Sahar Sawani, Liubov Arbeeva, Katherine A Yates, Carolina Alvarez, Todd A Schwartz, Serena Savage-Guin, Jordan B Renner, Catherine J Bakewell, Minna J Kohler, Janice Lin, Jonathan Samuels, Amanda E Nelson
{"title":"Patterns of Shared Variation in Knee Ultrasound for Osteoarthritis: A Machine Learning Approach.","authors":"Sahar Sawani, Liubov Arbeeva, Katherine A Yates, Carolina Alvarez, Todd A Schwartz, Serena Savage-Guin, Jordan B Renner, Catherine J Bakewell, Minna J Kohler, Janice Lin, Jonathan Samuels, Amanda E Nelson","doi":"10.1016/j.ostima.2025.100373","DOIUrl":"10.1016/j.ostima.2025.100373","url":null,"abstract":"<p><strong>Objective: </strong>To identify phenotypes of knee osteoarthritis (KOA) based on demographic and clinical variables, symptoms, and ultrasound (US) features using a novel machine learning approach.</p><p><strong>Design: </strong>Johnston County Health Study participants provided demographics, symptomatic and functional assessments, and joint radiographs, which were transformed into the clinical data block. Standardized knee US were obtained, and US features composed the second data block. The Angle-based Joint and Individual Variation Explained (AJIVE) algorithm was used to identify shared and individual modes of variation. We focused on shared structure to explore how US features and non-US clinical data vary together overall, and in the subset with radiographic KOA (rKOA).</p><p><strong>Results: </strong>This analysis included 861 participants (mean age 55 years, mean BMI 33 kg/m<sup>2</sup>); 335 (39%) had rKOA. AJIVE identified two components of shared variation (SC1 and SC2). SC1 associated osteophytes and cartilage damage on US with higher BMI, older age, and worse symptoms and outcome scores. SC2 correlated the presence of effusion and synovitis but less cartilage damage on US with better physical function and lower BMI. A similar pattern was seen in those with rKOA.</p><p><strong>Conclusions: </strong>We identified two shared directions of variation which may represent distinct phenotypes of KOA. The first fits with prior KOA studies linking presence of osteophytes and cartilage damage to worse symptoms and function. The second may represent an inflammatory subtype of KOA, with greater effusion and synovitis but less osteophytosis and cartilage damage. These clinically feasible phenotypes should be confirmed in future studies.</p>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The 18th international workshop on osteoarthritis imaging. Structure and pain: Where are we today?","authors":"Hamid Harandi , Soheil Mohammadi , Ali Guermazi","doi":"10.1016/j.ostima.2025.100356","DOIUrl":"10.1016/j.ostima.2025.100356","url":null,"abstract":"<div><h3>Objective</h3><div>This paper provides a comprehensive overview of the key themes, new findings, and research directions highlighted during the keynote presentations and panel discussions at the IWOAI 2024.</div></div><div><h3>Design</h3><div>Comprehensive literature review of keynote lectures and submitted scientific abstracts presented during the 18th IWOAI held in Marrakesh, Morocco.</div></div><div><h3>Results</h3><div>The 18th International Workshop on Osteoarthritis Imaging (IWOAI) was held from June 25 to June 28, 2024, in Marrakesh, Morocco. The main theme of the workshop was Structure and Pain: Where Are We Today? Ten sessions covering various aspects of new concepts and strategies related to structure and pain in the imaging of osteoarthritis (OA) were held. These sessions included nine keynote presentations and oral presentations of abstracts, addressing different topics such as structural factors in OA, pain management challenges in OA-related trials, and imaging outcomes as endpoints in these trials. The final session was a round table featuring participants from diverse scientific and clinical fields who discussed their perspectives on the utility of imaging in OA.</div></div><div><h3>Conclusion</h3><div>The meeting successfully informed the radiology community about current advances, research, and future directions in osteoarthritis-related structure and pain through keynote speeches and oral presentations.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 3","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Quantitative meniscus imaging and analysis: A narrative review","authors":"Kalpana Sharma","doi":"10.1016/j.ostima.2025.100358","DOIUrl":"10.1016/j.ostima.2025.100358","url":null,"abstract":"<div><h3>Objective</h3><div>In this review, we summarize the literature on the evolution of magnetic resonance imaging (MRI), segmentation, and quantitative analysis (qMRI) of the meniscus, while bearing in mind the pivotal role of the meniscus in the development (incidence) and progression of symptomatic and structural knee osteoarthritis (KOA).</div></div><div><h3>Design</h3><div>We performed a literature search across PubMed and Google Scholar, spanning 35 years (1989–2024). We utilized keywords such as “meniscus”, “fibrocartilage”, “imaging”, “magnetic resonance”, “radiography”, “morphometry”, “quantitative analysis”, “knee”, “osteoarthritis”, “symptoms”, “pain”, “structure”, “progression”, “radiographic”, and “reproducibility”</div></div><div><h3>Results</h3><div>Technological advances in image acquisition, segmentation, and derivation of quantitative analytic endpoints pertinent to meniscus morphometry (e.g., height, width, and volume) and position (e.g., tibial coverage, extrusion area, and distance) within the joint are highlighted in the literature. Three-dimensional qMRI of the meniscus has emerged as a reliable and reproducible non-invasive measurement technology, offering enhanced efficacy for assessing the relationship of the meniscus with radiographic joint space width (JSW), knee pain, structural (radiographic) KOA status, and with symptomatic and structural progression of KOA. Quantitative measures of meniscal extrusion were found to be robust predictors of various imaging endpoints, including osteophyte formation, subchondral bone changes, cartilage loss, as well as significant clinical outcomes.</div></div><div><h3>Conclusions</h3><div>The emergence of quantitative meniscus measurement technology has revamped the field of meniscal imaging research, providing accurate 3D analysis of both morphometric and positional measures. The systematic application of this methodology has unveiled significant insights into a better understanding of the incidence and symptomatic and structural progression of KOA.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 3","pages":"Article 100358"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145100072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Faysal Altahawi , Richard Lartey , Nancy Obuchowski , Xiaojuan Li , Carl S. Winalski
{"title":"Capturing deep partial-thickness cartilage loss with semiquantitative scoring: A supplemented MRI Osteoarthritis Knee Score (sMOAKS)","authors":"Faysal Altahawi , Richard Lartey , Nancy Obuchowski , Xiaojuan Li , Carl S. Winalski","doi":"10.1016/j.ostima.2025.100272","DOIUrl":"10.1016/j.ostima.2025.100272","url":null,"abstract":"<div><h3>Objective</h3><div>We propose a supplement to MOAKS (MRI Osteoarthritis Knee Score) for capturing >50 % partial thickness cartilage loss on knee MRI and measure reader agreement.</div></div><div><h3>Design</h3><div>MOAKS scores 2 severity levels of cartilage damage (any loss, full-thickness loss) within knee subregions with lesional area graded 0–3. We propose supplemented MOAKS (sMOAKS) by adding a similarly graded third level assessment for deep cartilage loss (DCL), >50 % thickness, in addition to traditional MOAKS for improved granularity of partial thickness cartilage loss. Using sMOAKS, two radiologists independently graded cartilage subscores for 40 knees and rescored 20 knees. Consolidated inter-reader and intra-reader agreement was calculated with kappa values for the DCL level supplement. To measure agreement for one example of a more granular combined sMOAKS outcome, coverage probability reader agreement was calculated for a scaled cartilage damage score (CDS), a summed normalized score (0–100) with equal weighting to articular surfaces combining subregion scores.</div></div><div><h3>Results</h3><div>DCL represented 27.8 % (63/227) of partial but not full-thickness cartilage loss subregion interpretations. Pooled subregion DCL involving >10 % surface area demonstrated 97.7 % (<em>ĸ</em> = 0.71) inter-reader agreement and 98.8 % (<em>ĸ</em> = 0.78) intra-reader agreement. For greatest subregion DCL size, weighted ĸ agreement was 0.73/0.82 (inter-reader/intra-reader) for articular surfaces and 0.75/0.83 for joint compartments. At 90 % CDS intra-reader agreement coverage, inter-reader CDS agreement values were 83 %, 82 %, and 78 % for surfaces, compartments, and whole joints, respectively.</div></div><div><h3>Conclusions</h3><div>There is substantial agreement for deep cartilage loss detection using sMOAKS across varied analysis methods. Further assessment will determine when the added granularity of sMOAKS is beneficial.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 3","pages":"Article 100272"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sheikh Muhammad Usman Shami , Nobuhiko Hata , Yan Epelboym
{"title":"Genicular artery embolization and nerve ablation: Interventional radiology solutions for osteoarthritis related knee pain","authors":"Sheikh Muhammad Usman Shami , Nobuhiko Hata , Yan Epelboym","doi":"10.1016/j.ostima.2025.100271","DOIUrl":"10.1016/j.ostima.2025.100271","url":null,"abstract":"<div><h3>Objective</h3><div>Osteoarthritis (OA) is a major cause of chronic knee pain, with treatment options ranging from conservative therapies to total knee replacement. Minimally invasive, image-guided interventions such as genicular artery embolization (GAE) and genicular nerve ablation (GNA) have emerged as alternatives for patients with refractory OA-related pain. This review explores these techniques and the role of interventional radiologists in multidisciplinary OA management.</div></div><div><h3>Design</h3><div>This narrative review synthesizes current evidence on the safety, efficacy, and technical aspects of GAE and GNA. GAE selectively embolizes genicular arteries supplying the knee joint and synovium, reducing synovitis by targeting abnormal neovascularity and hyperemia. The procedure is performed under fluoroscopic guidance and clinical studies have reported significant improvements in pain. GNA can be performed with ultrasound or fluoroscopic guidance. This technique utilizes radiofrequency ablation (RFA) to denervate sensory nerves thereby alleviating knee pain. Conventional, pulsed, and cooled RFA techniques are available and have demonstrated neuro-ablative effects.</div></div><div><h3>Results</h3><div>GAE and GNA have demonstrated high technical and clinical success, with significant reductions in Visual Analog Scale (VAS) pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and other patient reported outcome measures. Pain relief usually lasts from 6 to 12 months, with GAE benefits reported up to 24 months. Both procedures exhibit favorable safety profiles, with mostly mild, self-limiting adverse events.</div></div><div><h3>Conclusion</h3><div>GAE and GNA are effective minimally invasive options for patients who are not candidates for or unwilling to undergo knee replacement. Further randomized placebo-controlled trials are needed to confirm long-term efficacy for these interventions.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 2","pages":"Article 100271"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Imaging of cartilage, meniscus, and beyond: Role of Magnetic Resonance Imaging (MRI) and Computed Tomography (CT)","authors":"Patrick Omoumi","doi":"10.1016/j.ostima.2025.100268","DOIUrl":"10.1016/j.ostima.2025.100268","url":null,"abstract":"<div><div>Magnetic Resonance Imaging (MRI) remains the reference standard for imaging cartilage and meniscus, offering superior soft tissue contrast essential for comprehensive joint assessment in osteoarthritis (OA). However, recent technological advancements in Computed Tomography (CT)—spectral imaging, and weight-bearing scanners—have sparked renewed interest in utilizing CT, and CT arthrography in the evaluation of OA. This narrative mini-review explores the strengths and limitations of both MRI and CT in imaging cartilage and meniscus, and presents some trends in the research setting.</div><div>MRI remains the modality of choice for joint imaging, offering excellent soft tissue contrast and comprehensive articular assessment. CT is the reference for the assessment of mineralized tissue imaging, and in association with arthrography (CT arthrography, CTA), provides high performance in the diagnosis of surface lesions.</div><div>In the research setting, efforts have focused on the acceleration of MRI acquisitions, with deep learning reconstructions disrupting the traditional trade-off between acquisition speed and image quality. Efforts are undertaken to standardize compositional MRI techniques, which probe early-stage biochemical tissular changes. Emerging techniques such as synthetic imaging may offer the ability to provide information on bone and soft tissues in a single acquisition. Weight-bearing acquisitions have allowed the assessment of joint structures, in particular menisci, in a loaded position. Photon-counting CT promises higher resolution, improved material separation without increasing radiation exposure. Finally, post-processing tools are being developed to leverage large quantities of data and integrate both modalities in a complementary framework that could provide a robust toolset for the assessment of OA.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 2","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Imaging of osteoarthritis-related bone marrow lesions in clinical trials","authors":"Kamyar Moradi , Olga Kubassova , John A. Carrino","doi":"10.1016/j.ostima.2025.100270","DOIUrl":"10.1016/j.ostima.2025.100270","url":null,"abstract":"<div><h3>Objective</h3><div>This narrative review aims to summarize current evidence regarding the imaging detection of bone marrow lesions (BMLs), their prognostic value for osteoarthritis (OA) progression and pain, as well as potential therapeutic interventions targeting BMLs in OA clinical trials.</div></div><div><h3>Design</h3><div>We performed a literature search in PubMed and Google Scholar for articles focusing on OA-related BMLs. Studies were included if they examined detection, pathophysiology, clinical significance, or treatments of knee BMLs. Non-OA etiologies (e.g., malignancy, rheumatologic diseases) were excluded.</div></div><div><h3>Results</h3><div>BMLs, present in approximately two-thirds of patients with knee OA, are considered key indicators of subchondral bone damage or microfracture. MRI is highly sensitive for detecting BMLs, using validated semi-quantitative and quantitative measurement methods. The lack of disease-modifying OA drugs has shifted interest toward targeting BMLs for potential therapeutic interventions. Clinical studies have shown that changes in BML volume can predict the subsequent incidence of OA in joints without established disease, and that their presence is associated with pain progression and structural deterioration when OA is already established. Potential treatments for OA-related BMLs include pharmacological agents that modify subchondral bone turnover, anti-inflammatory interventions, biomechanical stress reduction techniques, cellular therapies, dietary modifications, and surgical approaches.</div></div><div><h3>Conclusions</h3><div>A holistic and personalized approach is essential for advancing OA management and improving patient outcomes by effectively targeting BMLs. Incorporating patient-reported outcomes and quality-of-life measures, as well as considering combined treatment strategies, will strengthen future trials aimed at modifying BMLs.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 2","pages":"Article 100270"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Valtteri Peitso , Shuvashis Das Gupta , Ali Mobasheri
{"title":"Microstructural imaging of the cartilaginous endplate in the intervertebral disc","authors":"Valtteri Peitso , Shuvashis Das Gupta , Ali Mobasheri","doi":"10.1016/j.ostima.2025.100269","DOIUrl":"10.1016/j.ostima.2025.100269","url":null,"abstract":"<div><h3>(1) Objective</h3><div>Intervertebral disc (IVD) degeneration is a major risk factor for the development of chronic low back pain (LBP), affecting millions globally, particularly as they age. IVD degeneration can promote inflammation, and reduce spinal stability leading to compression of nerve roots. Research has primarily focused on the annulus fibrosus (AF) or nucleus pulposus (NP), with an unmet need to explore the physiology of the cartilaginous endplate (CEP) and its microstructural assessment in IVD degeneration. Imaging the microstructure of the CEP, a relatively thin layer between the IVD and vertebral body, is challenging. This mini-review discusses advanced imaging methods to capture the microstructure of the CEP.</div></div><div><h3>(2) Design</h3><div>This narrative mini-review explores current methods for <em>in vitro</em> and <em>ex vivo</em> microstructural imaging of the CEP using advanced techniques such as three-dimensional (3D) micro-computed tomography (µCT) and two-dimensional (2D) light microscopy.</div></div><div><h3>(3) Results</h3><div>Advanced imaging techniques can provide detailed visualization of IVD microarchitecture, structural integrity, and degeneration, including CEP structure. Optical light microscopy techniques provide detailed 2D images of the CEP from stained or unstained IVD sections. Imaging the IVD in a 3D modality, such as contrast-enhanced µCT, enables a better understanding of the CEP’s microstructural changes in IVD degeneration.</div></div><div><h3>(4) Conclusions</h3><div>High-resolution 3D imaging of the CEP could be useful for visualizing and quantifying the response of degenerated tissue to experimental therapeutics <em>ex vivo</em>. Moreover, analyzing CEP-driven microstructural degeneration is crucial for developing preclinical anatomical models that spine surgeons can use to test and evaluate medical and therapeutic candidates.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 2","pages":"Article 100269"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jonathan R. Hill , Edwin H.G. Oei , Kay M. Crossley , Hylton B. Menz , Erin M. Macri , Michelle D. Smith , Narelle Wyndow , Liam R. Maclachlan , Megan H. Ross , Natalie J. Collins
{"title":"Methods of measuring radiographic patellofemoral joint alignment and morphology: A scoping review","authors":"Jonathan R. Hill , Edwin H.G. Oei , Kay M. Crossley , Hylton B. Menz , Erin M. Macri , Michelle D. Smith , Narelle Wyndow , Liam R. Maclachlan , Megan H. Ross , Natalie J. Collins","doi":"10.1016/j.ostima.2025.100262","DOIUrl":"10.1016/j.ostima.2025.100262","url":null,"abstract":"<div><h3>Objective</h3><div>Conduct a scoping review to identify radiographic measures of patellofemoral joint (PFJ) alignment and bony morphology reported in literature published during a representative period (2014–2018), and describe their reported measurement properties.</div></div><div><h3>Design</h3><div>Eight electronic databases were searched using keywords relating to “patellofemoral” and “radiograph”. Identified records were screened for eligibility by two independent assessors. English-language studies published in the years 2014–2018 were included if they reported: (i) acquiring PFJ radiographs; (ii) method of radiograph acquisition; and (iii) descriptions of radiographic PFJ alignment and bony morphology measures. Non-human and cadaveric studies, single-case studies, and studies with mean participant age <10 years were excluded. For studies that reported measurement properties (reliability, validity, responsiveness), quality appraisal was performed by two independent assessors using the COSMIN Risk of Bias tool. Descriptive data were reported.</div></div><div><h3>Results</h3><div>Of 18,678 records identified, 336 articles met our criteria . Ninety-one unique radiographic alignment and morphology measures were described. Most prevalent were measures of patellar height (222, 66.1 %), patellar alignment (142, 42.3 %), and patellar inclination (121, 36 %). Reliability data were reported by 83 (24.7 %) of the studies.</div></div><div><h3>Conclusions</h3><div>During the selected period, 91 different radiographic measures of PFJ alignment and morphology were reported, with multiple methods used to obtain similar measures, and limited data on reliability and validity. These findings make it difficult to recommend specific measures for clinical and research use. Further studies are needed to determine the measurement properties of radiographic PFJ alignment and morphology measures, and to establish consensus-based recommendations for priority measures and acquisition methods for specific PFJ conditions.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 2","pages":"Article 100262"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}