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Bio

Bio


Dr. Marianne Black is a Postdoctoral Fellow in Radiology in the IMMERS (Incubator for Medical Mixed and Extended Reality), BMR (Body Magnetic Resonance) and JOINT (Joint and Osteoarthritis Imaging with Novel Technology) groups. Dr. Black currently works with with Drs. Brian Hargreaves, Bruce Daniel and Garry Gold. Her postdoctoral research is focused on imaging to detect and treat musculoskeletal disease. She is developing immersive mixed reality tools to improve surgical outcomes in orthopaedics.

Dr. Black?s PhD research under Drs. Marc Levenston, Brian Hargreaves and Garry Gold focused on the application and development of novel methods and analysis techniques for quantitative knee imaging using MRI and CT. Her work included leading a study measuring quantitative MRI parameters of ACL-injured subjects, and her analysis methods that built upon Dr. Hargreaves group?s previous analysis methods showed the ability to differentiate ACL-injured and healthy cartilage as early as 3-months post-surgery. Prior to attending Stanford, she completed her MASc at the University of British Columbia in Biomedical Engineering under Dr. Dave Wilson. Dr. Black's research studied the effect of wedge and slope in medical opening high tibial osteotomy on joint kinematics and tibiofemoral joint contact pressure. She also co-founded Arbutus Medical during this time, which develops orthopaedic medical devices for low-resource hospitals.

Stanford Advisors


Patents


  • Marianne Black, Michael Cancilla, Lawrence Buchan, Elise Huisman, Jeremy Kooyman. "United States Patent 10405937 DRILL COVER AND CHUCK MECHANISM", ARBUTUS MEDICAL INC, Sep 10, 2019

Publications

All Publications


  • Characterizing the transient response of knee cartilage to running: Decreases in cartilage T2 of female recreational runners. Journal of orthopaedic research : official publication of the Orthopaedic Research Society Crowder, H. A., Mazzoli, V. n., Black, M. S., Watkins, L. E., Kogan, F. n., Hargreaves, B. A., Levenston, M. E., Gold, G. E. 2021

    Abstract

    Cartilage transmits and redistributes biomechanical loads in the knee joint during exercise. Exercise-induced loading alters cartilage hydration and is detectable using quantitative MRI, where T2 relaxation time (T2 ) is influenced by cartilage collagen composition, fiber orientation, and changes in extracellular matrix. This study characterized short-term transient responses of healthy knee cartilage to running-induced loading using bilateral scans and image registration. Eleven healthy female recreational runners (33.73±4.22 years) and four healthy female controls (27.25±1.38 years) were scanned on a 3T GE MRI scanner with qDESS before running over-ground (runner group) or resting (control group) for 40 minutes. Subjects were scanned immediately post-activity at five-minute intervals for 60 minutes. T2 times were calculated for femoral, tibial, and patellar cartilage at each time point and analyzed using a mixed-effects model and Bonferroni post-hoc. There were immediate decreases in T2 (mean±SEM) post-run in superficial femoral cartilage of at least 3.3±0.3% (P=0.002) between baseline and Time 0 that remained for 25 minutes, a decrease in superficial tibial cartilage T2 of 2.9±0.4% (P=0.041) between baseline and Time 0, and a decrease in superficial patellar cartilage T2 of 3.6±0.3% (P=0.020) 15 minutes post-run. There were decreases in the medial posterior region of superficial femoral cartilage T2 of at least 5.3±0.2% (P=0.022) within five minutes post-run that remained at 60 minutes post-run. Clinical Significance: These results increase understanding of transient responses of healthy cartilage to repetitive, exercise-induced loading and establish preliminary recommendations for future definitive studies of cartilage response to running. This article is protected by copyright. All rights reserved.

    View details for DOI 10.1002/jor.24994

    View details for PubMedID 33483997

  • Effects of the Competitive Season and Off-Season on Knee Articular Cartilage in Collegiate Basketball Players Using Quantitative MRI: A Multicenter Study. Journal of magnetic resonance imaging : JMRI Rubin, E. B., Mazzoli, V. n., Black, M. S., Young, K. n., Desai, A. D., Koff, M. F., Sreedhar, A. n., Kogan, F. n., Safran, M. R., Vincentini, D. J., Knox, K. A., Yamada, T. n., McCabe, A. n., Majumdar, S. n., Potter, H. G., Gold, G. E. 2021

    Abstract

    Injuries to the articular cartilage in the knee are common in jumping athletes, particularly high-level basketball players. Unfortunately, these are often diagnosed at a late stage of the disease process, after tissue loss has already occurred.To evaluate longitudinal changes in knee articular cartilage and knee function in National Collegiate Athletic Association (NCAA) basketball players and their evolution over the competitive season and off-season.Longitudinal, multisite cohort study.Thirty-two NCAA Division 1 athletes: 22 basketball players and 10 swimmers.Bilateral magnetic resonance imaging (MRI) using a combined T1? and T2 magnetization-prepared angle-modulated portioned k-space spoiled gradient-echo snapshots (MAPSS) sequence at 3T.We calculated T2 and T1? relaxation times to compare compositional cartilage changes between three timepoints: preseason 1, postseason 1, and preseason 2. Knee Osteoarthritis Outcome Scores (KOOS) were used to assess knee health.One-way variance model hypothesis test, general linear model, and chi-squared test.In the femoral articular cartilage of all athletes, we saw a global decrease in T2 and T1? relaxation times during the competitive season (all P

    View details for DOI 10.1002/jmri.27610

    View details for PubMedID 33763929

  • The prevalence of femoroacetabular impingement anatomy in Division 1 aquatic athletes who tread water Journal of Hip Preservation Surgery Langner, J. L., Black, M. S., MacKay, J. W., Hall, K. E., Safran, M. R., Kogan, F., Gold, G. E. 2020; 0: 1-9

    Abstract

    Femoroacetabular impingement (FAI) is a disorder that causes hip pain and disability in young patients, particularly athletes. Increased stress on the hip during development has been associated with increased risk of cam morphology. The specific forces involved are unclear, but may be due to continued rotational motion, like the eggbeater kick. The goal of this prospective cohort study was to use magnetic resonance imaging (MRI) to identify the prevalence of FAI anatomy in athletes who tread water and compare it to the literature on other sports. With university IRB approval, 20 Division 1 water polo players and synchronized swimmers (15 female, 5 male), ages 18-23?years (mean age 20.7?±?1.4), completed the 33-item International Hip Outcome Tool and underwent non-contrast MRI scans of both hips using a 3 Tesla scanner. Recruitment was based on sport, with both symptomatic and asymptomatic individuals included. Cam and pincer morphology were identified. The Wilcoxon Signed-Rank/Rank Sum tests were used to assess outcomes. Seventy per cent (14/20) of subjects reported pain in their hips yet only 15% (3/20) sought clinical evaluation. Cam morphology was present in 67.5% (27/40) of hips, while 22.5% (9/40) demonstrated pincer morphology. The prevalence of cam morphology in water polo players and synchronized swimmers is greater than that reported for the general population and at a similar level as some other sports. From a clinical perspective, acknowledgment of the high prevalence of cam morphology in water polo players and synchronized swimmers should be considered when these athletes present with hip pain.

    View details for DOI 10.1093/jhps/hnaa009

    View details for PubMedCentralID PMC7605769

  • Rapid volumetric gagCEST imaging of knee articular cartilage at 3 T: evaluation of improved dynamic range and an osteoarthritic population. NMR in biomedicine Watkins, L. E., Rubin, E. B., Mazzoli, V. n., Uhlrich, S. D., Desai, A. D., Black, M. n., Ho, G. K., Delp, S. L., Levenston, M. E., Beaupré, G. S., Gold, G. E., Kogan, F. n. 2020: e4310

    Abstract

    Chemical exchange saturation transfer of glycosaminoglycans, gagCEST, is a quantitative MR technique that has potential for assessing cartilage proteoglycan content at field strengths of 7 T and higher. However, its utility at 3 T remains unclear. The objective of this work was to implement a rapid volumetric gagCEST sequence with higher gagCEST asymmetry at 3 T to evaluate its sensitivity to osteoarthritic changes in knee articular cartilage and in comparison with T2 and T1? measures. We hypothesize that gagCEST asymmetry at 3 T decreases with increasing severity of osteoarthritis (OA). Forty-two human volunteers, including 10 healthy subjects and 32 subjects with medial OA, were included in the study. Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed for all subjects, and Kellgren-Lawrence grading was performed for OA volunteers. Healthy subjects were scanned consecutively at 3 T to assess the repeatability of the volumetric gagCEST sequence at 3 T. For healthy and OA subjects, gagCEST asymmetry and T2 and T1? relaxation times were calculated for the femoral articular cartilage to assess sensitivity to OA severity. Volumetric gagCEST imaging had higher gagCEST asymmetry than single-slice acquisitions (p = 0.015). The average scan-rescan coefficient of variation was 6.8%. There were no significant differences in average gagCEST asymmetry between younger and older healthy controls (p = 0.655) or between healthy controls and OA subjects (p = 0.310). T2 and T1? relaxation times were elevated in OA subjects (p < 0.001 for both) compared with healthy controls and both were moderately correlated with total KOOS scores (rho = -0.181 and rho = -0.332 respectively). The gagCEST technique developed here, with volumetric scan times under 10 min and high gagCEST asymmetry at 3 T, did not vary significantly between healthy subjects and those with mild-moderate OA. This further supports a limited utility for gagCEST imaging at 3 T for assessment of early changes in cartilage composition in OA.

    View details for DOI 10.1002/nbm.4310

    View details for PubMedID 32445515

  • Smooth Ride: Low-Pass Filtering of Manual Segmentations Improves Consensus Bildverarbeitung für die Medizin Maier, J., Black, M. S., Hall, M. E., Choi, J., Levenston, M. E., Gold, G. E., Fahrig, R., Eskofier, B., Maier, A. 2019: 86-91
  • The effect of wedge and tibial slope angles on knee contact pressure and kinematics following medial opening-wedge high tibial osteotomy CLINICAL BIOMECHANICS Black, M. S., d'Entremont, A. G., McCormack, R. G., Hansen, G., Carr, D., Wilson, D. R. 2018; 51: 17?25

    Abstract

    High tibial osteotomy is a surgical procedure to treat medial compartment osteoarthritis in varus knees. The reported success rates of the procedure are inconsistent, which may be due to sagittal plane alignment of the osteotomy. The objective of this study was to determine the effect of changing tibial slope, for a range of tibial wedge angles in high tibial osteotomy, on knee joint contact pressure location and kinematics during continuous loaded flexion/extension.Seven cadaveric knee specimens were cycled through flexion and extension in an Oxford knee-loading rig. The osteotomy on each specimen was adjusted to seven clinically relevant wedge and slope combinations. We used pressure sensors to determine the position of the centre of pressure in each compartment of the tibial plateau and infrared motion capture markers to determine tibiofemoral and patellofemoral kinematics.In early knee flexion, a 5° increase in tibial slope shifted the centre of pressure in the medial compartment anteriorly by 4.5mm (P?0.001), (from the neutral slope/wedge position). Increasing the tibial slope also resulted in the tibia translating anteriorly (P?0.001).Changes to the tibial slope during high tibial osteotomy for all tested wedge angles shifted the centre of pressure in both the medial and lateral compartments substantially and altered knee kinematics. Tibial slope should be controlled during high tibial osteotomy to prevent unwanted changes in tibial plateau contact loads.

    View details for PubMedID 29154178

  • Five-minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double-echo in steady-state at 3T. Journal of magnetic resonance imaging : JMRI Chaudhari, A. S., Black, M. S., Eijgenraam, S. n., Wirth, W. n., Maschek, S. n., Sveinsson, B. n., Eckstein, F. n., Oei, E. H., Gold, G. E., Hargreaves, B. A. 2018; 47 (5): 1328?41

    Abstract

    Biomarkers for assessing osteoarthritis activity necessitate multiple MRI sequences with long acquisition times.To perform 5-minute simultaneous morphometry (thickness/volume measurements) and T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS).Prospective.Fifteen healthy volunteers for morphometry and T2 measurements, and 15 patients (five each Kellgren-Lawrence grades 0/2/3) for MOAKS assessment.A 5-minute double-echo steady-state (DESS) sequence was evaluated for generating quantitative and semiquantitative osteoarthritis biomarkers at 3T.Flip angle simulations evaluated tissue signals and sensitivity of T2 measurements. Morphometry and T2 reproducibility was compared against morphometry-optimized and relaxometry-optimized sequences. Repeatability was assessed by scanning five volunteers twice. MOAKS reproducibility was compared to MOAKS derived from a clinical knee MRI protocol by two readers.Coefficients of variation (CVs), concordance confidence intervals (CCI), and Wilcoxon signed-rank tests compared morphometry and relaxometry measurements with their reference standards. DESS MOAKS positive percent agreement (PPA), negative percentage agreement (NPA), and interreader agreement was calculated using the clinical protocol as a reference. Biomarker variations between Kellgren-Lawrence groups were evaluated using Wilcoxon rank-sum tests.Cartilage thickness (P?=?0.65), cartilage T2 (P?=?0.69), and meniscus T2 (P?=?0.06) did not significantly differ from their reference standard (with a 20° DESS flip angle). DESS slightly overestimated meniscus volume (P < 0.001). Accuracy and repeatability CVs were <3.3%, except the meniscus T2 accuracy (7.6%). DESS MOAKS had substantial interreader agreement and high PPA/NPA values of 87%/90%. Bone marrow lesions and menisci had slightly lower PPAs. Cartilage and meniscus T2 , and MOAKS (cartilage surface area, osteophytes, cysts, and total score) was higher in Kellgren-Lawrence groups 2 and 3 than group 0 (P < 0.05).The 5-minute DESS sequence permits MOAKS assessment for a majority of tissues, along with repeatable and reproducible simultaneous cartilage and meniscus T2 relaxometry and morphometry measurements.2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1328-1341.

    View details for PubMedID 29090500

    View details for PubMedCentralID PMC5899635

  • Comparison of Different Approaches for Measuring Tibial Cartilage Thickness JOURNAL OF INTEGRATIVE BIOINFORMATICS Maier, J., Black, M., Bonaretti, S., Bier, B., Eskofier, B., Choi, J., Levenston, M., Gold, G., Fahrig, R., Maier, A. 2017; 14 (2)

    Abstract

    Osteoarthritis is a degenerative disease affecting bones and cartilage especially in the human knee. In this context, cartilage thickness is an indicator for knee cartilage health. Thickness measurements are performed on medical images acquired in-vivo. Currently, there is no standard method agreed upon that defines a distance measure in articular cartilage. In this work, we present a comparison of different methods commonly used in literature. These methods are based on nearest neighbors, surface normal vectors, local thickness and potential field lines. All approaches were applied to manual segmentations of tibia and lateral and medial tibial cartilage performed by experienced raters. The underlying data were contrast agent-enhanced cone-beam C-arm CT reconstructions of one healthy subject's knee. The subject was scanned three times, once in supine position and two times in a standing weight-bearing position. A comparison of the resulting thickness maps shows similar distributions and high correlation coefficients between the approaches above 0.90. The nearest neighbor method results on average in the lowest cartilage thickness values, while the local thickness approach assigns the highest values. We showed that the different methods agree in their thickness distribution. The results will be used for a future evaluation of cartilage change under weight-bearing conditions.

    View details for DOI 10.1515/jib-2017-0015

    View details for Web of Science ID 000406931200005

    View details for PubMedID 28753537

  • Making Safe Surgery Affordable: Design of a Surgical Drill Cover System for Scale. Journal of orthopaedic trauma Buchan, L. L., Black, M. S., Cancilla, M. A., Huisman, E. S., Kooyman, J. J., Nelson, S. C., O?Hara, N. N., O?Brien, P. J., Blachut, P. A. 2015; 29 Suppl 10: S29?32

    Abstract

    Many surgeons in low-resource settings do not have access to safe, affordable, or reliable surgical drilling tools. Surgeons often resort to nonsterile hardware drills because they are affordable, robust, and efficient, but they are impossible to sterilize using steam. A promising alternative is to use a Drill Cover system (a sterilizable fabric bag plus surgical chuck adapter) so that a nonsterile hardware drill can be used safely for surgical bone drilling. Our objective was to design a safe, effective, affordable Drill Cover system for scale in low-resource settings. We designed our device based on feedback from users at Mulago Hospital (Kampala, Uganda) and focused on 3 main aspects. First, the design included a sealed barrier between the surgical field and hardware drill that withstands pressurized fluid. Second, the selected hardware drill had a maximum speed of 1050 rpm to match common surgical drills and reduce risk of necrosis. Third, the fabric cover was optimized for ease of assembly while maintaining a sterile technique. Furthermore, with the Drill Cover approach, multiple Drill Covers can be provided with a single battery-powered drill in a "kit," so that the drill can be used in back-to-back surgeries without requiring immediate sterilization. The Drill Cover design presented here provides a proof-of-concept for a product that can be commercialized, produced at scale, and used in low-resource settings globally to improve access to safe surgery.

    View details for PubMedID 26356212

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