Skeletal Radiology

, Volume 38, Issue 5, pp 505–511 | Cite as

Magnetic resonance image segmentation using semi-automated software for quantification of knee articular cartilage—initial evaluation of a technique for paired scans

  • M. H. Brem
  • P. K. Lang
  • G. Neumann
  • P. M. Schlechtweg
  • E. Schneider
  • R. Jackson
  • J. Yu
  • C. B. Eaton
  • F. F. Hennig
  • H. Yoshioka
  • G. Pappas
  • J. DuryeaEmail author
Scientific Article



Software-based image analysis is important for studies of cartilage changes in knee osteoarthritis (OA). This study describes an evaluation of a semi-automated cartilage segmentation software tool capable of quantifying paired images for potential use in longitudinal studies of knee OA. We describe the methodology behind the analysis and demonstrate its use by determination of test–retest analysis precision of duplicate knee magnetic resonance imaging (MRI) data sets.


Test–retest knee MR images of 12 subjects with a range of knee health were evaluated from the Osteoarthritis Initiative (OAI) pilot MR study. Each subject was removed from the magnet between the two scans. The 3D DESS (sagittal, 0.456 mm × 0.365 mm, 0.7 mm slice thickness, TR 16.5 ms, TE 4.7 ms) images were obtained on a 3-T Siemens Trio MR system with a USA Instruments quadrature transmit–receive extremity coil. Segmentation of one 3D-image series was first performed and then the corresponding retest series was segmented by viewing both image series concurrently in two adjacent windows. After manual registration of the series, the first segmentation cartilage outline served as an initial estimate for the second segmentation. We evaluated morphometric measures of the bone and cartilage surface area (tAB and AC), cartilage volume (VC), and mean thickness ( for medial/lateral tibia (MT/LT), total femur (F) and patella (P). Test–retest reproducibility was assessed using the root-mean square coefficient of variation (RMS CV%).


For the paired analyses, RMS CV % ranged from 0.9% to 1.2% for VC, from 0.3% to 0.7% for AC, from 0.6% to 2.7% for tAB and 0.8% to 1.5% for


Paired image analysis improved the measurement precision of cartilage segmentation. Our results are in agreement with other publications supporting the use of paired analysis for longitudinal studies of knee OA.


Osteoarthritis Knee Cartilage MRI Segmentation 



The Osteoarthritis Initiative (OAI) and this pilot study are conducted and supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases in collaboration with the OAI Investigators and Consultants. This manuscript has been reviewed by the OAI Publications committee for scientific content and data interpretation. The research reported in this article was supported in part by contracts N01-AR-2-2261, N01-AR-2-2262 and N01-AR-2-2258 from NIAMS. Support for this project was also provided by a contract with the NIAMS intramural program.

This work was also supported by a contract with the NIH/NIAMS intramural program. We would like to thank Raphaela Goldbach-Mansky of the NIH/NIAMS Intramural Research Program for her support in developing early versions of the software.

NIAMS funded this work in part (contracts N01-AR-2-2261, N01-AR-2-2262 and N01-AR-2-2258).

Conflict of Interest Statement

ES, RJ, JY, and CBE received direct salary support or had fee for service contracts associated with the OAI. In particular:

ES is the principal of SciTrials, LLC, is the NIAMS OAI Technical Advisor and is under contract to NIAMS for this

purpose; RJ and JU are at The Ohio State University that is under contract (N01-AR-2-2261) as a clinical center for the

OAI; CBE is at the Memorial Hospital of Rhode Island that is under contract (N01-AR-2-2262) as a clinical center for the OAI.


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Copyright information

© ISS 2009

Authors and Affiliations

  • M. H. Brem
    • 1
    • 6
  • P. K. Lang
    • 1
  • G. Neumann
    • 1
  • P. M. Schlechtweg
    • 1
  • E. Schneider
    • 2
    • 3
  • R. Jackson
    • 4
  • J. Yu
    • 4
  • C. B. Eaton
    • 5
  • F. F. Hennig
    • 6
  • H. Yoshioka
    • 1
  • G. Pappas
    • 1
  • J. Duryea
    • 1
    Email author
  1. 1.Department of RadiologyBrigham and Women’s HospitalBostonUSA
  2. 2.SciTrialsLLCRocky RiverUSA
  3. 3.The Cleveland Clinic, Imaging InstituteClevelandUSA
  4. 4.Diabetes and Metabolism and Radiology, Department of EndocrinologyThe Ohio State UniversityColumbusUSA
  5. 5.Memorial Hospital of Rhode IslandCenter for Primary Care and Prevention and the Warren Alpert Medical School of Brown UniversityProvidenceUSA
  6. 6.Division of Orthopaedic and Trauma Surgery, Department of SurgeryFriedrich-Alexander-University Erlangen NurembergErlangenGermany

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