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Review
. 2015 May;23(5):716-31.
doi: 10.1016/j.joca.2015.03.004.

OARSI Clinical Trials Recommendations: Hip imaging in clinical trials in osteoarthritis

G E Gold  1 , F Cicuttini  2 , M D Crema  3 , F Eckstein  4 , A Guermazi  5 , R Kijowski  6 , T M Link  7 , E Maheu  8 , J Martel-Pelletier  9 , C G Miller  10 , J-P Pelletier  9 , C G Peterfy  11 , H G Potter  12 , F W Roemer  13 , D J Hunter  14
Affiliations
Review

OARSI Clinical Trials Recommendations: Hip imaging in clinical trials in osteoarthritis

G E Gold et al. Osteoarthritis Cartilage. 2015 May.

Abstract

Imaging of hip in osteoarthritis (OA) has seen considerable progress in the past decade, with the introduction of new techniques that may be more sensitive to structural disease changes. The purpose of this expert opinion, consensus driven recommendation is to provide detail on how to apply hip imaging in disease modifying clinical trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for magnetic resonance imaging (MRI)); commonly encountered problems (including positioning, hardware and coil failures, artifacts associated with various MRI sequences); quality assurance/control procedures; measurement methods; measurement performance (reliability, responsiveness, and validity); recommendations for trials; and research recommendations.

Keywords: Clinical trial guidelines; Hip osteoarthritis; Imaging.

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Conflict of interest statement

Conflict of interest

  1. Garry E. Gold receives honoraria as a consultant from Boston Scientific Inc. Has a grant from GE Healthcare for improved MR Systems and two from the NIH for advanced MRI of Osteoarthritis.

  2. Flavia Cicuttini - Receives honoraria from Jansen. Has grants from the NHMRC for Statin RCT, Zolendronic Acid RCT and ACL study. Holds a volunteered paid position in Repatriation Medical Authority as a Medical Officer and as an Associate Editor in the BMC Musculoskeletal Journal, ART Journal.

  3. Michel D. Crema – has shares in Boston Imaging Core Lab, LLC a company providing image assessment services to academia and the pharmaceutical and medical device industry.

  4. Jeffrey Duryea - has a grant from NIH/NIAMS for a Quantitative MRI analysis method for longitudinal assessment of knee OA.

  5. Felix Eckstein receives honoraria from Mariel Therpeutics, MerckSerono, and Medtronic. Is CEO and co-owner of Chondrometrics Gmbh, a quantitative image analysis company and is involved in, clinical trials including FGF 18 from MerckSerono. Holds a voluntary unpaid position in Annals of Anatomy, Cell Tissue Organs as an associate editor and in Osteoarthritis & Cartilage as part of the editorial board.

  6. Ali Guermazi receives honoraria from Genzyme, TissueGene, OrthoTrophix and Merck Serono. He has shares in Boston Imaging Core Lab, LLC. Deputy Editor of Radiology.

  7. Richard Kijowski has grants from the National Institute of Health for NIAMS/Rapid MRI for Assessing Joint Degeneration, for the NAIMS/Cartilage Contact and for Early degeneration after ACL Injury.

  8. Thomas M. Link receives honoraria from Springer. He has grants from the National Institutes of Health (NIAMS and NIBIB) and General Electric for the MAVRIC protocol and Insightec Exablate protocols. Holds a paid position in Current Radiology Reports as Editor-in-Chief. He is on the editorial boards of Osteoarthritis and Cartilage, Radiology, AJR and Skeletal Radiology. He is also section editor for European Radiology.

  9. Emanuelle Maheu - On the Board of Bioventus. Consultant for Rottapharm s.a., Pierre Fabre Labs – France, and Expanscience Labs – France. Grants from the Institut de Recherche International Servier

  10. Colin G. Miller- Senior vice president at Bioclinica.

  11. Johanne Martel-Pelletier & Jean-Pierre Pelletier – receive honoraria from ArthroLab/ArthroVision, Bioiberica, Elanco, Ferring, Merck, Pfizer, Servier, TRB Chemedica. Have grants from The Arthritis Society, Canadian Institutes of Health Research (CIHR). Has investment in non-medical industry at ArthroLab/ArthroVision and is a Shareholder. Holds a volunteered paid position at the ESCEO13-IOF European Congress on Osteoporosis and Osteoarthritis.

  12. Charles Peterfy – has shares in Spire Sciences, inc., which provides Image analysis for clinical trials to multiple pharmaceutical and medical device companies. He holds a volunteered paid position in The International Society for Musculoskeletal Imaging in Rheumatology as treasurer.

  13. Hollis Potter – receives grant support from NIH and institutional research support from GE Healthcare.

  14. Frank Roemer – has shares in Boston Imaging Core Lab, LLC, a company providing image assessment services to academia and the pharmaceutical and medical device industry. Associate Editor for Osteoarthritis and Cartilage.

  15. David Hunter has royalties from DJO for a patent granted for a patellofemoral buttress. Has grants from the NIH, Australian Research Council and NHMRC. Associate Editor for Osteoarthritis and Cartilage.

Figures

Figure 1
Figure 1
AP supine radiograph of the pelvis. Focus to film distance was approximately 100 cm, and digital detector was used.
Figure 2
Figure 2
(a) Supine and (b) weight-bearing radiographs of the hip. Note the weight bearing view has overlying pannus that degrades image quality. Either image could be used to measure joint space width.
Figure 2
Figure 2
(a) Supine and (b) weight-bearing radiographs of the hip. Note the weight bearing view has overlying pannus that degrades image quality. Either image could be used to measure joint space width.
Figure 3
Figure 3
Standard MRI examination of the hip with two-dimensional fast or turbo spin echo sequences. (a) Axial intermediate weighted MRI without fat suppression. (b) Axial T2-weighted MRI with fat suppression. (c) Coronal intermediate weighted MRI with fat suppression. (d) Coronal T1-weighted MRI without fat suppression. (e) Sagittal intermediate-weighted MRI with fat suppression. All relevant anatomy (bone, cartilage, joint fluid, labrum) can be evaluated on these images.
Figure 3
Figure 3
Standard MRI examination of the hip with two-dimensional fast or turbo spin echo sequences. (a) Axial intermediate weighted MRI without fat suppression. (b) Axial T2-weighted MRI with fat suppression. (c) Coronal intermediate weighted MRI with fat suppression. (d) Coronal T1-weighted MRI without fat suppression. (e) Sagittal intermediate-weighted MRI with fat suppression. All relevant anatomy (bone, cartilage, joint fluid, labrum) can be evaluated on these images.
Figure 3
Figure 3
Standard MRI examination of the hip with two-dimensional fast or turbo spin echo sequences. (a) Axial intermediate weighted MRI without fat suppression. (b) Axial T2-weighted MRI with fat suppression. (c) Coronal intermediate weighted MRI with fat suppression. (d) Coronal T1-weighted MRI without fat suppression. (e) Sagittal intermediate-weighted MRI with fat suppression. All relevant anatomy (bone, cartilage, joint fluid, labrum) can be evaluated on these images.
Figure 3
Figure 3
Standard MRI examination of the hip with two-dimensional fast or turbo spin echo sequences. (a) Axial intermediate weighted MRI without fat suppression. (b) Axial T2-weighted MRI with fat suppression. (c) Coronal intermediate weighted MRI with fat suppression. (d) Coronal T1-weighted MRI without fat suppression. (e) Sagittal intermediate-weighted MRI with fat suppression. All relevant anatomy (bone, cartilage, joint fluid, labrum) can be evaluated on these images.
Figure 3
Figure 3
Standard MRI examination of the hip with two-dimensional fast or turbo spin echo sequences. (a) Axial intermediate weighted MRI without fat suppression. (b) Axial T2-weighted MRI with fat suppression. (c) Coronal intermediate weighted MRI with fat suppression. (d) Coronal T1-weighted MRI without fat suppression. (e) Sagittal intermediate-weighted MRI with fat suppression. All relevant anatomy (bone, cartilage, joint fluid, labrum) can be evaluated on these images.
Figure 4
Figure 4
Reformations from an axial 0.8 mm isotropic 3D fast spin echo acquisition at 3T. (a) Coronal reformat, 3 mm slice. (b) Sagittal reformat, 3 mm slice.
Figure 4
Figure 4
Reformations from an axial 0.8 mm isotropic 3D fast spin echo acquisition at 3T. (a) Coronal reformat, 3 mm slice. (b) Sagittal reformat, 3 mm slice.
Figure 5
Figure 5
T1rho (left) and T2 (right) color maps of the hip in a healthy volunteer, for evaluation of cartilage matrix properties. T2 is correlated with collagen organization, and T1rho with proteoglycan content.
Figure 6
Figure 6
(a) Coronal reformation of computed tomography study of the pelvis, demonstrating os acetabula (arrow). (b) Three-dimensional shaded-surface display of the same hip, shown from a sagittal orientation. Arrows show the os acetabula.
Figure 6
Figure 6
(a) Coronal reformation of computed tomography study of the pelvis, demonstrating os acetabula (arrow). (b) Three-dimensional shaded-surface display of the same hip, shown from a sagittal orientation. Arrows show the os acetabula.
Figure 7
Figure 7
T1-weighted fat-suppressed images from an MRI arthrogram in a subject with a history of femoroacetabular impingement. (a) Coronal image showing a labral tear (arrow). (b) Sagittal image showing an anterior labral tear. (c) Oblique axial image for measurement of alpha angle.
Figure 7
Figure 7
T1-weighted fat-suppressed images from an MRI arthrogram in a subject with a history of femoroacetabular impingement. (a) Coronal image showing a labral tear (arrow). (b) Sagittal image showing an anterior labral tear. (c) Oblique axial image for measurement of alpha angle.
Figure 7
Figure 7
T1-weighted fat-suppressed images from an MRI arthrogram in a subject with a history of femoroacetabular impingement. (a) Coronal image showing a labral tear (arrow). (b) Sagittal image showing an anterior labral tear. (c) Oblique axial image for measurement of alpha angle.
See this image and copyright information in PMC

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