Abstract
Objective
To compare a semi-quantitative and a quantitative morphological score for assessment of early osteoarthritis (OA) evolution.
Materials and methods
3.0 T MRI of the knee was performed in 60 women, 30 with early OA (each 15 with Kellgren–Lawrence grade 2 and 3) and 30 age-matched controls at baseline and at 12 and 24 months. Pathological condition was assessed with the whole-organ magnetic resonance imaging score (WORMS). Cartilage abnormalities and bone marrow edema pattern (BMEP) were also quantified using a previously introduced morphological quantitative score. These data were correlated with changes in clinical parameters and joint space width using generalized estimation equations (GEE).
Results
At baseline, OA patients had significantly (p < 0.05) more and larger cartilage lesions and BMEP. During follow-up, cartilage lesions increased significantly (p < 0.05) in the patients compared with controls: WORMS showed progression only at the lateral patella, whereas the quantitative score revealed progression additionally at the trochlea and at the medial compartment. Both scores showed a significant (p < 0.05) increase in BMEP at the lateral femur in OA patients. In addition, quantitative scores of BMEP of the whole knee decreased significantly (p < 0.05) after 12 months and increased after 24 months in the patients, but showed an increase in controls at all follow-up examinations. Only weak correlations between structural imaging findings and clinical parameters were observed.
Conclusion
Quantitative assessment of cartilage lesions and BMEP is more sensitive to changes during the course of the disease than semi-quantitative scoring. However, structural imaging findings do not correlate well with the clinical progression of OA.
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Acknowledgement
This work was supported by Pfizer Inc., Eastern Point Road, Groton, CT, 06340, USA. We are grateful to the dedicated group of A9001140 investigators: Cecil Charles, Julia Crim, David Hunter, Gary Hutchins, Chris Jackson, Virginia Byers Kraus, Steve Mazzuca, Prasad Pottumarthi, Thomas Schnitzer, Mihra Taljanovic, and Berchman Vaz. Also to the dedicated study coordinators whose skills were essential in ensuring the successful conduct of this research: Emily Brown, Sandra Chapman, Eugene Dunkle, Kristen Fredley, Donna Gilmore, Joyce Goggins, Mohsen Haddad-Kaveh, Norine Hall, Thelma Munoz, and Kim Tally. We would also like to express our thanks to the dedicated MRI technologists, the Duke Image Analysis Laboratory staff: Cecil Charles, Maureen Ainslie, April Davis, Allison Fowlkes, Mark Ward, Scott White, and the Pfizer A9001140 Team: Lydia Brunstetter, Peggy Coyle, Yevgenia Davidoff, Charles Packard, Ann Remmers, Mark Tengowski, Jeff Evelhoch (now Merck,West Point, PA, USA), and John Kotyk (now Washington University, St. Louis, MI, USA).
Conflicts of interest/funding and grants
Dr. Hellio Le Graverand-Gastineau and B. Wyman are employees of Pfizer. Drs. Majumdar and Link were partially funded by Pfizer. All investigators worked under grants received by Pfizer to conduct the A9001140 study.
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Stahl, R., Jain, S.K., Lutz, J. et al. Osteoarthritis of the knee at 3.0 T: comparison of a quantitative and a semi-quantitative score for the assessment of the extent of cartilage lesion and bone marrow edema pattern in a 24-month longitudinal study. Skeletal Radiol 40, 1315–1327 (2011). https://doi.org/10.1007/s00256-011-1156-9
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DOI: https://doi.org/10.1007/s00256-011-1156-9