Abstract
Alterations in cartilage thickness (CTh) are a hallmark of knee osteoarthritis, which remain difficult to characterize at high resolution, even with modern magnetic resonance imaging (MRI), due to a paucity of standardization tools. This study aimed to assess a computational anatomy method producing standardized two-dimensional femorotibial CTh maps. The method was assessed with twenty knees, processed following three common experimental scenarios. Cartilage thickness maps were obtained for the femorotibial cartilages by reconstructing bone and cartilage mesh models in tree-dimension, calculating three-dimensional CTh maps, and anatomically standardizing the maps. The intra-operator accuracy (median (interquartile range, IQR) of −0.006 (0.045) mm), precision (0.152 (0.070) mm), entropy (7.02 (0.71) and agreement (0.975 (0.020))) results suggested that the method is adequate to capture the spatial variations in CTh and compare knees at varying osteoarthritis stages. The lower inter-operator precision (0.496 (0.132) mm) and agreement (0.808 (0.108)) indicate a possible loss of sensitivity to detect differences in a setting with multiple operators. The results confirmed the promising potential of anatomically standardized maps, with the lower inter-operator reproducibility stressing the need to coordinate operators. This study also provided essential reference data and indications for future research using CTh maps.
Highlights
Knee osteoarthritis (OA) is a serious health concern [1,2], requiring better measure of the alterations in cartilage thickness (CTh) to allow more sensitive monitoring of its development and improve our understanding of its physiopathology
While regions of interest (ROIs) revealed to be useful to evaluate CTh and provided important insight into the pathogenesis of knee OA, their uses limit the analysis of spatial variations in CTh
This study aimed to provide a basis for the interpretation of 2D anatomically standardized CTh maps by characterizing the intra- and inter-operator reproducibility and quantifying the differences among healthy knees for three common comparison scenarios
Summary
Knee osteoarthritis (OA) is a serious health concern [1,2], requiring better measure of the alterations in cartilage thickness (CTh) to allow more sensitive monitoring of its development and improve our understanding of its physiopathology. MR images are usually segmented to create 3D CTh maps corresponding to the 3D surface of the subchondral bones, describing CTh with high spatial resolution [5,6]. Comparing CTh maps among different knees is challenging, because the size and shape of the subchondral bone surfaces differ from knee to knee. There is a need for standardization methods to mitigate the differences in bone morphologies and allow for comparing maps between time points and knees
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