Imorphics Ltd.

Manchester, United Kingdom

Imorphics Ltd.

Manchester, United Kingdom

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Patent
Imorphics Ltd | Date: 2016-11-14

A computer-implemented method for identifying features in an image. The method comprises fitting a plurality of second models to the image, the plurality of second models together modelling a region of interest, wherein each part of the region of interest is modelled by at least two of the plurality of second models; and identifying the features in the image based upon the fit of the plurality of second models.


Neogi T.,Boston University | Bowes M.A.,Imorphics Ltd. | Niu J.,Boston University | De Souza K.M.,Imorphics Ltd. | And 5 more authors.
Arthritis and Rheumatism | Year: 2013

Objective To examine whether magnetic resonance imaging (MRI)-based 3-dimensional (3-D) bone shape predicts the onset of radiographic knee osteoarthritis (OA). Methods We conducted a case-control study using data from the Osteoarthritis Initiative by identifying knees that developed incident tibiofemoral radiographic knee OA (case knees) during followup, and matching them each to 2 random control knees. Using knee MRIs, we performed active appearance modeling of the femur, tibia, and patella and linear discriminant analysis to identify vectors that best classified knees with OA versus those without OA. Vectors were scaled such that -1 and +1 represented the mean non-OA and mean OA shapes, respectively. We examined the relation of 3-D bone shape to incident OA (new-onset Kellgren and Lawrence [K/L] grade ≥2) occurring 12 months later using conditional logistic regression. Results A total of 178 case knees (incident OA) were matched to 353 control knees. The whole joint (i.e., tibia, femur, and patella) 3-D bone shape vector had the strongest magnitude of effect, with knees in the highest tertile having a 3.0 times higher likelihood of developing incident radiographic knee OA 12 months later compared with those in the lowest tertile (95% confidence interval [95% CI] 1.8-5.0, P < 0.0001). The associations were even stronger among knees that had completely normal radiographs before incidence (K/L grade of 0) (odds ratio 12.5 [95% CI 4.0-39.3]). Bone shape at baseline, often several years before incidence, predicted later OA. Conclusion MRI-based 3-D bone shape predicted the later onset of radiographic OA. Further study is warranted to determine whether such methods can detect treatment effects in trials and provide insight into the pathophysiology of OA development. Copyright © 2013 by the American College of Rheumatology.


PubMed | Keele University, University of Leeds and Imorphics Ltd
Type: Journal Article | Journal: Rheumatology (Oxford, England) | Year: 2016

There is growing understanding of the importance of bone in OA. Our aim was to determine the relationship between 3D MRI bone shape and total knee replacement (TKR).A nested case-control study within the Osteoarthritis Initiative cohort identified case knees with confirmed TKR for OA and controls that were matched using propensity scores. Active appearance modelling quantification of the bone shape of all knee bones identified vectors between knees having or not having OA. Vectors were scaled such that -1 and +1 represented the mean non-OA and mean OA shapes.Compared to controls (n = 310), TKR cases (n = 310) had a more positive mean baseline 3D bone shape vector, indicating more advanced structural OA, for the femur [mean 0.98 vs -0.11; difference (95% CI) 1.10 (0.88, 1.31)], tibia [mean 0.86 vs -0.07; difference (95% CI) 0.94 (0.72, 1.16)] and patella [mean 0.95 vs 0.03; difference (95% CI) 0.92 (0.65, 1.20)]. Odds ratios (95% CI) for TKR per normalized unit of 3D bone shape vector for the femur, tibia and patella were: 1.85 (1.59, 2.16), 1.64 (1.42, 1.89) and 1.36 (1.22, 1.50), respectively, all P < 0.001. After including Kellgren-Lawrence grade in a multivariable analysis, only the femur 3D shape vector remained significantly associated with TKR [odds ratio 1.24 (1.02, 1.51)].3D bone shape was associated with the endpoint of this study, TKR, with femoral shape being most associated. This study contributes to the validation of quantitative MRI bone biomarkers for OA structure-modification trials.


Patent
DePuy and Imorphics Ltd. | Date: 2016-01-25

An x-ray calibration apparatus includes a radiolucent knee alignment jig configured to receive a knee of a patient and a radiolucent cushion configured to hold a patients knee at a fixed angle of flexion. The x-ray calibration apparatus also includes a number of radio-opaque fiducial markers positioned within the radiolucent knee alignment jig.


Laslett L.L.,University of Leeds | Kingsbury S.R.,University of Leeds | Hensor E.M.A.,University of Leeds | Bowes M.A.,Imorphics Ltd | Conaghan P.G.,University of Leeds
Annals of the Rheumatic Diseases | Year: 2014

Objectives Bisphosphonates have some reported beneficial effects in treating osteoarthritis (OA). This study examined the effects of bisphosphonate use on symptoms and structural progression of knee OA in participants from the NIH Osteoarthritis Initiative cohort. Methods People with typical OA trial entry criteria (KL2/3, minimum joint space width 2.5-5.0 mm and pain ≥4 on a numeric rating scale) were classified as bisphosphonate users (≥3 of the 5 years; n=55) or non-users (no use in the preceding 5 years or during follow-up; n=268). Annual data over 4 years were analysed using linear mixed modelling and generalised estimating equations. Results Bisphosphonate compliance was 85% at year 1, reducing to 76% by year 4. Numeric rating scale pain scores were significantly reduced among bisphosphonate users at years 2 and 3 (year 3, -0.9 vs -2.2, p=0.004), though not year 4, after adjustment for baseline pain and analgesic use. Differences in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and disability scores did not reach statistical significance at any time point. There was a trend to less joint space narrowing in bisphosphonate users over time (year 4, 0.51 vs 0.29 mm; p=0.06). Conclusions Significant reduction in numeric rating scale pain was observed in the first 3 years with bisphosphonate use; diminution of effects by year 4 may reflect reduced compliance. Differences in results obtained using numeric rating scale and WOMAC may reflect different constructs measured by these tools. The beneficial trend on structural progression should be considered in terms of the sample size.


Bowes M.A.,Imorphics Ltd | Vincent G.R.,Imorphics Ltd | Wolstenholme C.B.,Imorphics Ltd | Conaghan P.G.,University of Leeds
Annals of the Rheumatic Diseases | Year: 2013

Background: Modern image analysis enables the accurate quantification of knee osteoarthritis (OA) bone using MRI. We hypothesised that three-dimensional changes in bone would be characteristic of OA and provide a responsive measure of progression. Methods: 1312 participants with radiographic knee OA, and 885 non-OA controls with MRIs at baseline, 1, 2 and 4 years were selected from the NIH Osteoarthritis Initiative. Automated segmentation of all knee bones and calculation of bone area was performed using active appearance models. In a subset of 352 participants, responsiveness of bone area change was compared with change in radiographic joint space width (JSW) and MRI cartilage thickness over a 2-year period. Results: All OA knee compartments showed increased bone area over time compared with non-OA participants: for example, the 4-year percentage change from baseline in medial femur area for OA (95% CI) was 1.87(0.13), non-OA 0.43 (0.07); p<0.0001. Bone area change was more responsive than cartilage thickness or JSW; 2-year SRM for bone area in the medial femur was 0.83, for the most responsive cartilage thickness measure central medial femorotibial composite (cMFTC): 0.38, JSW: 0.35. Almost half of all knees had change greater than smallest detectable difference at 2 years. Body mass index, gender and alignment had only a small effect on the rate of change of bone area. Conclusions: Changes in bone area discriminated people with OA from controls and was more responsive than the current and impending standards for assessing OA progression. The shape change in OA bone provides a new window on OA pathogenesis and a focus for clinical trials. © 2013 BMJ Publishing Group Ltd & European League Against Rheumatism.


Barr A.J.,University of Leeds | Campbell T.M.,University of Leeds | Campbell T.M.,University of Ottawa | Hopkinson D.,Imorphics Ltd | And 3 more authors.
Arthritis Research and Therapy | Year: 2015

Introduction: Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. Methods: A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. Results: In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Conclusion: Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. Systematic review: PROSPERO registration number: CRD 42013005009 © 2015 Barr et al.


Bowes M.A.,Imorphics Ltd. | Vincent G.R.,Imorphics Ltd. | Wolstenholme C.B.,Imorphics Ltd. | Conaghan P.G.,University of Leeds
Annals of the Rheumatic Diseases | Year: 2015

Background: Modern image analysis enables the accurate quantification of knee osteoarthritis (OA) bone using MRI. We hypothesised that three-dimensional changes in bone would be characteristic of OA and provide a responsive measure of progression. Methods: 1312 participants with radiographic knee OA, and 885 non-OA controls with MRIs at baseline, 1, 2 and 4 years were selected from the NIH Osteoarthritis Initiative. Automated segmentation of all knee bones and calculation of bone area was performed using active appearance models. In a subset of 352 participants, responsiveness of bone area change was compared with change in radiographic joint space width (JSW) and MRI cartilage thickness over a 2-year period. Results: All OA knee compartments showed increased bone area over time compared with non-OA participants: for example, the 4-year percentage change from baseline in medial femur area for OA (95% CI) was 1.87(0.13), non-OA 0.43 (0.07); p<0.0001. Bone area change was more responsive than cartilage thickness or JSW; 2-year SRM for bone area in the medial femur was 0.83, for the most responsive cartilage thickness measure central medial femorotibial composite (cMFTC): 0.38, JSW: 0.35. Almost half of all knees had change greater than smallest detectable difference at 2 years. Body mass index, gender and alignment had only a small effect on the rate of change of bone area. Conclusions: Changes in bone area discriminated people with OA from controls and was more responsive than the current and impending standards for assessing OA progression. The shape change in OA bone provides a new window on OA pathogenesis and a focus for clinical trials.


Patent
IMORPHICS Ltd | Date: 2010-02-10

A computer-implemented method for identifying features in an image. The method comprises fitting a plurality of second models to the image, the plurality of second models together modelling a region of interest, wherein each part of the region of interest is modelled by at least two of the plurality of second models; and identifying the features in the image based upon the fit of the plurality of second models.


Grant
Agency: GTR | Branch: Innovate UK | Program: | Phase: Smart - Proof of Concept | Award Amount: 99.99K | Year: 2014

Rheumatoid arthritis (RA) is a painful disease of the joints which affects significant numbers of adults. Powerful drugs are available to treat the disease, however these drugs do have limitations; they are typically expensive and require hospital care to administer. Development of new drugs for RA is hampered by the clinical tools available to assess the progress of the disease. Clinical trials are typically conducted using radiographs (X-rays) of the hand, evaluated by experts. Radiographs are excellent at visualising bone damage, but this kind of damage is now uncommon in RA. Magnetic resonance (MR) imaging, which can visualise soft tissues and swelling are becoming common. Typically MR images are also ‘read’ by experts; this method provides an improvement over the reading of radiographs, but remains unable to discriminate the very small changes which occur within clinical trials. Agreement between experts is poor, due to the difficulty in assessing complex 3D images, and the semi-quantitative methodology is relatively insensitive to change. Imorphics has proved successful at accurately measuring musculoskeletal structures using proprietary 3-dimensional statistical modelling using MR images. Imorphics recently identified that this technology could be applied to the field of RA measurement, using models of the whole of the hand, including bone, ligaments, tendons, cartilage, joint capsule and skin. The POC project objectives are to technically demonstrate that MR images of an RA hand can be consistently and automatically processed to provide accurate quantitative measurements. Removing inconsistencies in clinical assessment will provide increased accuracy in both treatment and clinical trials. Commercially, the effective measurement of small improvements in RA management and treatment could result in quicker drug testing, lower overheads and therefore reduced time to market.

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