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Li X, Chen W, Liu D, Chen P, Li P, Li F, Yuan W, Wang S, Chen C, Chen Q, Li F, Guo S, Hu Z. Radiomics analysis using magnetic resonance imaging of bone marrow edema for diagnosing knee osteoarthritis. Front Bioeng Biotechnol 2024; 12:1368188. [PMID: 38933540 PMCID: PMC11199411 DOI: 10.3389/fbioe.2024.1368188] [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: 01/31/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
This study aimed to develop and validate a bone marrow edema model using a magnetic resonance imaging-based radiomics nomogram for the diagnosis of osteoarthritis. Clinical and magnetic resonance imaging (MRI) data of 302 patients with and without osteoarthritis were retrospectively collected from April 2022 to October 2023 at Longhua Hospital affiliated with the Shanghai University of Traditional Chinese Medicine. The participants were randomly divided into two groups (a training group, n = 211 and a testing group, n = 91). We used logistic regression to analyze clinical characteristics and established a clinical model. Radiomics signatures were developed by extracting radiomic features from the bone marrow edema area using MRI. A nomogram was developed based on the rad-score and clinical characteristics. The diagnostic performance of the three models was compared using the receiver operating characteristic curve and Delong's test. The accuracy and clinical application value of the nomogram were evaluated using calibration curve and decision curve analysis. Clinical characteristics such as age, radiographic grading, Western Ontario and McMaster Universities Arthritis Index score, and radiological features were significantly correlated with the diagnosis of osteoarthritis. The Rad score was constructed from 11 radiological features. A clinical model was developed to diagnose osteoarthritis (training group: area under the curve [AUC], 0.819; testing group: AUC, 0.815). Radiomics models were used to effectively diagnose osteoarthritis (training group,: AUC, 0.901; testing group: AUC, 0.841). The nomogram model composed of Rad score and clinical characteristics had better diagnostic performance than a simple clinical model (training group: AUC, 0.906; testing group: AUC, 0.845; p < 0.01). Based on DCA, the nomogram model can provide better diagnostic performance in most cases. In conclusion, the MRI-bone marrow edema-based radiomics-clinical nomogram model showed good performance in diagnosing early osteoarthritis.
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Affiliation(s)
- Xuefei Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenhua Chen
- Institute of Chinese Materia Medica, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dan Liu
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pinghua Chen
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pan Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangfang Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Weina Yuan
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shiyun Wang
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen Chen
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qian Chen
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangyu Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Suxia Guo
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhijun Hu
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Lin W, Xie L, Zhou L, Zheng J, Zhai W, Lin D. Effects of platelet-rich plasma on subchondral bone marrow edema and biomarkers in synovial fluid of knee osteoarthritis. Knee 2023; 42:161-169. [PMID: 37001332 DOI: 10.1016/j.knee.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/06/2023] [Accepted: 03/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The aim of the study was to investigate the effect of platelet-rich plasma (PRP) on subchondral bone marrow edema (BME) and the level of biomarkers in synovial fluid of the knee osteoarthritis. METHODS Eighty-one patients with symptomatic knee osteoarthritis were randomly divided into two groups according to the number of inpatients. Forty-five cases were treated with intra-articular injection of PRP (PRP group), 36 cases were treated with sodium hyaluronate (SH group), and the clinical effects were evaluated using the Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. The changes of subchondral BME were assessed by magnetic resonance imaging (MRI) before and after treatment. The levels of TNFα, IL-6, MCP-1, MMP-1, MMP-3, and MMP-9 in synovial fluid were also detected. RESULTS All the patients completed the corresponding treatment and were followed up for 12 months without serious complications. After the treatment, the VAS and WOMAC scores of the two groups were significantly decreased, and the difference was statistically significant at different time points (P < 0.05). The VAS and WOMAC scores of the PRP group were better than those of the SH group (P < 0.05). MRI showed that the subchondral bone edema of the two groups were reduced in varying degrees, and the reduction was more noticeable in the PRP group (P < 0.05). The levels of TNFα, IL-6, MCP-1, MMP-1, MMP-3, and MMP-9 in two groups were decreased, and the difference was statistically significant at different time points (P < 0.05). However, the levels of TNFα, IL-6, MCP-1, MMP-1, MMP-3, and MMP-9 in the PRP group were significantly lower than those in the SH group (P < 0.05). CONCLUSIONS Intra-articular injection of PRP can significantly reduce the subchondral BME and the level of biomarkers in synovial fluid of the symptomatic knee osteoarthritis.
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Affiliation(s)
- Wanchang Lin
- Orthopaedic Center of People's Liberation Army, Xiamen University Affiliated Southeast Hospital, Zhangzhou, China
| | - Li Xie
- Orthopaedic Center of People's Liberation Army, Xiamen University Affiliated Southeast Hospital, Zhangzhou, China
| | - Liang Zhou
- Orthopaedic Center of People's Liberation Army, Xiamen University Affiliated Southeast Hospital, Zhangzhou, China
| | - Jiapeng Zheng
- Orthopaedic Center of People's Liberation Army, Xiamen University Affiliated Southeast Hospital, Zhangzhou, China
| | - Wenliang Zhai
- Orthopaedic Center of People's Liberation Army, Xiamen University Affiliated Southeast Hospital, Zhangzhou, China.
| | - Dasheng Lin
- Orthopaedic Center of People's Liberation Army, Xiamen University Affiliated Southeast Hospital, Zhangzhou, China.
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Zhao H, Li H, Xie X, Tang HY, Liu XX, Wen Y, Xiao X, Ye L, Tang YW, Dai GY, He JN, Chen L, Wang Q, Tang DQ, Pan SN. Dual-energy CT virtual non-calcium: an accurate method for detection of knee osteoarthritis-related edema-like marrow signal intensity. Insights Imaging 2023; 14:74. [PMID: 37121955 PMCID: PMC10149542 DOI: 10.1186/s13244-023-01407-8] [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: 07/04/2022] [Accepted: 03/11/2023] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVES To evaluate the performance of a dual-energy computed tomography (DECT) virtual non-calcium (VNCa) technique in the detection of edema-like marrow signal intensity (ELMSI) in patients with knee joint osteoarthritis (OA) compared to magnetic resonance imaging (MRI). METHODS The study received local ethics board approval, and written informed consent was obtained. DECT and MRI were used to examine 28 knees in 24 patients with OA. VNCa images were generated by dual-energy subtraction of calcium. The knee joint was divided into 15 regions for ELMSI grading, performed independently by two musculoskeletal radiologists, with MRI as the reference standard. We also analyzed CT numbers through receiver operating characteristics and calculated cut-off values. RESULTS For the qualitative analysis, we obtained CT sensitivity (Readers 1, 2 = 83.7%, 89.8%), specificity (Readers 1, 2 = 99.5%, 99.5%), positive predictive value (Readers 1, 2 = 95.3%, 95.7%), and negative predictive value (Readers 1, 2 = 97.9%, 98.7%) for ELMSI. The interobserver agreement was excellent (κ = 0.92). The area under the curve for Reader 1 and Reader 2 was 0.961 (95% CI 0.93, 0.99) and 0.992 (95% CI 0.98, 1.00), respectively. CT numbers obtained from the VNCa images were significantly different between regions with and without ELMSI (p < .001). CONCLUSIONS VNCa images have good diagnostic performance for the qualitative and quantitative analysis of knee osteoarthritis-related ELMSI.
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Affiliation(s)
- Heng Zhao
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No. 36, Heping District, Shenyang, 110004, Liaoning, China
| | - Hui Li
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
- Department of Radiology, The First People's Hospital of Zhaoqing City, Zhaoqing, China
| | - Xia Xie
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Hai-Yan Tang
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Xiao-Xin Liu
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Yi Wen
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Xin Xiao
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Lu Ye
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - You-Wei Tang
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Gao-Yue Dai
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Jia-Ni He
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Li Chen
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - Qian Wang
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China
| | - De-Qiu Tang
- The First Affiliated Hospital, Department of Radiology, Hengyang Medical School, University of South China, Hengyang, 421001, Hunan, China.
| | - Shi-Nong Pan
- Department of Radiology, Shengjing Hospital of China Medical University, Sanhao Street No. 36, Heping District, Shenyang, 110004, Liaoning, China.
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Culvenor AG, Øiestad BE, Hart HF, Stefanik JJ, Guermazi A, Crossley KM. Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis. Br J Sports Med 2018; 53:1268-1278. [PMID: 29886437 PMCID: PMC6837253 DOI: 10.1136/bjsports-2018-099257] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 11/04/2022]
Abstract
Background Knee MRI is increasingly used to inform clinical management. Features associated with osteoarthritis are often present in asymptomatic uninjured knees; however, the estimated prevalence varies substantially between studies. We performed a systematic review with meta-analysis to provide summary estimates of the prevalence of MRI features of osteoarthritis in asymptomatic uninjured knees. Methods We searched six electronic databases for studies reporting MRI osteoarthritis feature prevalence (ie, cartilage defects, meniscal tears, bone marrow lesions and osteophytes) in asymptomatic uninjured knees. Summary estimates were calculated using random-effects meta-analysis (and stratified by mean age: <40 vs ≥40 years). Meta-regression explored heterogeneity. Results We included 63 studies (5397 knees of 4751 adults). The overall pooled prevalence of cartilage defects was 24% (95% CI 15% to 34%) and meniscal tears was 10% (7% to 13%), with significantly higher prevalence with age: cartilage defect <40 years 11% (6%to 17%) and ≥40 years 43% (29% to 57%); meniscal tear <40 years 4% (2% to 7%) and ≥40 years 19% (13% to 26%). The overall pooled estimate of bone marrow lesions and osteophytes was 18% (12% to 24%) and 25% (14% to 38%), respectively, with prevalence of osteophytes (but not bone marrow lesions) increasing with age. Significant associations were found between prevalence estimates and MRI sequences used, physical activity, radiographic osteoarthritis and risk of bias. Conclusions Summary estimates of MRI osteoarthritis feature prevalence among asymptomatic uninjured knees were 4%–14% in adults aged <40 years to 19%–43% in adults ≥40 years. These imaging findings should be interpreted in the context of clinical presentations and considered in clinical decision-making.
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Affiliation(s)
- Adam G Culvenor
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria.,La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | | | - Harvi F Hart
- La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Joshua J Stefanik
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Ali Guermazi
- Department of Radiology, Quantitative Imaging Centre, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kay M Crossley
- La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
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