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Singh A, Venn A, Blizzard L, March L, Eckstein F, Jones G, Wirth W, Cicuttini F, Ding C, Antony B. Association between knee magnetic resonance imaging markers and knee symptoms over 6-9 years in young adults. Rheumatology (Oxford) 2024; 63:436-445. [PMID: 37202358 PMCID: PMC10836990 DOI: 10.1093/rheumatology/kead227] [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] [Received: 11/17/2022] [Revised: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVES To describe associations between MRI markers with knee symptoms in young adults. METHODS Knee symptoms were assessed using the WOMAC scale during the Childhood Determinants of Adult Health Knee Cartilage study (CDAH-knee; 2008-2010) and at the 6- to 9-year follow-up (CDAH-3; 2014-2019). Knee MRI scans obtained at baseline were assessed for morphological markers (cartilage volume, cartilage thickness, subchondral bone area) and structural abnormalities [cartilage defects and bone marrow lesions (BMLs)]. Univariable and multivariable (age, sex, BMI adjusted) zero-inflated Poisson (ZIP) regression models were used for analysis. RESULTS The participants' mean age in CDAH-knee and CDAH-3 were 34.95 (s.d. 2.72) and 43.27 (s.d. 3.28) years, with 49% and 48% females, respectively. Cross-sectionally, there was a weak but significant negative association between medial femorotibial compartment (MFTC) [ratio of the mean (RoM) 0.99971084 (95% CI 0.9995525, 0.99986921), P < 0.001], lateral femorotibial compartment (LFTC) [RoM 0.99982602 (95% CI 0.99969915, 0.9999529), P = 0.007] and patellar cartilage volume [RoM 0.99981722 (95% CI 0.99965326, 0.9999811), P = 0.029] with knee symptoms. Similarly, there was a negative association between patellar cartilage volume [RoM 0.99975523 (95% CI 0.99961427, 0.99989621), P = 0.014], MFTC cartilage thickness [RoM 0.72090775 (95% CI 0.59481806, 0.87372596), P = 0.001] and knee symptoms assessed after 6-9 years. The total bone area was negatively associated with knee symptoms at baseline [RoM 0.9210485 (95% CI 0.8939677, 0.9489496), P < 0.001] and 6-9 years [RoM 0.9588811 (95% CI 0.9313379, 0.9872388), P = 0.005]. The cartilage defects and BMLs were associated with greater knee symptoms at baseline and 6-9 years. CONCLUSION BMLs and cartilage defects were positively associated with knee symptoms, whereas cartilage volume and thickness at MFTC and total bone area were weakly and negatively associated with knee symptoms. These results suggest that the quantitative and semiquantitative MRI markers can be explored as a marker of clinical progression of OA in young adults.
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Affiliation(s)
- Ambrish Singh
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Lyn March
- Institute of Bone and Joint Research, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
- Florance and Cope Professorial Rheumatology Department, University of Sydney Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Felix Eckstein
- Chondrometrics GmbH, Ainring, Germany
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
| | - Wolfgang Wirth
- Chondrometrics GmbH, Ainring, Germany
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University, Salzburg, Austria
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TS, Australia
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Lawson T, Joenathan A, Patwa A, Snyder BD, Grinstaff MW. Tantalum Oxide Nanoparticles for the Quantitative Contrast-Enhanced Computed Tomography of Ex Vivo Human Cartilage: Assessment of Biochemical Composition and Biomechanics. ACS NANO 2021; 15:19175-19184. [PMID: 34882411 DOI: 10.1021/acsnano.1c03375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Nanoparticle-based contrast agents, when used in concert with imaging modalities such as computed tomography (CT), enhance the visualization of tissues and boundary interfaces. However, the ability to determine the physiological state of the tissue via the quantitative assessment of biochemical or biomechanical properties remains elusive. We report the synthesis and characterization of tantalum oxide (Ta2O5) nanoparticle (NP) contrast agents for rapid, nondestructive, and quantitative contrast-enhanced computed tomography (CECT) to assess both the glycosaminoglycan (GAG) content and the biomechanical integrity of human metacarpal phalangeal joint (MCPJ) articular cartilage. Ta2O5 NPs 3-6 nm in diameter and coated with either nonionic poly(ethylene) glycol (PEG) or cationic trimethylammonium ligands readily diffuse into both healthy and osteoarthritic MCPJ cartilage. The CECT attenuation for the cationic and neutral NPs correlates with the glycosaminoglycan (GAG) content (R2 = 0.8975, p < 0.05 and 0.7054, respectively) and the equilibrium modulus (R2 = 0.8285, p < 0.05 and 0.9312, p < 0.05, respectively). The results highlight the importance of the surface charge and size in the design of NP agents for targeting and imaging articular cartilage. Further, nanoparticle CECT offers the visualization of both soft tissue and underlying bone unlike plain radiography, which is the standard for imaging bone in musculoskeletal diseases, and the ability to provide a real-time quantitative assessment of both hard and soft tissues to provide a comprehensive image of the disease stage, as demonstrated herein.
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Affiliation(s)
- Taylor Lawson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Department of Mechanical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Anisha Joenathan
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Division of Material Science, Boston University, Boston, Massachusetts 02215, United States
| | - Amit Patwa
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Department of Chemistry, School of Science, Navrachana University, Vadodara, Gujarat 391410, India
| | - Brian D Snyder
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, United States
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02215, United States
| | - Mark W Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
- Department of Medicine, Boston University, Boston, Massachusetts 02215 United States
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3
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Seyedpour SM, Nafisi S, Nabati M, Pierce DM, Reichenbach JR, Ricken T. Magnetic Resonance Imaging-based biomechanical simulation of cartilage: A systematic review. J Mech Behav Biomed Mater 2021; 126:104963. [PMID: 34894500 DOI: 10.1016/j.jmbbm.2021.104963] [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] [Received: 09/05/2020] [Revised: 10/30/2021] [Accepted: 11/06/2021] [Indexed: 11/19/2022]
Abstract
MRI-based mathematical and computational modeling studies can contribute to a better understanding of the mechanisms governing cartilage's mechanical performance and cartilage disease. In addition, distinct modeling of cartilage is needed to optimize artificial cartilage production. These studies have opened up the prospect of further deepening our understanding of cartilage function. Furthermore, these studies reveal the initiation of an engineering-level approach to how cartilage disease affects material properties and cartilage function. Aimed at researchers in the field of MRI-based cartilage simulation, research articles pertinent to MRI-based cartilage modeling were identified, reviewed, and summarized systematically. Various MRI applications for cartilage modeling are highlighted, and the limitations of different constitutive models used are addressed. In addition, the clinical application of simulations and studied diseases are discussed. The paper's quality, based on the developed questionnaire, was assessed, and out of 79 reviewed papers, 34 papers were determined as high-quality. Due to the lack of the best constitutive models for various clinical conditions, researchers may consider the effect of constitutive material models on the cartilage disease simulation. In the future, research groups may incorporate various aspects of machine learning into constitutive models and MRI data extraction to further refine the study methodology. Moreover, researchers should strive for further reproducibility and rigorous model validation and verification, such as gait analysis.
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Affiliation(s)
- S M Seyedpour
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany
| | - S Nafisi
- Faculty of Pharmacy, Istinye University, Maltepe, Cirpici Yolu B Ck. No. 9, 34010 Zeytinburnu, Istanbul, Turkey
| | - M Nabati
- Department of Mechanical Engineering, Faculty of Engineering, Boğaziçi University, 34342 Bebek, Istanbul, Turkey
| | - D M Pierce
- Department of Mechanical Engineering, University of Connecticut, 191 Auditorium Road, Unit 3139, Storrs, CT, 06269, USA; Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, CT, 06269, USA
| | - J R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital-Friedrich Schiller University Jena, Jena, Germany; Center of Medical Optics and Photonics, Friedrich Schiller University Jena, Germany; Michael Stifel Center for Data-driven and Simulation Science Jena, Friedrich Schiller University Jena, Germany
| | - T Ricken
- Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany; Biomechanics Lab, Institute of Mechanics, Structural Analysis and Dynamics, Faculty of Aerospace Engineering and Geodesy, University of Stuttgart, Pfaffenwaldring 27, 70569 Stuttgart, Germany.
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Liu W, Balu N, Canton G, Hippe DS, Watase H, Waterton JC, Hatsukami T, Yuan C. Understanding Atherosclerosis Through an Osteoarthritis Data Set. Arterioscler Thromb Vasc Biol 2020; 39:1018-1025. [PMID: 31070477 DOI: 10.1161/atvbaha.119.312513] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Atherosclerotic cardiovascular disease remains a worldwide epidemic and one of the leading causes of death nowadays. Vessel wall imaging can be used to understand the development and progression of atherosclerosis, but it is rarely done because of the high cost. We recently identified the Osteoarthritis Initiative, a large prospective cohort study of knee osteoarthritis, which might serve as a valuable source for atherosclerosis research with its serial knee magnetic resonance imaging data. We have found that these images are suitable for vessel wall image analysis of the lower extremity arteries. Here, we will introduce the Osteoarthritis Initiative data set and explain why it could be used for cardiovascular research purposes. Also, we will briefly comment on peripheral artery atherosclerosis as it is covered in the Osteoarthritis Initiative image data set and review the use of vessel wall imaging for studying atherosclerosis. We think data mining of imaging studies, not originally designed on cardiovascular research, can not only maximize the value of the imaging data set but also boost our understanding of atherosclerosis.
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Affiliation(s)
- Wenjin Liu
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Niranjan Balu
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Gador Canton
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Daniel S Hippe
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
| | - Hiroko Watase
- Division of Vascular Surgery, Department of Surgery (H.W., T.H.), University of Washington, Seattle
| | - John C Waterton
- Centre for Imaging Sciences, Manchester Academic Health Science Centre, The University of Manchester, United Kingdom (J.C.W.)
| | - Thomas Hatsukami
- Division of Vascular Surgery, Department of Surgery (H.W., T.H.), University of Washington, Seattle
| | - Chun Yuan
- From the Department of Radiology (W.L., N.B., G.C., D.S.H., C.Y.), University of Washington, Seattle
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Role of Imaging in Musculoskeletal Care. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016. [DOI: 10.1007/s40141-016-0106-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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6
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Binks DA, Hodgson RJ, Ries ME, Foster RJ, Smye SW, McGonagle D, Radjenovic A. Quantitative parametric MRI of articular cartilage: a review of progress and open challenges. Br J Radiol 2013; 86:20120163. [PMID: 23407427 DOI: 10.1259/bjr.20120163] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
With increasing life expectancies and the desire to maintain active lifestyles well into old age, the impact of the debilitating disease osteoarthritis (OA) and its burden on healthcare services is mounting. Emerging regenerative therapies could deliver significant advances in the effective treatment of OA but rely upon the ability to identify the initial signs of tissue damage and will also benefit from quantitative assessment of tissue repair in vivo. Continued development in the field of quantitative MRI in recent years has seen the emergence of techniques able to probe the earliest biochemical changes linked with the onset of OA. Quantitative MRI measurements including T(1), T(2) and T(1ρ) relaxometry, diffusion weighted imaging and magnetisation transfer have been studied and linked to the macromolecular structure of cartilage. Delayed gadolinium-enhanced MRI of cartilage, sodium MRI and glycosaminoglycan chemical exchange saturation transfer techniques are sensitive to depletion of cartilage glycosaminoglycans and may allow detection of the earliest stages of OA. We review these current and emerging techniques for the diagnosis of early OA, evaluate the progress that has been made towards their implementation in the clinic and identify future challenges in the field.
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Affiliation(s)
- D A Binks
- Section of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
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7
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Wirth W, Duryea J, Le Graverand MPH, John MR, Nevitt M, Buck R, Eckstein F. Direct comparison of fixed flexion, radiography and MRI in knee osteoarthritis: responsiveness data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2013; 21:117-25. [PMID: 23128183 PMCID: PMC3569717 DOI: 10.1016/j.joca.2012.10.017] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 10/09/2012] [Accepted: 10/26/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Minimum radiographic joint space width (mJSW) represents the Food and Drug Administration (FDA) standard for demonstrating structural therapeutic benefits for knee osteoarthritis (KOA), but only shows moderate responsiveness (sensitivity to change). We directly compare the responsiveness of magnetic resonance imaging (MRI)-based cartilage thickness and JSW measures from fixed-flexion radiography (FFR) and explore the correlation of region-matched changes between both methods. METHODS Nine hundred and sixty-seven knees of Osteoarthritis Initiative participants with radiographic KOA were studied: 445 over 1 year with coronal FLASH MRI and FFR, and 375/522 over 1/2 years with sagittal DESS MRI and FFR. Standardized response means (SRM) of cartilage thickness and mJSW were compared using the sign-test. RESULTS With FLASH MRI, SRM was -0.28 for medial femorotibial compartment (MFTC) cartilage loss vs -0.15 for mJSW, and -0.32 vs -0.22 for the most sensitive MRI subregion (central MFTC) vs the most sensitive fixed-location JSW(x = 0.25). With DESS MRI, 1-year SRM was -0.34 for MFTC vs -0.22 for mJSW and -0.44 vs -0.28 for central MFTC vs JSW(x = 0.225). Over 2 years, the SRM was significantly greater for MFTC than for mJSW (-0.43 vs -0.31, P = 0.017) and for central MFTC than for JSW(x = 0.225) (-0.51 vs -0.44, P < 0.001). Correlations between changes in spatially matched MRI subregions and fixed-location JSW were not consistently higher (r = 0.10-0.51) than those between non-matched locations (r = 0.15-0.50). CONCLUSIONS MRI displays greater responsiveness in KOA than JSW FFR-based JSW, with the greatest SRM observed in the central medial femorotibial compartment. Fixed-location radiographic measures appear not capable of determining the spatial distribution of femorotibial cartilage loss.
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Affiliation(s)
- Wolfgang Wirth
- Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria,Chondrometrics GmbH, Ainring, Germany
| | - Jeff Duryea
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
| | | | | | - Michel Nevitt
- University of California San Francisco, San Francisco, CA
| | | | - Felix Eckstein
- Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria,Chondrometrics GmbH, Ainring, Germany
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8
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Hanifi A, Bi X, Yang X, Kavukcuoglu B, Lin PC, DiCarlo E, Spencer RG, Bostrom MP, Pleshko N. Infrared fiber optic probe evaluation of degenerative cartilage correlates to histological grading. Am J Sports Med 2012; 40:2853-61. [PMID: 23108637 PMCID: PMC4235670 DOI: 10.1177/0363546512462009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteoarthritis (OA), a degenerative cartilage disease, results in alterations of the chemical and structural properties of tissue. Arthroscopic evaluation of full-depth tissue composition is limited and would require tissue harvesting, which is inappropriate in daily routine. Fourier transform infrared (FT-IR) spectroscopy is a modality based on molecular vibrations of matrix components that can be used in conjunction with fiber optics to acquire quantitative compositional data from the cartilage matrix. PURPOSE To develop a model based on infrared spectra of articular cartilage to predict the histological Mankin score as an indicator of tissue quality. STUDY DESIGN Comparative laboratory study. METHODS Infrared fiber optic probe (IFOP) spectra were collected from nearly normal and more degraded regions of tibial plateau articular cartilage harvested during knee arthroplasty (N = 61). Each region was graded using a modified Mankin score. A multivariate partial least squares algorithm using second-derivative spectra was developed to predict the histological modified Mankin score. RESULTS The partial least squares model derived from IFOP spectra predicted the modified Mankin score with a prediction error of approximately 1.4, which resulted in approximately 72% of the Mankin-scored tissues being predicted correctly and 96% being predicted within 1 grade of their true score. CONCLUSION These data demonstrate that IFOP spectral parameters correlate with histological tissue grade and can be used to provide information on tissue composition. CLINICAL RELEVANCE Infrared fiber optic probe studies have significant potential for the evaluation of cartilage tissue quality without the need for tissue harvest. Combined with arthroscopy, IFOP analysis could facilitate the definition of tissue margins in debridement procedures.
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Affiliation(s)
- Arash Hanifi
- Department of Bioengineering, Temple University, Philadelphia, PA 19122
| | - Xiaohong Bi
- Research Division, Hospital for Special Surgery, New York, NY10021
| | - Xu Yang
- Research Division, Hospital for Special Surgery, New York, NY10021
| | - Beril Kavukcuoglu
- Department of Bioengineering, Temple University, Philadelphia, PA 19122
| | - Ping Chang Lin
- The National Institute on Aging, National Institutes of Health, Baltimore, MD 21224
| | - Edward DiCarlo
- Research Division, Hospital for Special Surgery, New York, NY10021
| | - Richard G. Spencer
- The National Institute on Aging, National Institutes of Health, Baltimore, MD 21224
| | | | - Nancy Pleshko
- Department of Bioengineering, Temple University, Philadelphia, PA 19122
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Ohashi S, Ohnishi I, Matsumoto T, Bessho M, Matsuyama J, Tobita K, Kaneko M, Nakamura K. Measurement of articular cartilage thickness using a three-dimensional image reconstructed from B-mode ultrasonography mechanical scans feasibility study by comparison with MRI-derived data. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:402-411. [PMID: 22261513 DOI: 10.1016/j.ultrasmedbio.2011.11.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 11/12/2011] [Accepted: 11/29/2011] [Indexed: 05/31/2023]
Abstract
The present study aimed to develop a method to measure three-dimensional (3-D) thickness of cartilage (Tc) at the femoral condyle using B-mode ultrasonography (US) and to clarify the feasibility of US in clinical evaluations of articular cartilage by comparing the results with 3-D measurement values using magnetic resonance imaging (MRI) and assessing repeatability. The medial surface of the right knees of two healthy male volunteers (age, 37 and 59 years) and the knees on affected side of three male patients with osteoarthritis (OA) (age, 73, 81 and 83 years) were scanned using B-mode US with the knee flexed at 120°. The range of the angle of probe rotation for the arm was 0-80° and B-mode images (total, 101 images) were acquired every 0.8°. MRI of the knees was also performed using the double echo steady-state sequence. Both US and MRI images were used to create 3-D models of medial femoral condyle articular cartilage. Tc was determined at points 1 mm apart from one another in the US model (Tc-US) and MRI model (Tc-MRI). Tc-US was compared with Tc-MRI and the repeatability of Tc-US was assessed by mean Tc in the specific region of interest of the femoral condyle. Tc-US correlated significantly with Tc-MRI both in volunteers and in OA patients (p < 0.0001 each) and coefficients of correlation were 0.976 and 0.964 for volunteers and OA patients, respectively. The coefficient of variance for mean Tc-US was 4.90%. Our results show that 3-D US measurements of femoral cartilage are reproducible and correlate strongly with MRI measurements.
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Affiliation(s)
- Satoru Ohashi
- Department of Sensory and Motor System Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
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Kasaragod DK, Lu Z, Jacobs J, Matcher SJ. Experimental validation of an extended Jones matrix calculus model to study the 3D structural orientation of the collagen fibers in articular cartilage using polarization-sensitive optical coherence tomography. BIOMEDICAL OPTICS EXPRESS 2012; 3:378-87. [PMID: 22435087 PMCID: PMC3296527 DOI: 10.1364/boe.3.000378] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 12/23/2011] [Accepted: 12/23/2011] [Indexed: 05/18/2023]
Abstract
We report results to verify a theoretical framework to analyze the 3D depth-wise structural organization of collagen fibers in articular cartilage using polarization-sensitive optical coherence tomography. Apparent birefringence data obtained from multi-angle measurements using a time domain polarization-sensitive optical coherence tomography system has been compared with simulated data based on the extended Jones matrix calculus. Experimental data has been shown to agree with the lamellar model previously proposed for the cartilage microstructure based on scanning electron microscopy data. This tool could have potential application in mapping the collagen structural orientation information of cartilage non-invasively during arthroscopy.
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11
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Ohashi S, Ohnishi I, Matsumoto T, Bessho M, Matsuyama J, Tobita K, Kaneko M, Nakamura K. Evaluation of the accuracy of articular cartilage thickness measurement by B-mode ultrasonography with conventional imaging and real-time spatial compound ultrasonography imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2012; 38:324-334. [PMID: 22230136 DOI: 10.1016/j.ultrasmedbio.2011.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 11/18/2011] [Accepted: 11/19/2011] [Indexed: 05/31/2023]
Abstract
The present study aimed to quantify the thickness of articular cartilage (Tc) in vitro using both conventional and real-time spatial compound B-mode ultrasonography (US) with a clinically used transducer and to evaluate the accuracy of measurement by comparing the results with values obtained microscopically. Femoral condyle samples were obtained from a 6-month-old pig and a 3-year-old pig. B-mode US images with conventional imaging and real-time spatial compound imaging (RTSCI) of osteochondral blocks were acquired. Tc determined using US (Tc-US) was measured from line data parallel to US beam direction acquired from B-mode images with an objective method for determining cartilage surface and bone-cartilage interfaces at the peak brightness values. Tc was also determined under microscopy (Tc-optical) using the corresponding points from US measurement. Tc-US was compared with Tc-optical to assess accuracy. Tc-US correlated significantly with Tc in both conventional imaging and RTSCI (r = 0.961, 0.976, respectively). Bland-Altman plots showed mean differences between Tc-optical and Tc-US were -0.0073 mm and 0.0139 mm with standard deviations of 0.171 mm and 0.131 mm for conventional imaging and RTSCI, respectively. Our results show that Tc-US measurement using B-mode US allows accurate measurement of Tc. Considering correlation coefficients between Tc-US and Tc-optical, RTSCI US may offer higher accuracy for measuring Tc than conventional methods when an objective tissue border determination algorithm is used, even though both showed good accuracy in our study.
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Affiliation(s)
- Satoru Ohashi
- Department of Sensory and Motor System Medicine, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
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12
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Eckstein F, Wirth W, Hunter DJ, Guermazi A, Kwoh CK, Nelson DR, Benichou O. Magnitude and regional distribution of cartilage loss associated with grades of joint space narrowing in radiographic osteoarthritis--data from the Osteoarthritis Initiative (OAI). Osteoarthritis Cartilage 2010; 18:760-8. [PMID: 20171298 PMCID: PMC2975907 DOI: 10.1016/j.joca.2009.12.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 12/07/2009] [Accepted: 12/21/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Clinically, radiographic joint space narrowing (JSN) is regarded a surrogate of cartilage loss in osteoarthritis (OA). Using magnetic resonance imaging (MRI), we explored the magnitude and regional distribution of differences in cartilage thickness and subchondral bone area associated with specific Osteoarthritis Research Society International (OARSI) JSN grades. METHOD Seventy-three participants with unilateral medial JSN were selected from the first half (2678 cases) of the OA Initiative cohort (45, 21, and 7 with OARSI JSN grades 1, 2, and 3, respectively, no medial JSN in the contra-lateral knee). Bilateral sagittal baseline DESSwe MRIs were segmented by experienced operators. Intra-person between-knee differences in cartilage thickness and subchondral bone areas were determined in medial femorotibial subregions. RESULTS Knees with medial OARSI JSN grades 1, 2, and 3 displayed a 190 microm (5.2%), 630 microm (18%), and 1560 microm (44%) smaller cartilage thickness in weight-bearing medial femorotibial compartments compared to knees without JSN, respectively. The weight-bearing femoral condyle displayed relatively greater differences than the posterior femoral condyle or the medial tibia (MT). The central subregion within the weight-bearing medial femur (cMF) of the femoral condyle (30-75 degrees ), and the external and central subregions within the tibia displayed relatively greater JSN-associated differences compared to other medial femorotibial subregions. Knees with higher JSN grades also displayed larger than contra-lateral femorotibial subchondral bone areas. CONCLUSIONS This study provides quantitative estimates of JSN-related cartilage loss, with the central part of the weight-bearing femoral condyle being most strongly affected. Knees with higher JSN grades displayed larger subchondral bone areas, suggesting that an increase in subchondral bone area occurs in advanced OA.
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Affiliation(s)
- F Eckstein
- Institute of Anatomy, PMU Salzburg, Austria.
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Sensitivity to change of cartilage morphometry using coronal FLASH, sagittal DESS, and coronal MPR DESS protocols--comparative data from the Osteoarthritis Initiative (OAI). Osteoarthritis Cartilage 2010; 18:547-54. [PMID: 20060948 PMCID: PMC2846231 DOI: 10.1016/j.joca.2009.12.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 11/13/2009] [Accepted: 12/01/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The Osteoarthritis Initiative (OAI) is targeted at identifying sensitive biomarkers and risk factors of symptomatic knee osteoarthritis (OA) onset and progression. Quantitative cartilage imaging in the OAI relies on validated fast low angle shot (FLASH) sequences that suffer from relatively long acquisition times, and on a near-isotropic double echo steady-state (DESS) sequence. We therefore directly compared the sensitivity to cartilage thickness changes and the correlation of these protocols longitudinally. METHODS Baseline (BL) and 12 month follow-up data of 80 knees were acquired using 1.5 mm coronal FLASH and 0.7 mm sagittal DESS (sagDESS) sequences. In these and in 1.5 mm coronal multi-planar reconstructions (MPR) of the DESS the medial femorotibial cartilage was segmented with blinding to acquisition order. In the weight-bearing femoral condyle, a 60% (distance between the trochlear notch and the posterior femur) and a 75% region of interest (ROI) were studied. RESULTS The standardized response mean (SRM = mean change/standard deviation of change) in central medial femorotibial (cMFTC) cartilage thickness was -0.34 for coronal FLASH, -0.37 for coronal MPR DESS, -0.36 for sagDESS with the 60% ROI, and -0.38 for the 75% ROI. Using every second 0.7 mm sagittal slice (DESS) yielded similar SRMs in cMFTC for the 60% and 75% ROI from odd (-0.35/-0.36) and even slice numbers (-0.36/-0.39), respectively. BL cartilage thickness displayed high correlations (r > or = 0.94) between the three protocols; the correlations of longitudinal changes were > or = 0.79 (Pearson) and > or = 0.45 (Spearman). CONCLUSIONS Cartilage morphometry with FLASH and DESS displays similar longitudinal sensitivity to change. Analysis of every second slice of the 0.7 mm DESS provides adequate sensitivity to change.
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Regatte RR, Schweitzer ME. Novel contrast mechanisms at 3 Tesla and 7 Tesla. Semin Musculoskelet Radiol 2008; 12:266-80. [PMID: 18850506 DOI: 10.1055/s-0028-1083109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Osteoarthritis (OA) is the most common musculoskeletal degenerative disease, affecting millions of people. Although OA has been considered primarily a cartilage disorder associated with focal cartilage degeneration, it is accompanied by well-known changes in subchondral and trabecular bone, including sclerosis and osteophyte formation. The exact cause of OA initiation and progression remains under debate, but OA typically first affects weightbearing joints such as the knee. Magnetic resonance imaging (MRI) has been recognized as a potential tool for quantitative assessment of cartilage abnormalities due to its excellent soft tissue contrast. Over the last two decades, several new MR biochemical imaging methods have been developed to characterize the disease process and possibly predict the progression of knee OA. These new MR biochemical methods play an important role not only for diagnosis of disease at an early stage, but also for their potential use in monitoring outcome of various drug therapies (success or failure). Recent advances in multicoil radiofrequency technology and high field systems (3 T and above) significantly improve the sensitivity and specificity of imaging studies for the diagnosis of musculoskeletal disorders. The current state-of-the-art MR imaging methods are briefly reviewed for the quantitative biochemical and functional imaging assessment of musculoskeletal systems.
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Affiliation(s)
- Ravinder R Regatte
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York 10003, USA.
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Minimum joint space width and tibial cartilage morphology in the knees of healthy individuals: a cross-sectional study. BMC Musculoskelet Disord 2008; 9:119. [PMID: 18778479 PMCID: PMC2542509 DOI: 10.1186/1471-2474-9-119] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Accepted: 09/08/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The clinical use of minimum joint space width (mJSW) and cartilage volume and thickness has been limited to the longitudinal measurement of disease progression (i.e. change over time) rather than the diagnosis of OA in which values are compared to a standard. This is primarily due to lack of establishment of normative values of joint space width and cartilage morphometry as has been done with bone density values in diagnosing osteoporosis. Thus, the purpose of this pilot study is to estimate reference values of medial joint space width and cartilage morphometry in healthy individuals of all ages using standard radiography and peripheral magnetic resonance imaging. DESIGN For this cross-sectional study, healthy volunteers underwent a fixed-flexion knee X-ray and a peripheral MR (pMR) scan of the same knee using a 1T machine (ONI OrthOne, Wilmington, MA). Radiographs were digitized and analyzed for medial mJSW using an automated algorithm. Only knees scoring <or=1 on the Kellgren-Lawrence scale (no radiographic evidence of knee OA) were included in the analyses. All 3D SPGRE fat-sat sagittal pMR scans were analyzed for medial tibial cartilage morphometry using a proprietary software program (Chondrometrics GmbH). RESULTS Of 119 healthy participants, 73 were female and 47 were male; mean (SD) age 38.2 (13.2) years, mean BMI 25.0 (4.4) kg/m2. Minimum JSW values were calculated for each sex and decade of life. Analyses revealed mJSW did not significantly decrease with increasing decade (p > 0.05) in either sex. Females had a mean (SD) medial mJSW of 4.8 (0.7) mm compared to males with corresponding larger value of 5.7 (0.8) mm. Cartilage morphometry results showed similar trends with mean (SD) tibial cartilage volume and thickness in females of 1.50 (0.19) microL/mm2 and 1.45 (0.19) mm, respectively, and 1.77 (0.24) microL/mm2 and 1.71 (0.24) mm, respectively, in males. CONCLUSION These data suggest that medial mJSW values do not decrease with aging in healthy individuals but remain fairly constant throughout the lifespan with "healthy" values of 4.8 mm for females and 5.7 mm for males. Similar trends were seen for cartilage morphology. Results suggest there may be no need to differentiate a t-score and a z-score in OA diagnosis because cartilage thickness and JSW remain constant throughout life in the absence of OA.
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Wirth W, Eckstein F. A technique for regional analysis of femorotibial cartilage thickness based on quantitative magnetic resonance imaging. IEEE TRANSACTIONS ON MEDICAL IMAGING 2008; 27:737-744. [PMID: 18541481 DOI: 10.1109/tmi.2007.907323] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The objective of this work was to develop a methodology for measuring cartilage thickness in anatomically based subregions in the tibial and in the central weight-bearing femoral cartilage from magnetic resonance (MR) images. The tibial plateau was divided into a central area of the total subchondral bone area (tAB), and anterior, posterior, internal, and external subregions surrounding it. In the weight-bearing femoral condyles, central, internal, and external subregions were determined. The Euclidean distance between the tAB and cartilage surface was used for determining cartilage thickness. The reproducibility of the method was evaluated on test-retest data sets of 12 participants (six healthy, six with osteoarthritis). The subregion size was varied systematically to study the influence on the reproducibility. The size of the subregions was highly consistent under conditions of repositioning (standard deviation 0.0%-0.3%). The precision errors for regional mean cartilage thickness measurements ranged from 19 microm (1.5%) to 84 microm (4.7%). The computation of regional cartilage thickness values from segmented MR images is shown to be highly reproducible and robust under conditions of joint repositioning. In longitudinal studies, this technique may substantially enhance the ability of quantitative MRI to monitor structural changes in osteoarthritis at narrow time intervals.
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Affiliation(s)
- Wolfgang Wirth
- Chondrometrics GmbH, Ulrichshöglerstr. 23, 83404 Ainring, Germany.
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Lopez O, Amrami KK, Manduca A, Ehman RL. Characterization of the dynamic shear properties of hyaline cartilage using high-frequency dynamic MR elastography. Magn Reson Med 2008; 59:356-64. [PMID: 18228594 DOI: 10.1002/mrm.21474] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This work evaluated the feasibility of dynamic MR Elastography (MRE) to quantify structural changes in bovine hyaline cartilage induced by selective enzymatic degradation. The ability of the technique to quantify the frequency-dependent response of normal cartilage to shear in the kilohertz range was also explored. Bovine cartilage plugs of 8 mm in diameter were used for this study. The shear stiffness (mu(s)) of each cartilage plug was measured before and after 16 hr of enzymatic treatments by dynamic MRE at 5000 Hz of shear excitation. Collagenase and trypsin were used to selectively affect the collagen and proteoglycans contents of the matrix. Additionally, normal cartilage plugs were tested by dynamic MRE at shear-excitations of 3000-7000 Hz. Measured micro(s) of cartilage plugs showed a significant decrease (-37%, P < 0.05) after collagenase treatment and a significant decrease (-28%, P < 0.05) after trypsin treatment. Furthermore, a near-linear increase (R(2) = 0.9141) in the speed of shear wave propagation with shear-excitation frequency was observed in cartilage, indicating that wave speed is dominated by viscoelastic effects. These experiments suggest that dynamic MRE can provide a sensitive quantitative tool to characterize the degradation process and viscoelastic behavior of cartilage.
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Affiliation(s)
- Orlando Lopez
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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D'Anjou MA, Moreau M, Troncy E, Martel-Pelletier J, Abram F, Raynauld JP, Pelletier JP. Osteophytosis, subchondral bone sclerosis, joint effusion and soft tissue thickening in canine experimental stifle osteoarthritis: comparison between 1.5 T magnetic resonance imaging and computed radiography. Vet Surg 2008; 37:166-77. [PMID: 18251811 DOI: 10.1111/j.1532-950x.2007.00363.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare use of 1.5 T magnetic resonance imaging (MRI) and computed radiography (CR) for morphologic and temporal evaluation of osteophytosis, subchondral sclerosis, joint effusion, and synovial thickening in experimentally induced canine stifle osteoarthritis (OA). STUDY DESIGN Prospective study. ANIMALS Dogs (n=8). METHODS CR (mediolateral and caudocranial projections) and MRI (dorsal 3D T1-weighted gradient echo, sagittal 3D SPGR and T2-weighted fast spin echo with fat saturation) were performed at baseline (n=8) and at week 4 (n=5), week 8 (n=8), and week 26 (n=5) after cranial cruciate ligament transection. Osteophytosis, subchondral bone sclerosis, and joint effusion were scored on CR and MRI, and synovial thickening on MRI. RESULTS MRI was more sensitive than CR for detection of osteophytosis and could better discriminate joint effusion from soft tissue thickening, although scores for these variables strongly correlated between modalities (rho=0.94 [osteophytosis] and 0.80 [effusion]; P<.001). Scores for subchondral bone sclerosis also correlated (rho=0.54, P<.004), although this variable may have been over interpreted on CR. Joint effusion and synovial thickening peaked at week 8, before partially regressing at week 26. Conversely, osteophytosis and sclerosis progressed semi-linearly over 26 weeks. CONCLUSION MRI is more sensitive than radiography in assessing onset and progression of osteophytosis in canine experimental stifle OA and provides enhanced discrimination between joint effusion and synovial thickening. CLINICAL RELEVANCE MRI is as a more powerful imaging modality that should be increasingly used in animals to assess the joint related effects of disease-modifying OA drugs.
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Affiliation(s)
- Marc-André D'Anjou
- Companion Animal Research Group, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada.
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Abstract
PURPOSE OF REVIEW MRI has revolutionized osteoarthritis research by providing semi-quantitative and quantitative imaging endpoints on most articular tissues. With the first image data of the Osteoarthritis Initiative now becoming publicly available, this article reviews recent developments in quantitative imaging of osteoarthritis. RECENT FINDINGS Although radiography remains the standard for regulatory studies on disease modifying osteoarthritis drugs, there is no consensus on the optimal positioning and acquisition protocol. With MRI, semi-quantitative scoring systems for evaluation of multiple articular tissue changes have been developed and are currently investigated in the context of correlation with symptoms and of predicting structural progression of osteoarthritis. Most efforts on quantitative measurement of imaging endpoints have focused on cartilage morphology and composition, with higher field strength (3T), newer sequences, and new measurement endpoints being a driver of current innovation. SUMMARY The semi-quantitative and quantitative tools for analysis of articular structure are now available and permit comprehensive analysis of morphological and compositional tissue changes in osteoarthritis. These changes will need to be related to clinical outcomes (e.g. how a patient feels or functions) with current epidemiological studies, such as the Osteoarthritis Initiatives, providing the opportunity for clinical validation of these imaging biomarkers.
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Affiliation(s)
- Felix Eckstein
- aInstitute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria.
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Affiliation(s)
- Todd P Stitik
- Department of Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA
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Stoker AM, Cook JL, Kuroki K, Fox DB. Site-specific analysis of gene expression in early osteoarthritis using the Pond-Nuki model in dogs. J Orthop Surg Res 2006; 1:8. [PMID: 17150128 PMCID: PMC1636033 DOI: 10.1186/1749-799x-1-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Accepted: 10/10/2006] [Indexed: 11/10/2022] Open
Abstract
Background Osteoarthritis (OA) is a progressive and debilitating disease that often develops from a focal lesion and may take years to clinically manifest to a complete loss of joint structure and function. Currently, there is not a cure for OA, but early diagnosis and initiation of treatment may dramatically improve the prognosis and quality of life for affected individuals. This study was designed to determine the feasibility of analyzing changes in gene expression of articular cartilage using the Pond-Nuki model two weeks after ACL-transection in dogs, and to characterize the changes observed at this time point. Methods The ACL of four dogs was completely transected arthroscopically, and the contralateral limb was used as the non-operated control. After two weeks the dogs were euthanatized and tissues harvested from the tibial plateau and femoral condyles of both limbs. Two dogs were used for histologic analysis and Mankin scoring. From the other two dogs the surface of the femoral condyle and tibial plateau were divided into four regions each, and tissues were harvested from each region for biochemical (GAG and HP) and gene expression analysis. Significant changes in gene expression were determined using REST-XL, and Mann-Whitney rank sum test was used to analyze biochemical data. Significance was set at (p < 0.05). Results Significant differences were not observed between ACL-X and control limbs for Mankin scores or GAG and HP tissue content. Further, damage to the tissue was not observed grossly by India ink staining. However, significant changes in gene expression were observed between ACL-X and control tissues from each region analyzed, and indicate that a unique regional gene expression profile for impending ACL-X induced joint pathology may be identified in future studies. Conclusion The data obtained from this study lend credence to the research approach and model for the characterization of OA, and the identification and validation of future diagnostic modalities. Further, the changes observed in this study may reflect the earliest changes in AC reported during the development of OA, and may signify pathologic changes within a stage of disease that is potentially reversible.
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Affiliation(s)
- Aaron M Stoker
- The Comparative Orthopaedic Laboratory, University of Missouri Columbia, 379 E Campus Dr, Columbia, MO, USA
| | - James L Cook
- The Comparative Orthopaedic Laboratory, University of Missouri Columbia, 379 E Campus Dr, Columbia, MO, USA
| | - Keiichi Kuroki
- Kansas State University Veterinary Diagnostic Laboratory, Kansas State University, 1800 Denison Avenue, Manhattan, KS, USA
| | - Derek B Fox
- The Comparative Orthopaedic Laboratory, University of Missouri Columbia, 379 E Campus Dr, Columbia, MO, USA
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