Semiquantitative Imaging Biomarkers of Knee Osteoarthritis Progression: Data From the Foundation for the National Institutes of Health Osteoarthritis Biomarkers Consortium.
To determine the association between changes in semiquantitative magnetic resonance imaging (MRI) biomarkers over 24 months and radiographic and pain progression over 48 months in knees with mild-to-moderate osteoarthritis (OA).



We undertook a nested case-control study as part of the Foundation for the National Institutes of Health Biomarkers Consortium Project. We used multivariable logistic regression models to examine the association between change over 24 months in semiquantitative MRI markers and radiographic and pain progression in knee OA. MRIs were read according to the MRI OA Knee Score system. We focused on changes in cartilage, osteophytes, meniscus, bone marrow lesions, Hoffa-synovitis, and effusion-synovitis.



The most parsimonious model included changes in cartilage thickness and surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology (C statistic 0.740). Compared with no worsening, worsening in cartilage thickness in ≥3 subregions was associated with 2.8-fold (95% confidence interval [95% CI] 1.3-5.9) greater odds of being a case, and worsening in cartilage surface area in ≥3 subregions was associated with 2.4-fold (95% CI 1.3-4.4) greater odds of being a case. Worsening of meniscal morphology in any region was associated with 2.2-fold (95% CI 1.3-3.8) greater odds of being a case. Worsening effusion-synovitis and Hoffa-synovitis were also associated with a greater odds of being a case (odds ratios 2.7 and 2.0, respectively).



Twenty-four-month changes in cartilage thickness, cartilage surface area, effusion-synovitis, Hoffa-synovitis, and meniscal morphology were independently associated with OA progression, suggesting that these factors may serve as efficacy biomarkers in clinical trials of disease-modifying interventions for knee OA.
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts. jcollins13@partners.org.
Jamie E
JE
Collins
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Elena
E
Losina
University of California, San Francisco.
Michael C
MC
Nevitt
Boston University School of Medicine and Quantitative Imaging Center, Boston, Massachusetts, and University of Erlangen-Nuremberg, Erlangen, Germany.
Frank W
FW
Roemer
Boston University School of Medicine and Quantitative Imaging Center, Boston, Massachusetts.
Ali
A
Guermazi
University of California, San Francisco.
John A
JA
Lynch
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Jeffrey N
JN
Katz
University of Arizona College of Medicine, Tucson.
C
C
Kent Kwoh
Duke University School of Medicine, Durham, North Carolina.
Virginia B
VB
Kraus
Royal North Shore Hospital, Kolling Institute of Medical Research, and University of Sydney, New South Wales, Sydney, Australia.
David J
0000-0003-3197-752X
DJ
Hunter
D000368:Aged; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D001853:Bone Marrow / Q000000981:diagnostic imaging; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D002358:Cartilage, Articular / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000000981:diagnostic imaging; D008875:Middle Aged; D015999:Multivariate Analysis; D009929:Organ Size; D020370:Osteoarthritis, Knee / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D054850:Osteophyte / Q000000981:diagnostic imaging*; D011859:Radiography; D013585:Synovitis / Q000000981:diagnostic imaging*; D000070600:Tibial Meniscus Injuries / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology