MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)?inter-observer and intra-observer reproducibility of a compartment-based scoring system

Kornaat, Peter R.; Ceulemans, R.; Kroon, Herman M.; Riyazi, N.; Kloppenburg, Margreet; Carter, Wayne O.; Woodworth, Thasia; Bloem, Johan L.

doi:10.1007/s00256-004-0828-0

Cited by 278 publications

(178 citation statements)

References 28 publications

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“…The same classification system has recently been successfully applied to images acquired with a 1.0 T peripheral MR imaging system and a time-efficient sequence protocol has been proposed for this purpose that was compared with an established reference protocol with longer acquisition time (33). Another compartment-based scoring system, termed knee osteoarthritis scoring system (KOSS), has also been published, with intra-observer reproducibility of 0.76-0.96 (ICC) and inter-observer reproducibility amongst two independent observers of 0.63-0.915 (56). Some limitations of these scoring systems have been characterized by Conaghan et al (57), who applied the WORMS grading systems to knees of 336 subjects (three readers) and compared these with a Rasch measurement model.…”

Section: Image Analysis Techniquesmentioning

confidence: 99%

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

2006

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Magnetic resonance imaging (MRI) and quantitative image analysis technology has recently started to generate a great wealth of quantitative information on articular cartilage and bone physiology, pathophysiology and degenerative changes in osteoarthritis. This paper reviews semiquantitative scoring of changes of articular tissues (e.g. WORMS ¼ whole-organ MRI scoring or KOSS ¼ knee osteoarthritis scoring system), quantification of cartilage morphology (e.g. volume and thickness), quantitative measurements of cartilage composition (e.g. T 2 , T 1rho , T 1Gd ¼ dGEMRIC index) and quantitative measurement of bone structure (e.g. app. BV/TV, app. TbTh, app. Tb.N, app. Tb.Sp) in osteoarthritis. For each of these fields we describe the hardware and MRI sequences available, the image analysis systems and techniques used to derive semiquantitative and quantitative parameters, the technical accuracy and precision of the measurements reported to date and current results from cross-sectional and longitudinal studies in osteoarthritis. Moreover, the paper summarizes studies that have compared MRI-based measurements with radiography and discusses future perspectives of quantitative MRI in osteoarthritis. In summary, the above methodologies show great promise for elucidating the pathophysiology of various tissues and identifying risk factors of osteoarthritis, for developing structure modifying drugs (DMOADs) and for combating osteoarthritis with new and better therapy. Copyright # 2006 John Wiley & Sons, Ltd.KEYWORDS: osteoarthritis; joint; cartilage; bone; magnetic resonance imaging; knee; image analysis; disease-modifying drugs RATIONALE FOR QUANTITATIVE MRI OF CARTILAGE AND BONE IN OSTEOARTHRITISThe health and integrity of diarthrodial (synovial) joints are prerequisites for pain-free movement and have a major impact on the quality of life. However, the population of individuals above the age of 65 years is rapidly growing and 70% of the women and 60% of the men aged 65 years or older suffer from degenerative joint disease [¼ osteoarthritis (OA)] (1-7). OA has been defined by the American College of Rheumatology (ACR) as a 'heterogeneous group of conditions that leads to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins'. It remains an open question whether the initial changes take place in cartilage or bone or other articular tissues and, more importantly, what the causal relationship between these changes is (5-19). Also, within each NMR IN BIOMEDICINE NMR Biomed. 2006; 19: 822-854 Published online in Wiley InterScience (www.interscience.wiley.com). DOI:10.1002/nbm.1063 narrowing; JSW, joint space width; K, knee; KLG, Kellgren Lawrence grade; KOSS, knee osteoarthritis scoring system; LF, lateral femoral condyle; LT, lateral tibia; MRI, magnetic resonance imaging; MF, medial femoral condyle; MT, medial tibia; OA, osteoarthritis; OAI, Osteoarthritis Initiative; P, patella; PGs, proteoglycans;...

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Section: Image Analysis Techniquesmentioning

confidence: 99%

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

2006

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“…Despite the fact that these changes play a major role in this disease, semi-quantitative scoring systems [9][10][11][12][13] are generally used because a reliable quantification method is lacking. There have been very few technologies developed aimed at the quantification of BMLs using solely MRI.…”

Section: Discussionmentioning

confidence: 99%

“…In the last decade, scoring of BMLs in MRI systematically appears in the various osteoarthritis knee evaluation systems contributing to the final grade of an overall knee condition [9][10][11][12][13] commonly used in longitudinal studies. In parallel, the combination of MRI and image processing techniques has allowed several semiautomatic and automatic systems to be developed for articular tissue segmentation including bone [14][15][16][17][18] , cartilage [19][20][21][22][23] , menisci [24] , and synovitis [25] for quantitative and semi-quantitative evaluation.…”

Section: Introductionmentioning

confidence: 99%

A fully automated system for quantification of knee bone marrow lesions using MRI and the osteoarthritis initiative cohort

Dodin¹,

Abram²,

Pelletier³

et al. 2012

JBGC

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Background/Objective: Bone marrow lesions (BMLs) have been associated with pain and cartilage degeneration in patients with knee osteoarthritis; their specific detection and quantification is therefore of primary importance. This study aimed at developing a fully automated quantitative BML assessment technology for human knee osteoarthritis using magnetic resonance images (MRI) and two sequences, a T1/T2*-weighted gradient echo (DESS) and a water-sensitive intermediate-weighted turbo spin echo (IW-TSE). Methods:The automated BML quantification first characterizes the bone and cartilage domains in the DESS sequence using our already published automated technology, then proceeds to the BML quantification which was developed as a four-stage process: selection of structured bright areas corresponding to BMLs, geometric filtering of unrelated structures, segmentation of the BML, and quantification of BML proportion within bone regions. For the IW-TSE sequence, the first step consists of the transfer of the bone and cartilage objects from the DESS to the IW-TSE images, followed by the BML detection and quantification as for the DESS. Validation was performed on 154 OA patients from a subset of the Osteoarthritis Initiative (OAI) cohort (public data sets) in which BML manual segmentation intra-and inter-reader reliability was done for each sequence (DESS and IW-TSE) using the intraclass correlation (ICC). BML comparison between the newly developed automated method with a manual segmentation was performed with ICC for the proportion of BML and Dice similarity coefficient (DSC) for BML localization and geometric extent. Finally, comparisons between the DESS and the IW-TSE sequences were performed for BML incidence and proportion.Results: Excellent to very good correlations were obtained for both MRI sequences for intra-and inter-reader reliability of the manual BML segmentation. Comparison between the developed automated method and the manual BML segmentation showed excellent to very good correlations in the global knee and regions (ICC=0.99 to 0.68 for DESS and 0.99 to 0.77 for IW-TSE sequences) as well as very good to good similarity for the BML geometrical agreement (DESS, 0.60 to 0.41; IW-TSE, 0.59 to 0.41). Data revealed greater BML incidence at the sites of high articular constraints: lateral femoropatellar and medial tibiofemoral articulation. Average BML proportion revealed a scaling factor of about 4.5-fold more for the IW-TSE compared to the DESS. www.sciedu.ca/jbgc Journal of Biomedical Graphics and Computing, 2013, Vol. 3, No. 1 ISSN 1925-4008 E-ISSN 1925 52 Conclusions: The newly developed fully automated MRI based BML assessment technology not only detects the absence/ presence of these pathological signals in the osteoarthritic human knee, but also provides accurate quantitative assessment of BMLs in the global knee and knee regions. Such automated system will enable large scale studies to be conducted within shorter durations, as well as increase stability of the reading.

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“…Klinik pratikte, dizde kıkırdak lezyonları sıklıkla modifiye Noyes, Outerbridge skalasıy-la ya da ICRS (International Cartilage Repair Society) sınıflandırmasıyla derecelendirilir [10]. Klinik araştırmalarda özellikle diz osteoartrit çalışmalarında MR görüntüleme ile kıkır-dağın morfolojik değerlendirmesinde; WOR-MS (Whole-Organ MR Imaging Score) [11] BLOKS (Boston-Leeds Osteoarthritis Knee Score) [12] ve KOSS (Knee Osteoarthritis Scoring System) [13] gibi yarı kantitatif skorlama sistemleri kullanılmaktadır. Bu skorlama sistemlerinde, eklem kıkırdağının morfolojik özellikleri, diz etrafındaki diğer yapılar (örn; menisküsler, subkondral kemik, osteofitler ve sinovyum) ile birlikte değerlendirilir.…”

Section: Kıkırdak Lezyonlarının Tarif Edilmesiunclassified

Diz Eklemi: Kikirdak

Sabir¹,

Tanriverdi²

2017

Trd Sem

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Kıkırdak Yapısı ve FonksiyonuEklem kıkırdağı net ağırlığının %4'ü kondrositlerden, geri kalan büyük kısmı ekstraselü-ler matriksten oluşur. Ekstraselüler mesafenin %65-85'ini su, çok az bir kısmını proteoglikan ve tip II kollajen oluşturur [1,2]. Yüksek sı-kıştırma kuvvetine dayanmayı sağlayan proteoglikan kıkırdak net ağırlığının %3-10'unu oluştururken, gerilme kuvvetinden sorumlu kollajen %15-20'sini yapar [1]. Eklem kıkırda-ğının lenfatiklerden, kan damarı ve sinirlerden yoksun olması iyileşme ve onarım potansiyelini kısıtlar [2]. Eklem kıkırdağının makromoleküler matris yapısının korunması eklem sağ-lığı için hayatidir. Tip II kollajenin kompleks üç boyutlu oryantasyonu doku anizotropisinden sorumludur [3]. Kıkırdağın eklem yüzeyi lamina splendis ile korunur; yoğun kollajen demetlerinin yüzeyindeki lubrisin adı verilen proteoglikan ve sinovyal sıvı kayganlık sağlar [4]. Kıkırdağın yüzeyel zonu kollajen lifleri ve eklem yüzeyine paralel elonge kondrositlerden; orta zon yuvarlak kontrositler ile rastgele konumlanmış kollajen fiberlerinden; derin zon ise kemik yüzeye dik olarak yerleşmiş elonge kondrositlerden ve kalın kollajen demetlerinden oluşur. Derin zonda radyal uzanan kollajen fibrilleri subkondral kemiğe bağlanmak için kalsifiye zona uzanır [2].Ayak bileği kıkırdak kalınlığı ortalama 1,1 mm iken; patella kıkırdağı farklı olarak 5 mm ve üzeri olabilir [5,6]. Farklı eklemlerdeki farklı kıkırdak yapıları gelişen farklı tipte kı-kırdak lezyonlarını da açıklar; örneğin idyopatik osteoartrit diz eklemi kıkırdağında daha sık iken osteokondral lezyonlar daha sık ayak bileğinde görülür [7]. Kıkırdak Görüntüleme EndikasyonlarıOsteoartrit, kronik ve akut osteokondral zedelenme, kondromalazi patella, femur kondilinin spontan osteonekrozu (SONK veya Ahlbaeck's hastalığı), enflamatuar artropatiler, invaziv kıkırdak onarımı ve konzervatif terapiler

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MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)?inter-observer and intra-observer reproducibility of a compartment-based scoring system

Cited by 278 publications

References 28 publications

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

A fully automated system for quantification of knee bone marrow lesions using MRI and the osteoarthritis initiative cohort

Diz Eklemi: Kikirdak

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