Osteoarthritis imaging最新文献

{"title":"Classification approaches used to grade radiographic patellofemoral osteoarthritis: A scoping review","authors":"Jonathan R. Hill ,&nbsp;Edwin H.G. Oei ,&nbsp;Kay M. Crossley ,&nbsp;Hylton B. Menz ,&nbsp;Erin M. Macri ,&nbsp;Michelle D. Smith ,&nbsp;Narelle Wyndow ,&nbsp;Liam R. Maclachlan ,&nbsp;Megan H. Ross ,&nbsp;Natalie J. Collins","doi":"10.1016/j.ostima.2024.100258","DOIUrl":"10.1016/j.ostima.2024.100258","url":null,"abstract":"<div><h3>Objective</h3><div>Conduct a scoping review to describe the use and application of different radiographic classification approaches to grade patellofemoral osteoarthritis (PFOA) in literature published during a representative period (2014–2018), and describe reported measurement properties of these grading criteria.</div></div><div><h3>Design</h3><div>The scoping review was conducted in accordance with PRISMA-ScR guidelines. Eight electronic databases were searched using keywords relating to “patellofemoral” and “radiograph”. Two independent assessors screened each record for eligibility. English-language studies published in the years 2014 to 2018 were included if they acquired patellofemoral joint (PFJ) radiographs, described the method of radiograph acquisition, and reported grading PFOA. We excluded non-human and cadaveric studies, single-case studies, and studies with mean participant age &lt;10 years. Studies that reported measurement properties underwent quality appraisal using the COSMIN Risk of Bias Tool. Descriptive statistics were reported.</div></div><div><h3>Results</h3><div>Of 18,678 records identified, 177 articles were selected. Twenty-six classification approaches to grade radiographic PFOA were reported, with Kellgren-Lawrence (KL) (<em>n</em> = 70, 40 %), OsteoArthritis Research Society International (OARSI) (<em>n</em> = 26, 15 %), and Iwano (<em>n</em> = 25, 14 %) most prevalent. Axial projections (<em>n</em> = 81, 46 %) were most commonly used to grade PFOA, followed by lateral (<em>n</em> = 31, 18 %) and frontal (<em>n</em> = 16, 9 %) projections. KL was most frequently used across settings, disciplines, and regions. Reliability data was reported by 32 (18 %) studies.</div></div><div><h3>Conclusions</h3><div>Multiple radiographic OA classification approaches were used to grade PFOA during the representative period, although few are specific to the PFJ. We recommend that a reliable and valid PFOA radiographic grading approach be developed using standardized PFJ radiograph acquisition techniques.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684671","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":"Wireless vs. traditional ultrasound assessed knee cartilage outcomes utilizing automated gain and normalization techniques","authors":"Arjun Parmar ,&nbsp;Corey D Grozier ,&nbsp;Robert Dima ,&nbsp;Jessica E Tolzman ,&nbsp;Ilker Hacihaliloglu ,&nbsp;Kenneth L Cameron ,&nbsp;Ryan Fajardo ,&nbsp;Matthew S Harkey","doi":"10.1016/j.ostima.2024.100260","DOIUrl":"10.1016/j.ostima.2024.100260","url":null,"abstract":"<div><div>Advancements in wireless ultrasound technology allow for point of care cartilage imaging, yet validation against traditional ultrasound units remains to be established for knee cartilage outcomes. Therefore, the purpose of our study was to establish the replicability, reliability and agreement, of articular cartilage thickness and echo-intensity measures between traditional and wireless ultrasound units utilizing automatic-gain and normalization techniques. We used traditional and wireless ultrasound to assess the femoral cartilage via transverse suprapatellar scans with the knee in maximum flexion in 71 female NCAA Division I athletes (age: 20.0 ± 1.3 years, height: 171.7 ± 8.7 cm, mass: 69.4 ± 11.0 kg). Wireless ultrasound images (auto-gain and standard gain) were compared to traditional ultrasound images (standard gain) before and after normalization. Ultrasound image pixel values were algebraically scaled to normalize differences between units in image acquisition. Mean thickness and echo-intensity of the global and sub-regions of interest were measured across imaging parameters. Intraclass correlation coefficients (ICC_2,<em>_k</em>) for reliability, standard error of the measurement, minimum detectable difference, and Bland-Altman plots for agreement were calculated between ultrasound units across imaging parameters. Cartilage thickness demonstrated good to excellent reliability (ICC_2,<em>_k</em> = 0.83–0.95) and minimal bias (-0.06–0.03 mm), in all regions regardless of gain and normalization. However, mean echo-intensity demonstrated poor to moderate reliability (ICC_2,<em>_k</em> = 0.23–0.68) and moderate bias (-9.8–6.5 au) in all regions, regardless of gain and normalization. While there was a high level of replicability between units when assessing cartilage thickness, further research in ultrasound beam forming may lead to improvements in replicability of cartilage echo-intensity between ultrasound units.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684675","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":"Perspective: Empowering osteoarthritis drug development through assessment of synovitis by CE-MRI: A new approach in clinical trials","authors":"Francis Berenbaum","doi":"10.1016/j.ostima.2024.100259","DOIUrl":"10.1016/j.ostima.2024.100259","url":null,"abstract":"<div><div>Knee osteoarthritis (OA) is a global health challenge with substantial unmet therapeutic needs. Current treatments primarily target symptoms without altering the disease's progression. Synovitis, the inflammation of synovial tissue, is a key driver of both pain and structural changes in OA. This Perspective proposes a paradigm shift, positioning synovial health assessment as a cornerstone in the evaluation of new OA therapies. By doing so, it aims to accelerate development of effective disease modifying OA drugs (DMOADs) and improving patient outcomes. It highlights the potential of contrast enhanced-MRI (CE-MRI) to serve as a surrogate marker for synovial health, offering precise visualization of inflammation and its relationship with disease progression and pain.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684676","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":"Editorial for the Special -Issue on Biomechanics and Imaging","authors":"Patrick Omoumi,&nbsp;Julien Favre","doi":"10.1016/j.ostima.2024.100254","DOIUrl":"10.1016/j.ostima.2024.100254","url":null,"abstract":"","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684677","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":"Which endpoints should be applied in interventional trials? – From single uni-dimensional assessment tailored to a drug's mechanism of action to multi-component measures and multi-domain composites","authors":"Felix Eckstein ,&nbsp;Tanja Stamm ,&nbsp;Jamie Collins","doi":"10.1016/j.ostima.2024.100256","DOIUrl":"10.1016/j.ostima.2024.100256","url":null,"abstract":"<div><h3>Objective</h3><div>A vast array of structural/imaging and clinical endpoints/outcomes are available today to osteoarthritis epidemiologists or trialists. Which assessments are best suited for which studies remains unsettled. When several assessments are available, these may be analyzed together (simultaneously or hierarchically), using statistical modeling and adjustment. Or, alternatively, they may be combined to form more complex multi-component or composite (potentially multi-domain) endpoints/outcomes. This review describes such concepts and their challenges, using examples from current osteoarthritis imaging research.</div></div><div><h3>Design</h3><div>A narrative, non-systematic literature search (PubMed and others) was conducted, and informal consultations were held with experts in the field. The identified concepts and experimental findings were then organized to present an integrated framework.</div></div><div><h3>Results</h3><div>Single imaging assessments can encompass one (uni-dimensional) or more (multi-dimensional) structures. Integration of image assessments of one structure/tissue across anatomical locations provides aggregate measures. This can also be created across heterogeneous (multi-dimensional) types of assessments (multi-component/composite), either within an area (such as imaging - single domain) or across broader areas of health and well-being (multi-domain). Weighting, standardization, and (clinical) usefulness are crucial characteristics of multi-component/composite endpoints. Examples of these concepts are here provided in the context of osteoarthritis imaging.</div></div><div><h3>Conclusions</h3><div>Options for multi-component/composite endpoints in osteoarthritis research are virtually infinite. Smart research strategies are required to explore and validate these vast possibilities, with appropriate statistical treatment being paramount. A one-size/endpoint-fits-all approach will likely fail in observational and interventional studies. Imaging assessment needs to be tailored to both the drug's unique mechanism of action, and to the participants’ morpho-type.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684764","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 importance of central sensitization for clinical trials of disease modifying osteoarthritis drugs (DMOADs)","authors":"David A Walsh ,&nbsp;Daniel F McWilliams","doi":"10.1016/j.ostima.2025.100261","DOIUrl":"10.1016/j.ostima.2025.100261","url":null,"abstract":"<div><div>Osteoarthritis (OA) pain is associated with structural changes in the joint, which are usually quantified by imaging techniques. It is anticipated that structural disease modifying OA drugs (DMOADs) would reduce the burden of OA pain. However, nociceptive pain is moderated by the central nervous system. Central sensitization, increased activity in central nervous system neurones in response to a standard nociceptive input, is one reason why disease modification might not effectively relieve OA pain. Central sensitization may result from facilitated central neuronal activity, or inadequate inhibition by endogenous analgesic mechanisms. It changes the experience of pain: its severity, distribution and qualities, and its emotional and cognitive dimensions. Central sensitization can be a barrier to analgesic benefit from treatments directed at joint structure, and central pain processing can obscure analgesic benefit from structural modification in randomised controlled trials. Indices of central pain hypersensitivity might reflect central sensitization in humans. They include self-report questionnaires such as the Central Aspects of Pain (CAP) and short form Central Sensitization Inventory (CSI-9), and quantitative sensory testing (QST) modalities of Pressure Pain detection Thresholds distant to the affected joint, Temporal Summation, and Conditioned Pain Modulation. Understanding, measuring, managing and adjusting for central pain hypersensitivity should increase the power of clinical trials to demonstrate that DMOADs not only improve joint imaging outcomes, but also improve pain, the predominant clinical problem of OA.</div></div>","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100261"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684672","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":"Erratum regarding missing Editor Disclosure statements in previously published articles","authors":"","doi":"10.1016/j.ostima.2024.100253","DOIUrl":"10.1016/j.ostima.2024.100253","url":null,"abstract":"","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 1","pages":"Article 100253"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684678","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":"STRUCTURAL EFFICACY OF INTRA-ARTICULAR SPRIFERMIN TREATMENT ON KNEE OSTEO-ARTHRITIS AS A FUNCTION OF SYMPTOMATIC AND RADIOGRAPHIC DISEASE SEVERITY - A POST-HOC ANALYSIS FROM THE FORWARD PHASE 2 RANDOMIZED CONTROLLED TRIAL","authors":"C. Knight ,&nbsp;F. Eckstein ,&nbsp;W. Wirth ,&nbsp;C. Clemmensen ,&nbsp;W. Ma ,&nbsp;A. Collins ,&nbsp;S. Basnet","doi":"10.1016/j.ostima.2025.100297","DOIUrl":"10.1016/j.ostima.2025.100297","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;A putative disease-modifying osteoarthritis drug, “Sprifermin” was studied by a phase 2B RCT (FORWARD - NCT01919164). Given at a 100µg dose, sprifermin increased cartilage thickness, both in absolute terms and compared with placebo [1]. In the full cohort with MRI results (mITT), this effect did, however, not lead to a pain relief greater than placebo [1]. FORWARD contained patients with a variety of radiographic disease stages (KLG 2 or 3, with a medial minimum joint space width (JSW) &gt; 2.5mm). Although all patients had to display &gt; 40mm pain levels at screening, not all of them exceeded that threshold at the actual baseline measurement [2].&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;To elucidate post-hoc whether structural treatment effects on cartilage (thickness) by sprifermin differ between severity strata of symptoms (WOMAC) and radiographic disease status. These observations may inform future clinical trials at which stage (sprifermin-) treatment is structurally and symptomatically most effective.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;Total femorotibial joint (TFTJ) cartilage thickness change at year (Y) 2 by MRI represented the primary endpoint; WOMAC pain was secondary [1]. Patients aged 40–85 with primary symptomatic TFTJ OA (KLG 2 or 3; medial mJSW ≥2.5 mm) were studied. Cartilage thickness was determined quantitatively from 1.5-3T MRI by expert readers, using proprietary software (Chondrometrics). The analysis focused on the 2Y MRI TFTJ cartilage thickness change for the two highest sprifermin dose groups (100µg given every 6 or 12 months combined) vs. placebo. The Hedges G (sample-size-independent effect size measure) was determined, with 95% CIs obtained by bootstrapping. We studied the modified intent to treat cohort with 24-month data (mITT), and the so-called “subcohort at risk” (SAR)[2] a subgroup with baseline WOMAC pain &gt;40 and more severe radiographic involvement by mJSW criteria.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Of 549 FORWARD patients randomized, 474 completed 2Y follow-up. 69% of the mITT with 24M data were female; the median age was 67 and the medial BMI 29.6. The treatment effect on cartilage thickness was 45.6µm for the mITT (Hedges G=0.63). Participants with baseline WOMAC pain ≥ the median displayed a somewhat smaller effect (17±70 µm change over 2 years in treated vs. -15±55µm in placebo participants; Hedges G =0.49 [0.11, 0.86] than those with pain &lt; median (37±69µm in treated vs. -27±84µm in placebo participants; Hedges G =0.86 [0.47, 1.25].&lt;/div&gt;&lt;div&gt;KLG2 subjects displayed a marginally greater treatment effect (30±75µm in treated vs. -16±46µm in placebo participants; Hedges G =0.68 [0.36, 1.00]) than KLG3 participants (13±68µm in treated vs. -33±110µm in placebo participants; Hedges G =0.55 [0.07, 1.03]). Those with JSN grade 0 (no JSN) showed a stronger treatment effect (50±59µm in those treated vs. -11±45µm in placebo participants; Hedges G =1.09 [0.63, 1.54] than those","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100297"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144521547","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":"NEURAL SHAPE MODEL QUANTIFIES EARLY AND PROGRESSIVE BONE SHAPE CHANGES AFTER ACLR","authors":"S.A. Pai,&nbsp;M. Black,&nbsp;K. Young,&nbsp;S. Sherman,&nbsp;C. Chu,&nbsp;A. Williams,&nbsp;G. Gold,&nbsp;F. Kogan,&nbsp;B. Hargreaves,&nbsp;A. Chaudhari,&nbsp;A. Gatti","doi":"10.1016/j.ostima.2025.100342","DOIUrl":"10.1016/j.ostima.2025.100342","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;Femoral bone shape scores (B-Score) derived from shape models quantify 3D structural features associated with OA&lt;sup&gt;1,2&lt;/sup&gt;. A higher B-Score is indicative of more OA-like bone shape. B-Scores have high sensitivity to quantify OA progression and stratify patients for interventions&lt;sup&gt;1&lt;/sup&gt;. Neural Shape Models (NSM) capture non-linear bone shape features and outperform traditional Statistical Shape Models (SSMs) in encoding OA-related shapes&lt;sup&gt;3&lt;/sup&gt;. Prior work that used a SSM-based B-Score showed that anterior cruciate ligament reconstructed (ACLR) knees exhibit higher B-Scores than their contralateral knees 2 years post-surgery, reflecting OA-like bone shape features&lt;sup&gt;4&lt;/sup&gt;. However, little is known about how femoral bone shape changes immediately following ACLR and how it progresses during the early post-surgical period—a critical window when post-traumatic osteoarthritis (PTOA) may still be most responsive to intervention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;To use a Neural Shape Model-based B-Score to quantify femoral shape differences between ACLR and contralateral knees immediately post-surgery (3-weeks) and to detect early PTOA bone shape changes over 30 months.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;ACLR and contralateral knees of 17 subjects (11M/6F, age=38±10 yrs, BMI=24±2 kg/m&lt;sup&gt;2&lt;/sup&gt;) were scanned at 3 weeks (baseline), 3, 9, 18, and 30 months post-ACLR in a 3T MRI scanner (GE Healthcare, USA) using a qDESS sequence (TE/TR=6/22 ms&lt;sub&gt;,&lt;/sub&gt; flip angle=25°, FOV=160 × 160 mm, bandwidth=31.25 kHz, pixel spacing=0.42 × 0.50 mm, slice thickness=1.5 mm). The femur was automatically segmented, and the B-Score was computed for each subject at all visits using a NSM that was trained on 9,376 femoral segmentations from the baseline DESS images in the OAI dataset&lt;sup&gt;1&lt;/sup&gt;. To assess bone shape differences immediately after surgery, we compared B-Scores between the ACLR and contralateral knees at the baseline visit using a linear mixed effects model. To capture longitudinal bone shape changes after surgery, we calculated change in B-Score at each follow-up visit with respect to the baseline visit. We used a linear mixed effects model to assess the effect of knee-type and time post-surgery on B-Scores. Effect sizes [η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2&lt;/sup&gt; is small (0.01), medium (0.06), or large (0.14)] were computed for significant effects (p&lt;0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS AND DISCUSSION&lt;/h3&gt;&lt;div&gt;At baseline, the ACLR knee B-Score was significantly lower than the contralateral knee (η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2&lt;/sup&gt;=0.40, p=0.005; Fig. 1A). Longitudinally, ACLR knees showed a significantly greater increase in B-Score than contralateral knees (η&lt;sub&gt;p&lt;/sub&gt;&lt;sup&gt;2&lt;/sup&gt;=0.19, p&lt;0.001; Fig 2A). The lower B-Scores in ACLR knees at baseline indicate that the surgical knee had a healthier, less OA-like bone shape than the contralateral knee. Visualization revealed that ACLR knees had a wider intercondylar no","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522509","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":"3-D LANDMARKING REPEATABILITY EMPHASIZES CHALLENGES IN SCAN POSITIONING DURING WEIGHT BEARING CT OF THE KNEE","authors":"A. Boddu ,&nbsp;T. Whitmarsh ,&nbsp;N.A. Segal ,&nbsp;N.H. Degala ,&nbsp;J.A. Lynch ,&nbsp;T.D. Turmezei","doi":"10.1016/j.ostima.2025.100278","DOIUrl":"10.1016/j.ostima.2025.100278","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;INTRODUCTION&lt;/h3&gt;&lt;div&gt;Weight bearing CT (WBCT) has shown promise in the evaluation of the knee joint instead of radiography. However, bringing weight bearing to 3-D imaging poses technical challenges that have to be overcome if repeatability is to be optimised. From prior study and experience, maintaining knee flexion angle (KFA) and centering in the vertical scan range with consistency can be difficult. One means to evaluate these distance and angle measurements from WBCT is to use a bone surface landmarking system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;(1) To evaluate the repeatability of a manual WBCT landmarking system of the femur and tibia at the knee; and (2) from this develop a technique for evaluating repeatability of KFA and vertical scan range centering.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;METHODS&lt;/h3&gt;&lt;div&gt;14 individuals recruited and consented at the University of Kansas Medical Center had baseline and follow-up WBCT imaging suitable for analysis. Participant demographics were: mean ± SD age 61.3 ± 8.4 years, BMI 30.7 ± 4.3 kg/m&lt;sup&gt;2&lt;/sup&gt; and male:female ratio 8:6. All scanning was performed on the same XFI WBCT scanner (Planmed Oy, Helsinki, Finland) with the mean ± SD interval between baseline and follow-up attendances 14.9 ± 8.1 days. A Synaflexer&lt;sup&gt;TM&lt;/sup&gt; device was used to standardise knee positioning during scanning. Imaging acquisition parameters were 96 kV tube voltage, 51.4 mA tube current, 3.5 s exposure time. A standard bone algorithm was applied for reconstruction with 0.3 mm isotropic voxels and a 21 cm vertical scan range. Both knees were included in all analyses with SD adjustments made for multiple observations from the same individual. Participant identification and scan sequence were anonymised prior to analyses. A first observer (A.B.) placed 10 femoral and 12 tibial landmarks using Stradview. These landmarks were reviewed by a second observer (T.D.T.), who placed additional landmarks at the extremes of the vertical scan within the centre of the bone medullary cavities. Bone segmentations from ScanXM were used to register landmarks from follow-up to baseline in wxRegSurf; the follow-up-to-baseline femur registration was applied to the follow-up tibial co-ordinates to assess joint positioning. Landmark repeatability was taken as the mean ± SD distance (mm) between baseline and follow-up for each landmark. A method to extract KFA and valgus alignment was developed as the angle between the lines of the extreme scan range landmarks (F00 and T00) and the centre of gravity (CoG) of the rest of the landmarks in the same bone. Valgus alignment was taken from the anterior view (&lt;180° laterally = valgus) and KFA from lateral.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Landmark placement with their codes is shown in Figure 1a (in a left knee), with code definitions given in Table 1. An example of baseline and follow-up landmarking is shown on the same knee in Figure 1b with error results from all landmarks given in Table 1. Outsi","PeriodicalId":74378,"journal":{"name":"Osteoarthritis imaging","volume":"5 ","pages":"Article 100278"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522639","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}