Rationale and Objectives
To use radiomics to detect the subtle changes of cartilage and subchondral bone in
chronic lateral ankle instability (CLAI) patients based on MRI PD-FS images.
Materials and Methods
A total of 215 CLAI patients and 186 healthy controls were included and randomly split
into a training set (n=281, patients/controls=151/130) and an independent test set (n=120, patients/controls=64/56). They underwent ankle MRI examinations. On sagittal
PD-FS images, eight cartilage regions and their corresponding subchondral bone regions
were drawn. Radiomics models of cartilage, subchondral bone and combined cartilage
and subchondral bone were built to differentiate CLAI patients from controls. A receiver
operating characteristic curve (ROC) was used to assess the model's performance.
Results
In the test dataset, the cartilage model yielded an area under the curve (AUC) of
0.0.912 (95% confidence interval (CI): 0.858-0.965, p<0.001), a sensitivity of 0.859, a specificity of 0.893, a negative predictive value
(NPV) of 0.848, and a positive predictive value (PPV) of 0.902. The subchondral bone
model yielded an AUC of 0.837 (95% CI: 0.766-0.907, p<0.001), a sensitivity of 0.875, a specificity of 0.714, an NPV of 0.833, and a PPV
of 0.778. For the combined model, the AUC was 0.921 (95% CI: 0.863-0.972, p<0.001), sensitivity was 0.844, specificity was 0.911, NPV was 0.836, and PPV was
0.915, whose AUC was higher than those of both the cartilage model and the subchondral
bone model.
Conclusion
The combined radiomics model achieved satisfying performance in detecting potential
early architectural changes in cartilage and subchondral bone for CLAI patients.
Keywords
Abbreviations:
CLAI (chronic lateral ankle instability), PD-FS (proton density with fat-suppression), ROC (Receiver operating characteristic curve), AUC (area under curve), CI (confidence interval), NPV (negative predictive value), PPV (positive predictive value), ATFL (anterior talofibular ligament), CFL (calcaneofibular ligament), OA (osteoarthritis), T1WI (T1-weighted imaging), T2WI (T2-weighted imaging), BMI (body mass index), OCL (osteochondral lesion), pSTJ (posterior subtalar joints), C-S (cartilage and subchondral), SMOTE (Synthetic Minority Oversampling Technique), PCC (Pearson Correlation Coefficient), RFE (Recursive Feature Elimination), SVM (support vector machine)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Academic RadiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The frequency of injury, mechanism of injury, and epidemiology of ankle sprains.Am J Sports Med. 1977; 5: 241-242
- A systematic review on ankle injury and ankle sprain in sports.Sports Med. 2007; 37: 73-94
- Lateral ankle sprain and chronic ankle instability: a critical review.Foot Ankle Spec. 2014; 7: 298-326
- Chronic lateral ankle istability: topical review.Foot Ankle Int. 2020; 41: 1571-1581
- Articular cartilage lesions in ankles with lateral ligament injury. An arthroscopic study.Am J Sports Med. 1993; 21 (discussion 6-7): 120-126
- The role of the interosseous talocalcaneal ligament in subtalar joint stability.Foot Ankle Int. 2004; 25: 588-596
- Overuse ballet injury of the base of the second metatarsal. A diagnostic problem.Am J Sports Med. 1993; 21: 591-598
- A randomized, prospective study of operative and non-operative treatment of injuries of the fibular collateral ligaments of the ankle.J Bone Joint Surg Am. 1998; 80: 345-351
- Peritalar instability.Foot Ankle Int. 2012; 33: 450-454
- Subtalar instability. Etiology, diagnosis, and management.Foot Ankle Clin. 2002; 7: 577-609
- Nutrition, osteoarthritis and cartilage metabolism.Aging Clin Exp Res. 2019; 31: 807-813
- Bone-cartilage crosstalk: a conversation for understanding osteoarthritis.Bone Res. 2016; 4: 16028
- The bone-cartilage unit in osteoarthritis.Nat Rev Rheumatol. 2011; 7: 43-49
- Changes in articular cartilage and subchondral bone histomorphometry in osteoarthritic knee joints in humans.Bone. 2003; 32: 284-290
- Correlation between subchondral bone plate thickness and cartilage degeneration in osteoarthritis of the ankle.Foot Ankle Int. 2014; 35: 1341-1349
- Role of subchondral bone in the initiation and progression of cartilage damage.Clin Orthop Relat Res. 1986; : 34-40
- Bone mineralization changes in the subchondral bone of the medial gutter in chronic lateral ankle instability.Foot Ankle Int. 2020; 41: 1419-1426
- Imaging of talar dome chondral and osteochondral lesions.Top Magn Reson Imaging. 2010; 21: 3-13
- T2 and T2* mapping in patients after matrix-associated autologous chondrocyte transplantation: initial results on clinical use with 3.0-Tesla MRI.Eur Radiol. 2010; 20: 1515-1523
- Accuracy of T2-weighted fast spin-echo MR imaging with fat saturation in detecting cartilage defects in the knee: comparison with arthroscopy in 130 patients.AJR Am J Roentgenol. 1999; 172: 1073-1080
- Quantitative magnetic resonance imaging (MRI) evaluation of cartilage repair after microfracture (MF) treatment for adult unstable osteochondritis dissecans (OCD) in the ankle: correlations with clinical outcome.Eur Radiol. 2014; 24: 1758-1767
- Comparison of quantitative cartilage T2 measurements and qualitative MR imaging between professional ballet dancers and healthy volunteers.Radiology. 2015; 276: 199-206
- T1rho MRI of the talar articular cartilage is increased in those with chronic ankle instability.Osteoarthritis Cartilage. 2019; 27: 646-649
- T2* mapping of subtalar cartilage: precision and association between anatomical variants and cartilage composition.J Orthop Res. 2016; 34: 1969-1976
- T2 -Mapping evaluation of early cartilage alteration of talus for chronic lateral ankle instability with isolated anterior talofibular ligament tear or combined with calcaneofibular ligament tear.J Magn Reson Imaging. 2018; 47: 69-77
- Comparison of T2 relaxation values in subtalar cartilage between patients with lateral instability of the ankle joint and healthy volunteers.Eur Radiol. 2018; 28: 4151-4162
- A machine learning approach to distinguish between knees without and with osteoarthritis using MRI-based radiomic features from tibial bone.Eur Radiol. 2021; 31: 8513-8521
- Diagnosis and treatment of chronic lateral ankle instability: review of our biomechanical evidence.J Am Acad Orthop Surg. 2021; 29: 3-16
- Accuracy of MRI scan in the diagnosis of ligamentous and chondral pathology in the ankle.Foot Ankle Surg. 2010; 16: 78-80
- The anterior talo-fibular ligament reconstruction in surgical treatment of chronic lateral ankle instability.Int Orthop. 2010; 34: 991-996
- MRI of injury to the lateral collateral ligamentous complex of the ankle.J Comput Assist Tomogr. 1993; 17: 102-107
- Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline.Br J Sports Med. 2018; 52: 956
- Statistical validation of image segmentation quality based on a spatial overlap index.Acad Radiol. 2004; 11: 178-189
- Mechanical stability of the subtalar joint after lateral ligament sectioning and ankle brace application: a biomechanical experimental study.Am J Sports Med. 2009; 37: 2451-2458
- Ligament structures in the tarsal sinus and canal.Foot Ankle Int. 2013; 34: 1729-1736
- Lateral talocalcaneal instability following section of the calcaneofibular ligament: a kinesiologic study.Foot Ankle. 1987; 7: 355-361
- Impact of chronic lateral ankle instability with lateral collateral ligament injuries on biochemical alterations in the cartilage of the subtalar and midtarsal joints based on MRI T2 mapping.Korean J Radiol. 2021; 22: 384-394
- Pain prediction by serum biomarkers of bone turnover in people with knee osteoarthritis: an observational study of TRAcP5b and cathepsin K in OA.Osteoarthritis Cartilage. 2017; 25: 858-865
- Relationship between subchondral bone microstructure and articular cartilage in the osteoarthritic knee using 3T MRI.J Magn Reson Imaging. 2018; 48: 669-679
- Magnetic resonance imaging of normal and osteoarthritic trabecular bone structure in the human knee.Arthritis Rheum. 2002; 46: 385-393
- Bone remodelling in osteoarthritis.Nat Rev Rheumatol. 2012; 8: 665-673
- Bone-cartilage interface crosstalk in osteoarthritis: potential pathways and future therapeutic strategies.Osteoarthritis Cartilage. 2014; 22: 1077-1089
Article info
Publication history
Published online: December 02, 2022
Accepted:
November 13,
2022
Received in revised form:
November 8,
2022
Received:
July 31,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
