Institute of Anatomy @ PMU Salzburg

Paracelsus Medical University | Strubergasse 21, A-5020 Salzburg | www.pmu.ac.at

Team at the Institute of Anatomy

Prof. Felix Eckstein, MD

Martin Hudelmaier, MD

Anja Ruhdorfer, MD, PhD

Torben Dannhauer, PhD

Wolfgang Wirth, PhD

Sebastian Cotofana, MD

Chondrometrics GmbH

Founded in 2003 CEO: Prof. Felix Eckstein Provides quantitative cartilage analyses for industry & academia Overlap of people between PMU & CHM

Institute of Anatomy

Research focus:» Knee osteoarthritis» Structural changes of cartilage and surrounding tissues » Morphometric analyses

Portfolio

Morphometric analyses» Usually MRI-based» Manual or semi-automated segmentation» Dedicated software

Cartilage Meniscus Thigh muscles

Portfolio: Cartilage

Measurement of:» Cartilage thickness» Cartilage volume» Cartilage areas (subchondral bone area/

cartilage surface area)

High-resolution, high-field MRI Manual segmentation with quality control

readings

P TrF

cLF

LT

pLF

MT

cMF

LT

cLFcMF cLF

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Portfolio: Cartilage composition

Measurement of T2 (spin-spin) relaxation time Multi-echo spin-echo MRI Spin-spin relaxation time in cartilage:

» Collagen content» Collagen orientation» Water content

Manual segmentation with QC readings

19.4 ms 38.8 ms 58.2 ms

Portfolio: Meniscus

Measurement of:» 3D meniscus extrusion» 3D meniscus morphology» Tibia plateau coverage» Regional analysis

Manual segmentation with QC readings

Portfolio: Muscle

Measurement of:» 3D thigh muscle volume » 2D anatomical cross-sectional areas (ACSA)» Inter-muscular tissue» Subcutaneous fat» Femoral medulla & corticalis

T1 weighted spin-echo MRI Manual / semi-automated segmentation

Osteoarthritis Initiative (OAI)

Longitudinal multi-center study (8 years) 4796 Participants (45-79 years at baseline) Data and image assessments publicly available Focus:

» Identification and evaluation of risk factors for incidence / progression of knee OA

» Validation of imaging biomarkers

http://www.oai.epi-ucsf.org

OAI: Available assessments

Assessments:» Isometric strength» Physical activity scores» Alignment measurements (full-limb x-rays, knee x-rays)» Physical performance examinations» Knee examination (Joint laxity, …)» Semi-quantitative KLG, JSN, osteophyte readings» Radiographic joint space width» MRI-based cartilage thickness, meniscus, muscle measurements

Questionnaires:» Pain (severity, frequency)» Function» Quality of Life» Medication» Nutrition» Occupation» …

OAI Thigh MRI

Acquisition started 100mm proximal to the distal epiphyseal line Covers 15 slices (5mm slice thickness) T1-weighted spin-echo MRI Computation of comparable slices between subjects required Specific strength (strength / ACSA)

Muscle groups• Quadriceps• Hamstrings• Adductors• Sartorius

Quadriceps heads• Vastus medialis• Vastus intermedius• Vastus lateralis• Rectus femors

ESR10: Muscle morphology and osteoarthritis disease progression

Objectives:» To identify the role of muscle tissue characteristics in predicting OA joint damage» To assess the impact of joint biomechanics on this relationship

Profile:» Background: Engineering / computer science ?» 2 years+ PhD program (doctorate of medical sciences)» KneeMo funding: 3 years

Project:» Automation of the segmentation of muscle ACSAs» Quantitative analysis of muscle ACSAs in OAI participants with and without

progressive cartilage thickness loss

ESR10: Muscle morphology and osteoarthritis disease progression

Cohort selected by the OAI coordinating center (n=445 with Y4 FU) KLG 2/3 knees (established radiographic OA)

» Comparison of change in muscle ACSAs between participants with and without severe cartilage loss (matched cases & controls)

» Combination with other assessments (e.g. alignment, knee injuries, joint laxity, meniscus surgery)

BL Y1 Y2 Y3 Y4

Cartilage thicknessCartilage thickness

Muscle ACSA Muscle ACSA

Progressors

Non-progressors

ER3: Predicting OA outcome through muscle tissue characteristics

Objective: To establish the predictive value of structural and physiological factors on outcome in KOA

Profile:» Background: Life sciences» KneeMo funding: 2 years

Project:» Quantitative analysis of muscle ACSAs in OAI participants, that

underwent total knee replacement surgery» Case-control study with up to 4 years prior to surgery (n=222+)» Available assessments:

• Cartilage thickness measurements• Meniscus measurements• Semi-quantitative MRI readings (cartilage lesions, ligaments,

bone-marrow lesions, …)

ER3: Predicting OA outcome through muscle tissue characteristics

Cohort selected as part of the OAI POMA project (Kwoh & Hunter) Knees with confirmed knee replacement surgery

BL Y1 Y2 Y3 Y4 Y5 Y6 Y7

T0T-1T-2T-3T-4

T0T-1T-2T-3T-4T-5

T0T-1T-2T-3T-4T-5T-6

T0T-1T-2T-3

Exchange

Anatomy training » Lectures» Dissection course

Quantitative image analysis» Background (MRI)» Techniques

Small projects? » Based on data from the OAI» Quantitative analysis of a small cohort

Anatomy trainingNanoDiaRa project meeting