{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T12:47:32Z","timestamp":1793710052033,"version":"4.6.1"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["nyaspubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann NY Acad Sci"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Intra\u2010articular hyaluronic acid (IAHA) injections are used for knee osteoarthritis, but clinical response is highly variable. This study evaluated whether quantitative magnetic resonance imaging (MRI) radiomics provides incremental predictive value over clinical variables and assessed the impact of cross\u2010validation strategies on performance. Using data from the Osteoarthritis Initiative (OAI), we identified 262 participants (329 knees) treated with IAHA, of whom 106 participants (128 knees) had baseline 3D double\u2010echo steady\u2010state (DESS) MRI suitable for automated segmentation and radiomics extraction. We compared clinical\u2010only, radiomics\u2010only, and combined models. Under rigorous participant\u2010level grouped cross\u2010validation, the clinical\u2010only model achieved the highest performance (ROC\u2010AUC: 0.716; 95% CI: 0.689\u20130.742 in the full cohort; ROC\u2010AUC: 0.718 in the MRI subset). The radiomics\u2010only model failed to predict response (ROC\u2010AUC: 0.499; 95% CI: 0.446\u20130.549), and the combined model (ROC\u2010AUC: 0.693; 95% CI: 0.646\u20130.736) did not improve upon clinical predictors alone. A knee\u2010level sensitivity analysis yielded higher but artificially inflated estimates (combined AUC: 0.773), confirming the necessity of participant\u2010level grouping. We conclude that routine clinical variables, principally baseline pain and age, outperform DESS\u2010MRI radiomics for predicting IAHA response. This study demonstrates that improper validation strategies significantly overestimate radiomics utility, highlighting the critical necessity of participant\u2010level grouping in musculoskeletal imaging research to prevent data leakage.<\/jats:p>","DOI":"10.1111\/nyas.70288","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:56:16Z","timestamp":1779699376000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Features Outperform MRI Radiomics for Predicting Intra\u2010Articular Hyaluronic Acid Response in Knee Osteoarthritis"],"prefix":"10.1111","volume":"1559","author":[{"given":"Tariq","family":"Alkhatatbeh","sequence":"first","affiliation":[{"name":"Department of Joint Surgery, Center for Orthopaedic Surgery The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province)  Guangzhou China"},{"name":"Orthopedic Hospital of Guangdong Province  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Alkhatatbeh","sequence":"additional","affiliation":[{"name":"Department of Orthopedics The First Affiliated Hospital of Shantou University Medical College  Shantou City China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Center for Orthopaedic Surgery The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province)  Guangzhou China"},{"name":"Orthopedic Hospital of Guangdong Province  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhilin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Center for Orthopaedic Surgery The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province)  Guangzhou China"},{"name":"Orthopedic Hospital of Guangdong Province  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Joint Surgery, Center for Orthopaedic Surgery The Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province)  Guangzhou China"},{"name":"Orthopedic Hospital of Guangdong Province  Guangzhou China"},{"name":"Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases  Guangzhou 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