Evaluation of an automated laminar cartilage T2 relaxation time analysis method in an early osteoarthritis model.

Abstract

A fully automated laminar cartilage composition (MRI-based T2) analysis method was technically and clinically validated by comparing radiographically normal knees with (CL-JSN) and without contra-lateral joint space narrowing or other signs of radiographic osteoarthritis (OA, CL-noROA). 2D U-Nets were trained from manually segmented femorotibial cartilages (n = 72) from all 7 echoes (All_E), or from the 1st echo only (1^st_E) of multi-echo-spin-echo (MESE) MRIs acquired by the Osteoarthritis Initiative (OAI). Because of its greater accuracy, only the All_E U-Net was then applied to knees from the OAI healthy reference cohort (n = 10), CL-JSN (n = 39), and (1:1) matched CL-noROA knees (n = 39) that all had manual expert segmentation, and to 982 non-matched CL-noROA knees without expert segmentation. The agreement (Dice similarity coefficient) between automated vs. manual expert cartilage segmentation was between 0.82 ± 0.05/0.79 ± 0.06 (All_E/1^st_E) and 0.88 ± 0.03/0.88 ± 0.03 (All_E/1^st_E) across femorotibial cartilage plates. The deviation between automated vs. manually derived laminar T2 reached up to - 2.2 ± 2.6 ms/ + 4.1 ± 10.2 ms (All_E/1^st_E). The All_E U-Net showed a similar sensitivity to cross-sectional laminar T2 differences between CL-JSN and CL-noROA knees in the matched (Cohen's D ≤ 0.54) and the non-matched (D ≤ 0.54) comparison as the matched manual analyses (D ≤ 0.48). Longitudinally, the All_E U-Net also showed a similar sensitivity to CL-JSN vs. CS-noROA differences in the matched (D ≤ 0.51) and the non-matched (D ≤ 0.43) comparison as matched manual analyses (D ≤ 0.41). The fully automated T2 analysis showed a high agreement, acceptable accuracy, and similar sensitivity to cross-sectional and longitudinal laminar T2 differences in an early OA model, compared with manual expert analysis. Clinicaltrials.gov identification: NCT00080171.