20 years of the international workshop on osteoarthritis imaging (IWOAI): From a small pre-alpine village to a global community

Introduction: The International Workshop on Osteoarthritis Imaging (IWOAI) was founded in 2007 to create a focused scientific forum dedicated to imaging (biomarkers) in osteoarthritis. In contrast to large international congresses, the workshop was conceived as a small and interactive meeting encouraging open discussion and interdisciplinary exchange among researchers from academia and industry.

Perspective: Since its first meeting in 2007 in the remote pre-Alpine village of Ainring, IWOAI has evolved into an annual global series of workshops bringing together international experts from many different disciplines. Despite its worldwide expansion, the workshop has remained limited in size, with up to 150 participants (South Carolina in 2012) but often smaller. The retreat-like format has allowed ample time for discussion and personal interaction. It has fostered a collaborative environment in which methodological challenges, emerging imaging technologies, publicly accessible cohorts and image repositories (e.g. the Osteoarthritis Initiative), and regulatory aspects of imaging biomarkers are discussed in depth. Informal interactions during social events and post-conference excursions have strengthened professional networks, collaborations, and personal friendships across disciplines and institutions. Over time, the workshop community also contributed to strengthening the field institutionally by establishing the International Society for Osteoarthritis Imaging (ISOAI) in 2019.

Outlook: As imaging technologies, AI-based automated image analysis, and data science continue to advance, imaging biomarkers are expected to play an increasingly important role in osteoarthritis clinical research and therapeutic development. Continued collaboration among academic researchers, clinicians, industry scientists and regulators will remain essential for translating imaging advances into meaningful clinical applications, trials, and ultimately disease-modifying therapy.