Quantitative 3D imaging parameters improve prediction of hip osteoarthritis outcome

Abstract

Osteoarthritis is an increasingly important health problem for which the main treatment remains joint replacement. Therapy developments have been hampered by a lack of biomarkers that can reliably predict disease, while 2D radiographs interpreted by human observers are still the gold standard for clinical trial imaging assessment. We propose a 3D approach using computed tomography-a fast, readily available clinical technique-that can be applied in the assessment of osteoarthritis using a new quantitative 3D analysis technique called joint space mapping (JSM). We demonstrate the application of JSM at the hip in 263 healthy older adults from the AGES-Reykjavík cohort, examining relationships between 3D joint space width, 3D joint shape, and future joint replacement. Using JSM, statistical shape modelling, and statistical parametric mapping, we show an 18% improvement in prediction of joint replacement using 3D metrics combined with radiographic Kellgren & Lawrence grade (AUC 0.86) over the existing 2D FDA-approved gold standard of minimum 2D joint space width (AUC 0.73). We also show that assessment of joint asymmetry can reveal significant differences between individuals destined for joint replacement versus controls at regions of the joint that are not captured by radiographs. This technique is immediately implementable with standard imaging technologies.

Hip osteoarthritis: A novel network analysis of subchondral trabecular bone structures

“…Moreover, parameters describing subchondral trabecular bone structure in HOA (bone volume fraction, trabecular bone pattern factor, trabecular number, trabecular thickness, trabecular separation, and structure model index) that are often described by micro-CT are already adapted and evaluated in-vivo using multi-detector row CT 50–52 . More recently it was elegantly demonstrated that use of clinical CT is a new and promising imaging tool in clinical assessment of both hip and knee OA 53–55 . Thus, we believe that our method will further enrich current knowledge about subchondral bone involvement in pathogenesis of HOA.…”

Osteoarthritis year in review 2021: imaging

“…J o u r n a l P r e -p r o o f 12 Changes in bone are part of the OA disease process. Recent studies have investigated the role of bone shape [19][20][21][22][23][24] , subchondral bone structure and texture [25][26][27][28] , and bone morphology in OA [29][30][31] as well as the interplay between subchondral bone changes and articular cartilage damage 32,33 .…”

Bone in osteoarthritis: imaging and interventions

“…From the AGES-Reykjavik cohort, further use of 3D shape modelling using CT has also enabled accurate 3D assessment of JSW distribution across the hip joint [20 ▪ ]. In a group of 80 cases and 187 controls, when combined with KL grade, these 3D metrics improved prediction of joint replacement by 18%, when compared with radiographic minimum JSW alone.…”