Advanced Science · Oct 30, 2026
A Multi-Structural Radiomic Digital Phenotyping Framework for Deciphering Preclinical Evolution of Degenerative Meniscal Tears
By Li S, Liu H, Zhu Y et al.
Degenerative meniscus tears (DMTs) are pivotal in knee osteoarthritis progression, yet conventional MRI often fails to capture the subvisual alterations preceding macroscopic failure. We developed a multi-structural digital risk stratification framework (MSC-RM) that integrates standardized radiomic signatures from six knee structures (femur, tibia, cartilages, and menisci) derived from 3D double-echo steady-state MRI with baseline clinical risk profiles. Utilizing a longitudinal cohort (n = 674), our framework decoded complex degeneration patterns, achieving superior 4-year predictive performance (AUC 0.871). Survival analysis revealed that high-risk individuals had a 6.12-fold greater hazard of developing DMTs than the low-risk group. Furthermore, a reader test with five resident surgeons demonstrated that MSC-RM significantly enhanced diagnostic consistency (Kappa increased from 0.38 to 0.55), effectively bridging the expertise gap. By shifting the paradigm from reactive lesion detection to proactive risk management, this framework provides a scalable strategy for precision preventive medicine and establishes digital biomarkers as critical tools for optimizing musculoskeletal health in aging populations.