Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis

Kothari, Mrityunjay; Guermazi, Ali; Ingersleben, Gabriele von; Miaux, Y; Sieffert, Martine; Block, Jon E.; Stevens, R.; Peterfy, Charles

doi:10.1007/s00330-004-2312-6

Cited by 202 publications

(186 citation statements)

References 19 publications

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“…Previous studies found that computerized JSW measurements in the medial and lateral knee compartments were more precise, accurate, and reproducible. [7][8][9] Shamir et al 10 proposed an automated method using features of a 2D X-ray image to determine the equivalent grade on the Kellgren-Lawrence scale. Duryea et al 11 introduced a trainable rule-based algorithm for measuring JSW in projection knee radiographs.…”

Section: Introductionmentioning

confidence: 99%

Quantifying the tibiofemoral joint space using x‐ray tomosynthesis

Kalinosky

Sabol²,

Piacsek³

et al. 2011

Medical Physics

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Purpose: Digital x-raytomosynthesis (DTS) has the potential to provide 3D information about the knee joint in a load-bearing posture, which may improve diagnosis and monitoring of knee osteoarthritis compared with projection radiography, the current standard of care. Manually quantifying and visualizing the joint space width (JSW) from 3D tomosynthesis datasets NOT THE PUBLISHED VERSION; this is the author's final, peer-reviewed manuscript. The published version may be accessed by following the link in the citation at the bottom of the page.Medical Physics, Vol. 38, No. 12 (December 2011): pg. 6672-6682. DOI. This article is © American Association of Physicists in Medicine and permission has been granted for this version to appear in e-Publications@Marquette. American Association of Physicists in Medicine does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from American Association of Physicists in Medicine.2 may be challenging. This work developed a semiautomated algorithm for quantifying the 3D tibiofemoral JSW from reconstructed DTS images. The algorithm was validated through anthropomorphic phantom experiments and applied to three clinical datasets. Methods:A user-selected volume of interest within the reconstructed DTS volume was enhanced with 1D multiscale gradient kernels. The edgeenhanced volumes were divided by polarity into tibial and femoral edge maps and combined across kernel scales. A 2D connected components algorithm was performed to determine candidate tibial and femoral edges. A 2D joint space width map (JSW) was constructed to represent the 3D tibiofemoral joint space. To quantify the algorithm accuracy, an adjustable knee phantom was constructed, and eleven posterior-anterior (PA) and lateral DTS scans were acquired with the medial minimum JSW of the phantom set to 0-5 mm in 0.5 mm increments (VolumeRad™, GE Healthcare, Chalfont St. Giles, United Kingdom). The accuracy of the algorithm was quantified by comparing the minimum JSW in a region of interest in the medial compartment of the JSW map to the measured phantom setting for each trial. In addition, the algorithm was applied to DTS scans of a static knee phantom and the JSW map compared to values estimated from a manually segmented computed tomography(CT) dataset. The algorithm was also applied to three clinical DTS datasets of osteoarthritic patients. Results:The algorithm segmented the JSW and generated a JSW map for all phantom and clinical datasets. For the adjustable phantom, the estimated minimum JSW values were plotted against the measured values for all trials. A linear fit estimated a slope of 0.887 (R 2 = 0.962) and a mean error across all trials of 0.34 mm for the PA phantom data. The estimated minimum JSW values for the lateral adjustable phantom acquisitions were found to have low correlation to the measured values (R 2 = 0.377), with a mean error of 2.13 mm. The error in the lateral adjustable-phantom datasets appeared to be caused by artifacts ...

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Section: Introductionmentioning

confidence: 99%

Quantifying the tibiofemoral joint space using x‐ray tomosynthesis

Kalinosky

Sabol²,

Piacsek³

et al. 2011

Medical Physics

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“…The TF angle was measured on AP radiographs in full extension [44]. The reliability of the radiographic measurements of the TF angle (ICC C 0.93 [38,44]) and medial knee JS (ICC = 0.94 [43]) have been documented in the past.…”

Section: Methodsmentioning

confidence: 99%

Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study

Zifchock

Kirane

Hillstrom

2011

Clinical Orthopaedics &Amp; Related Research

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Background Although the severity of knee osteoarthritis (OA) usually is assessed using different measures of joint structure, function, and pain, the relationships between these measures are unclear. Purpose Therefore, we: (1) examined the relationships between the measures of knee structure (flexion-extension range of motion, radiographic tibiofemoral angle, and medial joint space), function (Knee Osteoarthritis Outcome Scores [KOOS], peak adduction angle, and moment), and pain (visual analog scale [VAS]); and (2) identified variables that best predicted knee pain. Methods We assessed 15 patients with medial knee OA using VAS pain, KOOS questionnaire, 3-D gait analysis, and radiographic examination. Parameter relationships were assessed using Pearson correlation, and variables most predictive of knee pain were determined using a stepwise multiple regression. Results Subjective measurements correlated (|r| C 0.54) with one another, as did most of the objective measurements (|r| C 0.56) except for adduction moment which did not correlate with any variable. All variables correlated (|r| [ 0.54) with VAS knee pain except peak adduction moment. Medial joint space and peak adduction angle best predicted knee pain, accounting for approximately threequarters of the model variance (r 2 = 0.73).

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“…All 40 participants had both knees (total 80 knees) imaged using the VolumeRAD TM imaging apparatus (GE Healthcare, Milwaukee, Wisconsin, USA) in a weight-bearing fixed-flexion position with the aid of the SynaFlexer TM positioning frame (CCBR-Synarc, Newark, New Jersey, USA) (24,25). Thirty-nine reconstructed coronal section tomosynthesis images were acquired with a nominal section thickness of 1 mm without any overlap.…”

Section: Acquisition Of Tomosynthesis Imagesmentioning

confidence: 99%

Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise

Hayashi

Gusenburg³

et al. 2014

Diagn Interv Radiol

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ORIGINAL ARTICLE PURPOSE We aimed to assess reliability of the evaluation of osteophytes and subchondral cysts on tomosynthesis images when read by radiologists with different levels of expertise. MATERIALS AND METHODSForty subjects aged >40 years had both knees evaluated using tomosynthesis. Images were read by an "experienced" reader (musculoskeletal radiologist with prior experience) and an "inexperienced" reader (radiology resident with no prior experience). Readers graded osteophytes from 0 to 3 and noted the presence/absence of subchondral cysts in four locations of the tibiofemoral joint. Twenty knees were randomly selected and re-read. Inter-and intrareader reliabilities were calculated using overall exact percent agreement and weighted κ statistics. Diagnostic performance of the two readers was compared against magnetic resonance imaging readings by an expert reader (professor of musculoskeletal radiology). RESULTSThe experienced reader showed substantial intrareader reliability for graded reading of osteophytes (90%, κ=0.93), osteophyte detection (95%, κ=0.86) and cyst detection (95%, κ=0.83). The inexperienced reader showed perfect intrareader reliability for cyst detection (100%, κ=1.00) but intrareader reliability for graded reading (75%, κ=0.79) and detection (80%, κ=0.61) of osteophytes was lower than the experienced reader. Inter-reader reliability was 61% (κ=0.72) for graded osteophyte reading, 91% (κ=0.82) for osteophyte detection, and 88% (κ=0.66) for cyst detection. Diagnostic performance of the experienced reader was higher than the inexperienced reader regarding osteophyte detection (sensitivity range 0.74-0.95 vs. 0.54-0.75 for all locations) but diagnostic performance was similar for subchondral cysts. CONCLUSION Tomosynthesis offers excellent intrareader reliability regardless of the reader experience, but experience is important for detection of osteophytes.

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Fixed-flexion radiography of the knee provides reproducible joint space width measurements in osteoarthritis

Cited by 202 publications

References 19 publications

Quantifying the tibiofemoral joint space using x‐ray tomosynthesis

Quantifying the tibiofemoral joint space using x‐ray tomosynthesis

Are Joint Structure and Function Related to Medial Knee OA Pain? A Pilot Study

Reliability of semiquantitative assessment of osteophytes and subchondral cysts on tomosynthesis images by radiologists with different levels of expertise

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