Reliability and Validity of Novel Multi-View, Whole-Knee Effusion-Synovitis Quantification with Axial and Sagittal Segmentation on 3T Knee MRI

Motivation: Knee osteoarthritis (KOA) is a widespread condition that lacks approved disease-modifying drugs. There is a critical need to develop and evaluate biomarkers of KOA, including effusion-synovitis (ES). Goal(s): The goal is to develop a novel, rapid, semi-automated segmentation of ES by non-experts that utilizes multiple perspectives simultaneously. Approach: A custom system allowing display of axial DESS and sagittal TSE 3T knee MRI images with continuous localization and quantification enabled precise biplanar ES measurement in parallel or simultaneously via projection. Results: Extremely high intra- and inter-reader reliabilities (ICCs > 0.98) were found for both methods, suggesting their use for rapid, accurate assessments of ES. Impact: Our results have broad public health impact, given the prevalence of knee osteoarthritis. Our next step involves precise quantification and localization of effusion-synovitis on large datasets to identify early disease stage progressors, facilitating the development of targeted treatments and prevention.