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Eckstein F, Walter-Rittel TC, Chaudhari AS, Brisson NM, Maleitzke T, Duda GN, Wisser A, Wirth W, Winkler T. The design of a sample rapid magnetic resonance imaging (MRI) acquisition protocol supporting assessment of multiple articular tissues and pathologies in knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100505. [PMID: 39183946 PMCID: PMC11342198 DOI: 10.1016/j.ocarto.2024.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/21/2024] [Indexed: 08/27/2024] Open
Abstract
Objective This expert opinion paper proposes a design for a state-of-the-art magnetic resonance image (MRI) acquisition protocol for knee osteoarthritis clinical trials in early and advanced disease. Semi-quantitative and quantitative imaging endpoints are supported, partly amendable to automated analysis. Several (peri-) articular tissues and pathologies are covered, including synovitis. Method A PubMed literature search was conducted, with focus on the past 5 years. Further, osteoarthritis imaging experts provided input. Specific MRI sequences, orientations, spatial resolutions and parameter settings were identified to align with study goals. We strived for implementation on standard clinical scanner hardware, with a net acquisition time ≤30 min. Results Short- and long-term longitudinal MRIs should be obtained at ≥1.5T, if possible without hardware changes during the study. We suggest a series of gradient- and spin-echo-sequences, supporting MOAKS, quantitative analysis of cartilage morphology and T2, and non-contrast-enhanced depiction of synovitis. These sequences should be properly aligned and positioned using localizer images. One of the sequences may be repeated in each participant (re-test), optimally at baseline and follow-up, to estimate within-study precision. All images should be checked for quality and protocol-adherence as soon as possible after acquisition. Alternative approaches are suggested that expand on the structural endpoints presented. Conclusions We aim to bridge the gap between technical MRI acquisition guides and the wealth of imaging literature, proposing a balance between image acquisition efficiency (time), safety, and technical/methodological diversity. This approach may entertain scientific innovation on tissue structure and composition assessment in clinical trials on disease modification of knee osteoarthritis.
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Affiliation(s)
- Felix Eckstein
- Research Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Thula Cannon Walter-Rittel
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Berlin, Germany
| | | | - Nicholas M. Brisson
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin Movement Diagnostics (BeMoveD), Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Tazio Maleitzke
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Trauma Orthopaedic Research Copenhagen Hvidovre (TORCH), Department of Orthopaedic Surgery, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Georg N. Duda
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin Movement Diagnostics (BeMoveD), Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Anna Wisser
- Research Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Wolfgang Wirth
- Research Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Tobias Winkler
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
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Liu B, Xu HY, Zhang R, Han L, Li Y, Sun XF. An Update on Clinical Utility of Musculoskeletal Ultrasonography in Knee Osteoarthritis. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:1413-1422. [PMID: 36715025 DOI: 10.1002/jum.16176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/27/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
In knee osteoarthritis (KOA), timely and accurate assessment of the severity is essential to help orthopedic surgeons determine the most appropriate therapeutic strategies and evaluate disease outcomes and responses for corresponding treatments. In KOA, musculoskeletal ultrasonography (MSUS) could effectively help detect various abnormalities, including synovitis, osteophytes, and cartilage damage. Further, MSUS could be used to monitor the response to different therapies in KOA, to guide local diagnostic and therapeutic procedures. In the future, applications based on continuously evolving US tools could enhance the clinical utility of MSUS in KOA.
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Affiliation(s)
- Bo Liu
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hui-Ying Xu
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Rui Zhang
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Lu Han
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Yang Li
- Department of Thoracic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Xiao-Feng Sun
- Department of Cadre's Wards Ultrasound Diagnostics,Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, Jilin, China
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3
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Martel-Pelletier J, Paiement P, Pelletier JP. Magnetic resonance imaging assessments for knee segmentation and their use in combination with machine/deep learning as predictors of early osteoarthritis diagnosis and prognosis. Ther Adv Musculoskelet Dis 2023; 15:1759720X231165560. [PMID: 37151912 PMCID: PMC10155034 DOI: 10.1177/1759720x231165560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/23/2023] [Indexed: 05/09/2023] Open
Abstract
Knee osteoarthritis (OA) is a prevalent and disabling disease that can develop over decades. This disease is heterogeneous and involves structural changes in the whole joint, encompassing multiple tissue types. Detecting OA before the onset of irreversible changes is crucial for early management, and this could be achieved by allowing knee tissue visualization and quantifying their changes over time. Although some imaging modalities are available for knee structure assessment, magnetic resonance imaging (MRI) is preferred. This narrative review looks at existing literature, first on MRI-developed approaches for evaluating knee articular tissues, and second on prediction using machine/deep-learning-based methodologies and MRI as input or outcome for early OA diagnosis and prognosis. A substantial number of MRI methodologies have been developed to assess several knee tissues in a semi-quantitative and quantitative fashion using manual, semi-automated and fully automated systems. This dynamic field has grown substantially since the advent of machine/deep learning. Another active area is predictive modelling using machine/deep-learning methodologies enabling robust early OA diagnosis/prognosis. Moreover, incorporating MRI markers as input/outcome in such predictive models is important for a more accurate OA structural diagnosis/prognosis. The main limitation of their usage is the ability to move them in rheumatology practice. In conclusion, MRI knee tissue determination and quantification provide early indicators for individuals at high risk of developing this disease or for patient prognosis. Such assessment of knee tissues, combined with the development of models/tools from machine/deep learning using, in addition to other parameters, MRI markers for early diagnosis/prognosis, will maximize opportunities for individualized risk assessment for use in clinical practice permitting precision medicine. Future efforts should be made to integrate such prediction models into open access, allowing early disease management to prevent or delay the OA outcome.
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Affiliation(s)
- Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis, R11.412B,
Montreal, QC H2X 0A9, Canada
| | - Patrice Paiement
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of
Montreal Hospital Research Centre (CRCHUM), Montreal, QC, Canada
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Ye Q, He D, Ding X, Wang Y, Wei Y, Liu J. Quantitative evaluation of the infrapatellar fat pad in knee osteoarthritis: MRI-based radiomic signature. BMC Musculoskelet Disord 2023; 24:326. [PMID: 37098523 PMCID: PMC10127010 DOI: 10.1186/s12891-023-06433-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The infrapatellar fat pad (IFP) may have bilateral influence on knee osteoarthritis (KOA). IFP evaluation may be a key contributor to the diagnostic and clinical management of KOA. Few studies have evaluated KOA-related IFP alteration with radiomics. We investigated radiomic signature for the assessment of IFP for KOA progression in older adults. METHODS A total of 164 knees were enrolled and grouped based on Kellgren-Lawrence (KL) scoring. MRI-based radiomic features were calculated from IFP segmentation. The radiomic signature was developed using the most predictive subset of features and the machine-learning algorithm with minimum relative standard deviation. KOA severity and structure abnormality were assessed using a modified whole-organ magnetic resonance imaging score (WORMS). The performance of the radiomic signature was evaluated and the correlation with WORMS assessments was analyzed. RESULTS The area under the curve of the radiomic signature for diagnosing KOA was 0.83 and 0.78 in the training and test datasets, respectively. Rad-scores were 0.41 and 2.01 for the training dataset in the groups with and without KOA (P < 0.001) and 0.63 and 2.31 for the test dataset (P = 0.005), respectively. WORMS significantly and positively correlated with rad-scores. CONCLUSIONS The radiomic signature may be a reliable biomarker to detect IFP abnormality of KOA. Radiomic alterations in IFP were associated with severity and knee structural abnormalities of KOA in older adults.
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Affiliation(s)
- Qin Ye
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Dong He
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Xiaonan Ding
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yajie Wang
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yuguo Wei
- Precision Health Institution, General Electric Healthcare, Hangzhou, China
| | - Jing Liu
- Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Liu Z, Wu J, Xiang W, Wu J, Huang S, Zhou Y, Xia H, Ni Z, Liu B. Correlation between the Signal Intensity Alteration of Infrapatellar Fat Pad and Knee Osteoarthritis: A Retrospective, Cross-Sectional Study. J Clin Med 2023; 12:jcm12041331. [PMID: 36835867 PMCID: PMC9965223 DOI: 10.3390/jcm12041331] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Infrapatellar fat pad (IPFP) inflammation is a common pathological manifestation in knee osteoarthritis (OA). However, the significance of IPFP signal intensity alteration for clinical diagnosis and treatment of knee OA needs further research. We assessed IPFP signal intensity alteration (0-3), IPFP maximum cross-sectional area (CSA) and IPFP depth, meniscus injury, bone marrow edema, and cartilage injury from magnetic-resonance imaging (MRI) in 41 non-KOA patients (K-L grade 0 and grade I) and 68 KOA patients (K-L grade 2,3 and 4). We found that IPFP signaling was altered in all patients with KOA whose alteration was closely related to the K-L grading. We found that the IPFP signal intensity was increased in most OA patients, especially the ones in the late stage. There were significant differences in IPFP maximum CSA and IPFP depth between groups in KOA and non-KOA patients. Moreover, Spearman correlation analysis showed that IPFP signal intensity was moderately positively correlated with age, meniscal injury, cartilage injury, and bone marrow edema, and negatively correlated with height, while not correlated with visual analogue scale (VAS) scoring and body mass index (BMI). In addition, women have higher IPFP inflammation scores on MRI than men. In conclusion, IPFP signal intensity alteration is associated with joint damage in knee OA, which may have clinical significance for diagnosing and treating KOA.
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Affiliation(s)
- Zheng Liu
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Jiangyi Wu
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen 518036, China
| | - Wei Xiang
- State Key Laboratory of Trauma, Burns and Combined Injury, Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Jinhui Wu
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Shu Huang
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Yizhao Zhou
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Hui Xia
- Surgery Department I, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
| | - Zhenhong Ni
- State Key Laboratory of Trauma, Burns and Combined Injury, Department of Rehabilitation Medicine, Daping Hospital, Army Medical University, Chongqing 400042, China
- Correspondence: (Z.N.); (B.L.)
| | - Baorong Liu
- Department of Joint Surgery and Sport Medicine, The First Affiliated Hospital of Hunan Normal University, Changsha 410000, China
- Correspondence: (Z.N.); (B.L.)
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Cen H, Yan Q, Meng T, Chen Z, Zhu J, Wang Y, Ruan G, Wang T, Han W, Hunter D, Ding C. Quantitative infrapatellar fat pad signal intensity alteration as an imaging biomarker of knee osteoarthritis progression. RMD Open 2023; 9:rmdopen-2022-002565. [PMID: 36697038 PMCID: PMC9884854 DOI: 10.1136/rmdopen-2022-002565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/02/2023] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To determine the association of quantitative infrapatellar fat pad (IPFP) signal intensity alteration with knee osteoarthritis (OA) progression. METHOD This study was performed based on the Foundation for the National Institutes of Health OA Biomarkers Consortium study, a nested case-control study consisting of 600 participants. The IPFP signal intensity alterations were quantitatively measured at baseline, 12 months and 24 months. The associations of baseline and time-integrated values over 12 and 24 months of IPFP signal intensity measures with knee OA progression over 48 months were evaluated with adjustment for baseline confounders. RESULTS The baseline level of clustering effect of high signal intensity (Clustering factor (H)) was predictive of clinically relevant progression (both radiographic and pain progression) (OR 1.22). The time-integrated values of all IPFP signal intensity measures, except for mean value of IPFP signal intensity (Mean (IPFP)) over 24 months (ORs ranging from 1.23 to 1.39) as well was all except for Mean (IPFP) and mean value of IPFP high signal intensity (Mean (H)) over 12 months (ORs ranging from 1.20 to 1.31), were positively associated with clinically relevant progression. When the associations of quantitative IPFP signal intensity measures with radiographic and pain progression were examined separately, more IPFP signal intensity measures with stronger effect sizes were associated with radiographic progression compared with pain progression. CONCLUSION The associations of short-term alteration in quantitative IPFP signal intensity measures with long-term knee OA progression suggest that these measures might serve as efficacy of intervention biomarkers of knee OA.
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Affiliation(s)
- Han Cen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Qingran Yan
- Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Tao Meng
- Department of Rheumatology and Immunology, The Second Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhongshan Chen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,School of Mathematics and Information Science, Nanjing Normal University of Special Education, Nanjing, Jiangsu, China
| | - Jimin Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Department of Public Health and General Medicine, School of Life Sciences, Anhui University of Chinese Medicine, Hefei, Anhui, China
| | - Yuanyuan Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Guangfeng Ruan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Clinical Research Centre, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Tian Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia,Department of Rheumatology and Clinical Immunology, Beijing An Zhen Hospital, Capital Medical University, Beijing, Beijing, China
| | - Weiyu Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - David Hunter
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China,Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China .,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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7
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Xuan A, Chen H, Chen T, Li J, Lu S, Fan T, Zeng D, Wen Z, Ma J, Hunter D, Ding C, Zhu Z. The application of machine learning in early diagnosis of osteoarthritis: a narrative review. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158198. [PMID: 36937823 PMCID: PMC10017946 DOI: 10.1177/1759720x231158198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023] Open
Abstract
Osteoarthritis (OA) is the commonest musculoskeletal disease worldwide, with an increasing prevalence due to aging. It causes joint pain and disability, decreased quality of life, and a huge burden on healthcare services for society. However, the current main diagnostic methods are not suitable for early diagnosing patients of OA. The use of machine learning (ML) in OA diagnosis has increased dramatically in the past few years. Hence, in this review article, we describe the research progress in the application of ML in the early diagnosis of OA, discuss the current trends and limitations of ML approaches, and propose future research priorities to apply the tools in the field of OA. Accurate ML-based predictive models with imaging techniques that are sensitive to early changes in OA ahead of the emergence of clinical features are expected to address the current dilemma. The diagnostic ability of the fusion model that combines multidimensional information makes patient-specific early diagnosis and prognosis estimation of OA possible in the future.
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Affiliation(s)
| | | | - Tianyu Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jia Li
- Division of Orthopaedic Surgery, Department of Orthopaedics, Nafang Hospital, Southern Medical University, Guangzhou, China
| | - Shilong Lu
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Tianxiang Fan
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Dong Zeng
- College of Automation Science and Engineering, South China University of Technology, Guangzhou, China
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jianhua Ma
- School of Biomedical Engineering, Southern Medical University, Guangzhou, China
| | - David Hunter
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia
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8
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Li J, Fu S, Gong Z, Zhu Z, Zeng D, Cao P, Lin T, Chen T, Wang X, Lartey R, Kwoh CK, Guermazi A, Roemer FW, Hunter DJ, Ma J, Ding C. MRI-based Texture Analysis of Infrapatellar Fat Pad to Predict Knee Osteoarthritis Incidence. Radiology 2022; 304:611-621. [PMID: 35638929 PMCID: PMC9434820 DOI: 10.1148/radiol.212009] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 03/24/2022] [Accepted: 04/14/2022] [Indexed: 11/11/2022]
Abstract
Background Infrapatellar fat pad (IPFP) quality has been implicated as a marker for predicting knee osteoarthritis (KOA); however, no valid quantification for subtle IPFP abnormalities has been established. Purpose To investigate whether MRI-based three-dimensional texture analysis of IPFP abnormalities could help predict incident radiographic KOA. Materials and Methods In this prospective nested case-control study, 690 participants whose knees were at risk for KOA were included from the Pivotal Osteoarthritis Initiative MRI Analyses incident osteoarthritis cohort. All knees had a Kellgren-Lawrence grade of 1 or less at baseline. During the 4-year follow-up, case participants were matched 1:1 to control participants, with incident radiographic KOA as the outcome. MRI scans were segmented at the incident time point of KOA (hereafter, P0), 1 year before P0 (hereafter, P-1), and baseline. MRI-based three-dimensional texture analysis was performed to extract IPFP texture features. Least absolute shrinkage and selection operator and multivariable logistic regressions were applied in the development cohort and evaluated in the test cohort. The area under the receiver operating characteristic curve (AUC) was used to evaluate the discriminative value of the clinical score, IPFP texture score, and MRI Osteoarthritis Knee Score. Results Participants were allocated to development (n = 500, 340 women; mean age, 60 years) and test (n = 190, 120 women; mean age, 61 years) cohorts. In both cohorts, IPFP texture scores (AUC ≥0.75 for all) showed greater discrimination than clinical scores (AUC ≤0.69 for all) at baseline, P-1, and P0, with significant differences in pairwise comparisons (P ≤ .002 for all). Greater predictive and concurrent validities of IPFP texture scores (AUC ≥0.75 for all) compared with MRI Osteoarthritis Knee Scores (AUC ≤0.66 for all) were also demonstrated (P < .001 for all). Conclusion MRI-based three-dimensional texture of the infrapatellar fat pad was associated with future development of knee osteoarthritis. ClinicalTrials.gov registration no.: NCT00080171 © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Fischer in this issue.
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Affiliation(s)
| | | | - Ze Gong
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Zhaohua Zhu
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Dong Zeng
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Peihua Cao
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Ting Lin
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Tianyu Chen
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Xiaoshuai Wang
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Richard Lartey
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - C. Kent Kwoh
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Ali Guermazi
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Frank W. Roemer
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - David J. Hunter
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Jianhua Ma
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
| | - Changhai Ding
- From the Clinical Research Centre, Zhujiang Hospital, Southern
Medical University, Guangzhou, Guangdong, China (J.L., Z.Z., P.C., T.C., X.W.,
D.J.H., C.D.); Department of Orthopedics, Nanfang Hospital, Southern Medical
University, Guangzhou, Guangdong, China (J.L.); School of Biomedical
Engineering, Southern Medical University, Guangzhou, China (S.F., D.Z., J.M.);
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical
University, Guangzhou, China (Z.G.); School of Rehabilitation Medicine, Southern
Medical University, Guangzhou, China (Z.G.); Department of Radiology, Zhujiang
Hospital, Southern Medical University, Guangzhou, China (T.L.); Department of
Orthopedics, The Third Affiliated Hospital of Southern Medical University,
Guangzhou, China (T.C.); Department of Biomedical Engineering, Lerner Research
Institute, Cleveland Clinic, Cleveland, Ohio (R.L.); University of Arizona
College of Medicine, Tucson, Ariz (C.K.K.); University of Pittsburgh Graduate
School of Public Health, Pittsburgh, Pa (C.K.K.); Department of Radiology, VA
Boston Healthcare System, Boston University School of Medicine, Boston, Mass
(A.G., F.W.R.); Department of Radiology, University of Erlangen-Nuremberg,
Erlangen, Germany (F.W.R.); Department of Rheumatology, Royal North Shore
Hospital and Sydney Musculoskeletal Health, Kolling Institute, University of
Sydney, Australia (D.J.H.); and Menzies Institute for Medical Research,
University of Tasmania, Hobart, Australia (C.D.)
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9
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Cen H, Yan Q, Han W, Meng T, Chen Z, Ruan G, Wang T, Pan F, Chen D, Kraus VB, Hunter DJ, Ding C. Longitudinal association of infrapatellar fat pad signal intensity alteration with biochemical biomarkers in knee osteoarthritis. Rheumatology (Oxford) 2022; 62:439-449. [PMID: 35385111 PMCID: PMC9788819 DOI: 10.1093/rheumatology/keac214] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/30/2022] [Accepted: 03/30/2022] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To explore the longitudinal association of quantitative infrapatellar fat pad (IPFP) signal intensity alteration with OA-related biomarkers. METHODS Eighteen OA-related biochemical biomarkers of 600 knee OA participants in the Foundation for the National Institutes of Health OA Biomarkers Consortium (FNIH) study were extracted. The quantitative IPFP signal intensity measures were acquired based on magnetic resonance imaging, including mean value [Mean (IPFP)] and standard deviation [sDev (IPFP)] of the whole IPFP signal intensity, median value [Median (H)] and upper quartile value [UQ (H)] of high signal intensity, the ratio of volume of high signal intensity to volume of whole IPFP signal intensity [Percentage (H)] and Clustering factor (H). The linear mixed-effect model was applied to determine the longitudinal associations between IPFP signal intensity alteration and biochemical biomarkers over 2 years. RESULTS All IPFP measures except for Clustering factor (H) were positively associated with urine collagenase-cleaved type II collagen neoepitope (uC2C), urine C-terminal cross-linked telopeptide of type II collagen (uCTX-II), urine C-terminal cross-linked telopeptide of type I collagen-α (uCTX-Iα) and urine N-terminal cross-linked telopeptide of type I collagen (uNTX-I). Mean (IPFP), Median (H) and Percentage (H) were positively associated with the nitrated form of an epitope located in the triple helix of type II collagen (Coll2-1 NO2). Mean (IPFP), Median (H) and UQ (H) were positively associated with sCTX-I and uCTX-Iβ. Positive associations between sDev (IPFP), Percentage (H) and serum hyaluronic acid (sHA) were found. CONCLUSION Our results suggest a role of IPFP signal intensity alteration in joint tissue remodelling on a molecular level.
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Affiliation(s)
- Han Cen
- Correspondence to: Changhai Ding, Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China. E-mail:
| | - Qingran Yan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia,Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai
| | - Weiyu Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou
| | - Tao Meng
- Department of Rheumatology and Immunology, The Second Hospital of Anhui Medical University, Hefei
| | - Zhongshan Chen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia,School of Mathematics and Information Science, Nanjing Normal University of Special Education, Nanjing
| | - Guangfeng Ruan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou
| | - Tian Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia,Department of Rheumatology and Clinical Immunology, Beijing An Zhen Hospital, Capital Medical University, Beijing
| | - Feng Pan
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Di Chen
- Faculty of Pharmaceutical Sciences, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - David J Hunter
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou,Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou
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10
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Martel-Pelletier J, Tardif G, Pelletier JP. An Open Debate on the Morphological Measurement Methodologies of the Infrapatellar Fat Pad to Determine Its Association with the Osteoarthritis Process. Curr Rheumatol Rep 2022; 24:76-80. [PMID: 35235164 DOI: 10.1007/s11926-022-01057-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Knee osteoarthritis (OA) is a disease affecting all the neighboring articular tissues including the infrapatellar fat pad (IPFP). Although not yet as widely studied as other tissues in the knee, the IPFP has been recognized to have important metabolic activities and is a key player in OA. METHODS In this commentary, we will briefly describe the different methodologies employed for the MRI morphological measurement of this tissue and depict the findings in regard to OA. RESULTS The morphology of this tissue, monitored mainly with the use of magnetic resonance imaging (MRI), demonstrates changes during OA. However, studies of the IPFP morphological alterations and their association with the OA process have shown conflicting results, including a detrimental or beneficial role or no role at all. Although many reasons could explain such mixed findings, one might be the different methodologies used for the MRI measurement of area, volume, or signal intensity. In addition, several techniques are also employed for measuring the volume and signal intensity. An additional level of complexity is related to the presence within the IPFP of two different types of signal intensities, hyper-intensity, and hypo-intensity. CONCLUSION A consensus of a procedure to measure the morphology of the IPFP is urgently needed to fully appreciate the role of this tissue in the pathology of OA, as well as its uses for clinical decision-making.
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Affiliation(s)
- Johanne Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis Street, Pavilion R, Room R11.412, Montreal, Quebec, H2X 0A9, Canada.
| | - Ginette Tardif
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis Street, Pavilion R, Room R11.412, Montreal, Quebec, H2X 0A9, Canada
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), 900 Saint-Denis Street, Pavilion R, Room R11.412, Montreal, Quebec, H2X 0A9, Canada
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11
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Chen Y, Zhang X, Li M, Zhong L, Ding Y, Zhang Y, Du X, Mo X, Chen J, Chen Q, Huang W, Zhong S, Zhang X. Quantitative MR evaluation of the infrapatellar fat pad for knee osteoarthritis: using proton density fat fraction and T2* relaxation based on DIXON. Eur Radiol 2022; 32:4718-4727. [PMID: 35141779 DOI: 10.1007/s00330-022-08561-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/21/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To investigate the efficacy of fat fraction (FF) and T2* relaxation based on DIXON in the assessment of infrapatellar fat pad (IFP) for knee osteoarthritis (KOA) progression in older adults. METHODS Ninety volunteers (age range 51-70 years, 65 females) were enrolled in this study. Participants were grouped based on the Kellgren-Lawrence grading (KLG). The FF and T2* values were measured based on the 3D-modified DXION technique. Cartilage defects, bone marrow lesions, and synovitis were assessed based on a modified version of whole-organ magnetic resonance imaging score (WORMS). Knee pain was assessed by self-administered Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire. The differences of FF and T2* measurement and the correlation with WORMS and WOMAC assessments were analyzed. Diagnostic efficiency was analyzed by using receiver operating characteristic (ROC) curves. RESULTS A total of 60 knees were finally included (n = 20 in each group). The values were 82.6 ± 3.7%, 74.7 ± 5.4%, and 60.5 ± 14.1% for FF is the no OA, mild OA, and advanced OA groups, and were 50.7 ± 6.6 ms, 44.1 ± 6.6 ms, and 39.1 ± 4.2 ms for T2*, respectively (all p values < 0.001). The WORMS assessment and WOMAC pain assessment showed negative correlation with FF and T2* values. The ROC showed the area under the curve (AUC), sensitivity, and specificity for diagnosing OA were 0.93, 77.5%, and 100% using FF, and were 0.86, 75.0%, and 90.0% using T2*, respectively. CONCLUSIONS FF and T2* alternations in IFP are associated with knee structural abnormalities and clinical symptoms cross-sectionally and may have the potential to predict the severity of KOA. KEY POINTS • Fat fraction (FF) and T2* relaxation based on DIXON imaging are novel methods to quantitatively assess the infrapatellar fat pad for knee osteoarthritis (KOA) progression in older adults. • The alterations of FF and T2* using mDIXON technique in IFP were associated with knee structural abnormalities and clinical symptoms. • FF and T2* alternations in IFP can serve as the new imaging biomarkers for fast, simple, and noninvasive assessment in KOA.
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Affiliation(s)
- Yanjun Chen
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Xintao Zhang
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Mianwen Li
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Lijie Zhong
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Yukun Ding
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Yaru Zhang
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Xueting Du
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Guangzhou, Guangdong, China
| | - Xianfu Mo
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Jialing Chen
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Qianmin Chen
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China
| | - Wenhua Huang
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Shizhen Zhong
- School of Basic Medical Sciences, Southern Medical University, No.1023, Shatai Road South, Baiyun District, Guangzhou, 510515, Guangdong, China.
| | - Xiaodong Zhang
- The Third Affiliated Hospital of Southern Medical University, No.183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, Guangdong, China.
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12
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Zhu Z, Han W, Lu M, Lin J, Yin Z, Shang X, Weng X, Zha Z, Tian J, Lei G, Hunter DJ, Ding C. Effects of infrapatellar fat pad preservation versus resection on clinical outcomes after total knee arthroplasty in patients with knee osteoarthritis (IPAKA): study protocol for a multicentre, randomised, controlled clinical trial. BMJ Open 2020; 10:e043088. [PMID: 33099502 PMCID: PMC7590360 DOI: 10.1136/bmjopen-2020-043088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION The infrapatellar fat pad (IPFP) is commonly resected during total knee arthroplasty (TKA) for better exposure. However, our previous studies have suggested that IPFP size was protective against, while IPFP signal intensity alteration was detrimental on knee symptoms and structural abnormalities. We hypothesise that an IPFP with normal qualities, rather than abnormal qualities, should be preserved during TKA. The aim of this study is to compare, over a 1-year period, the postoperative clinical outcomes of IPFP preservation versus resection after TKA in patients with normal or abnormal IPFP signal intensity alteration on MRI. METHODS AND ANALYSIS Three hundred and sixty people with end-stage knee osteoarthritis and on the waiting list for TKA will be recruited and identified as normal IPFP quality (signal intensity alteration score ≤1) or abnormal IPFP quality (signal intensity alteration score ≥2). Patients in each hospital will then be randomly allocated to IPFP resection group or preservation group. The primary outcomes are the summed score of self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS subscales assessing function in daily activities and function in sport and recreation. Secondary endpoints will be included: KOOS subscales (pain, symptoms and quality of life), Knee Society Score, 100 mm Visual Analogue Scale (VAS) Pain, timed up-and-go test, patellar tendon shortening, 100 mm VAS self-reported efficacy of reduced pain and increased quality of life, and Insall-Salvati index assessed on plain X-ray. Adverse events will be recorded. Intention-to-treat analyses will be used. ETHICS AND DISSEMINATION The study is approved by the local Medical Ethics Committee (Zhujiang Hospital Ethics Committee, reference number 2017-GJGBK-001) and will be conducted according to the principle of the Declaration of Helsinki (64th, 2013) and the Good Clinical Practice standard, and in compliance with the Medical Research Involving Human Subjects Act . Data will be published in peer-reviewed journals and presented at conferences, both nationally and internationally. TRIAL REGISTRATION NUMBER This trial was registered at Clinicaltrial.gov website on 19 October 2018 with identify number NCT03763448.
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Affiliation(s)
- Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Weiyu Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Ming Lu
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jianhao Lin
- Arthritis Clinical and Research Center, Peking University People's Hospital, Beijing, China
| | - Zongsheng Yin
- Department of Orthopaedics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xifu Shang
- Department of Orthopaedic Surgery, Anhui Provincial Hospital, Hefei, China
| | - Xisheng Weng
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Zhengang Zha
- Institute of Orthopaedic Diseases and Center for Joint Surgery and Sports Medicine, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jin Tian
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Guanghua Lei
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - David J Hunter
- Institute of Bone and Joint Research, Kolling Institute, Sydney, New South Wales, Australia
- Department of Rheumatology, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Zeng N, Yan ZP, Chen XY, Ni GX. Infrapatellar Fat Pad and Knee Osteoarthritis. Aging Dis 2020; 11:1317-1328. [PMID: 33014539 PMCID: PMC7505265 DOI: 10.14336/ad.2019.1116] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/16/2019] [Indexed: 02/05/2023] Open
Abstract
Osteoarthritis is the most prevalent arthritis typically characterized by degradation of cartilage. However, its pathogenesis is not fully understood. Currently, osteoarthritis is best considered a disease of the whole "joint organ". Infrapatellar fat pad (IFP), an adipose tissue near synovium, is now attaching importance to researchers for its inflammatory phenotype. In this narrative review, a large body of evidence has been gathered for the involvement of IFP in the development of knee osteoarthritis. Additionally, the underlying mechanisms of how IFP can be involved in this process have been proposed. However, further investigations are needed to better understand its precise role in this process and its underlying mechanism, and beyond that, to develop new strategies to slow down the degenerative process and explore an effective and timely diagnosis of the disease.
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Affiliation(s)
- Ni Zeng
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhi-Peng Yan
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xin-Yuan Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Guo-Xin Ni
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
- Correspondence should be addressed to: Dr. Guo-Xin Ni, School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
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14
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Zhu Z, Yu Q, Leng X, Han W, Li Z, Huang C, Gu J, Zhao Y, Wang K, Li T, Mei Y, Xu J, Zhang Z, Hunter D, Cicuttini F, Zeng X, Ding C. Can low-dose methotrexate reduce effusion-synovitis and symptoms in patients with mid- to late-stage knee osteoarthritis? Study protocol for a randomised, double-blind, and placebo-controlled trial. Trials 2020; 21:795. [PMID: 32938470 PMCID: PMC7493135 DOI: 10.1186/s13063-020-04687-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 08/14/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a common chronic disease in older adults. Currently, there are no effective therapies to reduce disease severity and progression of knee OA (KOA), particularly in mid- to late-stages. This study aims to examine the effect of methotrexate (MTX) on knee effusion-synovitis and pain in symptomatic patients with mid- to late-stage KOA. METHODS/DESIGN This protocol describes a multicentre randomised placebo-controlled clinical trial aiming to recruit 200 participants with mid- to late-stage symptomatic KOA and with effusion-synovitis grade of ≥ 2. Participants will be randomly allocated to the MTX group (start from 5 mg per week for the first 2 weeks and increase to 10 mg per week for the second 2 weeks and 15 mg per week for the remaining period if tolerated) or the placebo group. Primary outcomes are effusion-synovitis size measured by magnetic resonance imaging (MRI) and knee pain assessed by visual analogue scale (VAS). Secondary outcomes are signal intensity alteration within infrapatellar fat pad (IPFP) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score and subscores, and the Outcome Measures in Rheumatology Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) responders. Both intention-to-treat and per-protocol analyses will be performed. DISCUSSION If MTX intervention can relieve symptoms and reduce inflammation in patients with mid- to late-stage KOA, it has the potential for significant clinical and public health impact as this low-cost and commonly used intervention would delay the time to knee replacement, leading to substantial cost savings and improve quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT03815448 . Registered on 21 January 2019.
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Affiliation(s)
- Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Department of Rheumatology and Clinical Immunology, Zhujiang Hospital of Southern Medical University, Guangzhou, China.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Qinghong Yu
- Department of Rheumatology and Clinical Immunology, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Xiaomei Leng
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Weiyu Han
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhanguo Li
- Department of Rheumatology & Immunology, Peking University People's Hospital, Beijing, China
| | - Cibo Huang
- Department of Rheumatology, Beijing Hospital, National Center of Gerontology, Beijing, China
| | - Jieruo Gu
- Department of Rheumatology, 3rd Affiliated Hospital of Sun Yet-Sen University Guangzhou, Guangzhou, Guangdong, China
| | - Yi Zhao
- Department of Rheumatology & Allergy, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kang Wang
- Department of Rheumatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Tianwang Li
- Department of Rheumatology and Immunology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yifang Mei
- Department of Rheumatology, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jianhua Xu
- Department of Rheumatology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhiyi Zhang
- Department of Rheumatology, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - David Hunter
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.,Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xiaofeng Zeng
- Department of Rheumatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China. .,Department of Rheumatology and Clinical Immunology, Zhujiang Hospital of Southern Medical University, Guangzhou, China. .,Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
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15
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Wang K, Ding C, Hannon MJ, Chen Z, Kwoh CK, Hunter DJ. Quantitative Signal Intensity Alteration in Infrapatellar Fat Pad Predicts Incident Radiographic Osteoarthritis: The Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2019; 71:30-38. [PMID: 29648688 DOI: 10.1002/acr.23577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/03/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To determine whether infrapatellar fat pad (IPFP) signal intensity measures are predictive of incident radiographic osteoarthritis (ROA) over 4 years in the Osteoarthritis Initiative study. METHODS Case knees (n = 355), as defined by incident ROA, were matched 1:1 with control knees, according to sex, age, and radiographic status. T2-weighted magnetic resonance images were assessed at P0 (the visit when incident ROA was observed on a radiograph), P1 (1 year prior to P0), and baseline and used to assess IPFP signal intensity semiautomatically. Conditional logistic regression analyses were performed to assess the risk of incident ROA associated with IPFP signal intensity alteration, after adjustment for covariates. RESULTS The mean age of the participants was 60.2 years, and most (66.7%) were female and overweight (mean body mass index 28.3 kg/m2 ). Baseline IPFP measures including the mean value and standard deviation of IPFP signal intensity, the mean value and standard deviation of IPFP high signal intensity, median and upper quartile values of IPFP high signal intensity, and the clustering effect of high signal intensity were associated with incident knee ROA over 4 years. All P1 IPFP measures were associated with incident ROA after 12 months. All P0 IPFP signal intensity measures were associated with ROA. CONCLUSION The quantitative segmentation of high signal intensity in the IPFP observed in our study confirms the findings of previous work based on semiquantitative assessment, suggesting the predictive validity of semiquantitative assessment of IPFP high signal intensity. The IPFP high signal intensity alteration could be an important imaging biomarker to predict the occurrence of ROA.
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Affiliation(s)
- Kang Wang
- University of Tasmania, Hobart, Tasmania, Australia
| | - Changhai Ding
- Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, New South Wales, Australia, Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China and Southern Medical University, Guangzhou, Guangdong, China
| | - Michael J Hannon
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Zhongshan Chen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia, and Nanjing Normal University of Special Education, Nanjing, China
| | - C Kent Kwoh
- University of Arizona School of Medicine, Tucson
| | - David J Hunter
- Nanjing Normal University of Special Education, Nanjing, China
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16
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Han W, Aitken D, Zheng S, Wang B, Wluka AE, Zhu Z, Blizzard L, Wang X, Winzenberg T, Cicuttini F, Jones G, Ding C. Higher Serum Levels of Resistin Are Associated With Knee Synovitis and Structural Abnormalities in Patients With Symptomatic Knee Osteoarthritis. J Am Med Dir Assoc 2019; 20:1242-1246. [DOI: 10.1016/j.jamda.2019.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 11/26/2022]
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17
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Han W, Aitken D, Zheng S, Wluka AE, Zhu Z, Blizzard L, Winzenberg T, Cicuttini F, Jones G, Ding C. Association Between Quantitatively Measured Infrapatellar Fat Pad High Signal‐Intensity Alteration and Magnetic Resonance Imaging–Assessed Progression of Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2019; 71:638-646. [DOI: 10.1002/acr.23713] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 07/17/2018] [Indexed: 12/16/2022]
Affiliation(s)
- Weiyu Han
- University of TasmaniaHobart, Tasmania, Australia, and Zhujiang Hospital, Southern Medical University Guangzhou China
| | - Dawn Aitken
- University of Tasmania Hobart Tasmania Australia
| | - Shuang Zheng
- University of Tasmania Hobart Tasmania Australia
| | | | - Zhaohua Zhu
- University of Tasmania Hobart Tasmania Australia
| | | | | | | | - Graeme Jones
- University of Tasmania Hobart Tasmania Australia
| | - Changhai Ding
- University of TasmaniaHobart, Tasmania, and Monash University, Melbourne, Victoria, Australia, and Zhujiang Hospital, Southern Medical University Guangzhou China
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18
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Zhou Z, Zhao G, Kijowski R, Liu F. Deep convolutional neural network for segmentation of knee joint anatomy. Magn Reson Med 2018; 80:2759-2770. [PMID: 29774599 PMCID: PMC6342268 DOI: 10.1002/mrm.27229] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/29/2018] [Accepted: 03/31/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE To describe and evaluate a new segmentation method using deep convolutional neural network (CNN), 3D fully connected conditional random field (CRF), and 3D simplex deformable modeling to improve the efficiency and accuracy of knee joint tissue segmentation. METHODS A segmentation pipeline was built by combining a semantic segmentation CNN, 3D fully connected CRF, and 3D simplex deformable modeling. A convolutional encoder-decoder network was designed as the core of the segmentation method to perform high resolution pixel-wise multi-class tissue classification for 12 different joint structures. The 3D fully connected CRF was applied to regularize contextual relationship among voxels within the same tissue class and between different classes. The 3D simplex deformable modeling refined the output from 3D CRF to preserve the overall shape and maintain a desirable smooth surface for joint structures. The method was evaluated on 3D fast spin-echo (3D-FSE) MR image data sets. Quantitative morphological metrics were used to evaluate the accuracy and robustness of the method in comparison to the ground truth data. RESULTS The proposed segmentation method provided good performance for segmenting all knee joint structures. There were 4 tissue types with high mean Dice coefficient above 0.9 including the femur, tibia, muscle, and other non-specified tissues. There were 7 tissue types with mean Dice coefficient between 0.8 and 0.9 including the femoral cartilage, tibial cartilage, patella, patellar cartilage, meniscus, quadriceps and patellar tendon, and infrapatellar fat pad. There was 1 tissue type with mean Dice coefficient between 0.7 and 0.8 for joint effusion and Baker's cyst. Most musculoskeletal tissues had a mean value of average symmetric surface distance below 1 mm. CONCLUSION The combined CNN, 3D fully connected CRF, and 3D deformable modeling approach was well-suited for performing rapid and accurate comprehensive tissue segmentation of the knee joint. The deep learning-based segmentation method has promising potential applications in musculoskeletal imaging.
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Affiliation(s)
- Zhaoye Zhou
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - Gengyan Zhao
- Departments of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Richard Kijowski
- Departments of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Fang Liu
- Departments of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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19
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Wang K, Ding C, Hannon MJ, Chen Z, Kwoh CK, Lynch J, Hunter DJ. Signal intensity alteration within infrapatellar fat pad predicts knee replacement within 5 years: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2018; 26:1345-1350. [PMID: 29842941 DOI: 10.1016/j.joca.2018.05.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 05/08/2018] [Accepted: 05/20/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate whether infrapatellar fat pad (IPFP) signal intensity (SI) alteration predicts the occurrence of knee replacement (KR) in knee osteoarthritis (OA) patients over 5 years. DESIGN The subjects were selected from Osteoarthritis Initiative (OAI) study. Case knees (n = 127) were defined as those who received KR during 5 years follow-up visit. They were matched by gender, age and radiographic status with control knees (n = 127). We used T2-weighted MR images to measure IPFP SI alteration using a newly developed algorithm in MATLAB. The measurements were assessed at baseline (BL), T0 (the visit just before KR) and 1 year before T0 (T-1). Conditional logistic regression was used to analyse the associations between IPFP SI alterations and the risk of KR. RESULTS Participants were mostly female (57%), with an average age of 63.7 years old and a mean body mass index (BMI) of 29.5 kg/m2. In multivariable analysis, the standard deviation (SD) of IPFP SI [sDev (IPFP)] and the ratio of high SI region volume to whole IPFP volume [Percentage (H)] measured at BL were significantly associated with increased risks of KR after adjustment for covariates. IPFP SI alterations measured at T-1 including sDev (IPFP), Percentage (H) and clustering effect of high SI [Clustering factor (H)] were significantly associated with higher risks of KR. All measurements were significantly associated with higher risks of KR at T0. CONCLUSIONS IPFP SI is associated with the occurrence of KR suggesting it may play a role in end-stage knee OA.
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Affiliation(s)
- K Wang
- Arthritis Research Institute, Department of Rheumatology, 1st Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - C Ding
- Arthritis Research Institute, Department of Rheumatology, 1st Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - M J Hannon
- Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Z Chen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; School of Mathematics and Information Science, Nanjing Normal University of Special Education, China
| | - C K Kwoh
- University of Arizona Arthritis Center, Division of Rheumatology, University of Arizona College of Medicine, Tucson, AZ, USA
| | - J Lynch
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - D J Hunter
- Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Australia
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20
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Steidle-Kloc E, Culvenor AG, Dörrenberg J, Wirth W, Ruhdorfer A, Eckstein F. Relationship Between Knee Pain and Infrapatellar Fat Pad Morphology: A Within- and Between-Person Analysis From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2018; 70:550-557. [PMID: 28704603 DOI: 10.1002/acr.23326] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 07/11/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Inflammation is known to be strongly associated with knee pain in osteoarthritis. The infrapatellar fat pad represents a potential source of proinflammatory cytokines. Yet the relationship between infrapatellar fat pad morphology and osteoarthritis symptoms is unclear. METHODS Here we investigate quantitative imaging parameters of infrapatellar fat pad morphology between painful versus contralateral pain-free legs of subjects with unilateral knee pain and patients with chronic knee pain versus those of matched pain-free control subjects. A total of 46 subjects with strictly unilateral frequent knee pain and bilateral radiographic osteoarthritis (Kellgren/Lawrence grade 2/3) were drawn from the Osteoarthritis Initiative. Further, 43 subjects with chronic knee pain over 4 years and 43 matched pain-free controls without pain over this period were studied. Infrapatellar fat pad morphology (volume, surface area, and depth) was determined by manual segmentation of sagittal magnetic resonance images. RESULTS No significant differences in infrapatellar fat pad morphology were observed between painful versus painless knees of persons with strictly unilateral knee pain (mean difference -0.7% (95% confidence interval [95% CI] -0.6, 0.9; P = 0.64) or between chronically painful knees versus matched painless controls (-2.1% [95% CI -2.2, 1.1]; P = 0.51). CONCLUSION Independent of the ambiguous role of the infrapatellar fat pad in knee osteoarthritis (a potential source of proinflammatory cytokines or a mechanical shock absorber), the size of the infrapatellar fat pad does not appear to be related to knee pain.
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Affiliation(s)
- Eva Steidle-Kloc
- Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Adam G Culvenor
- Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria, and La Trobe University, Bundoora, Victoria, Australia
| | - Jan Dörrenberg
- Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Wolfgang Wirth
- Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Anja Ruhdorfer
- Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
| | - Felix Eckstein
- Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria
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21
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Ruhdorfer A, Haniel F, Petersohn T, Dorrenberg J, Wirth W, Dannhauer T, Hunter DJ, Eckstein F. Between-group differences in infra-patellar fat pad size and signal in symptomatic and radiographic progression of knee osteoarthritis vs non-progressive controls and healthy knees - data from the FNIH Biomarkers Consortium Study and the Osteoarthritis Initiative. Osteoarthritis Cartilage 2017; 25:1114-1121. [PMID: 28216313 PMCID: PMC5466837 DOI: 10.1016/j.joca.2017.02.789] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 01/15/2017] [Accepted: 02/05/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine cross-sectional and longitudinal between-group differences of infra-patellar fat pad (IPFP) size and magnetic resonance imaging (MRI) signal from fat-suppressed intermediate-weighted images with clinically relevant symptomatic and radiographic progression of knee osteoarthritis (OA), vs healthy references. METHODS We studied 110 case knees (Kellgren-Lawrence Grade [KLG1-3]) with radiographic (≥0.7 mm loss in joint space width [JSW]) and symptomatic progression (≥+9/100 units on the Western Ontario and McMasters Universities Osteoarthritis Index [WOMAC] knee pain subscale) vs 118 control knees without progression from the Foundation for the National Institutes of Health (FNIH) Biomarkers Consortium cohort. We further studied 88 knees from the Osteoarthritis Initiative (OAI) healthy reference cohort without (risk factors) of knee OA. The IPFP was manually segmented using baseline and year-2 sagittal fat-suppressed intermediate-weighted spin-echo 3 T MRIs. Baseline measures and longitudinal change in IPFP volume and 3D MRI signal (mean, standard deviation [SD]) were compared between groups. RESULTS No statistically significant baseline differences in IPFP volume, 3D MRI signal mean or signal heterogeneity (SD) were observed between progressor and non-progressor OA knees. Yet, the IPFP 3D MRI signal SD, but not its volume, was statistically significantly greater in OA vs healthy knees. No statistically significant 2-year changes in IPFP volume were observed in either group, but the increase in 3D MRI signal heterogeneity (SD) was greater in progressor vs non-progressor knees, and was greater in OA vs healthy knees. CONCLUSION Whereas IPFP-related morphometric measures did not statistically significantly differ between groups, a stronger increase in 3D IPFP MRI signal and signal heterogeneity may be associated with radiographic/symptomatic progression of OA, when compared to non-progressive OA or healthy knees.
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Affiliation(s)
- Anja Ruhdorfer
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria
| | - Franziska Haniel
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria
| | - Tobias Petersohn
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria
| | - Jan Dorrenberg
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria
| | - Wolfgang Wirth
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria,Chrondrometrics GmbH, Ainring, Germany
| | - Torben Dannhauer
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria,Chrondrometrics GmbH, Ainring, Germany
| | - David J. Hunter
- Rheumatology Department, Royal North Shore Hospital & Institute
of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney,
Australia
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University Salzburg &
Nuremberg, Salzburg, Austria,Chrondrometrics GmbH, Ainring, Germany
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Wang CY, Hsu YJ, Peng YJ, Lee HS, Chang YC, Chang CS, Chiang SW, Hsu YC, Lin MH, Huang GS. Knee subchondral bone perfusion and its relationship to marrow fat and trabeculation on multi-parametric MRI and micro-CT in experimental CKD. Sci Rep 2017; 7:3073. [PMID: 28596576 PMCID: PMC5465086 DOI: 10.1038/s41598-017-03059-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/21/2017] [Indexed: 12/16/2022] Open
Abstract
The pathogenesis of chronic kidney disease (CKD) is multifactorial. In the progression of CKD arthropathy, arteriosclerosis may alter the knee subchondral bone marrow by altering blood flow through the bone vasculature. Herein, multi-parametric MRI assessment, including dynamic contrast enhanced magnetic resonance imaging (DCE-MRI), magnetic resonance spectroscopy (MRS), MRI T2*, contrast enhanced MR angiography (CE-MRA), and micro-CT were applied in a rodent nephrectomy model to: 1) investigate the blood perfusion of subchondral bone marrow and its relationship to fat water content and trabeculation pattern in CKD and 2) demonstrate the feasibility of using multi-parametric MRI parameters as imaging biomarkers to evaluate the disease’s progression. Two groups of rats in our study underwent either 1) no intervention or 2) 5/6 nephrectomy. We found that in the CKD group, perfusion amplitude A and elimination constant kel values were significantly decreased, and vascular permeability kep was significantly increased. MRS showed that fat fraction (FF) was significantly lower, water fraction (WF) was significantly higher in the CKD group. Micro-CT showed a significant loss of trabecular bone. Knee subchondral bone marrow perfusion deficiency in experimental CKD may be associated with decreased fat content, increased water content, and sparse trabeculation.
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Affiliation(s)
- Chao-Ying Wang
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan.,Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Juei Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Jen Peng
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Herng-Sheng Lee
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yue-Cune Chang
- Department of Mathematics, Tamkang University, New Taipei, Taiwan
| | - Chih-Shan Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Wei Chiang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Yi-Chih Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Huang Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - Guo-Shu Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. .,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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Wang CY, Peng YJ, Hsu YJ, Lee HS, Chang YC, Chang CS, Chiang SW, Hsu YC, Lin MH, Huang GS. Cartilage MRI T2 ∗ relaxation time and perfusion changes of the knee in a 5/6 nephrectomy rat model of chronic kidney disease. Osteoarthritis Cartilage 2017; 25:976-985. [PMID: 28011101 DOI: 10.1016/j.joca.2016.12.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 11/28/2016] [Accepted: 12/14/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Chronic kidney disease (CKD) is characterized by metabolic disturbances in calcium and phosphorus homeostasis as kidney function declines. Alterations in blood perfusion in bone resulting from arteriosclerosis of bone vessels may relate to the progression of CKD. Herein, change in dynamic contrast enhanced (DCE) MRI parameters (A: amplitude, kel: elimination constant, and kep: permeability rate constant) and MRI T2∗ relaxation time of the knee cartilage were measured in a rodent nephrectomy model in order to (1) examine the relationship of peripheral blood perfusion to CKD and (2) demonstrate the feasibility of using DCE-MRI parameters and MRI T2∗ as imaging biomarkers to monitor disease progression. DESIGN Two groups of male Sprague-Dawley rats received either (1) no intervention or (2) 5/6 nephrectomy. RESULTS We found that the CKD group (compared with the control group) had lower A and kel values and similar kep value in the lateral and medial articular cartilages beginning at 12 weeks (P < 0.05); statistically significantly higher T2∗ values in the lateral and medial articular cartilages beginning at 18 weeks (P < 0.05); statistically significantly decreased inner luminal diameter of the popliteal artery, and altered structure of the lateral and medial articular cartilages (P < 0.05). CONCLUSION Perfusion deficiency and CKD may be related. DCE parameters and MRI T2∗ could serve as imaging biomarkers of cartilage degeneration in CKD progression.
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Affiliation(s)
- C-Y Wang
- Department and Graduate Institute of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan; Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-J Peng
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-J Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - H-S Lee
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Y-C Chang
- Department of Mathematics, Tamkang University, New Taipei City, Taiwan
| | - C-S Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - S-W Chiang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan; Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Y-C Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - M-H Lin
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan
| | - G-S Huang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
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24
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Han W, Pan F, Liu Z, Zhu Z, Wang X, Zheng S, Antony B, Ding C. Response to: 'The role of infrapatellar fat pad resection in total knee arthroplasty' by White et al. Ann Rheum Dis 2016; 75:e67. [PMID: 27489226 DOI: 10.1136/annrheumdis-2016-210170] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/16/2016] [Indexed: 11/04/2022]
Affiliation(s)
- Weiyu Han
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China
| | - Zhenhua Liu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Zhaohua Zhu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Xia Wang
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Shuang Zheng
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Changhai Ding
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia Arthritis Research Institute, 1st Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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