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OPPORTUNISTIC POPLITEAL ARTERY ASSESSMENT ON KNEE MRI AND MEDIAL TIBIAL STRUCTURAL DAMAGE IN OSTEOARTHRITIS: FNIH
P Mirghaderi1, N Eshraghi1, F Pishgar1
1Department of Radiology, University of Washington, Seattle, WA, USA.
Introduction:
Vascular pathology has been proposed as a contributor to knee OA structural damage, but evidence remains inconsistent. Popliteal artery wall biomarkers extracted opportunistically from knee MRI may help characterize vascular-related structural phenotypes.
Objective:
To evaluate whether baseline MRI-derived popliteal artery wall biomarkers are associated with baseline severity and 24-month worsening of medial tibial cartilage loss and bone marrow lesions (BMLs) in the FNIH Osteoarthritis Biomarkers Consortium.
Methods:
This analysis included 600 FNIH participants, with one knee per participant. Baseline sagittal 3D DESS knee MRI was processed using FRAPPE, a fully automated popliteal artery wall segmentation tool, to extract eccentricity ratio (maximum-to-minimum wall thickness ratio), normalized wall index (wall area divided by total vessel area), wall area, and lumen area. Baseline and 24-month MRI were assessed by two musculoskeletal radiologists using MOAKS. Linear regression models evaluated associations with medial tibial cartilage damage and BML scores and 24-month worsening, adjusting for age, sex, BMI, and FNIH subgroup.
Results:
Mean age was 61.6 ± 8.9 years, mean BMI was 30.7 ± 4.8 kg/m², and 353/600 participants (58.8%) were female. Higher eccentricity ratio was associated with greater baseline medial tibial cartilage loss, including more involved subregions (β=0.44, 95% CI 0.09-0.79; p<0.05), higher summed full-thickness damage MOAKS scores (β=0.49, 95% CI 0.18-0.80; p<0.01), and higher summed surface-area damage MOAKS scores (β=0.88, 95% CI 0.16-1.60; p<0.05). Higher eccentricity ratio was also associated with greater medial tibial BML burden, including more involved subregions (β=0.40, 95% CI 0.10-0.70; p<0.01) and higher summed BML size MOAKS scores (β=0.67, 95% CI 0.16-1.17; p<0.01). Popliteal artery wall biomarkers were not associated with 24-month worsening of cartilage loss or BMLs.
Conclusion:
Popliteal artery wall eccentricity on knee MRI was associated with greater baseline medial tibial cartilage loss and BML severity, but not with 24-month worsening. Opportunistic vascular assessment on knee MRI may help characterize vascular-related baseline structural disease burden in knee OA.
Insights
Popliteal artery wall eccentricity measured by knee MRI is linked to more severe knee osteoarthritis (OA) at baseline, including cartilage loss and bone marrow lesions. However, it did not predict future OA worsening over 24 months.
Area of Science:
- Orthopedics
- Radiology
- Cardiovascular Imaging
Background:
- Vascular pathology's role in knee osteoarthritis (OA) structural damage is debated.
- Popliteal artery wall biomarkers from knee MRI may reveal vascular-related OA phenotypes.
Purpose of the Study:
- To assess if baseline MRI-derived popliteal artery wall biomarkers correlate with the severity of medial tibial cartilage loss and bone marrow lesions (BMLs).
- To determine if these biomarkers predict the 24-month worsening of medial tibial cartilage loss and BMLs in the FNIH Osteoarthritis Biomarkers Consortium.
Main Methods:
- Analysis of 600 participants' knee MRIs using automated segmentation (FRAPPE) to extract popliteal artery wall biomarkers.
- Assessment of medial tibial cartilage damage and BMLs using MOAKS by two radiologists.
- Linear regression models to evaluate associations with baseline severity and 24-month progression, adjusting for covariates.
Main Results:
- Higher popliteal artery eccentricity ratio correlated with greater baseline medial tibial cartilage loss and BML severity.
- Specifically, increased eccentricity was associated with more involved subregions and higher MOAKS scores for both cartilage damage and BMLs.
- No significant association was found between popliteal artery wall biomarkers and the 24-month worsening of cartilage loss or BMLs.
Conclusions:
- Popliteal artery wall eccentricity on knee MRI is linked to baseline medial tibial cartilage loss and BML severity in knee OA.
- Opportunistic vascular assessment via knee MRI can help characterize the baseline vascular-related structural disease burden.
- The study did not find these biomarkers predictive of OA progression over 24 months.
