{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:26:04Z","timestamp":1777577164028,"version":"3.51.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Radiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Femoroacetabular Impingement (FAI) is a hip pathology characterized by impingement of the femoral head-neck junction against the acetabular rim, due to abnormalities in bone morphology. FAI is normally diagnosed by manual evaluation of morphologic features on magnetic resonance imaging (MRI). In this study, we assess, for the first time, the feasibility of using radiomics to detect FAI by automatically extracting quantitative features from images.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>17 patients diagnosed with monolateral FAI underwent pre-surgical MR imaging, including a 3D Dixon sequence of the pelvis. An expert radiologist drew regions of interest on the water-only Dixon images outlining femur and acetabulum in both impingement (IJ) and healthy joints (HJ). 182 radiomic features were extracted for each hip. The dataset numerosity was increased by 60 times with an ad-hoc data augmentation tool. Features were subdivided by type and region in 24 subsets. For each, a univariate ANOVA <jats:italic>F<\/jats:italic>-value analysis was applied to find the 5 features most correlated with IJ based on <jats:italic>p<\/jats:italic>-value, for a total of 48 subsets. For each subset, a K-nearest neighbor model was trained to differentiate between IJ and HJ using the values of the radiomic features in the subset as input. The training was repeated 100 times, randomly subdividing the data with 75%\/25% training\/testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The texture-based gray level features yielded the highest prediction max accuracy (0.972) with the smallest subset of features. This suggests that the gray image values are more homogeneously distributed in the HJ in comparison to IJ, which could be due to stress-related inflammation resulting from impingement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We showed that radiomics can automatically distinguish IJ from HJ using water-only Dixon MRI. To our knowledge, this is the first application of radiomics for FAI diagnosis. We reported an accuracy greater than 97%, which is higher than the 90% accuracy for detecting FAI reported for standard diagnostic tests (90%). Our proposed radiomic analysis could be combined with methods for automated joint segmentation to rapidly identify patients with FAI, avoiding time-consuming radiological measurements of bone morphology.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fradi.2023.1151258","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T10:26:39Z","timestamp":1679307999000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["A radiomics approach to the diagnosis of femoroacetabular impingement"],"prefix":"10.3389","volume":"3","author":[{"given":"Eros","family":"Montin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Kijowski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Youm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Lattanzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1177\/0363546520970914","article-title":"Incidence of femoroacetabular impingement and surgical management trends over time","volume":"49","author":"Hale","year":"2021","journal-title":"Am J Sports Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1136\/bjsports-2016-096743","article-title":"The warwick agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement","volume":"50","author":"Griffin","year":"2016","journal-title":"Br J Sports Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1093\/jhps\/hnw035","article-title":"Imaging of femoroacetabular impingement-current concepts","volume":"3","author":"Albers","year":"2016","journal-title":"J Hip Preserv Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"585","DOI":"10.2214\/AJR.20.22783","article-title":"Best practices: hip femoroacetabular impingement","volume":"216","author":"Schmaranzer","year":"2021","journal-title":"AJR Am J Roentgenol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1302\/0301-620X.87B7.15203","article-title":"Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip","volume":"87","author":"Beck","year":"2005","journal-title":"J Bone Joint Surg Br"},{"key":"B6","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1007\/s11999-009-1138-6","article-title":"Surgical treatment of femoroacetabular impingement: a systematic review of the literature","volume":"468","author":"Clohisy","year":"2010","journal-title":"Clin Orthop Relat Res"},{"key":"B7","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1136\/bjsports-2014-094302","article-title":"Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement\/labral tear: a systematic review with meta-analysis","volume":"49","author":"Reiman","year":"2015","journal-title":"Br J Sports Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.1007\/s11999-014-3936-8","article-title":"Which radiographic hip parameters do not have to be corrected for pelvic rotation and tilt?","volume":"473","author":"Tannast","year":"2015","journal-title":"Clin Orthop Relat Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1097\/01.blo.0000167669.26068.c5","article-title":"Tilt and rotation correction of acetabular version on pelvic radiographs","volume":"438","author":"Tannast","year":"2005","journal-title":"Clin Orthop Relat Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1097\/00003086-200302000-00033","article-title":"Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers","volume":"407","author":"Siebenrock","year":"2003","journal-title":"Clin Orthop Relat Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1016\/j.ejrad.2014.02.005","article-title":"Correlations between the alpha angle and femoral head asphericity: implications and recommendations for the diagnosis of cam femoroacetabular impingement","volume":"83","author":"Harris","year":"2014","journal-title":"Eur J Radiol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2325967117708307","DOI":"10.1177\/2325967117708307","article-title":"Radiographic diagnosis of pincer-type femoroacetabular impingement: a systematic review","volume":"5","author":"Rhee","year":"2017","journal-title":"Orthop J Sports Med"},{"key":"B13","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.arthro.2017.08.235","article-title":"Computed tomography scans in patients with young adult hip pain carry a lifetime risk of malignancy","volume":"34","author":"Wylie","year":"2018","journal-title":"Arthroscopy"},{"key":"B14","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s12891-017-1443-2","article-title":"Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement: systematic review and meta-analysis","volume":"18","author":"Saied","year":"2017","journal-title":"BMC Musculoskelet Disord"},{"key":"B15","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1007\/s00256-018-3049-7","article-title":"3D-MRI Versus 3D-CT in the evaluation of osseous anatomy in femoroacetabular impingement using dixon 3D FLASH sequence","volume":"48","author":"Samim","year":"2019","journal-title":"Skeletal Radiol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"20180474","DOI":"10.1259\/bjr.20180474","article-title":"Does 3DMR provide equivalent information as 3DCT for the pre-operative evaluation of adult hip pain conditions of femoroacetabular impingement and hip dysplasia?","volume":"91","author":"Yan","year":"2018","journal-title":"Br J Radiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2966","DOI":"10.1177\/0363546519869681","article-title":"Patient-Specific 3-D magnetic resonance imaging-based dynamic simulation of hip impingement and range of motion can replace 3-D computed tomography-based simulation for patients with femoroacetabular impingement: implications for planning open hip preservation surgery and hip arthroscopy","volume":"47","author":"Lerch","year":"2019","journal-title":"Am J Sports Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.ejca.2011.11.036","article-title":"Radiomics: extracting more information from medical images using advanced feature analysis","volume":"48","author":"Lambin","year":"2012","journal-title":"Eur J Cancer"},{"key":"B19","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1002\/jmri.25791","article-title":"Radiomic analysis of soft tissues sarcomas can distinguish intermediate from high-grade lesions","volume":"47","author":"Corino","year":"2018","journal-title":"J Magn Reson Imaging"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e4265","DOI":"10.1002\/nbm.4265","article-title":"Relevance of apparent diffusion coefficient features for a radiomics-based prediction of response to induction chemotherapy in sinonasal cancer","volume":"35","author":"Bologna","year":"2022","journal-title":"NMR Biomed"},{"key":"B21","doi-asserted-by":"publisher","first-page":"879","DOI":"10.1007\/s10278-018-0092-9","article-title":"Assessment of stability and discrimination capacity of radiomic features on apparent diffusion coefficient images","volume":"31","author":"Bologna","year":"2018","journal-title":"J Digit Imaging"},{"key":"B22","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s13244-021-01008-3","article-title":"CT And MRI radiomics of bone and soft-tissue sarcomas: a systematic review of reproducibility and validation strategies","volume":"12","author":"Gitto","year":"2021","journal-title":"Insights Imaging"},{"key":"B23","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1097\/RLI.0000000000000907","article-title":"Radiomics and deep learning for disease detection in musculoskeletal radiology: an overview of novel MRI- and CT-based approaches","volume":"58","author":"Fritz","year":"2023","journal-title":"Invest Radiol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1007\/s12178-020-09663-7","article-title":"Advances in FAI imaging: a focused review","volume":"13","author":"Mascarenhas","year":"2020","journal-title":"Curr Rev Musculoskelet Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/j.neuroimage.2006.01.015","article-title":"User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability","volume":"31","author":"Yushkevich","year":"2006","journal-title":"Neuroimage"},{"key":"B26","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3389\/fninf.2014.00013","article-title":"ITK: enabling reproducible research and open science","volume":"8","author":"McCormick","year":"2014","journal-title":"Front Neuroinform"},{"key":"B27","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1109\/PROC.1979.11328","article-title":"Statistical and structural approaches to texture","volume":"67","author":"Haralick","year":"1979","journal-title":"P IEEE"},{"key":"B28","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1007\/s00256-009-0745-3","article-title":"Cam-type femoral-acetabular impingement: is the alpha angle the best MR arthrography has to offer?","volume":"38","author":"Lohan","year":"2009","journal-title":"Skeletal Radiol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1148\/radiol.12112479","article-title":"How useful is the alpha angle for discriminating between symptomatic patients with cam-type femoroacetabular impingement and asymptomatic volunteers?","volume":"264","author":"Sutter","year":"2012","journal-title":"Radiology"},{"key":"B30","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1093\/jhps\/hnw014","article-title":"Is there a pathological alpha angle for hip impingement? A diagnostic test study","volume":"3","author":"Barrientos","year":"2016","journal-title":"J Hip Preserv Surg"},{"key":"B31","doi-asserted-by":"publisher","first-page":"3097","DOI":"10.1177\/0363546518800825","article-title":"Can we discriminate symptomatic hip patients from asymptomatic volunteers based on anatomic predictors? A 3-dimensional magnetic resonance study on cam, pincer, and spinopelvic parameters","volume":"46","author":"Mascarenhas","year":"2018","journal-title":"Am J Sports Med"},{"key":"B32","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s12891-020-3049-3","article-title":"Diagnostic sensitivity and specificity of dynamic three-dimensional CT analysis in detection of cam and pincer type femoroacetabular impingement","volume":"21","author":"Roling","year":"2020","journal-title":"BMC Musculoskelet Disord"},{"key":"B33","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1007\/s00264-011-1302-y","article-title":"Reliability and predictability of the centre-edge angle in the assessment of pincer femoroacetabular impingement","volume":"36","author":"Kutty","year":"2012","journal-title":"Int Orthop"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1016\/j.arthro.2014.11.042","article-title":"Prevalence of femoroacetabular impingement imaging findings in asymptomatic volunteers: a systematic review","volume":"31","author":"Frank","year":"2015","journal-title":"Arthroscopy"}],"container-title":["Frontiers in Radiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2023.1151258\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T10:26:42Z","timestamp":1679308002000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fradi.2023.1151258\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,20]]},"references-count":34,"alternative-id":["10.3389\/fradi.2023.1151258"],"URL":"https:\/\/doi.org\/10.3389\/fradi.2023.1151258","relation":{},"ISSN":["2673-8740"],"issn-type":[{"value":"2673-8740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,20]]},"article-number":"1151258"}}