Assessment of Cartilage Abnormalities on MRI in Patients with Osteoarthritis of Knee (original) (raw)
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Comparison of cartilage thickness with radiologic grade of knee osteoarthritis
Skeletal Radiology, 2008
Objective-To compare joint space width (JSW) measurements obtained from magnetic resonance imaging (MRI) with a semi-automated computer algorithm to the Kellgren and Lawrence grading of osteoarthritis (OA). Materials and methods-Three hundred and six patients (234 female, 72 male) with a mean age of 56.7 years (range 31-81 years) underwent MRI of their knees with a fast oblique spiral spoiled gradient (SPGR) sequence. A board-certified musculoskeletal radiologist graded the OA of all the patients in accordance with the Kellgren and Lawrence OA scale. A previously validated computer algorithm was used to determine the minimum JSW for both the tibiofemoral joint and the patellofemoral joint. An analysis of variance (ANOVA) with the Student-Newman-Kuels post-hoc test was used to determine if there were differences in JSW as a function of OA grade. Results-The radiologic grade of OA was inversely associated with the JSW. In the medial compartment the JSW did not change significantly between grade 1 and grade 2, but there was a significant decrease in JSW between grade 0 (normal) and grade 1 and for each OA grade above grade 2. In the lateral compartment no statistical differences were found till grade 2, while grade 3 was found to be statistically different from the previous one. The number of patients with a grade 4 patellofemoral OA was too low for the statistical significance to be assessed. In the patellofemoral joint the JSW did not change significantly until grade 2, while a statistically significant reduction was found for both grade 3 and grade 4. Conclusion-This study showed that an inverse non-linear relationship exists between radiologic grade and JSW. The relationship differs for the tibiofemoral and the patellofemoral joint.
Journal of Magnetic Resonance Imaging, 2006
Purpose: To investigate the comparability of two osteoarthritis (OA) surrogate endpoints-average cartilage thickness and cartilage volume-acquired from healthy volunteers on two 3.0T magnetic resonance imaging (MRI) systems from different manufacturers. Materials and Methods: Ten knees of five healthy volunteers were scanned on a 3.0T General Electric (GE) and a 3.0T Philips scanner using a fast three-dimensional fatsuppressed spoiled gradient (SPGR) imaging sequence. The acquisition parameters were optimized beforehand and were kept as comparable as possible on both scanners. For quantitative analysis, the average cartilage thickness and volume of the load-bearing regions of the femoral condyles were compared. Data were analyzed using a univariate repeated-measures analysis of variance (ANOVA) to examine the effects of position, condyle, and imaging system on the measurements. Results: The average cartilage thickness and volume of the load-bearing regions of the femoral condyles did not differ between the two different 3.0T MRI systems (P Ͼ 0.05). There was no significant effect of position or condyle on the average cartilage thickness measurements (P Ͼ 0.05; range ϭ 0.41-0.93) or cartilage volume (P Ͼ 0.05; range ϭ 0.14-0.87). Conclusion: Two OA surrogate endpoints-average cartilage thickness and cartilage volume-acquired on two 3.0T MRI systems from different manufacturers are comparable.
Knee MRI Underestimates the Grade of Cartilage Lesions
Applied Sciences
Purpose: This study was conducted in order to evaluate the clinical utility of MRI in detecting cartilage lesions and its dependence on anatomical location and lesion grade. Methods: A retrospective analysis of MRI reports and arthroscopic findings was performed on 190 consecutive patients treated in one orthopaedic department. MRI protocols were prepared by 18 radiologists from 10 different MRI centers with the use of 1.5 T magnets. The image protocols were selected by reading radiologists. Four hundred and fifty-three chondral lesions in five anatomic locations were identified during this study and graded according to the ICRS classification. Sensitivity, specificity, receiver operating characteristic (ROC), and Bangdiwala’s observer agreement charts were utilized to evaluate the diagnostic performance. Results: Only approximately 30% of MRI showed an adequate cartilage status in all anatomical locations. The sensitivity ranged from 92% in healthy cartilage to 5% in grade I lesion...
Osteoarthritis and Cartilage, 2003
Objectives: Although accurate spatial measurement of cartilage thickness from MRI is possible, no studies have assessed the accuracy of measuring cartilage defect dimensions from MRI. In addition, current MR grading scales for assessing cartilage lesions have limited categories, and little is known about how well these scales correlate with histological assessment of the lesion. The objective of this preliminary study is to address both these issues. Methods: We performed two experiments on four cadaver knee joints from elderly donors: Experiment 1 assessed the accuracy of measuring controlled defects in cartilage, and Experiment 2 compared MRI grading (Noyes scale) of natural cartilage lesions to histological grading (Mankin scale) of the sectioned cartilage tissue. MRI was performed on 1.5 T clinical scanner (fat-suppressed 3D-SPGR at TR/TE/α=55/ 13.5/45 and 256×256 matrix). Results: The mean difference between defect diameters measured and introduced was less than 0.1 mm, which was statistically insignificant (Pϭ0.754). Defect depth was less accurate at >0.4 mm, significantly under predicting actual defect depth (Pϭ0.004). Correlation between Noyes grading scores and Mankin grading scores of natural lesions was moderately high (rϭ0.7) and statistically significant (Pϭ0.001). Conclusions: Three-dimensional mapping of cartilage thickness shows great promise for the accurate measurement of focal cartilage defects, though improvement is needed. The Noyes grading scale is consistent with histological Mankin grading of cartilage lesions, though enhancement of MR grading scales is needed, and warranted, based on the signal intensity information available from clinical MRI. Integration of these two analyses-focal defect measurement and signal intensity analysis-could potentially result in a valuable clinical tool for early osteoarthritis diagnosis and longitudinal tracking.
Association between quantitative MRI and ICRS arthroscopic grading of articular cartilage
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014
To investigate the association of quantitative magnetic resonance imaging (qMRI) parameters with arthroscopic grading of cartilage degeneration. Arthroscopy of the knee is considered to be the gold standard of osteoarthritis diagnostics; however, it is operator-dependent and limited to the evaluation of the articular surface. qMRI provides information on the quality of articular cartilage and its changes even at early stages of a disease. qMRI techniques included T 1 relaxation time, T 2 relaxation time, and delayed gadolinium-enhanced MRI of cartilage mapping at 3 T in ten patients. Due to a lack of generally accepted semiquantitative scoring systems for evaluating severity of cartilage degeneration during arthroscopy, the International Cartilage Repair Society (ICRS) classification system was used to grade the severity of cartilage lesions. qMRI parameters were statistically compared to arthroscopic grading conducted with the ICRS classification system. qMRI parameters were not li...
" Distribution Of Cartilage Thickness In Knee Joint Of Osteoarthritis Patients Using 3t Mri"
BACKGROUND: Osteoarthritis is a highly prevalent and severely debilitating chronic disease. Characteristic changes in the cartilage macromolecular matrix occur with osteoarthritis, including a decrease in proteoglycan content and disruption of the highly organized collagen fiber network. Various quantitative magnetic resonance (MR) imaging techniques have been used to identify changes in the composition and ultrastructure of articular cartilage in patients with osteoarthritis. AIM: To study the distribution of cartilage thickness in knee joint of osteoarthritis patients using 3T MRI and report the same. RESULTS: In our study the average cartilage articular thickness of medial femoral compartment was found to be 3.2mm, in lateral femoral compartment was 2.5mm, medial tibial compartment was 2.5mm, lateral tibial compartment was 2.1mm, medial patellar compartment was 2.1mm and lateral patellar compartment was about 2.3mm. Maximum cartilage articular thickness of medial femoral compartment was found to be 3.4mm, lateral femoral compartment was 3.8mm, medial tibial compartment was 3.8mm, lateral tibial compartment 5 , medial patellar compartment was 5.2mm and lateral patellar compartment was about 5.3mm..Minimum cartilage articular thickness of medial femoral compartment was found to be 1.8mm, lateral femoral compartment was 1.9mm, medial tibial compartment was 1.8mm, lateral tibial compartment 2mm , medial patellar compartment was 2.1mm and lateral patellar compartment was about 1.8 mm. CONCLUSION: Cartilage is important factor in any joint disease. Indications for MRI of the cartilage include both the detection of cartilage damage and monitor treatment such as cartilage repair procedures and pharmacological therapies. Early identification of cartilage damage, either post traumatic or degenerative, is indispensable for treatment at an early stage of osteoarthritis. Both quantitative and qualitative measurements of the cartilage are needed for the follow-up of disease progression and its response to treatment.
Radiology, 2014
To describe a scoring system for quantification of cartilage lesions (Cartilage Lesion Score [CaLS]), to determine its reproducibility, to examine the association of CaLSdetected longitudinal change with known risk factors for osteoarthritis (OA) progression by comparing a group of subjects with OA risk factors with a group of subjects without OA risk factors, and to compare the CaLS system with the established semiquantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in terms of detection of cartilage defect progression. Materials and Methods: All subjects provided written informed consent, and the local institutional review board approved this HIPAAcompliant study. Fifty-two subjects with and 25 subjects without risk factors for knee OA were randomly selected from the Osteoarthritis Initiative. Inclusion criteria were age of 45-60 years, body mass index of 19-27 kg/m 2 , and no knee pain or OA on radiographs at baseline. Baseline and 24-month follow-up right knee 3-T magnetic resonance images were analyzed with WORMS, BLOKS, and CaLS systems. Progression of cartilage lesions with each scoring system was compared by using multilevel mixedeffects linear-regression models. k values were calculated to determine reliability. Results: Intraclass coefficient values for inter-and intraobserver reliability of the CaLS system were 0.86 and 0.91, respectively. Interobserver k value range for individual features was 0.81-0.94. The CaLS system enabled significantly higher detection of cartilage lesion progression than did WORMS or BLOKS systems (P , .001); 51.8% (56 of 108), 17.6% (19 of 108), and 13.0% (14 of 108) of the lesions progressed when analyzed with the CaLS, WORMS, and BLOKS systems, respectively. With the CaLS system, subjects with OA risk factors had significantly higher odds of progression than did subjects without risk factors (odds ratio, 2.78; P = .005). Conclusion: The CaLS system is a reproducible scoring system for cartilage lesions that yields an improved detection rate for monitoring progression when compared with detection rates of semiquantitative WORMS and BLOKS systems.
CARTILAGE, 2016
Objective To design a simple magnetic resonance (MR)–based assessment system for quantification of osteochondral defect severity prior to cartilage repair surgery at the knee. Design The new scoring tool was supposed to include 3 different parameters: (1) cartilage defect size, (2) depth/morphology of the cartilage defect, and (3) subchondral bone quality, resulting in a specific 3-digit code. A clearly defined numeric score was developed, resulting in a final score of 0 to 100. Defect severity grades I through IV were defined. For intra- and interobserver agreement, defects were assessed by 2 independent readers on preoperative knee MR images of n = 44 subjects who subsequently received cartilage repair surgery. For statistical analyses, mean values ± standard deviation (SD), interclass correlation coefficients (ICC), and linear weighted kappa values were calculated. Results The mean total Area Measurement And DEpth & Underlying Structures (AMADEUS) score was 48 ± 24, (range, 0-85)...
Subchondral bone histology and grading in osteoarthritis
PLOS ONE, 2017
Objective Osteoarthritis (OA) has often regarded as a disease of articular cartilage only. New evidence has shifted the paradigm towards a system biology approach, where also the surrounding tissue, especially bone is studied more vigorously. However, the histological features of subchondral bone are only poorly characterized in current histological grading scales of OA. The aim of this study is to specifically characterize histological changes occurring in subchondral bone at different stages of OA and propose a simple grading system for them. Design 20 patients undergoing total knee replacement surgery were randomly selected for the study and series of osteochondral samples were harvested from the tibial plateaus for histological analysis. Cartilage degeneration was assessed using the standardized OARSI grading system, while a novel four-stage grading system was developed to illustrate the changes in subchondral bone. Subchondral bone histology was further quantitatively analyzed by measuring the thickness of uncalcified and calcified cartilage as well as subchondral bone plate. Furthermore, internal structure of calcified cartilage-bone interface was characterized utilizing local binary patterns (LBP) based method. Results The histological appearance of subchondral bone changed drastically in correlation with the OARSI grading of cartilage degeneration. As the cartilage layer thickness decreases the subchondral plate thickness and disorientation, as measured with LBP, increases. Calcified cartilage thickness was highest in samples with moderate OA. Conclusion The proposed grading system for subchondral bone has significant relationship with the corresponding OARSI grading for cartilage. Our results suggest that subchondral bone remodeling is a fundamental factor already in early stages of cartilage degeneration.