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Villarreal CX, Shen X, Alhulail AA, Buffo NM, Zhou X, Ozen AC, Chiew M, Sawiak S, Emir U, Chan DD. An Accelerated PETALUTE MRI Sequence for In Vivo Quantification of Sodium Content in Human Articular Cartilage at 3T. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.02.24305807. [PMID: 38746343 PMCID: PMC11092686 DOI: 10.1101/2024.05.02.24305807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
In this work, we demonstrate the sodium magnetic resonance imaging (MRI) capabilities of a three-dimensional (3D) dual-echo ultrashort echo time (UTE) sequence with a novel rosette petal trajectory (PETALUTE), in comparison to the 3D density-adapted (DA) radial spokes UTE sequence. We scanned five healthy subjects using a 3D dual-echo PETALUTE acquisition and two comparable implementations of 3D DA-radial spokes acquisitions, one matching the number of k-space projections (Radial-Matched Trajectories) and the other matching the total number of samples (Radial-Matched Samples) acquired in k-space. The PETALUTE acquisition enabled equivalent sodium quantification in articular cartilage volumes of interest (168.8 ± 29.9 mM) to those derived from the 3D radial acquisitions (171.62 ± 28.7 mM and 149.8 ± 22.2 mM, respectively). We achieved a shorter scan time of 2:06 for 3D PETALUTE, compared to 3:36 for 3D radial acquisitions. We also evaluated the feasibility of further acceleration of the PETALUTE sequence through retrospective compressed sensing with 2× and 4× acceleration of the first echo and showed structural similarity of 0.89 ± 0.03 and 0.87 ± 0.03 when compared to non-retrospectively accelerated reconstruction. Together, these results demonstrate improved scan time with equivalent performance of the PETALUTE sequence compared to the 3D DA-radial sequence for sodium MRI of articular cartilage.
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2
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Zbýň Š, Ludwig KD, Watkins LE, Lagore RL, Nowacki A, Tóth F, Tompkins MA, Zhang L, Adriany G, Gold GE, Shea KG, Nagel AM, Carlson CS, Metzger GJ, Ellermann JM. Changes in tissue sodium concentration and sodium relaxation times during the maturation of human knee cartilage: Ex vivo 23 Na MRI study at 10.5 T. Magn Reson Med 2024; 91:1099-1114. [PMID: 37997011 PMCID: PMC10751033 DOI: 10.1002/mrm.29930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE To evaluate the influence of skeletal maturation on sodium (23 Na) MRI relaxation parameters and the accuracy of tissue sodium concentration (TSC) quantification in human knee cartilage. METHODS Twelve pediatric knee specimens were imaged with whole-body 10.5 T MRI using a density-adapted 3D radial projection sequence to evaluate 23 Na parameters: B1 + , T1 , biexponentialT 2 * $$ {\mathrm{T}}_2^{\ast } $$ , and TSC. Water, collagen, and sulfated glycosaminoglycan (sGAG) content were calculated from osteochondral biopsies. The TSC was corrected for B1 + , relaxation, and water content. The literature-based TSC (TSCLB ) used previously published values for corrections, whereas the specimen-specific TSC (TSCSP ) used measurements from individual specimens. 23 Na parameters were evaluated in eight cartilage compartments segmented on proton images. Associations between 23 Na parameters, TSCLB - TSCSP difference, biochemical content, and age were determined. RESULTS From birth to 12 years, cartilage water content decreased by 18%; collagen increased by 59%; and sGAG decreased by 36% (all R2 ≥ 0.557). The shortT 2 * $$ {\mathrm{T}}_2^{\ast } $$ (T 2 * S $$ {{\mathrm{T}}_2^{\ast}}_{\mathrm{S}} $$ ) decreased by 72%, and the signal fraction relaxing withT 2 * S $$ {{\mathrm{T}}_2^{\ast}}_{\mathrm{S}} $$ (fT 2 * S $$ {{\mathrm{fT}}_2^{\ast}}_{\mathrm{S}} $$ ) increased by 55% during the first 5 years but remained relatively stable after that. TSCSP was significantly correlated with sGAG content from biopsies (R2 = 0.739). Depending on age, TSCLB showed higher or lower values than TSCSP . The TSCLB - TSCSP difference was significantly correlated withT 2 * S $$ {{\mathrm{T}}_2^{\ast}}_{\mathrm{S}} $$ (R2 = 0.850),fT 2 * S $$ {{\mathrm{fT}}_2^{\ast}}_{\mathrm{S}} $$ (R2 = 0.651), and water content (R2 = 0.738). CONCLUSION TSC and relaxation parameters measured with 23 Na MRI provide noninvasive information about changes in sGAG content and collagen matrix during cartilage maturation. Cartilage TSC quantification assuming fixed relaxation may be feasible in children older than 5 years.
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Affiliation(s)
- Štefan Zbýň
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Radiology, University of Minnesota, Minneapolis, MN
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH
| | - Kai D. Ludwig
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Radiology, University of Minnesota, Minneapolis, MN
| | - Lauren E. Watkins
- Department of Radiology, Department of Bioengineering, Stanford University, Palo Alto, CA
- Steadman Philippon Research Institute, Vail, CO
| | - Russell L. Lagore
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Amanda Nowacki
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- University of Texas, Austin, TX
| | - Ferenc Tóth
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Marc A. Tompkins
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN
| | - Lin Zhang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Gregor Adriany
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Garry E. Gold
- Department of Radiology, Department of Bioengineering, Stanford University, Palo Alto, CA
| | - Kevin G. Shea
- Lucile Packard Children’s Hospital, Stanford University School of Medicine, Palo Alto, CA
| | - Armin M. Nagel
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Cathy S. Carlson
- Department of Veterinary Clinical Sciences, University of Minnesota, St. Paul, MN
| | - Gregory J. Metzger
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
| | - Jutta M. Ellermann
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN
- Department of Radiology, University of Minnesota, Minneapolis, MN
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Mantebea H, Singh A, Badar F, Abdelmessih G, Sebastian TM, Baker K, Newton M, Xia Y. Characteristics of distal femoral articular cartilage in 6 weeks posttraumatic osteoarthritis by a subcritical impact. J Orthop Res 2023. [PMID: 37874329 DOI: 10.1002/jor.25721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 09/09/2023] [Accepted: 10/17/2023] [Indexed: 10/25/2023]
Abstract
Traumatized knee greatly contributes to osteoarthritis (OA) of the knee in young adults. To intervene effectively before the onset of severe structural disruption, detection of the disease at the early onset is crucial. In this study, we put together the findings for the detection of OA from the femoral knee joint cartilage of the rabbit at 6 weeks posttrauma. Articular cartilage samples are taken from the impacted and nonimpacted joints at 0 week (serving as the control group) and at 6 weeks posttrauma by minimal force. The samples were imaged using microscopic magnetic resonance imaging (µMRI) at 11.7 µm/pixel and polarized light microscopy (PLM) at 1 µm/pixel. In addition, an inductively coupled plasma - optical emission spectrometry analysis was performed using the adjacent cartilage samples. The outcomes of this study demonstrate an increase in T2 values in 6 weeks samples compared to the 0 week samples by µMRI technique, indicating a general increase of tissue hydration within cartilage. PLM detects a decrease in the average thickness of the superficial zones in the posttraumatic osteoarthritis samples, significant in the impacted femurs. There was an average increasing trend of maximum retardation in the tide mark in comparison to the reported calcium concentration (mg/L) in impacted samples suggesting a possible rise in mineralization in the 6 weeks samples. Qualitatively, physical observation of the joint after 6 weeks showed signs of reddening in the anterior femur suggesting the disease process is a localized phenomenon. Through microscopic imaging, we are able to detect these changes at 6 weeks posttrauma qualitatively and quantitatively.
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Affiliation(s)
- Hannah Mantebea
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan, USA
| | - Amanveer Singh
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan, USA
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan, USA
| | - Gabrielle Abdelmessih
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan, USA
| | | | - Kevin Baker
- Bone & Joint Center, Henry Ford Hospital, Detroit, Michigan, USA
| | - Michael Newton
- Research Institute, Beaumont Hospital, Royal Oak, Michigan, USA
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan, USA
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4
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Jena A, Taneja S, Rana P, Goyal N, Vaish A, Botchu R, Vaishya R. Emerging role of integrated PET-MRI in osteoarthritis. Skeletal Radiol 2021; 50:2349-2363. [PMID: 34185124 DOI: 10.1007/s00256-021-03847-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/16/2021] [Accepted: 06/16/2021] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a common degenerative disorder of the articular cartilage, which is associated with hypertrophic changes in the bone, synovial inflammation, subchondral sclerosis, and joint space narrowing (JSN). Radiography remains the first line of imaging till now. Due to the lack of soft-tissue depiction in radiography, researchers are exploring various imaging techniques to detect OA at an early stage and understand its pathophysiology to restrict its progression and discover disease-modifying agents in OA. As the OA relates to the degradation of articular cartilage and remodeling of the underlying bone, an optimal imaging tool must be sensitive to the bone and soft tissue health. In that line, many non-invasive imaging and minimally invasive techniques have been explored. Out of these, the non-invasive compositional magnetic resonance imaging (MRI) for evaluation of the integrity of articular cartilage and positron emission tomography (PET) scan with fluorodeoxyglucose (FDG) and more specific bone-seeking tracer like sodium fluoride (18F-NaF) for bone cartilage interface are some of the leading areas of ongoing work. Integrated PET-MRI system, a new hybrid modality that combines the virtues of the above two individual modalities, allows detailed imaging of the entire joint, including soft tissue cartilage and bone, and holds great potential to research complex disease processes of OA. This narrative review attempts to signify individual characteristics of MRI, PET, the fusion of these characteristics in PET-MRI, and the ongoing research on PET-MRI as a potential tool to understand the pathophysiology of OA.
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Affiliation(s)
- Amarnath Jena
- PET SUITE (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India
| | - Sangeeta Taneja
- PET SUITE (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India
| | - Prerana Rana
- PET SUITE (Indraprastha Apollo Hospitals and House of Diagnostics), Department of Molecular Imaging and Nuclear Medicine, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India.,Apollo Hospitals Education & Research Foundation, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India
| | - Nidhi Goyal
- Department of Radiodiagnosis and Imaging, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India
| | - Abhishek Vaish
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK.
| | - Raju Vaishya
- Department of Orthopaedics and Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, New Delhi, 110076, India
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Keppie SJ, Mansfield JC, Tang X, Philp CJ, Graham HK, Önnerfjord P, Wall A, McLean C, Winlove CP, Sherratt MJ, Pavlovskaya GE, Vincent TL. Matrix-Bound Growth Factors are Released upon Cartilage Compression by an Aggrecan-Dependent Sodium Flux that is Lost in Osteoarthritis. FUNCTION (OXFORD, ENGLAND) 2021; 2:zqab037. [PMID: 34423304 PMCID: PMC8374957 DOI: 10.1093/function/zqab037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/25/2021] [Accepted: 07/30/2021] [Indexed: 01/07/2023]
Abstract
Articular cartilage is a dense extracellular matrix-rich tissue that degrades following chronic mechanical stress, resulting in osteoarthritis (OA). The tissue has low intrinsic repair especially in aged and osteoarthritic joints. Here, we describe three pro-regenerative factors; fibroblast growth factor 2 (FGF2), connective tissue growth factor, bound to transforming growth factor-beta (CTGF-TGFβ), and hepatoma-derived growth factor (HDGF), that are rapidly released from the pericellular matrix (PCM) of articular cartilage upon mechanical injury. All three growth factors bound heparan sulfate, and were displaced by exogenous NaCl. We hypothesised that sodium, sequestered within the aggrecan-rich matrix, was freed by injurious compression, thereby enhancing the bioavailability of pericellular growth factors. Indeed, growth factor release was abrogated when cartilage aggrecan was depleted by IL-1 treatment, and in severely damaged human osteoarthritic cartilage. A flux in free matrix sodium upon mechanical compression of cartilage was visualised by 23Na -MRI just below the articular surface. This corresponded to a region of reduced tissue stiffness, measured by scanning acoustic microscopy and second harmonic generation microscopy, and where Smad2/3 was phosphorylated upon cyclic compression. Our results describe a novel intrinsic repair mechanism, controlled by matrix stiffness and mediated by the free sodium concentration, in which heparan sulfate-bound growth factors are released from cartilage upon injurious load. They identify aggrecan as a depot for sequestered sodium, explaining why osteoarthritic tissue loses its ability to repair. Treatments that restore matrix sodium to allow appropriate release of growth factors upon load are predicted to enable intrinsic cartilage repair in OA. SIGNIFICANCE STATEMENT Osteoarthritis is the most prevalent musculoskeletal disease, affecting 250 million people worldwide.1 We identify a novel intrinsic repair response in cartilage, mediated by aggrecan-dependent sodium flux, and dependent upon matrix stiffness, which results in the release of a cocktail of pro-regenerative growth factors after injury. Loss of aggrecan in late-stage osteoarthritis prevents growth factor release and likely contributes to disease progression. Treatments that restore matrix sodium in osteoarthritis may recover the intrinsic repair response to improve disease outcome.
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Affiliation(s)
- Stuart J Keppie
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, OX3 7FY, UK
| | | | - Xiaodi Tang
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, OX3 7FY, UK
| | - Christopher J Philp
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2QX, UK
| | - Helen K Graham
- School of Biological Sciences, The University of Manchester, Manchester, M13 9PT, UK
| | - Patrik Önnerfjord
- Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Alanna Wall
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, OX3 7FY, UK
| | - Celia McLean
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, OX3 7FY, UK
| | - C Peter Winlove
- School of Physics and Astronomy, University of Exeter, Exeter, EX4 4QL, UK
| | - Michael J Sherratt
- School of Biological Sciences, The University of Manchester, Manchester, M13 9PT, UK
| | - Galina E Pavlovskaya
- Sir Peter Mansfield Imaging Centre, University of Nottingham, Nottingham, NG7 2QX, UK
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Müller-Lutz A, Kamp B, Nagel AM, Ljimani A, Abrar D, Schleich C, Wollschläger L, Nebelung S, Wittsack HJ. Sodium MRI of human articular cartilage of the wrist: a feasibility study on a clinical 3T MRI scanner. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:241-248. [PMID: 32500389 DOI: 10.1007/s10334-020-00856-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To measure sodium relaxation times and concentrations in human wrists on a clinical magnetic resonance imaging (MRI) scanner with a density-adapted radial sequence. MATERIALS AND METHODS Sodium MRI of human wrists was conducted on a 3T MR system using a dual-tuned 1H/23Na surface coil. We performed two studies with 10 volunteers each investigating either sodium T1 (study 1) or sodium T2* (study 2) relaxation times in the radiocarpal joint (RCJ) and midcarpal joint (MCJ). Sodium concentrations of both regions were determined. RESULTS No differences for transversal of longitudinal relaxation times were found between RCJ and MCJ (T2,s*(RCJ) = (0.9 ± 0.4) ms; T2,s*(MCJ) = (0.9 ± 0.3) ms; T2,l*(RCJ) = (14.9 ± 0.9) ms; T2,l*(MCJ) = (13.9 ± 1.1) ms; T1(RCJ) = (19.0 ± 2.4) ms; T1(MCJ) = (18.5 ± 2.1) ms). Sodium concentrations were (157.7 ± 28.4) mmol/l for study 1 and (159.8 ± 29.1) mmol/l for study 2 in the RCJ, and (172.7 ± 35.6) mmol/l for study 1 and (163.4 ± 26.3) mmol/l for study 2 in the MCJ. CONCLUSION We successfully determined sodium relaxation times and concentrations of the human wrist on a 3T MRI scanner.
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Affiliation(s)
- Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Daniel Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Lena Wollschläger
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Juras V, Mlynarik V, Szomolanyi P, Valkovič L, Trattnig S. Magnetic Resonance Imaging of the Musculoskeletal System at 7T: Morphological Imaging and Beyond. Top Magn Reson Imaging 2019; 28:125-135. [PMID: 30951006 PMCID: PMC6565434 DOI: 10.1097/rmr.0000000000000205] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In 2017, a whole-body 7T magnetic resonance imaging (MRI) device was given regulatory approval for clinical use in both the EU and United States for neuro and musculoskeletal applications. As 7 Tesla allows for higher signal-to-noise , which results in higher resolution images than those obtained on lower-field-strength scanners, it has attracted considerable attention from the musculoskeletal field, as evidenced by the increasing number of publications in the last decade. Besides morphological imaging, the quantitative MR methods, such as T2, T2∗, T1ρ mapping, sodium imaging, chemical-exchange saturation transfer, and spectroscopy, substantially benefit from ultrahigh field scanning. In this review, we provide technical considerations for the individual techniques and an overview of (mostly) clinical applications for the assessment of cartilage, tendon, meniscus, and muscle. The first part of the review is dedicated to morphological applications at 7T, and the second part describes the most recent developments in quantitative MRI at 7T.
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Affiliation(s)
- Vladimir Juras
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Vladimir Mlynarik
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Karl Landsteiner Society, St. Pölten, Austria
| | - Pavol Szomolanyi
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Ladislav Valkovič
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Oxford Centre for Clinical Magnetic Resonance Research, BHF Centre of Research Excellence, University of Oxford, Oxford, UK.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Siegfried Trattnig
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
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8
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Thulborn KR. Quantitative sodium MR imaging: A review of its evolving role in medicine. Neuroimage 2018; 168:250-268. [PMID: 27890804 PMCID: PMC5443706 DOI: 10.1016/j.neuroimage.2016.11.056] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/23/2016] [Accepted: 11/22/2016] [Indexed: 12/26/2022] Open
Abstract
Sodium magnetic resonance (MR) imaging in humans has promised metabolic information that can improve medical management in important diseases. This technology has yet to find a role in clinical practice, lagging proton MR imaging by decades. This review covers the literature that demonstrates that this delay is explained by initial challenges of low sensitivity at low magnetic fields and the limited performance of gradients and electronics available in the 1980s. These constraints were removed by the introduction of 3T and now ultrahigh (≥7T) magnetic field scanners with superior gradients and electronics for proton MR imaging. New projection pulse sequence designs have greatly improved sodium acquisition efficiency. The increased field strength has provided the expected increased sensitivity to achieve resolutions acceptable for metabolic interpretation even in small target tissues. Consistency of quantification of the sodium MR image to provide metabolic parametric maps has been demonstrated by several different pulse sequences and calibration procedures. The vital roles of sodium ion in membrane transport and the extracellular matrix will be reviewed to indicate the broad opportunities that now exist for clinical sodium MR imaging. The final challenge is for the technology to be supplied on clinical ≥3T scanners.
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Affiliation(s)
- Keith R Thulborn
- Center for Magnetic Resonance Research, University of Illinois at Chicago, 1801 West Taylor Street, Chicago, IL 60612, United States.
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9
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Platt T, Umathum R, Fiedler TM, Nagel AM, Bitz AK, Maier F, Bachert P, Ladd ME, Wielpütz MO, Kauczor HU, Behl NG. In vivo self-gated 23
Na MRI at 7 T using an oval-shaped body resonator. Magn Reson Med 2018; 80:1005-1019. [DOI: 10.1002/mrm.27103] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/08/2017] [Accepted: 01/02/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Tanja Platt
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Reiner Umathum
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Thomas M. Fiedler
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Armin M. Nagel
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Institute of Radiology; University Hospital Erlangen, Maximiliansplatz 3; 91054 Erlangen Germany
| | - Andreas K. Bitz
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Faculty of Electrical Engineering and Information Technology; University of Applied Sciences Aachen, Eupener Str. 70; 52066 Aachen Germany
| | - Florian Maier
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
| | - Peter Bachert
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Faculty of Physics and Astronomy; University of Heidelberg, Im Neuenheimer Feld 226; 69120 Heidelberg Germany
| | - Mark E. Ladd
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
- Faculty of Physics and Astronomy; University of Heidelberg, Im Neuenheimer Feld 226; 69120 Heidelberg Germany
- Faculty of Medicine; University of Heidelberg, Im Neuenheimer Feld 672; 69120 Heidelberg Germany
| | - Mark O. Wielpütz
- Translational Lung Research Center (TLRC); University of Heidelberg, German Center for Lung Research (DZL), Im Neuenheimer Feld 430; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology; University Hospital of Heidelberg, Im Neuenheimer Feld 110; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine; Thoraxklinik at University of Heidelberg, Röntgenstr. 1; 69126 Heidelberg Germany
| | - Hans-Ulrich Kauczor
- Translational Lung Research Center (TLRC); University of Heidelberg, German Center for Lung Research (DZL), Im Neuenheimer Feld 430; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology; University Hospital of Heidelberg, Im Neuenheimer Feld 110; 69120 Heidelberg Germany
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine; Thoraxklinik at University of Heidelberg, Röntgenstr. 1; 69126 Heidelberg Germany
| | - Nicolas G.R. Behl
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280; 69120 Heidelberg Germany
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10
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Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T. Eur Radiol 2018; 28:2874-2881. [PMID: 29383528 PMCID: PMC5986839 DOI: 10.1007/s00330-017-5277-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/18/2017] [Accepted: 12/21/2017] [Indexed: 12/04/2022]
Abstract
Objectives The purpose was to implement a fast 3D glycosaminoglycan Chemical Exchange Saturation Transfer (gagCEST) sequence at 7 T, test stability and reproducibility in cartilage in the knee in healthy volunteers, and evaluate clinical applicability in cartilage repair patients. Methods Experiments were carried out on a 7-T scanner using a volume transmit coil and a 32-channel receiver wrap-around knee coil. The 3D gagCEST measurement had an acquisition time of 7 min. Signal stability and reproducibility of the GAG effect were assessed in eight healthy volunteers. Clinical applicability of the method was demonstrated in five patients before cartilage repair surgery. Results Coefficient of variation of the gagCEST signal was 1.9%. The reproducibility of the GAG effect measurements was good in the medial condyle (ICC = 0.87) and excellent in the lateral condyle (ICC = 0.97). GAG effect measurements in healthy cartilage ranged from 2.6%-12.4% compared with 1.3%-5.1% in damaged cartilage. Difference in GAG measurement between healthy cartilage and damaged cartilage was significant (p < 0.05). Conclusions A fast 3D gagCEST sequence was applied at 7 T for use in cartilage in the knee, acquired within a clinically feasible scan time of 7 min. We demonstrated that the method has high stability, reproducibility and clinical applicability. Key Points • gagCEST measurements are stable and reproducible • A non-invasive GAG measurement with gagCEST can be acquired in 7 min • gagCEST is able to discriminate between healthy and damaged cartilage Electronic supplementary material The online version of this article (10.1007/s00330-017-5277-y) contains supplementary material, which is available to authorized users.
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Madelin G, Xia D, Brown R, Babb J, Chang G, Krasnokutsky S, Regatte RR. Longitudinal study of sodium MRI of articular cartilage in patients with knee osteoarthritis: initial experience with 16-month follow-up. Eur Radiol 2017; 28:133-142. [PMID: 28687914 DOI: 10.1007/s00330-017-4956-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate the potential of sodium MRI to detect changes over time of apparent sodium concentration (ASC) in articular cartilage in patients with knee osteoarthritis (OA). METHODS The cartilage of 12 patients with knee OA were scanned twice over a period of approximately 16 months with two sodium MRI sequences at 7 T: without fluid suppression (radial 3D) and with fluid suppression by adiabatic inversion recovery (IR). Changes between baseline and follow-up of mean and standard deviation of ASC (in mM), and their rate of change (in mM/day), were measured in the patellar, femorotibial medial and lateral cartilage regions for each subject. A matched-pair Wilcoxon signed rank test was used to assess significance of the changes. RESULTS Changes in mean and in standard deviation of ASC, and in their respective rate of change over time, were only statistically different when data was acquired with the fluid-suppressed sequence. A significant decrease (p = 0.001) of approximately 70 mM in mean ASC was measured between the two IR scans. CONCLUSION Quantitative sodium MRI with fluid suppression by adiabatic IR at 7 T has the potential to detect a decrease of ASC over time in articular cartilage of patients with knee osteoarthritis. KEY POINTS • Sodium MRI can detect apparent sodium concentration (ASC) in cartilage • Longitudinal study: sodium MRI can detect changes in ASC over time • Potential for follow-up studies of cartilage degradation in knee osteoarthritis.
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Affiliation(s)
- Guillaume Madelin
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA.
| | - Ding Xia
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - Ryan Brown
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - James Babb
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - Gregory Chang
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - Svetlana Krasnokutsky
- Department of Medicine, Rheumatology Division, New York University School of Medicine, 305 Second Avenue, New York, NY, 10003, USA
| | - Ravinder R Regatte
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
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Eagle S, Potter HG, Koff MF. Morphologic and quantitative magnetic resonance imaging of knee articular cartilage for the assessment of post-traumatic osteoarthritis. J Orthop Res 2017; 35:412-423. [PMID: 27325163 DOI: 10.1002/jor.23345] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Orthopedic trauma, such as anterior cruciate ligament (ACL) disruption, is a common source of osteoarthritis in the knee. Magnetic resonance imaging (MRI) is a non-invasive multi-planar imaging modality commonly used to evaluate hard and soft tissues of diarthrodial joints following traumatic injury. The contrast provided by generated images enables the evaluation of bone marrow lesions as well as delamination and degeneration of articular cartilage. We will provide background information about MRI signal generation and decay (T1 and T2 values), the utility of morphologic MRI, and the quantitative MRI techniques of T1ρ , T2 , and T2 * mapping, to evaluate subjects with traumatic knee injuries, such as ACL rupture. Additionally, we will provide information regarding the dGEMRIC, sodium, and gagCEST imaging techniques. Finally, the description and utility of newer post hoc analysis techniques, such as texture analysis, will be given. Continued development and refinement of these advanced MRI techniques will facilitate their clinical translation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:412-423, 2017.
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Affiliation(s)
- Sonja Eagle
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Hollis G Potter
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Matthew F Koff
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
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Bar-Or D, Rael LT, Brody EN. Use of Saline as a Placebo in Intra-articular Injections in Osteoarthritis: Potential Contributions to Nociceptive Pain Relief. Open Rheumatol J 2017; 11:16-22. [PMID: 28400868 PMCID: PMC5366377 DOI: 10.2174/1874312901711010016] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/06/2017] [Accepted: 01/08/2017] [Indexed: 11/23/2022] Open
Abstract
Background: Osteoarthritis of the knee (OAK) is a severe debilitating condition characterized by joint pain, stiffness, and resultant limited mobility. In recent years, intra-articular (IA) injections have been used to relieve symptoms and have succeeded to varying degrees either with sodium hyaluronate preparations or with a biologic. Objective: The objective of this review is to evaluate multiple studies that demonstrate some relief from the symptoms of OAK in the saline arm of various clinical trials. Method: A thorough literature search (PubMed) was performed assessing the pain efficacy of various compounds compared to saline injections in clinical trials. A total of 73 studies were identified in the literature search including a total of 5,816 patients. These clinical trials all involved the IA injection of a viscosupplement (hyaluronate, platelet rich plasma (PRP), etc.) or a biologic (the low molecular weight fraction (< 5kDa) of human serum albumin (LMWF-5A)). For all of these studies, the control arm was injection of sterile physiological saline that approximates the salt concentration and total solute concentration of blood and most tissues. Results: Based on our review of the current literature, the tested compounds performed with mixed results when compared to saline injections. Moreover, OAK is a variable disease, with severity measured on the Kellgren and Lawrence (KL) scale where various hyaluronate preparations have a therapeutic effect mostly on KL 2-3 patients while a biologic works best on KL 3-4 patients. Conclusion: Since the effect of saline injection is always greater than no treatment, the evaluations of these treatments can be confounded in clinical trials. Therefore, the question of whether there are known therapeutic effects of saline injections might explain these results.
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Affiliation(s)
- David Bar-Or
- Swedish Medical Center, Trauma Research, Englewood, CO 80133, USA; St. Anthony Hospital, Lakewood, CO 80228, USA; The Medical Center of Plano, Plano, TX 75075, USA; Penrose Hospital, Colorado Springs, CO 80907, USA; Ampio Pharmaceuticals Inc., Englewood, CO 80112, USA
| | - Leonard T Rael
- Swedish Medical Center, Trauma Research, Englewood, CO 80133, USA; St. Anthony Hospital, Lakewood, CO 80228, USA; The Medical Center of Plano, Plano, TX 75075, USA; Penrose Hospital, Colorado Springs, CO 80907, USA; Ampio Pharmaceuticals Inc., Englewood, CO 80112, USA
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Spatial variation of fixed charge density in knee joint cartilage from sodium MRI – Implication on knee joint mechanics under static loading. J Biomech 2016; 49:3387-3396. [DOI: 10.1016/j.jbiomech.2016.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 09/03/2016] [Accepted: 09/07/2016] [Indexed: 11/22/2022]
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Optimized cartilage visualization using 7-T sodium ((23)Na) imaging after patella dislocation. Knee Surg Sports Traumatol Arthrosc 2016; 24:1601-9. [PMID: 25429766 DOI: 10.1007/s00167-014-3455-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 11/18/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Retropatellar cartilage lesions often occur in the course of recurrent patella dislocation. Aim of this study was to develop a more detailed method for examining cartilage tissue, in order to reduce patient discomfort and time of care. METHODS For detailed diagnosing, a 7-T MRI of the knee joint and patella was performed in nine patients, with mean age of 26.4 years, after patella dislocation to measure the cartilage content in three different regions of interest of the patella. Axial sodium ((23)Na) images were derived from an optimized 3D GRE sequence on a 7-T MR scanner. Morphological cartilage grading was performed, and sodium signal-to-noise ratio (SNR) values were calculated. Mean global sodium values and SNR were compared between patients and volunteers. RESULTS Two out of nine patients showed a maximum cartilage defect of International Cartilage Repair Society (ICRS) grade 3, three of grade 2, three of grade 1, and one patient showed no cartilage defect. The mean SNR in sodium images for cartilage was 13.4 ± 2.5 in patients and 14.6 ± 3.7 in volunteers (n.s.). A significant negative correlation between age and global sodium SNR for cartilage was found in the medial facet (R = -0.512; R (2) = 0.26; p = 0.030). Mixed-model ANOVA yielded a marked decrease of the sodium SNR, with increasing grade of cartilage lesions (p < 0.001). CONCLUSIONS Utilization of the (23)Na MR imaging will make earlier detection of alterations to the patella cartilage after dislocation possible and will help prevent subsequent disease due to start adequate therapy earlier in the rehabilitation process. LEVEL OF EVIDENCE II.
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Zbýň Š, Mlynárik V, Juras V, Szomolanyi P, Trattnig S. Evaluation of cartilage repair and osteoarthritis with sodium MRI. NMR IN BIOMEDICINE 2016; 29:206-15. [PMID: 25810325 DOI: 10.1002/nbm.3280] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/20/2015] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
The growing need for early diagnosis and higher specificity than that which can be achieved with morphological MRI is a driving force in the application of methods capable of probing the biochemical composition of cartilage tissue, such as sodium imaging. Unlike morphological imaging, sodium MRI is sensitive to even small changes in cartilage glycosaminoglycan content, which plays a key role in cartilage homeostasis. Recent advances in high- and ultrahigh-field MR systems, gradient technology, phase-array radiofrequency coils, parallel imaging approaches, MRI acquisition strategies and post-processing developments have resulted in many clinical in vivo sodium MRI studies of cartilage, even at 3 T. Sodium MRI has great promise as a non-invasive tool for cartilage evaluation. However, further hardware and software improvements are necessary to complete the translation of sodium MRI into a clinically feasible method for 3-T systems. This review is divided into three parts: (i) cartilage composition, pathology and treatment; (ii) sodium MRI; and (iii) clinical sodium MRI studies of cartilage with a focus on the evaluation of cartilage repair tissue and osteoarthritis.
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Affiliation(s)
- Štefan Zbýň
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Vladimír Mlynárik
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Vladimir Juras
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Pavol Szomolanyi
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Siegfried Trattnig
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
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Sodium magnetic resonance imaging of ankle joint in cadaver specimens, volunteers, and patients after different cartilage repair techniques at 7 T: initial results. Invest Radiol 2015; 50:246-54. [PMID: 25436618 DOI: 10.1097/rli.0000000000000117] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The goal of cartilage repair techniques such as microfracture (MFX) or matrix-associated autologous chondrocyte transplantation (MACT) is to produce repair tissue (RT) with sufficient glycosaminoglycan (GAG) content. Sodium magnetic resonance imaging (MRI) offers a direct and noninvasive evaluation of the GAG content in native cartilage and RT. In the femoral cartilage, this method was able to distinguish between RTs produced by MFX and MACT having different GAG contents. However, it needs to be clarified whether sodium MRI can be useful for evaluating RT in thin ankle cartilage. Thus, the aims of this 7-T study were (1) to validate our sodium MRI protocol in cadaver ankle samples, (2) to evaluate the sodium corrected signal intensities (cSI) in cartilage of volunteers, (3) and to compare sodium values in RT between patients after MFX and MACT treatment. MATERIALS AND METHODS Five human cadaver ankle samples as well as ankles of 9 asymptomatic volunteers, 6 MFX patients and 6 MACT patients were measured in this 7-T study. Sodium values from the ankle samples were compared with histochemically evaluated GAG content. In the volunteers, sodium cSI values were calculated in the cartilages of ankle and subtalar joint. In the patients, sodium cSI in RT and reference cartilage were measured, morphological appearance of RT was evaluated using the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system, and clinical outcome before and after surgery was assessed using the American Orthopaedic Foot and Ankle Society score and Modified Cincinnati Knee Scale. All regions of interest were defined on morphological images and subsequently transferred to the corresponding sodium images. Analysis of variance, t tests, and Pearson correlation coefficients were evaluated. RESULTS In the patients, significantly lower sodium cSI values were found in RT than in reference cartilage for the MFX (P = 0.007) and MACT patients (P = 0.008). Sodium cSI and MOCART scores in RT did not differ between the MFX and MACT patients (P = 0.185). No significant difference in sodium cSI was found between reference cartilage of the volunteers and the patients (P = 0.355). The patients showed significantly higher American Orthopaedic Foot and Ankle Society and Modified Cincinnati scores after treatment than they did before treatment. In the volunteers, sodium cSI was significantly higher in the tibial cartilage than in the talar cartilage of ankle joint (P = 0.002) and in the talar cartilage than in the calcaneal cartilage of subtalar joint (P < 0.001). Data from the cadaver ankle samples showed a strong linear relationship between the sodium values and the histochemically determined GAG content (r = 0.800; P < 0.001; R = 0.639). CONCLUSIONS This study demonstrates the feasibility of in vivo quantification of sodium cSI, which can be used for GAG content evaluation in thin cartilages of ankle and subtalar joints at 7 T. A strong correlation observed between the histochemically evaluated GAG content and the sodium values proved the sufficient sensitivity of sodium MRI to changes in the GAG content of cartilages in the ankle. Both MFX and MACT produced RT with lower sodium cSI and, thus, of lower quality compared with reference cartilage in the patients or in the volunteers. Our results suggest that MFX and MACT produce RT with similar GAG content and similar morphological appearance in patients with similar surgery outcome. Sodium MRI at 7 T allows a quantitative evaluation of RT quality in the ankle and may thus be useful in the noninvasive assessment of new cartilage repair procedures.
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Schrauth JHX, Lykowsky G, Hemberger K, Kreutner J, Weber D, Rackwitz L, Nöth U, Jakob PM, Haddad D. Comparison of multiple quantitative MRI parameters for characterization of the goat cartilage in an ongoing osteoarthritis: dGEMRIC, T1ρ and sodium. Z Med Phys 2015; 26:270-82. [PMID: 26725167 DOI: 10.1016/j.zemedi.2015.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 11/18/2015] [Accepted: 11/25/2015] [Indexed: 12/19/2022]
Abstract
RATIONALE AND OBJECTIVES Osteoarthritis (OA) is a degenerative joint disease leading to cartilage deterioration by loss of matrix, fibrillation, formation of fissures, and ultimately complete loss of the cartilage surface. Here, three magnetic resonance imaging (MRI) techniques, dGEMRIC (delayed Gadolinium enhanced MRI of cartilage; dG1=T1,post; dG2=1/T1,post-1/T1,pre), T1ρ,and sodium MRI, are compared in a preclinical in vivo study to evaluate the differences in their potential for cartilage characterization and to establish an examination protocol for a following clinical study. MATERIALS AND METHODS OA was induced in 12 caprine knees (6 control, 6 therapy). Adipose derived stem cells were injected afterwards as a treatment. The animals were examined healthy, 3 and 16 weeks postoperatively with all three MRI methods. Using statistical analysis, the OA development and the degree of correlation between the different MRI methods were determined. RESULTS A strong correlation was observed between the dGEMRIC indices dG1 and dG2 (r=-0.87) which differ only in considering or not considering the T1 baseline. Moderate correlations were found between T1ρ and dG1 (r=0.55), T1ρ and dG2 (r=0.47) and at last, sodium and dG1 (r=0.45). The correlations found in this study match to the biomarkers which the methods are sensitive to. CONCLUSION Even though the goat cartilage is significantly thinner than the human cartilage and even more in a degenerated cartilage, all three methods were able to characterize the cartilage over the whole period of time during an ongoing OA. Due to measurement and post processing optimizations, as well as the correlations detected in this work, the overall measurement time in future goat studies can be minimized. Moreover, an examination protocol for characterizing the cartilage in a clinical study was established.
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Affiliation(s)
- Joachim H X Schrauth
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany; Department of Experimental Physics 5 (Biophysics), University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany.
| | - Gunthard Lykowsky
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany; Department of Experimental Physics 5 (Biophysics), University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany.
| | - Kathrin Hemberger
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany; Department of Experimental Physics 5 (Biophysics), University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany.
| | - Jakob Kreutner
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany; Department of Experimental Physics 5 (Biophysics), University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany.
| | - Daniel Weber
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany.
| | - Lars Rackwitz
- König-Ludwig-Haus, Orthopedic Center for Musculoskeletal Research, Brettreichstraße 11, 97074 Wuerzburg, Germany.
| | - Ulrich Nöth
- König-Ludwig-Haus, Orthopedic Center for Musculoskeletal Research, Brettreichstraße 11, 97074 Wuerzburg, Germany.
| | - Peter M Jakob
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany; Department of Experimental Physics 5 (Biophysics), University of Wuerzburg, Am Hubland, 97074 Wuerzburg, Germany.
| | - Daniel Haddad
- MRB Research Center for Magnetic Resonance Bavaria, Am Hubland, 97074 Wuerzburg, Germany.
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Kijowski R, Chaudhary R. Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am 2014; 22:649-69. [PMID: 25442027 DOI: 10.1016/j.mric.2014.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Osteoarthritis is characterized by a decrease in the proteoglycan content and disruption of the highly organized collagen fiber network of articular cartilage. Various quantitative magnetic resonance imaging techniques have been developed for noninvasive assessment of the proteoglycan and collagen components of cartilage. These techniques have been extensively used in clinical practice to detect early cartilage degeneration and in osteoarthritis research studies to monitor disease-related and treatment-related changes in cartilage over time. This article reviews the role of quantitative magnetic resonance imaging in evaluating the composition and ultrastructure of the articular cartilage of the knee joint.
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Affiliation(s)
- Richard Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA.
| | - Rajeev Chaudhary
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA
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Non-invasive and in vivo assessment of osteoarthritic articular cartilage: a review on MRI investigations. Rheumatol Int 2014; 35:1-16. [PMID: 24879325 DOI: 10.1007/s00296-014-3052-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 05/16/2014] [Indexed: 10/25/2022]
Abstract
Early detection of knee osteoarthritis (OA) is of great interest to orthopaedic surgeons, rheumatologists, radiologists, and researchers because it would allow physicians to provide patients with treatments and advice to slow the onset or progression of the disease. Early detection can be achieved by identifying early changes in selected features of degenerative articular cartilage (AC) using non-invasive imaging modalities. Magnetic resonance imaging (MRI) is becoming the standard for assessment of OA. The aim of this paper was to review the influence of MRI on the selection, detection, and measurement of AC features associated with early OA. Our review of the literature indicates that the changes associated with early OA are in cartilage thickness, cartilage volume, cartilage water content, and proteoglycan content that can be accurately, consistently, and non-invasively measured using MRI. Choosing an MR pulse sequence that provides the capability to assess cartilage physiology and morphology in a single acquisition and advanced multi-nuclei MRI is desirable. The results of the review indicate that using an ultra-high magnetic strength, MR imager does not affect early OA detection. In conclusion, MRI is currently the most suitable modality for early detection of knee OA, and future research should focus on the quantitative evaluation of early OA features using advances in MR hardware, software, and data processing with sophisticated image/pattern recognition techniques.
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Zbýň Š, Mlynárik V, Juras V, Szomolanyi P, Trattnig S. Sodium MR Imaging of Articular Cartilage Pathologies. CURRENT RADIOLOGY REPORTS 2014; 2:41. [PMID: 24683524 PMCID: PMC3963441 DOI: 10.1007/s40134-014-0041-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Many studies have proved that noninvasive sodium MR imaging can directly determine the cartilage GAG content, which plays a central role in cartilage homeostasis. New technical developments in the recent decade have helped to transfer this method from in vitro to pre-clinical in vivo studies. Sodium imaging has already been applied for the evaluation of cartilage and repair tissue in patients after various cartilage repair surgery techniques and in patients with osteoarthritis. These studies showed that this technique could be helpful not only for assessment of the cartilage status, but also predictive for osteoarthritis. However, due to the low detectable sodium MR signal in cartilage, sodium imaging is still challenging, and further hardware and software improvements are necessary for translating sodium MR imaging into clinical practice, preferably to 3T MR systems.
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Affiliation(s)
- Štefan Zbýň
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Vladimír Mlynárik
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Vladimir Juras
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Pavol Szomolanyi
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Feldman RE, Stobbe R, Watts A, Beaulieu C. Sodium imaging of the human knee using soft inversion recovery fluid attenuation. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2013; 234:197-206. [PMID: 23896067 DOI: 10.1016/j.jmr.2013.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/27/2013] [Accepted: 06/30/2013] [Indexed: 06/02/2023]
Abstract
Sodium signal strength in MRI is low when compared with (1)H. Thus, image voxel volumes must be relatively large in order to produce a sufficient signal-to-noise ratio (SNR). The measurement of sodium in cartilage is hindered by conflation with signal from the adjacent fluid spaces. Inversion recovery can be used to null signal from fluid, but reduces SNR. The purpose of this work was to optimize inversion recovery sodium MRI to enhance cartilage SNR while nulling fluid. Sodium relaxation was first measured for knee cartilage (T1=21±1 ms, T(2 fast)(∗)=0.8±0.2 ms, T(2 slow)(∗)=19.7±0.5 ms) and fluid (T1=48±3 ms, T2(∗)=47±4 ms) in nine healthy subjects at 4.7 T. The rapid relaxation of cartilage in relation to fluid permits the use of a lengthened inversion pulse to preferentially invert the fluid components. Simulations of inversion pulse length were performed to yield a cartilage SNR enhancing combination of parameters that nulled fluid. The simulations were validated in a phantom and then in vivo. B0 inhomogeneity was measured and the effect of off-resonance during the soft inversion pulse was assessed with simulation. Soft inversion recovery yielded twice the SNR and much improved sodium images of cartilage in human knee with little confounding signal from fluid.
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Danisch M, Kalayciyan R, Wetterling F, Schad LR. [Bilateral 23Na MR imaging of the breast and quantification of sodium concentration]. Z Med Phys 2013; 24:65-72. [PMID: 23969091 DOI: 10.1016/j.zemedi.2013.07.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 07/03/2013] [Accepted: 07/04/2013] [Indexed: 10/26/2022]
Abstract
A novel setup for (23)Na MRI, which allows bilateral imaging of the breast, is presented. For this purpose a figure-eight receive-only (23)Na surface coil was developed. For our experiments on three samples with NaCl solutions of different sodium concentrations and two female subjects we used an asymmetric birdcage coil in transmit mode and the developed surface coil for receiving the signal at 3T. Imaging of the samples showed the applicability of the employed normalization method for measuring the distribution of sodium concentration. In a sample of concentration [Na(+)]=51mM we achieved SNR=70 at a nominal isotropic resolution of 2,5mm (TR=66ms, TE=0,6ms, TA=20min). Furthermore we showed that by means of this setup it is possible to quantify the sodium concentration in breast tissue (TSC) of a female subject with an accuracy of 23% (TR=150ms, TE=0,5ms, TA=45min).
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Affiliation(s)
- Meike Danisch
- Computerunterstützte Klinische Medizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany.
| | - Raffi Kalayciyan
- Computerunterstützte Klinische Medizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
| | | | - Lothar R Schad
- Computerunterstützte Klinische Medizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany
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Newbould RD, Miller SR, Upadhyay N, Rao AW, Swann P, Gold GE, Strachan RK, Matthews PM, Taylor PC, Brown AP. T1-weighted sodium MRI of the articulator cartilage in osteoarthritis: a cross sectional and longitudinal study. PLoS One 2013; 8:e73067. [PMID: 23940822 PMCID: PMC3733834 DOI: 10.1371/journal.pone.0073067] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 07/16/2013] [Indexed: 11/23/2022] Open
Abstract
Structural magnetic resonance imaging (MRI) has shown great utility in diagnosing soft tissue burden in osteoarthritis (OA), though MRI measures of cartilage integrity have proven more elusive. Sodium MRI can reflect the proteoglycan content of cartilage; however, it requires specialized hardware, acquisition sequences, and long imaging times. This study was designed to assess the potential of a clinically feasible sodium MRI acquisition to detect differences in the knee cartilage of subjects with OA versus healthy controls (HC), and to determine whether longitudinal changes in sodium content are observed at 3 and 6 months. 28 subjects with primary knee OA and 19 HC subjects age and gender matched were enrolled in this ethically-approved study. At baseline, 3 and 6 months subjects underwent structural MRI and a 0.4ms echo time 3D T1-weighted sodium scan as well as the knee injury and osteoarthritis outcome score (KOOS) and knee pain by visual analogue score (VAS). A standing radiograph of the knee was taken for Kellgren-Lawrence (K-L) scoring. A blinded reader outlined the cartilage on the structural images which was used to determine median T1-weighted sodium concentrations in each region of interest on the co-registered sodium scans. VAS, K-L, and KOOS all significantly separated the OA and HC groups. OA subjects had higher T1-weighted sodium concentrations, most strongly observed in the lateral tibial, lateral femoral and medial patella ROIs. There were no significant changes in cartilage volume or sodium concentration over 6 months. This study has shown that a clinically-feasible sodium MRI at a moderate 3T field strength and imaging time with fluid attenuation by T1 weighting significantly separated HCs from OA subjects.
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Affiliation(s)
- Rexford D Newbould
- Imanova Centre for Imaging Sciences, Hammersmith Hospital, Imperial College London, London, United Kingdom.
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25
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Wang N, Chopin E, Xia Y. The effects of mechanical loading and gadolinium concentration on the change of T1 and quantification of glycosaminoglycans in articular cartilage by microscopic MRI. Phys Med Biol 2013; 58:4535-47. [PMID: 23760174 DOI: 10.1088/0031-9155/58/13/4535] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Microscopic MRI (µMRI) T1 experiments were carried out to investigate the strain dependence of the T1 change and glycosaminoglycans (GAG) quantification in articular cartilage at a spatial resolution of 17.6 µm. Both native and trypsin-degraded specimens were immersed in various concentrations of gadolinium (Gd) (up to 1 mM) and imaged at different strains (up to 50% strains). Adjacent specimens were treated identically and analyzed biochemically by an inductively coupled plasma optical emission spectrometer. The T1 profile in the native tissue was found to be both strain-dependent and depth-dependent, while there was no obvious depth-dependence in the degraded tissue. For the native tissue, compression reduced the tissue T1 when Gd in the solution was low (less than 0.4 mM) and increased the tissue T1 when Gd in the solution was high. A set of critical points, where the tissue T1 showed no change at a certain Gd concentration between two different loadings, was observed for the first time in the native tissue. It is concluded that the GAG quantification by MRI was accurate as long as the Gd concentration in the solution reached at least 0.2 mM (tissue not loaded) or 0.4 mM (tissue loaded).
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Affiliation(s)
- Nian Wang
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309, USA
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Kotecha M, Klatt D, Magin RL. Monitoring cartilage tissue engineering using magnetic resonance spectroscopy, imaging, and elastography. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:470-84. [PMID: 23574498 DOI: 10.1089/ten.teb.2012.0755] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A key technical challenge in cartilage tissue engineering is the development of a noninvasive method for monitoring the composition, structure, and function of the tissue at different growth stages. Due to its noninvasive, three-dimensional imaging capabilities and the breadth of available contrast mechanisms, magnetic resonance imaging (MRI) techniques can be expected to play a leading role in assessing engineered cartilage. In this review, we describe the new MR-based tools (spectroscopy, imaging, and elastography) that can provide quantitative biomarkers for cartilage tissue development both in vitro and in vivo. Magnetic resonance spectroscopy can identify the changing molecular structure and alternations in the conformation of major macromolecules (collagen and proteoglycans) using parameters such as chemical shift, relaxation rates, and magnetic spin couplings. MRI provides high-resolution images whose contrast reflects developing tissue microstructure and porosity through changes in local relaxation times and the apparent diffusion coefficient. Magnetic resonance elastography uses low-frequency mechanical vibrations in conjunction with MRI to measure soft tissue mechanical properties (shear modulus and viscosity). When combined, these three techniques provide a noninvasive, multiscale window for characterizing cartilage tissue growth at all stages of tissue development, from the initial cell seeding of scaffolds to the development of the extracellular matrix during construct incubation, and finally, to the postimplantation assessment of tissue integration in animals and patients.
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Affiliation(s)
- Mrignayani Kotecha
- Department of Bioengineering, University of Illinois at Chicago , Chicago, Illinois
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Nieminen MT, Nissi MJ, Mattila L, Kiviranta I. Evaluation of chondral repair using quantitative MRI. J Magn Reson Imaging 2013; 36:1287-99. [PMID: 23165732 DOI: 10.1002/jmri.23644] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 02/17/2012] [Indexed: 01/30/2023] Open
Abstract
Various quantitative magnetic resonance imaging (qMRI) biomarkers, including but not limited to parametric MRI mapping, semiquantitative evaluation, and morphological assessment, have been successfully applied to assess cartilage repair in both animal and human studies. Through the interaction between interstitial water and constituent macromolecules the compositional and structural properties of cartilage can be evaluated. In this review a comprehensive view of a variety of quantitative techniques, particularly those involving parametric mapping, and their relationship to the properties of cartilage repair is presented. Some techniques, such as T2 relaxation time mapping and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), are well established, while the full potential of more recently introduced techniques remain to be demonstrated. A combination of several MRI techniques is necessary for a comprehensive characterization of chondral repair.
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Affiliation(s)
- Miika T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
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Madelin G, Babb J, Xia D, Chang G, Krasnokutsky S, Abramson SB, Jerschow A, Regatte RR. Articular cartilage: evaluation with fluid-suppressed 7.0-T sodium MR imaging in subjects with and subjects without osteoarthritis. Radiology 2013; 268:481-91. [PMID: 23468572 DOI: 10.1148/radiol.13121511] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE To assess the potential use of sodium magnetic resonance (MR) imaging of cartilage, with and without fluid suppression by using an adiabatic pulse, for classifying subjects with versus subjects without osteoarthritis at 7.0 T. MATERIALS AND METHODS The study was approved by the institutional review board and was compliant with HIPAA. The knee cartilage of 19 asymptomatic (control subjects) and 28 symptomatic (osteoarthritis patients) subjects underwent 7.0-T sodium MR imaging with use of two different sequences: one without fluid suppression (radial three-dimensional sequence) and one with fluid suppression (inversion recovery [IR] wideband uniform rate and smooth truncation [WURST]). Fluid suppression was obtained by using IR with an adiabatic inversion pulse (WURST pulse). Mean sodium concentrations and their standard deviations were measured in the patellar, femorotibial medial, and lateral cartilage regions over four consecutive sections for each subject. The minimum, maximum, median, and average means and standard deviations were calculated over all measurements for each subject. The utility of these measures in the detection of osteoarthritis was evaluated by using logistic regression and the area under the receiver operating characteristic curve (AUC). Bonferroni correction was applied to the P values obtained with logistic regression. RESULTS Measurements from IR WURST were found to be significant predicators of all osteoarthritis (Kellgren-Lawrence score of 1-4) and early osteoarthritis (Kellgren-Lawrence score of 1 or 2). The minimum standard deviation provided the highest AUC (0.83) with the highest accuracy (>78%), sensitivity (>82%), and specificity (>74%) for both all osteoarthritis and early osteoarthritis groups. CONCLUSION Quantitative sodium MR imaging at 7.0 T with fluid suppression by using adiabatic IR is a potential biomarker for osteoarthritis.
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Affiliation(s)
- Guillaume Madelin
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, 4th Floor, New York, NY 10016, USA.
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Shapiro L, Harish M, Hargreaves B, Staroswiecki E, Gold G. Advances in musculoskeletal MRI: technical considerations. J Magn Reson Imaging 2013; 36:775-87. [PMID: 22987756 DOI: 10.1002/jmri.23629] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The technology of musculoskeletal magnetic resonance imaging (MRI) is advancing at a dramatic rate. MRI is now done at medium and higher field strengths with more specialized surface coils and with more variable pulse sequences and postprocessing techniques than ever before. These innumerable technical advances are advantageous as they lead to an increased signal-to-noise ratio and increased variety of soft-tissue contrast options. However, at the same time they potentially produce more imaging artifacts when compared with past techniques. Substantial technical advances have considerable clinical challenges in musculoskeletal radiology such as postoperative patient imaging, cartilage mapping, and molecular imaging. In this review we consider technical advances in hardware and software of musculoskeletal MRI along with their clinical applications.
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Affiliation(s)
- Lauren Shapiro
- Department of Radiology, Stanford University, Stanford, California, USA
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30
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Wetterling F, Corteville DM, Kalayciyan R, Rennings A, Konstandin S, Nagel AM, Stark H, Schad LR. Whole body sodium MRI at 3T using an asymmetric birdcage resonator and short echo time sequence: first images of a male volunteer. Phys Med Biol 2012; 57:4555-67. [PMID: 22722731 DOI: 10.1088/0031-9155/57/14/4555] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Sodium magnetic resonance imaging (²³Na MRI) is a non-invasive technique which allows spatial resolution of the tissue sodium concentration (TSC) in the human body. TSC measurements could potentially serve to monitor early treatment success of chemotherapy on patients who suffer from whole body metastases. Yet, the acquisition of whole body sodium (²³Na) images has been hampered so far by the lack of large resonators and the extremely low signal-to-noise ratio (SNR) achieved with existing resonator systems. In this study, a ²³Na resonator was constructed for whole body ²³Na MRI at 3T comprising of a 16-leg, asymmetrical birdcage structure with 34 cm height, 47.5 cm width and 50 cm length. The resonator was driven in quadrature mode and could be used either as a transceiver resonator or, since active decoupling was included, as a transmit-only resonator in conjunction with a receive-only (RO) surface resonator. The relative B₁-field profile was simulated and measured on phantoms, and 3D whole body ²³Na MRI data of a healthy male volunteer were acquired in five segments with a nominal isotropic resolution of (6 × 6 × 6) mm³ and a 10 min acquisition time per scan. The measured SNR values in the ²³Na-MR images varied from 9 ± 2 in calf muscle, 15 ± 2 in brain tissue, 23 ± 2 in the prostate and up to 42 ± 5 in the vertebral discs. Arms, legs, knees and hands could also be resolved with applied resonator and short time-to-echo (TE) (0.5 ms) radial sequence. Up to fivefold SNR improvement was achieved through combining the birdcage with local RO surface coil. In conclusion, ²³Na MRI of the entire human body provides sub-cm spatial resolution, which allows resolution of all major human body parts with a scan time of less than 60 min.
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31
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Advanced MR methods at ultra-high field (7 Tesla) for clinical musculoskeletal applications. Eur Radiol 2012; 22:2338-46. [DOI: 10.1007/s00330-012-2508-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 05/02/2012] [Accepted: 05/04/2012] [Indexed: 12/16/2022]
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Abstract
The technology of musculoskeletal magnetic resonance imaging is advancing at a dramatic rate. Magnetic resonance imaging is now done at medium and higher field strengths with more specialized surface coils and with more variable pulse sequences and postprocessing techniques than ever before. These numerable technical advances are advantageous because they lead to an increased signal-to-noise ratio and increased variety of soft tissue contrast options. However, at the same time, they potentially produce more imaging artifacts when compared with past techniques. Substantial technical advances have considerable clinical challenges in musculoskeletal radiology such as postoperative patient imaging, cartilage mapping, and molecular imaging. In this review, we consider technical advances in hardware and software of musculoskeletal magnetic resonance imaging along with their clinical applications.
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33
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Madelin G, Jerschow A, Regatte RR. Sodium relaxation times in the knee joint in vivo at 7T. NMR IN BIOMEDICINE 2012; 25:530-7. [PMID: 21853493 PMCID: PMC3292672 DOI: 10.1002/nbm.1768] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Revised: 04/18/2011] [Accepted: 04/25/2011] [Indexed: 05/09/2023]
Abstract
The sodium concentration correlates directly with the concentration of proteoglycans (PG) in cartilage, the loss of which is an early signature of osteoarthritis (OA). As a result, quantitative sodium MRI is a promising technique for assessing the degradation of articular cartilage in patients with OA. Sodium relaxation times can also provide information on the degradation of cartilage: it has already been shown on bovine cartilage that T(1) and T2long are longer and T2short shorter when the PG concentration decreases. In this study, sodium T(1), T2*short and T2*long relaxation maps were measured in vivo at 7 T on 8 healthy volunteers and in 4 different regions of the cartilage in the knee joint. The patellar, femoro-tibial medial, lateral, and femoral condyle cartilage have an average T(1)~20 ms, but different T2*short (from 0.5 ms to 1.4 ms) and T2*long (from 11.4 ms to 14.8 ms). Statistically significant differences in T(1), T2*short and T2*long were observed between the different regions in cartilage (p << 10(- 5)). Statistical differences in T(1) were also observed between male and female data (p << 10(- 5)). These relaxation times measurements can further be applied as correction factors for sodium concentration maps in vivo and can also be useful as complementary information to quantitative sodium MRI in the quest for detecting early OA. These measurements were done on low resolution sodium images in order to acquire sufficient quality data for fitting (5 images for T(1) and 9 images for T2*) while keeping the total time of acquisition of the data reasonable for the volunteer's comfort (1 h 15 min).
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Affiliation(s)
- Guillaume Madelin
- Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, NY, USA
- Chemistry Department, New York University, New York, NY, USA
| | - Alexej Jerschow
- Chemistry Department, New York University, New York, NY, USA
- Corresponding authors: R. R. Regatte, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016, USA. ravinder.regatte@nyumc,org, A. Jerschow, Chemistry Department, New York University, New York, NY 10012,
| | - Ravinder R. Regatte
- Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, NY, USA
- Corresponding authors: R. R. Regatte, Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016, USA. ravinder.regatte@nyumc,org, A. Jerschow, Chemistry Department, New York University, New York, NY 10012,
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Wu G, Zhu J. NMR studies of alkali metal ions in organic and biological solids. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2012; 61:1-70. [PMID: 22340207 DOI: 10.1016/j.pnmrs.2011.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Accepted: 05/31/2011] [Indexed: 05/31/2023]
Affiliation(s)
- Gang Wu
- Department of Chemistry, Queen's University, 90 Bader Lane, Kingston, Ontario, Canada.
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Madelin G, Chang G, Otazo R, Jerschow A, Regatte RR. Compressed sensing sodium MRI of cartilage at 7T: preliminary study. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2012; 214:360-5. [PMID: 22204825 PMCID: PMC3278671 DOI: 10.1016/j.jmr.2011.12.005] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 12/01/2011] [Accepted: 12/03/2011] [Indexed: 05/11/2023]
Abstract
Sodium MRI has been shown to be highly specific for glycosaminoglycan (GAG) content in articular cartilage, the loss of which is an early sign of osteoarthritis (OA). Quantitative sodium MRI techniques are therefore under development in order to detect and assess early biochemical degradation of cartilage, but due to low sodium NMR sensitivity and its low concentration, sodium images need long acquisition times (15-25 min) even at high magnetic fields and are typically of low resolution. In this preliminary study, we show that compressed sensing can be applied to reduce the acquisition time by a factor of 2 at 7 T without losing sodium quantification accuracy. Alternatively, the nonlinear reconstruction technique can be used to denoise fully-sampled images. We expect to even further reduce this acquisition time by using parallel imaging techniques combined with SNR-improved 3D sequences at 3T and 7 T.
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Affiliation(s)
- Guillaume Madelin
- Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, NY, USA
- Chemistry Department, New York University, New York, NY, USA
| | - Gregory Chang
- Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, NY, USA
| | - Ricardo Otazo
- Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, NY, USA
| | - Alexej Jerschow
- Chemistry Department, New York University, New York, NY, USA
- Corresponding author: Chemistry Department, New York University, New York, NY 10012.
| | - Ravinder R. Regatte
- Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, NY, USA
- Corresponding author: Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, New York University Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016, USA.
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Reproducibility of sodium MRI measures of articular cartilage of the knee in osteoarthritis. Osteoarthritis Cartilage 2012; 20:29-35. [PMID: 22040861 PMCID: PMC3270258 DOI: 10.1016/j.joca.2011.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/05/2011] [Accepted: 10/11/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the stability and reproducibility of the sodium magnetic resonance imaging (MRI) signal measured in the articular cartilage of the knee in both healthy volunteers and osteoarthritis (OA) patients. DESIGN This was a prospective Research Ethics Committee approved study that acquired sodium and proton MRI data from 15 subjects with OA (three males, age 64 ± 10) and five healthy controls age and sex matched over the group. Each subject underwent standing planar radiographs of their knees for radiological scoring as well as symptomatological assessment questionnaires. In two MRI sessions on the same day, high resolution double-echo steady state (DESS) and 3D short echo time sodium MRI images of the most diseased knee were acquired and co-registered in each session. A blinded reader (LT) manually delineated the articular cartilage into four discrete regions, and two combined regions, on the DESS images. These regions were applied to the sodium images, and a median sodium signal from each reported. Within-subject and between-subject coefficients of variation were estimated and intraclass correlation coefficients for the healthy control group, OA subject group, and all pooled subjects group were calculated. RESULTS Within-subject variability of sodium MRI at 3T was 3.2% overall, and 2.0% in healthy age-matched volunteers compared to a reproducibility of 3.6% on OA subjects. CONCLUSIONS The reproducibility of sodium MRI was similar in both healthy controls and OA subjects. Researchers piloting techniques in healthy controls thus may expect a similar reproducibility in a controlled trial involving subjects with American College of Rheumatology (ACR)-defined OA of the knee.
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Madelin G, Babb JS, Xia D, Chang G, Jerschow A, Regatte RR. Reproducibility and repeatability of quantitative sodium magnetic resonance imaging in vivo in articular cartilage at 3 T and 7 T. Magn Reson Med 2011; 68:841-9. [PMID: 22180051 DOI: 10.1002/mrm.23307] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 11/03/2011] [Indexed: 01/05/2023]
Abstract
Osteoarthritis is a degenerative disease of articular cartilage that may be associated with a loss of glycosaminoglycans. Quantitative sodium magnetic resonance imaging is highly specific to glycosaminoglycan content and could be used to assess the biochemical degradation of cartilage in early osteoarthritis. However, the reproducibility and repeatability of this technique are not well documented. The aim of this study is to test the reproducibility and repeatability of sodium quantification in cartilage in vivo using intraday and interday acquisitions at 3 T and 7 T, with a radial 3D sequence, with and without fluid suppression. Fluid suppression was obtained by adiabatic inversion recovery (IR WURST) and is expected to improve the sensitivity of the method to glycosaminoglycan content. The root mean square of coefficients of variation are all in the range of 7.5-13.6%. No significant intermagnet, intersequence, intraday, and interday differences in the coefficients of variation were observed. Sodium quantification using IR WURST gave values closer to those reported in the literature for healthy cartilage (220-310 mM) than radial 3D. In conclusion, IR WURST was more accurate in context of sodium measurement, with a reproducibility and repeatability comparable to other compositional magnetic resonance imaging techniques of cartilage.
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Affiliation(s)
- Guillaume Madelin
- Quantitative Multinuclear Musculoskeletal Imaging Group (QMMIG), Center for Biomedical Imaging, Radiology Department, New York University Langone Medical Center, New York, New York, United States of America.
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Fenty MC, Dodge GR, Kassey VB, Witschey WRT, Borthakur A, Reddy R. Quantitative cartilage degeneration associated with spontaneous osteoarthritis in a guinea pig model. J Magn Reson Imaging 2011; 35:891-8. [PMID: 22128105 DOI: 10.1002/jmri.22867] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 09/30/2011] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine (i) the feasibility and intra- and inter-scan reproducibility of T(1ρ) MRI in assessing cartilage degeneration in a guinea pig model with naturally occurring joint disease that closely mimics human osteoarthritis (OA), (ii) demonstrate the sensitivity of T(1ρ) MRI in assessing the age dependent cartilage degeneration in OA progression as compared to histopathological changes. MATERIALS AND METHODS Duncan-Hartley guinea pigs were obtained at various ages and maintained under an IACUC approved protocol. The left hind stifle joint was imaged using T(1ρ) MRI on a 9.4 Tesla Varian horizontal 20 cm bore scanner using a custom surface coil. Reproducibility of T(1ρ) MRI was assessed using 4-month-old guinea pigs (N = 3). Three age cohorts; 3 month (N = 8), 5 month (N = 6), and 9 month (N = 5), were used to determine the age-dependent osteoarthritic changes as measured by T(1ρ) MRI. Validation of age-dependent cartilage degeneration was confirmed by histology and Safranin-O staining. RESULTS T(1ρ) values obtained in the cartilage of the stifle joint in guinea pigs were highly reproducible with an inter-scan mean coefficient of variation (CV) of 6.57% and a maximum intra-scan CV of 9.29%. Mean cartilage T(1ρ) values in animals with late stage cartilage degeneration were 56.3-56.9 ms (5-9 month cohorts) were both significantly (P < 0.01) higher than that obtained from 3-month-old cohort (44 ms) demonstrating an age-dependent variation. T(1ρ) was shown to be significantly greater than T(2) . T(1ρ) dispersion was observed in this animal model for the first time showing an increase of 45% between 500 Hz and 1500 Hz spin-locking frequency. Cartilage thickness measurements were calculated from single mid-coronal histology sections from same animals used for T(1ρ) MRI. Thickness calculations showed insignificant differences between 3- and 5-month cohorts and was significantly decreased by 9 months of age (P < 0.01). A moderate correlation (R(2) = 0.45) existed between T(1ρ) values and signal intensity of Safranin-O stain. CONCLUSION The data presented demonstrate that T(1ρ) MRI is highly reproducible in this spontaneous model of OA and may serve as a noninvasive tool to characterize joint cartilage degeneration during OA. Age-dependent changes, verified with histological measurements of proteoglycan loss, correlated with T(1ρ) across different age groups. T(1ρ) has adequate dynamic range and is sensitive to detect and track the progression of cartilage degeneration in the guinea pig model before gross anatomical changes such as cartilage thinning has occurred. This study presents a technological advancement that would permit longitudinal studies of evaluating disease-modifying therapies useful for treating human OA.
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Affiliation(s)
- Matthew C Fenty
- CMROI, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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Orientational dependent sensitivities of T2 and T1ρ towards trypsin degradation and Gd-DTPA2- presence in bovine nasal cartilage. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2011; 25:297-304. [PMID: 22071581 DOI: 10.1007/s10334-011-0288-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 09/26/2011] [Accepted: 09/30/2011] [Indexed: 10/15/2022]
Abstract
OBJECTIVE To study the orientational dependencies of T(2) and T(1ρ) in native and trypsin-degraded bovine nasal cartilage, with and without the presence of 1 mM Gd-DTPA(2-). MATERIALS AND METHODS Sixteen specimens were prepared in two orthogonal fibril directions (parallel and perpendicular), treated using different protocols (native, Gd treated, trypsin-treated, and combination), and imaged using μMRI at 0° and 55° (the magic angle) fibril orientations with respect to the magnetic field B(0). Two-dimensional (2D) T(2) and T(1ρ) images were then calculated quantitatively. RESULTS Without Gd, native perpendicular tissues demonstrated significant T(1ρ) dispersion (including T(2) at the zero spin-lock field) at 0° and less dispersion at 55°, while native parallel specimens exhibited smaller T(1ρ) dispersion at both 0° and 55°. Trypsin degradation caused a minimum 50% increase in T(1ρ). With Gd, trypsin degradation caused significant reduction in T(1ρ) values up to 60%. CONCLUSION The collagen orientation in nasal cartilage can influence T(2) and T(1ρ) MRI of cartilage. Without Gd, T(1ρ) was sensitive to the proteoglycan content and its sensitivity was nearly constant regardless of fibril orientation. In comparison, the T(2) sensitivity to proteoglycan was dependant upon fibril orientation, i.e., more sensitive at 55° than 0°. When Gd ions were present, both T(2) and T(1ρ) became insensitive to the proteoglycan content.
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Abstract
The newer magnetic resonance (MR) imaging methods can give insights into the initiation, progression, and eventual treatment of osteoarthritis. Sodium imaging is specific for changes in proteoglycan (PG) content without the need for an exogenous contrast agent. T1ρ imaging is sensitive to early PG depletion. Delayed gadolinium-enhanced MR imaging has high resolution and sensitivity. T2 mapping is straightforward and is sensitive to changes in collagen and water content. Ultrashort echo time MR imaging examines the osteochondral junction. Magnetization transfer provides improved contrast between cartilage and fluid. Diffusion-weighted imaging may be a valuable tool in postoperative imaging.
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Abstract
Musculoskeletal MRI is advancing rapidly, with innovative technology and significant potential for immediate clinical impact. In particular, cartilage imaging has become a topic of increasing interest as our aging population develops diseases such as osteoarthritis. Advances in MRI hardware and software have led to increased image quality and tissue contrast. Additional developments have allowed the assessment of cartilage macromolecular content, which may be crucial to the early detection of musculoskeletal diseases. This comprehensive article considers current morphological and physiological cartilage imaging techniques, their clinical applications, and their potential to contribute to future improvements in the imaging of cartilage.
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Roemer FW, Crema MD, Trattnig S, Guermazi A. Advances in imaging of osteoarthritis and cartilage. Radiology 2011; 260:332-54. [PMID: 21778451 DOI: 10.1148/radiol.11101359] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis, with major implications for individual and public health care without effective treatment available. The field of joint imaging, and particularly magnetic resonance (MR) imaging, has evolved rapidly owing to technical advances and the application of these to the field of clinical research. Cartilage imaging certainly is at the forefront of these developments. In this review, the different aspects of OA imaging and cartilage assessment, with an emphasis on recent advances, will be presented. The current role of radiography, including advances in the technology for joint space width assessment, will be discussed. The development of various MR imaging techniques capable of facilitating assessment of cartilage morphology and the methods for evaluating the biochemical composition of cartilage will be presented. Advances in quantitative morphologic cartilage assessment and semiquantitative whole-organ assessment will be reviewed. Although MR imaging is the most important modality in imaging of OA and cartilage, others such as ultrasonography play a complementary role that will be discussed briefly.
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Affiliation(s)
- Frank W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, 820 Harrison Ave, FGH Building, 3rd Floor, Boston, MA 02118, USA.
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Watts A, Stobbe RW, Beaulieu C. Signal-to-noise optimization for sodium MRI of the human knee at 4.7 Tesla using steady state. Magn Reson Med 2011; 66:697-705. [PMID: 21437972 DOI: 10.1002/mrm.22838] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 12/17/2010] [Accepted: 12/27/2010] [Indexed: 11/07/2022]
Abstract
Sodium magnetic resonance imaging of knee cartilage is a possible diagnostic method for osteoarthritis, but low signal-to-noise ratio yields low spatial resolution images and long scan times. For a given scan time, a steady-state approach with reduced repetition time and increased averaging may improve signal-to-noise ratio and hence attainable resolution. However, repetition time reduction results in increased power deposition, which must be offset with increased radiofrequency pulse length and/or reduced flip angle to maintain an acceptable specific absorption rate. Simulations varying flip angle, repetition time, and radiofrequency pulse length were performed for constant power deposition corresponding to ∼6 W/kg over the human knee at 4.7 T. For 10% agar, simulation closely matched experiment. For healthy human knee cartilage, a 37% increase in signal-to-noise ratio was predicted for steady-state over "fully relaxed" parameters while a 29% ± 4% increase was determined experimentally (n=10). Partial volume of cartilage with synovial fluid, inaccurate relaxation parameters used in simulation, and/or quadrupolar splitting may be responsible for this disagreement. Excellent quality sodium images of the human knee were produced in 9 mins at 4.7 T using the signal-to-noise ratio enhancing steady-state technique.
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Affiliation(s)
- Alexander Watts
- Department of Biomedical Engineering, University of Alberta, Edmonton, Canada
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Madelin G, Jerschow A, Regatte RR. Sodium MRI with fluid suppression: will it improve early detection of osteoarthritis? ACTA ACUST UNITED AC 2011. [DOI: 10.2217/iim.10.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Keenan KE, Besier TF, Pauly JM, Han E, Rosenberg J, Smith RL, Delp SL, Beaupre GS, Gold GE. Prediction of glycosaminoglycan content in human cartilage by age, T1ρ and T2 MRI. Osteoarthritis Cartilage 2011; 19:171-9. [PMID: 21112409 PMCID: PMC3041640 DOI: 10.1016/j.joca.2010.11.009] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 10/17/2010] [Accepted: 11/19/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A relationship between T1ρ relaxation time and glycosaminoglycan (GAG) content has been demonstrated in chemically degraded bovine cartilage, but has not been demonstrated with quantitative biochemistry in human cartilage. A relationship has also been established between T2 relaxation time in cartilage and osteoarthritis (OA) severity. We hypothesized that T1ρ relaxation time would be associated with GAG content in human cartilage with normal T2 relaxation times. METHODS T2 relaxation time, T1ρ relaxation time, and glycosaminoglycan as a percentage of wet weight (sGAG) were measured for top and bottom regions at 7 anatomical locations in 21 human cadaver patellae. For our analysis, T2 relaxation time was classified as normal or elevated based on a threshold defined by the mean plus one standard deviation of the T2 relaxation time for all samples. RESULTS In the normal T2 relaxation time subset, T1ρ relaxation time correlated with sGAG content in the full-thickness and bottom regions, but only marginally in the top region alone. sGAG content decreased significantly with age in all regions. CONCLUSION In the subset of cartilage specimens with normal T2 relaxation time, T1ρ relaxation time was inversely associated with sGAG content, as hypothesized. A predictive model, which accounts for T2 relaxation time and the effects of age, might be able to determine longitudinal trends in GAG content in the same person based on T1ρ relaxation time maps.
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Affiliation(s)
- Kathryn E Keenan
- Department of Mechanical Engineering, Stanford University, Stanford, California
| | - Thor F Besier
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - John M Pauly
- Magnetic Resonance Systems Research Laboratory, Department of Electrical Engineering, Stanford University, Stanford, California
| | - Eric Han
- Global Applied Science Laboratory, Menlo Park, California
| | | | - R. Lane Smith
- Department of Orthopaedic Surgery, Stanford University, Stanford, California,Department of Veterans Affairs, Rehabilitation R&D Center, Palo Alto, California
| | - Scott L Delp
- Department of Mechanical Engineering, Stanford University, Stanford, California,Department of Bioengineering, Stanford University, Stanford, California
| | - Gary S Beaupre
- Department of Veterans Affairs, Rehabilitation R&D Center, Palo Alto, California
| | - Garry E Gold
- Department of Orthopaedic Surgery, Stanford University, Stanford, California,Department of Radiology, Stanford University, Stanford, California,Department of Bioengineering, Stanford University, Stanford, California
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Keinan-Adamsky K, Shinar H, Shabat S, Brin YS, Nyska M, Navon G. 23Na and 2H magnetic resonance studies of osteoarthritic and osteoporotic articular cartilage. Magn Reson Med 2011; 64:653-61. [PMID: 20806373 DOI: 10.1002/mrm.22479] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
In this study, the short component of the (23)Na T(2) (T(2f)) and the (23)Na and (2)H quadrupolar interactions (nu(Q)) were measured in bone-cartilage samples of osteoarthritic (OA) and osteoporotic (OP) patients. (23)Na nu(Q) was found to increase in osteoarthritic articular cartilage relative to controls. Similar results were found in bovine cartilage following proteoglycan (PG) depletion, a condition that prevails in osteoarthritis. (23)Na nu(Q) and 1/T(2f) for articular cartilage obtained from osteoporotic patients were significantly larger than for control and osteoarthritic cartilage. Decalcification of both human and bovine articular cartilage resulted in an increase of (23)Na nu(Q) and 1/T(2f), showing the same trend as the osteoporotic samples. Differences in the ratio of the intensity of the large (2)H splitting to that of the small one in the calcified zone were also observed. In osteoporosis, this ratio was twice as large as that obtained for both control and osteoarthritic samples. The (2)H and (23)Na results can be interpreted as due to sodium ions and water molecules filling the void created by the calcium depletion and to calcium ions being located in close association with the collagen fibers. To the best of our knowledge, this is the first study reporting differences of NMR parameters in cartilage of osteoporotic patients.
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Madelin G, Lee JS, Inati S, Jerschow A, Regatte RR. Sodium inversion recovery MRI of the knee joint in vivo at 7T. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2010; 207:42-52. [PMID: 20813569 PMCID: PMC2989635 DOI: 10.1016/j.jmr.2010.08.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 08/06/2010] [Accepted: 08/06/2010] [Indexed: 05/11/2023]
Abstract
The loss of proteoglycans (PG) in the articular cartilage is an early signature of osteoarthritis (OA). The ensuing changes in the fixed charge density in the cartilage can be directly linked to sodium concentration via charge balance. Sodium ions in the knee joint appear in two pools: in the synovial fluids or joint effusion where the ions are in free motion and bound within the cartilage tissue where the Na(+) ions have a restricted motion. The ions in these two compartments have therefore different T₁ and T₂ relaxation times. The purpose of this study is to demonstrate the feasibility of a fluid-suppressed 3D ultrashort TE radial sodium sequence by implementing an inversion recovery (IR) preparation of the magnetization at 7T. This method could allow a more accurate and more sensitive quantification of loss of PG in patients with OA. It is shown that adiabatic pulses offer significantly improved performance in terms of robustness to B₁ and B₀ inhomogeneities when compared to the hard pulse sequence. Power deposition considerations further pose a limit to the RF inversion power, and we demonstrate in simulations and experiments how a practical compromise can be struck between clean suppression of fluid signals and power deposition levels. Two IR sequences with different types of inversion pulses (a rectangular pulse and an adiabatic pulse) were tested on a liquid phantom, ex vivo on a human knee cadaver and then in vivo on five healthy volunteers, with a (Nyquist) resolution of ∼3.6 mm and a signal-to-noise ratio of ∼30 in cartilage without IR and ∼20 with IR. Due to specific absorption rate limitations, the total acquisition time was ∼17 min for the 3D radial sequence without inversion or with the rectangular IR, and 24:30 min for the adiabatic IR sequence. It is shown that the adiabatic IR sequence generates a more uniform fluid suppression over the whole sample than the rectangular IR sequence.
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Affiliation(s)
- Guillaume Madelin
- Center for Biomedical Imaging, New York University Medical Center, New York, NY, USA
- Chemistry Department, New York University, New York, NY, USA
| | - Jae-Seung Lee
- Center for Biomedical Imaging, New York University Medical Center, New York, NY, USA
- Chemistry Department, New York University, New York, NY, USA
| | | | - Alexej Jerschow
- Chemistry Department, New York University, New York, NY, USA
- Corresponding authors: R. R. Regatte, Center for Biomedical Imaging, New York University Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016, USA, Fax: +1 212 263 7541, A. Jerschow, Chemistry Department, New York University, New York, NY 10012. (Alexej Jerschow), (Ravinder R. Regatte)
| | - Ravinder R. Regatte
- Center for Biomedical Imaging, New York University Medical Center, New York, NY, USA
- Corresponding authors: R. R. Regatte, Center for Biomedical Imaging, New York University Medical Center, 660 First Avenue, 4th Floor, New York, NY 10016, USA, Fax: +1 212 263 7541, A. Jerschow, Chemistry Department, New York University, New York, NY 10012. (Alexej Jerschow), (Ravinder R. Regatte)
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Moser E, Meyerspeer M, Fischmeister FPS, Grabner G, Bauer H, Trattnig S. Windows on the human body--in vivo high-field magnetic resonance research and applications in medicine and psychology. SENSORS (BASEL, SWITZERLAND) 2010; 10:5724-57. [PMID: 22219684 PMCID: PMC3247729 DOI: 10.3390/s100605724] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 04/02/2010] [Accepted: 05/17/2010] [Indexed: 12/30/2022]
Abstract
Analogous to the evolution of biological sensor-systems, the progress in "medical sensor-systems", i.e., diagnostic procedures, is paradigmatically described. Outstanding highlights of this progress are magnetic resonance imaging (MRI) and spectroscopy (MRS), which enable non-invasive, in vivo acquisition of morphological, functional, and metabolic information from the human body with unsurpassed quality. Recent achievements in high and ultra-high field MR (at 3 and 7 Tesla) are described, and representative research applications in Medicine and Psychology in Austria are discussed. Finally, an overview of current and prospective research in multi-modal imaging, potential clinical applications, as well as current limitations and challenges is given.
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Affiliation(s)
- Ewald Moser
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
- Department of Diagnostic Radiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Martin Meyerspeer
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Florian Ph. S. Fischmeister
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
- Brain Research Lab, Department of Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria; E-Mail:
| | - Günther Grabner
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Department of Diagnostic Radiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
| | - Herbert Bauer
- Brain Research Lab, Department of Clinical, Biological and Differential Psychology, Faculty of Psychology, University of Vienna, Liebiggasse 5, A-1010 Vienna, Austria; E-Mail:
| | - Siegfried Trattnig
- MR Center of Excellence, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria; E-Mails: (M.M.); (F.Ph.S.F.); (G.G.); (S.T.)
- Department of Diagnostic Radiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
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Zheng S, Xia Y. The impact of the relaxivity definition on the quantitative measurement of glycosaminoglycans in cartilage by the MRI dGEMRIC method. Magn Reson Med 2010; 63:25-32. [PMID: 19918900 DOI: 10.1002/mrm.22169] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The relaxivities (R-values) of the gadolinium diethylene triamine pentaacetic acid (Gd(DTPA)2-) ions in a series of skim-milk solutions at 0-40% milk concentrations were measured using NMR spectroscopy. The R-value was found to be approximately linearly proportional to the concentration of the solid component in the milk solution. Using the R-value at 20% solid component (approximately the solid concentration in bovine nasal cartilage), the glycosaminoglycan concentration in bovine nasal cartilage can be quantified using the MRI delayed gadolinium-enhanced MRI of cartilage method without the customary scaling factor of 2. This finding is also supported by the measurements using 23Na NMR spectroscopy, 23Na inductively coupled plasma analysis, and biochemical assay. The choice of the R-value definition in the MRI delayed gadolinium-enhanced MRI of cartilage method is discussed, and the definition of Gd(DTPA)2- ions as "millimole per volume of tissue (or milk solution for substitution)" should be used.
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Affiliation(s)
- Shaokuan Zheng
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan 48309, USA
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Abstract
STUDY DESIGN This study demonstrated the diagnostic potential of sodium (Na) magnetic resonance imaging (MRI) for noninvasive quantification of proteoglycan (PG) in the intervertebral discs. OBJECTIVE To determine the existence of a linear correlation between intervertebral disc [Na] measured from sodium MRI and [PG] measurement from DMMB assay. SUMMARY OF BACKGROUND DATA Previous studies have shown the possibility of quantifying Na in vivo using sodium MRI, however, none has shown a direct linear correlation between Na measured from sodium MRI and in the invertebral discs. METHODS Three-dimensional sodium MRI images of bovine discs were acquired and converted into [Na] maps. Samples were systematically removed from the discs for DMMB assay. The removal locations were photographically recorded and applied to the [Na] maps to extract the [Na] measurements for comparison. In vivo sodium MRI scans were also carried out on a pair of symptomatic and asymptomatic subjects. RESULTS The linear regression fit of [Na] versus [PG] data yielded a significant linear correlation coefficient of 0.71. The in vivo sodium MRI image of the symptomatic subject showed significant [Na] decrease when compared to that of the asymptomatic subject. CONCLUSION Specificity of sodium MRI for PG in the intervertebral discs makes it a promising diagnostic tool for the earlier phase of disc degeneration.
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