Time-saving opportunities in knee osteoarthritis: T2 mapping and structural imaging of the knee using a single 5-min MRI scan.

OBJECTIVES: To assess the discriminative power of a 5-min quantitative double-echo steady-state (qDESS) sequence for simultaneous T2 measurements of cartilage and meniscus, and structural knee osteoarthritis (OA) assessment, in a clinical OA population, using radiographic knee OA as reference standard. METHODS: Fifty-three subjects were included and divided over three groups based on radiographic and clinical knee OA: 20 subjects with no OA (Kellgren-Lawrence grade (KLG) 0), 18 with mild OA (KLG2), and 15 with moderate OA (KLG3). All patients underwent a 5-min qDESS scan. We measured T2 relaxation times in four cartilage and four meniscus regions of interest (ROIs) and performed structural OA evaluation with the MRI Osteoarthritis Knee Score (MOAKS) using qDESS with multiplanar reformatting. Between-group differences in T2 values and MOAKS were calculated using ANOVA. Correlations of the reference standard (i.e., radiographic knee OA) with T2 and MOAKS were assessed with correlation analyses for ordinal variables. RESULTS: In cartilage, mean T2 values were 36.1 ± SD 4.3, 40.6 ± 5.9, and 47.1 ± 4.3 ms for no, mild, and moderate OA, respectively (p < 0.001). In menisci, mean T2 values were 15 ± 3.6, 17.5 ± 3.8, and 20.6 ± 4.7 ms for no, mild, and moderate OA, respectively (p < 0.001). Statistically significant correlations were found between radiographic OA and T2 and between radiographic OA and MOAKS in all ROIs (p < 0.05). CONCLUSION: Quantitative T2 and structural assessment of cartilage and meniscus, using a single 5-min qDESS scan, can distinguish between different grades of radiographic OA, demonstrating the potential of qDESS as an efficient tool for OA imaging. KEY POINTS: • Quantitative T 2values of cartilage and meniscus as well as structural assessment of the knee with a single 5-min quantitative double-echo steady-state (qDESS) scan can distinguish between different grades of knee osteoarthritis (OA). • Quantitative and structural qDESS-based measurements correlate significantly with the reference standard, radiographic degree of OA, for all cartilage and meniscus regions. • By providing quantitative measurements and diagnostic image quality in one rapid MRI scan, qDESS has great potential for application in large-scale clinical trials in knee OA

A method to evaluate equitable accessibility: combining ethical theories and accessibility-based approaches

In this paper, we present the case that traditional transport appraisal methods do not sufficiently capture the social dimensions of mobility and accessibility. However, understanding this is highly relevant for policymakers to understand the impacts of their transport decisions. These dimensions include the distribution of mobility and accessibility levels over particular areas or for specific population groups, as well as how this may affect various social outcomes, including their levels of participation, social inclusion and community cohesion. In response, we propose a method to assess the socially relevant accessibility impacts (SRAIs) of policies in some of these key dimensions. The method combines the use of underlying ethics principles, more specifically the theories of egalitarianism and sufficientarianism, in combination with accessibility-based analysis and the Lorenz curve and Gini index. We then demonstrate the method in a case study example. Our suggestion is that policymakers can use these ethical perspectives to determine the equity of their policies decisions and to set minimum standards for local transport delivery. This will help them to become more confident in the development and adoption of new decision frameworks that promote accessibility over mobility and which also disaggregate the costs and benefits of transport policies over particular areas or for specific under-served population groups

The Wrapping Effect, Ellipsoid Arithmetic, Stability and Confidence Regions

. The wrapping effect is one of the main reasons that the application of interval arithmetic to the enclosure of dynamical systems is difficult. In this paper the source of wrapping is analyzed algebraically and geometrically. A new method for reducing the wrapping effect is proposed, based on an interval ellipsoid arithmetic. Applications are given to the verification of stability regions for nonlinear discrete dynamical systems and to the computation of rigorous confidence regions for nonlinear functions of normally distributed random vectors. Zusammenfassung. Der Verpackungseffekt ist eine der Hauptursachen dafur, daß die Anwendung von Intervallverfahren auf die Einschließung dynamischer Systeme schwierig ist. In dieser Arbeit wird dieser Effekt algebraisch und geometrisch analysiert. Um den Verpackungseffekt zu reduzieren, wird eine neue Methode vorgestellt, die auf einer Intervall-Ellipsoidarithmetik basiert. Als Anwendungen werden die Verifikation von Stabilitatsbereichen nichtli..