Dataset Information

Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA.

ABSTRACT: To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA).Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the SWEdish FarmacOTherapy study. Fully automated JSW measurements of bilateral metacarpals 2, 3 and 4 were compared with the joint space narrowing (JSN) score in SHS. Multilevel mixed model statistics were applied to calculate the significance of the association between ?JSW and ?BMD over 1?year, and the JSW differences between damaged and undamaged joints as evaluated by the JSN.Based on 576 joints of 96 patients with eRA, a significant reduction from baseline to 1?year was observed in the JSW from 1.69 (±0.19) mm to 1.66 (±0.19) mm (p<0.01),?and BMD from 0.583 (±0.068) g/cm2 to 0.566 (±0.074) g/cm2 (p<0.01). A significant positive association was observed between ?JSW and ?BMD over 1?year (p<0.0001). On an individual joint level, JSWs of undamaged (JSN=0) joints were wider than damaged (JSN>0) joints: 1.68?mm (95%?CI 1.70 to 1.67) vs 1.54?mm (95%?CI 1.63 to 1.46). Similarly the unadjusted multilevel model showed significant differences in JSW between undamaged (1.68?mm (95%?CI 1.72 to 1.64)) and damaged joints (1.63?mm (95%?CI 1.68 to 1.58)) (p=0.0048). This difference remained significant in the adjusted model: 1.66?mm (95%?CI 1.70 to 1.61) vs 1.62?mm (95%?CI 1.68 to 1.56) (p=0.042).To measure the JSW with this fully automated digital tool may be useful as a quick and observer-independent application for evaluating cartilage damage in eRA.NCT00764725.

SUBMITTER: Platten M

PROVIDER: S-EPMC5574453 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA.

Platten Michael M Kisten Yogan Y Kälvesten Johan J Arnaud Laurent L Forslind Kristina K van Vollenhoven Ronald R

RMD open 20170629 1

<h4>Objectives</h4>To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA).<h4>Methods</h4>Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the SWEdish FarmacOTherapy study. Fully automated JSW measurements of bilateral metacarpals 2, 3 and 4 were compared with the joint space narrowing (JSN) score in SHS. Multile ...[more]

PMID: 28879043

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Project description:BACKGROUND:No consensus is available regarding the best method for measuring tibiofemoral joint space width (JSW) on radiographs to quantify joint changes after injury. Studies that track articular cartilage thickness after injury frequently use patients' uninjured contralateral knees as controls, although the literature supporting this comparison is limited. PURPOSE:(1) To compare JSW measurements using 2 established measurement techniques in healthy control participants and (2) to determine whether the mean JSW of the uninjured contralateral knee in a cohort with anterior cruciate ligament (ACL) reconstruction is different from that obtained from a true control population. STUDY DESIGN:Cohort study (diagnosis); Level of evidence, 2. METHODS:Medial and lateral JSWs were measured on standardized, bilateral, semiflexed metatarsophalangeal positioning, posteroanterior radiographs of 60 healthy individuals (26 females; mean ± SD age, 25 ± 6.2 years; no history of knee injury) via 2 published techniques: a computerized surface-delineation method (surface-fit method) and a manual digitization method (midpoint method). Bland-Altman method was used to examine the agreement between JSW measurements obtained with the 2 methods and to examine the agreement between measurements obtained on left and right knees within a participant for each measurement method. Within- and between-participant variance components and intraclass correlation coefficients (ICCs) were computed for JSW measurements corresponding to each method. Two-sample t tests were used to compare the surface-fit method measurements of mean JSW of the true control group (n = 60) with the previously published mean JSW measurements from the Multicenter Orthopaedics Outcomes Network (MOON) nested cohort of 262 contralateral uninjured knees 2 to 3 years after ACL reconstruction. RESULTS:For JSW in the medial compartment, the surface-fit method had lower within-participant interknee variability (?2within, 0.064; 95% CI, 0.04-0.09) compared with the midpoint method (?2within, 0.28; 95% CI, 0.20-0.43) and a higher ICC (0.93 vs 0.65; P < .001). Lateral JSW values were similar for the surface-fit method (?2within, 0.27; 95% CI, 0.18-0.43) and the midpoint method (?2within, 0.20; 95% CI, 0.14-0.31), with ICCs of 0.75 and 0.77, respectively (P = .80). With the surface-fit method, mean JSW measurements of the medial and lateral compartments of a control population were not significantly different from the contralateral uninjured knees of patients after ACL reconstruction. CONCLUSION:For measuring medial JSW, the surface-fit method was less variable across knees within a participant than the midpoint method, as evidenced by larger ICCs and lower interknee variability. For measuring lateral JSW, the 2 methods were similar. The JSW measurements of uninjured contralateral knees of patients with ACL reconstruction at 2 to 3 years postsurgery were not significantly different from those of a cohort of healthy control participants. Future work should be performed to demonstrate the validity of these methods for documenting change over time in the ACL-reconstructed knee.

Project description:Background While digital breast tomosynthesis (DBT) is rapidly replacing digital mammography (DM) in breast cancer screening, the potential of DBT density measures for breast cancer risk assessment remains largely unexplored. Purpose To compare associations of breast density estimates from DBT and DM with breast cancer. Materials and Methods This retrospective case-control study used contralateral DM/DBT studies from women with unilateral breast cancer and age- and ethnicity-matched controls (September 19, 2011-January 6, 2015). Volumetric percent density (VPD%) was estimated from DBT using previously validated software. For comparison, the publicly available Laboratory for Individualized Breast Radiodensity Assessment software package, or LIBRA, was used to estimate area-based percent density (APD%) from raw and processed DM images. The commercial Quantra and Volpara software packages were applied to raw DM images to estimate VPD% with use of physics-based models. Density measures were compared by using Spearman correlation coefficients (r), and conditional logistic regression was performed to examine density associations (odds ratios [OR]) with breast cancer, adjusting for age and body mass index. Results A total of 132 women diagnosed with breast cancer (mean age ± standard deviation [SD], 60 years ± 11) and 528 controls (mean age, 60 years ± 11) were included. Moderate correlations between DBT and DM density measures (r = 0.32-0.75; all P < .001) were observed. Volumetric density estimates calculated from DBT (OR, 2.3 [95% CI: 1.6, 3.4] per SD for VPD%DBT) were more strongly associated with breast cancer than DM-derived density for both APD% (OR, 1.3 [95% CI: 0.9, 1.9] [P < .001] and 1.7 [95% CI: 1.2, 2.3] [P = .004] per SD for LIBRA raw and processed data, respectively) and VPD% (OR, 1.6 [95% CI: 1.1, 2.4] [P = .01] and 1.7 [95% CI: 1.2, 2.6] [P = .04] per SD for Volpara and Quantra, respectively). Conclusion The associations between quantitative breast density estimates and breast cancer risk are stronger for digital breast tomosynthesis compared with digital mammography. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Yaffe in this issue.

Project description:BackgroundIt has been hypothesized that quadriceps muscle weakness is directly associated with the onset and progression of posttraumatic osteoarthritis after anterior cruciate ligament (ACL) injury and reconstruction (ACLR). This relationship, however, has not been studied with a prospective approach that includes the use of tibiofemoral joint space width difference (JSW-D) measurements to characterize the onset of posttraumatic osteoarthritis before the clinical manifestation of the disease.PurposeTo assess the relationship between thigh muscle strength and JSW-D at presurgery baseline and at 1- and 4-year follow-up after ACLR compared with healthy, noninjured participants of similar sex, age, body mass index, and activity level.Study designCohort study; Level of evidence, 3.MethodsA total of 39 unilateral ACL-injured patients and 32 healthy controls were followed prospectively. During each follow-up, JSW, isokinetic knee strength, single-legged hop, and clinical- and patient-oriented outcomes were assessed. At final follow-up, ACL-injured participants who had JSW-D values (considered as the injured minus normal knee) that were less than the 95% confidence interval of controls were considered to be in the ACLR-narrow group, while those with JSW-D values that fell within the confidence intervals were in the ACLR-normal group. Relationships were evaluated between ACLR groups and controls via multilevel regression, as well as Kruskal-Wallis tests for between-group comparisons at 4-year follow-up.ResultsAt 4-year follow-up, 30 participants (79%) were in the ACLR-normal group and 8 (21%) were in the ACLR-narrow group. At baseline, the extension, flexion, and extension/flexion ratio strength values for both ACLR groups were significantly lower than those of controls (P ≤ .05), while the ACLR-narrow group had significantly lower extension strength at 60 and 180 deg/s (P = .04 and .03, respectively), as well as extension/flexion ratio at 60 deg/s (P = .04) in comparison with the ACL-normal group. At 4-year follow-up, 60 deg/s extension strength deficits persisted in the ACLR-narrow group compared with controls and ACLR-normal participants (P = .01 and .04, respectively). Flexion strength at 180 and 300 deg/s was also significantly lower in the ACLR-narrow group compared with ACLR-normal (P = .02 and .04, respectively), as was single-legged hop distance (P = .04).ConclusionStrength deficits present within months after ACL injury and persist through 4 years after ACLR in participants with significantly narrowed JSW-D, compared with ACLR participants with normal JSW-D and controls. This study revealed a significant relationship between quadriceps strength loss that occurred soon after injury and JSW narrowing.

Project description:BackgroundAlthough the association between femoroacetabular impingement (FAI) syndrome and hip osteoarthritis (OA) is well established, not all hips exhibiting cam or pincer morphologies (i.e. imaging findings of FAI syndrome) are symptomatic or arthritic. It is difficult to detect which subgroup will wear out, or how does the arthritic process start radiographically. Therefore, we measured in a retrospective study based on computed tomography (CT) analysis, the joint space width (JSW) according to a standard protocol and we investigated its variation according to the presence of a cam and/or pincer morphology. We hypothesized that the radiological presence of a cam and/or pincer hip morphologies, even in asymptomatic subjects, would affect JSW.MethodsTwo hundred pelvic CT scans performed for non-orthopedic etiologies in asymptomatic patients were analyzed using a 3D software. After excluding patients with hip OA or previous hip surgery, 194 pelvic CT scans (388 hips) were retained. We measured for each hip the presence of FAI syndrome imaging findings (cam and pincer morphologies) using the classical parameters of coxometry. In addition, we performed a measurement of articular joint space width according to a standard protocol. We then calculated the mean thickness of 3 defined regions along the femoroacetabular joint: anterior-superior, posterior-inferior, and posterior-superior. Lastly, we compared the JSW across 4 groups: hips with (1) no cam or pincer, (2) pincer, (3) cam, and (4) cam and pincer morphologies using a multivariate analysis. Additionally, a topographic heatmap of JSW was plotted allowing quantitative representation of JSW along the joint.ResultsIncreased JSW with peak difference of 0.9 mm (25.7%) was found in hips with cam and pincer morphologies when compared to normal ones (p = 0.002) and to hips with pincer or cam morphologies only.ConclusionPositive variations in JSW were associated to the presence of cam and pincer morphologies. This significant increase in JSW could be one of the earliest measurable changes preceding later classical alterations.

Project description:BackgroundPosttraumatic osteoarthritis (PTOA) of the subtalar joint is a serious, disabling, and frequent complication following intra-articular calcaneal fractures (IACFs). Using plain radiographs to assess the subtalar joint for PTOA is imprecise and insensitive, hindering progress toward improving treatment and assessing outcomes. This study explored how low-dose weightbearing computed tomography (WBCT) can be used to provide reliable, quantitative 3D measures of subtalar joint space width (JSW) following IACF and correlated the 3D JSW with clinical outcomes.MethodsAfter institutional review board approval, 21 patients (15 male; age, 28-70 years) who sustained IACFs and were treated with percutaneous surgical reduction underwent WBCT scans at follow-up visits 2 to 15 years (average, 7.8 years) after surgical treatment. Subtalar joint 3D JSW was computed after a semiautomated protocol was used to segment the talus and calcaneus from the WBCT data. Mean and minimum 3D JSW measurements were calculated and compared with Kellgren-Lawrence (KL) radiographic osteoarthritis grade, RAND-36 Physical (PCS) and Mental (MCS) Component Scores, and visual analog scale (VAS) pain scores. Spearman's rank correlation was used to detect the strength of association between variables, with significance set at P < .05.ResultsMean 3D JSW values measured from WBCT for patients with IACFs ranged from 0.9 to 2.5 mm (1.7 ± 0.4 mm) over the entire subtalar joint. Intra- and interrater reliabilities for the WBCT-based JSW measurement technique were 0.95 (95% CI, 0.91-0.97) and 0.97 (95% CI, 0.95-0.98), respectively. Mean and minimum 3D JSW values correlated inversely with VAS pain scores and KL grade (P < .05), particularly in central and posterior subtalar regions.ConclusionWBCT-based methods were used to quantify the preservation/loss of JSW in patients with IACFs, enabling more accurate, definitive measurement of subtalar PTOA. The results of this study demonstrate that WBCT can be utilized to objectively assess subtalar PTOA and help us to better understand how arthritic changes affect actual patient experience.Level of evidenceLevel III, prognostic comparative study.

Dataset Information

Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA.

Publications

Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA.

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