Search Results (307)

This study investigates whether multi-component T₂ mapping, using bi-exponential (BE) and stretched-exponential (SE) models, enhances the early detection of knee osteoarthritis (OA) compared with the conventional mono-exponential (ME) approach. T₂ relaxation maps were derived from 26 patients with early-stage OA and 26 healthy controls. To minimize the influence of age-related cartilage changes, all model-derived parameters were adjusted for age prior to analysis. Quantitative T₂ parameters were extracted from six anatomically defined cartilage sub-regions to capture spatially heterogeneous tissue alterations characteristic of early OA. These parameters were then integrated using linear discriminant analysis to assess combined diagnostic performance. Global whole-cartilage analyses demonstrated limited discriminatory power across all models, with area under the receiver operating characteristic curve (AUC) values not exceeding 0.65, indicating that diffuse averaging obscures subtle, localized degeneration. In contrast, sub-regional analysis improved classification accuracy, highlighting the importance of regional assessment in early disease. Among the evaluated models, the BE-T₂ model showed the highest performance, achieving an AUC of 0.68, and marginally outperforming both the SE model (AUC = 0.60) and the ME model (AUC = 0.51). These findings suggest that multi-component T₂ mapping, particularly when applied at a sub-regional level, may offer improved sensitivity to early cartilage compositional changes. Overall, this approach shows strong potential as a noninvasive imaging biomarker for the early detection of knee OA. Full article

Background: Cartilage defects remain a clinical challenge due to the limited intrinsic repair capacity of hyaline cartilage, driving increasing interest in blood-derived products, including platelet-rich plasma (PRP). Variability in PRP preparation and activation protocols limits reproducibility and clinical translation, particularly in large animal models where species-specific differences are an additional cue. This study aimed to standardize and optimize in pigs a protocol for plasma rich in growth factors (PRGF), a leukocyte-poor PRP, aligned with current human clinical practice. Methods: Whole blood from six female pigs was processed via three centrifugation protocols and activated with varying CaCl₂ concentrations to evaluate gelation and morphology. PRGF was characterized through hematological analysis, ELISA-based quantification of soluble factors, and structural imaging of fibrin gel via histology and scanning electron microscopy. Data were further analyzed using protein–protein interaction networks, hierarchical clustering, and comparative human PRGF proteomic profiles. Results: Protocol with 400× g centrifugation followed by 13.3 mM CaCl₂ activation achieved the most favorable performance, yielding the highest platelet recovery, effective leukocyte clearance, and consistent formation of a well-organized fibrin network. Porcine activated PRGF showed substantial overlap in detected factors and concentration ranges with human activated PRGF prepared with the same protocol. Conclusions: These findings establish a robust, clinically aligned porcine PRGF protocol and support the pig as a relevant translational model for PRP-based regenerative strategies, providing a reliable platform for preclinical evaluation of cartilage therapies. Full article

In regenerative medicine, three-dimensional (3D) printing provides precise spatial control over the fabrication of complex, biomimetic tissue constructs, enabling the production of architecturally defined and functionally tailored scaffolds. By enabling precise layer-by-layer deposition of cells, biomaterials, and bioactive compounds, 3D printing overcomes many limitations associated with conventional scaffold fabrication methods. This approach facilitates the development of tailored structures that mimic the mechanical, biological, and structural characteristics of native tissues, thereby enhancing cellular organization, proliferation, and differentiation. Extensive research in tissue engineering has led to the development of 3D-printed scaffolds for the regeneration of vascular, skin, bone, cartilage, and soft tissues. Advances in bioink formulations—including growth factor-loaded systems, decellularized extracellular matrix components, and natural and synthetic polymers—have further improved tissue-specific functionality. Moreover, multimaterial and multiscale printing strategies enable the fabrication of heterogeneous constructs with controlled porosity, mechanical gradients, and spatially regulated biological cues. Although vascularized tissue constructs remain a major challenge for clinical translation, recent bioprinting advancements have significantly accelerated progress in this area. Integration of computer-aided design with patient-specific imaging data has further strengthened the potential of 3D printing for personalized regenerative therapies. Despite these advances, challenges related to scalability, regulatory approval, and long-term functionality persist. Nevertheless, continued progress in printing technologies, biomaterials, and regulatory and standards frameworks is expected to drive the clinical adoption of 3D printing. Ultimately, 3D printing represents a transformative approach in tissue engineering, redefining strategies for functional tissue regeneration and translational regenerative medicine. Full article

Osteoarthritis (OA) is a prevalent degenerative joint disease which affects millions of patients across the globe. The infrapatellar fat pad (IPFP) harbors diverse cell types with intricate intercellular interactions. Its mesenchymal stem cells (MSCs) and extracellular vesicles (EVs) possess significant biological functions and hold promising applications in regenerative medicine. IPFP exhibits active secretory capacity, releasing adipokines including leptin and adiponectin, along with various cytokines. Furthermore, it contains a rich neural network playing a crucial role in knee pain perception and sensation. Moreover, IPFP and synovium can be considered an integrated unit, exhibiting interactions both with each other and with cartilage. In imaging applications, IPFP is gaining widespread attention as an emerging biomarker. In clinical practice, the decision to resect or preserve IPFP remains a controversial topic. This article will review the latest research regarding the mechanism of IPFP in OA, and discuss its clinical applications, providing a theoretical basis for the prevention and treatment of OA. Full article

Traditional artificial joints mainly face the challenges of severe wear and aseptic loosening, which limits their application as joint bearing interfaces under high-stress loading conditions. To improve this problem, inspired by the gradient modulus structure of natural cartilage/subchondral bone and the inherent negative charge characteristics of the surface, a negatively charged hydrogel layer was adhered to a porous Ti6Al4V surface through a combination of ultraviolet irradiation and freeze–thaw cycles. The cross-sectional SEM image exhibited that the hydrogel layer was closely bonded to the hard substrate. After physical doping with SBMA, the lubrication performance of the composite bearing interface was significantly improved, primarily attributable to the biphasic lubrication of the hydrogel layer and the hydration lubrication mechanism of SBMA. Full article

Introduction: Distal intracapsular minimally invasive osteotomies (DICMOs) for central metatarsals are described as intracapsular procedures; however, neither their intracapsular location throughout the entire cut nor the optimal anatomical position for their execution have been fully validated. The aim of this study was to assess the geometric position of the DICMO osteotomy in the central metatarsals (third and fourth) and quantify associated anatomical damage when performed under three different guidance modalities: anatomical palpation, fluoroscopic control, and ultrasound guidance. Material and methods: An experimental cadaveric study was conducted using 29 fresh specimens (11 males, 18 females), contributing a total of 58 central metatarsals (third and fourth). All specimens underwent a DICMO-type metatarsal osteotomy. Osteotomies were randomly allocated to three intervention groups: (1) ultrasound (n = 20), (2) fluoroscopy (n = 19), and (3) anatomical guidance (n = 19). Metatarsal length, the distance between the osteotomy line and the articular surface, and post-dissection soft-tissue damage were recorded. Results: After dissection, all osteotomies were confirmed to be intracapsular. A constant proportional relationship was identified between osteotomy location and metatarsal length: distance to the joint line = 0.239 × metatarsal length. This relationship was independent of the guidance technique used. Only one iatrogenic lesion was observed: an articular cartilage injury of a third metatarsal in the anatomical-guidance group. Conclusions: The optimal position for DICMO osteotomy placement is approximately 24% of the total distal metatarsal length. This ensures an intracapsular trajectory and may contribute to intrinsic osteotomy stability. Image guidance—either fluoroscopy or ultrasound—appears essential to optimize outcomes and prevent avoidable anatomical damage. Full article

Background: Knee osteoarthritis (KOA) is characterized by cartilage degradation and joint-space narrowing, resulting in increased friction and observable structural damage. Methods: This study introduces a composite hybrid framework for the automatic classification of KOA severity using anteroposterior knee X-ray images. The methodology applies joint-centered cropping and data augmentation to standardize inputs and uses class weighting to mitigate class imbalance. Deep features extracted from fine-tuned ResNet-101 and EfficientNetB7 models are integrated with handcrafted Gray Level Co-occurrence Matrix (GLCM) texture descriptors, and the final predictions are obtained using a soft-voting ensemble. Results: the proposed ensemble achieves 73% test accuracy (macro-F1 ≈ 0.70; weighted-F1 ≈ 0.73) in a four-class setting (KL-0, KL-2, KL-3, and KL-4). Additional experiments across different classification setups demonstrate consistent performance trends, while Grad-CAM indicates that the model primarily focuses on the joint region. Overall, Conclusions: combining ensemble deep learning with complementary handcrafted texture features provides a reliable and interpretable approach for grading radiographic KOA severity. Full article

Background: Laryngeal cancer constitutes a major burden. Accurate staging is important to determine the optimal treatment approach. However, a head-to-head comparison of diagnostic performance between CT and MRI in patients with laryngeal cancer is lacking. Furthermore, the performance of CT and MRI in detecting the invasion of different laryngeal structures is yet to be determined. Objective: To compare the diagnostic performance of CT and MRI in patients with laryngeal cancer. Methods: We searched PubMed, Scopus, and Web of Science in November 2025 for cohort studies that compared both index tests (CT and MRI) to histopathological examination of laryngeal cancer. We assessed the quality of the included studies using the QUADAS 2 tool. A bivariate meta-analysis was performed using R and RevMan software to compare pooled sensitivity and specificity, with summary receiver operating characteristic (SROC) curves generated for each outcome. Results: We included eight studies. The pooled data showed that CT was significantly less sensitive compared to MRI in detecting invasion of the thyroid cartilage with an absolute difference of −0.43 (95% CI −0.59 to −0.26), cricoid cartilage −0.65 (95% CI −1.14 to −0.15), paraglottic space −0.5 (95% CI −0.68 to −0.32), and anterior commissure −0.48 (95% CI −0.1 to −0.86). Specificity was similarly high for both modalities across all structures. For arytenoid cartilage and epiglottis invasion, MRI showed a non-significant trend towards higher sensitivity. Summary receiver operating characteristic (SROC) curves indicated superior overall diagnostic accuracy for MRI. In T-staging, MRI consistently demonstrated a lower rate of understaging compared to CT across five studies. Conclusions: MRI had superior diagnostic performance compared to CT in detecting laryngeal cartilage and deep space invasion; it had significantly higher sensitivity, comparable specificity, and lower risk of understaging, thus supporting the use of MRI for accurate pretreatment T-staging. However, given the limited number of studies, the results should be interpreted with caution, and further studies are needed to confirm our findings. Full article

Background/Objectives: Juvenile osteochondritis dissecans (JOCD) of the knee is commonly treated using conservative or joint-preserving surgical techniques. While clinical outcomes are generally favorable, the risk of early cartilage degeneration remains unclear. Joint space width (JSW) on weight-bearing radiographs serves as an indirect marker of cartilage health. Artificial intelligence (AI)-based JSW assessment may enable sensitive and reproducible detection of early degenerative changes. Methods: This cross-sectional feasibility study included 21 skeletally immature patients treated for JOCD of the distal femur between 2002 and 2017. Treatment modalities comprised conservative management, retrograde drilling, and fragment refixation. Fully automated JSW measurements were performed on standardized anteroposterior knee radiographs using a validated AI-based software IB Lab KOALA™, Version 2.4. JSW of the affected compartment was compared with the contralateral knee and between treatment groups. Clinical outcomes were assessed using the Lysholm Knee Scoring Scale and the International Knee Documentation Committee (IKDC) score. Additionally, a systematic review of the literature on post-treatment degenerative changes following OCD therapy was conducted according to PRISMA guidelines. Results: Compared with manually reviewing images, the software IB Lab KOALA™, Version 2.4 as easy to implement. AI-based analysis revealed no significant differences in JSW between the affected and contralateral knees, nor between treatment modalities. Average JSW exceeded 6 mm in all groups after a median follow-up of 64 (min. 27, max. 177) months. Clinical scores were high and comparable across treatments. A moderate positive correlation was observed between the JSW and Lysholm score, while increasing age and longer follow-up were associated with a reduced JSW. The systematic review identified ten relevant studies, reporting generally favorable long-term clinical outcomes with a low but present risk of osteoarthritis progression. Conclusions: Our AI-based analysis showed no differences in JSW between conservative and joint-preserving surgical treatments of JOCD in the follow-up. This technology can provide a valuable tool for standardized and sensitive radiographic monitoring in young patients. Full article

The current study investigated proximal femur bone shape asymmetry and its associations with cartilage composition and functional performance in individuals with hip osteoarthritis (OA). Forty-seven participants with hip OA (mean age: 53.77 ± 12.47 years; 22 females; BMI: 24.49 ± 4.0 kg/m²) were included in this study. Bilateral hip MRI was performed using a 3.0 T MR scanner with 3D proton density fat-saturated CUBE and MAPSS sequences. Automatic segmentation of the proximal femur was achieved using a U-Net framework refined through a human-in-the-loop annotation strategy, followed by three-dimensional bone shape analysis to quantify asymmetry. Cartilage relaxation times were assessed using atlas-based segmentation and quantification, while functional activity was evaluated according to OARSI-recommended criteria. The proposed proximal femur bone segmentation showed a DSC of 96.48% (95%-CI: 96.33–96.64) and Hausdorff Distance of 4.66 mm (95%-CI: 3.80–5.51). Increased bone shape asymmetry in the posterior–lateral–superior region of the proximal femur was associated with functional activity in the chair stand test (rho = −0.41; p = 0.006), and the anterior–lateral–inferior region demonstrated a comparatively higher significant positive correlation ($\mathrm{rho}=0.37$; p = 0.006) with the ${\mathrm{T}}_{1\mathrm{rho}}$values of the acetabular cartilage region. Overall, the findings indicate that region-specific proximal femoral bone shape asymmetry in hip OA is associated with cartilage characteristics and functional impairment, highlighting the potential value of bone shape features as imaging biomarkers relevant to clinical function. Full article

Glucocorticoids are widely applied intra-articularly to alleviate inflammation and pain in osteoarthritis (OA). However, repeated administration and high local concentrations can lead to crystal deposition on the cartilage surface, contributing to chondrocyte damage and extracellular matrix (ECM) degradation, potentially accelerating OA progression. Calcium-dependent mechanosensors play a critical role in mediating catabolic responses in chondrocytes, but it remains unclear whether glucocorticoids affect chondrocyte mechanosensitivity or biomechanical properties. This in vitro study examined the dose-dependent effects of triamcinolone acetonide (TA) on chondrocyte biomechanics and mechanosensitivity. Primary human chondrocytes (N = 23) were cultured for one week with TA (2 µM–2 mM) or control medium. Cytoskeletal organization was visualized by F-actin staining (N = 6), and cellular elasticity (N = 5) was quantified via atomic force microscopy (AFM). Mechanotransduction was analyzed by Ca²⁺ imaging (Fluo-4 AM) upon AFM-based indentation (500 nN). Expression of matrix-related and mechanosensitive genes (N = 9) was assessed by qPCR. TA exposure induced a concentration-dependent reorganization of the F-actin cytoskeleton, pronounced at 0.2 mM, accompanied by a significant increase in the elastic modulus (p < 0.001). TA further augmented Ca²⁺ fluorescence intensity under basal conditions and during mechanical stimulation. Blocking cationic mechanosensitive channels with GsMtx4 (N = 3) markedly reduced the TA-evoked Ca²⁺ influx (p < 0.0001). Significant reduction in MMP1 was observed on the transcriptional level (N = 9) after TA-treatment (p < 0.05). In summary, TA enhances chondrocyte stiffness through cytoskeletal condensation and amplifies Ca²⁺-dependent mechanotransduction but reduces MMP1 expression, indicating a dual biomechanical response of chondrocytes to OA under exposure of potent corticosteroid. Full article

Background/Objectives: Radiomics, the high-throughput extraction of quantitative features from medical imaging, offers a promising method for identifying laryngeal cancer imaging biomarkers. We aim to systematically review the literature on radiomics in laryngeal squamous cell carcinoma, assessing applications in tumour staging, prognosis, recurrence prediction, and treatment response evaluation. PROSPERO ID: CRD420251117983. Methods: MEDLINE and EMBASE databases were searched in May 2025. Inclusion criteria: studies published between 1 January 2010 and 31 January 2024, extracted radiomic features from CT, PET/CT, or MRI, and analysed outcomes related to diagnosis, staging, survival, recurrence, or treatment response in laryngeal cancer. Exclusion criteria: case reports, abstracts, editorials, reviews, or conference proceedings, exclusive focus on preclinical or animal models, lack of a clear radiomics methodology, or did not include imaging-based feature extraction. Results were synthesised narratively by modelling objective, alongside formal assessment of methodological quality using the Radiomics Quality Score (RQS). Results: Twenty studies met the inclusion criteria, with most using CT-based radiomics. Seven incorporated PET/CT. Radiomic models demonstrated moderate-to-high accuracy across tasks including T-staging, thyroid cartilage invasion, survival prediction, and local failure. Key predictive features included first-order entropy, skewness, and texture metrics such as size zone non-uniformity and GLCM correlation. Methodological variability, limited external validation, and small samples were frequent limitations. Conclusions: Radiomics holds strong promise as a non-invasive biomarker for laryngeal cancer. However, methodological heterogeneity identified through formal quality assessment indicates that improved standardisation, reproducibility, and multicentre validation are required before widespread clinical implementation. Full article

Tracheal stent fracture is a major complication of endoluminal tracheal stent (ELS) for canine tracheal collapse, and optimal management strategies remain unclear. A 4-year-old Yorkshire Terrier presented with respiratory distress caused by complete ELS fracture. Imaging and bronchoscopy revealed intraluminal protrusion of fractured stent segments, ventral tracheal cartilage invagination, and marked luminal deformation. A parallel loop line prosthesis (PLLP) was selected as an external tracheal support. Its continuous band-like structure allowed broad and uniform reinforcement of the tracheal wall and redistribution of mechanical stress. PLLP placement successfully restored a near-normal tracheal contour and stabilized the fractured stent without introducing additional intraluminal material. Postoperative bronchoscopy confirmed improved tracheal patency, and no further deformation or stent damage was observed despite several months of altered airway dynamics associated with laryngeal paralysis. This case suggests that PLLP may represent a valid surgical option for managing tracheal stent fracture in dogs. Full article

Background/Objectives: Osteoarthritis (OA) remains a global health problem, as it can cause permanent joint damage, leading to irreversible disability. Therefore, there is a need for accessible and non-invasive alternative examinations, such as USG, serum COMP, and 25-hydroxyvitamin D [25(OH)D] assessment. This study aims to analyze the correlation between serum COMP and 25(OH)D levels and the degree of articular cartilage degradation in patients with knee OA, based on findings from USG and MRI examinations. Methods: A cross-sectional analytical study was conducted at Mohammad Hoesin Hospital, Palembang, from December 2024 to August 2025. 31 patients diagnosed with knee OA based on the 1990 American College of Rheumatology (ACR) classification criteria were enrolled. Serum COMP and 25(OH)D levels were measured. All patients underwent standardized USG and MRI examinations of the knee. Spearman’s rank correlation coefficient was used for statistical analysis. Results: The majority of the study subjects were female, comprising 23 (74.2%). The mean age was 63.90 ± 7.77 years with a body mass index of 25.46 ± 5.51 kg/m². Most subjects were engaged in heavy physical activity 17 (54.8%). Laboratory examination showed serum COMP levels with a median of 869 ng/mL and a range of 136–3302 ng/mL. Meanwhile, the 25(OH)D level demonstrated a mean value of 24.84 ± 7.33 ng/mL. The analysis revealed a strong and statistically significant positive correlation between serum COMP levels and the degree of articular cartilage degradation in knee OA. This correlation was observed in both USG (r = 0.61; p < 0.001) and MRI assessments (r = 0.72; p < 0.001). In contrast, serum 25(OH)D levels showed no significant correlation with cartilage degradation. The correlation coefficient between 25(OH)D levels and USG-assessed cartilage degradation was r = −0.12 (p = 0.51), and for MRI assessment, it was r = 0.17 (p = 0.92). Conclusions: A strong and significant positive correlation exists between serum COMP levels and the degree of articular cartilage degradation based on USG (r = 0.61; p < 0.001) and MRI (r = 0.72; p < 0.001). In contrast, serum 25(OH)D levels showed no significant correlation with cartilage degradation, implying that 25(OH)D may not directly reflect the extent of structural cartilage damage in knee osteoarthritis. This finding proves that an increase in serum COMP levels is associated with an increase in the degree of articular cartilage degradation in knee OA as measured by both USG and MRI. Full article

Surface Plasmon Resonance imaging (SPRi) is a powerful label-free technique for high-throughput biochemical analysis. Wavelength modulation is particularly suitable for SPRi due to its wide dynamic range and robustness to fabrication tolerances. However, conventional systems relying on tunable filters (e.g., AOTF, LCTF) suffer from high cost, complexity, and limited temporal resolution. To overcome these drawbacks, we developed a rapid wavelength-modulation SPRi system using a multi-LED source and an adaptive second-order fitting (ASF) algorithm. The system covers the 730–805 nm spectrum with five LEDs. The ASF algorithm first performs a coarse full-spectrum scan to locate the resonance wavelength, then dynamically selects an optimal three-LED subset for fast second-order fitting, enabling accurate reconstruction of resonance wavelength without mechanical scanning. This approach significantly reduces cost and complexity while achieving a scanning cycle of 105 ms, RI resolution of 5.54 × 10⁻⁶ RIU, dynamic range of 0.0241 RIU, and excellent multi-channel consistency. The system has been successfully applied to monitor multi-channel antibody–antigen interactions in real time. Furthermore, it was used to detect cartilage oligomeric matrix protein (COMP) in synovial fluid, where an elevated concentration in an osteoarthritis sample versus a control aligned with its role as a cartilage catabolism marker. This work validates a practical and reliable platform for early diagnosis of osteoarthritis. Full article