Department of Radiology, University of Cambridge, Cambridge, UK.
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7UY, UK.
Eur Radiol. 2021 Aug;31(8):5746-5758. doi: 10.1007/s00330-021-07698-z. Epub 2021 Feb 16.
Evaluate test-retest repeatability, ability to discriminate between osteoarthritic and healthy participants, and sensitivity to change over 6 months, of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) biomarkers in knee OA.
Fourteen individuals aged 40-60 with mild-moderate knee OA and 6 age-matched healthy volunteers (HV) underwent DCE-MRI at 3 T at baseline, 1 month and 6 months. Voxelwise pharmacokinetic modelling of dynamic data was used to calculate DCE-MRI biomarkers including K and IAUC. Median DCE-MRI biomarker values were extracted for each participant at each study visit. Synovial segmentation was performed using both manual and semiautomatic methods with calculation of an additional biomarker, the volume of enhancing pannus (VEP). Test-retest repeatability was assessed using intraclass correlation coefficients (ICC). Smallest detectable differences (SDDs) were calculated from test-retest data. Discrimination between OA and HV was assessed via calculation of between-group standardised mean differences (SMD). Responsiveness was assessed via the number of OA participants with changes greater than the SDD at 6 months.
K demonstrated the best test-retest repeatability (K/IAUC/VEP ICCs 0.90/0.84/0.40, SDDs as % of OA mean 33/71/76%), discrimination between OA and HV (SMDs 0.94/0.54/0.50) and responsiveness (5/1/1 out of 12 OA participants with 6-month change > SDD) when compared to IAUC and VEP. Biomarkers derived from semiautomatic segmentation outperformed those derived from manual segmentation across all domains.
K demonstrated the best repeatability, discrimination and sensitivity to change suggesting that it is the optimal DCE-MRI biomarker for use in experimental medicine studies.
• Dynamic contrast-enhanced MRI (DCE-MRI) provides quantitative measures of synovitis in knee osteoarthritis which may permit early assessment of efficacy in experimental medicine studies. • This prospective observational study compared DCE-MRI biomarkers across domains relevant to experimental medicine: test-retest repeatability, discriminative validity and sensitivity to change. • The DCE-MRI biomarker K demonstrated the best performance across all three domains, suggesting that it is the optimal biomarker for use in future interventional studies.
评估动态对比增强磁共振成像（DCE-MRI）生物标志物在膝骨关节炎中的测试-重测重复性、区分骨关节炎患者和健康参与者的能力，以及 6 个月时的变化敏感性。
14 名年龄在 40-60 岁之间的轻度至中度膝骨关节炎患者和 6 名年龄匹配的健康志愿者（HV）在 3T 下进行基线、1 个月和 6 个月的 DCE-MRI。使用动态数据的容积分布模型计算 DCE-MRI 生物标志物，包括 K 和 IAUC。在每个研究访视时，为每个参与者提取中位数 DCE-MRI 生物标志物值。使用手动和半自动方法进行滑膜分割，并计算额外的生物标志物，即增强性滑膜体积（VEP）。使用组内相关系数（ICC）评估测试-重测重复性。从小测试-重测数据中计算最小可检测差异（SDD）。通过计算组间标准化均数差异（SMD）来评估 OA 和 HV 之间的区分。通过在 6 个月时大于 SDD 的变化的 OA 参与者数量来评估反应性。
K 显示出最好的测试-重测重复性（K/IAUC/VEP ICC 分别为 0.90/0.84/0.40，SDD 为 OA 平均值的 33/71/76%）、OA 和 HV 之间的区分（SMD 分别为 0.94/0.54/0.50）和反应性（12 名 OA 患者中有 5 名在 6 个月时的变化大于 SDD），与 IAUC 和 VEP 相比。半自动分割得到的生物标志物在所有领域都优于手动分割得到的生物标志物。
K 显示出最好的重复性、区分性和对变化的敏感性，这表明它是实验医学研究中使用的最佳 DCE-MRI 生物标志物。
动态对比增强磁共振成像（DCE-MRI）提供了膝关节骨关节炎滑膜炎症的定量测量，这可能允许在实验医学研究中早期评估疗效。
这项前瞻性观察研究比较了实验医学相关领域的 DCE-MRI 生物标志物：测试-重测重复性、判别有效性和变化敏感性。
DCE-MRI 生物标志物 K 在所有三个领域的表现都最好，这表明它是未来干预性研究中使用的最佳生物标志物。
