Imaging of early (pre-radiographic) joint tissue degeneration and OA progression using advanced MRI-based biomarkers

F. Eckstein, F. Roemer, W. Wirth, Chondrometrics GmbH

Abstract:  No successful structural therapy for osteoarthritis  has been developed to date because of the lack of early diagnostic methods. Once detected by radiography, degeneration is potentially too far advanced for successful intervention. Magnetic resonance imaging (MRI) has been used to delineate synovial structures and measure cartilage thickness in knees with established OA. However, early “pre-radiographic” structural changes that may provide potentially easier targets for biomechanical or pharmacological treatments are currently unknown. Here we propose a model of early human knee osteoarthritis, in order to establish potent imaging outcomes and predictors of the initial phase of the disease, applicable to other consortium projects (DUDA, MADRY). To achieve this, Chondrometrics will analyse imaging data from the Osteoarthritis Initiative (OAI) public data base using its quality controlled and validated manual segmentation approach and using analysis technology. The group by Zachow/Ertel will perform fully automated segmentations of the same image data sets. A similarity index of the segmentations, agreement of cartilage volume/thickness results (cross-sectional and longitudinal), and potential synergy of both segmentation and analysis approaches will be evaluated. These results will provide valuable insights into specific tissue pathologies and clinical variables that predict development of early osteoarthritis  , including, among others, adipose tissue and muscle mass, cartilage composition (i.e. the cartilage transverse relaxation time T2), bone marrow-, meniscus- and cartilage- lesions. Given the role of muscle in biomechanically protecting the joint from overload, the endocrine role of adipose tissue and pro-inflammatory effects of adipokines and the adipose tissue effects on muscle quality, muscle and local adipose tissue content are of particular interest. In addition, the HEGE and BERGMANN projects will provide models for estimating medial knee load from alignment, limb length, pelvic width, weight and muscle mass using measurements that are available from the OAI. Based on these, we will correlate estimates of joint loading and regional tissue strain to regional structural change in early incident osteoarthritis  . Current therapies of OA include surgical correction of mal-alignment, exercise and diet. This study will support the development of various quality controlled and automated imaging markers for monitoring the efficacy of prevention of and therapy for early osteoarthritis  that will be translatable to a large German cohort (PERKA) and to future clinical trials.

Hinweis

Diese Seite gibt es nur in englischer Sprache.