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Computer-Assisted Quantitative Analysis of Bone Marrow Edema of the Knee: Initial Experience with a New Method

Marius E. Mayerhoefer1, Martin Breitenseher1, Siegfried Hofmann2, Nicolas Aigner3, Roland Meizer3, Harald Siedentop4 and Josef Kramer5

1 Department of Radiology, Surgical Radiology Section and Osteoradiology Section, University of Vienna, Waehringer Guertel 18-20, Vienna A-1090, Austria.
2 Department of Orthopaedics, LKH Stolzalpe, Stolzalpe, Austria.
3 First Orthopaedic Department, Orthopaedic Hospital Vienna-Speising, Vienna, Austria.
4 Corporate Clinical Operations – Biometrics Europe, Schering AG, Berlin, Germany.
5 Institute of CT and MRI Diagnostics, Schillerpark, Linz, Austria.



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  		Fig. 1A. —Coronal STIR images depict definition of total volume of investigation (TVI). Maximal width of femoral condyles is determined through line M1. Length of M1 is then used as maximal height of TVI by drawing line M2, starting at most caudal point of condyles. Line orthogonal to M2 is then drawn (1) and remains in constant position for all slices to separate TVI from adjacent diaphysis.

 


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  		Fig. 1B. —Coronal STIR images depict definition of total volume of investigation (TVI). Coronal STIR image depicts manual definition of remaining borders of TVI.

 


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  		Fig. 1C. —Coronal STIR images depict definition of total volume of investigation (TVI). Coronal STIR image depicts color demarcation of bone marrow edema. Pixels with signal intensity lower than that of previously calculated threshold value are colored green if inside TVI and red if outside TVI. Green areas represent bone marrow edema of femoral condyles.

 

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