A comparison of multi-echo spin-echo and triple-echo steady-state T2 mapping for in vivo evaluation of articular cartilage

Multi-parametric MRI for radiotherapy simulation

Magnetic resonance imaging (MRI) has become an important imaging modality in the field of radiotherapy (RT) in the past decade, especially with the development of various novel MRI and image-guidance techniques. In this review article, we will describe recent developments and discuss the applications of multi-parametric MRI (mpMRI) in RT simulation. In this review, mpMRI refers to a general and loose definition which includes various multi-contrast MRI techniques. Specifically, we will focus on the implementation, challenges, and future directions of mpMRI techniques for RT simulation.

Possibility for Visualizing the Muscle Microstructure by q-Space Imaging Technique

In the human body, skeletal muscle microstructures have been evaluated only by biopsy. Noninvasive examination of the microstructure of muscles would be useful for research and clinical practice in sports and musculoskeletal areas. The study is aimed at determining if q-space imaging (QSI) can reveal the microstructure of muscles in humans. Forty-three Japanese subjects (controls, distance runners, powerlifting athletes, and teenage runners) were included in this cross-sectional study. Magnetic resonance imaging of the lower leg was performed. On each leg muscle, full width at half maximum (FWHM) which indicated the muscle cell diameters and pennation angle (PA) were measured and compared. FWHM showed significant positive correlations with PA, which is related to muscle strength. In addition, FWHM was higher for powerlifting, control, distance running, and teenager, in that order, suggesting that it may be directing the diameter of each muscle cell. Type 1 and type 2 fibers are enlarged by growth, so the fact that the FWHM of the control group was larger than that of the teenagers in this study may indicate that the muscle fibers were enlarged by growth. Also, FWHM has the possibility to increase with increased muscle fibers caused by training. We showed that QSI had the possibility to depict noninvasively the microstructure like muscle fiber type and subtle changes caused by growth and sports characteristics, which previously could only be assessed by biopsy.

Reproducibility of an Automated Quantitative MRI Assessment of Low-Grade Knee Articular Cartilage Lesions

OBJECTIVE

The goal of this study was to assess the reproducibility of an automated knee cartilage segmentation of 21 cartilage regions with a model-based algorithm and to compare the results with manual segmentation.

DESIGN

Thirteen patients with low-grade femoral cartilage defects were included in the study and were scanned twice on a 7-T magnetic resonance imaging (MRI) scanner 8 days apart. A 3-dimensional double-echo steady-state (3D-DESS) sequence was used to acquire MR images for automated cartilage segmentation, and T2-mapping was performed using a 3D triple-echo steady-state (3D-TESS) sequence. Cartilage volume, thickness, and T2 and texture features were automatically extracted from each knee for each of the 21 subregions. DESS was used for manual cartilage segmentation and compared with automated segmentation using the Dice coefficient. The reproducibility of each variable was expressed using standard error of measurement (SEM) and smallest detectable change (SDC).

RESULTS

The Dice coefficient for the similarity between manual and automated segmentation ranged from 0.83 to 0.88 in different cartilage regions. Test-retest analysis of automated cartilage segmentation and automated quantitative parameter extraction revealed excellent reproducibility for volume measurement (mean SDC for all subregions of 85.6 mm³), for thickness detection (SDC = 0.16 mm) and also for T2 values (SDC = 2.38 ms) and most gray-level co-occurrence matrix features (SDC = 0.1 a.u.).

CONCLUSIONS

The proposed technique of automated knee cartilage evaluation based on the segmentation of 3D MR images and correlation with T2 mapping provides highly reproducible results and significantly reduces the segmentation effort required for the analysis of knee articular cartilage in longitudinal studies.

Superficial fibromatosis: MRI radiomics and T2 mapping correlate with treatment response

BACKGROUND

Superficial fibromatosis exhibits variable MR signal intensity due to collagenous and fibroproliferative components. Quantifying this signal heterogeneity using image texture analysis and T2-mapping could have prognostic and therapeutic implications.

METHODS

This IRB-approved retrospective study included 13 patients with superficial fibromatosis, managed by observation, electron beam radiotherapy (EBT), or pentoxifylline/vitamin E. Two-dimensional regions of interest (ROIs) were drawn on proton-density or T2-weighted MRI for radiomics feature analysis, and corresponding T2-maps. Comparisons were made between baseline and follow-up T2 relaxation times and radiomics features: Shannon's entropy, kurtosis, skewness, mean of positive pixels (MPP), and uniformity of distribution of positive gray-level pixel values (UPP).

RESULTS

There were 19 nodules in 13 subjects. Mean patient age was 60 years; 62% (8/13) were female; mean follow-up was 9.7 months. Nodule diameter at baseline averaged 18.2 mm (std dev 16.2 mm) and decreased almost 10% to 16.6 mm (p = 0.1, paired t-test). Normalized T2 signal intensity decreased 23% from 0.71 to 0.55 (p = 0.03, paired t-test). T2 relaxation time decreased 16% from 46.5 to 39.1 ms (p < 0.001, paired t-test). Among radiomics features, skewness increased to 0.71 from 0.41 (p = 0.03, paired t-test), and entropy decreased from 8.37 to 8.03 (p = 0.05, paired t-test); differences in other radiomics features were not significant.

CONCLUSIONS

Radiomics analysis and T2-mapping of superficial fibromatosis is feasible; robust decreases in absolute T2 relaxation time, and changes in image textural features (increased skewness and decreased entropy) offer novel imaging biomarkers of nodule collagenization and maturation.

Quantitative assessment of acquisition imaging parameters on MRI radiomics features: a prospective anthropomorphic phantom study using a 3D-T2W-TSE sequence for MR-guided-radiotherapy

Background

MRI pulse sequences and imaging parameters substantially influence the variation of MRI radiomics features, thus impose a critical challenge on MRI radiomics reproducibility and reliability. This study aims to prospectively investigate the impact of various imaging parameters on MRI radiomics features in a 3D T2-weighted (T2W) turbo-spin-echo (TSE) pulse sequence for MR-guided-radiotherapy (MRgRT).

Methods

An anthropomorphic phantom was scanned using a 3D-T2W-TSE MRgRT sequence at 1.5T under a variety of acquisition imaging parameter changes. T1 and T2 relaxation times of the phantom were also measured. 93 first-order and texture radiomics features in the original and 14 transformed images, yielding 1,395 features in total, were extracted from 10 volumes-of-interest (VOIs). The percentage deviation (d%) of radiomics feature values from the baseline values and intra-class correlation coefficient (ICC) with the baseline were calculated. Robust radiomics features were identified based on the excellent agreement of radiomics feature values with the baseline, i.e., the averaged d% <5% and ICC >0.90 in all VOIs for all imaging parameter variations.

Results

The radiomics feature values changed considerably but to different degrees with different imaging parameter adjustments, in the ten VOIs. The deviation d% ranged from 0.02% to 321.3%, with a mean of 12.5% averaged for all original features in all ten VOIs. First-order and GLCM features were generally more robust to imaging parameters than other features in the original images. There were also significantly different radiomics feature values (ANOVA, P<0.001) between the original and the transformed images, exhibiting quite different robustness to imaging parameters. 330 out of 1395 features (23.7%) robust to imaging parameters were identified. GLCM and GLSZM features had the most (42.5%, 153/360) and least (3.8%, 9/240) robust features in the original and transformed images, respectively.

Conclusions

This study helps better understand the quantitative dependence of radiomics feature values on imaging parameters in a 3D-T2W-TSE sequence for MRgRT. Imaging parameter heterogeneity should be considered as a significant source of radiomics variability and uncertainty, which must be well harmonized for reliable clinical use. The identified robust features to imaging parameters are helpful for the pre-selection of radiomics features for reliable radiomics modeling.

Musculoskeletal MRI at 7 T: do we need more or is it more than enough?

Ultra-high field magnetic resonance imaging (UHF-MRI) provides important diagnostic improvements in musculoskeletal imaging. The higher signal-to-noise ratio leads to higher spatial and temporal resolution which results in improved anatomic detail and higher diagnostic confidence. Several methods, such as T2, T2*, T1rho mapping, delayed gadolinium-enhanced, diffusion, chemical exchange saturation transfer, and magnetisation transfer techniques, permit a better tissue characterisation. Furthermore, UHF-MRI enables in vivo measurements by low-γ nuclei (²³Na, ³¹P, ¹³C, and ³⁹K) and the evaluation of different tissue metabolic pathways. European Union and Food and Drug Administration approvals for clinical imaging at UHF have been the first step towards a more routinely use of this technology, but some drawbacks are still present limiting its widespread clinical application. This review aims to provide a clinically oriented overview about the application of UHF-MRI in the different anatomical districts and tissues of musculoskeletal system and its pros and cons. Further studies are needed to consolidate the added value of the use of UHF-MRI in the routine clinical practice and promising efforts in technology development are already in progress.

Accelerated T2 Mapping of the Lumbar Intervertebral Disc: Highly Undersampled K-Space Data for Robust T2 Relaxation Time Measurement in Clinically Feasible Acquisition Times

T2 mapping of the intervertebral disc (IVD) can depict quantitative changes reflecting biochemical change due to loss of glycosaminoglycan content. Conventional T2 mapping is usually performed using a 2-dimensional multi-echo-spin echo sequence (2D-MESE) with long acquisition times that are generally not compatible with clinical routine. This study investigates the applicability of GRAPPATINI, a T2 mapping sequence combining undersampling, model-based reconstruction, and parallel imaging, to offer clinically feasible acquisition times in T2 mapping of the lumbar IVD.

MATERIALS AND METHODS

Fifty-eight individuals (26 female; mean age, 23.3 ± 8.1 years) were prospectively studied at 3 T. GRAPPATINI was conducted with the same parameters as the 2D-MESE while shortening the acquisition time from 13:18 to 2:27 minutes. The setup was also validated in a phantom experiment using a 6.48-hour-long single echo-spin echo sequence as reference. The IVDs were manually segmented on 4 central slices.

RESULTS

The median nucleus pulposus showed a strong Pearson correlation coefficient between T2GRAPPATINI and T2MESE (rp = 0.919; P < 0.001). There was also a significant correlation for the ventral (rp = 0.241; P < 0.001) and posterior (rp = 0.418; P < 0.001) annular regions.In the single spin-echo phantom experiment, the most accurate T2 estimation was achieved using T2GRAPPATINI with a median absolute deviation of 15.3 milliseconds as compared with T2MESE with 26.5 milliseconds.

CONCLUSIONS

GRAPPATINI facilitates precise T2 mapping at 3 T in accordance with clinical standards and reference methods using the same parameters while shortening acquisition times from 13:18 to 2:27 minutes with the same parameters.

Phase-based T2 mapping with gradient echo imaging

PURPOSE

Transverse relaxation time (T₂ ) mapping with MRI has a plethora of clinical and research applications. Current T₂ mapping techniques are based primarily on spin-echo (SE) relaxometry strategies that rely on the signal magnitude, and often suffer from lengthy acquisition times. In this work, we propose a phase-based T₂ mapping technique where T₂ information is encoded into the signal phase of rapid gradient echo (GRE) acquisitions.

THEORY

Bloch equation simulations demonstrate that the phase of GRE acquisitions obtained with a very small inter-repetition RF phase increment has a strong monotonic dependence on T₂ , resulting from coherent transverse magnetization. This T₂ -dependent phase behavior forms the basis of the proposed T₂ mapping technique. To isolate T₂ -dependent phase from background phase, at least 2 data sets with different RF phase increments are acquired. The proposed method can also be combined with chemical shift encoded MRI to separate water and fat signals.

METHODS

The feasibility of the proposed technique was validated in a phantom experiment. In vivo feasibility was demonstrated in the brain, knee, abdomen, and pelvis. Comparisons were made with SE-based T₂ mapping, spectroscopy, and T₂ values from the literature.

RESULTS

The proposed method produced accurate T₂ maps compared with SE-based T₂ mapping in the phantom. Good qualitative agreement was observed in vivo between the proposed method and the reference. T₂ measured in various anatomies agreed well with values reported in the literature.

CONCLUSION

A phase-based T₂ mapping technique was developed and its feasibility demonstrated in phantoms and in vivo.

Magnetic Resonance Imaging of the Musculoskeletal System at 7T: Morphological Imaging and Beyond

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∗, T_1ρ 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.

An efficient 3D stack-of-stars turbo spin echo pulse sequence for simultaneous T2-weighted imaging and T2 mapping

PURPOSE

To design a pulse sequence for efficient 3D T2-weighted imaging and T2 mapping.

METHODS

A stack-of-stars turbo spin echo pulse sequence with variable refocusing flip angles and a flexible pseudorandom view ordering is proposed for simultaneous T2-weighted imaging and T2 mapping. An analytical framework is introduced for the selection of refocusing flip angles to maximize relative tissue contrast while minimizing T2 estimation errors and maintaining low specific absorption rate. Images at different echo times are generated using a subspace constrained iterative reconstruction algorithm. T2 maps are obtained by modeling the signal evolution using the extended phase graph model. The technique is evaluated using phantoms and demonstrated in vivo for brain, knee, and carotid imaging.

RESULTS

Numerical simulations demonstrate an improved point spread function with the proposed pseudorandom view ordering compared to golden angle view ordering. Phantom experiments show that T2 values estimated from the stack-of-stars turbo spin echo pulse sequence with variable refocusing flip angles have good concordance with spin echo reference values. In vivo results show the proposed pulse sequence can generate qualitatively comparable T2-weighted images as conventional Cartesian 3D SPACE in addition to simultaneously generating 3D T2 maps.

CONCLUSION

The proposed stack-of-stars turbo spin echo pulse sequence with pseudorandom view ordering and variable refocusing flip angles allows high resolution isotropic T2 mapping in clinically acceptable scan times. The optimization framework for the selection of refocusing flip angles improves T2 estimation accuracy while generating T2-weighted contrast comparable to conventional Cartesian imaging.

Rapid compositional mapping of knee cartilage with compressed sensing MRI

More than a decade after the introduction of compressed sensing (CS) in MRI, researchers are still working on ways to translate it into different research and clinical applications. The greatest advantage of CS in MRI is the reduced amount of k-space data needed to reconstruct images, which can be exploited to reduce scan time or to improve spatial resolution and volumetric coverage. Efficient data acquisition using CS is extremely important for compositional mapping of the musculoskeletal system in general and knee cartilage mapping techniques in particular. High-resolution quantitative information about tissue biochemical composition could be obtained in just a few minutes using CS MRI. However, in order to make this goal a reality, some issues still need to be addressed. In this article we review the current state of the art of CS methods for rapid compositional mapping of knee cartilage. Specifically, data acquisition strategies, image reconstruction algorithms, and data fitting models are discussed. Different CS studies for T2 and T1ρ mapping of knee cartilage are reviewed, with illustrative results. Future directions, opportunities, and challenges of rapid compositional mapping techniques are also discussed. Level of Evidence: 4 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2018;47:1185-1198.

The comparison of the performance of 3 T and 7 T T2 mapping for untreated low-grade cartilage lesions

OBJECTIVE

To investigate T₂ mapping as a possible marker for low-grade human articular cartilage lesions during a one-year follow-up, possible changes during the follow-up and compare the reliability and sensitivity of these measurements on high-field (3 T) and ultra-high-field (7 T) MRI scanners.

DESIGN

Twenty-one patients with femoral, tibial and patellar cartilage defect in the knee joint participated in the study. The MRI protocol consisted of morphological, as well as three-dimensional triple-echo steady-state (3D-TESS) T₂ mapping sequences with similar parameters at 3T and 7T. Patients were scanned at five time-points up to 12 months. T₂ values were evaluated in the lesion and healthy-appearing regions for superficial and deep cartilage zone. The repeated ANOVA was used to determine differences in T₂ values at various time points.

RESULTS

A significant decrease in T₂ values was observed between baseline and six months in the superficial layer of the lesion in patients at 3 T (decrease from 41.89 ± 9.3 ms to 31.21 ± 7.2 ms, which is a difference of -5.67 ± 2.2 ms (p = 0.031)), and at 12 months in the superficial layer of the lesion in patients at 3 T (decrease from 41.89 ± 9.3 ms to 35.28 ± 4.9 ms, which is a difference of -6.60 ± 4.4 ms (p = 0.044). No significant differences were recorded at 7 T.

CONCLUSION

The change in T₂ values acquired with 3 T 3D-TESS appears to be reflecting subtle changes of cartilage composition in the course of low-grade lesion development. 7 T T₂ mapping does not reflect these changes probably due to completely decayed short T₂ component.

Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis

OBJECTIVE

To assess reliability and discriminative validity of cartilage compositional magnetic resonance imaging (MRI) in knee osteoarthritis (OA).

DESIGN

The study was carried out per PRISMA recommendations. We searched MEDLINE and EMBASE (1974 - present) for eligible studies. We performed qualitative synthesis of reliability data. Where data from at least two discrimination studies were available, we estimated pooled standardized mean difference (SMD) between subjects with and without OA. Discrimination analyses compared controls and subjects with mild OA (Kellgren-Lawrence (KL) grade 1-2), severe OA (KL grade 3-4) and OA not otherwise specified (NOS) where not possible to stratify. We assessed quality of the evidence using Quality Appraisal of Diagnostic Reliability (QAREL) and Quality Assessment of Diagnostic Accuracy (QUADAS-2) tools.

RESULTS

Fifty-eight studies were included in the reliability analysis and 26 studies were included in the discrimination analysis, with data from a total of 2,007 knees. Intra-observer, inter-observer and test-retest reliability of compositional techniques were excellent with most intraclass correlation coefficients >0.8 and coefficients of variation <10%. T1rho and T2 relaxometry were significant discriminators between subjects with mild OA and controls, and between subjects with OA (NOS) and controls (P < 0.001). T1rho showed best discrimination for mild OA (SMD [95% CI] = 0.73 [0.40 to 1.06], P < 0.001) and OA (NOS) (0.60 [0.41 to 0.80], P < 0.001). Quality of evidence was moderate for both parts of the review.

CONCLUSIONS

Cartilage compositional MRI techniques are reliable and, in the case of T1rho and T2 relaxometry, can discriminate between subjects with OA and controls.

Diffusion effect on T2 relaxometry in triple-echo steady state free precession sequence

PURPOSE

The purpose of this study is to evaluate the effect of diffusion on SSFP (Steady-state Free Precession) signals in triple-echo steady state (TESS) sequence and ultimately on the accuracy of T2 relaxometry.

METHODS

The extended phase graph (EPG) algorithm was used to study the effect of diffusion on SSFP signals and T2 relaxometry. The simulation results were verified by a commercial phantom and in vivo studies. Based on the simulation results, a correction scheme was proposed to correct the estimated T2 values.

RESULTS

T2 underestimation in TESS was evident in case of small flip angle and large unbalanced gradient moment on objects with large T2 and D values. The T2 underestimation mainly originated from the diffusion sensitivity of SSFP-echo. It was also observed that SSFP-FID (Free Induction Decay) signals increased with increasing diffusion weighting under some specific conditions. The proposed correction scheme corrected the T2 underestimation, which verified that the underestimation was due to the neglect of diffusion effect. For clinical practice of TESS in tissues with short T2 such as cartilage and muscle, the diffusion effect of TESS is negligible.

CONCLUSION

The effect of diffusion cannot be neglected during TESS T2 quantification as it is the main source of T2 underestimation when small flip angle and large unbalanced gradient moment is used, especially for objects with large T2 and D values.

Exploiting multicompartment effects in triple-echo steady-state T2 mapping for fat fraction quantification

PURPOSE

To investigate and exploit the effect of intravoxel off-resonance compartments in the triple-echo steady-state (TESS) sequence without fat suppression for T₂ mapping and to leverage the results for fat fraction quantification.

METHODS

In multicompartment tissue, where at least one compartment is excited off-resonance, the total signal exhibits periodic modulations as a function of echo time (TE). Simulated multicompartment TESS signals were synthesized at various TEs. Fat emulsion phantoms were prepared and scanned at the same TE combinations using TESS. In vivo knee data were obtained with TESS to validate the simulations. The multicompartment effect was exploited for fat fraction quantification in the stomach by acquiring TESS signals at two TE combinations.

RESULTS

Simulated and measured multicompartment signal intensities were in good agreement. Multicompartment effects caused erroneous T₂ offsets, even at low water-fat ratios. The choice of TE caused T₂ variations of as much as 28% in cartilage. The feasibility of fat fraction quantification to monitor the decrease of fat content in the stomach during digestion is demonstrated.

CONCLUSIONS

Intravoxel off-resonance compartments are a confounding factor for T₂ quantification using TESS, causing errors that are dependent on the TE. At the same time, off-resonance effects may allow for efficient fat fraction mapping using steady-state imaging. Magn Reson Med 79:423-429, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

Morphologic and quantitative magnetic resonance imaging of knee articular cartilage for the assessment of post-traumatic osteoarthritis

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 T_1ρ , 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.

New Technology in Imaging Cartilage of the Ankle

The incidence of osteochondral lesions, as well as osteoarthritis of the ankle joint following osteochondritis dissecans and trauma, has been reappraised in recent years. Consequently, an increasing number of surgical interventions using different cartilage repair techniques is performed in the ankle joint, which has resulted in a growing demand for repetitive and objective assessment of cartilage tissue and its repair. While morphological imaging does enable monitoring of macroscopic changes with increasing precision, it fails to provide information about the ultrastructural composition of cartilage. The significance of molecular changes in cartilage matrix composition, however, is increasingly recognized, as it is assumed that macroscopic cartilage degeneration is preceded by a loss in glycosaminoglycans and a disorganization of the collagen network. Recent advances in biochemical magnetic resonance imaging (MRI) have yielded sequences sensitive to these changes, thus providing invaluable insight into both early cartilage degeneration and maturation of repair tissue, on a molecular level. The aim of this review was to provide a comprehensive overview of these techniques, including water and collagen-sensitive T2/T2* mapping, as well as glycosaminoglycan-sensitive sequences such as delayed gadolinium-enhanced MRI of cartilage dGEMRIC, and sodium imaging, and describe their applications for the ankle joint.

Changes in the T2 value of cartilage after meniscus transplantation over 1 year

OBJECTIVES

To evaluate the changes in the mean T2 values of articular cartilage on serial follow-up images up to 1 year in patients who underwent lateral meniscus allograft transplantation (MAT).

METHODS

Fifty-two patients who underwent lateral MAT surgery at our hospital were evaluated preoperatively and at 2 days, 6 weeks, 3 months, 6 months, and 1 year after MAT using 3.0-T magnetic resonance imaging (MRI) that included T2 mapping. T2 value changes according to the arthroscopic grading of chondromalacia were evaluated in the lateral and medial compartment. Lysholm scores were obtained pre- and postoperatively.

RESULTS

The T2 values of cartilage were significantly increased 2 days after operation, and then gradually reduced to the baseline level after 1 year in both compartments. In morphologic assessment performed after 1 year, most areas (92.9 %) showed no interval change of chondromalacia grade. Lyshom knee scores increased significantly from the mean preoperative value of 62.5 (range, 23-95) to 89.7 (range, 64-100) at 1 year (p < 0.001).

CONCLUSION

Mean T2 values of cartilage following MAT exhibited a return to baseline level after 1 year. T2 measurement can be a useful tool for quantitative evaluation of postoperative cartilage changes compared to conventional MRI.

KEY POINTS

• T2 mapping provides objective data for longitudinal monitoring following surgery. • Increased cartilage T2 values post-MAT returned to baseline in one year. • Further studies are required to predict the chondroprotective effect of MAT.

The influences of different spatial resolutions on the characteristics of T2 relaxation times in articular cartilage: A coarse-graining study of the microscopic magnetic resonance imaging data

Microscopic magnetic resonance imaging (µMRI) T2 data from canine cartilage at different tibial locations were analyzed to investigate the influences of spatial resolution and pixel position on the T2 sensitivity to osteoarthritis (OA). Five experimental factors were investigated: inaccurate pixel position, different pixel resolutions, different specimen orientations in the magnetic field, topographical variations over the tibial surface, and different OA stages. A number of significant trends were identified in this analysis, which shows the subtle but substantial influences to our abilities of detecting OA due to T2 changes. In particular, any deviation in locating the cartilage pixels may result in erratic values near the cartilage surface. Significant differences were found in T2 values between nearly any two comparison-groups under all resolutions both in the meniscus-covered and -uncovered areas, which were also showed interaction between the OA degradation stages. This multiresolution project should help to improve the detection sensitivities of MRI toward cartilage degeneration. Microsc. Res. Tech. 79:754-765, 2016. © 2016 Wiley Periodicals, Inc.

Quantitative assessment of morphology, T1ρ, and T2 of shoulder cartilage using MRI

OBJECTIVES

The aim of this study was to assess the feasibility of quantifying shoulder cartilage morphology and relaxometry in a clinically feasible scan time comparing different pulse sequences and assessing their reproducibility at 3 Tesla.

METHODS

Three pulse sequences were compared for morphological assessments of shoulder cartilage thickness and volume (SPGR, MERGE, FIESTA), while a combined T1ρ-T2 sequence was optimized for relaxometry measurements. The shoulders of six healthy subjects were scanned twice with repositioning, and the cartilage was segmented and quantified. The degree of agreement between the three morphological sequences was assessed using Bland-Altman plots, while the morphological and relaxometry reproducibility were assessed with root-mean-square coefficients of variation (RMS-CVs) RESULTS: Bland-Altman plots indicated good levels of agreement between the morphological assessments of the three sequences. The reproducibility of morphological assessments yielded RMS-CVs between 4.0 and 17.7 %. All sequences correlated highly (R > 0.9) for morphologic assessments with no statistically significant differences. For relaxometry assessments of humeral cartilage, RMS-CVs of 6.4 and 10.6 % were found for T1ρ and T2, respectively.

CONCLUSIONS

The assessment of both cartilage morphology and relaxometry is feasible in the shoulder with SPGR, humeral head, and T1ρ being the more reproducible morphological sequence, anatomic region, and quantitative sequence, respectively.

KEY POINTS

• The thin cartilage morphology can be assessed in the shoulder in vivo. • Non-invasive biochemical assessment of shoulder cartilage is feasible in vivo using MRI.