Relationship between medial meniscus extrusion and cartilage measurements in the knee by fully automatic three-dimensional MRI analysis

Abstract Background: We developed a fully automatic three-dimensional knee MRI analysis software that can quantify meniscus extrusion and cartilage measurements, including the projected cartilage area ratio (PCAR), which represents the ratio of the subject’s actual cartilage area to their ideal cartilage area. We also collected 3D MRI knee data from 561 volunteers (aged 30–79 years) from the “Kanagawa Knee Study.” Our purposes were to verify the accuracy of the software for automatic cartilage and meniscus segmentation using knee MRI and to examine the relationship between medial meniscus extrusion measurements and cartilage measurements from Kanagawa Knee Study data. Methods: We constructed a neural network for the software by randomly choosing 10 healthy volunteers and 103 patients with knee pain. We validated the algorithm by randomly selecting 108 of these 113 subjects for training, and determined Dice similarity coefficients from five other subjects. We constructed a neural network using all data (113 subjects) for training. Cartilage thickness, cartilage volume, and PCAR in the medial femoral, lateral femoral, medial tibial, and lateral tibial regions were quantified by using the trained software on Kanagawa Knee Study data and their relationship with subject height was investigated. We also quantified the medial meniscus coverage ratio (MMCR), defined as the ratio of the overlapping area between the medial meniscus area and the medial tibial cartilage area to the medial tibial cartilage area. Finally, we examined the relationship between MMCR and PCAR at middle central medial tibial (mcMT) subregion located in the center of nine subregions in the medial tibial cartilage. Results: Dice similarity coefficients for cartilage and meniscus were both approximately 0.9. The femoral and tibial cartilage thickness and volume at each region correlated with height, but PCAR did not correlate with height in most settings. PCAR at the mcMT was significantly correlated with MMCR. Conclusions: Our software showed high segmentation accuracy for the knee cartilage and meniscus. PCAR was more useful than cartilage thickness or volume since it was less affected by height. A relationship was observed between the medial tibial cartilage measurements and the medial meniscus extrusion measurement in our cross-sectional study.

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Relationship between medial meniscus extrusion and cartilage measurements in the knee by fully automatic three-dimensional MRI analysis

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03768-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Hayato Aoki ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Akinobu Hyodo ◽

Yugo Miura ◽

...

Keyword(s):

Medial Meniscus ◽

Three Dimensional ◽

Study Data ◽

Cartilage Thickness ◽

Similarity Coefficients ◽

Tibial Cartilage ◽

The Relationship ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion ◽

And Cartilage

Abstract Background We developed a fully automatic three-dimensional knee MRI analysis software that can quantify meniscus extrusion and cartilage measurements, including the projected cartilage area ratio (PCAR), which represents the ratio of the subject’s actual cartilage area to their ideal cartilage area. We also collected 3D MRI knee data from 561 volunteers (aged 30–79 years) from the “Kanagawa Knee Study.” Our purposes were to verify the accuracy of the software for automatic cartilage and meniscus segmentation using knee MRI and to examine the relationship between medial meniscus extrusion measurements and cartilage measurements from Kanagawa Knee Study data. Methods We constructed a neural network for the software by randomly choosing 10 healthy volunteers and 103 patients with knee pain. We validated the algorithm by randomly selecting 108 of these 113 subjects for training, and determined Dice similarity coefficients from five other subjects. We constructed a neural network using all data (113 subjects) for training. Cartilage thickness, cartilage volume, and PCAR in the medial femoral, lateral femoral, medial tibial, and lateral tibial regions were quantified by using the trained software on Kanagawa Knee Study data and their relationship with subject height was investigated. We also quantified the medial meniscus coverage ratio (MMCR), defined as the ratio of the overlapping area between the medial meniscus area and the medial tibial cartilage area to the medial tibial cartilage area. Finally, we examined the relationship between MMCR and PCAR at middle central medial tibial (mcMT) subregion located in the center of nine subregions in the medial tibial cartilage. Results Dice similarity coefficients for cartilage and meniscus were both approximately 0.9. The femoral and tibial cartilage thickness and volume at each region correlated with height, but PCAR did not correlate with height in most settings. PCAR at the mcMT was significantly correlated with MMCR. Conclusions Our software showed high segmentation accuracy for the knee cartilage and meniscus. PCAR was more useful than cartilage thickness or volume since it was less affected by height. Relations ips were observed between the medial tibial cartilage measurements and the medial meniscus extrusion measurements in our cross-sectional study. Trial registration UMIN, UMIN000032826; 1 September 2018,

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Relationship between medial meniscus extrusion and cartilage measurements in the knee by fully automatic three-dimensional MRI analysis

10.21203/rs.3.rs-43802/v2 ◽

2020 ◽

Author(s):

Hayato Aoki ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Akinobu Hyodo ◽

Yugo Miura ◽

...

Keyword(s):

Medial Meniscus ◽

Three Dimensional ◽

Cartilage Thickness ◽

Similarity Coefficients ◽

Tibial Cartilage ◽

Fully Automatic ◽

The Relationship ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion ◽

And Cartilage

Abstract BackgroundWe developed a fully automatic three-dimensional knee MRI analysis software that can quantify meniscus extrusion and cartilage measurements, including the projected cartilage area ratio (PCAR), which represents the ratio of the subject’s actual cartilage area to their ideal cartilage area. We also collected 3D MRI knee data from 561 volunteers (aged 30–79 years) from the “Kanagawa Knee Study.” Our purposes were to verify the accuracy of the software for automatic cartilage and meniscus segmentation using knee MRI and to examine the relationship between medial meniscus extrusion measurements and cartilage measurements from Kanagawa Knee Study data.MethodsWe constructed a neural network for the software by randomly choosing 10 healthy volunteers and 103 patients with knee pain. We validated the algorithm by randomly selecting 108 of these 113 subjects for training, and determined Dice similarity coefficients from five other subjects. We constructed a neural network using all data (113 subjects) for training. Cartilage thickness, cartilage volume, and PCAR in the medial femoral, lateral femoral, medial tibial, and lateral tibial regions were quantified by using the trained software on Kanagawa Knee Study data and their relationship with subject height was investigated. We also quantified the medial meniscus coverage ratio (MMCR), defined as the ratio of the overlapping area between the medial meniscus area and the medial tibial cartilage area to the medial tibial cartilage area. Finally, we examined the relationship between MMCR and PCAR at middle central medial tibial (mcMT) subregion located in the center of nine subregions in the medial tibial cartilage.ResultsDice similarity coefficients for cartilage and meniscus were both approximately 0.9. The femoral and tibial cartilage thickness and volume at each region correlated with height, but PCAR did not correlate with height in most settings. PCAR at the mcMT was significantly correlated with MMCR.ConclusionsOur software showed high segmentation accuracy for the knee cartilage and meniscus. PCAR was more useful than cartilage thickness or volume since it was less affected by height. A relationship was observed between the medial tibial cartilage measurements and the medial meniscus extrusion measurement in our cross-sectional study.Trial registration: UMIN, UMIN000032826; 1 September 2018,https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037299

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Difference in the joint space of the medial knee compartment between full extension and Rosenberg weight-bearing radiographs

European Radiology ◽

10.1007/s00330-021-08253-6 ◽

2021 ◽

Author(s):

Yugo Miura ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Hayato Aoki ◽

Noriya Okanouchi ◽

...

Keyword(s):

Correlation Coefficient ◽

Medial Meniscus ◽

Joint Space Width ◽

Joint Space ◽

Cartilage Thickness ◽

Medial Compartment ◽

The Difference ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion ◽

And Cartilage

Abstract Objectives Radiographs are the most widespread imaging tool for diagnosing osteoarthritis (OA) of the knee. Our purpose was to determine which of the two factors, medial meniscus extrusion (MME) or cartilage thickness, had a greater effect on the difference in the minimum joint space width (mJSW) at the medial compartment between the extension anteroposterior view (extension view) and the 45° flexion posteroanterior view (Rosenberg view). Methods The subjects were 546 participants (more than 50 females and 50 males in their 30 s, 40 s, 50 s, 60 s, and 70 s) in the Kanagawa Knee Study. The mJSW at the medial compartment was measured from both the extension and the Rosenberg views, and the “mJSW difference” was defined as the mJSW in the Rosenberg view subtracted from the mJSW in the extension view. The cartilage region was automatically extracted from MRI data and constructed in three dimensions. The medial region of the femorotibial joint cartilage was divided into 18 subregions, and the cartilage thickness in each subregion was determined. The MME was also measured from MRI data. Results The mJSW difference and cartilage thickness were significantly correlated at 4 subregions, with 0.248 as the highest absolute value of the correlation coefficient. The mJSW difference and MME were also significantly correlated, with a significantly higher correlation coefficient (0.547) than for the mJSW difference and cartilage thickness. Conclusions The MME had a greater effect than cartilage thickness on the difference between the mJSW at the medial compartment in the extension view and in the Rosenberg view. Key Points • The difference in the width at the medial compartment of the knee between the extension and the flexion radiographic views was more affected by medial meniscus extrusion than by cartilage thickness.

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Fully automatic three-dimensional MRI analysis for the cartilage and meniscus of the knee: Kanagawa Knee Study

10.21203/rs.3.rs-26389/v1 ◽

2020 ◽

Author(s):

Hayato Aoki ◽

Nobutake Ozeki ◽

Hisako Katano ◽

Akinobu Hyodo ◽

Junpei Matsuda ◽

...

Keyword(s):

Lateral Meniscus ◽

Three Dimensional ◽

Cross Sectional Study ◽

Cartilage Volume ◽

Cartilage Thickness ◽

Similarity Coefficients ◽

Cross Sectional ◽

Coverage Ratio ◽

Fully Automatic ◽

Meniscus Extrusion

Abstract Objective We have developed a fully automatic three-dimensional MRI analysis software that measures the projected cartilage area ratio (PCAR) to allow for the quantification of the cartilage in the knee. Our objectives for this cross-sectional study were to verify our software’s accuracy and to quantify cartilage and meniscus extrusion. We also examined which cartilage quantification was most affected by age and analyzed the relationship between PCAR and meniscus extrusion. Methods 108 subjects were selected for training, and Dice similarity coefficients were determined from 5 other subjects. This study included 561 subjects between 30–70 years of age. From their knee MRI data, we quantified cartilage thickness, cartilage volume, and PCAR (0.0–1.5 mm) in four regions, including the medial tibial (MT) cartilage. Furthermore, each region was divided into nine subregions. The medial central (mc) subregion was also analyzed. As a quantification for meniscus extrusion, the medial meniscus coverage ratio (MMCR) was also investigated. Results Dice similarity coefficients were 0.911 and 0.892 for the femoral and tibial cartilage and 0.916 and 0.891 for the medial and lateral meniscus. Among 48 cartilage quantifications, the highest absolute value of the correlation coefficient with age was mcMT PCAR 1.0 mm in females and mcMT cartilage thickness in males. In females, mcMT PCAR 1.0 mm was correlated with MMCR, although MMCR was not correlated with age. In males, mcMT PCAR 0.0 mm was correlated with MMCR. Conclusions Our software showed high segmentation accuracy and provided numerous quantifications of cartilage related to age and meniscus extrusion.

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Investigating the Chronology of Meniscus Root Tears: Do Medial Meniscus Posterior Root Tears Cause Extrusion or the Other Way Around?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00203 ◽

2021 ◽

Vol 9 (7_suppl4) ◽

pp. 2325967121S0020

Author(s):

Matthew LaPrade ◽

Mario Hevesi ◽

Ryan Wilbur ◽

Bryant Song ◽

Nicholas Rhodes ◽

...

Keyword(s):

Medial Meniscus ◽

Subsequent Development ◽

Posterior Root ◽

Meniscus Root ◽

Before And After ◽

Ligament Disruption ◽

The Relationship ◽

Meniscus Root Repair ◽

Medial Meniscus Extrusion ◽

Meniscus Extrusion

Objectives: Meniscus root tears are increasingly being recognized. Meniscus extrusion has previously been associated with medial root tears; however, the relationship between secondary meniscus restraints, such as the meniscotibial (MT) ligament, extrusion, and root tears has yet to be formally evaluated. The purpose of this study was to better understand the association between MT ligament competence, medial meniscus extrusion, and medial meniscus posterior root tears (MMPRT), as well as to determine the progression of meniscus extrusion over time. Methods: Serial MRI’s from our institution were reviewed for patients who showed evidence of medial meniscus extrusion and MMPRT on at least one of 2+ available MRI’s. All patients were symptomatic at the time of diagnosis. All MRI’s were analyzed independently by two board-certified musculoskeletal radiologists. MT ligament disruption, medial meniscus extrusion, and MMPRT presence was recorded for each MRI. The time between MRI’s, presence of insufficiency fractures, and Outerbridge classification for the medial femur and tibia were also evaluated. Results: 27 knees in 26 patients were included in this study, with a total of 63 MRI’s analyzed (21 knees with 2 MRI’s, 3 with 3 MRI’s, and 3 with 4 MRI’s). All patients demonstrated clear medial meniscus extrusion and meniscotibial ligament disruption prior to the subsequent development of MMPRTs (p < 0.001). Mean extrusion at the time of initial MRI was 3.3 ± 1.1 mm, and increased significantly to 5.5 ± 1.8 mm at the time of first imaging with an identified MMPRT (p < 0.001). The average time between initial MRI and the first identification of MMPRT on a later MRI was 1.7 ± 1.6 years. Conclusions: In a sample of 27 symptomatic knees with serial MRI’s both before and after MMPRT diagnosis, all patients demonstrated MT ligament disruption and associated meniscus extrusion prior to the development of subsequent medial meniscus root tears. These findings suggest that MT ligament disruption and medial meniscus extrusion represent early and predisposing events contributing to MMPRT. Therefore, this provides a possible explanation of why meniscus extrusion is not corrected with medial meniscus root repair.

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