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Exploring the differences between radiographic joint space width and MRI cartilage thickness changes using data from the IMI-APPROACH cohort

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Abstract

Objective

Longitudinal weight-bearing radiographic joint space width (JSW) and non-weight-bearing MRI-based cartilage thickness changes often show weak correlations. The current objective was to investigate these correlations, and to explore the influence of different factors that could contribute to longitudinal differences between the two methods.

Methods

The current study included 178 participants with medial osteoarthritis (OA) out of the 297 knee OA participants enrolled in the IMI-APPROACH cohort. Changes over 2 years in medial JSW (ΔJSWmed), minimum JSW (ΔJSWmin), and medial femorotibial cartilage thickness (ΔMFTC) were assessed using linear regression, using measurements from radiographs and MRI acquired at baseline, 6 months, and 1 and 2 years. Pearson R correlations were calculated. The influence of cartilage quality (T2 map**), meniscal extrusion (MOAKS scoring), potential pain-induced unloading (difference in knee-specific pain scores), and increased loading (BMI) on the correlations was analyzed by dividing participants in groups based on each factor separately, and comparing correlations (slope and strength) between groups using linear regression models.

Result

Correlations between ΔMFTC and ΔJSWmed and ΔJSWmin were statistically significant (p < 0.004) but weak (R < 0.35). Correlations were significantly different between groups based on cartilage quality and on meniscal extrusion: only patients with the lowest T2 values and with meniscal extrusion showed significant moderate correlations. Pain-induced unloading or BMI-induced loading did not influence correlations.

Conclusions

While the amount of loading does not seem to make a difference, weight-bearing radiographic JSW changes are a better reflection of non-weight-bearing MRI cartilage thickness changes in knees with higher quality cartilage and with meniscal extrusion.

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References

  1. Guermazi A, Roemer FW, Burstein D, Hayashi D. Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther. 2011;13:1–11.

    Article  Google Scholar 

  2. Hunter DJ, Zhang YQ, Tu X, LaValley M, Niu JB, Amin S, et al. Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum. 2006;54:2488–95.

    Article  CAS  PubMed  Google Scholar 

  3. Kinds MB, Vincken KL, Hop**a TN, Bleys RLAW, Viergever MA, Marijnissen ACA, et al. Influence of variation in semiflexed knee positioning during image acquisition on separate quantitative radiographic parameters of osteoarthritis, measured by Knee Images Digital Analysis. Osteoarthr Cartil. 2012;20:997–1003.

    Article  CAS  Google Scholar 

  4. Oo WM, Little C, Duong V, Hunter DJ. The Development of disease-modifying therapies for osteoarthritis (DMOADs): the evidence to date. Drug Des Devel Ther. 2021;15:2921.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gudbergsen H, Lohmander LS, Jones G, Christensen R, Bartels EM, Danneskiold-Samsøe B, et al. Correlations between radiographic assessments and MRI features of knee osteoarthritis - a cross-sectional study. Osteoarthr Cartil. 2013;21:535–43.

    Article  CAS  Google Scholar 

  6. Lonza GC, Gardner-Morse MG, Vacek PM, Beynnon BD. Radiographic-based measurement of tibiofemoral joint space width and magnetic resonance imaging derived articular cartilage thickness are not related in subjects at risk for post traumatic arthritis of the knee. J Orthop Res. 2019;37:1052–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Segal NA, Frick E, Duryea J, Roemer F, Guermazi A, Nevitt MC, et al. Correlations of medial joint space width on fixed-flexed standing computed tomography and radiographs with cartilage and meniscal morphology on magnetic resonance imaging. Arthritis Care Res. 2016;68:1410–6.

    Article  CAS  Google Scholar 

  8. Cicuttini F, Hankin J, Jones G, Wluka A. Comparison of conventional standing knee radiographs and magnetic resonance imaging in assessing progression of tibiofemoral joint osteoarthritis. Osteoarthr Cartil. 2005;13:722–7.

    Article  CAS  Google Scholar 

  9. Raynauld JP, Martel-Pelletier J, Berthiaume MJ, Beaudoin G, Choquette D, Haraoui B, et al. Long term evaluation of disease progression through the quantitative magnetic resonance imaging of symptomatic knee osteoarthritis patients: Correlation with clinical symptoms and radiographic changes. Arthritis Res Ther. 2005;8:R21.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Duryea J, Neumann G, Niu J, Totterman S, Tamez J, Dabrowski C, et al. Comparison of radiographic joint space width with magnetic resonance imaging cartilage morphometry: Analysis of longitudinal data from the osteoarthritis initiative. Arthritis Care Res (Hoboken). 2010;62:932–7.

    Article  PubMed  Google Scholar 

  11. Bruyere O, Genant H, Kothari M, Zaim S, White D, Peterfy C, et al. Longitudinal study of magnetic resonance imaging and standard X-rays to assess disease progression in osteoarthritis. Osteoarthr Cartil. 2007;15:98–103.

    Article  CAS  Google Scholar 

  12. Wirth W, Duryea J, Hellio Le Graverand MP, John MR, Nevitt M, Buck RJ, et al. Direct comparison of fixed flexion, radiography and MRI in knee osteoarthritis: responsiveness data from the Osteoarthritis Initiative. Osteoarthr Cartil. 2013;21:117–25.

    Article  CAS  Google Scholar 

  13. Jansen MP, Mastbergen SC, Eckstein F, van Heerwaarden RJ, Spruijt S, Lafeber FPJG. Comparison between 2D radiographic weight-bearing joint space width and 3D MRI non-weight-bearing cartilage thickness measures in the knee using non-weight-bearing 2D and 3D CT as an intermediary. Ther Adv Chronic Dis. 2021;12.

  14. Hunter DJ, Altman RD, Cicuttini F, Crema MD, Duryea J, Eckstein F, et al. OARSI Clinical Trials Recommendations: knee imaging in clinical trials inosteoarthritis. Osteoarthr Cartil. 2015;23:698–715.

    Article  CAS  Google Scholar 

  15. Hochberg MC, Guermazi A, Guehring H, Aydemir A, Wax S, Fleuranceau-Morel P, et al. Effect of intra-articular sprifermin vs placebo on femorotibial joint cartilage thickness in patients with osteoarthritis: The FORWARD Randomized Clinical Trial. JAMA - J Am Med Assoc. 2019;322:1360–70.

    Article  CAS  Google Scholar 

  16. van Helvoort EM, van Spil WE, Jansen MP, Welsing PMJ, Kloppenburg M, Loef M, et al. Cohort profile: the applied public-private research enabling osteoarthritis clinical headway (IMI-APPROACH) study: a 2-year, European, cohort study to describe, validate and predict phenotypes of osteoarthritis using clinical, imaging and biochemical mark. BMJ Open. 2020;10:e035101.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Buckland-Wright JC, Ward RJ, Peterfy C, Mojcik CF, Leff RL. Reproducibility of the semiflexed (metatarsophalangeal) radiographic knee position and automated measurements of medial tibiofemoral joint space width in a multicenter clinical trial of knee osteoarthritis. J Rheumatol. 2004;31:1588–97.

    PubMed  Google Scholar 

  18. Marijnissen ACA, Vincken KL, Vos PAJM, Saris DBF, Viergever MA, Bijlsma JWJ, et al. Knee Images Digital Analysis (KIDA): a novel method to quantify individual radiographic features of knee osteoarthritis in detail. Osteoarthr Cartil. 2008;16:234–43.

    Article  CAS  Google Scholar 

  19. Jansen MP, Welsing PMJ, Vincken KL, Mastbergen SC. Performance of knee image digital analysis of radiographs of patients with end-stage knee osteoarthritis. Osteoarthr Cartil. 2021;29:1530–9.

    Article  CAS  Google Scholar 

  20. Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM, et al. Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthr Cartil. 2011;19:990–1002.

    Article  CAS  Google Scholar 

  21. Kendrick DB, Strout TD. The minimum clinically significant difference in patient-assigned 11-point numeric pain scale scores for pain. Ann Emerg Med. 2004;44:S86–7.

    Google Scholar 

  22. Wirth W, Maschek S, Lalande A, Blanco FJ, Berenbaum F, Van de Stadt LA, et al. Test-retest precision and longitudinal cartilage thickness loss in the IMI-APPROACH cohort. Osteoarthr Cartil. 2022;

  23. Roemer FW, Jansen M, Marijnissen ACA, Guermazi A, Heiss R, Maschek S, et al. Structural tissue damage and 24-month progression of semi-quantitative MRI biomarkers of knee osteoarthritis in the IMI-APPROACH cohort. BMC Musculoskelet Disord. 2022;23:1–20.

    Article  Google Scholar 

  24. Jansen MP, Wirth W, Bacardit J, Van Helvoort EM, Marijnissen ACA, Kloppenburg M, et al. Machine-learning predicted and actual two-year structural progression in the IMI-APPROACH cohort. Quant Imaging Med Surg. 2022.

  25. Evans JD. Straightforward statistics for the behavioral sciences. 1st ed. Pacific Grove: Pacific Grove: Brooks/Cole Pub. Co.; 1996. 146

  26. Choi JA, Gold GE. MR imaging of articular cartilage physiology. Magn Reson Imaging Clin N Am. 2011;19:249–82.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Roth M, Emmanuel K, Wirth W, Kwoh CK, Hunter DJ, Eckstein F. Sensitivity to change and association of three-dimensional meniscal measures with radiographic joint space width loss in rapid clinical progression of knee osteoarthritis. Eur Radiol. 2018;28:1844–53.

    Article  PubMed  Google Scholar 

  28. Roth M, Wirth W, Emmanuel K, Culvenor AG, Eckstein F. The contribution of 3D quantitative meniscal and cartilage measures to variation in normal radiographic joint space width—Data from the Osteoarthritis Initiative healthy reference cohort. Eur J Radiol. 2017;87:90–8.

    Article  PubMed  Google Scholar 

  29. Marsh M, Souza RB, Wyman BT, Hellio Le Graverand MP, Subburaj K, Link TM, et al. Differences between X-ray and MRI-determined knee cartilage thickness in weight-bearing and non-weight-bearing conditions. Osteoarthr Cartil. 2013;21:1876–85.

    Article  CAS  Google Scholar 

  30. Gold GE, Han E, Stainsby J, Wright G, Brittain J, Beaulieu C. Musculoskeletal MRI at 3.0 T: relaxation times and image contrast. Am J Roentgenol. 2004;183:343–51.

    Article  Google Scholar 

Download references

Funding

The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking under Grant Agreement no 115770, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007–2013) and EFPIA companies’ in kind contribution. See www.imi.europa.eu and http://www.approachproject.eu

Author information

Authors and Affiliations

  1. Department of Rheumatology & Clinical Immunology, HP G02.228 Heidelberglaan 100 3584CX, Utrecht, The Netherlands

    Mylène P. Jansen, Anne Karien C. A. Marijnissen, Floris P. J. G. Lafeber, Paco M. J. Welsing & Simon C. Mastbergen

  2. Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA

    Frank W. Roemer

  3. Department of Radiology, Universitätsklinikum Erlangen and Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

    Frank W. Roemer

  4. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands

    Margreet Kloppenburg

  5. Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

    Margreet Kloppenburg

  6. Departamento de Fisioterapia Y Medicina, Grupo de Investigación de Reumatología (GIR), INIBIC – Complejo Hospitalario Universitario de A Coruña, SERGAS. Centro de Investigación CICA, Universidad de A Coruña, A Coruña, Spain. Servicio de Reumatologia, INIBIC- Universidade de A Coruña, A Coruña, Spain

    Francisco J. Blanco

  7. Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway

    Ida K. Haugen

  8. Department of Rheumatology, AP-HP Saint-Antoine Hospital, Paris, France

    Francis Berenbaum

  9. INSERM, Sorbonne University, Paris, France

    Francis Berenbaum

  10. Department of Imaging & Functional Musculoskeletal Research, Institute of Anatomy & Cell Biology, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria

    Wolfgang Wirth

  11. Ludwig Boltzmann Inst. for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria

    Wolfgang Wirth

  12. Chondrometrics GmbH, Freilassing, Germany

    Wolfgang Wirth

Authors
  1. Mylène P. Jansen
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Corresponding author

Correspondence to Mylène P. Jansen.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

FWR: shareholder of Boston Imaging Core Lab (BICL), LLC and consultant to Calibr and Grünenthal.

MK: consulting fees from Abbvie, Pfizer, Kiniksa, Flexion, Galapagos, Jansen, CHDR, Novartis, UCB, all paid to institution.

FJB: funding from Gedeon Richter Plc., Bristol-Myers Squibb International Corporation (BMSIC), Sun Pharma Global FZE, Celgene Corporation, Janssen Cilag International N.V, Janssen Research & Development, Viela Bio, Inc., Astrazeneca AB, UCB BIOSCIENCES GMBH, UCB BIOPHARMA SPRL, AbbVie Deutschland GmbH & Co.KG, Merck KGaA, Amgen, Inc., Novartis Farmacéutica, S.A., Boehringer Ingelheim España, S.A, CSL Behring, LLC, Glaxosmithkline Research & Development Limited, Pfizer Inc, Lilly S.A., Corbus Pharmaceuticals Inc., Biohope Scientific Solutions for Human Health S.L., Centrexion Therapeutics Corp., Sanofi, MEIJI FARMA S.A., Kiniksa Pharmaceuticals, Ltd. Grunenthal, Asofarma Mexico, Gebro Pharma, Roche, Galapagos, Regeneron.

IKH: research grant (ADVANCE) from Pfizer (payment to institution) and consulting fees from Novartis and GSK, outside of the submitted work.

FB: Institutional grants from TRB Chemedica and Pfizer. Consulting fees from AstraZeneca, Boehringer Ingelheim, Bone Therapeutics, Cellprothera, Galapagos, Gilead, Grunenthal, GSK, Eli Lilly, MerckSerono, Nordic Bioscience, Novartis, Pfizer, Sanofi, Servier, Peptinov, 4P Pharma. Honoraria for lectures from Pfizer, Eli Lilly, Viatris, Aché Laboratories. SShareholder of 4Moving Biotech, 4P Pharma and Peptinov.

WW: Employee and shareholder of Chondrometrics GmbH and consulting fees from Galapagos NV.

The other authors have nothing to disclose.

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Jansen, M.P., Roemer, F.W., Marijnissen, A.K.C.A. et al. Exploring the differences between radiographic joint space width and MRI cartilage thickness changes using data from the IMI-APPROACH cohort. Skeletal Radiol 52, 1339–1348 (2023). https://doi.org/10.1007/s00256-022-04259-3

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  • DOI: https://doi.org/10.1007/s00256-022-04259-3

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