Several imaging techniques are available to assess osteoarthritis (OA) in natural history studies and clinical trials. Imaging plays a crucial role in monitoring pathologic changes affecting relevant structures around the joint, helping in the understanding of incidence and progression of disease as well as in testing different treatment modalities.


To date, the recommended structural endpoint for disease-modifying OA drugs in clinical trials, by both the U.S. and European regulatory authorities, is the slowing of radiographically-assessed joint space narrowing. Assessment of joint space narrowing and presence of osteophytes may be performed semiquantitatively and quantitatively, with the Kellgren-Lawrence (KL) scoring system and the Osteoarthritis Research Society International (OARSI) atlas classification system been the more frequently applied in OA studies.


However, because radiography is a projecting technique, its sensitivity of detecting changes over time may be affected since the joint space assessed does not cover the entire articular surface for several joints. Also, its specificity is often affected since the joint space may represent by a combination of different structures, as in the tibiofemoral joints (the joint space is represented by both the articular cartilage and menisci).


Although conventional radiography is still the most commonly imaging technique applied in clinical practice and clinical research in OA, magnetic resonance imaging-based studies have revealed some of the limitations of radiography, as discussed below.



Conventional Radiography


This is the least expensive and simplest imaging technique to be applied in OA research. Radiographic assessment can determine the joint space width (JSW), considered as an indirect surrogate of cartilage thickness (and also other potential structures such as the menisci in the tibiofemoral joints). Semiquantitative assessment of OA using radiography may be achieved by using the KL scoring system (5) and the OARSI atlas classification system (6).


The KL scoring system is a widely accepted method to define the presence or absence of OA, with the grade 2 commonly used as the threshold. This system has some limitations, particularly when assessing longitudinal progression of disease: the KL grade 3 may include several degrees of JSN, regardless of the extent. To assess progression of structural damage in OA, it is recommended a focus on JSN alone using either a semiquantitative (10) or a quantitative method. The OARSI atlas grades JSW and osteophytes separately, showing better potential and sensitivity regarding longitudinal radiographic changes when compared to the KL scoring system.


Quantitative methods are available to evaluate JSN using either a physical device or a software application, measuring the distance between the projected subchondral bone margins on the image. At the tibiofemoral joints, the femoral margin is defined as the projected edge of the bone, with the tibial margin determined by the software as a bright band (projection of the x-ray beam through the radiodense cortical shell at the base of the tibial plateau). Quantitative methods to assess tibiofemoral JSN demonstrated usefulness when quantifying the responsiveness to change longitudinally (11). The responsiveness of radiographic JSN using automated software was successfully demonstrated using a software analysis of digital knee radiographs, and it was comparable with magnetic resonance imaging in detecting OA progression (12).

Magnetic Resonance Imaging (MRI)


MRI is able to overcome the limitations of radiographs, and to date it is considered as the reference imaging method to assess the morphology of all intra- and extra-articular structures due to its capability to visualize soft tissues with excellent contrast, providing high-resolution and multiplanar assessment of joints. Several semiquantitative and quantitative methods to evaluate morphology and composition of articular structures are available and were extensively applied in previous OA natural studies and clinical trials. Semiquantitative morphologic whole-organ scoring performed by our expert team of musculoskeletal radiologists in several OA studies has helped in the understanding of the associations of pathology in different structures with incidence and progression of structural damage, as well as with clinical symptoms, especially pain (13-33).


The first scoring system published was the Whole Organ Magnetic Resonance Imaging Score (WORMS), which has been used extensively for more than a decade in a multitude of OA studies world wide (34). Since then, three more whole organ knee scoring systems have been introduced: The Knee Osteoarthritis Scoring System (KOSS), the Boston Leeds Osteoarthritis Knee Score (BLOKS), and the MRI Osteoarthritis Knee Score (MOAKS) as an amalgamate of the WORMS and BLOKS scoring tools (35-37). Some musculoskeletal experts from our team extensively contributed to test the reproducibility and sensitivity to change in OA pathology regarding these available semiquantitative systems, directly participating in multiple scoring exercises, aiming to increase the efficacy of morphologic MRI assessment of the OA joint (38-40). In comparison to previous systems, the MOAKS refined the scoring of morphology of several articular structures, exhibiting very good to excellent reliability for the large majority of features assessed, and to date it is the most recommended tool for semiquantitative assessment of knee OA (37).


All of these scoring systems are based on MRI without intravenous or intra-articular administration of contrast agents, while other systems have been presented that are based on intravenous contrast-enhanced MRI specifically developed for assessment of synovitis in knee OA (17). Semiquantitative systems using MRI are also available for the assessment of hip OA, known as Hip Osteoarthritis MRI Scoring System (HOAMS) (41) and for the assessment of hand OA (42). 

Compositional MRI


Quantitative compositional assessment of some articular structures such as the articular cartilage has also the potential to help identifying factors related to incidence and progression of OA (1, 43). Some of these techniques are available in most of clinical MRIs, such as T2 mapping and dGEMRIC (44-47), and have the potential to become markers of the incidence and progression of OA, especially in the earliest stages of disease and could be useful in clinical trials when testing disease-modifying OA drugs.  

Joint Space Width (JSW) Quantitative Assesment
 Using Duryea's Method


We offer a fully quantitative measurement of radiographic JSW, which is a surrogate for cartilage loss. This is a novel software tool is used to delineate the joint margins and make measurements of minimum JSW (mJSW) (48) and location-specific JSW (LSJSW).  The method has been validated cross sectionally (48,49) and longitudinally (50,51). The assessment of knee positioning and beam angle is also available. This particular method also produces measurement of the knee alignment angle using the standard posteroanterior or anteroposterior radiographs (52).

JSW at Fixed Locations
Minimum JSW
Knee Alignment
Dynamic contrast-enhanced MRI


Dynamic contrast-enhanced MRI (DCE-MRI) enables quantitative assessment of tissue vascularization (53-55). The technique analyzes the temporal and spatial distribution of intravenously administered contrast agents in the microcirculation. Following non-enhanced baseline images, the volume of interest is captured repetitively at high temporal resolution over several minutes. Thereby, the time-intensity curve (TIC) represents the contrast enhancement over time for a certain volume or region of interest (VOI/ ROI).


Quantitative evaluation of TICs includes the assessment of descriptive parameters such as area under the curve (AUC) and peak enhancement (PE) that are associated with regional blood volume. Furthermore, pharmacokinetic models describe a more elaborate analysis of DCE-MRI data requiring additional information, e.g. arterial input function to determine surrogate parameters for regional blood volume or vessel permeability and tissue perfusion. Such mathematic modeling takes into account two compartments in the tissue of interest: The intra- and extravascular compartments.


The rationale of performing DCE-MRI in (osteo-)arthritis is to quantitatively determine parameters of vascularization in bone marrow, joint space and surrounding soft tissue to monitor inflammatory-induced vascular changes (56). Thus, DCE-MRI parameters associated with blood volume and vessel permeability may help to diagnose vascular changes of these compartments in arthritic disease, and to assess therapy response of drugs affecting the microvasculature.



Illustrative Cases

Examples of focal chondral defect in the knee joint using high-resolution 3D MRI: A) a partial-thickness defect is depicted at the central medial femur (MOAKS grade 1.0; arrows); B) a full-thickness defect is depicted at the posterior lateral tibia (MOAKS grade 1.1; arrows).
Improvement of a focal cartilage from baseline to follow-up. At baseline, the sagittal intermediate-weighted image with fat suppression depicted a full-thickness focal chondral defect at the posterior lateral femur (MOAKS grade 1.1; arrow - A). At follow-up, the defect was not depicted at the same site (arrow – B).
Improvement of a focal cartilage from baseline to follow-up. At baseline, the sagittal intermediate-weighted image with fat suppression depicted a full-thickness focal chondral defect at the central lateral femur (MOAKS grade 1.1; arrow - A). At follow-up, a partial-thickness focal chondral defect was detected at the same site (MOAKS grade 1.0; arrow – B).
 Hip OA:  this coronal intermediate-weighted image with fat suppression demonstrates marked thinning of cartilage at the superior and lateral aspect of the femoroacetabular joint, with a bone marrow lesion at the superior / lateral acetabulum (arrowheads), and marked degenerative changes and maceration of the acetabular labrum (arrow).
dGEMRIC assessment of the medial tibiofemoral compartment: the superficial and deep zones of cartilage demonstrating a color spectrum from orange to red exhibit low dGEMRIC indices (representing low proteoglycan content within the cartilage matrix). The zones of cartilage displaying a color spectrum from green to blue exhinit high dGEMRIC indices (representing areas of high proteoglycan content).



Hand OA

Hand OA is a prevalent disease leading to pain, stiffness and physical disability. Typical radiographic features include osteophytes, joint space narrowing, central erosions, malalignment, sclerosis and cysts.

Figure 1

Figure 2

Figure 1 shows an example of a person with hand OA. Mild joint space narrowing and small osteophytes are found in the majority of interphalangeal joints.

OA is also found in the thumb base joints with narrowing and osteophytes in the bilateral CMC1 joints. OA in the interphalangeal and the thumb base can occur separately, but often in combination. Persons with affection of the thumb base will often experience more disability than persons with isolated interphalangeal OA. The phenotype erosive OA is characterized by more severe symptoms, faster disease progression and more inflammation as compared to non-erosive disease.

In figure 2, there are good examples of erosive joints (left PIP4, right DIP3 and right PIP2). Remodelling of the joints, which represents end-stage disease, is found in the remaining DIP joints, except left DIP4. The erosive phases are characterized by extensive destruction and remodelling in the subchondral bone, leading to bone marrow lesions, and synovitis, which can be detected on MRI.

Figure 3

Figure 3 is a post-contrast T1 VIBE sequence with water excitation covering the 2nd-4th right PIP joints. Whereas small osteophytes are found in the 2nd and 4th PIP joint, the 3rd PIP joint shows complete cartilage loss, large osteophytes, erosive lesions, cysts and bone marrow lesions in the majority of the bone. On the sagittal plane, extensive synovitis is present in the 3rd PIP joint (Figure 4). Synovitis has been shown to be important in hand OA, being associated with symptoms as well as predicting future disease progression. 

Figure 4

  1. Roemer FW, Crema MD, Trattnig S, Guermazi A. Advances in imaging of osteoarthritis and cartilage. Radiology 2011;260:332-54.

  2. Conaghan PG, Hunter DJ, Maillefert JF, Reichmann WM, Losina E. Summary and recommendations of the OARSI FDA osteoarthritis Assessment of Structural Change Working Group. Osteoarthritis Cartilage 2011;19:606-10. FDA. Clinical Development for Drugs, Devices and Biological Products Intended for the Treatment of Osteoarthritis (OA) 1999.

  3. CHMP. Guideline on Clinical Investigation of Medicinal Products Used in the Treatment of Osteoarthritis (OA) 2010.

  4. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957;16:494-502.

  5. Altman RD, Hochberg M, Murphy WA, Jr., Wolfe F, Lequesne M. Atlas of individual radiographic features in osteoarthritis. Osteoarthritis Cartilage 1995;3 Suppl A:3-70.

  6. Crema MD, Nevitt MC, Guermazi A, Felson DT, Wang K, Lynch JA, et al. Progression of cartilage damage and meniscal pathology over 30 months is associated with an increase in radiographic tibiofemoral joint space narrowing in persons with knee OA--the MOST study. Osteoartrhitis Cartilage 2014;22:1743-7.

  7. Madan-Sharma R, Kloppenburg M, Kornaat PR, Botha-Scheepers SA, Le Graverand MP, Bloem JL, et al. Do MRI features at baseline predict radiographic joint space narrowing in the medial compartment of the osteoarthritic knee 2 years later? Skeletal Radiol 2008;37:805-11.

  8. Hunter DJ, Zhang YQ, Tu X, Lavalley M, Niu JB, Amin S, et al. Change in joint space width: hyaline articular cartilage loss or alteration in meniscus? Arthritis Rheum 2006;54:2488-95.

  9. Felson DT, Nevitt MC, Yang M, et al. A new approach yields high rates of radiographic progression in knee osteoarthritis. J Rheumatol 2008;35:2047–54.

  10. Neumann G, Hunter D, Nevitt M, et al. Location specific radiographic joint space width for osteoarthritis progression. Osteoarthritis Cartilage 2009;17:761–5

  11. Duryea J, Neumann G, Niu J, et al. Comparison of radiographic joint space width with magnetic resonance imaging cartilage morphometry: analysis of longitudinal data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2010;62:932–7.

  12. Roemer FW, Guermazi A, Javaid MK, et al. Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis. Ann Rheum Dis 2009;68(9):1461-1465.

  13. Crema MD, Roemer FW, Zhu Y, et al. Subchondral cystlike lesions develop longitudinally in areas of bone marrow edema-like lesions in Patients with or at risk for knee osteoarthritis: detection with MR imaging--the MOST study. Radiology 2010; 256(3):855-862.

  14. Roemer FW, Neogi T, Nevitt MC, et al. Subchondral bone marrow lesions are highly associated with, and predict subchondral bone attrition longitudinally: the MOST study. Osteoarthritis Cartilage 2010;18(1):47-53.

  15. Englund M, Guermazi A, Roemer FW, et al. Meniscal pathology on MRI increases the risk for both incident and enlarging subchondral bone marrow lesions of the knee: the MOST Study. Ann Rheum Dis 2010;69(10):1796-1802.

  16. Guermazi A, Roemer FW, Hayashi D, Crema MD, Niu J, Zhang Y, et al. Assessment of synovitis with contrast-enhanced MRI using a whole-joint semiquantitative scoring system in people with, or at high risk of, knee osteoarthritis: the MOST study. Ann Rheum Dis 2011;70:805-11.

  17. Crema MD, Guermazi A, Li L, et al. The association of prevalent medial meniscal pathology with cartilage loss in the medial tibiofemoral compartment over a 2-year period. Osteoarthritis Cartilage 2010;18(3):336-343.

  18. Roemer FW, Zhang Y, Niu J, et al. Tibiofemoral joint osteoarthritis: risk factors for MR-depicted fast cartilage loss over a 30-month period in the multicenter osteoarthritis study. Radiology 2009;252(3):772-780.

  19. Crema MD, Roemer FW, Felson DT, Englund M, Wang K, Jarraya M, et al. Factors associated with meniscal extrusion in knees with or at risk for osteoarthritis: the Multicenter Osteoarthritis study. Radiology 2012;264:494-503.

  20. Roemer FW, Felson DT, Wang K, Crema MD, Neogi T, Zhang Y, et al. Co-localisation of non-cartilaginous articular pathology increases risk of cartilage loss in the tibiofemoral joint--the MOST study. Ann Rheum Dis 2013;72:942-8.

  21. Guermazi A, Roemer FW, Haugen IK, Crema MD, Hayashi D. MRI-based semiquantitative scoring of joint pathology in osteoarthritis. Nat Rev Rheumatol 2013;9:236-51

  22. Roemer FW, Guermazi A, Felson DT, Niu J, Nevitt MC, Crema MD, Lynch JA, Lewis CE, Torner J, Zhang Y. Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: the MOST study.

  23. Ann Rheum Dis. 2011 Oct;70(10):1804-9.

  24. Crema MD, Guermazi A, Sayre EC, Roemer FW, Wong H, Thorne A, Singer J, Esdaile JM, Marra MD, Kopec JA, Nicolaou S, Cibere J. The association of magnetic resonance imaging (MRI)-detected structural pathology of the knee with crepitus in a population-based cohort with knee pain: the MoDEKO study. Osteoarthritis Cartilage. 2011 Dec;19(12):1429-32.

  25. Roemer FW, Kwoh CK, Hannon MJ, Green SM, Jakicic JM, Boudreau R, Crema MD, Moore CE, Guermazi A. Risk factors for magnetic resonance imaging-detected patellofemoral and tibiofemoral cartilage loss during a six-month period: the joints on glucosamine study. Arthritis Rheum. 2012 Jun;64(6):1888-98.

  26. Hayashi D, Englund M, Roemer FW, Niu J, Sharma L, Felson DT, Crema MD, Marra MD, Segal NA, Lewis CE, Nevitt MC, Guermazi A. Knee malalignment is associated with an increased risk for incident and enlarging bone marrow lesions in the more loaded compartments: the MOST study. Osteoarthritis Cartilage. 2012 Nov;20(11):1227-33.

  27. Crema MD, Felson DT, Roemer FW, Wang K, Marra MD, Nevitt MC, Lynch JA, Torner J, Lewis CE, Guermazi A. Prevalent cartilage damage and cartilage loss over time are associated with incident bone marrow lesions in the tibiofemoral compartments: the MOST study. Osteoarthritis Cartilage. 2013 Feb;21(2):306-13.

  28. Crema MD, Felson DT, Roemer FW, Niu J, Marra MD, Zhang Y, Lynch JA, El-Khoury GY, Lewis CE, Guermazi A. Peripatellar synovitis: comparison between non-contrast-enhanced and contrast-enhanced MRI and association with pain. The MOST study. Osteoarthritis Cartilage. 2013 Mar;21(3):413-8.

  29. Guermazi A, Hayashi D, Jarraya M, Roemer FW, Zhang Y, Niu J, Crema MD, Englund M, Lynch JA, Nevitt MC, Torner JC, Lewis CE, Felson DT. Medial posterior meniscal root tears are associated with development or worsening of medial tibiofemoral cartilage damage: the multicenter osteoarthritis study. Radiology 2013 Sep;268(3):814-21.

  30. Guermazi A, Hayashi D, Roemer FW, Zhu Y, Niu J, Crema MD, Javaid MK, Marra MD, Lynch JA, El-Khoury GY, Zhang Y, Nevitt MC, Felson DT. Synovitis in knee osteoarthritis assessed by contrast-enhanced magnetic resonance imaging (MRI) is associated with radiographic tibiofemoral osteoarthritis and MRI-detected widespread cartilage damage: the MOST study. J Rheumatol. 2014 Mar;41(3):501-8.

  31. Crema MD, Cibere J, Sayre EC, Roemer FW, Wong H, Thorne A, Singer J, Esdaile JM, Marra MD, Kopec JA, Nicolaou S, Guermazi A. The relationship between subchondral sclerosis detected with MRI and cartilage loss in a cohort of subjects with knee pain: the knee osteoarthritis progression (KOAP) study. Osteoarthritis Cartilage. 2014 Apr;22(4):540-6.

  32. Alizai H, Roemer FW, Hayashi D, Crema MD, Felson DT, Guermazi A. An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods. Eur Radiol. 2015 Mar;25(3):883-93.

  33. Roemer FW, Jarraya M, Kwoh CK, Hannon MJ, Boudreau RM, Green SM, Jakicic JM, Moore C, Guermazi A. Brief report: symmetricity of radiographic and MRI-detected structural joint damage in persons with knee pain - the Joints on Glucosamine (JOG) Study. Osteoarthritis Cartilage. 2015 Mar 6. Epub ahead of print

  34. Peterfy CG, Guermazi A, Zaim S, Tirman PF, Miaux Y, White D, et al. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage 2004;12:177-90.

  35. Kornaat PR, Ceulemans RY, Kroon HM, Riyazi N, Kloppenburg M, Carter WO, et al. MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS)--inter-observer and intra-observer reproducibility of a compartment-based scoring system. Skeletal Radiol 2005;34:95-102.

  36. Hunter DJ, Lo GH, Gale D, Grainger AJ, Guermazi A, Conaghan PG. The reliability of a new scoring system for knee osteoarthritis MRI and the validity of bone marrow lesion assessment: BLOKS (Boston Leeds Osteoarthritis Knee Score). Ann Rheum Dis 2008;67:206-11.

  37. Hunter DJ, Guermazi A, Lo GH, Grainger AJ, Conaghan PG, Boudreau RM, Roemer FW. Evolution of semi-quantitative whole joint assessment of knee OA: MOAKS (MRI Osteoarthritis Knee Score). Osteoarthritis Cartilage 2011;19:990-1002.

  38. Lynch JA, Roemer FW, Nevitt MC, Felson DT, Niu J, Eaton CB, Guermazi A. Comparison of BLOKS and WORMS scoring systems part I. Cross sectional comparison of methods to assess cartilage morphology, meniscal damage and bone marrow lesions on knee MRI: data from the osteoarthritis initiative. Osteoarthritis Cartilage 2010;18:1393-401.

  39. Felson DT, Lynch J, Guermazi A, Roemer FW, Niu J, McAlindon T, Nevitt MC. Comparison of BLOKS and WORMS scoring systems part II. Longitudinal assessment of knee MRIs for osteoarthritis and suggested approach based on their performance: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2010;18:1402-7.

  40. Roemer FW, Nevitt MC, Felson DT, Niu J, Lynch JA, Crema MD, et al. Predictive validity of within-grade scoring of longitudinal changes of MRI-based cartilage morphology and bone marrow lesion assessment in the tibio-femoral joint--the MOST study. Osteoarthritis Cartilage 2012;20:1391-8.

  41. Roemer FW, Hunter DJ, Winterstein A, Li L, Kim YJ, Cibere J, Mamisch TC, Guermazi A. Hip Osteoarthritis MRI Scoring System (HOAMS): reliability and associations with radiographic and clinical findings. Osteoarthritis Cartilage. 2011 Aug;19(8):946-62.

  42. Haugen IK, Lillegraven S, Slatkowsky-Christensen B, Haavardsholm EA, Sesseng S, Kvien TK, van der Heijde D, Bøyesen P. Hand osteoarthritis and MRI: development and first validation step of the proposed Oslo HandOsteoarthritis MRI score. Ann Rheum Dis. 2011 Jun;70(6):1033-8.

  43. Crema MD, Roemer FW, Marra MD, Burstein D, Gold GE, Eckstein F, Baum T, Mosher TJ, Carrino JA, Guermazi A. Articular cartilage in the knee: current MR imaging techniques and applications in clinical practice and research. Radiographics. 2011 Jan-Feb;31(1):37-61.

  44. Crema MD, Hunter DJ, Burstein D, Roemer FW, Li L, Eckstein F, Krishnan N, Hellio Le-Graverand MP, Guermazi A. Association of changes in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) with changes in cartilage thickness in the medial tibiofemoral compartment of the knee: a 2 year follow-up study using 3.0 T MRI. Ann Rheum Dis. 2014 Nov;73(11):1935-41

  45. Crema MD, Hunter DJ, Burstein D, Roemer FW, Li L, Krishnan N, Marra MD, Hellio Le-Graverand MP, Guermazi A. Delayed gadolinium-enhanced magnetic resonance imaging of medial tibiofemoral cartilage and its relationship with meniscal pathology: a longitudinal study using 3.0T magnetic resonance imaging. Arthritis Rheumatol. 2014 Jun;66(6):1517-24

  46. Joseph GB, Baum T, Alizai H, Carballido-Gamio J, Nardo L, Virayavanich W, Lynch JA, Nevitt MC, McCulloch CE, Majumdar S, Link TM. Baseline mean and heterogeneity of MR cartilage T2 are associated with morphologic degeneration of cartilage, meniscus, and bone marrow over 3 years--data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2012 Jul;20(7):727-35.

  47. Mosher TJ, Zhang Z, Reddy R, Boudhar S, Milestone BN, Morrison WB, Kwoh CK, Eckstein F, Witschey WR, Borthakur A. Knee articular cartilage damage in osteoarthritis: analysis of MR image biomarker reproducibility in ACRIN-PA 4001 multicenter trial. Radiology. 2011 Mar;258(3):832-42.

  48. Duryea J, Li J, Peterfy CG, Gordon C, Genant HK. Trainable rule-based algorithm for the measurement of joint space width in digital radiographic images of the knee. Med Phys. 2000;27(3):580-91.

  49. Duryea J, Zaim S, Genant HK. New radiographic-based surrogate outcome measures for osteoarthritis of the knee. Osteoarthritis Cartilage. 2003;11(2):102-10.

  50. Neumann G, Hunter D, Nevitt M, Chibnik LB, Kwoh K, Chen H, Harris T, Satterfield S, Duryea J., Location specific radiographic joint space width for osteoarthritis progression. Osteoarthritis Cartilage. 2009;17(6):761-5.

  51. Duryea J, Neumann G, Niu J, Totterman S, Tamez J, Dabrowski C, Le Graverand MP, Luchi M, Beals CR, Hunter DJ., Comparison of radiographic joint space width with magnetic resonance imaging cartilage morphometry: analysis of longitudinal data from the Osteoarthritis Initiative. Arthritis Care Res (Hoboken). 2010;62(7):932-7

  52. Iranpour-Boroujeni , Li J, Lynch JA, Nevitt M, Duryea J., A new method to measure anatomic knee alignment for large studies of OA: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage. 2014;22(10):1668-74.

  53. Gordon Y, Partovi S, Müller-Eschner M, Amarteifio E, Bäuerle T, Weber MA, Kauczor HU, Rengier F. Dynamic contrast-enhanced magnetic resonance imaging: fundamentals and application to the evaluation of the peripheral perfusion Cardiovasc Diagn Ther. 2014.4(2):147-64

  54. Bäuerle T, Komljenovic D, Merz M, Berger MR, Goodman SL, Semmler W. Cilengitide inhibits progression of experimental breast cancer bone metastases as imaged non-invasively using VCT, MRI and DCE-MRI in a longitudinal in vivo study. Int J Cancer 2011;47:2453-2462

  55. Bäuerle T, Bartling S, Berger MR, Schmitt-Gräff A, Kauczor HU, Delorme S, Kiessling F. Imaging anti-angiogenic treatment response with DCE-VCT, DCE-MRI and DWI in an animal model of breast cancer bone metastasis. Eur J Radiol 2010; 73: 280-28

  56. Gait AD, Hodgson R, Parkes MJ, Hutchinson CE, O'Neill TW, Maricar N, Marjanovic EJ, Cootes TF, Felson DT. Synovial volume vs synovial measurements from dynamic contrast enhanced MRI as measures of response in osteoarthritis.Osteoarthritis Cartilage 2016 Mar 31. pii: S1063-4584(16)30005-X. doi: 10.1016/j.joca.2016.03.015. [Epub ahead of print]