scholarly journals Assessment of bone marrow Oedema-like lesions using MRI in patellofemoral knee osteoarthritis: Comparison of different MRI pulse sequences

2021 ◽  
pp. 20201367
Author(s):  
Henry Noorveriandi ◽  
Matthew J Parkes ◽  
Michael J Callaghan ◽  
David T Felson ◽  
Terence W O'Neill ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Pain ◽  
Intraclass Correlation ◽  
Pulse Sequences ◽  
Correlation Coefficients ◽  
Bone Marrow Oedema ◽  
Volume Distribution ◽  
Data Set ◽  
Knee Oa ◽  
Contrast Enhanced

Objective: To compare bone marrow oedema-like lesion (BML) volume in subjects with symptomatic patellofemoral (PF) knee OA using four different MRI sequences and to determine reliability of BML volume assessment using these sequences and their correlation with pain. Methods: Seventy-six males and females (mean age 55.8 years) with symptomatic patellofemoral knee OA had 1.5 T MRI scans. PD fat suppressed (FS), STIR, contrast-enhanced (CE) T1-w FS, and 3D T1-w FFE sequences were obtained. All sequences were assessed by one reader, including repeat assessment of 15 knees using manual segmentation and the measurements were compared. We used random-effects panel linear regression to look for differences in the log-transformed BML volume (due to positive skew in the BML volume distribution) between sequences and to determine associations between BML volumes and knee pain. Results: Fifty-eight subjects had PF BMLs present on at least one sequence. Median BML volume measured using T1-w FFE sequence was significantly smaller (224.7 mm3, interquartile range [IQR] 82.50–607.95) than the other three sequences. BML volume was greatest on the CE sequence (1129.8 mm3, IQR 467.28–3166.02). Compared to CE sequence, BML volumes were slightly lower when assessed using PDFS (proportional difference = 0.79; 95% confidence interval [CI] 0.62, 1.01) and STIR sequences (proportional difference = 0.85; 95% CI 0.67, 1.08). There were strong correlations between BML volume on PDFS, STIR, and CE T1-w FS sequences (ρs = 0.98). Correlations were lower between these three sequences and T1-w FFE (ρs = 0.80–0.81). Intraclass correlation coefficients were excellent for PDFS, STIR, and CE T1-w FS sequences (0.991 to 0.995), while the ICC for T1-w FFE was good at 0.88. We found no significant association between BML volumes assessed using any of the sequences and knee pain. Conclusion: T1-w FFE sequences were less reliable and measured considerably smaller BML volume compared to other sequences. BML volume was larger when assessed using the contrast enhanced T1-w FS although not statistically significantly different from BMLs when assessed using PDFS and STIR sequences. Advances in knowledge: This is the first study to assess BMLs by four different MRI pulse sequences on the same data set, including different fluid sensitive sequences and gradient echo type sequence.

Image processing and machine learning for telehealth craniosynostosis screening in newborns

2021 ◽  
pp. 1-8
Author(s):  
Markus J. Bookland ◽  
Edward S. Ahn ◽  
Petronella Stoltz ◽  
Jonathan E. Martin
Keyword(s):  
Image Processing ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Asymmetry Index ◽  
Optical Measurements ◽  
Shape Classification ◽  
Data Set ◽  
Intraclass Correlation Coefficients ◽  
Optical Scanner ◽  
Cranial Shape

OBJECTIVE The authors sought to evaluate the accuracy of a novel telehealth-compatible diagnostic software system for identifying craniosynostosis within a newborn (< 1 year old) population. Agreement with gold standard craniometric diagnostics was also assessed. METHODS Cranial shape classification software accuracy was compared to that of blinded craniofacial specialists using a data set of open-source (n = 40) and retrospectively collected newborn orthogonal top-down cranial images, with or without additional facial views (n = 339), culled between April 1, 2008, and February 29, 2020. Based on image quality, midface visibility, and visibility of the cranial equator, 351 image sets were deemed acceptable. Accuracy, sensitivity, and specificity were calculated for the software versus specialist classification. Software agreement with optical craniometrics was assessed with intraclass correlation coefficients. RESULTS The cranial shape classification software had an accuracy of 93.3% (95% CI 86.8–98.8; p < 0.001), with a sensitivity of 92.0% and specificity of 94.3%. Intraclass correlation coefficients for measurements of the cephalic index and cranial vault asymmetry index compared to optical measurements were 0.95 (95% CI 0.84–0.98; p < 0.001) and 0.67 (95% CI 0.24–0.88; p = 0.003), respectively. CONCLUSIONS These results support the use of image processing–based neonatal cranial deformity classification software for remote screening of nonsyndromic craniosynostosis in a newborn population and as a substitute for optical scanner– or CT-based craniometrics. This work has implications that suggest the potential for the development of software for a mobile platform that would allow for screening by telemedicine or in a primary care setting.

scholarly journals Assessing the reproducibility of high temporal and spatial resolution dynamic contrast-enhanced magnetic resonance imaging in patients with gliomas

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woo Hyeon Lim ◽  
Joon Sik Park ◽  
Jaeseok Park ◽  
Seung Hong Choi
Keyword(s):  
Spatial Resolution ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Voxel Size ◽  
Dce Mri ◽  
Intraclass Correlation Coefficients ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Temporal And Spatial ◽  
Arterial Input Functions

AbstractTemporal and spatial resolution of dynamic contrast-enhanced MR imaging (DCE-MRI) is critical to reproducibility, and the reproducibility of high-resolution (HR) DCE-MRI was evaluated. Thirty consecutive patients suspected to have brain tumors were prospectively enrolled with written informed consent. All patients underwent both HR-DCE (voxel size, 1.1 × 1.1 × 1.1 mm3; scan interval, 1.6 s) and conventional DCE (C-DCE; voxel size, 1.25 × 1.25 × 3.0 mm3; scan interval, 4.0 s) MRI. Regions of interests (ROIs) for enhancing lesions were segmented twice in each patient with glioblastoma (n = 7) to calculate DCE parameters (Ktrans, Vp, and Ve). Intraclass correlation coefficients (ICCs) of DCE parameters were obtained. In patients with gliomas (n = 25), arterial input functions (AIFs) and DCE parameters derived from T2 hyperintense lesions were obtained, and DCE parameters were compared according to WHO grades. ICCs of HR-DCE parameters were good to excellent (0.84–0.95), and ICCs of C-DCE parameters were moderate to excellent (0.66–0.96). Maximal signal intensity and wash-in slope of AIFs from HR-DCE MRI were significantly greater than those from C-DCE MRI (31.85 vs. 7.09 and 2.14 vs. 0.63; p < 0.001). Both 95th percentile Ktrans and Ve from HR-DCE and C-DCE MRI could differentiate grade 4 from grade 2 and 3 gliomas (p < 0.05). In conclusion, HR-DCE parameters generally showed better reproducibility than C-DCE parameters, and HR-DCE MRI provided better quality of AIFs.

Dynamic contrast enhanced MRI of bone marrow oedema in rheumatoid arthritis

2007 ◽  
Vol 67 (2) ◽  
pp. 270-272 ◽  
Author(s):  
R Hodgson ◽  
A Grainger ◽  
P O’Connor ◽  
T Barnes ◽  
S Connolly ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Bone Marrow ◽  
Bone Marrow Oedema ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

Erosions and Fatty Lesions of Sacroiliac Joints in Patients with Axial Spondyloarthritis: Evaluation of Different MRI Techniques and Two Scoring Methods

2014 ◽  
Vol 41 (3) ◽  
pp. 473-480 ◽  
Author(s):  
Michaela Krohn ◽  
Leonie S. Braum ◽  
Joachim Sieper ◽  
In-Ho Song ◽  
Anja Weiß ◽  
...  
Keyword(s):  
Structural Damage ◽  
Spin Echo ◽  
Intraclass Correlation ◽  
Pulse Sequences ◽  
Correlation Coefficients ◽  
Scoring Systems ◽  
Scoring Methods ◽  
Sacroiliac Joints ◽  
Scoring Method ◽  
Phase Gradient

Objective.Assessment of structural damage of sacroiliac joints (SIJ) in patients with axial spondyloarthritides (axSpA) has been discussed as a useful outcome measure in clinical trials. The aim of our study was to evaluate different magnetic resonance imaging (MRI) scoring methods and pulse sequences with a focus on fatty lesions and bony erosions.Methods.Seventy-five patients with the diagnosis of axSpA underwent MRI at 3 timepoints as part of the ESTHER trial, which compared 2 groups of patients treated with etanercept or sulfasalazine. Two MRI sequences [unenhanced T1-weighted (T1w) turbo spin-echo (TSE) and unenhanced T1w opposed-phase gradient-echo sequences (opGRE)] and 2 different scoring systems (simple and comprehensive Berlin method) were used for the evaluation of fatty lesions and erosions of the SIJ. Differences between techniques and methods were evaluated by intraclass correlation coefficients (ICC) and standardized response means (SRM).Results.Applying the simple Berlin method, mean fatty lesion scores for etanercept-treated patients were 4.59 and 5.19 at baseline and Week 48, respectively, while the comprehensive Berlin method revealed mean fatty lesion scores of 6.59 and 7.64, respectively. Corresponding SRM were 0.59 and 0.86 for simple and comprehensive methods, respectively, while ICC dropped from 0.76–0.77 to 0.59–0.62. Scoring of erosions on T1w opGRE images resulted in a higher interreader agreement (ICC of 0.65) compared to T1w TSE sequences (ICC of 0.18).Conclusion.Better characterization of fatty lesion changes within 1 year was achieved by the comprehensive Berlin scoring method; however, more reader variation has to be taken into account. The delineation of erosions is markedly improved when using T1w opGRE pulse sequences.

scholarly journals Association of subchondral bone marrow lesion localisation with weight bearing pain in people with knee osteoarthritis: data from the Osteoarthritis Initiative

2021 ◽  
Author(s):  
Koji Aso ◽  
Seyed Mohsen Shahtaheri ◽  
Daniel F. McWilliams ◽  
David A. Walsh
Keyword(s):  
Bone Marrow ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Subchondral Bone ◽  
Negative Binomial ◽  
Weight Bearing ◽  
The Other ◽  
Knee Oa ◽  
Pain Scores ◽  
Osteoarthritis Initiative

Abstract Background Subchondral bone marrow lesions (BMLs) detected on MRI in knee osteoarthritis (OA) are associated with knee pain. The prevalence and progression of subchondral BMLs are increased by mechanical knee load. However, associations of subchondral BML location with weight-bearing knee pain are currently unknown. In this study, we aim to demonstrate associations of subchondral BML location and size with weight-bearing knee pain in knee OA.Methods We analyzed 1412 and 582 varus knees from cross-sectional and longitudinal Osteoarthritis Initiative datasets, respectively. BML scores were semi-quantitatively analysed with the MRI Osteoarthritis Knee Score for 4 subchondral regions (median and lateral femorotibial, medial and lateral patellofemoral) and subspinous region. Weight-bearing and non-weight-bearing pain scores were derived from WOMAC pain items. Correlation and negative binomial regression models were used for analysis of associations between the BML scores and pain at baseline, and changes in the BML scores and changes in pain after 24-month follow up.Results Greater BML scores at medial femorotibial and lateral patellofemoral compartments were associated with greater weight-bearing pain scores, and statistical significance was retained after adjusting for BML scores at the other 4 joint compartments and other OA features, as well as for non-weight-bearing pain, age, sex and Body Mass Index (BMI) (medial femorotibial; B=0.08, p=0.02. patellofemoral; B=0.13, p=0.01). Subanalysis revealed that greater medial femorotibial BML scores were associated with greater pain on walking and standing (B=0.11, p=0.01, and B=0.10, p=0.04, respectively). Lateral patellofemoral BML scores were associated with pain on climbing, respectively B=0.14, p=0.02. Increases or decreases over 24 months in BML score in the medial femorotibial compartment were significantly associated with increases or decreases in weight-bearing pain severity after adjusting for non-weight-bearing pain, age, sex, baseline weight-bearing pain, BMI, and BML at the other 4 joint compartments (B=0.10, p=0.01). Conclusions Subchondral BML size at the medial femorotibial joint compartment was specifically associated with the severity and the change in weight-bearing pain, independent of non-weight-bearing pain, in knee OA. Specific associations of weight-bearing pain with subchondral BMLs in weight-bearing compartments of the knee indicate that BMLs in subchondral bone contribute to biomechanically-induced OA pain.

scholarly journals Capturing patient-reported area of knee pain: a concurrent validity study using digital technology in patients with patellofemoral pain

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4406 ◽  
Author(s):  
Mark Matthews ◽  
Michael S. Rathleff ◽  
Bill Vicenzino ◽  
Shellie A. Boudreau
Keyword(s):  
Knee Pain ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Patellofemoral Pain ◽  
Digital Platforms ◽  
Pain Location ◽  
Significant Difference ◽  
Patient Reported ◽  
Pain Drawings ◽  
Pain Area

Background Patellofemoral pain (PFP) is often reported as a diffuse pain at the front of the knee during knee-loading activities. A patient’s description of pain location and distribution is commonly drawn on paper by clinicians, which is difficult to quantify, report and compare within and between patients. One way of overcoming these potential limitations is to have the patient draw their pain regions using digital platforms, such as personal computer tablets. Objective To assess the validity of using computer tablets to acquire a patient’s knee pain drawings as compared to paper-based records in patients with PFP. Methods Patients (N = 35) completed knee pain drawings on identical images (size and colour) of the knee as displayed on paper and a computer tablet. Pain area expressed as pixel density, was calculated as a percentage of the total drawable area for paper and digital records. Bland–Altman plots, intraclass correlation coefficient (ICC), Pearson’s correlation coefficients and one-sample tests were used in data analysis. Results No significant difference in pain area was found between the paper and digital records of mapping pain area (p = 0.98), with the mean difference = 0.002% (95% CI [−0.159–0.157%]). A very high agreement in pain area between paper and digital pain drawings (ICC = 0.966 (95% CI [0.93–0.98], F = 28.834, df = 31, p < 0.001). A strong linear correlation (R2 = 0.870) was found for pain area and the limits of agreement show less than ±1% difference between paper and digital drawings. Conclusion Pain drawings as acquired using paper and computer tablet are equivalent in terms of total area of reported knee pain. The advantages of digital recording platforms, such as quantification and reporting of pain area, could be realized in both research and clinical settings.

scholarly journals Validity and Reliability of the Community Balance and Mobility Scale in Individuals With Knee Osteoarthritis

2014 ◽  
Vol 94 (6) ◽  
pp. 866-874 ◽  
Author(s):  
Judit Takacs ◽  
S. Jayne Garland ◽  
Mark G. Carpenter ◽  
Michael A. Hunt
Keyword(s):  
Knee Osteoarthritis ◽  
Convergent Validity ◽  
Dynamic Balance ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Retest Reliability ◽  
Knee Oa ◽  
Test Retest Reliability

Background There is a high incidence of falls in older adults with knee osteoarthritis (OA). Adequate dynamic balance and mobility reduce the risk of falls; however, there are currently no validated, advanced tests of dynamic balance and mobility for individuals with knee OA. Objective The purpose of this study was to determine the convergent validity, known-groups validity, and test-retest reliability of a dynamic test of balance and mobility, the Community Balance and Mobility Scale (CB&M), in a knee OA population. Design A cross-sectional design was used. Methods Twenty-five individuals aged 50 years and older with medial knee OA and an equal number of healthy controls completed the CB&M and other tests of balance and mobility, including the Berg Balance Scale, the Timed “Up & Go” Test, a test of maximal single-leg stance time, and the 10-Meter Walk Test (self-selected and fast walking speed). Convergent validity of balance tests with the CB&M was assessed using Pearson product moment correlation coefficients, and known-groups validity was assessed using independent t tests. Test-retest reliability of the CB&M was assessed using intraclass correlation coefficients (ICCs) and standard error of measurement (SEM). Results Scores on the CB&M were significantly correlated with all measures of balance and mobility for those with knee OA. There were significant differences in CB&M scores between groups. Scores on the CB&M were highly reliable in people with knee OA (ICC=.95, 95% confidence interval [95% CI]=0.70 to 0.99; SEM=3, 95% CI=2.68 to 4.67). Limitations Few participants had severe knee OA. Conclusions The CB&M displayed moderate convergent validity, excellent known-groups validity, and high test-retest reliability. The CB&M can be used as a valid and reliable tool to assess dynamic balance and mobility deficits in people with knee OA.

Clinical Efficacy of Bone Marrow Aspirate Concentrate Versus Stromal Vascular Fraction Injection in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652110145
Author(s):  
Ioanna K. Bolia ◽  
Sofia Bougioukli ◽  
William J. Hill ◽  
Nicholas A. Trasolini ◽  
Frank A. Petrigliano ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Knee Joint ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Clinical Efficacy ◽  
Bone Marrow Aspirate ◽  
Meta Analysis ◽  
Stromal Vascular Fraction ◽  
Symptomatic Improvement ◽  
Knee Oa

Background: Knee injection using either bone marrow aspirate concentrate (BMAC) or stromal vascular fraction (SVF) from adipose tissue has been shown to result in symptomatic improvement in patients with knee osteoarthritis (OA). It is still unclear whether one of these therapies is superior over the other. Purpose: To systematically report the clinical studies evaluating BMAC and SVF in the treatment of knee OA and to compare the clinical efficacy of these 2 injection therapies. Study Design: Meta-analysis; Level of evidence, 4. Methods: This meta-analysis was performed per the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Studies were included if they reported the clinical outcomes after a single BMAC or SVF injection in the knee joint of patients with OA. Studies evaluating preparations of culture-expanded stem cells were excluded. A random effects model was used; the clinical efficacy of BMAC or SVF injection was assessed using the standardized mean difference (SMD) and compared. Visual analog scale (VAS) scores for pain and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) knee index were the primary outcomes. The level of statistical significance was set at P < .05. Results: Ten studies and 472 patients with knee OA who received either BMAC (233 patients) or SVF (239 patients) were included. Patients who received an injection had improved VAS outcomes (mean ± SD): from 5.8 ± 1.3 to 2.6 ± 17 for BMAC and from 6.4 ± 1.4 to 3.4 ± 0.5 for SVF. They also experienced significantly reduced pain (SMD [VAS], 2.6 for BMAC and 3.4 for SVF) and improved function (SMD [WOMAC], 1.4 for BMAC and 1.2 for SVF). However, the SVF injection had a significantly greater effect on pain reduction than did the BMAC injection ( P < .0001). Based on WOMAC, the clinical effect of BMAC versus SVF knee injection in patients with knee OA was equivalent ( P = .626). Results were limited by the presence of publication bias as well as variability in the preparation methods utilized in the BMAC and SVF injection protocols. Complications were reported in 50% of the BMAC studies (knee stiffness, persistent knee swelling) and 67% of the SVF studies (knee swelling, knee pain, positive SVF cultures without symptoms of infection, and bleeding at the abdominal harvest site). Conclusion: A single BMAC or SVF injection into the knee joint of patients with OA resulted in symptomatic improvement at short-term follow-up. However, SVF seemed to be more effective than did BMAC in the reduction of knee pain. There was significant variation in the BMAC and SVF injection preparation techniques used across the studies and a lack of stratification of outcomes based on the radiologic classification of OA. Therefore, these results should be taken with caution.

scholarly journals Detection of knee synovitis using non-contrast-enhanced qDESS compared with contrast-enhanced MRI

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Bas A. de Vries ◽  
Stephan J. Breda ◽  
Bragi Sveinsson ◽  
Emily J. McWalter ◽  
Duncan E. Meuffels ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Sensitivity And Specificity ◽  
Intraclass Correlation ◽  
Reference Standard ◽  
Characteristic Analysis ◽  
Knee Oa ◽  
Contrast Enhanced ◽  
Sum Score ◽  
Absolute Agreement ◽  
Sum Scores

Abstract Background To assess diagnostic accuracy of quantitative double-echo in steady-state (qDESS) MRI for detecting synovitis in knee osteoarthritis (OA). Methods Patients with different degrees of radiographic knee OA were included prospectively. All underwent MRI with both qDESS and contrast-enhanced T1-weighted magnetic resonance imaging (CE-MRI). A linear combination of the two qDESS images can be used to create an image that displays contrast between synovium and the synovial fluid. Synovitis on both qDESS and CE-MRI was assessed semi-quantitatively, using a whole-knee synovitis sum score, indicating no/equivocal, mild, moderate, and severe synovitis. The correlation between sum scores of qDESS and CE-MRI (reference standard) was determined using Spearman’s rank correlation coefficient and intraclass correlation coefficient for absolute agreement. Receiver operating characteristic analysis was performed to assess the diagnostic performance of qDESS for detecting different degrees of synovitis, with CE-MRI as reference standard. Results In the 31 patients included, very strong correlation was found between synovitis sum scores on qDESS and CE-MRI (ρ = 0.96, p < 0.001), with high absolute agreement (0.84 (95%CI 0.14–0.95)). Mean sum score (SD) values on qDESS 5.16 (3.75) were lower than on CE-MRI 7.13 (4.66), indicating systematically underestimated synovitis severity on qDESS. For detecting mild synovitis or higher, high sensitivity and specificity were found for qDESS (1.00 (95%CI 0.80–1.00) and 0.909 (0.571–1.00), respectively). For detecting moderate synovitis or higher, sensitivity and specificity were good (0.727 (95%CI 0.393–0.927) and 1.00 (0.800–1.00), respectively). Conclusion qDESS MRI is able to, however with an underestimation, detect synovitis in patients with knee OA.

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