Structural tissue damage and 24-month progression of semi-quantitative MRI biomarkers of knee osteoarthritis in the IMI-APPROACH cohort
Creators
- Roemer, Frank W.1
- Jansen, Mylène2
- Marijnissen, Anne C. A.2
- Guermazi, Ali3
- Heiss, Rafael1
- Maschek, Susanne4
- Lalande, Agnes5
- Blanco, Francisco J.6
- Berenbaum, Francis7
- van de Stadt, Lotte A.8
- Kloppenburg, Margreet8
- Haugen, Ida K.9
- Ladel, Christoph H.10
- Bacardit, Jaume11
- Wisser, Anna4
- Eckstein, Felix4
- Lafeber, Floris P. J. G.2
- Weinans, Harrie H.2
- Wirth, Wolfgang4
- 1. Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- 2. University Medical Center Utrecht, Utrecht, The Netherlands
- 3. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
- 4. Chondrometrics GmbH, Freilassing, Germany
- 5. Institut de Recherches Internationales Servier, Suresnes, France
- 6. Servicio de Reumatologia, INIBIC- Universidade de A Coruña, A Coruña, Spain
- 7. Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France
- 8. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
- 9. Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
- 10. Independent Consultant, Darmstadt, Germany
- 11. School of Computing, Newcastle University, Newcastle, UK
Description
Background: The IMI-APPROACH cohort is an exploratory, 5-centre, 2-year prospective follow-up study of knee osteoarthritis (OA). Aim was to describe baseline multi-tissue semiquantitative MRI evaluation of index knees and to describe change for different MRI features based on number of subregion-approaches and change in maximum grades over a 24-month period.
Methods: MRIs were acquired using 1.5 T or 3 T MRI systems and assessed using the semi-quantitative MRI OA Knee Scoring (MOAKS) system. MRIs were read at baseline and 24-months for cartilage damage, bone marrow lesions (BML), osteophytes, meniscal damage and extrusion, and Hoffa- and effusion-synovitis. In descriptive fashion, the frequencies of MRI features at baseline and change in these imaging biomarkers over time are presented for the entire sample in a subregional and maximum score approach for most features. Differences between knees without and with structural radiographic (R) OA are analyzed in addition.
Results: Two hundred eighty-nine participants had readable baseline MRI examinations. Mean age was 66.6 ± 7.1 years and participants had a mean BMI of 28.1 ± 5.3 kg/m2. The majority (55.3%) of included knees had radiographic OA. Any change in total cartilage MOAKS score was observed in 53.1% considering full-grade changes only, and in 73.9% including full-grade and within-grade changes. Any medial cartilage progression was seen in 23.9% and any lateral progression on 22.1%. While for the medial and lateral compartments numbers of subregions with improvement and worsening of BMLs were very similar, for the PFJ more improvement was observed compared to worsening (15.5% vs. 9.0%). Including within grade changes, the number of knees showing BML worsening increased from 42.2% to 55.6%. While for some features 24-months change was rare, frequency of change was much more common in knees with vs. without ROA (e.g. worsening of total MOAKS score cartilage in 68.4% of ROA knees vs. 36.7% of no-ROA knees, and 60.7% vs. 21.8% for an increase in maximum BML score per knee).
Conclusions: A wide range of MRI-detected structural pathologies was present in the IMI-APPROACH cohort. Baseline prevalence and change of features was substantially more common in the ROA subgroup compared to the knees without ROA.
Trial Registration: Clinicaltrials.gov identification: NCT03883568.
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