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Wang Q, Zhao W, Ji X, Chen Y, Liu K, Zhu Y, Yan R, Qin S, Xin P, Lang N. Broken-fat pad sign: a characteristic radiographic finding to distinguish between knee rheumatoid arthritis and osteoarthritis. Insights Imaging 2024; 15:33. [PMID: 38315274 PMCID: PMC10844185 DOI: 10.1186/s13244-024-01608-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/21/2023] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVES Diagnostic imaging plays an important role in the pre-treatment workup of knee osteoarthritis (OA) and rheumatoid arthritis (RA). Herein, we identified a useful MRI sign of infrapatellar fat pad (IPFP) to improve diagnosis. METHODS Eighty-one age- and sex-matched RA and OA patients each, with pathological diagnosis and pre-treatment MRI were retrospectively evaluated. All randomized MR images were blinded and independently reviewed by two radiologists. The assessment process included initial diagnosis, sign evaluation, and final diagnosis, with a 3-week interval between each assessment. Broken-fat pad (BFP) sign was assessed on sagittal T2-weighted-imaging in routine MRI. The area under the curve and Cohen's kappa (κ) were used to assess the classification performance. Two shape features were extracted from IPFP for quantitative interpretation. RESULTS The median age of the study population was 57.6 years (range: 31.0-78.0 years). The BFP sign was detected more frequently in patients with RA (72.8%) than those with OA (21.0%). Both radiologists achieved better performance by referring to the BFP sign, with accuracies increasing from 58.0 to 75.9% and 72.8 to 79.6%, respectively. The inter-reader correlation coefficient showed an increase from fair (κ = 0.30) to substantial (κ = 0.75) upon the consideration of the BFP sign. For quantitative analysis, the IPFP of RA had significantly lower sphericity (0.54 ± 0.04 vs. 0.59 ± 0.03, p < 0.01). Despite larger surface-volume-ratio of RA (0.38 ± 0.05 vs. 0.37 ± 0.04, p = 0.25) than that of OA, there was no statistical difference. CONCLUSIONS The BFP sign is a potentially important diagnostic clue for differentiating RA from OA with routine MRI and reducing misdiagnosis. CRITICAL RELEVANCE STATEMENT With the simple and feasible broken-fat pad sign, clinicians can help more patients with early accurate diagnosis and proper treatment, which may be a valuable addition to the diagnostic workup of knee MRI assessment. KEY POINTS • Detailed identification of infrapatellar fat pad alterations of patients may be currently ignored in routine evaluation. • Broken-fat pad sign is helpful for differentiating rheumatoid arthritis and osteoarthritis. • The quantitative shape features of the infrapatellar fat pad may provide a possible explanation of the signs. • This sign has good inter-reader agreements and is feasible for clinical application.
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Affiliation(s)
- Qizheng Wang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Weili Zhao
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Xiaoxi Ji
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Yongye Chen
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Ke Liu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Yupeng Zhu
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Ruixin Yan
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Siyuan Qin
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Peijin Xin
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China
| | - Ning Lang
- Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, People's Republic of China.
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Griffith JF, Yip SWY, van der Heijden RA, Valenzuela RF, Yeung DKW. Perfusion Imaging of the Musculoskeletal System. Magn Reson Imaging Clin N Am 2024; 32:181-206. [PMID: 38007280 DOI: 10.1016/j.mric.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Perfusion imaging is the aspect of functional imaging, which is most applicable to the musculoskeletal system. In this review, the anatomy and physiology of bone perfusion is briefly outlined as are the methods of acquiring perfusion data on MR imaging. The current clinical indications of perfusion related to the assessment of soft tissue and bone tumors, synovitis, osteoarthritis, avascular necrosis, Keinbock's disease, diabetic foot, osteochondritis dissecans, and Paget's disease of bone are reviewed. Challenges and opportunities related to perfusion imaging of the musculoskeletal system are also briefly addressed.
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Affiliation(s)
- James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong.
| | - Stefanie W Y Yip
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
| | - Rianne A van der Heijden
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Raul F Valenzuela
- Department of Musculoskeletal Imaging, The University of Texas, MD Anderson Cancer Center, USA
| | - David K W Yeung
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong
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Mostert JM, Dur NB, Li X, Ellermann JM, Hemke R, Hales L, Mazzoli V, Kogan F, Griffith JF, Oei EH, van der Heijden RA. Advanced Magnetic Resonance Imaging and Molecular Imaging of the Painful Knee. Semin Musculoskelet Radiol 2023; 27:618-631. [PMID: 37935208 PMCID: PMC10629992 DOI: 10.1055/s-0043-1775741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Chronic knee pain is a common condition. Causes of knee pain include trauma, inflammation, and degeneration, but in many patients the pathophysiology remains unknown. Recent developments in advanced magnetic resonance imaging (MRI) techniques and molecular imaging facilitate more in-depth research focused on the pathophysiology of chronic musculoskeletal pain and more specifically inflammation. The forthcoming new insights can help develop better targeted treatment, and some imaging techniques may even serve as imaging biomarkers for predicting and assessing treatment response in the future. This review highlights the latest developments in perfusion MRI, diffusion MRI, and molecular imaging with positron emission tomography/MRI and their application in the painful knee. The primary focus is synovial inflammation, also known as synovitis. Bone perfusion and bone metabolism are also addressed.
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Affiliation(s)
- Jacob M. Mostert
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Niels B.J. Dur
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Orthopedics and Sports Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Xiufeng Li
- Department of Radiology, Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, Minnesota
| | - Jutta M. Ellermann
- Department of Radiology, Center for Magnetic Resonance Research (CMRR), University of Minnesota, Minneapolis, Minnesota
| | - Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Laurel Hales
- Department of Radiology, Stanford University, Stanford, California
| | | | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California
| | - James F. Griffith
- Department of Imaging and Interventional Radiology Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Edwin H.G. Oei
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rianne A. van der Heijden
- Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin
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Oei EHG, Runhaar J. Imaging of early-stage osteoarthritis: the needs and challenges for diagnosis and classification. Skeletal Radiol 2023; 52:2031-2036. [PMID: 37154872 PMCID: PMC10509094 DOI: 10.1007/s00256-023-04355-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/10/2023]
Abstract
In an effort to boost the development of new management strategies for OA, there is currently a shift in focus towards the diagnosis and treatment of early-stage OA. It is important to distinguish diagnosis from classification of early-stage OA. Diagnosis takes place in clinical practice, whereas classification is a process to stratify participants with OA in clinical research. For both purposes, there is an important opportunity for imaging, especially with MRI. The needs and challenges differ for early-stage OA diagnosis versus classification. Although it fulfils the need of high sensitivity and specificity for making a correct diagnosis, implementation of MRI in clinical practice is challenged by long acquisition times and high costs. For classification in clinical research, more advanced MRI protocols can be applied, such as quantitative, contrast-enhanced, or hybrid techniques, as well as advanced image analysis methods including 3D morphometric assessments of joint tissues and artificial intelligence approaches. It is necessary to follow a step-wise and structured approach that comprises, technical validation, biological validation, clinical validation, qualification, and cost-effectiveness, before new imaging biomarkers can be implemented in clinical practice or clinical research.
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Affiliation(s)
- Edwin H. G. Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, PO-Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Jos Runhaar
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, PO-Box 2040, 3000 CA Rotterdam, the Netherlands
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Hayashi D, Roemer FW, Jarraya M, Guermazi A. Update on recent developments in imaging of inflammation in osteoarthritis: a narrative review. Skeletal Radiol 2023; 52:2057-2067. [PMID: 36542129 DOI: 10.1007/s00256-022-04267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Synovitis is an important component of the osteoarthritis (OA) disease process, particularly regarding the "inflammatory phenotype" of OA. Imaging plays an important role in the assessment of synovitis in OA with MRI and ultrasound being the most deployed imaging modalities. Contrast-enhanced (CE) MRI, particularly dynamic CEMRI (DCEMRI) is the ideal method for synovitis assessment, but for several reasons CEMRI is not commonly performed for OA imaging in general. Effusion-synovitis and Hoffa-synovitis are commonly used as surrogate markers of synovitis on non-contrast-enhanced (NCE) MRI and have been used in many epidemiological observational studies of knee OA. Several semiquantitative MRI scoring systems are available for the evaluation of synovitis in knee OA. Synovitis can be a target tissue for disease-modifying OA drug (DMOAD) clinical trials. Both MRI and ultrasound may be used to determine the eligibility and assess the therapeutic efficacy of DMOAD approaches. Ultrasound is mostly used for evaluation of synovitis in hand OA, while MRI is typically used for larger joints, namely knees and hips. The role of other modalities such as CT (including dual-energy CT) and nuclear medicine imaging (such as positron-emission tomography (PET) and its hybrid imaging) is limited in the context of synovitis assessment in OA. Despite research efforts to develop NCEMRI-based synovitis evaluation methods, these typically underestimate the severity of synovitis compared to CEMRI, and thus more research is needed before we can rely only on NCEMRI.
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Affiliation(s)
- Daichi Hayashi
- Department of Radiology, Stony Brook University Renaissance School of Medicine, HSc Level 4, Room 120, Stony Brook, NY, 11794, USA.
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA.
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, West Roxbury, Boston, MA, USA
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Tan H, Kang W, Fan Q, Wang B, Yu Y, Yu N, Duan H, Yuan P, Wang S, Chen Q, Jin C. Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging Findings of Infrapatellar Fat Pad Signal Abnormalities: Comparison Between Symptomatic and Asymptomatic Knee Osteoarthritis. Acad Radiol 2023; 30:1374-1383. [PMID: 36609030 DOI: 10.1016/j.acra.2022.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/26/2022] [Accepted: 11/12/2022] [Indexed: 01/06/2023]
Abstract
RATIONALE AND OBJECTIVES Infrapatellar fat pad (IPFP) proton density-weighted images (PdWI) hyperintense regions on MRI are an important imaging feature of knee osteoarthritis (KOA) and are thought to represent inflammation which may induce knee pain. The aim of the study was to compare the intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) findings of PdWI hyperintense regions of IPFP between symptomatic and asymptomatic KOA and to determine whether IVIM-DWI parameters can be used as an objective biomarker for symptomatic KOA. MATERIALS AND METHODS In total, 84 patients with symptomatic KOA, 43 asymptomatic KOA persons, and 30 healthy controls with MRI were retrospectively reviewed. Demographic, IPFP-synovitis, Western Ontario and McMaster Osteoarthritis Index (WOMAC) pain sub-score, IPFP volume and depth and quantitative parameters of IVIM-DWI were collected. The chi-square test, Binary logistic regression and receiver operating characteristic curve (ROC) analysis were used for diagnostic performance comparison. RESULTS The IPFP volume and depth were statistically significant differences between the non-KOA and sKOA groups (p<0.05). The IPFP PdWI hyperintense regions demonstrated significantly higher values of D and D* in the symptomatic KOA compared to those in the asymptomatic KOA (1.51±0.47 vs. 1.73±0.40 for D and 19.24±6.44 vs. 27.09±9.75 for D*) (both p<0.05). Multivariate logistic regression analyses showed that Higher D and D* values of IPFP hyperintense region were significantly associated with higher risks of knee pain (OR: 1.97; 95% CI: 1.21-3.19; p=0.006 for D and OR: 1.24; 95% CI: 1.09-1.41; p=0.001 for D*). Sensitivity and specificity of D value for symptomatic KOA were 80.28% and 83.33%, with an AUC of 0.78 (0.68-0.86). D* value had the sensitivity with 92.96% and a specificity of 58.33%, with an AUC of 0.82 (0.73-0.89) for symptomatic KOA. CONCLUSION IVIM-DWI can be used as an additional functional imaging technique to study IPFP with signal abnormalities on PdWI, and the D and D* values may have potential value to predict the symptom in mild-to-moderate KOA patients.
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Affiliation(s)
- Hui Tan
- From the department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China; Department of Radiology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Wulin Kang
- Department of Orthopedics, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Qiuju Fan
- Department of Radiology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Bin Wang
- Institute of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Yong Yu
- Department of Radiology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Nan Yu
- Department of Radiology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Haifeng Duan
- Department of Radiology, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Puwei Yuan
- Department of Orthopedics, The Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Shaoyu Wang
- MR senior scientific marketing specialist, Siemens Healthineers, Shanghai, People's Republic of China
| | - Qing Chen
- Institute of Medical Technology, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, People's Republic of China
| | - Chenwang Jin
- From the department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, Shaanxi, 710061, People's Republic of China.
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Ye Q, He D, Ding X, Wang Y, Wei Y, Liu J. Quantitative evaluation of the infrapatellar fat pad in knee osteoarthritis: MRI-based radiomic signature. BMC Musculoskelet Disord 2023; 24:326. [PMID: 37098523 PMCID: PMC10127010 DOI: 10.1186/s12891-023-06433-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The infrapatellar fat pad (IFP) may have bilateral influence on knee osteoarthritis (KOA). IFP evaluation may be a key contributor to the diagnostic and clinical management of KOA. Few studies have evaluated KOA-related IFP alteration with radiomics. We investigated radiomic signature for the assessment of IFP for KOA progression in older adults. METHODS A total of 164 knees were enrolled and grouped based on Kellgren-Lawrence (KL) scoring. MRI-based radiomic features were calculated from IFP segmentation. The radiomic signature was developed using the most predictive subset of features and the machine-learning algorithm with minimum relative standard deviation. KOA severity and structure abnormality were assessed using a modified whole-organ magnetic resonance imaging score (WORMS). The performance of the radiomic signature was evaluated and the correlation with WORMS assessments was analyzed. RESULTS The area under the curve of the radiomic signature for diagnosing KOA was 0.83 and 0.78 in the training and test datasets, respectively. Rad-scores were 0.41 and 2.01 for the training dataset in the groups with and without KOA (P < 0.001) and 0.63 and 2.31 for the test dataset (P = 0.005), respectively. WORMS significantly and positively correlated with rad-scores. CONCLUSIONS The radiomic signature may be a reliable biomarker to detect IFP abnormality of KOA. Radiomic alterations in IFP were associated with severity and knee structural abnormalities of KOA in older adults.
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Affiliation(s)
- Qin Ye
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Dong He
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xiaonan Ding
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yajie Wang
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yuguo Wei
- Precision Health Institution, General Electric Healthcare, Hangzhou, China
| | - Jing Liu
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Cen H, Yan Q, Meng T, Chen Z, Zhu J, Wang Y, Ruan G, Wang T, Han W, Hunter D, Ding C. Quantitative infrapatellar fat pad signal intensity alteration as an imaging biomarker of knee osteoarthritis progression. RMD Open 2023; 9:rmdopen-2022-002565. [PMID: 36697038 PMCID: PMC9884854 DOI: 10.1136/rmdopen-2022-002565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/02/2023] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To determine the association of quantitative infrapatellar fat pad (IPFP) signal intensity alteration with knee osteoarthritis (OA) progression. METHOD This study was performed based on the Foundation for the National Institutes of Health OA Biomarkers Consortium study, a nested case-control study consisting of 600 participants. The IPFP signal intensity alterations were quantitatively measured at baseline, 12 months and 24 months. The associations of baseline and time-integrated values over 12 and 24 months of IPFP signal intensity measures with knee OA progression over 48 months were evaluated with adjustment for baseline confounders. RESULTS The baseline level of clustering effect of high signal intensity (Clustering factor (H)) was predictive of clinically relevant progression (both radiographic and pain progression) (OR 1.22). The time-integrated values of all IPFP signal intensity measures, except for mean value of IPFP signal intensity (Mean (IPFP)) over 24 months (ORs ranging from 1.23 to 1.39) as well was all except for Mean (IPFP) and mean value of IPFP high signal intensity (Mean (H)) over 12 months (ORs ranging from 1.20 to 1.31), were positively associated with clinically relevant progression. When the associations of quantitative IPFP signal intensity measures with radiographic and pain progression were examined separately, more IPFP signal intensity measures with stronger effect sizes were associated with radiographic progression compared with pain progression. CONCLUSION The associations of short-term alteration in quantitative IPFP signal intensity measures with long-term knee OA progression suggest that these measures might serve as efficacy of intervention biomarkers of knee OA.
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Affiliation(s)
- Han Cen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Qingran Yan
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Tao Meng
- Department of Rheumatology and Immunology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhongshan Chen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,School of Mathematics and Information Science, Nanjing Normal University of Special Education, Nanjing, Jiangsu, China
| | - Jimin Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Department of Public Health and General Medicine, School of Life Sciences, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Yuanyuan Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Guangfeng Ruan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Clinical Research Centre, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Tian Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Department of Rheumatology and Clinical Immunology, Beijing An Zhen Hospital, Capital Medical University, Beijing, Beijing, China
| | - Weiyu Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - David Hunter
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China,Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China .,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Zhong L, Li M, Du X, Ding Y, Zhang X, Mei Y, Yi P, Feng Y, Chen Y, Zhang X. Quantitative evaluation of the characteristic of infrapatellar fat pad Fat Content and Unsaturation Index by using hydrogen proton MR spectroscopy. Magn Reson Imaging 2022; 94:18-24. [DOI: 10.1016/j.mri.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 10/16/2022]
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10
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Exploring Anatomo-Morphometric Characteristics of Infrapatellar, Suprapatellar Fat Pad, and Knee Ligaments in Osteoarthritis Compared to Post-Traumatic Lesions. Biomedicines 2022; 10:biomedicines10061369. [PMID: 35740391 PMCID: PMC9220326 DOI: 10.3390/biomedicines10061369] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Several studies have investigated cartilage degeneration and inflammatory subchondral bone and synovial membrane changes using magnetic resonance (MR) in osteoarthritis (OA) patients. Conversely, there is a paucity of data exploring the role of knee ligaments, infrapatellar fat pad (IFP), and suprapatellar fat pad (SFP) in knee OA compared to post-traumatic cohorts of patients. Therefore, the aim of this study was to analyze the volumetric and morphometric characteristics of the following joint tissues: IFP (volume, surface, depth, femoral and tibial arch lengths), SFP (volume, surface, oblique, antero−posterior, and cranio−caudal lengths), anterior (ACL) and posterior cruciate ligament (PCL) (volume, surface, and length), and patellar ligament (PL) (volume, surface, arc, depth, and length). Eighty-nine MR images were collected in the following three groups: (a) 32 patients with meniscal tears, (b) 29 patients with ACL rupture (ACLR), and (c) 28 patients affected by end-stage OA. Volume, surface, and length of both ACL and PCL were determined in groups a and c. A statistical decrease of IFP volume, surface, depth, femoral and tibial arch lengths was found in end-stage OA compared to patients with meniscal tear (p = 0.002, p = 0.008, p < 0.0001, p = 0.028 and p < 0.001, respectively) and patients with ACLR (p < 0.0001, p < 0.0001, p = 0.008 and p = 0.011, respectively). An increment of volume and surface SFP was observed in group b compared to both groups a and c, while no differences were found in oblique, antero−posterior, and cranio−caudal lengths of SFP among the groups. No statistical differences were highlighted comparing volume, surface, arc, and length of PL between the groups, while PL depth was observed to be decreased in end-OA patients compared with meniscal tear patients (p = 0.023). No statistical differences were observed comparing ACL and PCL lengths between patients undergoing meniscectomy and TKR. Our study confirms that IFP MR morphometric characteristics are different between controls and OA, supporting an important role of IFP in OA pathology and progression in accordance with previously published studies. In addition, PL depth changes seem to be associated with OA pathology. Multivariate analysis confirmed that OA patients had a smaller IFP compared to patients with meniscal tears, confirming its involvement in OA.
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Chen Y, Zhang X, Li M, Zhong L, Ding Y, Zhang Y, Du X, Mo X, Chen J, Chen Q, Huang W, Zhong S, Zhang X. Quantitative MR evaluation of the infrapatellar fat pad for knee osteoarthritis: using proton density fat fraction and T2* relaxation based on DIXON. Eur Radiol 2022; 32:4718-4727. [PMID: 35141779 DOI: 10.1007/s00330-022-08561-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the efficacy of fat fraction (FF) and T2* relaxation based on DIXON in the assessment of infrapatellar fat pad (IFP) for knee osteoarthritis (KOA) progression in older adults. METHODS Ninety volunteers (age range 51-70 years, 65 females) were enrolled in this study. Participants were grouped based on the Kellgren-Lawrence grading (KLG). The FF and T2* values were measured based on the 3D-modified DXION technique. Cartilage defects, bone marrow lesions, and synovitis were assessed based on a modified version of whole-organ magnetic resonance imaging score (WORMS). Knee pain was assessed by self-administered Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire. The differences of FF and T2* measurement and the correlation with WORMS and WOMAC assessments were analyzed. Diagnostic efficiency was analyzed by using receiver operating characteristic (ROC) curves. RESULTS A total of 60 knees were finally included (n = 20 in each group). The values were 82.6 ± 3.7%, 74.7 ± 5.4%, and 60.5 ± 14.1% for FF is the no OA, mild OA, and advanced OA groups, and were 50.7 ± 6.6 ms, 44.1 ± 6.6 ms, and 39.1 ± 4.2 ms for T2*, respectively (all p values < 0.001). The WORMS assessment and WOMAC pain assessment showed negative correlation with FF and T2* values. The ROC showed the area under the curve (AUC), sensitivity, and specificity for diagnosing OA were 0.93, 77.5%, and 100% using FF, and were 0.86, 75.0%, and 90.0% using T2*, respectively. CONCLUSIONS FF and T2* alternations in IFP are associated with knee structural abnormalities and clinical symptoms cross-sectionally and may have the potential to predict the severity of KOA. KEY POINTS • Fat fraction (FF) and T2* relaxation based on DIXON imaging are novel methods to quantitatively assess the infrapatellar fat pad for knee osteoarthritis (KOA) progression in older adults. • The alterations of FF and T2* using mDIXON technique in IFP were associated with knee structural abnormalities and clinical symptoms. • FF and T2* alternations in IFP can serve as the new imaging biomarkers for fast, simple, and noninvasive assessment in KOA.
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Affiliation(s)
- Yanjun Chen
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Xintao Zhang
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Mianwen Li
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Lijie Zhong
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Yukun Ding
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Yaru Zhang
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Xueting Du
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Guangzhou, Guangdong, China
| | - Xianfu Mo
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Jialing Chen
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Qianmin Chen
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Wenhua Huang
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Shizhen Zhong
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China.
| | - Xiaodong Zhang
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China.
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12
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Oei EHG, Hirvasniemi J, van Zadelhoff TA, van der Heijden RA. Osteoarthritis year in review 2021: imaging. Osteoarthritis Cartilage 2022; 30:226-236. [PMID: 34838670 DOI: 10.1016/j.joca.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/16/2021] [Accepted: 11/11/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To provide a narrative review of original articles on imaging of osteoarthritis (OA) published between January 1, 2020 and March 31, 2021, with a special focus on imaging of inflammation, imaging of bone, cartilage and bone-cartilage interactions, imaging of peri-articular tissues, imaging scoring methods for OA, and artificial intelligence (AI) applied to OA imaging. METHODS The Embase, Pubmed, Medline, Cochrane databases were searched for original research articles in the English language on human, in vivo, imaging of OA published between January 1, 2020 and March 31, 2021. Search terms related to osteoarthritis combined with all imaging modalities and artificial intelligence were applied. A selection of articles reporting on one of the focus topics was discussed further. RESULTS The search resulted in 651 articles, of which 214 were deemed relevant to human OA imaging. Among the articles included, the knee joint (69%) and magnetic resonance imaging (MRI) (52%) were the predominant anatomical area and imaging modality studied. There were also a substantial number of papers (n = 46) reporting on AI applications in the field of OA imaging. CONCLUSION Imaging continues to play an important role in the assessment of OA. Recent advances in OA imaging include quantitative, non-contrast, and hybrid imaging techniques for improved characterization of multiple tissue processes in OA. In addition, an increasing effort in AI techniques is undertaken to enhance OA imaging acquisition and analysis.
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Affiliation(s)
- E H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - J Hirvasniemi
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - T A van Zadelhoff
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
| | - R A van der Heijden
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands.
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13
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Holland MD, Morales A, Simmons S, Smith B, Misko SR, Jiang X, Hormuth DA, Christenson C, Koomullil RP, Morgan DE, Li Y, Xu J, Yankeelov TE, Kim H. Disposable point-of-care portable perfusion phantom for quantitative DCE-MRI. Med Phys 2021; 49:271-281. [PMID: 34802148 DOI: 10.1002/mp.15372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/12/2021] [Accepted: 11/05/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To develop a disposable point-of-care portable perfusion phantom (DP4) and validate its clinical utility in a multi-institutional setting for quantitative dynamic contrast-enhanced magnetic resonance imaging (qDCE-MRI). METHODS The DP4 phantom was designed for single-use and imaged concurrently with a human subject so that the phantom data can be utilized as the reference to detect errors in qDCE-MRI measurement of human tissues. The change of contrast-agent concentration in the phantom was measured using liquid chromatography-mass spectrometry. The repeatability of the contrast enhancement curve (CEC) was assessed with five phantoms in a single MRI scanner. Five healthy human subjects were recruited to evaluate the reproducibility of qDCE-MRI measurements. Each subject was imaged concurrently with the DP4 phantom at two institutes using three 3T MRI scanners from three different vendors. Pharmacokinetic (PK) parameters in the regions of liver, spleen, pancreas, and paravertebral muscle were calculated based on the Tofts model (TM), extended Tofts model (ETM), and shutter speed model (SSM). The reproducibility of each PK parameter over three measurements was evaluated with the intraclass correlation coefficient (ICC) and compared before and after DP4-based error correction. RESULTS The contrast-agent concentration in the DP4 phantom was linearly increased over 10 min (0.17 mM/min, measurement accuracy: 96%) after injecting gadoteridol (100 mM) at a constant rate (0.24 ml/s, 4 ml). The repeatability of the CEC within the phantom was 0.997 when assessed by the ICC. The reproducibility of the volume transfer constant, Ktrans , was the highest of the PK parameters regardless of the PK models. The ICCs of Ktrans in the TM, ETM, and SSM before DP4-based error correction were 0.34, 0.39, and 0.72, respectively, while those increased to 0.93, 0.98, and 0.86, respectively, after correction. CONCLUSIONS The DP4 phantom is reliable, portable, and capable of significantly improving the reproducibility of qDCE-MRI measurements.
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Affiliation(s)
- Martin D Holland
- Interdisciplinary Engineering, University of Alabama, Birmingham, Alabama, USA
| | - Andres Morales
- Engineering and Innovative Technology Development, University of Alabama, Birmingham, Alabama, USA
| | | | - Brandon Smith
- Engineering and Innovative Technology Development, University of Alabama, Birmingham, Alabama, USA
| | - Samuel R Misko
- Engineering and Innovative Technology Development, University of Alabama, Birmingham, Alabama, USA
| | - Xiaoyu Jiang
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - David A Hormuth
- The Oden Institute for Computational Engineering and Sciences, University of Texas, Austin, Texas, USA
| | - Chase Christenson
- The Oden Institute for Computational Engineering and Sciences, University of Texas, Austin, Texas, USA
| | - Roy P Koomullil
- Department of Mechanical Engineering, University of Alabama, Birmingham, Alabama, USA
| | - Desiree E Morgan
- Department of Radiology, University of Alabama, Birmingham, Alabama, USA
| | - Yufeng Li
- Department of Preventive Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Junzhong Xu
- Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas E Yankeelov
- The Oden Institute for Computational Engineering and Sciences, University of Texas, Austin, Texas, USA
| | - Harrison Kim
- Department of Radiology, University of Alabama, Birmingham, Alabama, USA
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14
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Changes of DCE-MRI Parameters in Patients with Rheumatoid Arthritis before and after Therapy and Their Value for the Efficacy Evaluation of Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6848359. [PMID: 34707673 PMCID: PMC8545511 DOI: 10.1155/2021/6848359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 09/30/2021] [Indexed: 11/17/2022]
Abstract
Objective To explore the changes of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters in patients with rheumatoid arthritis (RA) before and after therapy and their value for the efficacy evaluation of patients. Methods Totally, 90 patients with RA confirmed in our hospital between January 2018 and January 2020 were enrolled. All of them were examined with a Siemens Magnetom Avanto 1.5T imaging system, and data about the rate of enhancement in early stage (REE) and steep slope maximum (SSmax) were obtained. Then, the disease activity score in 28 joints (DAS-28), REE, and SSmax were analyzed, and the associations of SSmax and REE with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and DAS-28 were investigated. Additionally, the patients were assigned to the acute-stage group and the chronic-stage group according to their time-signal intensity curves after therapy, and the two groups were compared in SSmax, REE, ESR, CRP, and DAS-28. Corresponding receiver operating characteristic (ROC) curves were drawn for the analysis of potential markers for efficacy improvement in patients. Results After therapy, REE, SSmax, ESR, DAS-28, and CRP in the synovium of all patients declined greatly (all P < 0.05), with higher levels observed in the acute-stage group than those in the chronic-stage group (all P < 0.05). SSmax and REE of patients were positively bound up with their ESR, CRP, and DAS-28 (all P < 0.05). Additionally, according to ROC curve-based analysis, both SSmax and REE can be adopted as biological indexes for distinguishing between patients at the acute phase from those at the chronic stage, and joint detection of them can boost the sensitivity of DAS-28. Conclusion The SSmax and REE levels in RA patients after treatment were significantly decreased, and the levels in patients in the chronic phase were lower than those in patients in the acute phase. SSmax and REE are highly expressed in RA patients, and the combined detection can enhance the value of DAS-28 in the assessment of RA, and it is worthy of clinical promotion.
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15
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Oei EHG, van Zadelhoff TA, Eijgenraam SM, Klein S, Hirvasniemi J, van der Heijden RA. 3D MRI in Osteoarthritis. Semin Musculoskelet Radiol 2021; 25:468-479. [PMID: 34547812 DOI: 10.1055/s-0041-1730911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Osteoarthritis (OA) is among the top 10 burdensome diseases, with the knee the most affected joint. Magnetic resonance imaging (MRI) allows whole-knee assessment, making it ideally suited for imaging OA, considered a multitissue disease. Three-dimensional (3D) MRI enables the comprehensive assessment of OA, including quantitative morphometry of various joint tissues. Manual tissue segmentation on 3D MRI is challenging but may be overcome by advanced automated image analysis methods including artificial intelligence (AI). This review presents examples of the utility of 3D MRI for knee OA, focusing on the articular cartilage, bone, meniscus, synovium, and infrapatellar fat pad, and it highlights several applications of AI that facilitate segmentation, lesion detection, and disease classification.
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Affiliation(s)
- Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tijmen A van Zadelhoff
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Susanne M Eijgenraam
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Stefan Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jukka Hirvasniemi
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rianne A van der Heijden
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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16
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Gallina A, Abboud J, Blouin JS. A task-relevant experimental pain model to target motor adaptation. J Physiol 2021; 599:2401-2417. [PMID: 33638152 DOI: 10.1113/jp281145] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 02/22/2021] [Indexed: 01/23/2023] Open
Abstract
KEY POINTS Motor adaptation is thought to be a strategy to avoid pain. Current experimental pain models do not allow for consistent modulation of pain perception depending on movement. We showed that low-frequency sinusoidal stimuli delivered at painful intensity result in minimal habituation of pain perception (over 60 s) and minimal stimulation artefacts on electromyographic signals. When the amplitude of the low-frequency sinusoidal stimuli was modulated based on the vertical force participants applied to the ground with their right leg while standing upright, we demonstrated a strong association between perceived pain and motor adaptation. By enabling task-relevant modulation of perceived pain intensity and the recording electromyographic signals during electrical painful stimulation, our novel pain model will permit direct experimental testing of the relationship between pain and motor adaptation. ABSTRACT Contemporary pain adaptation theories predict that motor adaptation occurs to limit pain. Current experimental pain models, however, do not allow for pain intensity modulation according to one's posture or movements. We developed a task-relevant experimental pain model using low-frequency sinusoidal electrical stimuli applied over the infrapatellar fat pad. In fourteen participants, we compared perceived pain habituation and stimulation-induced artefacts in vastus medialis electromyographic recordings elicited by sinusoidal (4, 10, 20 and 50 Hz) and square electrical waveforms delivered at constant peak stimulation amplitude. Next, we simulated a clinical condition where perceived knee pain intensity is proportional to the load applied on the leg by controlling sinusoidal current amplitude (4 Hz) according to the vertical force the participants applied with their right leg to the ground while standing upright. Pain ratings habituated over a 60 s period for 50 Hz sinusoidal and square waveforms but not for low-frequency sinusoidal stimuli (P < 0.001). EMG filters removed most stimulation artefacts for low-frequency sinusoidal stimuli (4 Hz). While balancing upright, participants' pain ratings were correlated with the force applied by the right leg (R2 = 0.65), demonstrating task-relevant changes in perceived pain intensity. Low-frequency sinusoidal stimuli can induce knee pain of constant intensity for 60 s with minimal EMG artefacts while enabling task-relevant pain modulation when controlling current amplitude. By enabling task-dependent modulation of perceived pain intensity, our novel experimental model replicates key temporal aspects of clinical musculoskeletal pain while allowing quantification of neuromuscular activation during painful electrical stimulation. This approach will enable researchers to test the predicted relationship between movement strategies and pain.
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Affiliation(s)
- Alessio Gallina
- School of Kinesiology, University of British Columbia, Vancouver, Canada.,Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Jacques Abboud
- School of Kinesiology, University of British Columbia, Vancouver, Canada.,Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Jean-Sébastien Blouin
- School of Kinesiology, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada.,Institute for Computing, Information and Cognitive Systems, University of British Columbia, Vancouver, Canada
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17
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Chung C, Kalpathy-Cramer J, Knopp MV, Jaffray DA. In the Era of Deep Learning, Why Reconstruct an Image at All? J Am Coll Radiol 2021; 18:170-173. [PMID: 33413895 DOI: 10.1016/j.jacr.2020.09.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/21/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Caroline Chung
- Director of Imaging Technology and Innovation, Radiation Oncology, and Co-Chair, Data Governance Program, Co-Chair, MR Coordinating Committee and Dynamic Contrast-Enhanced MRI Committee, and Quantitative Imaging Biomarker Alliance, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Jayashree Kalpathy-Cramer
- Co-Director, The Quantitative Translational Imaging in Medicine Lab and Center for Machine Learning, Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Michael V Knopp
- Vice Chair of Research and Director of the Wright Center of Innovation in Biomedical Imaging and IROC Co-Director for Imaging and Chair of Imaging Committee, Alliance for Clinical Trials in Oncology, Wright Center of Innovation in Biomedical Imaging, Division of Imaging Science, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - David A Jaffray
- Chief Technology and Digital Officer, The University of Texas MD Anderson Cancer Center, Houston, Texas
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18
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Acanfora C, Bruno F, Palumbo P, Arrigoni F, Natella R, Mazzei MA, Carotti M, Ruscitti P, Di Cesare E, Splendiani A, Giacomelli R, Masciocchi C, Barile A. Diagnostic and interventional radiology fundamentals of synovial pathology. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:107-115. [PMID: 32945285 PMCID: PMC7944671 DOI: 10.23750/abm.v91i8-s.9993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 01/15/2023]
Abstract
The synovial membrane is a specialized mesenchymal tissue that lines the diarthrodial joints surfaces, bursae, and tendon sheaths of the body. This article aims to provide an overview of the fundamentals of synovial tissue, with particular regard to the imaging findings of the main pathologic processes that can affect the synovia and the role of image-guided interventions. (www.actabiomedica.it)
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Affiliation(s)
- Chiara Acanfora
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Federico Bruno
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Pierpaolo Palumbo
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Francesco Arrigoni
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy.
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Marina Carotti
- Department of Radiology - Division of Special and Pediatric Radiology, University Hospital "Umberto I - Lancisi - Salesi", Ancona, Italy.
| | - Piero Ruscitti
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Ernesto Di Cesare
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Alessandra Splendiani
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Roberto Giacomelli
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Carlo Masciocchi
- Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Antonio Barile
- Department of Applied Clinical Science and Biotechnology, University of L'Aquila, L'Aquila, Italy.
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