Deep learning-based effusion-synovitis volume measured on MRI is associated with osteoarthritis progression: A longitudinal analysis of data from the osteoarthritis initiative.

OBJECTIVE

To investigate whether the 48-month change in effusion-synovitis volume (ΔESV) is associated with concurrent knee osteoarthritis progression, and to compare these associations with those of semiquantitative change in effusion-synovitis using the MRI Osteoarthritis Knee Score (ΔMOAKS).

DESIGN

In this study using data from the Osteoarthritis Initiative conducted from 02/2004-10/2015, deep learning-based measurements of knee ESV were derived from baseline and 48-month follow-up knee MRI (n = 2469). OA outcomes included change of Kellgren-Lawrence (KL) grade, Whole-Organ Magnetic Resonance Imaging Score (WORMS) and its subscales (meniscus, bone marrow edema-like lesions [BMELL], cartilage), and symptom progression by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Associations of ESV change (ΔESV) with OA outcome changes were evaluated using spline-based regression models. Effect sizes were reported as interdecile differences (IDDs; 90th vs 10th percentile of the exposure). To compare the associations between ΔESV and ΔMOAKS, differences in IDD (ΔIDD) were estimated.

RESULTS

ΔESV was significantly associated with ΔKL grade, ΔWORMSTotal, ΔWORMSMeniscus, ΔWORMSBMELL, ΔWORMSCartilage, and ΔWOMAC (all p < 0.001). Compared with ΔMOAKS, ΔESV demonstrated significantly stronger associations for ΔKL grade (ΔIDD = 0.22; p = 0.002), ΔWORMSTotal (ΔIDD = 0.21; p = 0.008), and ΔWORMSMeniscus (ΔIDD = 0.20; p = 0.026), whereas differences were non-significant for ΔWORMSBMELL (p = 0.51), ΔWORMSCartilage (p = 0.25), or ΔWOMAC (p = 0.19).

CONCLUSIONS

Longitudinal change in ESV was associated with concurrent imaging-based and symptomatic osteoarthritis progression over 48 months. Compared with changes in MOAKS scores, ΔESV showed stronger associations with imaging-based OA outcomes. These findings underscore the potential of MRI-based ΔESV as an osteoarthritis imaging biomarker, while further studies are needed to establish its predictive and clinical utility.