Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study

Background/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complic...

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Main Authors: Louise Hindsø, Per Hölmich, Michael M. Petersen, Jack J. Xu, Søren Heerwagen, Michael B. Nielsen, Robert G. C. Riis, Adam E. Hansen, Lene Terslev, Mikkel Taudorf, Lars Lönn
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/14/22/2564
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author Louise Hindsø
Per Hölmich
Michael M. Petersen
Jack J. Xu
Søren Heerwagen
Michael B. Nielsen
Robert G. C. Riis
Adam E. Hansen
Lene Terslev
Mikkel Taudorf
Lars Lönn
author_facet Louise Hindsø
Per Hölmich
Michael M. Petersen
Jack J. Xu
Søren Heerwagen
Michael B. Nielsen
Robert G. C. Riis
Adam E. Hansen
Lene Terslev
Mikkel Taudorf
Lars Lönn
author_sort Louise Hindsø
collection DOAJ
description Background/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complications following GAE. Methods: This was a prospective, single-center trial including participants with mild-to-moderate knee osteoarthritis. Ultrasound, contrast-enhanced (CE), and non-CE-MRI were performed two days before and one and six months after GAE. Ultrasound biomarkers included synovial hypertrophy, effusion, and Doppler activity. A combined effusion-synovitis score was assessed on non-CE-MRI, while CE-MRI allowed differentiation between synovium and effusion and was used to calculate whole-joint and local synovitis scores. The post-GAE MRIs were reviewed for ischemic complications. Results: Seventeen participants (aged 43–71) were treated. Significant reductions were observed in ultrasound-assessed synovial hypertrophy and Doppler activity, as well as in CE-MRI local and whole-joint synovitis scores. While reductions in effusion were noted in both ultrasound and MRI, these changes did not reach statistical significance. At one month, MRI revealed three cases of nonspecific osteonecrosis-like areas, which resolved completely by six months. Conclusions: This study demonstrated a reduction in synovitis and no permanent ischemic complication following GAE in knee osteoarthritis. Larger studies with longer follow-up are needed to confirm the long-term efficacy and safety of the procedure.
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spelling doaj-art-3d3a5b07b3e346feb94781aeceb80ef72025-08-20T01:53:45ZengMDPI AGDiagnostics2075-44182024-11-011422256410.3390/diagnostics14222564Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI StudyLouise Hindsø0Per Hölmich1Michael M. Petersen2Jack J. Xu3Søren Heerwagen4Michael B. Nielsen5Robert G. C. Riis6Adam E. Hansen7Lene Terslev8Mikkel Taudorf9Lars Lönn10Department of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkFaculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2100 Copenhagen, DenmarkFaculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2100 Copenhagen, DenmarkDepartment of Radiology, Zealand University Hospital—Slagelse, Fælledvej 11, 4200 Slagelse, DenmarkDepartment of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkFaculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2100 Copenhagen, DenmarkDepartment of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkDepartment of Radiology, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, DenmarkBackground/Objectives: Genicular artery embolization (GAE) has demonstrated potential as a treatment for knee osteoarthritis by targeting inflammation and pain, although current evidence remains limited. This study used imaging biomarkers to objectively assess synovitis and possible ischemic complications following GAE. Methods: This was a prospective, single-center trial including participants with mild-to-moderate knee osteoarthritis. Ultrasound, contrast-enhanced (CE), and non-CE-MRI were performed two days before and one and six months after GAE. Ultrasound biomarkers included synovial hypertrophy, effusion, and Doppler activity. A combined effusion-synovitis score was assessed on non-CE-MRI, while CE-MRI allowed differentiation between synovium and effusion and was used to calculate whole-joint and local synovitis scores. The post-GAE MRIs were reviewed for ischemic complications. Results: Seventeen participants (aged 43–71) were treated. Significant reductions were observed in ultrasound-assessed synovial hypertrophy and Doppler activity, as well as in CE-MRI local and whole-joint synovitis scores. While reductions in effusion were noted in both ultrasound and MRI, these changes did not reach statistical significance. At one month, MRI revealed three cases of nonspecific osteonecrosis-like areas, which resolved completely by six months. Conclusions: This study demonstrated a reduction in synovitis and no permanent ischemic complication following GAE in knee osteoarthritis. Larger studies with longer follow-up are needed to confirm the long-term efficacy and safety of the procedure.https://www.mdpi.com/2075-4418/14/22/2564trans-arterial embolizationinflammationknee osteoarthritismagnetic resonance imagingultrasound
spellingShingle Louise Hindsø
Per Hölmich
Michael M. Petersen
Jack J. Xu
Søren Heerwagen
Michael B. Nielsen
Robert G. C. Riis
Adam E. Hansen
Lene Terslev
Mikkel Taudorf
Lars Lönn
Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
Diagnostics
trans-arterial embolization
inflammation
knee osteoarthritis
magnetic resonance imaging
ultrasound
title Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
title_full Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
title_fullStr Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
title_full_unstemmed Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
title_short Reduction in Synovitis Following Genicular Artery Embolization in Knee Osteoarthritis: A Prospective Ultrasound and MRI Study
title_sort reduction in synovitis following genicular artery embolization in knee osteoarthritis a prospective ultrasound and mri study
topic trans-arterial embolization
inflammation
knee osteoarthritis
magnetic resonance imaging
ultrasound
url https://www.mdpi.com/2075-4418/14/22/2564
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