Prognostication of Three-Month Genicular Artery Embolization Outcomes Using Pre-Procedural MRIs

Le résumé fourni par la source

PURPOSE: To assess the utility of pre-procedural knee MRI prior to genicular artery embolization (GAE) for the prognostication of early outcomes for symptomatic knee osteoarthritis (KOA). MATERIALS AND METHODS: A single-center study including 39 patients received GAE from 9/2021-4/2025 with pre-procedural MRIs. MRIs were evaluated for structural abnormalities including menisci, ligaments, cartilage, marrow signal, and loose bodies. For 24 patients, synovitis was assessed using a semiquantitative method. Clinical outcomes were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scoring system at pre-GAE and three-month postintervention. Categorical response was assessed as a 50% reduction in the WOMAC Pain. Student t-tests were used to evaluate WOMAC pain reduction, and subset analysis was performed between MRI structural abnormalities and categorical response. RESULTS: Fifty-two knees received GAE with pre-procedural MRIs (33 with contrast). There was a 34.6% clinical response rate (N = 8/52). Lateral meniscus and cartilage abnormality were predictive of poor categorical response at three months (P = 0.039-0.040). ≥ 4 structural abnormalities were associated with poor treatment response (P = 0.004). Pre-GAE synovitis was not predictive of categorical response at three months (P = 0.809). Kellgren-Lawrence ≥ 3 was predictive of poor response (P < 0.001). Lower adverse event rate was observed with temporary embolic compared to permanent embolic (P = 0.032). CONCLUSION: Pre-GAE knee MRI may offer short-term prognostic utility. Pre-procedural abnormalities in the lateral menisci and cartilage can predict poor response to GAE at three months. A greater degree of structural abnormality (≥ 4 structural abnormalities) was associated with poor response. Temporary embolic agent may be safer than permanent embolic agent.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.