Quantitative measurement of medial femoral knee cartilage volume – analysis of the OA Biomarkers Consortium FNIH Study cohort

Abstract

OBJECTIVE Large studies of knee osteoarthritis (KOA) require well-characterized efficient methods to assess progression. We previously developed the local-area cartilage segmentation (LACS) software method, to measure cartilage volume on MRI scans. The present study further validates this method in a larger patient cohort and assesses predictive validity in a case-control study. METHOD The OA Biomarkers Consortium FNIH Project, a case-control study of KOA progression nested within the Osteoarthritis Initiative (OAI), includes 600 subjects in four subgroups based on radiographic and pain progression. Our software tool measured change in medial femoral cartilage volume in a central weight-bearing region. Different sized regions of cartilage were assessed to explore their sensitivity to change. The readings were performed on MRI scans at the baseline and 24-month visits. We used standard response means (SRM) for responsiveness and logistic regression for predictive validity. RESULTS Cartilage volume change was associated strongly with radiographic progression (OR=4.66; 95% CI=2.85-7.62). Odds ratios were significant but of lesser magnitude for the combined radiographic and pain progression outcome (OR=1.70; 95% CI=1.40-2.07). For the full 600 subjects, the SRM was −0.51 for the largest segmented area. Smaller areas of cartilage segmentation were also able to predict the case-control status. The average reader time for the largest area was less than 20 minutes per scan. Smaller areas could be assessed with less reader time. CONCLUSION We demonstrated that the LACS method is fast, responsive, and associated with radiographic and pain progression, and is appropriate for existing and future large studies of KOA.

A low cartilage formation and repair endotype predicts radiographic progression of symptomatic knee osteoarthritis

“…These data agree with results from the Foundation for National Institute of Health (FNIH) initiative on PIIANP [22], another type II collagen biomarker indicative of collagen formation. In addition, cartilage oligomeric protein (COMP) and urinary CTX-II (uCTX-II) have all shown potential as prognostic biomarkers [22][23][24][25][26][27]. Interestingly, however, uCTX-II and PIIANP did not provide the same prognostic, nor predictive value in the current study (see supplementary data Fig.…”

MRI UTE‐T2* shows high incidence of cartilage subsurface matrix changes 2 years after ACL reconstruction

“…First, while we showed correlations between 2‐D and 3‐D UTE‐T2*, our ability to characterize possible UTE‐T2* changes 2 years after ACLR was limited by relatively small numbers. Second, the 3‐D femoral “tread mark” ROIs studied in this work are modeled after those found to be the most responsive to cartilage volume change and radiographic progression in an OA population. While our tread mark ROIs encompass the majority of the central weight‐bearing medial tibiofemoral surfaces in the knee previously shown to be most responsive to volume change and radiographic progression, peripheral medial cartilage regions and cartilage to the lateral, patellar, and trochlear compartments was not assessed.…”

Predictive and concurrent validity of cartilage thickness change as a marker of knee osteoarthritis progression: data from the Osteoarthritis Initiative

“…These efforts were recently undertaken under the auspices of the Foundation for the National Institutes of Health (FNIH) OA Biomarkers Consortium 8–13 , and we previously reported that one- and two-year (BL→Y1 and BL→Y2) loss in central medial femorotibial cartilage thickness was associated with the combination of pain and radiographic progression in knee OA from baseline (BL) to up to year four follow-up (BL→Y4) 8 and this association was found to be stronger for radiographic progression than for pain progression More recently, Schaefer et al used the FNIH design to validate a new cartilage segmentation method 12 and reported odds ratios for change in cartilage volume in localized areas of the medial femur that were in the same range as that observed in the FNIH study for cartilage thickness 8 .…”