nets were trained on both knees of odd- or even-numbered participants and were then employed to segment the knees from the other participants (even- or odd-numbered), respectively. T2 was computed for the FTJ cartilages as previously described [2]. Deep and superficial layer T2 were computed based on the position of the voxels relative to the subchondral bone and cartilage surface and were averaged across the FTJ. The segmentation agreement was evaluated using the Dice similarity coefficient (DSC). T2 was compared between segmentations using Bland & Altman plots and correlation analysis. FTJ T2 of the ACL knees was compared to T2 of uninjured CL and healthy control knees using Conover-Iman and Dunn post-hoc tests, respectively. Paired (between-knee) or unpaired (between-group) Cohen's D was used as measure of effect size of T2 differences.
RESULTS
The agreement of automated vs. manual cartilage segmentation across the four FTJ cartilages was high, with DSCs between 0.90±0.05 (centr
{"title":"VALIDATION OF A FULLY AUTOMATED CARTILAGE SPIN-SPIN (T2) RELAXATION TIME ANALYSIS WORKFLOW FROM QUANTITATIVE DESS (QDESS) MRI","authors":"W. Wirth , S. Herger , S. Maschek , A. Wisser , F. Eckstein , A. Mündermann","doi":"10.1016/j.ostima.2024.100199","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100199","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Cartilage T2 is commonly measured by multi-echo spin-echo (MESE) MRI. MESE, however, requires long acquisition times to obtain sufficient in-plane resolution for laminar T2 analysis and does not fully cover the deep cartilage lamina [1]. Quantitative DESS (qDESS) retains both acquired echoes so that both cartilage morphology and cartilage T2 can be extracted simultaneously from a single acquisition with relatively short acquisition time [2, 3]. The qDESS thus reduces patient burden and analysis time. The MechSens trial [4] investigated the impact of unilateral anterior cruciate ligament (ACL) injury on femorotibial (FTJ) cartilage 2–10 years after injury and is the first clinical study to use qDESS MRI. Based on manual segmentations, deep layer FTJ T2 was longer in ACL than in contra-lateral (CL) non-ACL and in healthy control knees, whereas no differences in superficial layer T2 or cartilage thickness were observed.</p></div><div><h3>OBJECTIVE</h3><p>To technically validate an image analysis technique based on convolutional neural networks (CNN) for automated laminar cartilage T2 analysis for qDESS vs. manual segmentations, and to test whether between-knee and -group differences in deep cartilage T2 can be replicated in ACL-injured vs. control knees.</p></div><div><h3>METHODS</h3><p>Of 85 participants from two age groups (20–30y & 40–60y) 37 had a unilateral ACL-injury (2–10y prior to baseline: ACL<sub>20-30</sub>: n=23, ACL<sub>40-60</sub>, n=14). 48 healthy controls had no history of knee injury (HEA<sub>20-30</sub>, n=24, HEA<sub>40-60</sub>, n=24). Coronal qDESS MRIs were acquired using a 3T Siemens Prisma in both knees (resolution: 0.31mm x 0.31mm x 1.5mm, repetition time: 17ms, echo times: 4.85/12.15ms, flip angle: 15°). Manual segmentation of weight-bearing FTJ cartilages was performed with expert quality control. Automated cartilage segmentation was based on a 2D U-Net image analysis workflow. Two U-Nets were trained on both knees of odd- or even-numbered participants and were then employed to segment the knees from the other participants (even- or odd-numbered), respectively. T2 was computed for the FTJ cartilages as previously described [2]. Deep and superficial layer T2 were computed based on the position of the voxels relative to the subchondral bone and cartilage surface and were averaged across the FTJ. The segmentation agreement was evaluated using the Dice similarity coefficient (DSC). T2 was compared between segmentations using Bland & Altman plots and correlation analysis. FTJ T2 of the ACL knees was compared to T2 of uninjured CL and healthy control knees using Conover-Iman and Dunn post-hoc tests, respectively. Paired (between-knee) or unpaired (between-group) Cohen's D was used as measure of effect size of T2 differences.</p></div><div><h3>RESULTS</h3><p>The agreement of automated vs. manual cartilage segmentation across the four FTJ cartilages was high, with DSCs between 0.90±0.05 (centr","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000278/pdfft?md5=3e743e95747b96602e4a07283209e749&pid=1-s2.0-S2772654124000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434015","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.2024.100212
M.A. van den Berg , F. Boel , M.M.A. van Buuren , N.S. Riedstra , J. Tang , H. Ahedi , V. Arbabi , N. Arden , S.M.A. Bierma-Zeinstra , C.G. Boer , 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 , R. Agricola
INTRODUCTION
Early identification of hip OA is crucial in enhancing our understanding of HOA development and treatment options. Hip morphology could be a modifiable risk factor for the development of radiographic hip osteoarthritis (RHOA), but the exact risk contribution of hip morphology in the general population remains unclear. By combining individual participant data (IPD) of various studies while considering study heterogeneity, novel modeling techniques could be explored to work towards individualized prediction models.
OBJECTIVE
To develop hip morphology based RHOA risk prediction models on multi-cohort datasets and assessed their generalizability to similar and unseen populations.
METHODS
We combined IPD from nine prospective cohort studies collected within the Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH consortium). These studies all had standardized anteroposterior (AP) pelvic, long-limb, and/or hip radiographs taken and graded for RHOA at baseline and 4-8 years follow-up. Risk of incident RHOA was defined as hips with no signs of RHOA at baseline (any RHOA grade <2) which developed RHOA within this follow-up period (any RHOA grade ≥ 2). The lateral center edge angle (LCEA) and alpha angle (AA) were calculated automatically and relied on automated landmark placements on the outline of the hip (Figure 1). Included subjects had a mean age of 66.4 years (SD= 8.5), 71.3% was female, and mean body mass index (BMI) was 27.4 kg/m2 (SD=4.6).
Risk prediction models were built with generalized linear mixed effects models (GLMM) and random forest models (RF). The discriminative performance (AUC) of models including the LCEA and AA measurements was compared to models based on hip side, sex, age, BMI and baseline RHOA grade alone. Stratified 5-fold cross-validation was performed to investigate the effect of a cohort specific intercept on predicted risk by a GLMM model. With leave-one-cohort-out cross-validation, the generalizability to a new population was evaluated for both GLMM and RF models. The mean AUC over the resulting test sets was compared in both settings.
RESULTS
In total, 35,922 hips without definite RHOA at baseline were included of which 4.7% developed RHOA within 4-8 years . Performance differences between the model configurations and between GLMM and RF models were small (Table 1). Using a marginal intercept instead of a cohort-specific intercept in the GLMM on caused a decrease (∼0.1 in AUC) in performance in the stratified 5-fold cross-validation. The leave-one-cohort-out cross-validation showed mean AUC values between 0.70-0.73.
CONCLUSION
In hips free of definite RHOA, we could fairly predict incident RHOA in both similar and unseen populations. However, the added value of hip morphology measurements on the discriminative performance is small.
{"title":"DEVELOPING RISK PREDICTION MODELS FOR HIP OSTEOARTHRITIS BASED ON AUTOMATED HIP MORPHOLOGY MEASUREMENTS AND EVALUATING ON UNSEEN POPULATIONS: DATA OF THE WORLD COACH CONSORTIUM","authors":"M.A. van den Berg , F. Boel , M.M.A. van Buuren , N.S. Riedstra , J. Tang , H. Ahedi , V. Arbabi , N. Arden , S.M.A. Bierma-Zeinstra , C.G. Boer , 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 , R. Agricola","doi":"10.1016/j.ostima.2024.100212","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100212","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Early identification of hip OA is crucial in enhancing our understanding of HOA development and treatment options. Hip morphology could be a modifiable risk factor for the development of radiographic hip osteoarthritis (RHOA), but the exact risk contribution of hip morphology in the general population remains unclear. By combining individual participant data (IPD) of various studies while considering study heterogeneity, novel modeling techniques could be explored to work towards individualized prediction models.</p></div><div><h3>OBJECTIVE</h3><p>To develop hip morphology based RHOA risk prediction models on multi-cohort datasets and assessed their generalizability to similar and unseen populations.</p></div><div><h3>METHODS</h3><p>We combined IPD from nine prospective cohort studies collected within the Worldwide Collaboration on OsteoArthritis prediCtion for the Hip (World COACH consortium). These studies all had standardized anteroposterior (AP) pelvic, long-limb, and/or hip radiographs taken and graded for RHOA at baseline and 4-8 years follow-up. Risk of incident RHOA was defined as hips with no signs of RHOA at baseline (any RHOA grade <2) which developed RHOA within this follow-up period (any RHOA grade ≥ 2). The lateral center edge angle (LCEA) and alpha angle (AA) were calculated automatically and relied on automated landmark placements on the outline of the hip (Figure 1). Included subjects had a mean age of 66.4 years (SD= 8.5), 71.3% was female, and mean body mass index (BMI) was 27.4 kg/m<sup>2</sup> (SD=4.6).</p><p>Risk prediction models were built with generalized linear mixed effects models (GLMM) and random forest models (RF). The discriminative performance (AUC) of models including the LCEA and AA measurements was compared to models based on hip side, sex, age, BMI and baseline RHOA grade alone. Stratified 5-fold cross-validation was performed to investigate the effect of a cohort specific intercept on predicted risk by a GLMM model. With leave-one-cohort-out cross-validation, the generalizability to a new population was evaluated for both GLMM and RF models. The mean AUC over the resulting test sets was compared in both settings.</p></div><div><h3>RESULTS</h3><p>In total, 35,922 hips without definite RHOA at baseline were included of which 4.7% developed RHOA within 4-8 years . Performance differences between the model configurations and between GLMM and RF models were small (Table 1). Using a marginal intercept instead of a cohort-specific intercept in the GLMM on caused a decrease (∼0.1 in AUC) in performance in the stratified 5-fold cross-validation. The leave-one-cohort-out cross-validation showed mean AUC values between 0.70-0.73.</p></div><div><h3>CONCLUSION</h3><p>In hips free of definite RHOA, we could fairly predict incident RHOA in both similar and unseen populations. However, the added value of hip morphology measurements on the discriminative performance is small.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000400/pdfft?md5=61ee32fa57dcd22e00d2572777857e53&pid=1-s2.0-S2772654124000400-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434386","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.2024.100210
M.A. van den Berg , F. Boel , N.S. Riedstra , M.M.A. van Buuren , J. Tang , S.M.A. Bierma-Zeinstra , D. Felson , J.H. Krijthe , J.A. Lynch , A.E. Nelson , M. Nevitt , J. Runhaar , R. Agricola
INTRODUCTION
Current epidemiological research on management and prevention of hip OA faces challenges due to the lack of a uniform OA definition. Automated detection of radiographic features on x-ray images across studies such as the minimal JSW (mJSW) could be a solution. However, having radiographic evidence of hip OA does not always imply having symptoms or disability and vice-versa. In order to create an automated hip OA definition, we need to improve our understanding of the interplay between the mJSW and clinical and radiographic factors in a large and diverse population.
OBJECTIVE
To investigate the differences in automatically determined mJSW values between subjects without hip complaints, with radiographic hip OA, and/or with hip pain.
METHODS
We utilized individual participant data (IPD) from two prospective cohort studies: Cohort Hip and Cohort Knee (CHECK), Johnston County Osteoarthritis Project (JoCoOA), and the Multicenter Osteoarthritis Study (MOST). These studies had weight-bearing (CHECK, MOST) or supine (JoCoOA) standardized anteroposterior (AP) pelvic, long-limb, and/or hip radiographs taken and graded for radiographic hip OA (RHOA) with the KLG. Additionally, the presence of hip pain was determined by converting survey questions into a binary variable. We uniformly measured the mJSW by measuring the minimal distance (in mm) between outlines of the femoral head and weight-bearing part of the acetabulum based on linear B-spline interpolation between automatically placed landmark points (Figure 1). Our study population consisted of 2,400 subjects (4,745 hips), of which 64.5% were female, with a mean age of 61.0 years (SD = 9.0) and a mean body mass index of 28.9 kg/m2 (SD = 5.5). We used ANOVA with post-hoc pairwise comparisons to analyze differences in mJSW between four groups: subjects without hip pain and RHOA, with only hip pain, with only RHOA (KLG ≥2), or both RHOA and hip pain. To adjust for correlations between subjects and cohorts, a linear mixed-effects model was fitted with a nested intercept for subject and cohort, and with a correction factor for hip side. We performed separate analyses for male and female subjects.
RESULTS
From the total of 4,745 included hips, 2,080 (43.8%) had RHOA, hip pain or both. In both male and female subjects, the mJSW was found to be significantly lower in people with RHOA (Figure 2). Subjects that experienced hip pain did not have a significantly different mJSW than subjects without hip pain, both with and without RHOA present.
CONCLUSION
The automatically measured mJSW showed significant differences in mean values between people with and without RHOA, irrespective of the presence of pain. No significant differences were found between people with and without hip pain, irrespective of RHOA.
简介：由于缺乏统一的 OA 定义，目前有关髋关节 OA 管理和预防的流行病学研究面临挑战。自动检测不同研究的 X 光图像上的放射学特征（如最小 JSW（mJSW））可能是一种解决方案。然而，髋关节 OA 的影像学证据并不总是意味着有症状或残疾，反之亦然。为了创建一个自动髋关节 OA 定义，我们需要进一步了解大量不同人群中 mJSW 与临床和放射学因素之间的相互作用。目的研究无髋关节不适、有放射学髋关节 OA 和/或髋关节疼痛的受试者之间自动确定的 mJSW 值的差异：我们利用了两项前瞻性队列研究中的个体参与者数据（IPD）：髋关节和膝关节队列研究（CHECK）、约翰斯顿县骨关节炎项目（JoCoOA）和多中心骨关节炎研究（MOST）。这些研究都采用了负重（CHECK、MOST）或仰卧（JoCoOA）的标准化骨盆、长肢和/或髋关节正侧位 (AP) X 光片，并使用 KLG 对放射学髋关节 OA (RHOA) 进行分级。此外，通过将调查问题转换成二元变量来确定是否存在髋关节疼痛。我们通过测量股骨头轮廓与髋臼负重部分之间的最小距离（以毫米为单位）来统一测量 mJSW，该测量基于自动放置的标志点之间的线性 B-样条插值（图 1）。我们的研究对象包括 2,400 名受试者（4,745 个髋关节），其中 64.5% 为女性，平均年龄为 61.0 岁（SD = 9.0），平均体重指数为 28.9 kg/m2（SD = 5.5）。我们使用方差分析和事后配对比较来分析四组受试者之间 mJSW 的差异：无髋关节疼痛和 RHOA 的受试者、仅有髋关节疼痛的受试者、仅有 RHOA 的受试者（KLG ≥2）或同时有 RHOA 和髋关节疼痛的受试者。为了调整受试者和队列之间的相关性，我们使用线性混合效应模型对受试者和队列进行了嵌套截距拟合，并对髋部一侧使用了校正因子。我们分别对男性和女性受试者进行了分析。结果在总共 4745 个纳入的髋部中，有 2080 个（43.8%）受试者患有 RHOA、髋部疼痛或同时患有这两种疾病。在男性和女性受试者中，有 RHOA 的人的 mJSW 都明显较低（图 2）。结论 自动测量的 mJSW 显示，有 RHOA 和没有 RHOA 的人，无论是否有疼痛，其平均值都有显著差异。无论是否存在 RHOA，有髋关节疼痛和无髋关节疼痛的人之间均无明显差异。
{"title":"AUTOMATICALLY DETERMINED MINIMAL JOINT SPACE WIDTH IS LOWER IN SUBJECTS WITH RADIOGRAPHIC HIP OA BUT NOT SIGNIFICANTLY DIFFERENT IF HIP PAIN IS PRESENT: A MULTI-COHORT ANALYSIS","authors":"M.A. van den Berg , F. Boel , N.S. Riedstra , M.M.A. van Buuren , J. Tang , S.M.A. Bierma-Zeinstra , D. Felson , J.H. Krijthe , J.A. Lynch , A.E. Nelson , M. Nevitt , J. Runhaar , R. Agricola","doi":"10.1016/j.ostima.2024.100210","DOIUrl":"https://doi.org/10.1016/j.ostima.2024.100210","url":null,"abstract":"<div><h3>INTRODUCTION</h3><p>Current epidemiological research on management and prevention of hip OA faces challenges due to the lack of a uniform OA definition. Automated detection of radiographic features on x-ray images across studies such as the minimal JSW (mJSW) could be a solution. However, having radiographic evidence of hip OA does not always imply having symptoms or disability and vice-versa. In order to create an automated hip OA definition, we need to improve our understanding of the interplay between the mJSW and clinical and radiographic factors in a large and diverse population.</p></div><div><h3>OBJECTIVE</h3><p>To investigate the differences in automatically determined mJSW values between subjects without hip complaints, with radiographic hip OA, and/or with hip pain.</p></div><div><h3>METHODS</h3><p>We utilized individual participant data (IPD) from two prospective cohort studies: Cohort Hip and Cohort Knee (CHECK), Johnston County Osteoarthritis Project (JoCoOA), and the Multicenter Osteoarthritis Study (MOST). These studies had weight-bearing (CHECK, MOST) or supine (JoCoOA) standardized anteroposterior (AP) pelvic, long-limb, and/or hip radiographs taken and graded for radiographic hip OA (RHOA) with the KLG. Additionally, the presence of hip pain was determined by converting survey questions into a binary variable. We uniformly measured the mJSW by measuring the minimal distance (in mm) between outlines of the femoral head and weight-bearing part of the acetabulum based on linear B-spline interpolation between automatically placed landmark points (Figure 1). Our study population consisted of 2,400 subjects (4,745 hips), of which 64.5% were female, with a mean age of 61.0 years (SD = 9.0) and a mean body mass index of 28.9 kg/m<sup>2</sup> (SD = 5.5). We used ANOVA with post-hoc pairwise comparisons to analyze differences in mJSW between four groups: subjects without hip pain and RHOA, with only hip pain, with only RHOA (KLG ≥2), or both RHOA and hip pain. To adjust for correlations between subjects and cohorts, a linear mixed-effects model was fitted with a nested intercept for subject and cohort, and with a correction factor for hip side. We performed separate analyses for male and female subjects.</p></div><div><h3>RESULTS</h3><p>From the total of 4,745 included hips, 2,080 (43.8%) had RHOA, hip pain or both. In both male and female subjects, the mJSW was found to be significantly lower in people with RHOA (Figure 2). Subjects that experienced hip pain did not have a significantly different mJSW than subjects without hip pain, both with and without RHOA present.</p></div><div><h3>CONCLUSION</h3><p>The automatically measured mJSW showed significant differences in mean values between people with and without RHOA, irrespective of the presence of pain. No significant differences were found between people with and without hip pain, irrespective of RHOA.</p></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"4 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772654124000382/pdfft?md5=3d439f92542f1af832cd20daceda31fe&pid=1-s2.0-S2772654124000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434409","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}
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