Abstract
PurposeSynovitis is common in knee osteoarthritis and is associated with both knee pain and progression of disease. Semiautomated methods have been developed for quantitative assessment of structure in knee osteoarthritis. Our aims were to apply a novel semiautomated assessment method using 3D active appearance modeling for the quantification of synovial tissue volume (STV) and to compare its performance with conventional manual segmentation.MethodsThirty‐two sagittal T1‐weighted fat‐suppressed contrast‐enhanced MRIs were assessed for STV by a single observer using 1) manual segmentation and 2) a semiautomated approach. We compared the STV analysis using the semiautomated and manual segmentation methods, including the time taken to complete the assessments. We also examined the reliability of STV assessment using the semiautomated method in a subset of 12 patients who had participated in a clinical trial of vitamin D therapy in knee osteoarthritis.ResultsThere was no significant difference in STV using the semiautomated quantitative method compared to manual segmentation, mean difference = 207.2 mm3 (95% confidence interval −895.2 to 1309.7). The semiautomated method was significantly quicker than manual segmentation (18 vs. 71 min). For the semiautomated method, intraobserver agreement was excellent (intraclass correlation coefficient (3,1) = 0.99) and interobserver agreement was very good (intraclass correlation coefficient (3,1) = 0.83).ConclusionWe describe the application of a semiautomated method that is accurate, reliable, and quicker than manual segmentation for assessment of STV. The method may help increase efficiency of image assessment in large imaging studies and may also assist investigation of treatment efficacy in knee osteoarthritis.
Highlights
Osteoarthritis (OA) is a painful and debilitating disorder of the synovial joints, with the knee being the most frequently involved painful site.[1]
Each training image was loosely annotated by manual segmentation for regions containing synovitis across the whole joint; work completed as part of the Brace and TASK studies
The intraobserver agreement was excellent for assessment of STV using the semiautomated method, and interobserver agreement was very good
Summary
Semiautomated methods have been developed for quantitative assessment of structure in knee osteoarthritis. We compared the STV analysis using the semiautomated and manual segmentation methods, including the time taken to complete the assessments. We examined the reliability of STV assessment using the semiautomated method in a subset of 12 patients who had participated in a clinical trial of vitamin D therapy in knee osteoarthritis. Results: There was no significant difference in STV using the semiautomated quantitative method compared to manual segmentation, mean difference = 207.2 mm[3] (95% confidence interval −895.2 to 1309.7). Conclusion: We describe the application of a semiautomated method that is accurate, reliable, and quicker than manual segmentation for assessment of STV. The method may help increase efficiency of image assessment in large imaging studies and may assist investigation of treatment efficacy in knee osteoarthritis
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