Knee Osteoarthritis Labeling Assistant

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IB Lab KOALA™ uses deep learning technology for detecting radiographic signs of knee osteoarthritis and augments the reporting workflow. The software application scores the stage of osteoarthritis according to the Kellgren & Lawrence grading system. It  also provides precise and automated measurements of the minimum joint space width, as well as assessment of the severity of joint space narrowing, osteophytosis and sclerosis based on OARSI criteria.


IB Lab KOALA™ highlights relevant clinical findings by applying the latest international medical standards to enable timely and accurate decision making. The findings are summarized in a visual output report, attached to the original x-ray image and saved automatically in the PACS system. The AI-results are fed as text into the predefined RIS-template for accelerated reporting. IB Lab KOALA™ facilitates monitoring of disease progression by facilitating comparison of radiographic disease parameters over time.



Radiological findings and measurements: Kellgren & Lawrence grade, (standardized) minimum joint space width, joint space narrowing, sclerosis, osteophytosis.



  • Enables instant, verifiable decision making in difficult cases
  • Facilitates monitoring of knee osteoarthritis progression
  • Enhances diagnosing and reporting knee osteoarthritis according to the latest clinical guidelines
  • Reduces the risk of inter-rater variability for evaluating knee radiographs in a standardized manner

Intended Use

Knee osteoarthritis is a paralyzing joint disease that can lead to joint replacement. Knee osteoarthritis has a life time risk as high as 45% 1, with the risk becoming even more severe due to two major risk factors: ageing and obesity 1, 2.

Knee osteoarthritis affects over 200 million patients worldwide 3, resulting in approximately 100 million knee radiographs taken in the EU alone in 2020 4. Consistent tracking of radiographic damage over time could help early diagnosis and prevention of disease progression.  

It should not be used in-lieu of full patient evaluation or solely relied upon to make or confirm a diagnosis. The system is to be used by trained medical professionals including, but not limited to, orthopedists and radiologists.


Training and Validation

  • Deep learning algorithms trained on over 35,000 individual knee radiographs
  • Data from a longitudinal study with centers across the United States
  • Each image was consensus-graded by board certified radiologists following OARSI criteria and the Kellgren and Lawrence scale
  • The AI follows the established radiological workflow: measurement of anatomical distances and angles recognition of disease symptoms, standardized classification and reporting
  • Validated on over 10,000 knees

What our customers say

Jack Farr - Orthopedist

ImageBiopsy AI software is highly accurate and efficient within our PACS system, which provides valuable information on the status of the knee along the continuum of chondrosis to arthrosis.

Jack Farr, MD

The integration of the AI ​​solutions by ImageBiopsy Lab into our RIS and PACS is easy and well done. It is fun to work with and the clarity of the visualized report is an ideal support for our patient consultation.

Jochen Mueller-Stromberg, MD

AI-based solutions reduce the amount of work and the findings become more accurate. An objective value is given which can be used both for monitoring and forecasting the progress. We offer something that others don’t have.

Michael Gruber, MD

Exact diagnosis and reproducible follow-up exams are indispensable for a successful osteoarthritis therapy. Software-based methods can assist the physician in the therapy management and adjustment process.

Stefan Nehrer, MD