629 EP025 – Utilizing novel MRI biomarkers for early achilles tendon injury detection and prevention

Background MRI is a powerful tool for assessing soft tissue, but it's rarely used for injury prevention due to time, cost, and result quantification challenges. Objective In this study, we validate novel biomarkers for early Achilles tendon (AT) issue detection using a fast, cost-effective MRI approach. Design We first evaluated the structure of AT using T2*-weighted GRE echo MRI and then assessed the function of the lower limb in four groups: dynamic strength, stabilographic indices, range of motion, and muscle torque. Expert radiologists analyzed the MRI data, which was further statistically compared with functional assessments. Four MRI-based biomarkers (one for each functional group) were calculated based on the maximum total variance explanation between the distribution of structural and functional parameters. Setting The study took place in a biomechanical laboratory and MRI clinic, with all participants undergoing all tests within a week and 90% on the same day. Participants We studied 72 athletes. Participants met the inclusion criteria of regular high-risk AT injury sports training and good health, excluding those with MRI contraindications, acute lower limb injuries, or other illnesses. Risk Assessment We calculated normalized risk scores (0–100%) based on MRI biomarkers for each participant's legs. Those with at least one marker over 25% were classified into a high-risk group. Outcome 23 individuals were classified as higher risk and significantly differed from the others. Results The high-risk group consisted of individuals with higher metabolic and biological age, as well as different body composition, which as observed in e.g. Domaradzki et al. are well-known risk factors (Table 1). The division into groups was evident and observed both statistically (Image 1) and radiologically. Conclusions Our novel MRI-derived biomarker and risk-scoring methodology can support AT screening and injury prevention, as well as address lower limb issues enabling efficient MRI-based soft tissue prophylaxis.