Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank
Objective: We aimed to create an imaging biomarker for knee shape using knee dual-energy x-ray absorptiometry (DXA) scans and investigate its potential association with subsequent total knee replacement (TKR), independently of radiographic features of knee osteoarthritis and established risk factors...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Osteoarthritis and Cartilage Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2665913124000359 |
| _version_ | 1827250305570439168 |
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| author | Rhona A. Beynon Fiona R. Saunders Raja Ebsim Monika Frysz Benjamin G. Faber Jennifer S. Gregory Claudia Lindner Aliya Sarmanova Richard M. Aspden Nicholas C. Harvey Timothy Cootes Jonathan H. Tobias |
| author_facet | Rhona A. Beynon Fiona R. Saunders Raja Ebsim Monika Frysz Benjamin G. Faber Jennifer S. Gregory Claudia Lindner Aliya Sarmanova Richard M. Aspden Nicholas C. Harvey Timothy Cootes Jonathan H. Tobias |
| author_sort | Rhona A. Beynon |
| collection | DOAJ |
| description | Objective: We aimed to create an imaging biomarker for knee shape using knee dual-energy x-ray absorptiometry (DXA) scans and investigate its potential association with subsequent total knee replacement (TKR), independently of radiographic features of knee osteoarthritis and established risk factors. Methods: Using a 129-point statistical shape model, knee shape (expressed as a B-score) and minimum joint space width (mJSW) of the medial joint compartment (binarized as above or below the first quartile) were derived. Osteophytes were manually graded in a subset of images and an overall score was assigned. Cox proportional hazards models were used to examine the associations of B-score, mJSW and osteophyte score with TKR risk, adjusting for age, sex, height and weight. Results: The analysis included 37,843 individuals (mean age 63.7 years). In adjusted models, B-score was associated with TKR: each unit increase in B-score, reflecting one standard deviation from the mean healthy shape, corresponded to a hazard ratio (HR) of 2.25 (2.08, 2.43), while a lower mJSW had a HR of 2.28 (1.88, 2.77). Among the 6719 images scored for osteophytes, mJSW was replaced by osteophyte score in the most strongly predictive model for TKR. In ROC analyses, a model combining B-score, osteophyte score, and demographics outperformed a model including demographics alone (AUC = 0.87 vs 0.73). Conclusions: Using statistical shape modelling, we derived a DXA-based imaging biomarker for knee shape that was associated with kOA progression. When combined with osteophytes and demographic data, this biomarker may help identify individuals at high risk of TKR, facilitating targeted interventions. |
| first_indexed | 2024-04-24T08:12:11Z |
| format | Article |
| id | doaj.art-c4c3ff415ab44f73aa0ce2a06285f078 |
| institution | Directory Open Access Journal |
| issn | 2665-9131 |
| language | English |
| last_indexed | 2025-03-22T00:01:26Z |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj.art-c4c3ff415ab44f73aa0ce2a06285f0782024-05-17T04:19:00ZengElsevierOsteoarthritis and Cartilage Open2665-91312024-06-0162100468Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK BiobankRhona A. Beynon0Fiona R. Saunders1Raja Ebsim2Monika Frysz3Benjamin G. Faber4Jennifer S. Gregory5Claudia Lindner6Aliya Sarmanova7Richard M. Aspden8Nicholas C. Harvey9Timothy Cootes10Jonathan H. Tobias11University of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom; Corresponding author.University of Aberdeen, Centre for Arthritis and Musculoskeletal Health, Aberdeen, United KingdomThe University of Manchester, Division of Informatics, Imaging & Data Sciences, Manchester, United KingdomUniversity of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom; University of Bristol, Medical Research Council Integrative Epidemiology Unit, Bristol, United KingdomUniversity of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom; University of Bristol, Medical Research Council Integrative Epidemiology Unit, Bristol, United KingdomUniversity of Aberdeen, Centre for Arthritis and Musculoskeletal Health, Aberdeen, United KingdomThe University of Manchester, Division of Informatics, Imaging & Data Sciences, Manchester, United KingdomUniversity of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United KingdomUniversity of Aberdeen, Centre for Arthritis and Musculoskeletal Health, Aberdeen, United KingdomUniversity of Southampton, MRC Lifecourse Epidemiology Centre, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, United KingdomThe University of Manchester, Division of Informatics, Imaging & Data Sciences, Manchester, United KingdomUniversity of Bristol, Musculoskeletal Research Unit, Bristol Medical School, Bristol, United Kingdom; University of Bristol, Medical Research Council Integrative Epidemiology Unit, Bristol, United KingdomObjective: We aimed to create an imaging biomarker for knee shape using knee dual-energy x-ray absorptiometry (DXA) scans and investigate its potential association with subsequent total knee replacement (TKR), independently of radiographic features of knee osteoarthritis and established risk factors. Methods: Using a 129-point statistical shape model, knee shape (expressed as a B-score) and minimum joint space width (mJSW) of the medial joint compartment (binarized as above or below the first quartile) were derived. Osteophytes were manually graded in a subset of images and an overall score was assigned. Cox proportional hazards models were used to examine the associations of B-score, mJSW and osteophyte score with TKR risk, adjusting for age, sex, height and weight. Results: The analysis included 37,843 individuals (mean age 63.7 years). In adjusted models, B-score was associated with TKR: each unit increase in B-score, reflecting one standard deviation from the mean healthy shape, corresponded to a hazard ratio (HR) of 2.25 (2.08, 2.43), while a lower mJSW had a HR of 2.28 (1.88, 2.77). Among the 6719 images scored for osteophytes, mJSW was replaced by osteophyte score in the most strongly predictive model for TKR. In ROC analyses, a model combining B-score, osteophyte score, and demographics outperformed a model including demographics alone (AUC = 0.87 vs 0.73). Conclusions: Using statistical shape modelling, we derived a DXA-based imaging biomarker for knee shape that was associated with kOA progression. When combined with osteophytes and demographic data, this biomarker may help identify individuals at high risk of TKR, facilitating targeted interventions.http://www.sciencedirect.com/science/article/pii/S2665913124000359Knee shapeOsteoarthritisStatistical shape modellingOsteophytes |
| spellingShingle | Rhona A. Beynon Fiona R. Saunders Raja Ebsim Monika Frysz Benjamin G. Faber Jennifer S. Gregory Claudia Lindner Aliya Sarmanova Richard M. Aspden Nicholas C. Harvey Timothy Cootes Jonathan H. Tobias Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank Osteoarthritis and Cartilage Open Knee shape Osteoarthritis Statistical shape modelling Osteophytes |
| title | Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank |
| title_full | Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank |
| title_fullStr | Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank |
| title_full_unstemmed | Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank |
| title_short | Dual-energy X-ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement: Findings from a study of 37,843 people in UK Biobank |
| title_sort | dual energy x ray absorptiometry derived knee shape may provide a useful imaging biomarker for predicting total knee replacement findings from a study of 37 843 people in uk biobank |
| topic | Knee shape Osteoarthritis Statistical shape modelling Osteophytes |
| url | http://www.sciencedirect.com/science/article/pii/S2665913124000359 |
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