Bone Texture Analysis for Prediction of Incident Radio-graphic Hip Osteoarthritis Using Machine Learning: Data from the Cohort Hip and Cohort Knee (CHECK) study

Our aim was to assess the ability of radiography-based bone texture parameters in proximal femur and acetabulum to predict incident radiographic hip osteoarthritis (rHOA) over a 10 years period. Pelvic radiographs from CHECK (Cohort Hip and Cohort Knee) at baseline (987 hips) were analyzed for bone texture using fractal signature analysis in proximal femur and acetabulum. Elastic net (machine learning) was used to predict the incidence of rHOA (Kellgren-Lawrence grade (KL) > 1 or total hip replacement (THR)), joint space narrowing score (JSN, range 0-3), and osteophyte score (OST, range 0-3) after 10 years. Performance of prediction models was assessed using the area under the receiver operating characteristic curve (ROC AUC). Of the 987 hips without rHOA at baseline, 435 (44%) had rHOA at 10-year follow-up. Of the 667 hips with JSN grade 0 at baseline, 471 (71%) had JSN grade > 0 at 10-year follow-up. Of the 613 hips with OST grade 0 at baseline, 526 (86%) had OST grade > 0 at 10-year follow-up. AUCs for the models including age, gender, and body mass index to predict incident rHOA, JSN, and OST were 0.59, 0.54, and 0.51, respectively. The inclusion of bone texture parameters in the models improved the prediction of incident rHOA (ROC AUC 0.66 and 0.71 when baseline KL was also included in the model) and JSN (ROC AUC 0.62), but not incident OST (ROC AUC 0.53). Bone texture analysis provides additional information for predicting incident rHOA or THR over 10 years.