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Wen D, Zhou X, Hou B, Zhang Q, Raithel E, Wang Y, Wu G, Li X. 3D-DESS MRI with CAIPIRINHA two- and fourfold acceleration for quantitatively assessing knee cartilage morphology. Skeletal Radiol 2024; 53:1481-1494. [PMID: 38347270 DOI: 10.1007/s00256-024-04605-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVES This study aimed to assess the diagnostic image quality and compare the knee cartilage segmentation results using a controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA)-accelerated 3D-dual echo steady-state (DESS) research package sequence in the knee. MATERIALS AND METHODS A total of 64 subjects underwent both two- and fourfold CAIPIRINHA-accelerated 3D-DESS and DESS without parallel acceleration technique of the knee on a 3.0 T system. Two musculoskeletal radiologists evaluated the images independently for image quality and diagnostic capability following randomization and anonymization. The consistency of automatic segmentation results between sequences was explored using an automatic knee cartilage segmentation research application. The descriptive statistics and inter-observer and inter-method concordance of various acceleration sequences were investigated. P values < .05 were considered significant. RESULTS For image quality evaluation, the image signal-to-noise ratio and contrast-to-noise ratio decreased with the decrease in scanning time. However, it is accompanied by the reduction of artifacts. Using 3D-DESS without parallel acceleration technique as the standard for cartilage grading diagnosisand the diagnostic agreement of two- and fourfold CAIPIRINHA-accelerated 3D-DESS was good, kappa value was 0.860 (P < .001) and 0.804 (p < 0.001), respectively. Regarding cartilage defects, the sensitivity and specificity of the twofold acceleration 3D-CAIPIRINHA-DESS were 95.56% and 97.70%, and the fourfold CAIPIRINHA-accelerated 3D-DESS were 91.49% and 97.65%, respectively. The intraclass correlation coefficients of various sequences in cartilage segmentation were almost all greater than 0.9. CONCLUSION The CAIPIRINHA-accelerated 3D-DESS sequence maintained comparable diagnostic and segmentations performance of knee cartilage after a 60% scan time reduction.
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Affiliation(s)
- Donglin Wen
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan City, 430030, Hubei Province, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Bowen Hou
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan City, 430030, Hubei Province, China
| | - Qiong Zhang
- Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China
| | | | - Yi Wang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan City, 430030, Hubei Province, China
| | - Gang Wu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan City, 430030, Hubei Province, China.
| | - Xiaoming Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095, Jiefang Road, Wuhan City, 430030, Hubei Province, China.
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Albano D, Viglino U, Esposito F, Rizzo A, Messina C, Gitto S, Fusco S, Serpi F, Kamp B, Müller-Lutz A, D’Ambrosi R, Sconfienza LM, Sewerin P. Quantitative and Compositional MRI of the Articular Cartilage: A Narrative Review. Tomography 2024; 10:949-969. [PMID: 39058044 PMCID: PMC11280587 DOI: 10.3390/tomography10070072] [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: 04/21/2024] [Revised: 06/01/2024] [Accepted: 06/11/2024] [Indexed: 07/28/2024] Open
Abstract
This review examines the latest advancements in compositional and quantitative cartilage MRI techniques, addressing both their potential and challenges. The integration of these advancements promises to improve disease detection, treatment monitoring, and overall patient care. We want to highlight the pivotal task of translating these techniques into widespread clinical use, the transition of cartilage MRI from technical validation to clinical application, emphasizing its critical role in identifying early signs of degenerative and inflammatory joint diseases. Recognizing these changes early may enable informed treatment decisions, thereby facilitating personalized medicine approaches. The evolving landscape of cartilage MRI underscores its increasing importance in clinical practice, offering valuable insights for patient management and therapeutic interventions. This review aims to discuss the old evidence and new insights about the evaluation of articular cartilage through MRI, with an update on the most recent literature published on novel quantitative sequences.
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Affiliation(s)
- Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche, Chirurgiche ed Odontoiatriche, Università degli Studi di Milano, 20122 Milan, Italy
| | - Umberto Viglino
- Unit of Radiology, Ospedale Evangelico Internazionale, 16100 Genova, Italy;
| | - Francesco Esposito
- Division of Radiology, Department of Precision Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Aldo Rizzo
- Postgraduate School of Diagnostic and Interventional Radiology, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy;
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Salvatore Gitto
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Stefano Fusco
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Francesca Serpi
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (B.K.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany; (B.K.); (A.M.-L.)
| | - Riccardo D’Ambrosi
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy; (C.M.); (S.G.); (S.F.); (F.S.); (R.D.); (L.M.S.)
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20122 Milan, Italy
| | - Philipp Sewerin
- Rheumazentrum Ruhrgebiet, Ruhr University Bochum, 44649 Herne, Germany;
- Department and Hiller-Research-Unit for Rheumatology, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany
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Akai H, Yasaka K, Sugawara H, Furuta T, Tajima T, Kato S, Yamaguchi H, Ohtomo K, Abe O, Kiryu S. Faster acquisition of magnetic resonance imaging sequences of the knee via deep learning reconstruction: a volunteer study. Clin Radiol 2024; 79:453-459. [PMID: 38614869 DOI: 10.1016/j.crad.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 12/29/2023] [Accepted: 03/02/2024] [Indexed: 04/15/2024]
Abstract
AIM To evaluate whether deep learning reconstruction (DLR) can accelerate the acquisition of magnetic resonance imaging (MRI) sequences of the knee for clinical use. MATERIALS AND METHODS Using a 1.5-T MRI scanner, sagittal fat-suppressed T2-weighted imaging (fs-T2WI), coronal proton density-weighted imaging (PDWI), and coronal T1-weighted imaging (T1WI) were performed. DLR was applied to images with a number of signal averages (NSA) of 1 to obtain 1DLR images. Then 1NSA, 1DLR, and 4NSA images were compared subjectively, and by noise (standard deviation of intra-articular water or medial meniscus) and contrast-to-noise ratio between two anatomical structures or between an anatomical structure and intra-articular water. RESULTS Twenty-seven healthy volunteers (age: 40.6 ± 11.9 years) were enrolled. Three 1DLR image sequences were obtained within 200 s (approximately 12 minutes for 4NSA image). According to objective evaluations, PDWI 1DLR images showed the smallest noise and significantly higher contrast than 1NSA and 4NSA images. For fs-T2WI, smaller noise and higher contrast were observed in the order of 4NSA, 1DLR, and 1NSA images. According to the subjective analysis, structure visibility, image noise, and overall image quality were significantly better for PDWI 1DLR than 1NSA images; moreover, the visibility of the meniscus and bone, image noise, and overall image quality were significantly better for 1DLR than 4NSA images. Fs-T2WI and T1WI 1DLR images showed no difference between 1DLR and 4NSA images. CONCLUSION Compared to PDWI 4NSA images, PDWI 1DLR images were of higher quality, while the quality of fs-T2WI and T1WI 1DLR images was similar to that of 4NSA images.
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Affiliation(s)
- H Akai
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan; Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-0124, Japan
| | - K Yasaka
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-0124, Japan; Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Sugawara
- Department of Diagnostic Radiology, McGill University, 1650 Cedar Avenue, Montreal, Quebec, H3G 1A4, Canada
| | - T Furuta
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - T Tajima
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-0124, Japan; Department of Radiology, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - S Kato
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - H Yamaguchi
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - K Ohtomo
- International University of Health and Welfare, 2600-1 Kiakanemaru, Ohtawara, Tochigi, 324-8501, Japan
| | - O Abe
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Kiryu
- Department of Radiology, International University of Health and Welfare Narita Hospital, 852 Hatakeda, Narita, Chiba, 286-0124, Japan.
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Krebs P, Nägele M, Fomina P, Virtanen V, Nippolainen E, Shaikh R, Afara I, Töyräs J, Usenov I, Sakharova T, Artyushenko V, Tafintseva V, Solheim J, Zimmermann B, Kohler A, König O, Saarakkala S, Mizaikoff B. Laser-irradiating infrared attenuated total reflection spectroscopy of articular cartilage: Potential and challenges for diagnosing osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100466. [PMID: 38623306 PMCID: PMC11016904 DOI: 10.1016/j.ocarto.2024.100466] [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: 09/20/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024] Open
Abstract
Objective A prototype infrared attenuated total reflection (IR-ATR) laser spectroscopic system designed for in vivo classification of human cartilage tissue according to its histological health status during arthroscopic surgery is presented. Prior to real-world in vivo applications, this so-called osteoarthritis (OA) scanner has been tested at in vitro conditions revealing the challenges associated with complex sample matrices and the accordingly obtained sparse spectral datasets. Methods In vitro studies on human knee cartilage samples at different contact pressures (i.e., 0.2-0.5 MPa) allowed recording cartilage degeneration characteristic IR signatures comparable to in vivo conditions with high temporal resolution. Afterwards, the cartilage samples were assessed based on the clinically acknowledged osteoarthritis cartilage histopathology assessment (OARSI) system and correlated with the obtained sparse IR data. Results Amide and carbohydrate signal behavior was observed to be almost identical between the obtained sparse IR data and previously measured FTIR data used for sparse partial least squares discriminant analysis (SPLSDA) to identify the spectral regions relevant to cartilage condition. Contact pressures between 0.3 and 0.4 MPa seem to provide the best sparse IR spectra for cylindrical (d = 3 mm) probe tips. Conclusion Laser-irradiating IR-ATR spectroscopy is a promising analytical technique for future arthroscopic applications to differentiate healthy and osteoarthritic cartilage tissue. However, this study also revealed that the flexible connection between the laser-based analyzer and the arthroscopic ATR-probe via IR-transparent fiberoptic cables may affect the robustness of the obtained IR data and requires further improvements.
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Affiliation(s)
- P. Krebs
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany
| | | | - P. Fomina
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany
| | - V. Virtanen
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - E. Nippolainen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - R. Shaikh
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - I.O. Afara
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - J. Töyräs
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, Kuopio, Finland
- School of Electrical Engineering and Computer Science, The University of Queensland, Brisbane, Australia
| | | | | | | | - V. Tafintseva
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - J.H. Solheim
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - B. Zimmermann
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - A. Kohler
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
| | - O. König
- Nanoplus Advanced Photonics Gerbrunn GmbH, Gerbrunn, Germany
| | - S. Saarakkala
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - B. Mizaikoff
- Institute of Analytical and Bioanalytical Chemistry, Ulm University, Ulm, Germany
- Hahn-Schickard, Ulm, Germany
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Richard MJ, Lo GH, Driban JB, Canavatchel AR, LaValley M, Zhang M, Price LL, Miller E, Eaton CB, McAlindon TE. Knee cartilage change on magnetic resonance imaging: Should we lump or split topographical regions? A 2-year study of data from the osteoarthritis initiative. Clin Anat 2024; 37:210-217. [PMID: 38058252 PMCID: PMC10922267 DOI: 10.1002/ca.24127] [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: 01/17/2023] [Revised: 08/14/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE We challenge the paradigm that a simplistic approach evaluating anatomic regions (e.g., medial femur or tibia) is ideal for assessing articular cartilage loss on magnetic resonance (MR) imaging. We used a data-driven approach to explore whether specific topographical locations of knee cartilage loss may identify novel patterns of cartilage loss over time that current assessment strategies miss. DESIGN We assessed 60 location-specific measures of articular cartilage on a sample of 99 knees with baseline and 24-month MR images from the Osteoarthritis Initiative, selected as a group with a high likelihood to change. We performed factor analyses of the change in these measures in two ways: (1) summing the measures to create one measure for each of the six anatomically regional-based summary (anatomic regions; e.g., medial tibia) and (2) treating each location separately for a total of 60 measures (location-specific measures). RESULTS The first analysis produced three factors accounting for 66% of the variation in the articular cartilage changes that occur over 24 months of follow-up: (1) medial tibiofemoral, (2) medial and lateral patellar, and (3) lateral tibiofemoral. The second produced 20 factors accounting for 75% of the variance in cartilage changes. Twelve factors only involved one anatomic region. Five factors included locations from adjoining regions (defined by the first analysis; e.g., medial tibiofemoral). Three factors included articular cartilage loss from disparate locations. CONCLUSIONS Novel patterns of cartilage loss occur within each anatomic region and across these regions, including in disparate regions. The traditional anatomic regional approach is simpler to implement and interpret but may obscure meaningful patterns of change.
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Affiliation(s)
- Michael J. Richard
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| | - Grace H. Lo
- Medical Care Line and Research Care Line; Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VAMC, Houston, TX, USA
- Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey B. Driban
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| | - Amanda R. Canavatchel
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| | | | - Ming Zhang
- Boston University, School of Computer Science, Boston, MA, USA
| | - Lori Lyn Price
- Tufts Clinical and Translational Science Institute and The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Eric Miller
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA, USA
| | - Charles B. Eaton
- Warren Alpert Medical School of Brown University, Department of Family Medicine, Providence, RI and School of Public Health of Brown University, Providence, RI, USA
| | - Timothy E. McAlindon
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
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Zhang R, Zhou X, Raithel E, Ren C, Zhang P, Li J, Bai L, Zhao J. A reproducibility study of knee cartilage volume and thickness values derived by fully automatic segmentation based on three-dimensional dual-echo in steady state data from 1.5 T and 3 T magnetic resonance imaging. MAGMA (NEW YORK, N.Y.) 2024; 37:69-82. [PMID: 37815638 DOI: 10.1007/s10334-023-01122-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 10/11/2023]
Abstract
OBJECTIVE To evaluate the repeatability of cartilage volume and thickness values at 1.5 T MRI using a fully automatic cartilage segmentation method and reproducibility of the method between 1.5 T and 3 T data. METHODS The study included 20 knee joints from 10 healthy subjects with each subject having undergone double-knee MRI. All knees were scanned at 1.5 T and 3 T MR scanners using a three-dimensional (3D) high-resolution dual-echo in steady state (DESS) sequence. Cartilage volume and thickness of 21 subregions were quantified using a fully automatic cartilage segmentation research application (MR Chondral Health, version 3.0, Siemens Healthcare, Erlangen, Germany). The volume and thickness values derived from fully automatically computed segmentation masks were analyzed for the scan-rescan data from the same volunteers. The accuracy of the automatic segmentation of the cartilage in 1.5 T images was evaluated by the dice similarity coefficient (DSC) and Hausdorff distance (HD) using the manually corrected segmentation as a reference. The volume and thickness values calculated from 1.5 T and 3 T were also compared. RESULTS No statistically significant differences were found for cartilage thickness or volume across all subregions between the scan-rescanned data at 1.5 T (P > 0.05). The mean DSC between the fully automatic and manually corrected knee cartilage segmentation contours at 1.5 T was 0.9946. The average value of HD was 2.41 mm. Overall, there was no statistically significant difference in the cartilage volume or thickness in most-subregions between the two field strengths (P > 0.05) except for the medial region of femur and tibia. Bland-Altman plot and intraclass correlation coefficient (ICC) showed high consistency between results obtained based on same and different scanning sequences. CONCLUSION The cartilage segmentation software had high repeatability for DESS images obtained from the same device. In addition, the overall reproducibility of the images obtained from equipment of two different field strengths was satisfactory.
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Affiliation(s)
- Ranxu Zhang
- Department of CT/MR, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, 050051, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd, Shanghai, 200126, China
| | | | - Congcong Ren
- Department of CT/MR, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, 050051, China
| | - Ping Zhang
- Department of CT/MR, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, 050051, China
| | - Junfei Li
- Department of CT/MR, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, 050051, China
| | - Lin Bai
- Department of CT/MR, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, 050051, China
| | - Jian Zhao
- Department of CT/MR, The Third Hospital of Hebei Medical University, Hebei Province Biomechanical Key Laboratory of Orthopedics, Shijiazhuang, 050051, China.
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Schadow JE, Maxey D, Smith TO, Finnilä MAJ, Manske SL, Segal NA, Wong AKO, Davey RA, Turmezei T, Stok KS. Systematic review of computed tomography parameters used for the assessment of subchondral bone in osteoarthritis. Bone 2024; 178:116948. [PMID: 37926204 DOI: 10.1016/j.bone.2023.116948] [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: 08/15/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To systematically review the published parameters for the assessment of subchondral bone in human osteoarthritis (OA) using computed tomography (CT) and gain an overview of current practices and standards. DESIGN A literature search of Medline, Embase and Cochrane Library databases was performed with search strategies tailored to each database (search from 2010 to January 2023). The search results were screened independently by two reviewers against pre-determined inclusion and exclusion criteria. Studies were deemed eligible if conducted in vivo/ex vivo in human adults (>18 years) using any type of CT to assess subchondral bone in OA. Extracted data from eligible studies were compiled in a qualitative summary and formal narrative synthesis. RESULTS This analysis included 202 studies. Four groups of CT modalities were identified to have been used for subchondral bone assessment in OA across nine anatomical locations. Subchondral bone parameters measuring similar features of OA were combined in six categories: (i) microstructure, (ii) bone adaptation, (iii) gross morphology (iv) mineralisation, (v) joint space, and (vi) mechanical properties. CONCLUSIONS Clinically meaningful parameter categories were identified as well as categories with the potential to become relevant in the clinical field. Furthermore, we stress the importance of quantification of parameters to improve their sensitivity and reliability for the evaluation of OA disease progression and the need for standardised measurement methods to improve their clinical value.
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Affiliation(s)
- Jemima E Schadow
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
| | - David Maxey
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
| | - Toby O Smith
- Warwick Medical School, University of Warwick, United Kingdom.
| | - Mikko A J Finnilä
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Sarah L Manske
- Department of Radiology, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Neil A Segal
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, United States.
| | - Andy Kin On Wong
- Joint Department of Medical Imaging, University Health Network, Toronto, Canada; Schroeder's Arthritis Institute, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
| | - Rachel A Davey
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Kathryn S Stok
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
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Yao Y, Zhong J, Zhang L, Khan S, Chen W. CartiMorph: A framework for automated knee articular cartilage morphometrics. Med Image Anal 2024; 91:103035. [PMID: 37992496 DOI: 10.1016/j.media.2023.103035] [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: 10/13/2022] [Revised: 08/25/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
We introduce CartiMorph, a framework for automated knee articular cartilage morphometrics. It takes an image as input and generates quantitative metrics for cartilage subregions, including the percentage of full-thickness cartilage loss (FCL), mean thickness, surface area, and volume. CartiMorph leverages the power of deep learning models for hierarchical image feature representation. Deep learning models were trained and validated for tissue segmentation, template construction, and template-to-image registration. We established methods for surface-normal-based cartilage thickness mapping, FCL estimation, and rule-based cartilage parcellation. Our cartilage thickness map showed less error in thin and peripheral regions. We evaluated the effectiveness of the adopted segmentation model by comparing the quantitative metrics obtained from model segmentation and those from manual segmentation. The root-mean-squared deviation of the FCL measurements was less than 8%, and strong correlations were observed for the mean thickness (Pearson's correlation coefficient ρ∈[0.82,0.97]), surface area (ρ∈[0.82,0.98]) and volume (ρ∈[0.89,0.98]) measurements. We compared our FCL measurements with those from a previous study and found that our measurements deviated less from the ground truths. We observed superior performance of the proposed rule-based cartilage parcellation method compared with the atlas-based approach. CartiMorph has the potential to promote imaging biomarkers discovery for knee osteoarthritis.
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Affiliation(s)
- Yongcheng Yao
- CU Lab of AI in Radiology (CLAIR), Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
| | - Junru Zhong
- CU Lab of AI in Radiology (CLAIR), Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Liping Zhang
- CU Lab of AI in Radiology (CLAIR), Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - Sheheryar Khan
- School of Professional Education and Executive Development, The Hong Kong Polytechnic University, Hong Kong, China
| | - Weitian Chen
- CU Lab of AI in Radiology (CLAIR), Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.
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9
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Wu J, Wu C, Cai Z, Gu H, Liu L, Xia C, Lui S, Gong Q, Song B, Ai H. Ultra-small superparamagnetic iron oxide nanoparticles for intra-articular targeting of cartilage in early osteoarthritis. Regen Biomater 2023; 10:rbad052. [PMID: 37397872 PMCID: PMC10307945 DOI: 10.1093/rb/rbad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 07/04/2023] Open
Abstract
Early diagnosis of osteoarthritis (OA) is critical for effective cartilage repair. However, lack of blood vessels in articular cartilage poses a barrier to contrast agent delivery and subsequent diagnostic imaging. To address this challenge, we proposed to develop ultra-small superparamagnetic iron oxide nanoparticles (SPIONs, 4 nm) that can penetrate into the matrix of articular cartilage, and further modified with the peptide ligand WYRGRL (particle size, 5.9 nm), which allows SPIONs to bind to type II collagen in the cartilage matrix and increase the retention of probes. Type II collagen in the cartilage matrix is gradually lost with the progression of OA, consequently, the binding of peptide-modified ultra-small SPIONs to type II collagen in the OA cartilage matrix is less, thus presenting different magnetic resonance (MR) signals in OA group from the normal ones. By introducing the AND logical operation, damaged cartilage can be differentiated from the surrounding normal tissue on T1 and T2 AND logical map of MR images, and this was also verified in histology studies. Overall, this work provides an effective strategy for delivering nanosized imaging agents to articular cartilage, which could potentially be used to diagnosis joint-related diseases such as osteoarthritis.
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Affiliation(s)
- Jun Wu
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610207, China
- Medical Imaging Key Laboratory of Sichuan Province, School of Medical Imaging, North Sichuan Medical College, Nanchong 637000, China
| | - Changqiang Wu
- Correspondence address. Tel: +86 28 85413991, E-mail: (H.A.); (C.W.)
| | - Zhongyuan Cai
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Haojie Gu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Li Liu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Su Lui
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Key Laboratory of Transplant Engineering and Immunology, NHC, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610064, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Fujian, Xiamen 361000, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Radiology, Sanya People’s Hospital, Hainan, Sanya 572000, China
| | - Hua Ai
- Correspondence address. Tel: +86 28 85413991, E-mail: (H.A.); (C.W.)
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10
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Kuwasawa A, Okazaki K, Noda K, Fukushima T, Nihei K. Intra-articular injection of culture-expanded adipose tissue-derived stem cells for knee osteoarthritis: Assessments with clinical symptoms and quantitative measurements of articular cartilage volume. J Orthop Sci 2023; 28:408-415. [PMID: 35063331 DOI: 10.1016/j.jos.2021.12.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/13/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Intra-articular administration of adipose tissue-derived stem cells (ADSC) is an alternative treatment option for knee osteoarthritis (OA) after conventional treatment fails; however, the clinical results related to the severity of OA grade and changes of cartilage volumes after the administration of ADSC is unknown. This study aimed to determine 1) clinical outcomes after the ADSC administration in knee OA with consideration of radiographic OA grades and 2) changes in cartilage volumes after ADSC administration. METHODS This observational study included 86 knees from 51 patients who underwent intra-articular administration of cultured ADSC; 47 patients (80 knees) completed follow-up for 6 months (follow-up rate: 93%). The Knee injury and Osteoarthritis Outcome Scores (KOOS) were reported at baseline and 1, 3, and 6 months after the administration. The efficacy rate in the Outcome Measures in Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) was evaluated using the KOOS. Cartilage volume of the knee joint was measured using quantitative 3-dimensional magnetic resonance imaging (3D-MRI) software at baseline and 6 months in 52 knees in 31 patients (follow-up rate: 61%). RESULTS All items on the KOOS except "sports/recreation" improved significantly at 6 months with more significance in knees with a Kellgren-Lawrence (KL) grade 2 or 3 compared with KL grade 4 knees. The OMERACT-OARSI responder at 6 months was significantly greater in knees with KL grade 2 or 3 (64%) than in knees with KL grade 4 (42%, p = 0.045). Cartilage volume changes varied among patients and were not related to the changes in KOOS after ADSC administration. CONCLUSIONS Intra-articular administration of ADSC in knee OA improved KOOS at 6 months. The effects were more significant in knees with KL grade 2 or 3 than with KL grade 4. Changes in KOOS were not related to change in cartilage volumes after ADSC administration.
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Affiliation(s)
- Ayano Kuwasawa
- Department of Orthopaedic Surgery, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831 Japan
| | - Ken Okazaki
- Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, 162-8666 Japan.
| | - Kuniko Noda
- Department of Orthopaedic Surgery, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831 Japan
| | - Takashi Fukushima
- Department of Orthopaedic Surgery, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831 Japan
| | - Kotaro Nihei
- Department of Orthopaedic Surgery, Saitama Cooperative Hospital, 1317 Kizoro, Kawaguchi, Saitama, 333-0831 Japan
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11
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Akatsuka Y, Nakanishi M, Uemura M, Imamura R, Hayakawa K. [Costal Cartilage Injury Using MRI: A Case Report]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:469-473. [PMID: 36806212 DOI: 10.6009/jjrt.2023-1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
A magnetic resonance imaging (MRI) scan was performed to rule out a sternal fracture in a woman in 30s. Short tau inversion recovery (STIR) coronal showed no signal change in the sternum but increased signal from the mediastinum to the anterior thoracic region. We could not detect significant findings until midway through the examination. T2-weighted fat-suppressed images revealed a suspected left first costal cartilage injury at the end of the examination. In addition, three-dimensional gradient-recalled echo (3D GRE) T1-weighted fat-suppressed images clearly revealed a lesion area with a high signal intensity in the costal cartilage and a low signal intensity in the surrounding tissue, and we diagnosed costal cartilage injury definitely. In case of MRI for posttraumatic chest pain, T1-weighted fat-suppressed images with 3D GRE may be useful for the detection of lesion area.
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Affiliation(s)
- Yoshihiro Akatsuka
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
| | - Mitsuhiro Nakanishi
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
| | - Miho Uemura
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
| | - Rui Imamura
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
| | - Kohei Hayakawa
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital
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12
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Improving knee osteoarthritis classification using multimodal intermediate fusion of X-ray, MRI, and clinical information. Neural Comput Appl 2023. [DOI: 10.1007/s00521-023-08214-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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13
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Prodromidis AD, Charalambous CP, Moran E, Venkatesh R, Pandit H. The role of Platelet-Rich Plasma (PRP) intraarticular injections in restoring articular cartilage of osteoarthritic knees. A systematic review and meta-analysis. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100318. [DOI: 10.1016/j.ocarto.2022.100318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 11/07/2022] Open
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14
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Automatic Segmentation of Lumbar Spine MRI Images Based on Improved Attention U-Net. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:4259471. [PMID: 36156962 PMCID: PMC9492365 DOI: 10.1155/2022/4259471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022]
Abstract
Lumbar spine segmentation is important to help doctors diagnose lumbar disc herniation (LDH) and patients' rehabilitation treatment. In order to accurately segment the lumbar spine, a lumbar spine image segmentation algorithm based on improved Attention U-Net is proposed. The algorithm is based on Attention U-Net, the attention module based on multilevel feature map fusion is adopted, two residual modules are introduced instead of the original convolution blocks. a hybrid loss function is used for prediction during the training process, and finally, the image superposition process is realized. In this experiment, we expanded 420 lumbar MRI images of 180 patients to 1000 images and trained them by different algorithms, respectively, and accuracy, recall, and Dice similarity coefficient metrics were used to analyze these algorithms. The results show that compared with SVM, FCN, R-CNN, U-Net, and Attention U-Net models, the improved model achieved better results in all three evaluations, with 95.50%, 94.53%, and 95.01%, respectively, which proves the better performance of the proposed method for segmentation in lumbar disc and caudal vertebrae.
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15
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Jiang S, Zhang C, Lu Y, Yuan F. The molecular mechanism research of cartilage calcification induced by osteoarthritis. Bioengineered 2022; 13:13082-13088. [PMID: 35611765 PMCID: PMC9276012 DOI: 10.1080/21655979.2022.2078025] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
To explore the molecular mechanism of cartilage calcification induced by osteoarthritis (OA) based on distal-less homeobox gene 5 – alkaline phosphatase – integrin-binding sialoprotein – ecto-nucleotide pyrophosphatase 1 (DLX5-ALPL-IBSP-ENPP1) signal axis. Twenty-four rabbits were selected to build models of cartilage calcification induced by OA and randomly divided into 3 groups. The first group was the normal group whose rabbits were injected into 0.9% saline (0.3 mL), and the second group was model group. The third group was model group whose rabbits were injected into DLX5 antibody by caudal vein. Alizarin red calcium staining was used to analyze calcium deposition of cartilage matrix. Immunohistochemical staining was used to analyze the relative expression levels of proteins DLX5 and ENPP1, and western blot was used to analyze the DLX5, ALPL, IBSP, and ENPP1 expression. Calcium salt precipitation was the most serious, and the calcification area increased in the model group. Although calcified nodules appeared in the anti-DLX5 group, they were relatively few. Immunohistochemical staining analysis showed that the protein DLX5 located in the nucleus and the protein ENPP1 located in the extracellular matrix. Western blot analysis showed that the expressions of proteins DLX5, ALPL, IBSP, and ENPP1 were the highest in OA Model group than that of NC group, followed by anti-DLX5 group. The proteins DLX5, ALPL, IBSP, and ENPP1 can promote cartilage calcification induced by OA based on DLX5-ALPL-IBSP-ENPP1 signal axis.
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Affiliation(s)
- Shilin Jiang
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chengyuan Zhang
- Department of Orthopedics Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Ye Lu
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Feng Yuan
- Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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16
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Hiranaka T, Suda Y, Saitoh A, Tanaka A, Arimoto A, Koide M, Fujishiro T, Okamoto K. Current concept of kinematic alignment total knee arthroplasty and its derivatives. Bone Jt Open 2022; 3:390-397. [PMID: 35532356 PMCID: PMC9134837 DOI: 10.1302/2633-1462.35.bjo-2022-0021.r2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The kinematic alignment (KA) approach to total knee arthroplasty (TKA) has recently increased in popularity. Accordingly, a number of derivatives have arisen and have caused confusion. Clarification is therefore needed for a better understanding of KA-TKA. Calipered (or true, pure) KA is performed by cutting the bone parallel to the articular surface, compensating for cartilage wear. In soft-tissue respecting KA, the tibial cutting surface is decided parallel to the femoral cutting surface (or trial component) with in-line traction. These approaches are categorized as unrestricted KA because there is no consideration of leg alignment or component orientation. Restricted KA is an approach where the periarthritic joint surface is replicated within a safe range, due to concerns about extreme alignments that have been considered ‘alignment outliers’ in the neutral mechanical alignment approach. More recently, functional alignment and inverse kinematic alignment have been advocated, where bone cuts are made following intraoperative planning, using intraoperative measurements acquired with computer assistance to fulfill good coordination of soft-tissue balance and alignment. The KA-TKA approach aims to restore the patients’ own harmony of three knee elements (morphology, soft-tissue balance, and alignment) and eventually the patients’ own kinematics. The respective approaches start from different points corresponding to one of the elements, yet each aim for the same goal, although the existing implants and techniques have not yet perfectly fulfilled that goal.
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Affiliation(s)
- Takafumi Hiranaka
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Yoshihito Suda
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Akira Saitoh
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Atsuki Tanaka
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Akihiko Arimoto
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Motoki Koide
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Takaaki Fujishiro
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
| | - Koji Okamoto
- Department of Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, Japan
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17
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Fast quantitative bone marrow lesion measurement on knee MRI for the assessment of osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2022; 4:100234. [DOI: 10.1016/j.ocarto.2022.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/07/2021] [Accepted: 01/07/2022] [Indexed: 11/21/2022] Open
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18
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Almajalid R, Zhang M, Shan J. Fully Automatic Knee Bone Detection and Segmentation on Three-Dimensional MRI. Diagnostics (Basel) 2022; 12:123. [PMID: 35054290 PMCID: PMC8774512 DOI: 10.3390/diagnostics12010123] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/24/2021] [Accepted: 12/30/2021] [Indexed: 02/06/2023] Open
Abstract
In the medical sector, three-dimensional (3D) images are commonly used like computed tomography (CT) and magnetic resonance imaging (MRI). The 3D MRI is a non-invasive method of studying the soft-tissue structures in a knee joint for osteoarthritis studies. It can greatly improve the accuracy of segmenting structures such as cartilage, bone marrow lesion, and meniscus by identifying the bone structure first. U-net is a convolutional neural network that was originally designed to segment the biological images with limited training data. The input of the original U-net is a single 2D image and the output is a binary 2D image. In this study, we modified the U-net model to identify the knee bone structures using 3D MRI, which is a sequence of 2D slices. A fully automatic model has been proposed to detect and segment knee bones. The proposed model was trained, tested, and validated using 99 knee MRI cases where each case consists of 160 2D slices for a single knee scan. To evaluate the model's performance, the similarity, dice coefficient (DICE), and area error metrics were calculated. Separate models were trained using different knee bone components including tibia, femur, patella, as well as a combined model for segmenting all the knee bones. Using the whole MRI sequence (160 slices), the method was able to detect the beginning and ending bone slices first, and then segment the bone structures for all the slices in between. On the testing set, the detection model accomplished 98.79% accuracy and the segmentation model achieved DICE 96.94% and similarity 93.98%. The proposed method outperforms several state-of-the-art methods, i.e., it outperforms U-net by 3.68%, SegNet by 14.45%, and FCN-8 by 2.34%, in terms of DICE score using the same dataset.
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Affiliation(s)
- Rania Almajalid
- Department of Computer Science, Seidenberg School of CSIS, Pace University, New York, NY 10038, USA;
- College of Computing and Informatics, Saudi Electronic University, Riyadh 11673, Saudi Arabia
| | - Ming Zhang
- Department of Computer Science & Networking, Wentworth Institute of Technology, Boston, MA 02115, USA
- Division of Rheumatology, Tufts Medical Center, Boston, MA 02111, USA
| | - Juan Shan
- Department of Computer Science, Seidenberg School of CSIS, Pace University, New York, NY 10038, USA;
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19
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Ebrahimkhani S, Dharmaratne A, Jaward MH, Wang Y, Cicuttini FM. Automated segmentation of knee articular cartilage: Joint deep and hand-crafted learning-based framework using diffeomorphic mapping. Neurocomputing 2022. [DOI: 10.1016/j.neucom.2021.09.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Huang C, Xu Z, Shen Z, Luo T, Li T, Nissman D, Nelson A, Golightly Y, Niethammer M, Zhu H. DADP: Dynamic abnormality detection and progression for longitudinal knee magnetic resonance images from the Osteoarthritis Initiative. Med Image Anal 2022; 77:102343. [PMID: 35026528 PMCID: PMC8901568 DOI: 10.1016/j.media.2021.102343] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/27/2021] [Accepted: 12/27/2021] [Indexed: 10/19/2022]
Abstract
Osteoarthritis (OA) is the most common disabling joint disease. Magnetic resonance (MR) imaging has been commonly used to assess knee joint degeneration due to its distinct advantage in detecting morphologic cartilage changes. Although several statistical methods over conventional radiography have been developed to perform quantitative cartilage analyses, little work has been done capturing the development and progression of cartilage lesions (or abnormal regions) and how they naturally progress. There are two major challenges, including (i) the lack of building spatial-temporal correspondences and correlations in cartilage thickness and (ii) the spatio-temporal heterogeneity in abnormal regions. The goal of this work is to propose a dynamic abnormality detection and progression (DADP) framework for quantitative cartilage analysis, while addressing the two challenges. First, spatial correspondences are established on flattened 2D cartilage thickness maps extracted from 3D knee MR images both across time within each subject and across all subjects. Second, a dynamic functional mixed effects model (DFMEM) is proposed to quantify abnormality progression across time points and subjects, while accounting for the spatio-temporal heterogeneity. We systematically evaluate our DADP using simulations and real data from the Osteoarthritis Initiative (OAI). Our results show that DADP not only effectively detects subject-specific dynamic abnormal regions, but also provides population-level statistical disease mapping and subgroup analysis.
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Affiliation(s)
- Chao Huang
- Department of Statistics, Florida State University, Tallahassee, 32304, USA
| | - Zhenlin Xu
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Zhengyang Shen
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Tianyou Luo
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Tengfei Li
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Amanda Nelson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Yvonne Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA
| | - Marc Niethammer
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA.
| | - Hongtu Zhu
- Department of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA; Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, 27599, USA.
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21
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Latif MHA, Faye I. Automated tibiofemoral joint segmentation based on deeply supervised 2D-3D ensemble U-Net: Data from the Osteoarthritis Initiative. Artif Intell Med 2021; 122:102213. [PMID: 34823835 DOI: 10.1016/j.artmed.2021.102213] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
Improving longevity is one of the greatest achievements in humanity. Because of this, the population is growing older, and the ubiquity of knee osteoarthritis (OA) is on the rise. Nonetheless, the understanding and ability to investigate potential precursors of knee OA have been impeded by time-consuming and laborious manual delineation processes which are prone to poor reproducibility. A method for automatic segmentation of the tibiofemoral joint using magnetic resonance imaging (MRI) is presented in this work. The proposed method utilizes a deeply supervised 2D-3D ensemble U-Net, which consists of foreground class oversampling, deep supervision loss branches, and Gaussian weighted softmax score aggregation. It was designed, optimized, and tested on 507 3D double echo steady-state (DESS) MR volumes using a two-fold cross-validation approach. A state-of-the-art segmentation accuracy measured as Dice similarity coefficient (DSC) for the femur bone (98.6 ± 0.27%), tibia bone (98.8 ± 0.31%), femoral cartilage (90.3 ± 2.89%), and tibial cartilage (86.7 ± 4.07%) is achieved. Notably, the proposed method yields sub-voxel accuracy for an average symmetric surface distance (ASD) less than 0.36 mm. The model performance is not affected by the severity of radiographic osteoarthritis (rOA) grades or the presence of pathophysiological changes. The proposed method offers an accurate segmentation with high time efficiency (~62 s) per 3D volume, which is well suited for efficient processing and analysis of the large prospective cohorts of the Osteoarthritis Initiative (OAI).
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Affiliation(s)
- Muhamad Hafiz Abd Latif
- Centre for Intelligent Signal and Imaging Research, Universiti Teknologi PETRONAS, 32610 Seri Iskandar, Perak, Malaysia; Electrical & Electronic Engineering Department, Universiti Teknologi PETRONAS, 32610 Seri Iskandar, Perak, Malaysia.
| | - Ibrahima Faye
- Centre for Intelligent Signal and Imaging Research, Universiti Teknologi PETRONAS, 32610 Seri Iskandar, Perak, Malaysia; Fundamental & Applied Sciences Department, Universiti Teknologi PETRONAS, 32610 Seri Iskandar, Perak, Malaysia.
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22
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Wang X, Bennell KL, Wang Y, Fortin K, Saxby DJ, Killen BA, Wrigley TV, Cicuttini FM, Van Ginckel A, Lloyd DG, Feller JA, Vertullo CJ, Whitehead T, Gallie P, Bryant AL. Patellar cartilage increase following ACL reconstruction with and without meniscal pathology: a two-year prospective MRI morphological study. BMC Musculoskelet Disord 2021; 22:909. [PMID: 34711188 PMCID: PMC8555213 DOI: 10.1186/s12891-021-04794-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/15/2021] [Indexed: 11/10/2022] Open
Abstract
Background Anterior cruciate ligament reconstruction (ACLR) together with concomitant meniscal injury are risk factors for the development of tibiofemoral (TF) osteoarthritis (OA), but the potential effect on the patellofemoral (PF) joint is unclear. The aim of this study was to: (i) investigate change in patellar cartilage morphology in individuals 2.5 to 4.5 years after ACLR with or without concomitant meniscal pathology and in healthy controls, and (ii) examine the association between baseline patellar cartilage defects and patellar cartilage volume change. Methods Thirty two isolated ACLR participants, 25 ACLR participants with combined meniscal pathology and nine healthy controls underwent knee magnetic resonance imaging (MRI) with 2-year intervals (baseline = 2.5 years post-ACLR). Patellar cartilage volume and cartilage defects were assessed from MRI using validated methods. Results Both ACLR groups showed patellar cartilage volume increased over 2 years (p < 0.05), and isolated ACLR group had greater annual percentage cartilage volume increase compared with controls (mean difference 3.6, 95% confidence interval (CI) 1.0, 6.3%, p = 0.008) and combined ACLR group (mean difference 2.2, 95% CI 0.2, 4.2%, p = 0.028). Patellar cartilage defects regressed in the isolated ACLR group over 2 years (p = 0.02; Z = − 2.33; r = 0.3). Baseline patellar cartilage defect score was positively associated with annual percentage cartilage volume increase (Regression coefficient B = 0.014; 95% CI 0.001, 0.027; p = 0.03) in the pooled ACLR participants. Conclusions Hypertrophic response was evident in the patellar cartilage of ACLR participants with and without meniscal pathology. Surprisingly, the increase in patellar cartilage volume was more pronounced in those with isolated ACLR. Although cartilage defects stabilised in the majority of ACLR participants, the severity of patellar cartilage defects at baseline influenced the magnitude of the cartilage hypertrophic response over the subsequent ~ 2 years. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04794-5.
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Affiliation(s)
- Xinyang Wang
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia
| | - Yuanyuan Wang
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karine Fortin
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia.,Faculty of Arts, Monash University, Melbourne, Victoria, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Griffith University Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Gold Coast, Australia
| | - Bryce A Killen
- Human Movement Biomechanics Research Group, KU Leuven, Leuven, Belgium
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia
| | - Flavia M Cicuttini
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ans Van Ginckel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Griffith University Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Gold Coast, Australia
| | - Julian A Feller
- OrthoSport Victoria, Melbourne, Australia.,College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Christopher J Vertullo
- Griffith University Centre for Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute Queensland, Gold Coast, Australia.,Knee Research Australia, Gold Coast, Australia
| | | | | | - Adam L Bryant
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, Victoria, 3010, Australia.
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23
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Jansen MP, Mastbergen SC, Eckstein F, van Heerwaarden RJ, Spruijt S, Lafeber FPJG. Comparison between 2D radiographic weight-bearing joint space width and 3D MRI non-weight-bearing cartilage thickness measures in the knee using non-weight-bearing 2D and 3D CT as an intermediary. Ther Adv Chronic Dis 2021; 12:20406223211037868. [PMID: 34434539 PMCID: PMC8381425 DOI: 10.1177/20406223211037868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 07/20/2021] [Indexed: 11/24/2022] Open
Abstract
Background: In knee osteoarthritis, radiographic joint space width (JSW) is frequently
used as a surrogate marker for cartilage thickness; however, longitudinal
changes in radiographic JSW have shown poor correlations with those of
magnetic resonance imaging (MRI) cartilage thickness. There are fundamental
differences between the techniques: radiographic JSW represents
two-dimensional (2D), weight-bearing, bone-to-bone distance, while on MRI
three-dimensional (3D) non-weight-bearing cartilage thickness is measured.
In this exploratory study, computed tomography (CT) was included as a third
technique, as it can measure bone-to-bone under non-weight-bearing
conditions. The objective was to use CT to compare the impact of
weight-bearing versus non-weight-bearing, as well as
bone-to-bone JSW versus actual cartilage thickness, in the
knee. Methods: Osteoarthritis patients (n = 20) who were treated with knee
joint distraction were included. Weight-bearing radiographs,
non-weight-bearing MRIs and CTs were acquired before and 2 years after
treatment. The mean radiographic JSW and cartilage thickness of the most
affected compartment were measured. From CT, the 3D median JSW was
calculated and a 2D projectional image was rendered, positioned similarly
and measured identically to the radiograph. Pearson correlations between the
techniques were derived, both cross-sectionally and longitudinally. Results: Fourteen patients could be analyzed. Cross-sectionally, all comparisons
showed moderate to strong significant correlations (R = 0.43–0.81; all
p < 0.05). Longitudinal changes over time were
small; only the correlations between 2D CT and 3D CT (R = 0.65;
p = 0.01) and 3D CT and MRI (R = 0.62;
p = 0.02) were statistically significant. Conclusion: The poor correlation between changes in radiographic JSW and MRI cartilage
thickness appears primarily to result from the difference in weight-bearing,
and less so from measuring bone-to-bone distance versus
cartilage thickness.
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Affiliation(s)
- Mylène P Jansen
- Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Heidelberglaan 100 (G02.228), Utrecht 3584CX, The Netherlands
| | - Simon C Mastbergen
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Felix Eckstein
- Department of Imaging and Functional Musculoskeletal Research, Institute of Anatomy and Cell Biology, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Ronald J van Heerwaarden
- Centre for Deformity Correction and Joint Preserving Surgery, Kliniek ViaSana, Mill, The Netherlands
| | - Sander Spruijt
- Reinier Haga Orthopaedic Centre, Zoetermeer, The Netherlands
| | - Floris P J G Lafeber
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
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24
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Jogi SP, Thaha R, Rajan S, Mahajan V, Venugopal VK, Mehndiratta A, Singh A. Device for Assessing Knee Joint Dynamics During Magnetic Resonance Imaging. J Magn Reson Imaging 2021; 55:895-907. [PMID: 34369633 DOI: 10.1002/jmri.27877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Knee assessment with and without load using magnetic resonance imaging (MRI) can provide information on knee joint dynamics and improve the diagnosis of knee joint diseases. Performing such studies on a routine MRI-scanner require a load-exerting device during scanning. There is a need for more studies on developing loading devices and evaluating their clinical potential. PURPOSE Design and develop a portable and easy-to-use axial loading device to evaluate the knee joint dynamics during the MRI study. STUDY TYPE Prospective study. SUBJECTS Nine healthy subjects. FIELD STRENGTH/SEQUENCE A 0.25 T standing-open MRI and 3.0 T MRI. PD-T2 -weighted FSE, 3D-fast-spoiled-gradient-echo, FS-PD, and CartiGram sequences. ASSESSMENT Design and development of loading device, calibration of loads, MR safety assessment (using projectile angular displacement, torque, and temperature tests). Scoring system for ease of doing. Qualitative (by radiologist) and quantitative (using structural similarity index measure [SSIM]) image-artifact assessment. Evaluation of repeatability, comparison with various standing stances load, and loading effect on knee MR parameters (tibiofemoral bone gap [TFBG], femoral cartilage thickness [FCT], tibial cartilage thickness [TCT], femoral cartilage T2 -value [FCT2], and tibia cartilage T2 -value [TCT2]). The relative percentage change (RPC) in parameters due to the device load was computed. STATISTICAL TEST Pearson's correlation coefficient (r). RESULTS The developed device is conditional-MR safe (details in the manuscript and supplementary materials), 15 × 15 × 45 cm3 dimension, and <3 kg. The ease of using the device was 4.9/5. The device introduced no visible image artifacts, and SSIM of 0.9889 ± 0.0153 was observed. The TFBG intraobserver variability (absolute difference) was <0.1 mm. Interobserver variability of all regions of interest was <0.1 mm. The load exerted by the device was close to the load during standing on both legs in 0.25 T scanner with r > 0.9. Loading resulted in RPC of 1.5%-11.0%, 7.9%-8.5%, and -1.5% to 13.0% in the TFBG, FCT, and TCT, respectively. FCT2 and TCT2 were reduced in range of 1.5-2.7 msec and 0.5-2.3 msec due to load. DATA CONCLUSION The proposed device is conditionally MR safe, low cost (material cost < INR 6000), portable, and effective in loading the knee joint with up to 50% of body weight. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Sandeep P Jogi
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, ASET, Amity University Haryana, Gurgaon, Haryana, India
| | - Rafeek Thaha
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India
| | | | | | | | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
| | - Anup Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, India
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25
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Tse Ve Koon K, Grenier D, Taborik F, Perrier AL, Mahieu-Williame L, Magnier L, Chuzel T, Contamin H, Chereul E, Beuf O. Comparison of high-resolution magnetic resonance imaging and micro-computed tomography arthrography for in-vivo assessment of cartilage in non-human primate models. Quant Imaging Med Surg 2021; 11:3431-3447. [PMID: 34341721 DOI: 10.21037/qims-20-116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 10/23/2020] [Indexed: 11/06/2022]
Abstract
Background Non-human primate (NHP) could be an interesting model for osteoarthritis (OA) longitudinal studies but standard medical imaging protocols are not able to acquire sufficiently high-resolution images to depict the thinner cartilage (compared to human) in an in vivo context. The aim of this study was thus to develop and validate the acquisition protocols for knee joint examination of NHP using magnetic resonance imaging (MRI) at 1.5 T and X-ray micro-computed tomography arthrography (µCTA). Methods The first phase of the study focused on developing dedicated in vivo HR-MRI and µCTA protocols for simultaneous acquisitions of both knee joints on NHP. For MR, a dedicated two-channel receiver array coil and acquisition sequence were developed on a 1.5 T Siemens Sonata system and tuned to respect safety issues and reasonable examination time. For µCTA, an experimental setup was devised so as to fulfill similar requirements. The two imaging protocols were used during a longitudinal study so as to confirm that repeated injections of loxaglic acid (contrast agent used for µCTA) didn't induce any bias in cartilage assessment and to compare segmentation results from the two modalities. Lateral and medial cartilage tibial plateaus were assessed using a common image processing protocol leading to a 3D estimation of the cartilage thickness. Results From HR-MRI and µCTA images, thickness distributions were extracted allowing for proper evaluation of knee cartilage thickness of the primates. Results obtained in vivo indicated that the µCTA protocol did not induce any bias in the measured cartilage parameters and moreover, segmentation results obtained from the two imaging modalities were consistent. Conclusions MR and µCTA are valuable imaging tools for the morphological evaluation of cartilage in NHP models which in turn can be used for OA studies.
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Affiliation(s)
- Kevin Tse Ve Koon
- Univ. Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | - Denis Grenier
- Univ. Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | | | - Anne-Laure Perrier
- Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, CNRS, LOCIE, Chambéry, France
| | - Laurent Mahieu-Williame
- Univ. Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
| | | | | | | | | | - Olivier Beuf
- Univ. Lyon, INSA-Lyon, Université Claude Bernard Lyon 1, UJM-Saint Etienne, CNRS, Inserm, CREATIS UMR 5220, U1294, Lyon, France
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26
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Favre J, Babel H, Cavinato A, Blazek K, Jolles BM, Andriacchi TP. Analyzing Femorotibial Cartilage Thickness Using Anatomically Standardized Maps: Reproducibility and Reference Data. J Clin Med 2021; 10:461. [PMID: 33530358 PMCID: PMC7865848 DOI: 10.3390/jcm10030461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/26/2022] Open
Abstract
Alterations in cartilage thickness (CTh) are a hallmark of knee osteoarthritis, which remain difficult to characterize at high resolution, even with modern magnetic resonance imaging (MRI), due to a paucity of standardization tools. This study aimed to assess a computational anatomy method producing standardized two-dimensional femorotibial CTh maps. The method was assessed with twenty knees, processed following three common experimental scenarios. Cartilage thickness maps were obtained for the femorotibial cartilages by reconstructing bone and cartilage mesh models in tree-dimension, calculating three-dimensional CTh maps, and anatomically standardizing the maps. The intra-operator accuracy (median (interquartile range, IQR) of -0.006 (0.045) mm), precision (0.152 (0.070) mm), entropy (7.02 (0.71) and agreement (0.975 (0.020))) results suggested that the method is adequate to capture the spatial variations in CTh and compare knees at varying osteoarthritis stages. The lower inter-operator precision (0.496 (0.132) mm) and agreement (0.808 (0.108)) indicate a possible loss of sensitivity to detect differences in a setting with multiple operators. The results confirmed the promising potential of anatomically standardized maps, with the lower inter-operator reproducibility stressing the need to coordinate operators. This study also provided essential reference data and indications for future research using CTh maps.
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Affiliation(s)
- Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (J.F.); (A.C.); (B.M.J.)
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA; (K.B.); (T.P.A.)
| | - Hugo Babel
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (J.F.); (A.C.); (B.M.J.)
| | - Alessandro Cavinato
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (J.F.); (A.C.); (B.M.J.)
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA; (K.B.); (T.P.A.)
| | - Katerina Blazek
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA; (K.B.); (T.P.A.)
- Palo Alto VA, Palo Alto, CA 94304, USA
| | - Brigitte M. Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (J.F.); (A.C.); (B.M.J.)
- Institute of Microengineering, Ecole Polytechnique Fédérale Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Thomas P. Andriacchi
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA; (K.B.); (T.P.A.)
- Palo Alto VA, Palo Alto, CA 94304, USA
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA 94061, USA
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27
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Lee LS, Chan PK, Fung WC, Chan VWK, Yan CH, Chiu KY. Imaging of knee osteoarthritis: A review of current evidence and clinical guidelines. Musculoskeletal Care 2021; 19:363-374. [PMID: 33387447 DOI: 10.1002/msc.1536] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) is one of the most common and debilitating degenerative joint diseases worldwide. While radiography is the most commonly used imaging modality, it is associated with drawbacks which newer modalities such as magnetic resonance imaging (MRI) and ultrasound could overcome. Nevertheless, the role of imaging in clinical practice and research in knee OA has not been clearly defined. Furthermore, guidelines on imaging in knee OA from different authoritative bodies have not been compared in previous studies. Therefore, the present review aims to summarise existing evidence and compare guidelines on the use of different imaging modalities in evaluating knee OA. METHODS This is a narrative review based on a search of published clinical guidelines and the PubMed database for articles published between 1 January 1990 and 31 May 2020. RESULTS There is no broad consensus on the value of imaging in patients with typical OA presentation. If imaging is required, current evidence and clinical guidelines support the use of radiography and MRI as first- and second-line diagnostic modalities respectively. Since radiographic OA features have limited sensitivity and do not manifest in early stages, MRI is the preferred option for whole-joint evaluation in OA research. Discrepancies exist regarding the use of alternative imaging modalities including ultrasound, computed tomography and nuclear medicine. CONCLUSION Radiography and MRI are the imaging modalities of choice. Other modalities have their respective advantages, and more research is warranted for the standardisation of image acquisition and interpretation methodology, in order to evaluate their validity, reliability and responsiveness in OA research.
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Affiliation(s)
- Lok Sze Lee
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ping Keung Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Wing Chiu Fung
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Vincent Wai Kwan Chan
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong SAR, China
| | - Chun Hoi Yan
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kwong Yuen Chiu
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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28
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Xiao S, Chen L. The emerging landscape of nanotheranostic-based diagnosis and therapy for osteoarthritis. J Control Release 2020; 328:817-833. [PMID: 33176171 DOI: 10.1016/j.jconrel.2020.11.007] [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] [Received: 10/09/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 02/06/2023]
Abstract
Osteoarthritis (OA) is a common degenerative disease involving numerous joint tissues and cells, with a growing rate in prevalence that ultimately results in a negative social impact. Early diagnosis, OA progression monitoring and effective treatment are of significant importance in halting OA process. However, traditional imaging techniques lack sensitivity and specificity, which lead to a delay in timely clinical intervention. Additionally, current treatments only slow the progression of OA but have not meet the largely medical need for disease-modifying therapy. In order to overcome the above-mentioned problems and improve clinical efficacy, nanotheranostics has been proposed on OA remedy, which has confirmed success in animal models. In this review, different imaging targets-based nanoprobe for early and timely OA diagnosis is first discussed. Second, therapeutic strategies delivered by nanosystem are summarized as much as possible. Their advantages and the potential for clinical translation are detailed discussed. Third, nanomedicine simultaneously combined with the imaging for OA treatment is introduced. Nanotheranostics dynamically tracked the OA treatment outcomes to timely and individually adjust therapy. Finally, future prospects and challenges of nanotechnology-based OA diagnosis, imaging and treatment are concluded and predicted. It is believed that nanoprobe and nanomedicine will become prospective in OA therapeutic revolution.
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Affiliation(s)
- Shuyi Xiao
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China; Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China
| | - Liang Chen
- Department of Orthopedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, PR China.
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29
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Brui E, Efimtcev AY, Fokin VA, Fernandez R, Levchuk AG, Ogier AC, Samsonov AA, Mattei JP, Melchakova IV, Bendahan D, Andreychenko A. Deep learning-based fully automatic segmentation of wrist cartilage in MR images. NMR IN BIOMEDICINE 2020; 33:e4320. [PMID: 32394453 PMCID: PMC7784718 DOI: 10.1002/nbm.4320] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 05/10/2023]
Abstract
The study objective was to investigate the performance of a dedicated convolutional neural network (CNN) optimized for wrist cartilage segmentation from 2D MR images. CNN utilized a planar architecture and patch-based (PB) training approach that ensured optimal performance in the presence of a limited amount of training data. The CNN was trained and validated in 20 multi-slice MRI datasets acquired with two different coils in 11 subjects (healthy volunteers and patients). The validation included a comparison with the alternative state-of-the-art CNN methods for the segmentation of joints from MR images and the ground-truth manual segmentation. When trained on the limited training data, the CNN outperformed significantly image-based and PB-U-Net networks. Our PB-CNN also demonstrated a good agreement with manual segmentation (Sørensen-Dice similarity coefficient [DSC] = 0.81) in the representative (central coronal) slices with a large amount of cartilage tissue. Reduced performance of the network for slices with a very limited amount of cartilage tissue suggests the need for fully 3D convolutional networks to provide uniform performance across the joint. The study also assessed inter- and intra-observer variability of the manual wrist cartilage segmentation (DSC = 0.78-0.88 and 0.9, respectively). The proposed deep learning-based segmentation of the wrist cartilage from MRI could facilitate research of novel imaging markers of wrist osteoarthritis to characterize its progression and response to therapy.
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Affiliation(s)
- Ekaterina Brui
- University of Information Technology Mechanics and Optics, International Research Center Nanophotonics and Metamaterials, 199034 S.-Petersburg, Russia
| | - Aleksandr Y. Efimtcev
- University of Information Technology Mechanics and Optics, International Research Center Nanophotonics and Metamaterials, 199034 S.-Petersburg, Russia
- Federal Almazov North-West Medical Research Center, 197341 S.-Petersburg, Russia
| | - Vladimir A. Fokin
- University of Information Technology Mechanics and Optics, International Research Center Nanophotonics and Metamaterials, 199034 S.-Petersburg, Russia
- Federal Almazov North-West Medical Research Center, 197341 S.-Petersburg, Russia
| | - Remi Fernandez
- APHM, Service de Radiologie, Hôpital de la Conception, Marseille, France
| | - Anatoliy G. Levchuk
- Federal Almazov North-West Medical Research Center, 197341 S.-Petersburg, Russia
| | - Augustin C. Ogier
- Aix-Marseille Universite, CNRS, Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| | - Alexey A. Samsonov
- University of Wisconsin-Madison, Department of Radiology, Madison, WI 53705-2275 USA
| | - Jean. P. Mattei
- Aix-Marseille Universite, CNRS, Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
- Assistance Publique Hôpitaux de Marseille, Institut de l’appareil locomoteur, Service de Rhumatologie, Hôpital Sainte Marguerite, Marseille, France
| | - Irina V. Melchakova
- University of Information Technology Mechanics and Optics, International Research Center Nanophotonics and Metamaterials, 199034 S.-Petersburg, Russia
| | - David Bendahan
- Aix-Marseille Universite, CNRS, Centre de Résonance Magnétique Biologique et Médicale, UMR 7339, Marseille, France
| | - Anna Andreychenko
- University of Information Technology Mechanics and Optics, International Research Center Nanophotonics and Metamaterials, 199034 S.-Petersburg, Russia
- Research and Practical Clinical Center of Diagnostics and Telemedicine Technologies, Department of Health Care of Moscow, Moscow, Russia
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30
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Miniaturized Water-Jet Ultrasound Indentation System for Quantitative Assessment of Articular Cartilage Degeneration: A Validation Study. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2316369. [PMID: 32724796 PMCID: PMC7381965 DOI: 10.1155/2020/2316369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022]
Abstract
Osteoarthritis is a common joint disease affecting a large population especially the elderly where cartilage degeneration is one of its hallmark symptoms. There is a need to develop new devices and instruments for the early detection and treatment of cartilage degeneration. In this study, we describe the development of a miniaturized water-jet ultrasound indentation probe for this purpose. To evaluate the system, we applied it to characterize the degeneration of articular cartilage with the measurement of its morphologic, acoustic, and mechanical properties, using the enzymatic digestions of cartilage as a model of OA. Fifty cartilage samples were tested with 10 of them used for the reproducibility study and the other 40 for collagenase and trypsin digestions. Thickness, integrated reflection coefficient (IRC), effective stiffness, and energy dissipation ratio (EDR) were used to quantify the change of articular cartilage before and after degeneration. The measurement reproducibility as represented by the standardized coefficient of variation (SCV) was 2.6%, 10.2%, 11.5%, and 12.8% for thickness, IRC, stiffness, and EDR, respectively. A significant change of IRC, stiffness, and EDR was detected after degeneration by the designed probe (p < 0.05). There was also a significant difference of IRC, stiffness, and EDR between trypsin and collagenase digestions (p < 0.001). In conclusion, a miniaturized water-jet ultrasound indentation probe has been designed, which has been successfully used to detect and differentiate cartilage degeneration simulated by enzymatic digestions. This probe, with future development, can be potentially suitable for quantitative assessment of cartilage degeneration with an arthroscopic operation.
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31
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Tracking Osteoarthritis Progress through Cationic Nanoprobe-Enhanced Photoacoustic Imaging of Cartilage. Acta Biomater 2020; 109:153-162. [PMID: 32339712 DOI: 10.1016/j.actbio.2020.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/21/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022]
Abstract
A major obstacle in osteoarthritis (OA) theranostics is the lack of a timely and accurate monitoring method. It is hypothesized that the loss of anionic glycosaminoglycans (GAGs) in articular cartilage reflects the progression of OA. Thus, this study investigated the feasibility of photoacoustic imaging (PAI) applied for monitoring the in vivo course of OA progression via GAG-targeted cationic nanoprobes. The nanoprobes were synthesized through electrostatic attraction between poly-l-Lysine and melanin (PLL-MNPs). Cartilage explants with different concentrations of GAGs incubated with PLL-MNPs to test the relationship between GAGs content and PA signal intensity. GAG activity was then evaluated in vivo in destabilization of the medial meniscus (DMM) surgically-induced mouse model. To track OA progression over time, mice were imaged consistently for 10 weeks after OA-inducing surgery. X-ray was used to verify the superiority of PAI in detecting OA. The correlation between PAI data and histologic results was also analyzed. In vitro study demonstrated the ability of PLL-MNPs in sensitively detecting different GAGs concentrations. In vivo PAI exhibited significantly lower signal intensity from OA knees compared to normal knees. More importantly, PA signal intensity showed serial reduction over the course of OA, while X-ray showed visible joint destruction until 6 weeks. A decrease in GAGs content was confirmed by histologic examinations; moreover, histologic findings were well correlated with PAI results. Therefore, using cationic nanoprobe-enhanced PAI to detect the changes in GAG contents provides sensitive and consistent visualization of OA development. This approach will further facilitate OA theranostics and clinical translation. STATEMENT OF SIGNIFICANCE: The study of in vivo monitoring osteoarthritis (OA) is of high significance to tracking the trajectory of OA development and therapeutic monitoring. Here, we developed a cartilage-targeted cationic nanoprobe, poly-l-Lysine-melanin nanoparticles (PLL-MNPs), enhancing photoacoustic imaging (PAI) to monitor the progression of OA. The in vitro study demonstrated the ability of PLL-MNPs to detect different concentrations of GAGs with high sensitivity. We found that the contents of GAGs in vivo steadily decreased from the development of OA initial-stage to the end-point of our investigation via PAI; it reflected the course of OA in living subjects with high sensitivity. These results allow for further development in various aspects of OA research. It has potential for clinical translation and has a great impact on personalized medicine.
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Kim S, Jang H, Jang J, Lee YH, Hwang D. Deep‐learned short tau inversion recovery imaging using multi‐contrast MR images. Magn Reson Med 2020; 84:2994-3008. [DOI: 10.1002/mrm.28327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Sewon Kim
- School of Electrical and Electronic Engineering Yonsei University Seoul Korea
| | - Hanbyol Jang
- School of Electrical and Electronic Engineering Yonsei University Seoul Korea
| | - Jinseong Jang
- School of Electrical and Electronic Engineering Yonsei University Seoul Korea
| | - Young Han Lee
- Department of Radiology and Center for Clinical Imaging Data Science (CCIDS) Yonsei University College of Medicine Seoul Korea
| | - Dosik Hwang
- School of Electrical and Electronic Engineering Yonsei University Seoul Korea
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A review on segmentation of knee articular cartilage: from conventional methods towards deep learning. Artif Intell Med 2020; 106:101851. [DOI: 10.1016/j.artmed.2020.101851] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 02/09/2020] [Accepted: 03/29/2020] [Indexed: 12/14/2022]
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Serum RANKL levels and bioelectric impedance assessments in knee osteoarthritis patients. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.697686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shapiro SA, Arthurs JR, Heckman MG, Bestic JM, Kazmerchak SE, Diehl NN, Zubair AC, O’Connor MI. Quantitative T2 MRI Mapping and 12-Month Follow-up in a Randomized, Blinded, Placebo Controlled Trial of Bone Marrow Aspiration and Concentration for Osteoarthritis of the Knees. Cartilage 2019; 10:432-443. [PMID: 30160168 PMCID: PMC6755869 DOI: 10.1177/1947603518796142] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Bone marrow aspiration and concentration (BMAC) is becoming a more common regenerative therapy for musculoskeletal pathology. In our current pilot study, we studied patients with mild-to-moderate bilateral knee osteoarthritis, compared pain at 12-month follow-up between BMAC-injected and saline-injected knees, and examined cartilage appearance measured by magnetic resonance imaging (MRI) T2 quantitative mapping. DESIGN Twenty-five patients with mild-to-moderate bilateral osteoarthritic knee pain were randomized to receive BMAC into one knee and saline placebo into the other. Bone marrow was aspirated from the iliac crests, concentrated in an automated centrifuge, combined with platelet-poor plasma for knee injection, and compared with saline injection into the contralateral knee. Primary outcome measures were T2 MRI cartilage mapping at 6-month and Visual Analog Scale and Osteoarthritis Research Society International Intermittent and Constant Osteoarthritis Pain scores and radiographs at 12-month follow-up. RESULTS Constant, intermittent, and overall knee pain remained significantly decreased from baseline at 12-month follow-up (all P ⩽ 0.01), with no apparent difference between BMAC- and saline-treated knees (all P ⩾ 0.54). A similar significant increase from baseline to 12-month follow-up regarding quality of life was observed for both BMAC- and saline-treated knees (all P ⩽ 0.04). T2 quantitative MRI mapping showed no significant changes as a result of treatment. CONCLUSIONS BMAC is safe to perform and relieves pain from knee arthritis but showed no superiority to saline injection at 12-month follow-up. MRI cartilage sequences failed to show regenerative benefit with single BMAC injection. The mechanisms of action that led to pain relief remain unclear and warrant further studies.
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Affiliation(s)
- Shane A. Shapiro
- Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA,Shane A. Shapiro, Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224, USA.
| | | | - Michael G. Heckman
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Nancy N. Diehl
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | - Abba C. Zubair
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Mary I. O’Connor
- Department of Orthopedic Surgery, Yale-New Haven Hospital, New Haven, CT, USA
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Variation in the Thickness of Knee Cartilage. The Use of a Novel Machine Learning Algorithm for Cartilage Segmentation of Magnetic Resonance Images. J Arthroplasty 2019; 34:2210-2215. [PMID: 31445869 PMCID: PMC7251923 DOI: 10.1016/j.arth.2019.07.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The variation in articular cartilage thickness (ACT) in healthy knees is difficult to quantify and therefore poorly documented. Our aims are to (1) define how machine learning (ML) algorithms can automate the segmentation and measurement of ACT on magnetic resonance imaging (MRI) (2) use ML to provide reference data on ACT in healthy knees, and (3) identify whether demographic variables impact these results. METHODS Patients recruited into the Osteoarthritis Initiative with a radiographic Kellgren-Lawrence grade of 0 or 1 with 3D double-echo steady-state MRIs were included and their gender, age, and body mass index were collected. Using a validated ML algorithm, 2 orthogonal points on each femoral condyle were identified (distal and posterior) and ACT was measured on each MRI. Site-specific ACT was compared using paired t-tests, and multivariate regression was used to investigate the risk-adjusted effect of each demographic variable on ACT. RESULTS A total of 3910 MRI were included. The average femoral ACT was 2.34 mm (standard deviation, 0.71; 95% confidence interval, 0.95-3.73). In multivariate analysis, distal-medial (-0.17 mm) and distal-lateral cartilage (-0.32 mm) were found to be thinner than posterior-lateral cartilage, while posterior-medial cartilage was found to be thicker (0.21 mm). In addition, female sex was found to negatively impact cartilage thickness (OR, -0.36; all values: P < .001). CONCLUSION ML was effectively used to automate the segmentation and measurement of cartilage thickness on a large number of MRIs of healthy knees to provide normative data on the variation in ACT in this population. We further report patient variables that can influence ACT. Further validation will determine whether this technique represents a powerful new tool for tracking the impact of medical intervention on the progression of articular cartilage degeneration.
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Wang X, Bennell KL, Wang Y, Wrigley TV, Van Ginckel A, Fortin K, Saxby DJ, Cicuttini FM, Lloyd DG, Vertullo CJ, Feller JA, Whitehead T, Gallie P, Bryant AL. Tibiofemoral joint structural change from 2.5 to 4.5 years following ACL reconstruction with and without combined meniscal pathology. BMC Musculoskelet Disord 2019; 20:312. [PMID: 31272448 PMCID: PMC6610973 DOI: 10.1186/s12891-019-2687-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/20/2019] [Indexed: 01/05/2023] Open
Abstract
Background People who have had anterior cruciate ligament reconstruction (ACLR) are at a high risk of developing tibiofemoral joint (TFJ) osteoarthritis (OA), with concomitant meniscal injury elevating this risk. This study aimed to investigate OA-related morphological change over 2 years in the TFJ among individuals who have undergone ACLR with or without concomitant meniscal pathology and in healthy controls. A secondary aim was to examine associations of baseline TFJ cartilage defects and bone marrow lesions (BML) scores with tibial cartilage volume change in ACLR groups. Methods Fifty seven ACLR participants aged 18–40 years (32 isolated ACLR, 25 combined meniscal pathology) underwent knee magnetic resonance imaging (MRI) 2.5 and 4.5 years post-surgery. Nine healthy controls underwent knee MRI at the ~ 2-year intervals. Tibial cartilage volume, TFJ cartilage defects and BMLs were assessed from MRI. Results For both ACLR groups, medial and lateral tibial cartilage volume increased over 2 years (P < 0.05). Isolated ACLR group had greater annual percentage increase in lateral tibial cartilage volume compared with controls and with the combined group (P = 0.03). Cartilage defects remained unchanged across groups. Both ACLR groups showed more lateral tibia BML regression compared with controls (P = 0.04). Baseline cartilage defects score was positively associated with cartilage volume increase at lateral tibia (P = 0.002) while baseline BMLs score was inversely related to medial tibia cartilage volume increase (P = 0.001) in the pooled ACLR group. Conclusions Tibial cartilage hypertrophy was apparent in ACLR knees from 2.5 to 4.5 years post-surgery and was partly dependent upon meniscal status together with the nature and location of the underlying pathology at baseline. Magnitude and direction of change in joint pathologies (i.e., cartilage defects, BMLs) were less predictable and either remained stable or improved over follow-up. Electronic supplementary material The online version of this article (10.1186/s12891-019-2687-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xinyang Wang
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Orthopaedic Surgery, Beijing Chao-Yang Hospital, Beijing, China
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yuanyuan Wang
- School of Public Health & Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia
| | - Tim V Wrigley
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ans Van Ginckel
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Karine Fortin
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - David J Saxby
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Gold Coast, Australia.,Gold Coast Orthopaedic Research and Education Alliance, Gold Coast, Australia
| | - Flavia M Cicuttini
- School of Public Health & Preventive Medicine, Monash University, Alfred Hospital, Melbourne, Victoria, Australia
| | - David G Lloyd
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia.,Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Gold Coast, Australia.,Gold Coast Orthopaedic Research and Education Alliance, Gold Coast, Australia
| | - Christopher J Vertullo
- Core Group for Innovation in Health Technology, Menzies Health Institute Queensland, Gold Coast, Australia.,Knee Research Australia, Gold Coast, Australia
| | - Julian A Feller
- OrthoSport Victoria, Melbourne, Australia.,College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | | | | | - Adam L Bryant
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
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Burchard R, Huflage H, Soost C, Richter O, Bouillon B, Graw JA. Efficiency of platelet-rich plasma therapy in knee osteoarthritis does not depend on level of cartilage damage. J Orthop Surg Res 2019; 14:153. [PMID: 31126348 PMCID: PMC6534904 DOI: 10.1186/s13018-019-1203-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/17/2019] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Osteoarthritis of the knee is common and often leads to significant physical disability. While classic conservative therapeutic approaches aim for symptoms like pain and inflammation, procedures like the intraarticular application of hyaluronic acids (HA) or platelet-rich plasma (PRP) are thought to stimulate the endogenous HA production, stop catabolism of cartilage tissue, and promote tissue regeneration. To analyse whether the positive effects of PRP injections are associated with the level of cartilage damage, patient satisfaction with the treatment was correlated with the level of knee joint osteoarthritis quantified by MRI. METHODS PRP was performed with a low-leukocyte autologous conditioned plasma (ACP) system in 59 patients. A pre-treatment MRI was performed and a Whole-Organ MRI Score (WORMS) was used to score the level of knee osteoarthritis by 14 features: integrity of the cartilage, affection of the bone marrow, subcortical cysts, bone attrition, osteophytes, integrity of the menisci and ligaments, presence of synovitis, loose bodies, and periarticular cysts. A multivariate analysis with ordinary least squares regressions was used. RESULTS Although pain symptoms and severity of clinical osteoarthritis symptoms decreased, regression analysis could not detect a correlation between the degree of cartilage damage measured by the WORMS score and a positive response to PRP therapy. CONCLUSION This study suggests that intraarticular injection of PRP might improve osteoarthritis symptoms and reduces the pain in patients suffering from osteoarthritis of the knee joint independent from the level of cartilage damages quantified by the whole-organ MRI scoring method WORMS.
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Affiliation(s)
- Rene Burchard
- Department of Health, University of Witten/Herdecke, Witten, Germany. .,Department of Trauma- and Orthopaedic Surgery, Kreisklinikum Siegen, Siegen, Germany. .,School of Science and Technology, University of Siegen, Siegen, Germany.
| | - Hanno Huflage
- Department of Health, University of Witten/Herdecke, Witten, Germany
| | - Christian Soost
- Department of Statistics an Econometrics, University of Siegen, Siegen, Germany
| | - Oliver Richter
- Institute of Diagnostic Radiology at Kreisklinikum Siegen, Siegen, Germany
| | - Bertil Bouillon
- Department of Health, University of Witten/Herdecke, Witten, Germany.,Department of Orthopaedics, Trauma Surgery and Sports Traumatology, Kliniken der Stadt Köln, Köln, Germany
| | - Jan Adriaan Graw
- Department of Anaesthesiology and Operative Intensive Care Medicine (CCM, CVK) Charité, Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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CORR Insights®: Do dGEMRIC and T2 Imaging Correlate With Histologic Cartilage Degeneration in an Experimental Ovine FAI Model? Clin Orthop Relat Res 2019; 477:1004-1006. [PMID: 30801288 PMCID: PMC6494300 DOI: 10.1097/corr.0000000000000664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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40
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Atkinson HF, Birmingham TB, Moyer RF, Yacoub D, Kanko LE, Bryant DM, Thiessen JD, Thompson RT. MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:182. [PMID: 31039785 PMCID: PMC6492327 DOI: 10.1186/s12891-019-2547-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls. Methods We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments. Results 55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p < 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p < 0.001). Conclusions T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation. Electronic supplementary material The online version of this article (10.1186/s12891-019-2547-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hayden F Atkinson
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. .,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada. .,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada. .,Musculoskeletal Rehabilitation, Elborn College, University of Western Ontario, London, Ontario, N6G 1H1, Canada.
| | - Rebecca F Moyer
- Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.,School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Yacoub
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Lauren E Kanko
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Dianne M Bryant
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Jonathan D Thiessen
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
| | - R Terry Thompson
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
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Lonza GC, Gardner-Morse MG, Vacek PM, Beynnon BD. Radiographic-based measurement of tibiofemoral joint space width and magnetic resonance imaging derived articular cartilage thickness are not related in subjects at risk for post traumatic arthritis of the knee. J Orthop Res 2019; 37:1052-1058. [PMID: 30908712 PMCID: PMC6499682 DOI: 10.1002/jor.24283] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/12/2019] [Indexed: 02/04/2023]
Abstract
Joint space width (JSW), measured as the distance between the femoral and tibial subchondral bone margins on two-dimensional weight-bearing radiographs, is the initial imaging modality used in clinical settings to diagnose and evaluate the progression of osteoarthritis (OA). While, JSW is the only structural outcome approved by the FDA for studying the treatment of this disease in phase III clinical trials, recent reports suggest that magnetic resonance imaging (MRI)-based measurements of OA changes are superior due to increased sensitivity and specificity to the structural changes associated with progression of this disease. In the current study, we examined the relationship between radiographic JSW and MRI-derived articular cartilage thickness in subjects 4 years post anterior cruciate ligament reconstruction (ACLR) who were at increased risk for the onset and early progression of post-traumatic OA, and in uninjured subjects with normal knees (Control). In both ACLR and Control groups, there were large measurement biases, wide limits of agreement, and poor correlation between the two measurement techniques. Clinical significance: The finding from this study suggest that the two methods of examining changes associated with the onset and early progression of PTOA either characterize different structures about the knee and should not be used interchangeably, or two-dimensional JSW measurements are not sensitive to small changes in articular cartilage thickness. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- Geordie C. Lonza
- Department Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont
| | - Mack G. Gardner-Morse
- Department Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont
| | - Pamela M. Vacek
- Department of Biostatistics, Robert Larner M.D. College of Medicine, University of Vermont, Room 438A Stafford Hall, 95 Carrigan Drive, Burlington 05405-0084, Vermont
| | - Bruce D. Beynnon
- Department Orthopedics and Rehabilitation, Robert Larner M.D. College of Medicine, University of Vermont, Burlington, Vermont
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Omoumi P, Babel H, Jolles BM, Favre J. Relationships between cartilage thickness and subchondral bone mineral density in non-osteoarthritic and severely osteoarthritic knees: In vivo concomitant 3D analysis using CT arthrography. Osteoarthritis Cartilage 2019; 27:621-629. [PMID: 30611905 DOI: 10.1016/j.joca.2018.12.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 12/18/2018] [Accepted: 12/23/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To test whether subchondral bone mineral density (sBMD) and cartilage thickness (CTh) of femoral condyles are correlated in knees without and with severe medial femorotibial osteoarthritis (OA), using a subregional analysis with computerized tomography (CT) arthrography. METHODS CT arthrograms of 50 non-OA (18 males, 58.7 (interquartile range (IQR) = 6.6 years)) and 50 severe medial OA (24 males, 60.5 (IQR = 10.7) years) knees, were retrospectively analyzed. Bone and cartilage were segmented using custom-designed software, leading to 3D models on which each point of the subchondral surface is given a CTh and sBMD value. The average sBMD and CTh were then calculated for the entire weight-bearing regions as well as specific subregions of interest. Linear bivariate and multivariable analyses were performed to test for relationships between sBMD and CTh (regional and subregional measures, or medial-to-lateral ratios), with confounders of age, gender, femoral bone size and femorotibial angle. RESULTS In non-OA knees, the sBMD and CTh medial-to-lateral ratios were positively correlated for the total region and the external and internal subregions (r ≥ 0.341, P ≤ 0.015). In OA knees, sBMD and CTh medial-to-lateral ratios were negatively correlated for the total region and the external and central subregions (r ≤ -0.538, P < 0.001). Additional positive/negative relationships in the non-OA/OA knees were observed between sBMD and CTh measures in the medial compartment. CONCLUSIONS The positive correlation between sBMD and CTh in non-OA knees, and the negative one in OA knees, bring support to the theory of a subchondral bone/cartilage functional unit, which could help to better understand the pathophysiology of OA.
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Affiliation(s)
- P Omoumi
- Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire and University of Lausanne, Lausanne, Switzerland; Department of Radiology, Cliniques Universitaires St Luc - UC Louvain, Brussels, Belgium; Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
| | - H Babel
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - B M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland; Institute of Micro Engineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - J Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
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Okano T, Mamoto K, Di Carlo M, Salaffi F. Clinical utility and potential of ultrasound in osteoarthritis. Radiol Med 2019; 124:1101-1111. [DOI: 10.1007/s11547-019-01013-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/21/2019] [Indexed: 02/06/2023]
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Single- and Bicomponent Analyses of T2⁎ Relaxation in Knee Tendon and Ligament by Using 3D Ultrashort Echo Time Cones (UTE Cones) Magnetic Resonance Imaging. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8597423. [PMID: 30906782 PMCID: PMC6398070 DOI: 10.1155/2019/8597423] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 12/27/2018] [Accepted: 01/17/2019] [Indexed: 11/25/2022]
Abstract
The collagen density is not detected in the patellar tendon (PT), posterior cruciate ligament (PCL), and anterior cruciate ligament (ACL) in clinic. We assess the technical feasibility of three-dimension multiecho fat saturated ultrashort echo time cones (3D FS-UTE-Cones) acquisitions for single- and bicomponent T2⁎ analysis of bound and free water pools in PT, PCL, and ACL in clinic. The knees of five healthy volunteers and six knee joint samples from cadavers were scanned via 3D multiecho FS-UTE-Cones acquisitions on a clinical scanner. Single-component fitting of T2⁎M and bicomponent fitting of short T2⁎ (T2⁎S), long T2⁎ (T2⁎L), short T2⁎ fraction (Frac_S), and long T2⁎ fraction (Frac_L) were performed within tendons and ligaments. Our results showed that biexponential fitting was superior to single-exponential fitting in PT, PCL, and ACL. For knee joint samples, there was no statistical difference among all data in PT, PCL, and ACL. For volunteers, all parameters of bicomponent fitting were statistically different across PT, PCL, and ACL, except for T2⁎S, T2⁎L, and T2⁎M resulting in flawed measurements due to the magic angle effect. 3D multiecho FS-UTE-Cones acquisition allows high resolution T2⁎ mapping in PT, PCL, and ACL of keen joint samples and PT and PCL of volunteers. The T2⁎ values and their fractions can be characterized by bicomponent T2⁎ analysis that is superior to single-component T2⁎ analysis, except for ACL of volunteers.
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Evrard L, Audigié F, Bertoni L, Jacquet S, Denoix JM, Busoni V. Low field magnetic resonance imaging of the equine distal interphalangeal joint: Comparison between weight-bearing and non-weight-bearing conditions. PLoS One 2019; 14:e0211101. [PMID: 30689659 PMCID: PMC6349334 DOI: 10.1371/journal.pone.0211101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 01/08/2019] [Indexed: 11/28/2022] Open
Abstract
This descriptive study aimed to compare the magnetic resonance appearance of the distal interphalangeal joint articular cartilage between standing weight-bearing and non-weight-bearing conditions. Ten forefeet of live horses were scanned in a standing low-field magnetic resonance system (0.27 T). After euthanasia for reasons unrelated to the study, the non-weight-bearing isolated feet were scanned in a vertical positioning reproducing limb orientation in live horses. The same acquisition settings as during the weight-bearing examination were used. Thickness and cross-sectional area of the distal interphalangeal articular cartilage and joint space were measured on tridimensional T1-weighted gradient echo high resolution frontal and sagittal images at predetermined landmarks in both conditions and were compared using a linear mixed-effects model. Frontal images were randomized and submitted to 9 blinded readers with 3 different experience levels for identification of weight-bearing versus non-weight-bearing acquisitions based on cartilage appearance. Weight-bearing limbs had significantly thinner distal interphalangeal cartilage (p = 0.0001) than non-weight-bearing limbs. This change was greater in the distal phalanx cartilage than that of the middle phalanx. Blinded readers correctly identified 83% (range 65 to 95%) of the images as weight-bearing or non-weight-bearing acquisitions, with significantly different results observed among the different readers (p < 0.001) and groups (p < 0.001). These results indicate that distal interphalangeal articular cartilage and particularly cartilage of the distal phalanx thins when weight-bearing compared to the non-weight-bearing standing postmortem conditions and suggest that cartilage abnormalities may be more difficult to identify on weight-bearing standing magnetic resonance imaging.
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Affiliation(s)
- Laurence Evrard
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
- * E-mail:
| | - Fabrice Audigié
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Lélia Bertoni
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Sandrine Jacquet
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Jean-Marie Denoix
- Centre d’Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), Unité 957 BPLC, Ecole Nationale Vétérinaire d’Alfort, Normandie Equine Vallée, Goustranville, France
| | - Valeria Busoni
- Department of Clinical Sciences of Companion Animals and Equids, Equine Division, Diagnostic Imaging Section, University of Liège, Liège, Belgium
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Harkey MS, Blackburn JT, Nissman D, Davis H, Durrington I, Rizk C, Kuismanen A, Pietrosimone B. Ultrasonographic Assessment of Femoral Cartilage in Individuals With Anterior Cruciate Ligament Reconstruction: A Case-Control Study. J Athl Train 2019; 53:1082-1088. [PMID: 30615493 DOI: 10.4085/1062-6050-376-17] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT Developing osteoarthritis is common after anterior cruciate ligament reconstruction (ACLR). Monitoring changes in femoral cartilage size after ACLR may be a way to detect the earliest structural alterations before the radiographic onset of osteoarthritis. Diagnostic ultrasonography (US) offers a clinically accessible and valid method for evaluating anterior femoral cartilage size. OBJECTIVE To compare the US measurements of anterior femoral cross-sectional area and cartilage thickness between limbs in individuals with a unilateral ACLR and between the ACLR limbs of these individuals and the limbs of uninjured control participants. DESIGN Case-control study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 20 volunteers with an ACLR (37.0 ± 26.6 months after surgery) and 28 uninjured volunteers. MAIN OUTCOME MEASURE(S) We used US to assess anterior femoral cartilage cross-sectional area and thickness (ie, medial, lateral, and intercondylar) in the ACLR and contralateral limbs of participants with ACLR and unilaterally in the reference limbs of uninjured participants. RESULTS The ACLR limb presented with greater anterior femoral cartilage cross-sectional area (96.68 ± 22.68 mm2) than both the contralateral (85.69 ± 17.57 mm2, t19 = 4.47; P < .001) and uninjured (84.62 ± 15.89 mm2, t46 = 2.17; P = .04) limbs. The ACLR limb presented with greater medial condyle thickness (2.61 ± 0.61 mm) than both the contralateral (2.36 ± 0.47 mm, t19 = 2.78; P = .01) and uninjured limbs (2.22 ± 0.40 mm, t46 = 2.69; P = .01) and greater lateral condyle thickness (2.46 ± 0.65 mm) than the uninjured limb (2.12 ± 0.41 mm, t46 = 2.20; P = .03). CONCLUSIONS Anterior femoral cartilage cross-sectional area and thickness assessed via US were greater in the ACLR limb than in the contralateral and uninjured limbs. Greater thickness and cross-sectional area may have been due to cartilage swelling or hypertrophy after ACLR, which may affect the long-term health of the joint.
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Affiliation(s)
- Matthew S Harkey
- Division of Rheumatology, Tufts Medical Center, Boston, MA, and Department of Quantitative Health Science, University of Massachusetts Medical School, Worcester
| | - J Troy Blackburn
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill
| | - Daniel Nissman
- Department of Radiology, University of North Carolina at Chapel Hill
| | - Hope Davis
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill
| | | | - Christina Rizk
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill
| | | | - Brian Pietrosimone
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill
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Harkey MS, Davis JE, Lu B, Price LL, Eaton CB, Lo GH, Barbe MF, Ward RJ, Zhang M, Liu SH, Lapane KL, MacKay JW, McAlindon TE, Driban JB. Diffuse tibiofemoral cartilage change prior to the development of accelerated knee osteoarthritis: Data from the osteoarthritis initiative. Clin Anat 2018; 32:369-378. [PMID: 30521068 DOI: 10.1002/ca.23321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/30/2018] [Accepted: 12/01/2018] [Indexed: 01/23/2023]
Abstract
We compared the spatial distribution of tibiofemoral cartilage change between individuals who will develop accelerated knee osteoarthritis (KOA) versus typical onset of KOA prior to the development of radiographic KOA. We conducted a longitudinal case-control analysis of 129 individuals from the Osteoarthritis Initiative. We assessed the percent change in tibiofemoral cartilage on magnetic resonance images at 36 informative locations from 2 to 1 year prior to the development of accelerated (n = 44) versus typical KOA (n = 40). We defined cartilage change in the accelerated and typical KOA groups at 36 informative locations based on thresholds of cartilage percent change in a no KOA group (n = 45). We described the spatial patterns of cartilage change in the accelerated KOA and typical KOA groups and performed a logistic regression to determine if diffuse cartilage change (predictor; at least half of the tibiofemoral regions demonstrating change in multiple informative locations) was associated with KOA group (outcome). There was a non-significant trend that individuals with diffuse tibiofemoral cartilage change were 2.2 times more likely to develop accelerated knee OA when compared with individuals who develop typical knee OA (OR [95% CI] = 2.2 [0.90-5.14]. Adults with accelerated or typical KOA demonstrate heterogeneity in spatial distribution of cartilage thinning and thickening. These results provide preliminary evidence of a different spatial pattern of cartilage change between individuals who will develop accelerated versus typical KOA. These data suggest there may be different mechanisms driving the early structural disease progression between accelerated versus typical KOA. Clin. Anat. 32:369-378, 2019. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Matthew S Harkey
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts.,Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Julie E Davis
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
| | - Bing Lu
- Division of Rheumatology, Immunology and Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts.,Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, Rhode Island
| | - Grace H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development (HSR&D) Center of Excellence Michael E. DeBakey VAMC, Houston, Texas.,Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas
| | - Mary F Barbe
- Department of Anatomy and Cell Biology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Robert J Ward
- Department of Radiology, Tufts Medical Center, Boston, Massachusetts
| | - Ming Zhang
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts.,Department of Computer Science and Networking, Wentworth Institute of Technology, Boston, Massachusetts
| | - Shao-Hsien Liu
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Boston, Massachusetts
| | - Kate L Lapane
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Boston, Massachusetts
| | - James W MacKay
- Department of Radiology, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
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Automated segmentation of knee bone and cartilage combining statistical shape knowledge and convolutional neural networks: Data from the Osteoarthritis Initiative. Med Image Anal 2018; 52:109-118. [PMID: 30529224 DOI: 10.1016/j.media.2018.11.009] [Citation(s) in RCA: 133] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/06/2018] [Accepted: 11/16/2018] [Indexed: 11/23/2022]
Abstract
We present a method for the automated segmentation of knee bones and cartilage from magnetic resonance imaging (MRI) that combines a priori knowledge of anatomical shape with Convolutional Neural Networks (CNNs). The proposed approach incorporates 3D Statistical Shape Models (SSMs) as well as 2D and 3D CNNs to achieve a robust and accurate segmentation of even highly pathological knee structures. The shape models and neural networks employed are trained using data from the Osteoarthritis Initiative (OAI) and the MICCAI grand challenge "Segmentation of Knee Images 2010" (SKI10), respectively. We evaluate our method on 40 validation and 50 submission datasets from the SKI10 challenge. For the first time, an accuracy equivalent to the inter-observer variability of human readers is achieved in this challenge. Moreover, the quality of the proposed method is thoroughly assessed using various measures for data from the OAI, i.e. 507 manual segmentations of bone and cartilage, and 88 additional manual segmentations of cartilage. Our method yields sub-voxel accuracy for both OAI datasets. We make the 507 manual segmentations as well as our experimental setup publicly available to further aid research in the field of medical image segmentation. In conclusion, combining localized classification via CNNs with statistical anatomical knowledge via SSMs results in a state-of-the-art segmentation method for knee bones and cartilage from MRI data.
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Hu Y, Tao H, Qiao Y, Ma K, Hua Y, Yan X, Chen S. Evaluation of the Talar Cartilage in Chronic Lateral Ankle Instability with Lateral Ligament Injury Using Biochemical T2* Mapping: Correlation with Clinical Symptoms. Acad Radiol 2018; 25:1415-1421. [PMID: 29934022 DOI: 10.1016/j.acra.2018.01.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 01/16/2018] [Accepted: 01/16/2018] [Indexed: 01/24/2023]
Abstract
RATIONALE AND OBJECTIVES This study aims to quantitatively compare T2* measurements of the talar cartilage between chronic lateral ankle instability (LAI) patients with lateral ligament injury and healthy volunteers, and to assess the association of T2* value with American Orthopedic Foot and Ankle Society (AOFAS) score. MATERIALS AND METHODS Nineteen consecutive patients with chronic LAI (LAI group) and 19 healthy individuals (control group) were enrolled. Biochemical magnetic resonance examination of the ankle was performed in all participants using three-dimensional gradient-echo T2* mapping. Total talar cartilage was divided into six subcompartments, including medial anterior (MA), central medial, medial posterior, lateral anterior, central lateral (LC), and lateral posterior regions. T2* values of respective cartilage areas were measured and compared between the two groups using Student t test. AOFAS scoring was performed for clinical evaluation. Then, the association of T2* value with AOFAS score was evaluated by Pearson correlation. RESULTS The T2* values of total talar cartilage, as well as MA and LC cartilage compartments, in the chronic LAI group were significantly higher than control values (P < .001, P = .039, and P = .014, respectively). Furthermore, the T2* value of MA in the chronic LAI group was negatively correlated with AOFAS score (r = -0.8089, P < .001). CONCLUSIONS Chronic LAI with lateral ligament injury may have a causal connection with early cartilage degeneration in the ankle joint, especially in MA and LC cartilage compartments, as assessed by quantitative T2* measurements. The clinical score correlates highly with T2* value of the MA cartilage compartment, indicating that MA may be the principal cartilage area conferring clinical symptoms.
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THE ROLE OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF DEFORMING ARTHROSIS OF PROFESSIONAL ETIOLOGY IN MINERS. EUREKA: HEALTH SCIENCES 2018. [DOI: 10.21303/2504-5679.2018.00730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The paper analyzes the effectiveness of magnetic resonance imaging with cartilage diagram in diagnosing signs of professional deforming arthrosis of knee joints in miners working in conditions of significant physical loading.
Aim of the research – to determine of diagnostic efficiency of indicators of magnetic resonance imaging of the knee joint and cartilage diagram in miners of the main occupations suffering from deforming arthrosis.
Methods. The research is conducted in 30 miners of basic occupations: 20 mining workers of breakage face (MWBF) and 10 machinists of shearer mining machines (МSMM) have been treated in the inpatient department of occupational pathology of the Lviv Regional Clinical Hospital in 2015-2017 due to deforming arthrosis. Damages of the main anatomical elements of the knee joint with arthrosis were analyzed, visualized initially with the help of MRI, and then - cartilage diagram.
Results. According to the MRI data, in miners of the main occupations with arthrosis of the knee joint the posterior cross-shaped ligament are most commonly affected (in 75.0±9.7 % MWBF and 70.0±14.5 % МSMM), damage to the medial collateral ligament are diagnosed less frequently (in 5.0±4.9 % in the MWBF and in 10.0±9.5 % in the МSMM). On average 3.8±0.4 modified elements of the knee joint are visualized in patients, whereas 4.8±0.1 affected areas are visualized on the cartilage diagram (р<0.05). In 86.7±6.2 % patients, in the analysis of cartilage diagram, changes in all five analyzed areas are diagnosed, indicating a higher efficiency of the diagnosis of changes in the structures of the joint with DA of the professional etiology of the method of cartilage diagram compared with MRI. According to the cartilage diagram the most significant changes are noted in the hypertrophy of the femur: among all miners 62.5±0.3 ms (medial) and 62.6±0.4 ms (lateral), in the MWBF group the average time of Т2-delay is the largest in the area of the medial hypertrophy of the femur is 60.9±2.3 ms, in the МSMM group – in the area of the lateral hypertrophy of the femur: 66.7±3.3 ms, which can be linked to the peculiarities of the forced working position of miners of these professions and the kinetics of joint structures.
These results can be used to diagnose the initial lesions of joint structures with DA of professional genesis, as well as the creation of prognostic models for determining the the degree of risk of development of knee joint damage, which will allow to improve the system of personified approach to diagnostic and preventive measures in working persons in conditions of considerable physical activity and forced working position.
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