Cartilage lesion score: Comparison of a quantitative assessment score with established semiquantitative MR scoring systems

Hamza Alizai, Warapat Virayavanich, Gabby B. Joseph, Lorenzo Nardo, Felix Liu, Hans Liebl, Michael C. Nevitt, John A. Lynch, Charles E. McCulloch, Thomas M. Link

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To describe a scoring system for quantification of cartilage lesions (Cartilage Lesion Score [CaLS]), to determine its reproducibility, to examine the association of CaLSdetected longitudinal change with known risk factors for osteoarthritis (OA) progression by comparing a group of subjects with OA risk factors with a group of subjects without OA risk factors, and to compare the CaLS system with the established semiquantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston- Leeds Osteoarthritis Knee Score (BLOKS) systems in terms of detection of cartilage defect progression. Materials and Methods: All subjects provided written informed consent, and the local institutional review board approved this HIPAAcompliant study. Fifty-two subjects with and 25 subjects without risk factors for knee OA were randomly selected from the Osteoarthritis Initiative. Inclusion criteria were age of 45-60 years, body mass index of 19-27 kg/m2, and no knee pain or OA on radiographs at baseline. Baseline and 24-month follow-up right knee 3-T magnetic resonance images were analyzed with WORMS, BLOKS, and CaLS systems. Progression of cartilage lesions with each scoring system was compared by using multilevel mixedeffects linear-regression models. κ values were calculated to determine reliability. Results: Intraclass coefficient values for inter- and intraobserver reliability of the CaLS system were 0.86 and 0.91, respectively. Interobserver k value range for individual features was 0.81-0.94. The CaLS system enabled significantly higher detection of cartilage lesion progression than did WORMS or BLOKS systems (P < .001); 51.8% (56 of 108), 17.6% (19 of 108), and 13.0% (14 of 108) of the lesions progressed when analyzed with the CaLS, WORMS, and BLOKS systems, respectively. With the CaLS system, subjects with OA risk factors had significantly higher odds of progression than did subjects without risk factors (odds ratio, 2.78; P = .005). Conclusion: The CaLS system is a reproducible scoring system for cartilage lesions that yields an improved detection rate for monitoring progression when compared with detection rates of semiquantitative WORMS and BLOKS systems.

Original languageEnglish (US)
Pages (from-to)479-487
Number of pages9
JournalRadiology
Volume271
Issue number2
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Cartilage
Knee Osteoarthritis
Osteoarthritis
Magnetic Resonance Imaging
Linear Models
Knee
Research Ethics Committees
Informed Consent
Body Mass Index
Magnetic Resonance Spectroscopy
Odds Ratio
Pain

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Cartilage lesion score : Comparison of a quantitative assessment score with established semiquantitative MR scoring systems. / Alizai, Hamza; Virayavanich, Warapat; Joseph, Gabby B.; Nardo, Lorenzo; Liu, Felix; Liebl, Hans; Nevitt, Michael C.; Lynch, John A.; McCulloch, Charles E.; Link, Thomas M.

In: Radiology, Vol. 271, No. 2, 01.01.2014, p. 479-487.

Research output: Contribution to journalArticle

Alizai, H, Virayavanich, W, Joseph, GB, Nardo, L, Liu, F, Liebl, H, Nevitt, MC, Lynch, JA, McCulloch, CE & Link, TM 2014, 'Cartilage lesion score: Comparison of a quantitative assessment score with established semiquantitative MR scoring systems', Radiology, vol. 271, no. 2, pp. 479-487. https://doi.org/10.1148/radiol.13122056
Alizai, Hamza ; Virayavanich, Warapat ; Joseph, Gabby B. ; Nardo, Lorenzo ; Liu, Felix ; Liebl, Hans ; Nevitt, Michael C. ; Lynch, John A. ; McCulloch, Charles E. ; Link, Thomas M. / Cartilage lesion score : Comparison of a quantitative assessment score with established semiquantitative MR scoring systems. In: Radiology. 2014 ; Vol. 271, No. 2. pp. 479-487.
@article{f6afa912f4574a3fbcfe831e53d1308c,
title = "Cartilage lesion score: Comparison of a quantitative assessment score with established semiquantitative MR scoring systems",
abstract = "Purpose: To describe a scoring system for quantification of cartilage lesions (Cartilage Lesion Score [CaLS]), to determine its reproducibility, to examine the association of CaLSdetected longitudinal change with known risk factors for osteoarthritis (OA) progression by comparing a group of subjects with OA risk factors with a group of subjects without OA risk factors, and to compare the CaLS system with the established semiquantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston- Leeds Osteoarthritis Knee Score (BLOKS) systems in terms of detection of cartilage defect progression. Materials and Methods: All subjects provided written informed consent, and the local institutional review board approved this HIPAAcompliant study. Fifty-two subjects with and 25 subjects without risk factors for knee OA were randomly selected from the Osteoarthritis Initiative. Inclusion criteria were age of 45-60 years, body mass index of 19-27 kg/m2, and no knee pain or OA on radiographs at baseline. Baseline and 24-month follow-up right knee 3-T magnetic resonance images were analyzed with WORMS, BLOKS, and CaLS systems. Progression of cartilage lesions with each scoring system was compared by using multilevel mixedeffects linear-regression models. κ values were calculated to determine reliability. Results: Intraclass coefficient values for inter- and intraobserver reliability of the CaLS system were 0.86 and 0.91, respectively. Interobserver k value range for individual features was 0.81-0.94. The CaLS system enabled significantly higher detection of cartilage lesion progression than did WORMS or BLOKS systems (P < .001); 51.8{\%} (56 of 108), 17.6{\%} (19 of 108), and 13.0{\%} (14 of 108) of the lesions progressed when analyzed with the CaLS, WORMS, and BLOKS systems, respectively. With the CaLS system, subjects with OA risk factors had significantly higher odds of progression than did subjects without risk factors (odds ratio, 2.78; P = .005). Conclusion: The CaLS system is a reproducible scoring system for cartilage lesions that yields an improved detection rate for monitoring progression when compared with detection rates of semiquantitative WORMS and BLOKS systems.",
author = "Hamza Alizai and Warapat Virayavanich and Joseph, {Gabby B.} and Lorenzo Nardo and Felix Liu and Hans Liebl and Nevitt, {Michael C.} and Lynch, {John A.} and McCulloch, {Charles E.} and Link, {Thomas M.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1148/radiol.13122056",
language = "English (US)",
volume = "271",
pages = "479--487",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Cartilage lesion score

T2 - Comparison of a quantitative assessment score with established semiquantitative MR scoring systems

AU - Alizai, Hamza

AU - Virayavanich, Warapat

AU - Joseph, Gabby B.

AU - Nardo, Lorenzo

AU - Liu, Felix

AU - Liebl, Hans

AU - Nevitt, Michael C.

AU - Lynch, John A.

AU - McCulloch, Charles E.

AU - Link, Thomas M.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: To describe a scoring system for quantification of cartilage lesions (Cartilage Lesion Score [CaLS]), to determine its reproducibility, to examine the association of CaLSdetected longitudinal change with known risk factors for osteoarthritis (OA) progression by comparing a group of subjects with OA risk factors with a group of subjects without OA risk factors, and to compare the CaLS system with the established semiquantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston- Leeds Osteoarthritis Knee Score (BLOKS) systems in terms of detection of cartilage defect progression. Materials and Methods: All subjects provided written informed consent, and the local institutional review board approved this HIPAAcompliant study. Fifty-two subjects with and 25 subjects without risk factors for knee OA were randomly selected from the Osteoarthritis Initiative. Inclusion criteria were age of 45-60 years, body mass index of 19-27 kg/m2, and no knee pain or OA on radiographs at baseline. Baseline and 24-month follow-up right knee 3-T magnetic resonance images were analyzed with WORMS, BLOKS, and CaLS systems. Progression of cartilage lesions with each scoring system was compared by using multilevel mixedeffects linear-regression models. κ values were calculated to determine reliability. Results: Intraclass coefficient values for inter- and intraobserver reliability of the CaLS system were 0.86 and 0.91, respectively. Interobserver k value range for individual features was 0.81-0.94. The CaLS system enabled significantly higher detection of cartilage lesion progression than did WORMS or BLOKS systems (P < .001); 51.8% (56 of 108), 17.6% (19 of 108), and 13.0% (14 of 108) of the lesions progressed when analyzed with the CaLS, WORMS, and BLOKS systems, respectively. With the CaLS system, subjects with OA risk factors had significantly higher odds of progression than did subjects without risk factors (odds ratio, 2.78; P = .005). Conclusion: The CaLS system is a reproducible scoring system for cartilage lesions that yields an improved detection rate for monitoring progression when compared with detection rates of semiquantitative WORMS and BLOKS systems.

AB - Purpose: To describe a scoring system for quantification of cartilage lesions (Cartilage Lesion Score [CaLS]), to determine its reproducibility, to examine the association of CaLSdetected longitudinal change with known risk factors for osteoarthritis (OA) progression by comparing a group of subjects with OA risk factors with a group of subjects without OA risk factors, and to compare the CaLS system with the established semiquantitative Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston- Leeds Osteoarthritis Knee Score (BLOKS) systems in terms of detection of cartilage defect progression. Materials and Methods: All subjects provided written informed consent, and the local institutional review board approved this HIPAAcompliant study. Fifty-two subjects with and 25 subjects without risk factors for knee OA were randomly selected from the Osteoarthritis Initiative. Inclusion criteria were age of 45-60 years, body mass index of 19-27 kg/m2, and no knee pain or OA on radiographs at baseline. Baseline and 24-month follow-up right knee 3-T magnetic resonance images were analyzed with WORMS, BLOKS, and CaLS systems. Progression of cartilage lesions with each scoring system was compared by using multilevel mixedeffects linear-regression models. κ values were calculated to determine reliability. Results: Intraclass coefficient values for inter- and intraobserver reliability of the CaLS system were 0.86 and 0.91, respectively. Interobserver k value range for individual features was 0.81-0.94. The CaLS system enabled significantly higher detection of cartilage lesion progression than did WORMS or BLOKS systems (P < .001); 51.8% (56 of 108), 17.6% (19 of 108), and 13.0% (14 of 108) of the lesions progressed when analyzed with the CaLS, WORMS, and BLOKS systems, respectively. With the CaLS system, subjects with OA risk factors had significantly higher odds of progression than did subjects without risk factors (odds ratio, 2.78; P = .005). Conclusion: The CaLS system is a reproducible scoring system for cartilage lesions that yields an improved detection rate for monitoring progression when compared with detection rates of semiquantitative WORMS and BLOKS systems.

UR - http://www.scopus.com/inward/record.url?scp=84899575634&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899575634&partnerID=8YFLogxK

U2 - 10.1148/radiol.13122056

DO - 10.1148/radiol.13122056

M3 - Article

C2 - 24475848

AN - SCOPUS:84899575634

VL - 271

SP - 479

EP - 487

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -