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Published in: BMC Musculoskeletal Disorders 1/2022

Open Access 01-12-2022 | Magnetic Resonance Imaging | Technical advance

Clinical validation of the use of prototype software for automatic cartilage segmentation to quantify knee cartilage in volunteers

Authors: Ping Zhang, Ran Xu Zhang, Xiao Shuai Chen, Xiao Yue Zhou, Esther Raithel, Jian Ling Cui, Jian Zhao

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

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Abstract

Background

The cartilage segmentation algorithms make it possible to accurately evaluate the morphology and degeneration of cartilage. There are some factors (location of cartilage subregions, hydrarthrosis and cartilage degeneration) that may influence the accuracy of segmentation. It is valuable to evaluate and compare the accuracy and clinical value of volume and mean T2* values generated directly from automatic knee cartilage segmentation with those from manually corrected results using prototype software.

Method

Thirty-two volunteers were recruited, all of whom underwent right knee magnetic resonance imaging examinations. Morphological images were obtained using a three-dimensional (3D) high-resolution Double-Echo in Steady-State (DESS) sequence, and biochemical images were obtained using a two-dimensional T2* mapping sequence. Cartilage score criteria ranged from 0 to 2 and were obtained using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). The femoral, patellar, and tibial cartilages were automatically segmented and divided into subregions using the post-processing prototype software. Afterwards, all the subregions were carefully checked and manual corrections were done where needed. The dice coefficient correlations for each subregion by the automatic segmentation were calculated.

Results

Cartilage volume after applying the manual correction was significantly lower than automatic segmentation (P < 0.05). The percentages of the cartilage volume change for each subregion after manual correction were all smaller than 5%. In all the subregions, the mean T2* relaxation time within manual corrected subregions was significantly lower than in regions after automatic segmentation (P < 0.05). The average time for the automatic segmentation of the whole knee was around 6 min, while the average time for manual correction of the whole knee was around 27 min.

Conclusions

Automatic segmentation of cartilage volume has a high dice coefficient correlation and it can provide accurate quantitative information about cartilage efficiently without individual bias.
Advances in knowledge: Magnetic resonance imaging is the most promising method to detect structural changes in cartilage tissue. Unfortunately, due to the structure and morphology of the cartilages obtaining accurate segmentations can be problematic. There are some factors (location of cartilage subregions, hydrarthrosis and cartilage degeneration) that may influence segmentation accuracy. We therefore assessed the factors that influence segmentations error.
Literature
1.
go back to reference Liess C, Lusse S, Karger N, Heller M, Gluer CC. Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthritis Cartilage. 2002;10:907–13.CrossRef Liess C, Lusse S, Karger N, Heller M, Gluer CC. Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthritis Cartilage. 2002;10:907–13.CrossRef
2.
go back to reference Stelzeneder D, Shetty AA, Kim SJ, Trattnig S, Domayer SE, Shetty V, et al. Repair tissue quality after arthroscopic autologous collagen-induced chondrogenesis (ACIC) assessed via T2* mapping. Skeletal Radiol. 2013;42:1657–64.CrossRef Stelzeneder D, Shetty AA, Kim SJ, Trattnig S, Domayer SE, Shetty V, et al. Repair tissue quality after arthroscopic autologous collagen-induced chondrogenesis (ACIC) assessed via T2* mapping. Skeletal Radiol. 2013;42:1657–64.CrossRef
3.
go back to reference Wu Y, Yang R, Jia S, Li Z, Zhou Z, Lou T. Computer-aided diagnosis of early knee osteoarthritis based on MRI T2 mapping. Biomed Mater Eng. 2014;24:3379–88.PubMed Wu Y, Yang R, Jia S, Li Z, Zhou Z, Lou T. Computer-aided diagnosis of early knee osteoarthritis based on MRI T2 mapping. Biomed Mater Eng. 2014;24:3379–88.PubMed
4.
go back to reference Stehling C, Luke A, Stahl R, Baum T, Joseph G, Pan J, et al. Meniscal T1rho and T2 measured with 3.0T MRI increases directly after running a marathon. Skeletal Radiol. 2011;40:725–35.CrossRef Stehling C, Luke A, Stahl R, Baum T, Joseph G, Pan J, et al. Meniscal T1rho and T2 measured with 3.0T MRI increases directly after running a marathon. Skeletal Radiol. 2011;40:725–35.CrossRef
5.
go back to reference Ellingson AM, Mehta H, Polly DW, Ellermann J, Nuckley DJ. Disc degeneration assessed by quantitative T2* (T2 star) correlated with functional lumbar mechanics. Spine (Phila Pa 1976). 2013;38:E1533–40.CrossRef Ellingson AM, Mehta H, Polly DW, Ellermann J, Nuckley DJ. Disc degeneration assessed by quantitative T2* (T2 star) correlated with functional lumbar mechanics. Spine (Phila Pa 1976). 2013;38:E1533–40.CrossRef
6.
go back to reference Mamisch TC, Hughes T, Mosher TJ, Mueller C, Trattnig S, Boesch C, et al. T2 star relaxation times for assessment of articular cartilage at 3 T: a feasibility study. Skeletal Radiol. 2012;41:287–92.CrossRef Mamisch TC, Hughes T, Mosher TJ, Mueller C, Trattnig S, Boesch C, et al. T2 star relaxation times for assessment of articular cartilage at 3 T: a feasibility study. Skeletal Radiol. 2012;41:287–92.CrossRef
7.
go back to reference Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, et al. The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging. Br J Radiol. 2016;89:20151075.CrossRef Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, et al. The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging. Br J Radiol. 2016;89:20151075.CrossRef
8.
go back to reference Schleich C, Hesper T, Hosalkar HS, Rettegi F, Zilkens C, Krauspe R, et al. 3D double-echo steady-state sequence assessment of hip joint cartilage and labrum at 3 Tesla: comparative analysis of magnetic resonance imaging and intraoperative data. Eur Radiol. 2017;27:4360–71.CrossRef Schleich C, Hesper T, Hosalkar HS, Rettegi F, Zilkens C, Krauspe R, et al. 3D double-echo steady-state sequence assessment of hip joint cartilage and labrum at 3 Tesla: comparative analysis of magnetic resonance imaging and intraoperative data. Eur Radiol. 2017;27:4360–71.CrossRef
9.
go back to reference Van Dyck P, Vanhevel F, Vanhoenacker FM, Wouters K, Grodzki DM, Gielen JL, et al. Morphological MR imaging of the articular cartilage of the knee at 3 T-comparison of standard and novel 3D sequences. Insights Imaging. 2015;6:285–93.CrossRef Van Dyck P, Vanhevel F, Vanhoenacker FM, Wouters K, Grodzki DM, Gielen JL, et al. Morphological MR imaging of the articular cartilage of the knee at 3 T-comparison of standard and novel 3D sequences. Insights Imaging. 2015;6:285–93.CrossRef
10.
go back to reference Lee JG, Gumus S, Moon CH, Kwoh CK, Bae KT. Fully automated segmentation of cartilage from the MR images of knee using a multi-atlas and local structural analysis method. Med Phys. 2014;41:092303.CrossRef Lee JG, Gumus S, Moon CH, Kwoh CK, Bae KT. Fully automated segmentation of cartilage from the MR images of knee using a multi-atlas and local structural analysis method. Med Phys. 2014;41:092303.CrossRef
11.
go back to reference Fripp J, Crozier S, Warfield SK, Ourselin S. Automatic segmentation and quantitative analysis of the articular cartilages from magnetic resonance images of the knee. IEEE Trans Med Imaging. 2010;29:55–64.CrossRef Fripp J, Crozier S, Warfield SK, Ourselin S. Automatic segmentation and quantitative analysis of the articular cartilages from magnetic resonance images of the knee. IEEE Trans Med Imaging. 2010;29:55–64.CrossRef
12.
go back to reference Desai AD, Caliva F, Iriondo C, Mortazi A, Jambawalikar S, Bagci U, et al. The international workshop on osteoarthritis imaging knee MRI segmentation challenge: a multi-institute evaluation and analysis framework on a standardized dataset. Radiol Artif Intell. 2021;3:e200078.CrossRef Desai AD, Caliva F, Iriondo C, Mortazi A, Jambawalikar S, Bagci U, et al. The international workshop on osteoarthritis imaging knee MRI segmentation challenge: a multi-institute evaluation and analysis framework on a standardized dataset. Radiol Artif Intell. 2021;3:e200078.CrossRef
13.
go back to reference Liu F, Zhou Z, Jang H, Samsonov A, Zhao G, Kijowski R. Deep convolutional neural network and 3D deformable approach for tissue segmentation in musculoskeletal magnetic resonance imaging. Magn Reson Med. 2018;79:2379–91.CrossRef Liu F, Zhou Z, Jang H, Samsonov A, Zhao G, Kijowski R. Deep convolutional neural network and 3D deformable approach for tissue segmentation in musculoskeletal magnetic resonance imaging. Magn Reson Med. 2018;79:2379–91.CrossRef
14.
go back to reference Surowiec RK, Lucas EP, Fitzcharles EK, Petre BM, Dornan GJ, Giphart JE, et al. T2 values of articular cartilage in clinically relevant subregions of the asymptomatic knee. Knee Surg Sports Traumatol Arthrosc. 2014;22:1404–14.CrossRef Surowiec RK, Lucas EP, Fitzcharles EK, Petre BM, Dornan GJ, Giphart JE, et al. T2 values of articular cartilage in clinically relevant subregions of the asymptomatic knee. Knee Surg Sports Traumatol Arthrosc. 2014;22:1404–14.CrossRef
15.
go back to reference Huang M, Guo Y, Ye Q, Chen L, Zhou K, Wang Q, et al. Correlation between T2* (T2 star) relaxation time and cervical intervertebral disc degeneration: an observational study. Medicine (Baltimore). 2016;95:e4502.CrossRef Huang M, Guo Y, Ye Q, Chen L, Zhou K, Wang Q, et al. Correlation between T2* (T2 star) relaxation time and cervical intervertebral disc degeneration: an observational study. Medicine (Baltimore). 2016;95:e4502.CrossRef
16.
go back to reference Hesper T, Hosalkar HS, Bittersohl D, Welsch GH, Krauspe R, Zilkens C, et al. T2* mapping for articular cartilage assessment: principles, current applications, and future prospects. Skeletal Radiol. 2014;43:1429–45.CrossRef Hesper T, Hosalkar HS, Bittersohl D, Welsch GH, Krauspe R, Zilkens C, et al. T2* mapping for articular cartilage assessment: principles, current applications, and future prospects. Skeletal Radiol. 2014;43:1429–45.CrossRef
17.
go back to reference Bittersohl B, Miese FR, Hosalkar HS, Herten M, Antoch G, Krauspe R, et al. T2* mapping of hip joint cartilage in various histological grades of degeneration. Osteoarthritis Cartilage. 2012;20:653–60.CrossRef Bittersohl B, Miese FR, Hosalkar HS, Herten M, Antoch G, Krauspe R, et al. T2* mapping of hip joint cartilage in various histological grades of degeneration. Osteoarthritis Cartilage. 2012;20:653–60.CrossRef
18.
go back to reference Zhang X, Yang L, Gao F, Yuan Z, Lin X, Yao B, et al. Comparison of T1rho and T2* relaxation mapping in patients with different grades of disc degeneration at 3T MR. Med Sci Monit. 2015;21:1934–41.CrossRef Zhang X, Yang L, Gao F, Yuan Z, Lin X, Yao B, et al. Comparison of T1rho and T2* relaxation mapping in patients with different grades of disc degeneration at 3T MR. Med Sci Monit. 2015;21:1934–41.CrossRef
Metadata
Title
Clinical validation of the use of prototype software for automatic cartilage segmentation to quantify knee cartilage in volunteers
Authors
Ping Zhang
Ran Xu Zhang
Xiao Shuai Chen
Xiao Yue Zhou
Esther Raithel
Jian Ling Cui
Jian Zhao
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-021-04973-4

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