Trabecular morphometry by fractal signature analysis is a novel marker of osteoarthritis progression

Abstract

Objective To evaluate the utility of subchondral bone texture from a baseline x-ray image for predicting 3-year knee osteoarthritis (OA) progression. Methods A total of 138 participants in the Prediction of Osteoarthritis Progression (POP) study were evaluated at baseline and 3 years. Fixed-flexion knee radiographs of the 248 non-replaced knees underwent fractal analysis of the medial subchondral tibial plateau using a commercially available software tool. OA progression was defined as a 1-grade change in joint space narrowing (JSN) or osteophyte based on a standardized knee atlas. Statistical analysis of fractal signatures was performed using a new method based on modeling the overall shape of fractal dimension versus radius curves. Results Baseline fractal signature of the medial tibial plateau was predictive of medial knee JSN progression (area under the curve [AUC] of Receiver Operating Characteristic plot of 0.75), but not progression based on osteophyte or progression of the lateral compartment. The traditional covariates (age, gender, body mass index, knee pain), general bone mineral content, and baseline joint space width fared little better than random variables for predicting OA progression (AUC 0.52–0.58). The maximal predictive model combined baseline fractal signature, knee alignment, traditional covariates, and bone mineral content (AUC 0.79). Conclusions We identified a prognostic marker of OA that is readily extracted from a plain radiograph by fractal signature analysis. The global shape approach to analyzing these data is a potentially efficient means of identifying individuals at risk of knee OA progression that needs to be validated in a second cohort.

Quantifying the tibiofemoral joint space using x‐ray tomosynthesis

“…28,29 A texture based, morphometric analysis may be more accurate with tomosynthesis than standard projection imaging due to the lack of superimposed structure. This effect has recently been demonstrated for breast cancer risk assessment from breast tomosynthesis images.…”

Use magnetic resonance imaging to assess articular cartilage

“…Fractal analysis of trabecular bone texture on radiographs has been shown to be a promising approach for assessing early knee OA [Kraus et al 2009;Wolski et al 2010Wolski et al , 2011. In subjects without radiographic knee OA, trabecular bone texture in the proximal tibia is different between those with and without tibiofemoral cartilage defects, where trabecular bone texture roughness is greater in those with cartilage defects than in those without [Wolski et al 2011].…”

The causes of pain in osteoarthrosis and the factors of disease progression (a review of literature)

“…Kraus и соавт. [83] тоже была предприня-та попытка использования мониторинга рентгенографиче-ской структуры СХК для оценки прогрессирования гонар-троза. В данное проспективное исследование вошло 138 больных, период наблюдения составил 3 года, прогресси-рование гонартроза оценивалось по сужению суставной щели и росту остеофитов.…”