Limits...
Development of a rapid knee cartilage damage quantification method using magnetic resonance images.

Zhang M, Driban JB, Price LL, Harper D, Lo GH, Miller E, Ward RJ, McAlindon TE - BMC Musculoskelet Disord (2014)

Bottom Line: We tested the intra- and inter-tester reliability of the CDI and compared the CDI scores against different measures of severity (radiographic joint space narrowing [JSN] grade, KL score, joint space width [JSW]) and static knee alignment, both cross-sectionally and longitudinally.Baseline JSN grade and knee alignment also predicted subsequent 24-month longitudinal change in the CDI (p trends <0.05).During 24 months, knees with worsening in JSN or KL grade (i.e. progressors) had greater change in CDI score.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA 02111, USA. tmcalindon@tuftsmedicalcenter.org.

ABSTRACT

Background: Cartilage morphometry based on magnetic resonance images (MRIs) is an emerging outcome measure for clinical trials among patients with knee osteoarthritis (KOA). However, current methods for cartilage morphometry take many hours per knee and require extensive training on the use of the associated software. In this study we tested the feasibility, reliability, and construct validity of a novel osteoarthritis cartilage damage quantification method (Cartilage Damage Index [CDI]) that utilizes informative locations on knee MRIs.

Methods: We selected 102 knee MRIs from the Osteoarthritis Initiative that represented a range of KOA structural severity (Kellgren Lawrence [KL] Grade 0 - 4). We tested the intra- and inter-tester reliability of the CDI and compared the CDI scores against different measures of severity (radiographic joint space narrowing [JSN] grade, KL score, joint space width [JSW]) and static knee alignment, both cross-sectionally and longitudinally.

Results: Determination of the CDI took on average14.4 minutes (s.d. 2.1) per knee pair (baseline and follow-up of one knee). Repeatability was good (intra- and inter-tester reliability: intraclass correlation coefficient >0.86). The mean CDI scores related to all four measures of osteoarthritis severity (JSN grade, KL score, JSW, and knee alignment; all p values < 0.05). Baseline JSN grade and knee alignment also predicted subsequent 24-month longitudinal change in the CDI (p trends <0.05). During 24 months, knees with worsening in JSN or KL grade (i.e. progressors) had greater change in CDI score.

Conclusions: The CDI is a novel knee cartilage quantification method that is rapid, reliable, and has construct validity for assessment of medial tibiofemoral osteoarthritis structural severity and its progression. It has the potential to addresses the barriers inherent to studies requiring assessment of cartilage damage on large numbers of knees, and as a biomarker for knee osteoarthritis progression.

Show MeSH

Related in: MedlinePlus

3D medial cartilage images with 9 informative locations on femur and 9 informative locations on tibia (the 3D images were rotated for better viewing informative locations).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4126278&req=5

Figure 1: 3D medial cartilage images with 9 informative locations on femur and 9 informative locations on tibia (the 3D images were rotated for better viewing informative locations).

Mentions: We developed a rapid knee cartilage damage quantification method using knee MR images from three datasets (263 knees). Underlying this methodology is a 2-dimensional, rectangular, universal coordinate systems to represent the articular surface of the distal femur and proximal tibia. Using previously manually segmented knees [20], we projected the denuded cartilage area on our coordinate system to identify the areas in the joint surface that are most frequently denuded of cartilage. Based on the results of that analysis, we then selected nine locations within the region of the most commonly denuded areas on the medial femur and tibia (FigureĀ 1). A full description of the developmental methodology and related data is provided in the Additional file 1.


Development of a rapid knee cartilage damage quantification method using magnetic resonance images.

Zhang M, Driban JB, Price LL, Harper D, Lo GH, Miller E, Ward RJ, McAlindon TE - BMC Musculoskelet Disord (2014)

3D medial cartilage images with 9 informative locations on femur and 9 informative locations on tibia (the 3D images were rotated for better viewing informative locations).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4126278&req=5

Figure 1: 3D medial cartilage images with 9 informative locations on femur and 9 informative locations on tibia (the 3D images were rotated for better viewing informative locations).
Mentions: We developed a rapid knee cartilage damage quantification method using knee MR images from three datasets (263 knees). Underlying this methodology is a 2-dimensional, rectangular, universal coordinate systems to represent the articular surface of the distal femur and proximal tibia. Using previously manually segmented knees [20], we projected the denuded cartilage area on our coordinate system to identify the areas in the joint surface that are most frequently denuded of cartilage. Based on the results of that analysis, we then selected nine locations within the region of the most commonly denuded areas on the medial femur and tibia (FigureĀ 1). A full description of the developmental methodology and related data is provided in the Additional file 1.

Bottom Line: We tested the intra- and inter-tester reliability of the CDI and compared the CDI scores against different measures of severity (radiographic joint space narrowing [JSN] grade, KL score, joint space width [JSW]) and static knee alignment, both cross-sectionally and longitudinally.Baseline JSN grade and knee alignment also predicted subsequent 24-month longitudinal change in the CDI (p trends <0.05).During 24 months, knees with worsening in JSN or KL grade (i.e. progressors) had greater change in CDI score.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Rheumatology, Tufts Medical Center, 800 Washington Street, Box #406, Boston, MA 02111, USA. tmcalindon@tuftsmedicalcenter.org.

ABSTRACT

Background: Cartilage morphometry based on magnetic resonance images (MRIs) is an emerging outcome measure for clinical trials among patients with knee osteoarthritis (KOA). However, current methods for cartilage morphometry take many hours per knee and require extensive training on the use of the associated software. In this study we tested the feasibility, reliability, and construct validity of a novel osteoarthritis cartilage damage quantification method (Cartilage Damage Index [CDI]) that utilizes informative locations on knee MRIs.

Methods: We selected 102 knee MRIs from the Osteoarthritis Initiative that represented a range of KOA structural severity (Kellgren Lawrence [KL] Grade 0 - 4). We tested the intra- and inter-tester reliability of the CDI and compared the CDI scores against different measures of severity (radiographic joint space narrowing [JSN] grade, KL score, joint space width [JSW]) and static knee alignment, both cross-sectionally and longitudinally.

Results: Determination of the CDI took on average14.4 minutes (s.d. 2.1) per knee pair (baseline and follow-up of one knee). Repeatability was good (intra- and inter-tester reliability: intraclass correlation coefficient >0.86). The mean CDI scores related to all four measures of osteoarthritis severity (JSN grade, KL score, JSW, and knee alignment; all p values < 0.05). Baseline JSN grade and knee alignment also predicted subsequent 24-month longitudinal change in the CDI (p trends <0.05). During 24 months, knees with worsening in JSN or KL grade (i.e. progressors) had greater change in CDI score.

Conclusions: The CDI is a novel knee cartilage quantification method that is rapid, reliable, and has construct validity for assessment of medial tibiofemoral osteoarthritis structural severity and its progression. It has the potential to addresses the barriers inherent to studies requiring assessment of cartilage damage on large numbers of knees, and as a biomarker for knee osteoarthritis progression.

Show MeSH
Related in: MedlinePlus