Semi-quantitative MRI biomarkers of knee osteoarthritis progression in the FNIH biomarkers consortium cohort - Methodologic aspects and definition of change.
To describe the scoring methodology and MRI assessments used to evaluate the cross-sectional features observed in cases and controls, to define change over time for different MRI features, and to report the extent of changes over a 24-month period in the Foundation for National Institutes of Health Osteoarthritis Biomarkers Consortium study nested within the larger Osteoarthritis Initiative (OAI) Study.



We conducted a nested case-control study. Cases (n = 406) were knees having both radiographic and pain progression. Controls (n = 194) were knee osteoarthritis subjects who did not meet the case definition. Groups were matched for Kellgren-Lawrence grade and body mass index. MRIs were acquired using 3 T MRI systems and assessed using the semi-quantitative 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. We provide the definition and distribution of change in these biomarkers over time.



Seventy-three percent of the cases had subregions with BML worsening (vs. 66 % in controls) (p = 0.102). Little change in osteophytes was seen over 24 months. Twenty-eight percent of cases and 10 % of controls had worsening in meniscal scores in at least one subregion (p < 0.001). Seventy-three percent of cases and 53 % of controls had at least one area with worsening in cartilage surface area (p < 0.001). More cases experienced worsening in Hoffa- and effusion synovitis than controls (17 % vs. 6 % (p < 0.001); 41 % vs. 18 % (p < 0.001), respectively).



A wide range of MRI-detected structural pathologies was present in the FNIH cohort. More severe changes, especially for BMLs, cartilage and meniscal damage, were detected primarily among the case group suggesting that early changes in multiple structural domains are associated with radiographic worsening and symptomatic progression.
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd floor, 820 Harrison Avenue, Boston, MA, 02118, USA. froemer@bu.edu.|Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany. froemer@bu.edu.
Frank W
FW
Roemer
Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd floor, 820 Harrison Avenue, Boston, MA, 02118, USA.
Ali
A
Guermazi
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
Jamie E
JE
Collins
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
Elena
E
Losina
Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA.
Michael C
MC
Nevitt
Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA.
John A
JA
Lynch
Orthopaedic and Arthritis Center for Outcomes Research, Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
Jeffrey N
JN
Katz
University of Arizona Arthritis Center & Division of Rheumatology, University of Arizona College of Medicine, Tucson, AZ, USA.
C Kent
CK
Kwoh
Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
Virginia B
VB
Kraus
Department of Rheumatology, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, St Leonards, NSW, Australia.
David J
DJ
Hunter
D000368:Aged; D015415:Biomarkers; D001853:Bone Marrow / Q000000981:diagnostic imaging; D002358:Cartilage, Articular / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008592:Menisci, Tibial / Q000000981:diagnostic imaging; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging*; D054850:Osteophyte / Q000000981:diagnostic imaging; D013585:Synovitis / Q000000981:diagnostic imaging
D015415:Biomarkers
Biomarkers; MRI; Osteoarthritis; Progression; Scoring