West Lake staging: A new staging system orchestrated by X-ray and MRI on knee osteoarthritis

Purpose: To investigate the differences on X-ray and MRI among each stage of knee osteoarthritis (KOA) and further propose a new staging system called West Lake (WL) staging. Methods: A cross-sectional study was conducted on patients with KOA. Stage I, II, III, and IV were divided based on stepwise treatment strategy of Knee osteoarthritis (KOA). Joint space widths (JSW) were measured on X-rays, whereas cartilage injuries (CI) and bone marrow lesions (BML) were evaluated on MRI. The differences of them across the groups were calculated by T-test. Receiver operating characteristic (ROC) curves were rendered to obtain the areas under the curves (AUC), Youden index and corresponding cut-off points. Results: Eventually, there were significant differences on JSW, CI, and BML between stage II/III and III/IV, while no significant differences between stage I/II. In stage II/III, the AUC of JSW, CI, BML was 0.99, 0.76, 0.71 and the Youden index was 0.94, 0.38, 0.45, meanwhile the cut-off points were ≤5.1 mm, >1, >2. In stage III/IV, the AUC of JSW, CI, BML was 0.96, 0.79, 0.74 and the Youden index was 0.84, 0.58, 0.38, meanwhile the cut-off points were ≤3.2 mm, >3, >4. Conclusion: The WL staging was described as follows: Stage I, X-ray shows no joint space narrow, normal MRI or MRI shows cartilage degeneration and only 1 or 2 sections are involved in BML. Stage II, X-ray shows joint space narrow, MRI shows cartilage defect but no full-thickness cartilage defect, meanwhile 3 or 4 sections are involved in BML. Stage III, X-ray shows serious joint space narrow even JSW disappeared, MRI shows full-thickness cartilage defect, more than 4 sections are involved in BML.

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West Lake Staging: A New Staging System Orchestrated by X-Ray and MRI on Knee Osteoarthritis

10.21203/rs.3.rs-135790/v1 ◽

2020 ◽

Author(s):

Jiaxin Huang ◽

Xi Chen ◽

Mengting Xia ◽

Shuaijie Lv ◽

Peijian Tong

Keyword(s):

Knee Osteoarthritis ◽

Cartilage Defect ◽

Staging System ◽

Joint Space ◽

Youden Index ◽

X Rays ◽

Full Thickness ◽

West Lake ◽

X Ray ◽

Orthopedic Surgeons

Abstract Background: Although widely used of Kellgren - Lawrence (KL) staging system on knee osteoarthritis (KOA), it still had some disadvantages. The purpose of this study was to investigate the differences on X-ray and MRI among each stage of KOA and further propose a new staging system called West Lake (WL) staging.Methods: A cross-sectional study was conducted on patients with KOA. KL stages were defined by two qualified orthopedic surgeons. Joint space widths (JSW) were measured on X-rays, whereas cartilage injuries (CI) and bone marrow lesions (BML) were evaluated on MRI. The differences of them across the groups were calculated by T-test. Receiver operating characteristic (ROC) curves were rendered to obtain the areas under the curves (AUC), Youden index and corresponding cut-off points. Agreement Index (KAPPA) was used to analyze the consistency of KL stages and WL stages assessed by two qualified orthopedic surgeons. Results: Eventually, a total of 220 patients met the criteria. There were significant differences on JSW, CI and BML between KL II/III as well as KL III/IV. In KL II/III, the AUC of JSW, CI, BML was 0.99, 0.76, 0.71 and the Youden index was 0.94, 0.38, 0.45, meanwhile the cut-off points were £5.1mm, >1, >2. In KL III/IV, the AUC of JSW, CI, BML was 0.96, 0.79, 0.74 and the Youden index was 0.84, 0.58, 0.38, meanwhile the cut-off points were £3.2mm, >3, >4. The Kappa coefficients of KL stages and WL stages were 0.31 and 0.76.Conclusion: The WL staging was described as follows: Grade 0, normal X-ray. Grade 1, X-ray shows osteophyte but no joint space narrow, normal MRI or MRI shows cartilage degeneration and only 1 or 2 sections are involved in BML. Grade 2, X-ray shows joint space narrow, MRI shows cartilage defect but no full-thickness cartilage defect, meanwhile 3 or 4 sections are involved in BML. Grade 3, X-ray shows serious joint space narrow even JSW disappeared, MRI shows full-thickness cartilage defect, more than 4 sections are involved in BML.Trial registration: The study was approved by the First Affiliated Hospital of Zhejiang Chinese Medical University (2018-ZX-026-01).

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Development and validation of a survival staging system incorporating BNP in patients with light chain amyloidosis

Blood ◽

10.1182/blood-2018-06-858951 ◽

2019 ◽

Vol 133 (3) ◽

pp. 215-223 ◽

Cited By ~ 36

Author(s):

Brian Lilleness ◽

Frederick L. Ruberg ◽

Roberta Mussinelli ◽

Gheorghe Doros ◽

Vaishali Sanchorawala

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Light Chain ◽

Cardiac Involvement ◽

Staging System ◽

Stage I ◽

Stage Iiib ◽

Stage Ii ◽

Al Amyloidosis ◽

Derivation Cohort

Abstract Immunoglobulin light chain amyloidosis (AL amyloidosis) is caused by misfolded light chains that form soluble toxic aggregates that deposit in tissues and organs, leading to organ dysfunction. The leading determinant of survival is cardiac involvement. Current staging systems use N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponins T and I (TnT and TnI) for prognostication, but many centers do not offer NT-proBNP. We sought to derive a new staging system using brain natriuretic peptide (BNP) that would correlate with the Mayo 2004 staging system and be predictive for survival in AL amyloidosis. Two cohorts of patients were created: a derivation cohort of 249 consecutive patients who had BNP, NT-proBNP, and TnI drawn simultaneously to create the staging system and a complementary cohort of 592 patients with 10 years of follow-up to determine survival. In the derivation cohort, we found that a BNP threshold of more than 81 pg/mL best associated with Mayo 2004 stage and also best identified cardiac involvement. Three stages were developed based on a BNP higher than 81 pg/mL and a TnI higher than 0.1 ng/mL and compared with Mayo 2004 with high concordance (κ = 0.854). In the complementary cohort, 25% of patients had stage I, 44% had stage II, 15% had stage III, and 16% had stage IIIb disease with a median survival not reached in stage I, 9.4 years in stage II, 4.3 years in stage III, and 1 year in stage IIIb. This new Boston University biomarker scoring system will allow centers without access to NT-proBNP the ability to appropriately stage patients with AL amyloidosis. This trial was registered at www.clinicaltrials.gov as #NCT00898235.

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Clinical Staging for Sleep-Disordered Breathing

Otolaryngology ◽

10.1067/mhn.2002.126477 ◽

2002 ◽

Vol 127 (1) ◽

pp. 13-21 ◽

Cited By ~ 315

Author(s):

Michael Friedman ◽

Hani Ibrahim ◽

Lee Bass

Keyword(s):

Body Mass Index ◽

Success Rate ◽

Body Mass ◽

Sleep Disordered Breathing ◽

Staging System ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Clinical Staging ◽

Disordered Breathing

OBJECTIVE: The purpose of this study was to identify prognostic indicators that would lead to stratification of patients likely to have successful surgery for sleep-disordered breathing (SDB) versus those destined to fail. STUDY DESIGN: We retrospectively reviewed 134 patients to correlate palate position and tonsil size to the success of the UPPP as based on postoperative polysomnography results. Similar to our previously published data on the Friedman Score as a predictor of the presence and severity of SDB, the palate position was determined on physical examination of the oral cavity and was graded for each patient. This grade combined with tonsil size was used to stage the patients. Stage I was defined as having palate position 1 or 2 combined with tonsil size 3 or 4. Stage II was defined as having palate position 3 or 4 and tonsil size 3 or 4. Stage III patients had palate position 3 or 4 and tonsil size 0, 1, or 2. Any patient with body mass index of greater than 40 was placed in the stage III group. The results of uvulopalatopharyngoplasty (UPPP) were then graded as success or failure and success rates were compared by stage. SETTING: Academically affiliated tertiary care referral center. RESULTS: Stage I patients who underwent UPPP had a success rate of 80.6%, stage II patients had a success rate of 37.9%, and stage III patients had a success rate of 8.1%. CONCLUSION: A clinical staging system for SDB based on palate position, tonsil size, and body mass index is presented. It appears to be a valuable predictor of the success of UPPP. Additional studies and wider use of the staging system will ultimately define its role in the treatment of SDB.

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Convolutional Neural Network-Based Automatic Measurement of Joint Space Width to Predict Radiographic Severity and Progression of Knee Osteoarthritis

10.21203/rs.3.rs-221004/v1 ◽

2021 ◽

Author(s):

James Chung Wai Cheung ◽

Yiu Chow TAM ◽

Lok Chun CHAN ◽

Ping Keung CHAN ◽

Chunyi WEN

Keyword(s):

Neural Network ◽

Knee Osteoarthritis ◽

Convolutional Neural Network ◽

Pearson Correlation ◽

Joint Space Width ◽

Joint Space ◽

Receiver Operating Curve ◽

Radiographic Severity ◽

X Ray ◽

Space Width

Abstract Objectives To develop a deep convolutional neural network (CNN) for the segmentation of femur and tibia on plain x-ray radiographs, hence enabling an automated measurement of joint space width (JSW) to predict the severity and progression of knee osteoarthritis (KOA). Methods A CNN with ResU-Net architecture was developed for knee X-ray imaging segmentation. The efficiency was evaluated by the Intersection over Union (IoU) score by comparing the outputs with the annotated contour of the distal femur and proximal tibia. By leveraging imaging segmentation, the minimal and multiple JSWs in the tibiofemoral joint were estimated and then validated by radiologists’ measurements in the Osteoarthritis Initiative (OAI) dataset using Pearson correlation and Bland–Altman plot. The estimated JSWs were deployed to predict the radiographic severity and progression of KOA defined by Kellgren-Lawrence (KL) grades using the XGBoost model. The classification performance was assessed using F1 and area under receiver operating curve (AUC). Results The network has attained a segmentation efficiency of 98.9% IoU. Meanwhile, the agreement between the CNN-based estimation and radiologist’s measurement of minimal JSW reached 0.7801 (p < 0.0001). Moreover, the 32-point multiple JSW obtained the highest AUC score of 0.656 to classify KL-grade of KOA. Whereas the 64-point multiple JSWs achieved the best performance in predicting KOA progression defined by KL grade change within 48 months, with AUC of 0.621. The multiple JSWs outperform the commonly used minimum JSW with 0.587 AUC in KL-grade classification and 0.554 AUC in disease progression prediction. Conclusion Fine-grained characterization of joint space width of KOA yields comparable performance to the radiologist in assessing disease severity and progression. We provide a fully automated and efficient radiographic assessment tool for KOA.

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Exchange of International Staging System for Durie&Salmon Staging System in Therapeutic Strategy for Multiple Myeloma.

Blood ◽

10.1182/blood.v106.11.5167.5167 ◽

2005 ◽

Vol 106 (11) ◽

pp. 5167-5167

Author(s):

Shingo Kurahashi ◽

Hiroto Narimatsu ◽

Takumi Sugimoto ◽

Isamu Sugiura

Keyword(s):

Multiple Myeloma ◽

Overall Survival ◽

Clinical Outcome ◽

Therapeutic Strategy ◽

Staging System ◽

Stage I ◽

Stage Ii ◽

Clinical Staging ◽

Secondary Malignancy ◽

International Staging System

Abstract Introduction: Since multiple myeloma (MM) is not a curative disease and clinical outcome is variable, chemotherapy is started only when patients developed organ impairment or progression of disease. As for clinical staging, Durie&Salmon (DS) system is in use. The International Staging System (ISS) for MM has been recently reported to provide simple and useful prognostic grouping (Greipp et al. 2005). However, its usefulness in therapeutic strategy has not been clearly demonstrated. Patients and methods: We reviewed medical records of patients with MM, newly diagnosed in Toyohashi Municipal Hospital between May 1997 and April 2004. They were all stratified based on both ISS and DS system. Results: The median age of 55 patients was 67 years (range; 46–86). M protein isotypes included IgG (n=33), IgA (n=13), BJP (n=6) and IgD (n=1). Fifty-two patients were treated with chemotherapy and 12 of those patients underwent autologous peripheral blood stem cell transplantation. The median follow-up of the patients was 26.8 months (range; 1.4–77.5). Their staging and overall survival (OS) are summarized on the following table. ISS predicted OS more clearly than DS system in our study. Overall survival based on ISS and DS system ISS DS stage no. of patients OS at 3 yrs no. of patients OS at 3 yrs I 14 1.00 3 0.67 II 22 0.55 20 0.79 III 19 0.25 32 0.40 p-value 0.0102 0.3287 Thirteen of the 14 patients with ISS stage I are alive at median months of 31.5 (10.4–73.8), and only one patient died of secondary malignancy at 44.9 months from diagnosis. The patients with ISS stage I included 86% of DS stage II and III patients, who are usually required treatment. Conclusions and discussions: ISS could predict clinical outcome more clearly than DS system. The patients’ prognosis was good in ISS stage I although many patients with DS stage II and III was included in this group. We suggests that early treatment to the patients with ISS stage I might not be necessarily required. Further studies are needed to adopt ISS instead of DS system in therapeutic strategy. Figure Figure

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Serum Levels of OPG and MIP-1α in Untreated Multiple Myeloma Patients. Correlations with Staging, Survival and Bone Disease.

Blood ◽

10.1182/blood.v106.11.5074.5074 ◽

2005 ◽

Vol 106 (11) ◽

pp. 5074-5074

Author(s):

Argyro Papadogiannis ◽

Marie-Cristine Kyrtsonis ◽

Theodoros P. Vassilakopoulos ◽

Tatiana Tzenou ◽

Antonios G. Antoniadis ◽

...

Keyword(s):

Bone Disease ◽

Staging System ◽

Serum Levels ◽

High Serum ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Bone Lesions ◽

Disease Biology ◽

Significant Difference

Abstract Cytokines, such as MIP-1a (macrophage inhibiting factor) and OPG (osteoprotegerin) are assumed to play a role in MM disease biology and bone disease, by mechanisms that are still under investigation. MIP-1a is constitutively secreted by myeloma cells, plays a possible role in the development of MM bone lesions, enhance MM cell adhesion to stromal cells and its serum levels have been recently related to survival in MM. OPG is a soluble decoy receptor which acts as a soluble receptor antagonist that prevents osteoclasts activation and the development of bone disease. Reported findings on serum OPG levels in MM patients are controversial as well as its possible role in the biology of the disease. In order to investigate the possible relationship of MIP-1a and OPG levels in MM patients with prognosis and bone disease, we determined by ELISA serum MIP-1a and OPG levels in 20 MGUS, 82 MM patients and 27 healthy individuals (HI). Both cytokines were determined by ELISA (R&D, Quantikine, USA) in frozen sera collected at dignosis, before treatment. The median age of MM patients was 69 years (44–84) and 50% were males. MM patients’ stage was as follows: 23 stage I, 28 stage II, 31 stage III according to Durie-Salmon staging system and 27 stage I, 17 stage II, 35 stage III according to the International Scoring System (ISS). In HI median MIP-1a was 28 pg/ml (15–54) and median OPG 1600 pg/ml (450–4600). In subjects with MGUS, median MIP-1a was 34 pg/ml (17–58) and median OPG 2300 pg/ml (820–6200). In MM patients, median pretreatment serum MIP-1a was 32 pg/ml (16–100) and OPG 3000 pg/ml (820–25000). No statistical significant difference was observed between HI, MGUS and MM patients with regard to MIP-1a levels but for OPG levels differences between HI and MM patients and between MGUS and MM patients were both significant (0.01 and 0.05 respectively). No relationship was found between MIP-1a or OPG levels and bone disease. However, there was a trend for longer survival in patients with MIP-1a or OPG levels lower than median (5-year overall survival 60 ± 12 vs 38 ± 14, p=0.08 and 66 ± 13 vs 29 ± 13, p=0.07 respectively). In addition MIP-1a levels were correlated with ISS stage: MIP-1a levels were 28.3±11.3 in ISS stage 1, 29.8±11.1 in ISS stage 2, 39±19.2 in ISS stage 3 (p=0.02). In conclusion, in our experience serum OPG levels are higher in MM patients than in MGUS or HI, MIP-1a levels are correlated with the ISS stage and both high serum MIP-1a and OPG levels at diagnosis are related with a shorter survival.

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Dynamic Changes in International Staging System As a Predictor of Survival Outcome in Patients with Advanced Multiple Myeloma

Blood ◽

10.1182/blood-2018-99-112134 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 4438-4438

Author(s):

Jin-Liern Hong ◽

Victoria Crossland ◽

Aaron Galaznik ◽

Paul Dolin

Keyword(s):

Multiple Myeloma ◽

Mortality Rate ◽

Staging System ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Study Cohort ◽

Dynamic Changes ◽

Beta 2 Microglobulin ◽

Line Of Therapy

Abstract Background: The International Staging System (ISS) based on serum beta-2 microglobulin and serum albumin is a useful tool for risk stratification in patients with multiple myeloma. ISS is usually assessed at the time of diagnosis. Recent studies have suggested that risk stratification should be considered dynamic over the disease course. Our study aimed to describe dynamic changes in ISS over time and their impacts on mortality in patients with advanced multiple myeloma. Methods: This study included 417 patients with multiple myeloma from the Flatiron medical records database (Jan 2011- May 2018) who have received at least two lines of therapy and had data on ISS at the time of diagnosis (TDX) and at the time of initiating the second line of therapy (T2L). ISS stage was either abstracted from medical records or derived from the results of laboratory tests of serum beta-2 microglobulin and serum albumin. Patients were followed up from T2L until the earliest event of the last activity in database or death. We calculated mortality rates by TDX and T2L ISS stages, and generated Cox proportional hazard models to estimate the impact of TDX and T2L ISS stages on mortality. Additionally, in the subgroup of patients in ISS stage III at TDX, we used univariate logistic models to identify the predictors for downward shift to ISS stage I or II at T2L. Results: The study cohort had a median age of 70 (interquartile range: 61 to 77), and 59% were male. Based on ISS at TDX, 30%, 37%, and 33% of the study cohort were classified as stage I, II, and III with the mortality rate of 12, 11, and 24 deaths per 100 person-years, respectively. The hazard ratios were 0.95 (95% confidence interval (CI): 0.57-1.61) for patients in stage II and 1.96 (95% CI: 1.22-3.16) for patients in stage III, compared with patients in stage I. Based on ISS at T2L, 47%, 34%, and 20% were classified as stage I, II, and III, with the mortality rate of 7, 19, and 39 deaths per 100 person-years, respectively. The hazard ratios were 2.62 (95% CI: 1.61-4.25) for patients in stage II and 5.18 (95% CI: 3.10-8.64) for patients in stage III, compared with patients in stage I. Dynamic changes in ISS stages over time and mortality rates were depicted in the Table. Among patients in ISS stage I at TDX, about 25% shifted to higher stages at T2L, and had a higher mortality rate (26 per 100 person-years) than did patients remaining in stage I (8 per 100 person-years). For patients in ISS stage II at TDX, 43% stayed in Stage II at T2L, and 46% moved down to Stage I, with a mortality rate of 20 and 5 per 100 person-years, respectively. Among patients in ISS stage III at TDX, 58% moved down to lower stages at T2L. The mortality rate was 10, 21, and 40 per 100 person-years for patients moving down to Stage I and II at T2L and those remaining in Stage III, respectively. In the subgroup of patients in ISS stage III at TDX, strong predictors for shifting down to lower stages were younger age (odds ratio: 2.65; 95% CI:1.20-5.87 for age <65 vs ≥65 years) and serum creatinine ≤ 2 mg/dL at TDX (odds ratio: 2.26; 95% CI:1.03-4.92 for serum creatinine ≤ 2 vs >2 mg/dL), but not gender, race, or cytogenetic abnormality of del17p, t(4;14), and t(14;16). Conclusion: Large changes in ISS stages were observed in multiple myeloma patients when advancing the line of therapy. Changes in ISS stage were also associated with survival outcome. A downward shift to stage I was associated with substantially improved overall survival; in contrast, patients moving up to or remaining in higher stages had poor outcomes, especially for those remaining in ISS stage III. Our results suggest that re-evaluating ISS stage at the time of change in line of therapy can improve prediction of survival outcomes. Disclosures Hong: Takeda Pharmaceuticals International Co.: Employment. Crossland:Takeda Pharmaceuticals International Co.: Employment. Galaznik:Takeda Pharmaceuticals International Co.: Employment. Dolin:Shire: Other: PD holds shares in Shire ; GSK: Other: PD holds shares in GSK; Takeda Pharmaceuticals International Co.: Employment.

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Stage II Differentiated Thyroid Cancer Is a High-Risk Disease in Patients <45/55 Years Old

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-02809 ◽

2019 ◽

Vol 104 (11) ◽

pp. 4941-4948 ◽

Cited By ~ 1

Author(s):

Zeming Liu ◽

Xiaopei Shen ◽

Rengyun Liu ◽

Guangwu Zhu ◽

Tao Huang ◽

...

Keyword(s):

Thyroid Cancer ◽

Mortality Risk ◽

Older Patients ◽

Differentiated Thyroid Cancer ◽

Staging System ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Ajcc Staging System ◽

Ajcc Staging

Abstract Purpose The mortality risk of stage II differentiated thyroid cancer (DTC) based on the American Joint Committee on Cancer (AJCC) staging system requires further investigation. Methods Retrospective study of DTC in the US Surveillance, Epidemiology, and End Results program for disease-specific mortality risk in various AJCC stages, with patient age stratification of stage II disease. Results Using AJCC staging system 6.0, hazard ratios (HRs) of mortality for stage II DTC in patients <45 yo and patients ≥45 yo and stages III, IVA, IVB, and IVC compared with stage I were 46.95, 4.95, 9.82, 57.37, 222.10, and 468.68, respectively, showing a robustly higher mortality risk in stage II disease in patients <45 yo than in older patients (P < 0.001), comparable with stage IVA (P = 0.482). Similar results were obtained with AJCC 7.0. With AJCC 8.0, HRs of mortality for stage II in patients <55 yo and patients ≥55 yo and stages III, IVA, and IVB compared with stage I were 75.16, 11.23, 69.45, 134.94, and 235.70, respectively, showing a robustly higher risk in stage II disease in patients <55 yo than in older patients (P < 0.001), comparable with stage III (P = 0.57). Kaplan-Meier survival curves displayed a sharp decline with stage II disease in patients <45/55 yo compared with older patients. Conclusions The mortality risk of stage II DTC was sharply differentiated at patient age 45/55 years, being robustly high in younger patients and comparable with stage III/IVA. This emphasizes the importance of considering age when managing stage II DTC and not treating it as a uniformly low-risk disease.

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Masaoka-Koga and TNM Staging System in Thymic Epithelial Tumors: Prognostic Comparison and the Role of the Number of Involved Structures

Cancers ◽

10.3390/cancers13215254 ◽

2021 ◽

Vol 13 (21) ◽

pp. 5254

Author(s):

Marco Chiappetta ◽

Filippo Lococo ◽

Luca Pogliani ◽

Isabella Sperduti ◽

Diomira Tabacco ◽

...

Keyword(s):

Staging System ◽

Tnm Staging ◽

Multiple Organ ◽

Stage I ◽

Stage Ii ◽

Stage Iii ◽

Thymic Epithelial Tumors ◽

Epithelial Tumors ◽

Tnm Staging System ◽

Staging Systems

Background: The aim of this study was to evaluate the Masaoka–Koga and the tumor node metastases (TNM) staging system in thymic epithelial tumors (TET) considering possible improvements. Methods: We reviewed the data of 379 patients who underwent surgical resection for TET from 1 January 1985 to 1 January 2018, collecting and classifying the pathological report according to the Masaoka–Koga and the TMN system. The number of involved organs was also considered as a possible prognostic factor and integrated in the two staging systems to verify its impact. Results: Considering the Masaoka–Koga system, 5- and 10-year overall survival (5–10YOS) was 96.4% and 88.9% in stage I, 95% and 89.5% in stage II and 85.4% and 72.8% in stage III (p = 0.01), with overlapping in stage I and stage II curves. Considering the TNM system, 5–10YOS was 95.5% and 88.8% in T1, 84.8% and 70.7% in T2 and 88% and 76.3% in T3 (p = 0.02), with overlapping T2–T3 curves. Including the number of involved structures, in Masaoka–Koga stage III, patients with singular involved organs had a 100% and 76.6% vs. 87.7% 5–10YOS, which was 76.6% in patients with multiple organ infiltration. Considering the TNM, T3 patients with singular involved structures presented a 5–10YOS of 100% vs. 62.5% and 37.5% in patients with multiple organ involvement (p = 0.07). Conclusion: The two staging systems present limitations due to overlapping curves in early Masaoka–Koga stages and in advanced T stages for TNM. The addition of the number of involved organs seems to be a promising factor for the prognosis stratification in these patients.

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Accurate joint space quantification in knee osteoarthritis: a digital x-ray tomosynthesis phantom study

10.1117/12.878768 ◽

2011 ◽

Cited By ~ 1

Author(s):

Tanzania S. Sewell ◽

Kelly L. Piacsek ◽

Beth A. Heckel ◽

John M. Sabol

Keyword(s):

Knee Osteoarthritis ◽

Joint Space ◽

Phantom Study ◽

X Ray

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