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Almhdie-Imjabbar A, Toumi H, Lespessailles E. Radiographic Biomarkers for Knee Osteoarthritis: A Narrative Review. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010237. [PMID: 36676185 PMCID: PMC9862057 DOI: 10.3390/life13010237] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
Conventional radiography remains the most widely available imaging modality in clinical practice in knee osteoarthritis. Recent research has been carried out to develop novel radiographic biomarkers to establish the diagnosis and to monitor the progression of the disease. The growing number of publications on this topic over time highlights the necessity of a renewed review. Herein, we propose a narrative review of a selection of original full-text articles describing human studies on radiographic imaging biomarkers used for the prediction of knee osteoarthritis-related outcomes. To achieve this, a PubMed database search was used. A total of 24 studies were obtained and then classified based on three outcomes: (1) prediction of radiographic knee osteoarthritis incidence, (2) knee osteoarthritis progression and (3) knee arthroplasty risk. Results showed that numerous studies have reported the relevance of joint space narrowing score, Kellgren-Lawrence score and trabecular bone texture features as potential bioimaging markers in the prediction of the three outcomes. Performance results of reviewed prediction models were presented in terms of the area under the receiver operating characteristic curves. However, fair and valid comparisons of the models' performance were not possible due to the lack of a unique definition of each of the three outcomes.
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Affiliation(s)
- Ahmad Almhdie-Imjabbar
- Translational Medicine Research Platform, PRIMMO, University Hospital Centre of Orleans, 45100 Orleans, France
| | - Hechmi Toumi
- Translational Medicine Research Platform, PRIMMO, University Hospital Centre of Orleans, 45100 Orleans, France
- Department of Rheumatology, University Hospital Centre of Orleans, 45100 Orleans, France
| | - Eric Lespessailles
- Translational Medicine Research Platform, PRIMMO, University Hospital Centre of Orleans, 45100 Orleans, France
- Department of Rheumatology, University Hospital Centre of Orleans, 45100 Orleans, France
- Correspondence:
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2
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Subchondral tibial bone texture of conventional X-rays predicts total knee arthroplasty. Sci Rep 2022; 12:8327. [PMID: 35585147 PMCID: PMC9117303 DOI: 10.1038/s41598-022-12083-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/27/2022] [Indexed: 11/14/2022] Open
Abstract
Lacking disease-modifying osteoarthritis drugs (DMOADs) for knee osteoarthritis (KOA), Total Knee Arthroplasty (TKA) is often considered an important clinical outcome. Thus, it is important to determine the most relevant factors that are associated with the risk of TKA. The present study aims to develop a model based on a combination of X-ray trabecular bone texture (TBT) analysis, and clinical and radiological information to predict TKA risk in patients with or at risk of developing KOA. This study involved 4382 radiographs, obtained from the OsteoArthritis Initiative (OAI) cohort. Cases were defined as patients with TKA on at least one knee prior to the 108-month follow-up time point and controls were defined as patients who had never undergone TKA. The proposed TKA-risk prediction model, combining TBT parameters and Kellgren–Lawrence (KL) grades, was performed using logistic regression. The proposed model achieved an AUC of 0.92 (95% Confidence Interval [CI] 0.90, 0.93), while the KL model achieved an AUC of 0.86 (95% CI 0.84, 0.86; p < 0.001). This study presents a new TKA prediction model with a good performance permitting the identification of at risk patient with a good sensitivy and specificity, with a 60% increase in TKA case prediction as reflected by the recall values.
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Jang JY, Kim JH, Kim MW, Kim SH, Yong SY. Study of the Efficacy of Artificial Intelligence Algorithm-Based Analysis of the Functional and Anatomical Improvement in Polynucleotide Treatment in Knee Osteoarthritis Patients: A Prospective Case Series. J Clin Med 2022; 11:jcm11102845. [PMID: 35628972 PMCID: PMC9148053 DOI: 10.3390/jcm11102845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/15/2022] [Accepted: 05/16/2022] [Indexed: 12/19/2022] Open
Abstract
Knee osteoarthritis (OA) is one of the most common degenerative diseases in old age. Recent studies have suggested new treatment approaches dealing with subchondral remodeling, which is a typical feature of OA progression. However, diagnostic tools or therapeutic approaches related to such a process are still being researched. The automated artificial intelligence (AI) algorithm-based texture analysis is a new method used for OA-progression detection. We designed a prospective case series study to examine the efficacy of the AI algorithm-based texture analysis in detecting the restoration of the subchondral remodeling process, which is expected to follow therapeutic intervention. In this study, we used polynucleotide (PN) filler injections as the therapeutic modality and the treatment outcome was verified by symptom improvement, as well as by the induction of subchondral microstructural changes. We used AI algorithm-based texture analysis to observe these changes in the subchondral bone with the bone structure value (BSV). A total of 51 participants diagnosed with knee OA were enrolled in this study. Intra-articular PN filler (HP cell Vitaran J) injections were administered once a week and five times in total. Knee X-rays and texture analyses with BSVs were performed during the screening visit and the last visit three months after screening. The Visual Analogue Scale (VAS) and Korean-Western Ontario MacMaster (K-WOMAC) measurements were used at the screening visit, the fifth intra-articular injection visit, and the last visit. The VAS and K-WOMAC scores decreased after PN treatment and lasted for three months after the final injection. The BSV changed in the middle and deep layers of tibial bone after PN injection. This result could imply that there were microstructural changes in the subchondral bone after PN treatment, and that this change could be detected using the AI algorithm-based texture analysis. In conclusion, the AI- algorithm-based texture analysis could be a promising tool for detecting and assessing the therapeutic outcome in knee OA.
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Affiliation(s)
- Ji Yoon Jang
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.J.); (J.H.K.); (M.W.K.)
| | - Ji Hyun Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.J.); (J.H.K.); (M.W.K.)
| | - Min Woo Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.J.); (J.H.K.); (M.W.K.)
| | - Sung Hoon Kim
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.J.); (J.H.K.); (M.W.K.)
- Correspondence: (S.H.K.); (S.Y.Y.)
| | - Sang Yeol Yong
- Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea; (J.Y.J.); (J.H.K.); (M.W.K.)
- Yonsei Institute of Sports Science and Exercise Medicine, Wonju 26426, Korea
- Correspondence: (S.H.K.); (S.Y.Y.)
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4
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Almhdie-Imjabbar A, Podsiadlo P, Ljuhar R, Jennane R, Nguyen KL, Toumi H, Saarakkala S, Lespessailles E. Trabecular bone texture analysis of conventional radiographs in the assessment of knee osteoarthritis: review and viewpoint. Arthritis Res Ther 2021; 23:208. [PMID: 34362427 PMCID: PMC8344203 DOI: 10.1186/s13075-021-02594-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trabecular bone texture analysis (TBTA) has been identified as an imaging biomarker that provides information on trabecular bone changes due to knee osteoarthritis (KOA). Consequently, it is important to conduct a comprehensive review that would permit a better understanding of this unfamiliar image analysis technique in the area of KOA research. We examined how TBTA, conducted on knee radiographs, is associated to (i) KOA incidence and progression, (ii) total knee arthroplasty, and (iii) KOA treatment responses. The primary aims of this study are twofold: to provide (i) a narrative review of the studies conducted on radiographic KOA using TBTA, and (ii) a viewpoint on future research priorities. METHOD Literature searches were performed in the PubMed electronic database. Studies published between June 1991 and March 2020 and related to traditional and fractal image analysis of trabecular bone texture (TBT) on knee radiographs were identified. RESULTS The search resulted in 219 papers. After title and abstract scanning, 39 studies were found eligible and then classified in accordance to six criteria: cross-sectional evaluation of osteoarthritis and non-osteoarthritis knees, understanding of bone microarchitecture, prediction of KOA progression, KOA incidence, and total knee arthroplasty and association with treatment response. Numerous studies have reported the relevance of TBTA as a potential bioimaging marker in the prediction of KOA incidence and progression. However, only a few studies have focused on the association of TBTA with both OA treatment responses and the prediction of knee joint replacement. CONCLUSION Clear evidence of biological plausibility for TBTA in KOA is already established. The review confirms the consistent association between TBT and important KOA endpoints such as KOA radiographic incidence and progression. TBTA could provide markers for enrichment of clinical trials enhancing the screening of KOA progressors. Major advances were made towards a fully automated assessment of KOA.
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Affiliation(s)
- Ahmad Almhdie-Imjabbar
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
| | - Pawel Podsiadlo
- Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Bentley, WA, 6102, Australia
| | | | - Rachid Jennane
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
| | - Khac-Lan Nguyen
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
| | - Hechmi Toumi
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France
- Department of Rheumatology, Regional Hospital of Orleans, Orleans, France
| | - Simo Saarakkala
- Physics and Technology, Research Unit of Medical Imaging, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
| | - Eric Lespessailles
- EA 4708- I3MTO Laboratory, University of Orleans, Orleans, France.
- Translational Medicine Research Platform, PRIMMO, Regional Hospital of Orleans, Orleans, France.
- Department of Rheumatology, Regional Hospital of Orleans, Orleans, France.
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Deep learning for early detection of pathological changes in X-ray bone microstructures: case of osteoarthritis. Sci Rep 2021; 11:2294. [PMID: 33504863 PMCID: PMC7840670 DOI: 10.1038/s41598-021-81786-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 01/07/2021] [Indexed: 11/09/2022] Open
Abstract
Texture features are designed to quantitatively evaluate patterns of spatial distribution of image pixels for purposes of image analysis and interpretation. Unexplained variations in the texture patterns often lead to misinterpretation and undesirable consequences in medical image analysis. In this paper we explore the ability of machine learning (ML) methods to design a radiology test of Osteoarthritis (OA) at early stage when the number of patients’ cases is small. In our experiments we use high-resolution X-ray images of knees in patients which were identified with Kellgren–Lawrence scores progressing from 1. The existing ML methods have provided a limited diagnostic accuracy, whilst the proposed Group Method of Data Handling strategy of Deep Learning has significantly extended the diagnostic test. The comparative experiments demonstrate that the proposed framework using the Zernike-based texture features has significantly improved the diagnostic accuracy on average by 11%. This allows us to conclude that the designed model for early diagnostic of OA will provide more accurate radiology tests, although new study is required when a large number of patients’ cases will be available.
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Jarraya M, Heiss R, Duryea J, Nagel AM, Lynch JA, Guermazi A, Weber MA, Arkudas A, Horch RE, Uder M, Roemer FW. Bone Structure Analysis of the Radius Using Ultrahigh Field (7T) MRI: Relevance of Technical Parameters and Comparison with 3T MRI and Radiography. Diagnostics (Basel) 2021; 11:110. [PMID: 33445536 PMCID: PMC7826934 DOI: 10.3390/diagnostics11010110] [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: 12/22/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 12/29/2022] Open
Abstract
Bone fractal signature analysis (FSA-also termed bone texture analysis) is a tool that assesses structural changes that may relate to clinical outcomes and functions. Our aim was to compare bone texture analysis of the distal radius in patients and volunteers using radiography and 3T and 7T magnetic resonance imaging (MRI)-a patient group (n = 25) and a volunteer group (n = 25) were included. Participants in the patient group had a history of chronic wrist pain with suspected or confirmed osteoarthritis and/or ligament instability. All participants had 3T and 7T MRI including T1-weighted turbo spin echo (TSE) sequences. The 7T MRI examination included an additional high-resolution (HR) T1 TSE sequence. Radiographs of the wrist were acquired for the patient group. When comparing patients and volunteers (unadjusted for gender and age), we found a statistically significant difference of horizontal and vertical fractal dimensions (FDs) using 7T T1 TSE-HR images in low-resolution mode (horizontal: p = 0.04, vertical: p = 0.01). When comparing radiography to the different MRI sequences, we found a statistically significant difference for low- and high-resolution horizontal FDs between radiography and 3T T1 TSE and 7T T1 TSE-HR. Vertical FDs were significantly different only between radiographs and 3T T1 TSE in the high-resolution mode; FSA measures obtained from 3T and 7T MRI are highly dependent on the sequence and reconstruction resolution used, and thus are not easily comparable between MRI systems and applied sequences.
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Affiliation(s)
- Mohamed Jarraya
- Department of Radiology, Massachusetts General Hospital, Harvard University, Boston, MA 02114, USA
| | - Rafael Heiss
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
| | - Jeffrey Duryea
- Department of Radiology, Brigham and Women’s Hospital, Harvard University, Boston, MA 02114, USA;
| | - Armin M. Nagel
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - John A. Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco, CA 94143, USA;
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA;
- Department of Radiology, Boston Veteran Affairs Healthcare System, West Roxbury, MA 02132, USA
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, D-18057 Rostock, Germany;
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (A.A.); (R.E.H.)
| | - Raymund E. Horch
- Department of Plastic and Hand Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (A.A.); (R.E.H.)
| | - Michael Uder
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
| | - Frank W. Roemer
- Department of Radiology, Friedrich Alexander University Erlangen-Nürnberg (FAU) & Universitätsklinikum Erlangen, 91054 Erlangen, Germany; (R.H.); (A.M.N.); (M.U.); (F.W.R.)
- Department of Radiology, Boston University School of Medicine, Boston, MA 02118, USA;
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7
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Wahyuningrum RT, Purnama IKE, Verkerke GJ, van Ooijen PMA, Purnomo MH. A novel method for determining the Femoral-Tibial Angle of Knee Osteoarthritis on X-ray radiographs: data from the Osteoarthritis Initiative. Heliyon 2020; 6:e04433. [PMID: 32775740 PMCID: PMC7404555 DOI: 10.1016/j.heliyon.2020.e04433] [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: 08/25/2018] [Revised: 05/26/2019] [Accepted: 07/09/2020] [Indexed: 11/01/2022] Open
Abstract
Femoral-tibial alignment is a prominent risk factor for Knee Osteoarthritis (KOA) incidence and progression. One way of assessing alignment is by determining the Femoral-Tibial Angle (FTA). Several studies have investigated FTA determination; however, methods of assessment of FTA still present challenges. This paper introduces a new method for semi-automatic measurement of FTA as part of KOA research. Our novel approach combines preprocessing of X-ray images and the use of Active Shape Model (ASM) as the femoral and tibial segmentation method, followed by a thinning process. The result of the thinning process is used to predict FTA automatically by measuring the angle between the intersection of the two vectors of branching points on the femoral and tibial areas. The proposed method is trained on 10 x-ray images and tested on 50 different x-ray images of the Osteoarthritis Initiative (OAI) dataset. The outcomes of this approach were compared with manually obtained FTA measurements from the OAI dataset as the ground truth. Based on experiments, the difference in measurement results between the FTA of the OAI and the FTA obtained using our method is quite small, i.e., below 0.81° for the right FTA and below 0.77° for the left FTA with minimal average errors. This result indicates that this method is clinically suitable for semi-automatic measurement of the FTA.
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Affiliation(s)
- Rima Tri Wahyuningrum
- Department of Electrical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Department of Informatics, Universitas Trunojoyo Madura, Bangkalan, Indonesia
| | - I Ketut Eddy Purnama
- Department of Electrical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Department of Computer Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia
| | - Gijsbertus Jacob Verkerke
- Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, the Netherlands.,Department of Biomechanical Engineering, University of Twente, the Netherlands
| | - Peter M A van Ooijen
- Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Mauridhi Hery Purnomo
- Department of Electrical Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,Department of Computer Engineering, Institut Teknologi Sepuluh Nopember, Surabaya, Indonesia.,The Science and Technology Center of Artificial Intelligence for Healthcare and Society (PUI AI HeS), Indonesia
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8
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Sandhar S, Smith TO, Toor K, Howe F, Sofat N. Risk factors for pain and functional impairment in people with knee and hip osteoarthritis: a systematic review and meta-analysis. BMJ Open 2020; 10:e038720. [PMID: 32771991 PMCID: PMC7418691 DOI: 10.1136/bmjopen-2020-038720] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To identify risk factors for pain and functional deterioration in people with knee and hip osteoarthritis (OA) to form the basis of a future 'stratification tool' for OA development or progression. DESIGN Systematic review and meta-analysis. METHODS An electronic search of the literature databases, Medline, Embase, CINAHL, and Web of Science (1990-February 2020), was conducted. Studies that identified risk factors for pain and functional deterioration to knee and hip OA were included. Where data and study heterogeneity permitted, meta-analyses presenting mean difference (MD) and ORs with corresponding 95% CIs were undertaken. Where this was not possible, a narrative analysis was undertaken. The Downs & Black tool assessed methodological quality of selected studies before data extraction. Pooled analysis outcomes were assessed and reported using the Grading of Reccomendation, Assessment, Development and Evaluation (GRADE) approach. RESULTS 82 studies (41 810 participants) were included. On meta-analysis: there was moderate quality evidence that knee OA pain was associated with factors including: Kellgren and Lawrence≥2 (MD: 2.04, 95% CI 1.48 to 2.81; p<0.01), increasing age (MD: 1.46, 95% CI 0.26 to 2.66; p=0.02) and whole-organ MRI scoring method (WORMS) knee effusion score ≥1 (OR: 1.35, 95% CI 0.99 to 1.83; p=0.05). On narrative analysis: knee OA pain was associated with factors including WORMS meniscal damage ≥1 (OR: 1.83). Predictors of joint pain in hip OA were large acetabular bone marrow lesions (BML; OR: 5.23), chronic widespread pain (OR: 5.02) and large hip BMLs (OR: 4.43). CONCLUSIONS Our study identified risk factors for clinical pain in OA by imaging measures that can assist in predicting and stratifying people with knee/hip OA. A 'stratification tool' combining verified risk factors that we have identified would allow selective stratification based on pain and structural outcomes in OA. PROSPERO REGISTRATION NUMBER CRD42018117643.
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Affiliation(s)
- Sandeep Sandhar
- Institute for Infection and Immunity, University of London St George's, London, UK
| | - Toby O Smith
- Nuffield Department of Orthopaedics and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Kavanbir Toor
- Institute for Infection and Immunity, University of London St George's, London, UK
| | - Franklyn Howe
- Molecular and Clinical Sciences Research Institute, University of London St George's, London, UK
| | - Nidhi Sofat
- Institute for Infection and Immunity, University of London St George's, London, UK
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9
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Wolski M, Thorlund JB, Stachowiak GW, Holsgaard-Larsen A, Creaby MW, Jørgensen GM, Englund M, Podsiadlo P. Early tibial subchondral bone texture changes after arthroscopic partial meniscectomy in knees without radiographic OA: A prospective cohort study. J Orthop Res 2020; 38:1819-1825. [PMID: 31965586 DOI: 10.1002/jor.24593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/13/2020] [Indexed: 02/04/2023]
Abstract
Arthroscopic partial meniscectomy (APM) may lead to changes in underlying trabecular bone (TB) structure potentially promoting the development of knee joint osteoarthritis. Our aim was to investigate if there are early changes occurring in tibial subchondral TB texture in the leg undergoing medial APM compared with the unoperated non-injured contra-lateral leg. The bone texture was measured as the medial-to-lateral ratio of fractal dimensions (FD) calculated for regions selected on weight-bearing anteroposterior tibiofemoral x-rays. Twenty-one subjects before and 12 months after APM were included from 374 patients scheduled for unilateral medial APM. The medial-to-lateral ratio was calculated for horizontal, vertical, and roughest FDs respectively. Higher FD means higher bone roughness. Each FD was calculated over a range of scales using a variance orientation transform method. Mean values of medial-to-lateral horizontal FD calculated for APM knees at follow-up were higher than those at baseline. For unoperated knees the values were lower. The difference in the horizontal FD change from baseline to follow-up between APM and contra-lateral legs was 0.028 (95% CI, 0.004-0.052). The bone roughness changes may reflect the increase in peak knee adduction moment (KAM) and KAM impulse during walking reported for the same cohort in a previous study. They may also reflect early signs of osteoarthritis development and thus, we speculate that individuals with increased bone texture roughness ratio after APM might be at higher risk of knee osteoarthritis development.
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Affiliation(s)
- Marcin Wolski
- Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Australia
| | - Jonas B Thorlund
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Gwidon W Stachowiak
- Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Australia
| | - Anders Holsgaard-Larsen
- Department of Orthopedics and Traumatology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mark W Creaby
- School of Behavioural and Health Science, Australian Catholic University, Brisbane, Queensland, Australia
| | - Gitte M Jørgensen
- Department of Radiology, Odense University Hospital, Odense, Denmark
| | - Martin Englund
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts
| | - Pawel Podsiadlo
- Tribology Laboratory, School of Civil and Mechanical Engineering, Curtin University, Australia
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10
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Bayramoglu N, Tiulpin A, Hirvasniemi J, Nieminen MT, Saarakkala S. Adaptive segmentation of knee radiographs for selecting the optimal ROI in texture analysis. Osteoarthritis Cartilage 2020; 28:941-952. [PMID: 32205275 DOI: 10.1016/j.joca.2020.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/29/2020] [Accepted: 03/02/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purposes of this study were to investigate: 1) the effect of placement of region-of-interest (ROI) for texture analysis of subchondral bone in knee radiographs, and 2) the ability of several texture descriptors to distinguish between the knees with and without radiographic osteoarthritis (OA). DESIGN Bilateral posterior-anterior knee radiographs were analyzed from the baseline of Osteoarthritis Initiative (OAI) (9012 knee radiographs) and Multicenter Osteoarthritis Study (MOST) (3,644 knee radiographs) datasets. A fully automatic method to locate the most informative region from subchondral bone using adaptive segmentation was developed. Subsequently, we built logistic regression models to identify and compare the performances of several texture descriptors and each ROI placement method using 5-fold cross validation. Importantly, we also investigated the generalizability of our approach by training the models on OAI and testing them on MOST dataset. We used area under the receiver operating characteristic curve (ROC AUC) and average precision (AP) obtained from the precision-recall (PR) curve to compare the results. RESULTS We found that the adaptive ROI improves the classification performance (OA vs non-OA) over the commonly-used standard ROI (up to 9% percent increase in AUC). We also observed that, from all texture parameters, Local Binary Pattern (LBP) yielded the best performance in all settings with the best AUC of 0.840 [0.825, 0.852] and associated AP of 0.804 [0.786, 0.820]. CONCLUSION Compared to the current state-of-the-art approaches, our results suggest that the proposed adaptive ROI approach in texture analysis of subchondral bone can increase the diagnostic performance for detecting the presence of radiographic OA.
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Affiliation(s)
- N Bayramoglu
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland.
| | - A Tiulpin
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | - J Hirvasniemi
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
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11
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Hirvasniemi J, Gielis WP, Arbabi S, Agricola R, van Spil WE, Arbabi V, Weinans H. Bone texture analysis for prediction of incident radiographic hip osteoarthritis using machine learning: data from the Cohort Hip and Cohort Knee (CHECK) study. Osteoarthritis Cartilage 2019; 27:906-914. [PMID: 30825609 DOI: 10.1016/j.joca.2019.02.796] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/27/2019] [Accepted: 02/10/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the ability of radiography-based bone texture variables in proximal femur and acetabulum to predict incident radiographic hip osteoarthritis (rHOA) over a 10 years period. DESIGN Pelvic radiographs from CHECK at baseline (987 hips) were analyzed for bone texture using fractal signature analysis (FSA) in proximal femur and acetabulum. Elastic net (machine learning) was used to predict the incidence of rHOA (including Kellgren-Lawrence grade (KL) ≥ 2 or total hip replacement (THR)), joint space narrowing score (JSN, range 0-3), and osteophyte score (OST, range 0-3) after 10 years. Performance of prediction models was assessed using the area under the receiver operating characteristic curve (ROC AUC). RESULTS Of the 987 hips without rHOA at baseline, 435 (44%) had rHOA at 10-year follow-up. Of the 667 hips with JSN grade 0 at baseline, 471 (71%) had JSN grade ≥ 1 at 10-year follow-up. Of the 613 hips with OST grade 0 at baseline, 526 (86%) had OST grade ≥ 1 at 10-year follow-up. AUCs for the models including age, gender, and body mass index (BMI) to predict incident rHOA, JSN, and OST were 0.59, 0.54, and 0.51, respectively. The inclusion of bone texture variables in the models improved the prediction of incident rHOA (ROC AUC 0.68 and 0.71 when baseline KL was also included in the model) and JSN (ROC AUC 0.62), but not incident OST (ROC AUC 0.52). CONCLUSION Bone texture analysis provides additional information for predicting incident rHOA or THR over 10 years.
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Affiliation(s)
- J Hirvasniemi
- Center for Machine Vision and Signal Analysis, Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland; Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - W P Gielis
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - S Arbabi
- Department of Computer Engineering, Faculty of Engineering, University of Zabol, Zabol, Iran.
| | - R Agricola
- Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - W E van Spil
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - V Arbabi
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands; Department of Mechanical Engineering, Faculty of Engineering, University of Birjand, Birjand, Iran.
| | - H Weinans
- Department of Orthopedics, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands.
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Hafezi-Nejad N, Guermazi A, Demehri S, Roemer FW. New imaging modalities to predict and evaluate osteoarthritis progression. Best Pract Res Clin Rheumatol 2018; 31:688-704. [PMID: 30509414 DOI: 10.1016/j.berh.2018.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 04/17/2018] [Accepted: 04/25/2018] [Indexed: 12/18/2022]
Abstract
In this narrative review, we discuss the role of different imaging methods for the evaluation of progression of structural osteoarthritis. We will focus on the role of less commonly applied imaging modalities and imaging biomarkers that were introduced in recent years or on established methods that have evolved into more prominent positions in recent years. We will highlight findings from longitudinal studies that focused on structural osteoarthritis progression as their outcome of interest. Imaging modalities discussed include plain radiography (including novel approaches of joint space width assessment and fractal signature analysis), ultrasonography (including the assessment of synovitis), magnetic resonance imaging (including semiquantitative, quantitative, and compositional evaluation), and positron emission tomography.
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Affiliation(s)
- Nima Hafezi-Nejad
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, MD 21287 USA
| | - Ali Guermazi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA 02118, USA
| | - Shadpour Demehri
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University, 601 N Caroline St, JHOC 4240, Baltimore, MD 21287 USA
| | - Frank W Roemer
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building 3rd Floor, Boston, MA 02118, USA; Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 3, 91054 Erlangen, Germany.
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13
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Englund M, Turkiewicz A, Podsiadlo P. Editorial: Bone Reading to Predict the Future. Arthritis Rheumatol 2018; 70:1-3. [DOI: 10.1002/art.40349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/05/2017] [Indexed: 11/07/2022]
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Kraus VB, Collins JE, Charles HC, Pieper CF, Whitley L, Losina E, Nevitt M, Hoffmann S, Roemer F, Guermazi A, Hunter DJ. Predictive Validity of Radiographic Trabecular Bone Texture in Knee Osteoarthritis: The Osteoarthritis Research Society International/Foundation for the National Institutes of Health Osteoarthritis Biomarkers Consortium. Arthritis Rheumatol 2017; 70:80-87. [PMID: 29024470 DOI: 10.1002/art.40348] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 10/05/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate radiographic subchondral trabecular bone texture (TBT) as a predictor of clinically relevant osteoarthritis (OA) progression (combination of symptom and structural worsening). METHODS The Foundation for the National Institutes of Health (FNIH) OA Biomarkers Consortium undertook a study of progressive knee OA cases (n = 194 knees with both radiographic and pain progression over 24-48 months) and comparators (n = 406 OA knees not meeting the case definition). TBT parameters were extracted from a medial subchondral tibial region of interest by fractal signature analysis of radiographs using validated semiautomated software. Baseline TBT and time-integrated values over 12 and 24 months were evaluated for association with case status and separately with radiographic and pain progression status, adjusted for age, sex, body mass index, race, baseline Kellgren/Lawrence grade, baseline joint space width, Western Ontario and McMaster Universities Osteoarthritis Index pain score, and pain medication use. C statistics were generated from receiver operating characteristic curves. RESULTS Relative to comparators, cases were characterized by thinner vertical and thicker horizontal trabeculae. The summed composite of 3 TBT parameters at baseline and over 12 and 24 months best predicted case status (odds ratios 1.24-1.43). The C statistic for predicting case status using the TBT composite score (0.633-0.649) was improved modestly but statistically significantly over the use of covariates alone (0.608). One TBT parameter, reflecting thickened horizontal trabeculae in cases, at baseline and over 12 and 24 months, predicted risk of any progression (radiographic and/or pain progression). CONCLUSION Although associations are modest, TBT could be an attractive means of enriching OA trials for progressors since it can be generated from screening knee radiographs already standard in knee OA clinical trials.
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Affiliation(s)
| | - Jamie E Collins
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - H Cecil Charles
- Duke Image Analysis Laboratory, Duke University, Durham, North Carolina
| | - Carl F Pieper
- Duke University School of Medicine, Durham, North Carolina
| | | | - Elena Losina
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Steve Hoffmann
- Foundation for the National Institutes of Health, Bethesda, Maryland
| | - Frank Roemer
- Boston University School of Medicine, Boston, Massachusetts, and University of Erlangen-Nuremberg, Erlangen, Germany
| | - Ali Guermazi
- Boston University School of Medicine, Boston, Massachusetts
| | - David J Hunter
- Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia
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Janvier T, Jennane R, Toumi H, Lespessailles E. Subchondral tibial bone texture predicts the incidence of radiographic knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2017; 25:2047-2054. [PMID: 28935435 DOI: 10.1016/j.joca.2017.09.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 09/01/2017] [Accepted: 09/08/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To evaluate whether trabecular bone texture (TBT) parameters measured on computed radiographs (CR) could predict the onset of radiographic knee osteoarthritis (OA). MATERIALS AND METHODS Subjects from the Osteoarthritis Initiative (OAI) with no sign of radiographic OA at baseline were included. Cases that developed either a global radiographic OA defined by the Kellgren-Lawrence (KL) scale, a joint space narrowing (JSN) or tibial osteophytes (TOS) were compared with the controls with no changes after 48 months of follow-up. Baseline bilateral fixed flexion CR were analyzed using a fractal method to characterize the local variations. The prediction was explored using logistic regression models evaluated by the area under the receiver operating characteristic curves (AUC). RESULTS From the 344 knees, 79 (23%) developed radiographic OA after 48 months, 44 (13%) developed progressive JSN and 59 (17%) developed osteophytes. Neither age, gender and BMI, nor their combination predicted poorer KL (AUC 0.57), JSN or TOS (AUC 0.59) scores. The inclusion of the TBT parameters in the models improved the global prediction results for KL (AUC 0.69), JSN (AUC 0.73) and TOS (AUC 0.71) scores. CONCLUSIONS Several differences were found between the models predictive of three different outcomes (KL, JSN and TOS), indicating different underlying mechanisms. These results suggest that TBT parameters assessed when radiographic signs are not yet apparent on radiographs may be useful in predicting the onset of radiological tibiofemoral OA as well as identifying at-risk patients for future clinical trials.
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Affiliation(s)
- T Janvier
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France
| | - R Jennane
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France
| | - H Toumi
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France; CHR Orléans, Rheumatology Department, 45032 Orléans, France
| | - E Lespessailles
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France; CHR Orléans, Rheumatology Department, 45032 Orléans, France.
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Janvier T, Jennane R, Valery A, Harrar K, Delplanque M, Lelong C, Loeuille D, Toumi H, Lespessailles E. Subchondral tibial bone texture analysis predicts knee osteoarthritis progression: data from the Osteoarthritis Initiative: Tibial bone texture & knee OA progression. Osteoarthritis Cartilage 2017; 25:259-266. [PMID: 27742531 DOI: 10.1016/j.joca.2016.10.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 09/21/2016] [Accepted: 10/05/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To examine whether trabecular bone texture (TBT) parameters assessed on computed radiographs could predict knee osteoarthritis (OA) progression. METHODS This study was performed using data from the Osteoarthritis Initiative (OAI). 1647 knees in 1124 patients had bilateral fixed flexion radiographs acquired 48 months apart. Images were semi-automatically segmented to extract a patchwork of regions of interest (ROI). A fractal texture analysis was performed using different methods. OA progression was defined as an increase in the joint space narrowing (JSN) over 48 months. The predictive ability of TBT was evaluated using logistic regression and receiver operating characteristic (ROC) curve. An optimization method for features selection was used to reduce the size of models and assess the impact of each ROI. RESULTS Fractal dimensions (FD's) were predictive of the JSN progression for each method tested with an area under the ROC curve (AUC) up to 0.71. Baseline JSN grade was not correlated with TBT parameters (R < 0.21) but had the same predictive capacity (AUC 0.71). The most predictive model included the clinical covariates (age, gender, body mass index (BMI)), JSN and TBT parameters (AUC 0.77). From a statistical point of view we found higher differences in TBT parameters computed in medial ROI between progressors and non-progressors. However, the integration of TBT results from the whole patchwork including the lateral ROIs in the model provided the best predictive model. CONCLUSIONS Our findings indicate that TBT parameters assessed in different locations in the joint provided a good predictive ability to detect knee OA progression.
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Affiliation(s)
- T Janvier
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France
| | - R Jennane
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France
| | - A Valery
- CHR Orléans, Service de Rhumatologie, 45032 Orléans, France
| | - K Harrar
- Univ. M'Hamed Bougara Boumerdes, 35000 Boumerdes, Algeria
| | | | - C Lelong
- Med-Imaps SASU, 337700 Mérignac, France
| | - D Loeuille
- UMR 7561 - CHRU Nancy, 54511 Vandoeuvre les Nancy, France
| | - H Toumi
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France; CHR Orléans, Service de Rhumatologie, 45032 Orléans, France
| | - E Lespessailles
- Univ. Orléans, I3MTO Laboratory, EA 4708, 45067 Orléans, France; CHR Orléans, Service de Rhumatologie, 45032 Orléans, France.
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Stachowiak G, Wolski M, Woloszynski T, Podsiadlo P. Detection and prediction of osteoarthritis in knee and hand joints based on the X-ray image analysis. BIOSURFACE AND BIOTRIBOLOGY 2016. [DOI: 10.1016/j.bsbt.2016.11.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Imaging of osteoarthritis (OA): What is new? Best Pract Res Clin Rheumatol 2016; 30:653-669. [PMID: 27931960 DOI: 10.1016/j.berh.2016.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 09/04/2016] [Accepted: 09/06/2016] [Indexed: 12/17/2022]
Abstract
In daily clinical practice, conventional radiography is still the most applied imaging technique to supplement clinical examination of patients with suspected osteoarthritis (OA); it may not always be needed for diagnosis. Modern imaging modalities can visualize multiple aspects of the joint, and depending on the diagnostic need, radiography may no longer be the modality of choice. Magnetic resonance imaging (MRI) provides a complete assessment of the joint and has a pivotal role in OA research. Computed tomography (CT) and nuclear medicine offer alternatives in research scenarios, while ultrasound can visualize bony and soft-tissue pathologies and is highly feasible in the clinic. In this chapter, we overview the recent literature on established and newer imaging modalities, summarizing their ability to detect and quantify the range of OA pathologies and determining how they may contribute to early OA diagnosis. This accurate imaging-based detection of pathologies will underpin true understanding of much needed structure-modifying therapies.
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Conventional and novel imaging modalities in osteoarthritis: current state of the evidence. Curr Opin Rheumatol 2015; 27:295-303. [PMID: 25803224 DOI: 10.1097/bor.0000000000000163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Imaging modalities are currently an inseparable part of osteoarthritis diagnosis. In this review, we describe the current state of evidence regarding conventional and novel imaging modalities in evaluation of osteoarthritis. Modalities including radiography (qualitative and semi-quantitative assessments), ultrasonography, computed tomography [CT; conventional multidetector CT (MDCT), cone-beam CT (CBCT) and four-dimensional CT (4DCT)], MRI (MRI; semi-quantitative, quantitative and compositional) and PET and their applications are reviewed. RECENT FINDINGS Radiography is the modality of choice for initial assessment of osteoarthritis. However, due to its low sensitivity and specificity, numerous recent investigations have proposed MRI as a powerful addition to detect and grade osteoarthritis features, which are not apparent in radiography. Semi-quantitative MRI measurements are feasible to perform in routine clinical practice. Quantitative and compositional MRI measurements have extended the amount of information an MRI examination can provide regarding the three-dimensional shape and tissue composition of articular cartilage. 4DCT and CBCT are introduced as imaging examinations that may reveal biomechanical cartilage abnormalities in osteoarthritis joint by dynamic and weight-bearing evaluations, respectively. Recent PET studies may unveil the underlying metabolic activities that can be associated with osteoarthritis. SUMMARY In addition to the established role of radiographs, MRI is the advanced modality of choice for detection and quantification of various osteoarthritis features. 4DCT and CBCT may have specified applications when diagnosis of underlying motion abnormality or dynamic changes in weight-bearing situation is suspected. Future studies should elucidate the specific clinical applications of ultrasonography and PET.
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Bastick AN, Runhaar J, Belo JN, Bierma-Zeinstra SMA. Prognostic factors for progression of clinical osteoarthritis of the knee: a systematic review of observational studies. Arthritis Res Ther 2015; 17:152. [PMID: 26050740 PMCID: PMC4483213 DOI: 10.1186/s13075-015-0670-x] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 06/01/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION We performed a systematic review of prognostic factors for the progression of symptomatic knee osteoarthritis (OA), defined as increase in pain, decline in physical function or total joint replacement. METHOD We searched for available observational studies up to January 2015 in Medline and Embase according to a specified search strategy. Studies that fulfilled our initial inclusion criteria were assessed for methodological quality. Data were extracted and the results were pooled, or if necessary summarized according to a best evidence synthesis. RESULTS Of 1,392 articles identified, 30 met the inclusion criteria and 38 determinants were investigated. Pooling was not possible due to large heterogeneity between studies. The best evidence synthesis showed strong evidence that age, ethnicity, body mass index, co-morbidity count, magnetic resonance imaging (MRI)-detected infrapatellar synovitis, joint effusion and baseline OA severity (both radiographic and clinical) are associated with clinical knee OA progression. There was moderate evidence showing that education level, vitality, pain-coping subscale resting, MRI-detected medial femorotibial cartilage loss and general bone marrow lesions are associated with clinical knee OA progression. However, evidence for the majority of determinants was limited (including knee range of motion or markers) or conflicting (including age, gender and joint line tenderness). CONCLUSION Strong evidence was found for multiple prognostic factors for progression of clinical knee OA. A large variety in definitions of clinical knee OA (progression) remains, which makes it impossible to summarize the evidence through meta-analyses. More research on prognostic factors for knee OA is needed using symptom progression as an outcome measure. Remarkably, only few studies have been performed using pain progression as an outcome measure. The pathophysiology of radiographic factors and their relation with symptoms should be further explored.
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Affiliation(s)
- Alex N Bastick
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands.
| | - Jos Runhaar
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands.
| | - Janneke N Belo
- Department of Public Health and Primary Care, Leiden University Medical Center, PO Box 9600, Leiden, 2300 RC, The Netherlands.
| | - Sita M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, Rotterdam, 3000 CA, The Netherlands.
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Su Z, Bai Y, Zhang Y, Su B, Jiang T, Zhao X, Bian H, Zhao B. Video-assisted thoracic surgery resection of rib osteophytes. J Thorac Dis 2015; 7:490-3. [PMID: 25922730 DOI: 10.3978/j.issn.2072-1439.2014.12.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/10/2014] [Indexed: 11/14/2022]
Affiliation(s)
- Zhiyong Su
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Yuqin Bai
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Yilei Zhang
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Baihan Su
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Tianshuo Jiang
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Xin Zhao
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Hongliang Bian
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
| | - Bo Zhao
- 1 Department of Thoracic Surgery, Affiliated Hospital of Chifeng University, Chifeng 024005, China ; 2 Department of Clinical Medicine, Zhengzhou University, Zhengzhou 450001, China
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Roemer FW, Guermazi A. Osteoarthritis year in review 2014: imaging. Osteoarthritis Cartilage 2014; 22:2003-12. [PMID: 25456295 DOI: 10.1016/j.joca.2014.07.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 07/02/2014] [Accepted: 07/10/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE This narrative review covers original publications related to imaging in osteoarthritis (OA) published in English between April 2013 and March 2014. In vitro data, animal studies and studies with less than 20 observations were not included. METHODS To extract relevant studies, an extensive PubMed database search was performed based on, but not limited to the query terms "Osteoarthritis" in combination with "MRI", "Imaging", "Radiography", "Ultrasound", "Computed Tomography" and "Nuclear Medicine". Publications were sorted according to relevance based on potential impact to the OA research community with the overarching goal of a balanced overview covering all aspects of imaging. Focus was on publications in high impact special interest journals. The literature will be presented in a methodological fashion covering radiography, ultrasound, compositional and morphologic Magnetic resonance imaging (MRI), and from an anatomic perspective including bone, muscle, meniscus and synovitis. RESULTS AND CONCLUSIONS Imaging research in OA in the last year was characterized by a strong focus on MRI-based studies dealing with epidemiological and methodological aspects of the disease. Ultrastructural tissue assessment specifically of cartilage and meniscus using compositional MRI is evolving further. Additional subsets of the large publicly available Osteoarthritis Initiative (OAI) MRI dataset are being analyzed at present and have been published with muscle analyses coming increasingly into the focus of the community. Bone parameters were evaluated using varying technology and a persistent interest in inflammatory disease manifestations has been noted. Other modalities than MRI have been less explored. To date most OA imaging research is still focused on the knee joint.
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Affiliation(s)
- F W Roemer
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - A Guermazi
- Quantitative Imaging Center (QIC), Department of Radiology, Boston University School of Medicine, Boston, MA, USA
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