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Review
. 2023 Nov;52(11):2107-2122.
doi: 10.1007/s00256-022-04228-w. Epub 2022 Nov 15.

Quantitative measurement of cartilage morphology in osteoarthritis: current knowledge and future directions

Wolfgang Wirth  1   2   3 , Christoph Ladel  4 , Susanne Maschek  5   6 , Anna Wisser  5   7   6 , Felix Eckstein  5   7   6 , Frank Roemer  8   9
Affiliations
Review

Quantitative measurement of cartilage morphology in osteoarthritis: current knowledge and future directions

Wolfgang Wirth et al. Skeletal Radiol. 2023 Nov.

Abstract

Quantitative measures of cartilage morphology ("cartilage morphometry") extracted from high resolution 3D magnetic resonance imaging (MRI) sequences have been shown to be sensitive to osteoarthritis (OA)-related change and also to treatment interventions. Cartilage morphometry is therefore nowadays widely used as outcome measure for observational studies and randomized interventional clinical trials. The objective of this narrative review is to summarize the current status of cartilage morphometry in OA research, to provide insights into aspects relevant for the design of future studies and clinical trials, and to give an outlook on future developments. It covers the aspects related to the acquisition of MRIs suitable for cartilage morphometry, the analysis techniques needed for deriving quantitative measures from the MRIs, the quality assurance required for providing reliable cartilage measures, and the appropriate participant recruitment criteria for the enrichment of study cohorts with knees likely to show structural progression. Finally, it provides an overview over recent clinical trials that relied on cartilage morphometry as a structural outcome measure for evaluating the efficacy of disease-modifying OA drugs (DMOAD).

Keywords: Cartilage loss; Knee; MRI; Osteoarthritis.

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Conflict of interest statement

Wolfgang Wirth: employee and shareholder of Chondrometrics GmbH. Susanne Maschek: employee and shareholder of Chondrometrics GmbH. Anna Wisser: employee of Chondrometrics GmbH. Felix Eckstein: CEO and shareholder of Chondrometrics GmbH and received personal fees from AbbVie, Galapagos NV, HealthLink, ICM, IRIS, Kolon TissueGene, Merck KGaA, Novartis, Roche and Samumed and grants from Foundation for the NIH, University of California, San Francisco, NIH/National Heart, Lung, and Blood Institute, Bioclinica, Galapagos NV, Novartis, TissueGene, Erlangen University Hospital, University of Sydney, CALIBR, University of Basel, University of Western Ontario, Stanford University, ICM Co., Ltd., UMC Utrecht, Federal Ministry of Education and Research, Germany. Christoph Ladel received personal fees from LinkHealth Wengzhou, ReumaNederland Amsterdam, UMC Utrecht, Charité Hospital Berlin. Frank Roemer: shareholder of Boston Imaging Core Lab. (BICL), LLC. He is consultant to Calibr and Grünenthal.

Figures

Fig. 1
Fig. 1
Illustration showing the MRI orientations and the cartilages that can be analyzed from these orientations. a Sagittal MRI slice through the medial compartment, b sagittal MRI slice through the lateral compartment, c coronal MRI slice, d axial MRI slice (P: patella, TrF: trochlea of the femur, MF: medial femur, LF: lateral femur, MT: medial tibia, LT: lateral tibia). The double echo at steady state (DESS) MRIs were provided by the Osteoarthritis Initiative image data base
Fig. 2
Fig. 2
Illustration showing the segmentation of cartilages areas in a coronal FLASH MRI from the Osteoarthritis Initiative (tAB = total area of subchondral bone, AC = cartilage surface area, dAB = denuded area of subchondral bone, cAB = covered area of subchondral bone)
Fig. 3:
Fig. 3:
3D reconstruction of the total area of subchondral bone showing the femorotibial cartilage regions and the 16 femorotibial cartilage subregions (prefix a/c/e/i/p: anterior/central/external/internal/posterior subregion of the respective cartilage plate, e.g., cMT: central subregion of MT). a—Shows the tibial cartilage subregions, b—shows the weight-bearing, central femoral cartilage subregions, c—shows the medial and the lateral femorotibial compartment
See this image and copyright information in PMC

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