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Diagnosis of Osteoarthritis by Cartilage Surface Smoothness Quantified Automatically from Knee MRI.

Tummala S, Bay-Jensen AC, Karsdal MA, Dam EB - Cartilage (2011)

Bottom Line: A total of 140 subjects concluded the 21-month study.The diagnostic smoothness markers performed at least similar to JSW and were superior to volume markers (e.g., the AUC for femoral smoothness of 0.80 was higher than the 0.57 for volume, P < 0.0001, and marginally higher than 0.73 for JSW, P = 0.25).Thereby, smoothness markers may allow detection and monitoring of OA-supplemented currently accepted markers.

View Article: PubMed Central - PubMed

Affiliation: eScience Center, Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.

ABSTRACT

Objective: We investigated whether surface smoothness of articular cartilage in the medial tibiofemoral compartment quantified from magnetic resonance imaging (MRI) could be appropriate as a diagnostic marker of osteoarthritis (OA).

Method: At baseline, 159 community-based subjects aged 21 to 81 with normal or OA-affected knees were recruited to provide a broad range of OA states. Smoothness was quantified using an automatic framework from low-field MRI in the tibial, femoral, and femoral subcompartments. Diagnostic ability of smoothness was evaluated by comparison with conventional OA markers, specifically cartilage volume from MRI, joint space width (JSW) from radiographs, and pain scores.

Results: A total of 140 subjects concluded the 21-month study. Cartilage smoothness provided diagnostic ability in all compartments (P < 0.0001). The diagnostic smoothness markers performed at least similar to JSW and were superior to volume markers (e.g., the AUC for femoral smoothness of 0.80 was higher than the 0.57 for volume, P < 0.0001, and marginally higher than 0.73 for JSW, P = 0.25). The smoothness markers allowed diagnostic detection of pain presence (P < 0.05) and showed some correlation with pain severity (e.g., r = -0.32). The longitudinal change in smoothness was correlated with cartilage loss (r up to 0.60, P < 0.0001 in all compartments).

Conclusions: This study demonstrated the potential of cartilage smoothness markers for diagnosis of moderate radiographic OA. Furthermore, correlations between smoothness and pain values and smoothness loss and cartilage loss supported a link to progression of OA. Thereby, smoothness markers may allow detection and monitoring of OA-supplemented currently accepted markers.

No MeSH data available.


Related in: MedlinePlus

In early osteoarthritis, loss of the interior cartilage structure and loss of cartilage surface integrity occur before cartilage loss, sclerosis of underlying bone, and joint space narrowing.
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fig1-1947603510381097: In early osteoarthritis, loss of the interior cartilage structure and loss of cartilage surface integrity occur before cartilage loss, sclerosis of underlying bone, and joint space narrowing.

Mentions: The current requirement for acceptance of a DMOAD is to demonstrate efficacy in terms of joint space width (JSW) measured from radiographs and joint function investigated by questionnaires (such as the WOMAC scale12). Selection criteria could typically be based on the Kellgren and Lawrence (KL) score13 and age (e.g., KL 2 or 3 and age 50-70 years). This poses potential disadvantages. First, as selection currently is based on radiographs, this implies that subtle difference in cartilage pathology may not be accounted for as cartilage is not visible on radiographs. Second, studies may be designed to follow patients at relatively later stages of OA, as inclusion criteria are done by radiograph analysis in which bone sclerosis and osteophytes are evaluated. Since the later stages of OA are quite likely irreversible,14 new treatments focused at the earlier stages may have a higher chance of preventing progression or even curing the disease.15 Novel biomarkers may aid in the identification and assessment of interventions in early OA. Some of the central processes during the early stages of OA are illustrated in Figure 1. Healthy cartilage has a smooth lubricated surface (i.e., the superficial layer; Fig. 1A). The superficial layer is lost in early OA, and the upper articular cartilage layer is exposed, which results in surface irregularities such as deamination, fibrillation, fissures, and erosions (Fig. 1B). These irregularities can be detected by arthroscopy but not by radiographs. As OA progresses to later stages, erosions become deep and sclerosis is observed (Fig. 1C). It is at this stage that OA can be detected by radiographs as joint space narrowing (JSN).15,16 It would be of high value to be able to measure the early surface irregularities and thereby identify and treat OA at a stage where there is still articular cartilage left.


Diagnosis of Osteoarthritis by Cartilage Surface Smoothness Quantified Automatically from Knee MRI.

Tummala S, Bay-Jensen AC, Karsdal MA, Dam EB - Cartilage (2011)

In early osteoarthritis, loss of the interior cartilage structure and loss of cartilage surface integrity occur before cartilage loss, sclerosis of underlying bone, and joint space narrowing.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4300790&req=5

fig1-1947603510381097: In early osteoarthritis, loss of the interior cartilage structure and loss of cartilage surface integrity occur before cartilage loss, sclerosis of underlying bone, and joint space narrowing.
Mentions: The current requirement for acceptance of a DMOAD is to demonstrate efficacy in terms of joint space width (JSW) measured from radiographs and joint function investigated by questionnaires (such as the WOMAC scale12). Selection criteria could typically be based on the Kellgren and Lawrence (KL) score13 and age (e.g., KL 2 or 3 and age 50-70 years). This poses potential disadvantages. First, as selection currently is based on radiographs, this implies that subtle difference in cartilage pathology may not be accounted for as cartilage is not visible on radiographs. Second, studies may be designed to follow patients at relatively later stages of OA, as inclusion criteria are done by radiograph analysis in which bone sclerosis and osteophytes are evaluated. Since the later stages of OA are quite likely irreversible,14 new treatments focused at the earlier stages may have a higher chance of preventing progression or even curing the disease.15 Novel biomarkers may aid in the identification and assessment of interventions in early OA. Some of the central processes during the early stages of OA are illustrated in Figure 1. Healthy cartilage has a smooth lubricated surface (i.e., the superficial layer; Fig. 1A). The superficial layer is lost in early OA, and the upper articular cartilage layer is exposed, which results in surface irregularities such as deamination, fibrillation, fissures, and erosions (Fig. 1B). These irregularities can be detected by arthroscopy but not by radiographs. As OA progresses to later stages, erosions become deep and sclerosis is observed (Fig. 1C). It is at this stage that OA can be detected by radiographs as joint space narrowing (JSN).15,16 It would be of high value to be able to measure the early surface irregularities and thereby identify and treat OA at a stage where there is still articular cartilage left.

Bottom Line: A total of 140 subjects concluded the 21-month study.The diagnostic smoothness markers performed at least similar to JSW and were superior to volume markers (e.g., the AUC for femoral smoothness of 0.80 was higher than the 0.57 for volume, P < 0.0001, and marginally higher than 0.73 for JSW, P = 0.25).Thereby, smoothness markers may allow detection and monitoring of OA-supplemented currently accepted markers.

View Article: PubMed Central - PubMed

Affiliation: eScience Center, Department of Computer Science, University of Copenhagen, Copenhagen, Denmark.

ABSTRACT

Objective: We investigated whether surface smoothness of articular cartilage in the medial tibiofemoral compartment quantified from magnetic resonance imaging (MRI) could be appropriate as a diagnostic marker of osteoarthritis (OA).

Method: At baseline, 159 community-based subjects aged 21 to 81 with normal or OA-affected knees were recruited to provide a broad range of OA states. Smoothness was quantified using an automatic framework from low-field MRI in the tibial, femoral, and femoral subcompartments. Diagnostic ability of smoothness was evaluated by comparison with conventional OA markers, specifically cartilage volume from MRI, joint space width (JSW) from radiographs, and pain scores.

Results: A total of 140 subjects concluded the 21-month study. Cartilage smoothness provided diagnostic ability in all compartments (P < 0.0001). The diagnostic smoothness markers performed at least similar to JSW and were superior to volume markers (e.g., the AUC for femoral smoothness of 0.80 was higher than the 0.57 for volume, P < 0.0001, and marginally higher than 0.73 for JSW, P = 0.25). The smoothness markers allowed diagnostic detection of pain presence (P < 0.05) and showed some correlation with pain severity (e.g., r = -0.32). The longitudinal change in smoothness was correlated with cartilage loss (r up to 0.60, P < 0.0001 in all compartments).

Conclusions: This study demonstrated the potential of cartilage smoothness markers for diagnosis of moderate radiographic OA. Furthermore, correlations between smoothness and pain values and smoothness loss and cartilage loss supported a link to progression of OA. Thereby, smoothness markers may allow detection and monitoring of OA-supplemented currently accepted markers.

No MeSH data available.


Related in: MedlinePlus