Direct Comparison of Fixed Flexion Radiography and MRI in Knee Osteoarthritis: Responsiveness Data from the Osteoarthritis Initiative.
Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria Osteoarthritis and Cartilage
(Impact Factor: 4.17).
11/2012; 21(1). DOI: 10.1016/j.joca.2012.10.017
Minimum radiographic joint space width (mJSW) represents the Food and Drug Administration (FDA) standard for demonstrating structural therapeutic benefits for knee osteoarthritis (KOA), but only shows moderate responsiveness (sensitivity to change). We directly compare the responsiveness of magnetic resonance imaging (MRI)-based cartilage thickness and JSW measures from fixed-flexion radiography (FFR) and explore the correlation of region-matched changes between both methods.
Nine hundred and sixty-seven knees of Osteoarthritis Initiative participants with radiographic KOA were studied: 445 over 1 year with coronal FLASH MRI and FFR, and 375/522 over 1/2 years with sagittal DESS MRI and FFR. Standardized response means (SRM) of cartilage thickness and mJSW were compared using the sign-test.
With FLASH MRI, SRM was -0.28 for medial femorotibial compartment (MFTC) cartilage loss vs -0.15 for mJSW, and -0.32 vs -0.22 for the most sensitive MRI subregion (central MFTC) vs the most sensitive fixed-location JSW(x = 0.25). With DESS MRI, 1-year SRM was -0.34 for MFTC vs -0.22 for mJSW and -0.44 vs -0.28 for central MFTC vs JSW(x = 0.225). Over 2 years, the SRM was significantly greater for MFTC than for mJSW (-0.43 vs -0.31, P = 0.017) and for central MFTC than for JSW(x = 0.225) (-0.51 vs -0.44, P < 0.001). Correlations between changes in spatially matched MRI subregions and fixed-location JSW were not consistently higher (r = 0.10-0.51) than those between non-matched locations (r = 0.15-0.50).
MRI displays greater responsiveness in KOA than JSW FFR-based JSW, with the greatest SRM observed in the central medial femorotibial compartment. Fixed-location radiographic measures appear not capable of determining the spatial distribution of femorotibial cartilage loss.
Available from: Davood Mehrabani
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ABSTRACT: Experimental osteoarthritis (OA) was induced in the knee joints of rabbits and the trend of changes were compared by radiography, Magnetic Resonance Imaging (MRI) and histopathology. Twenty rabbits were randomly divided into two equal groups based on short (30 days) and long-term (180 days) follow ups. I n half of the animals in each group (n = 5) OA was induced by sectioning the cranial cruciate ligament and in the other half, only astronomy was performed as a sham operation. Radiography and M RI were carried out on days 0 and 30 in the group of short term studies, and on days 0, 90 and 180 in the other group. Histopathologicale were performed on day 30 in the short--term group after the animals had been saw examinations creviced and in the other group on day 180. The slope of changes over the course of the study between all 3 methods and the grade of changes, were both high sting histopathology, and then in MRI and radiology respectively. The slope of changes was 0.01 for histopathology, 0.009 for MRI and 0.004 for radiology. The ratios of slopes, when compare to each other, were as follows: His.//MRI = 1. 1, His./Rad. = 2.5, MRI/Rad. = 2. 2. Comparison of M RI with radiology revealed that radiology would not show signs of OA when the M RI grade is les than a grade of 0.27. Comparing both imaging techniques with histopathology showed that whenever the histopathological grade was below 0.22, radiology would not show signs of OA involvement, while MRI was capable of showing signs of OA involvement whenever it was more than 0.018 on histopathological grade.
Veterinarski Arhiv 01/2013; 83(5):537-550. · 0.36 Impact Factor
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ABSTRACT: Radiographic joint space width (JSW) is considered the reference standard for demonstrating structural therapeutic benefits in knee osteoarthritis. Our objective was to determine the proportion by which 3D (regional) meniscus and cartilage measures explain between-knee differences of JSW in the fixed flexion radiographs.
Segmentation of the medial meniscus and tibial and femoral cartilage was performed in double echo steady state (DESS) images. Quantitative measures of meniscus size and position, femorotibial cartilage thickness, and radiographic JSW (minimum, and fixed locations) were compared between both knees of 60 participants of the Osteoarthritis Initiative, with strictly unilateral medial joint space narrowing (JSN). Statistical analyses (between-knee, within-person comparison) were performed using regression analysis.
A strong relationship with side-differences in minimum and a central fixed location JSW was observed for percent tibial plateau coverage by the meniscus (r=.59 and .47; p<.01) and central femoral cartilage thickness (r=.69 and .75; p<.01); other meniscus and cartilage measures displayed lower coefficients. The correlation of central femoral cartilage thickness with JSW (but not that of meniscus measures) was greater (r=.78 and .85; p<.01) when excluding knees with non-optimal alignment between the tibia and X-ray beam.
3D measures of meniscus and cartilage provide significant, independent information in explaining side-differences in radiographic JSW in fixed flexion radiographs. Tibial coverage by the meniscus and central femoral cartilage explained two thirds of the variability in minimum and fixed location JSW. JSW provides a better representation of (central) femorotibial cartilage thickness, when optimal positioning of the fixed flexion radiographs is achieved.
European journal of radiology 09/2013; 82(12). DOI:10.1016/j.ejrad.2013.08.041 · 2.37 Impact Factor
Available from: Karupppasamy Subburaj
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ABSTRACT: Determine the effect of loading upon MRI-based mean medial femorotibial cartilage thickness (mMFT_th) and radiograph-based minimum joint space width (mJSW), and determine loading's effect on the relationship between these measures.
MRI and radiographs were analyzed of 25 knees in weight-bearing and non-weight-bearing conditions. 8 subjects had a Kellgren-Lawrence (KL) grade of 0, indicating no evidence of radiographic OA. The rest were KL = 2 or KL = 3, indicating mild to moderate OA. The change from unloaded to loaded conditions was calculated.
Joint space measures decreased from unloaded to loaded conditions for both radiographs (mJSW = 3.29 mm unloaded to 3.16 mm loaded, p<0.05) and MRI (mMFT_th = 2.70 mm unloaded to 2.55 mm loaded p<0.001). The mean absolute difference measured from radiographs was larger for the OA group than the control group, at -0.20 mm for OA vs. +0.01 mm for control. Loaded X-ray and loaded MRI joint space values from our study were no better correlated to one another than loaded X-ray and unloaded MRI.
Knee loading does not add a very significant value to the study of joint space on healthy knees, but loading may play a role in the study of OA knees. Unloaded MRI assessments of cartilage thickness are as correlated to loaded JSW as to loaded MRI measurements. More study is necessary to determine whether loaded MRI adds significant value to the study of OA progression.
Osteoarthritis and Cartilage 09/2013; 21(12). DOI:10.1016/j.joca.2013.09.006 · 4.17 Impact Factor
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