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Abstract：
Trabecular bone texture analysis (TBTA) has been identified as an imaging biomarker that provides information on trabecular bone changes due to knee osteoarthritis (KOA). Consequently, it is important to conduct a comprehensive review that would permit a better understanding of this unfamiliar image analysis technique in the area of KOA research. We examined how TBTA, conducted on knee radiographs, is associated to (i) KOA incidence and progression, (ii) total knee arthroplasty, and (iii) KOA treatment responses. The primary aims of this study are twofold: to provide (i) a narrative review of the studies conducted on radiographic KOA using TBTA, and (ii) a viewpoint on future research priorities.
Literature searches were performed in the PubMed electronic database. Studies published between June 1991 and March 2020 and related to traditional and fractal image analysis of trabecular bone texture (TBT) on knee radiographs were identified.
The search resulted in 219 papers. After title and abstract scanning, 39 studies were found eligible and then classified in accordance to six criteria: cross-sectional evaluation of osteoarthritis and non-osteoarthritis knees, understanding of bone microarchitecture, prediction of KOA progression, KOA incidence, and total knee arthroplasty and association with treatment response. Numerous studies have reported the relevance of TBTA as a potential bioimaging marker in the prediction of KOA incidence and progression. However, only a few studies have focused on the association of TBTA with both OA treatment responses and the prediction of knee joint replacement.
Clear evidence of biological plausibility for TBTA in KOA is already established. The review confirms the consistent association between TBT and important KOA endpoints such as KOA radiographic incidence and progression. TBTA could provide markers for enrichment of clinical trials enhancing the screening of KOA progressors. Major advances were made towards a fully automated assessment of KOA.
Literature searches were performed in the PubMed electronic database. Studies published between June 1991 and March 2020 and related to traditional and fractal image analysis of trabecular bone texture (TBT) on knee radiographs were identified.
The search resulted in 219 papers. After title and abstract scanning, 39 studies were found eligible and then classified in accordance to six criteria: cross-sectional evaluation of osteoarthritis and non-osteoarthritis knees, understanding of bone microarchitecture, prediction of KOA progression, KOA incidence, and total knee arthroplasty and association with treatment response. Numerous studies have reported the relevance of TBTA as a potential bioimaging marker in the prediction of KOA incidence and progression. However, only a few studies have focused on the association of TBTA with both OA treatment responses and the prediction of knee joint replacement.
Clear evidence of biological plausibility for TBTA in KOA is already established. The review confirms the consistent association between TBT and important KOA endpoints such as KOA radiographic incidence and progression. TBTA could provide markers for enrichment of clinical trials enhancing the screening of KOA progressors. Major advances were made towards a fully automated assessment of KOA.
摘要：
骨小梁结构分析（TBTA）已被确定为成像生物标志物，可提供有关膝关节骨关节炎（KOA）导致的骨小梁变化的信息。因此,重要的是要进行全面审查，以更好地了解KOA研究领域中这种不熟悉的图像分析技术。我们研究了TBTA，在膝盖射线照片上进行的，与(I)KOA发病率和进展有关，(ii)全膝关节置换术,和(iii)KOA治疗反应。这项研究的主要目的是双重的：提供（i）对使用TBTA进行的放射学KOA研究的叙述性综述，(ii)对未来研究重点的看法。
文献检索在PubMed电子数据库中进行。在1991年6月至2020年3月之间发表的研究以及与膝关节X射线照片上小梁骨纹理（TBT）的传统和分形图像分析有关的研究被确定。
搜索结果是219篇论文。标题和摘要扫描后，39项研究被发现合格，然后根据六个标准进行分类：骨关节炎和非骨关节炎膝盖的横断面评估，对骨骼微结构的理解，预测KOA进展，KOA发病率,和全膝关节置换术以及与治疗反应的关联。许多研究报道了TBTA作为预测KOA发病率和进展的潜在生物成像标志物的相关性。然而,只有少数研究关注TBTA与OA治疗反应和膝关节置换预测的相关性.
已经建立了在KOA中TBTA的生物学合理性的明确证据。该综述证实了TBT与重要的KOA终点之间的一致关联，如KOA影像学发病率和进展。TBTA可以为临床试验的富集提供标志物，从而增强对KOA进展者的筛选。在对KOA进行全自动评估方面取得了重大进展。
文献检索在PubMed电子数据库中进行。在1991年6月至2020年3月之间发表的研究以及与膝关节X射线照片上小梁骨纹理（TBT）的传统和分形图像分析有关的研究被确定。
搜索结果是219篇论文。标题和摘要扫描后，39项研究被发现合格，然后根据六个标准进行分类：骨关节炎和非骨关节炎膝盖的横断面评估，对骨骼微结构的理解，预测KOA进展，KOA发病率,和全膝关节置换术以及与治疗反应的关联。许多研究报道了TBTA作为预测KOA发病率和进展的潜在生物成像标志物的相关性。然而,只有少数研究关注TBTA与OA治疗反应和膝关节置换预测的相关性.
已经建立了在KOA中TBTA的生物学合理性的明确证据。该综述证实了TBT与重要的KOA终点之间的一致关联，如KOA影像学发病率和进展。TBTA可以为临床试验的富集提供标志物，从而增强对KOA进展者的筛选。在对KOA进行全自动评估方面取得了重大进展。
