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Nishimura Y, Ogawa M, Okamura K, Yamasaki T, Inagaki Y, Tanaka Y. Validation of compositional MRI from a histological standpoint: Advantages of three-dimensional T1ρ mapping for quantitative evaluation of articular cartilage. Magn Reson Imaging 2024; 110:210-217. [PMID: 38679298 DOI: 10.1016/j.mri.2024.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 03/02/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE We aimed to investigate the relationship between quantitative evaluation by compositional MRI, including T1ρ, and histological and macroscopic assessments, to verify the validity of compositional MRI, and examine the relationship between compositional MRI evaluation reconstructed in three dimensions (3D) and histological and visual assessments. METHOD Twenty-seven patients with knee osteoarthritis underwent T1ρ and T2 magnetic resonance imaging (MRI). Histological and gross tissue evaluations were performed on the excised bone sections of total knee arthroplasty. Semi-quantitative histological evaluation of tissue changes were assessed by measuring the optical density of digitally captured safranin O-stained and Collagen type II antibody-stained paraffin sections. Macroscopic cartilage severity was determined on a 5-grade scale (G0-G5). T1ρ and T2 values (3D and 2D), and their correlation with each of these parameters were investigated. RESULTS 3D T1 ρ is negatively correlated with histological evaluations and positively correlated with visual assessments. Only 3D T1ρ values correlated with histological quantitative evaluation (Safranin-O staining; r = -0.53, P = 0.014, Collagen type II antibody staining; r = -0.60, P = 0.019). 2D T1ρ and 3D, 2D T2 values did not correlate with histological evaluation results. Macroscopic cartilage severity grade correlated with all T1ρ and T2 values (3D T1ρ; r = 0.61, P < 0.001, 2D T1ρ; r = 0.52, P < 0.001, 3D T2; r = 0.33, P = 0.045, 2D T2; r = 0.41, P = 0.01). CONCLUSIONS 3D T1ρ mapping reflects the changes in the molecular structure of the cartilage matrix that occur in arthropathic changes and may be an effective tool for detecting cartilage degeneration.
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Affiliation(s)
- Yuki Nishimura
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
| | - Munehiro Ogawa
- Department of Sports Medicine, Nara Medical University, Kashihara, Japan.
| | - Kensuke Okamura
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
| | - Tsuyoshi Yamasaki
- Department of Orthopaedic Surgery, Nara Seiwa Medical Center, Sango Town, Ikoma-Gun, Japan
| | - Yusuke Inagaki
- Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
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Co M, Raterman B, Klamer B, Kolipaka A, Walter B. Nucleus pulposus structure and function assessed in shear using magnetic resonance elastography, quantitative MRI, and rheometry. JOR Spine 2024; 7:e1335. [PMID: 38741919 PMCID: PMC11089841 DOI: 10.1002/jsp2.1335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 04/04/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background In vivo quantification of the structure-function relationship of the intervertebral disc (IVD) via quantitative MRI has the potential to aid objective stratification of disease and evaluation of restorative therapies. Magnetic resonance elastography (MRE) is an imaging technique that assesses tissue shear properties and combined with quantitative MRI metrics reflective of composition can inform structure-function of the IVD. The objectives of this study were to (1) compare MRE- and rheometry-derived shear modulus in agarose gels and nucleus pulposus (NP) tissue and (2) correlate MRE and rheological measures of NP tissue with composition and quantitative MRI. Method MRE and MRI assessment (i.e., T1ρ and T2 mapping) of agarose samples (2%, 3%, and 4% (w/v); n = 3-4/%) and of bovine caudal IVDs after equilibrium dialysis in 5% or 25% PEG (n = 13/PEG%) was conducted. Subsequently, agarose and NP tissue underwent torsional mechanical testing consisting of a frequency sweep from 1 to 100 Hz at a rotational strain of 0.05%. NP tissue was additionally evaluated under creep and stress relaxation conditions. Linear mixed-effects models and univariate regression analyses evaluated the effects of testing method, %agarose or %PEG, and frequency, as well as correlations between parameters. Results MRE- and rheometry-derived shear moduli were greater at 100 Hz than at 80 Hz in all agarose and NP tissue samples. Additionally, all samples with lower water content had higher complex shear moduli. There was a significant correlation between MRE- and rheometry-derived modulus values for homogenous agarose samples. T1ρ and T2 relaxation times for agarose and tissue were negatively correlated with complex shear modulus derived from both techniques. For NP tissue, shear modulus was positively correlated with GAG/wet-weight and negatively correlated with %water content. Conclusion This work demonstrates that MRE can assess hydration-induced changes in IVD shear properties and further highlights the structure-function relationship between composition and shear mechanical behaviors of NP tissue.
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Affiliation(s)
- Megan Co
- Department of Biomedical EngineeringThe Ohio State UniversityColumbusOhioUSA
| | - Brian Raterman
- Department of RadiologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Brett Klamer
- Department of Biomedical Informatics, Center for BiostatisticsThe Ohio State UniversityColumbusOhioUSA
| | - Arunark Kolipaka
- Department of RadiologyThe Ohio State University Wexner Medical CenterColumbusOhioUSA
| | - Benjamin Walter
- Department of Biomedical EngineeringThe Ohio State UniversityColumbusOhioUSA
- Department of OrthopaedicsThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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Singh A, Mantebea H, Badar F, Batool S, Abdelmessih G, Sebastian T, Newton M, Baker K, Salem S, Xia Y. Assessment of articular cartilage degradation in response to an impact injury using µMRI. Connect Tissue Res 2024; 65:146-160. [PMID: 38415672 PMCID: PMC10994738 DOI: 10.1080/03008207.2024.2319050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Degradation of articular cartilage (AC) due to injury to the knee joint may initiate post-traumatic osteoarthritis (PTOA). Failure to diagnose the onset of the disease at an early stage makes the cure ineffective for PTOA. This study investigated the consequences of a mechanical injury to the knee in a rabbit model using microscopic magnetic resonance imaging (µMRI) at high resolution. MATERIALS AND METHODS A mechanical injury was induced to the knee joints of 12 rabbits. Cartilage blocks were extracted from the non-impacted and impacted knee joints after 2 and 14 weeks post-impact. The specimens were studied using µMRI T2 relaxation and inductively coupled plasma analysis to determine the early degradation of the articular cartilage. RESULTS The data established a connection between T2 relaxation time and the early progression of knee PTOA after an impact injury. T2 values were found to be higher in the impacted cartilage at both 2 and 14 weeks, in particular, T2-55° values in the impacted samples displayed a significant rise of 6.93% after 2 weeks and 20.02% after 14 weeks. Lower glycosaminoglycan measurement and higher water content in the impacted cartilage confirmed the µMRI results. CONCLUSIONS This µMRI T2 study was able to detect cartilage damage in the impacted knees. In addition, greater degradation in the affected knees at 14 weeks than at 2 weeks indicated the progressive nature of cartilage deterioration over time. The µMRI results were in accord with the biochemical analysis, indicating the detection of early structural damage in the cartilage.
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Affiliation(s)
- Amanveer Singh
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | - Hannah Mantebea
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | - Syeda Batool
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | | | - Talia Sebastian
- Department of Chemistry, Oakland University, Rochester, MI 48309
| | - Michael Newton
- Beaumont Hospital, Royal Oak, MI 48073
- Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI 48109
| | - Kevin Baker
- Beaumont Hospital, Royal Oak, MI 48073
- Henry Ford Hospital, Detroit, MI 48202
| | - Sarah Salem
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI 48309
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Malhi BS, Moazamian D, Shin SH, Athertya JS, Silva L, Jerban S, Jang H, Chang E, Ma Y, Carl M, Du J. Bi-Exponential 3D UTE-T1ρ Relaxation Mapping of Ex Vivo Human Knee Patellar Tendon at 3T. Bioengineering (Basel) 2024; 11:66. [PMID: 38247943 PMCID: PMC10813751 DOI: 10.3390/bioengineering11010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Introduction: The objective of this study was to assess the bi-exponential relaxation times and fractions of the short and long components of the human patellar tendon ex vivo using three-dimensional ultrashort echo time T1ρ (3D UTE-T1ρ) imaging. Materials and Methods: Five cadaveric human knee specimens were scanned using a 3D UTE-T1ρ imaging sequence on a 3T MR scanner. A series of 3D UTE-T1ρ images were acquired and fitted using single-component and bi-component models. Single-component exponential fitting was performed to measure the UTE-T1ρ value of the patellar tendon. Bi-component analysis was performed to measure the short and long UTE-T1ρ values and fractions. Results: The single-component analysis showed a mean single-component UTE-T1ρ value of 8.4 ± 1.7 ms for the five knee patellar tendon samples. Improved fitting was achieved with bi-component analysis, which showed a mean short UTE-T1ρ value of 5.5 ± 0.8 ms with a fraction of 77.6 ± 4.8%, and a mean long UTE-T1ρ value of 27.4 ± 3.8 ms with a fraction of 22.4 ± 4.8%. Conclusion: The 3D UTE-T1ρ sequence can detect the single- and bi-exponential decay in the patellar tendon. Bi-component fitting was superior to single-component fitting.
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Affiliation(s)
- Bhavsimran Singh Malhi
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Dina Moazamian
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Soo Hyun Shin
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Jiyo S. Athertya
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Livia Silva
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Saeed Jerban
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Hyungseok Jang
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Eric Chang
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
- Radiology Service, Veterans Affairs San Diego Healthcare System, La Jolla, San Diego, CA 92161, USA
| | - Yajun Ma
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
| | - Michael Carl
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
- General Electric Health Care, San Diego, CA 92037, USA
| | - Jiang Du
- Department of Radiology, University of California, La Jolla, San Diego, CA 92037, USA; (B.S.M.); (D.M.); (S.H.S.); (J.S.A.); (L.S.); (S.J.); (H.J.); (E.C.); (Y.M.); (M.C.)
- Radiology Service, Veterans Affairs San Diego Healthcare System, La Jolla, San Diego, CA 92161, USA
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Tong MW, Tolpadi AA, Bhattacharjee R, Han M, Majumdar S, Pedoia V. Synthetic Knee MRI T 1p Maps as an Avenue for Clinical Translation of Quantitative Osteoarthritis Biomarkers. Bioengineering (Basel) 2023; 11:17. [PMID: 38247894 PMCID: PMC10812962 DOI: 10.3390/bioengineering11010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
A 2D U-Net was trained to generate synthetic T1p maps from T2 maps for knee MRI to explore the feasibility of domain adaptation for enriching existing datasets and enabling rapid, reliable image reconstruction. The network was developed using 509 healthy contralateral and injured ipsilateral knee images from patients with ACL injuries and reconstruction surgeries acquired across three institutions. Network generalizability was evaluated on 343 knees acquired in a clinical setting and 46 knees from simultaneous bilateral acquisition in a research setting. The deep neural network synthesized high-fidelity reconstructions of T1p maps, preserving textures and local T1p elevation patterns in cartilage with a normalized mean square error of 2.4% and Pearson's correlation coefficient of 0.93. Analysis of reconstructed T1p maps within cartilage compartments revealed minimal bias (-0.10 ms), tight limits of agreement, and quantification error (5.7%) below the threshold for clinically significant change (6.42%) associated with osteoarthritis. In an out-of-distribution external test set, synthetic maps preserved T1p textures, but exhibited increased bias and wider limits of agreement. This study demonstrates the capability of image synthesis to reduce acquisition time, derive meaningful information from existing datasets, and suggest a pathway for standardizing T1p as a quantitative biomarker for osteoarthritis.
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Affiliation(s)
- Michelle W. Tong
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA (S.M.); (V.P.)
- Department of Bioengineering, University of California Berkeley, Berkeley, CA 94720, USA
| | - Aniket A. Tolpadi
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA (S.M.); (V.P.)
- Department of Bioengineering, University of California Berkeley, Berkeley, CA 94720, USA
| | - Rupsa Bhattacharjee
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA (S.M.); (V.P.)
| | - Misung Han
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA (S.M.); (V.P.)
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA (S.M.); (V.P.)
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94143, USA (S.M.); (V.P.)
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Wu Z, Zaylor W, Sommer S, Xie D, Zhong X, Liu K, Kim J, Beveridge JE, Zhang X, Li X. Assessment of ultrashort echo time (UTE) T 2* mapping at 3T for the whole knee: repeatability, the effects of fat suppression, and knee position. Quant Imaging Med Surg 2023; 13:7893-7909. [PMID: 38106304 PMCID: PMC10722028 DOI: 10.21037/qims-23-459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 10/07/2023] [Indexed: 12/19/2023]
Abstract
Background Knee tissues such as tendon, ligament and meniscus have short T2* relaxation times and tend to show little to no signal in conventional magnetic resonance acquisitions. An ultrashort echo time (UTE) technique offers a unique tool to probe fast-decaying signals in these tissues. Clinically relevant factors should be evaluated to quantify the sensitivity needed to distinguish diseased from control tissues. Therefore, the objectives of this study were to (I) quantify the repeatability of UTE-T2* relaxation time values, and (II) evaluate the effects of fat suppression and (III) knee positioning on UTE-T2* relaxation time quantification. Methods A dual-echo, three-dimensional center-out radially sampling UTE and conventional gradient echo sequences were utilized to image gadolinium phantoms, one ex-vivo specimen, and five in-vivo subjects on a clinical 3T scanner. Scan-rescan images from the phantom and in-vivo experiments were used to evaluate the repeatability of T2* relaxation time values. Fat suppressed and non-suppressed images were acquired for phantoms and the ex-vivo specimen to evaluate the effect of fat suppression on T2* relaxation time quantifications. The effect of knee positioning was evaluated by imaging in-vivo subjects in extended and flexed positions within the knee coil and comparing T2* relaxation times quantified from tissues in each position. Results Phantom and in-vivo measurements demonstrated repeatable T2* mapping, where the percent difference between T2* relaxation time quantified from scan-rescan images was less than 8% for the phantom and knee tissues. The coefficient of variation across fat suppressed and non-suppressed images was less than 5% for the phantoms and ex-vivo knee tissues, showing that fat suppression had a minimal effect on T2* relaxation time quantification. Knee position introduced variability to T2* quantification of the anterior cruciate ligament, posterior cruciate ligament, and patellar tendon, with percent differences exceeding 20%, but the meniscus showed a percent difference less than 10%. Conclusions The 3D radial UTE sequence presented in this study could potentially be used to detect clinically relevant changes in mean T2* relaxation time, however, reproducibility of these values is impacted by knee position consistency between scans.
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Affiliation(s)
- Zhenzhou Wu
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - William Zaylor
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Stefan Sommer
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthineers International AG, Zurich and Lausanne, Switzerland
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland
| | - Dongxing Xie
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaodong Zhong
- Siemens Medical Solutions USA, Inc., Los Angeles, CA, USA
| | - Kecheng Liu
- Siemens Medical Solutions USA, Inc., Malvern, PA, USA
| | - Jeehun Kim
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
| | - Jillian E. Beveridge
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
| | - Xiaoliang Zhang
- Department of Biomedical Engineering, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Xiaojuan Li
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, USA
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA
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Nosrat C, Gao KT, Bhattacharjee R, Pedoia V, Koff MF, Gold GE, Potter HG, Majumdar S. Multiparametric MRI of Knees in Collegiate Basketball Players: Associations With Morphological Abnormalities and Functional Deficits. Orthop J Sports Med 2023; 11:23259671231216490. [PMID: 38107843 PMCID: PMC10722938 DOI: 10.1177/23259671231216490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 06/29/2023] [Indexed: 12/19/2023] Open
Abstract
Background Rates of cartilage degeneration in asymptomatic elite basketball players are significantly higher compared with the general population due to excessive loads on the knee. Compositional quantitative magnetic resonance imaging (qMRI) techniques can identify local biochemical changes of macromolecules observed in cartilage degeneration. Purpose/Hypothesis The purpose of this study was to utilize multiparametric qMRI to (1) quantify how T1ρ and T2 relaxation times differ based on the presence of anatomic abnormalities and (2) correlate T1ρ and T2 with self-reported functional deficits. It was hypothesized that prolonged relaxation times will be associated with knees with MRI-graded abnormalities and knees belonging to basketball players with greater self-reported functional deficits. Study Design Cross-sectional study; Level of evidence, 3. Methods A total of 75 knees from National Collegiate Athletic Association Division I basketball players (40 female, 35 male) were included in this multicenter study. All players completed the Knee injury and Osteoarthritis Outcome Score (KOOS) and had bilateral knee MRI scans taken. T1ρ and T2 were calculated on a voxel-by-voxel basis. The cartilage surfaces were segmented into 6 compartments: lateral femoral condyle, lateral tibia, medial femoral condyle, medial tibia (MT), patella (PAT), and trochlea (TRO). Lesions from the MRI scans were graded for imaging abnormalities, and statistical parametric mapping was performed to study cross-sectional differences based on MRI scan grading of anatomic knee abnormalities. Pearson partial correlations between relaxation times and KOOS subscore values were computed, obtaining r value statistical parametric mappings and P value clusters. Results Knees without patellar tendinosis displayed significantly higher T1ρ in the PAT compared with those with patellar tendinosis (average percentage difference, 10.4%; P = .02). Significant prolongation of T1ρ was observed in the MT, TRO, and PAT of knees without compared with those with quadriceps tendinosis (average percentage difference, 12.7%, 13.3%, and 13.4%, respectively; P ≤ .05). A weak correlation was found between the KOOS-Symptoms subscale values and T1ρ/T2. Conclusion Certain tissues that bear the brunt of impact developed tendinosis but spared cartilage degeneration. Whereas participants reported minimal functional deficits, their high-impact activities resulted in structural damage that may lead to osteoarthritis after their collegiate careers.
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Affiliation(s)
- Cameron Nosrat
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Kenneth T. Gao
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Rupsa Bhattacharjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Matthew F. Koff
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Hollis G. Potter
- Department of Radiology and Imaging, Hospital for Special Surgery, New York City, New York, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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Vassileva MT, Kim JS, Valle AGD, Harris MD, Pedoia V, Lattanzi R, Kraus VB, Pascual-Garrido C, Bostrom MP. Arthritis Foundation/HSS Workshop on Hip Osteoarthritis, Part 2: Detecting Hips at Risk: Early Biomechanical and Structural Mechanisms. HSS J 2023; 19:428-433. [PMID: 37937085 PMCID: PMC10626933 DOI: 10.1177/15563316231192097] [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: 05/26/2023] [Accepted: 06/01/2023] [Indexed: 11/09/2023]
Abstract
Far more publications are available for osteoarthritis of the knee than of the hip. Recognizing this research gap, the Arthritis Foundation (AF), in partnership with the Hospital for Special Surgery (HSS), convened an in-person meeting of thought leaders to review the state of the science of and clinical approaches to hip osteoarthritis. This article summarizes the recommendations gleaned from 5 presentations given in the "early hip osteoarthritis" session of the 2023 Hip Osteoarthritis Clinical Studies Conference, which took place on February 17 and 18, 2023, in New York City. It also summarizes the workgroup recommendations from a small-group discussion on clinical research gaps.
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Affiliation(s)
| | | | | | - Michael D Harris
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Riccardo Lattanzi
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
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Radke KL, Grotheer V, Kamp B, Müller-Lutz A, Kertscher J, Strunk R, Martirosian P, Valentin B, Wittsack HJ, Sager M, Windolf J, Antoch G, Schiffner E, Jungbluth P, Frenken M. Comparison of compositional MRI techniques to quantify the regenerative potential of articular cartilage: a preclinical minipig model after osteochondral defect treatments with autologous mesenchymal stromal cells and unseeded scaffolds. Quant Imaging Med Surg 2023; 13:7467-7483. [PMID: 37969627 PMCID: PMC10644139 DOI: 10.21037/qims-23-570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/28/2023] [Indexed: 11/17/2023]
Abstract
Background The field of orthopedics seeks effective, safer methods for evaluating articular cartilage regeneration. Despite various treatment innovations, non-invasive, contrast-free full quantitative assessments of hyaline articular cartilage's regenerative potential using compositional magnetic resonance (MR) sequences remain challenging. In this context, our aim was to investigate the effectiveness of different MR sequences for quantitative assessment of cartilage and to compare them with the current gold standard delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) measurements. Methods We employed ex vivo imaging in a preclinical minipig model to assess knee cartilage regeneration. Standardized osteochondral defects were drilled in the proximal femur of the specimens (n=14), which were divided into four groups. Porcine collagen scaffolds seeded with autologous adipose-derived stromal cells (ASC), autologous bone marrow stromal cells (BMSC), and unseeded scaffolds (US) were implanted in femoral defects. Furthermore, there was a defect group which received no treatment. After 6 months, the specimens were examined using different compositional MR methods, including the gold standard dGEMRIC as well as T1, T2, T2*, and T1ρ techniques. The statistical evaluation involved comparing the defect region with the uninjured tibia and femur cartilage layers and all measurements were performed on a clinical 3T MR Scanner. Results In the untreated defect group, we observed significant differences in the defect region, with dGEMRIC values significantly lower (404.86±64.2 ms, P=0.018) and T2 times significantly higher (44.24±2.75 ms, P<0.001). Contrastingly, in all three treatment groups (ASC, BMSC, US), there were no significant differences among the three regions in the dGEMRIC sequence, suggesting successful cartilage regeneration. However, T1, T2*, and T1ρ sequences failed to detect such differences, highlighting their lower sensitivity for cartilage regeneration. Conclusions As expected, dGEMRIC is well suited for monitoring cartilage regeneration. Interestingly, T2 imaging also proved to be a reliable cartilage imaging technique and thus offers a contrast agent-free alternative to the former gold standard for subsequent in vivo studies investigating the cartilage regeneration potential of different treatment modalities.
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Affiliation(s)
- Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Vera Grotheer
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Justus Kertscher
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Rosanna Strunk
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Petros Martirosian
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Birte Valentin
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Martin Sager
- Central Unit for Animal Research and Animal Welfare Affairs, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Joachim Windolf
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Erik Schiffner
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Pascal Jungbluth
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
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10
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Jerban S, Afsahi AM, Ma Y, Moazamian D, Statum S, Lombardi AF, Kakos L, Dorthe E, Dlima D, Du J, Chung CB, Chang EY. Correlations between elastic modulus and ultrashort echo time (UTE) adiabatic T1ρ relaxation time (UTE-Adiab-T1ρ) in Achilles tendons and entheses. J Biomech 2023; 160:111825. [PMID: 37856976 PMCID: PMC10991081 DOI: 10.1016/j.jbiomech.2023.111825] [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: 04/11/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
Patients with psoriatic arthritis commonly have abnormalities of their entheses, which are the connections between tendons and bone. There are shortcomings with the use of conventional magnetic resonance imaging (MRI) sequences for the evaluation of entheses and tendons, whereas ultrashort echo time (UTE) sequences are superior for the detection of high signals, and can also be used for non-invasive quantitative assessments of these structures. The combination of UTE-MRI with an adiabatic-T1ρ preparation (UTE-Adiab-T1ρ) allows for reliable assessment of entheses and tendons with decreased susceptibility to detrimental magic angle effects. This study aimed to investigate the relationship between quantitative UTE-MRI measures and the biomechanical properties of Achilles tendons and entheses. In total, 28 tendon-enthesis sections were harvested from 11 fresh-frozen human cadaveric foot-ankle specimens (52 ± years old). Tendon-enthesis sections were scanned using the UTE-Adiab-T1ρ and UTE-T1 sequences on a clinical 3 T scanner. MRI-based measures and indentation tests were performed on the enthesis, transitional, and tensile tendon zones of the specimens. Hayes' elastic modulus showed significant inverse correlations (Spearman's) with UTE-Adiab-T1ρ in all zones (R= - 0.46, - 0.54, and - 0.61 in enthesis, transition, and tensile tendon zones, respectively). Oliver-Pharr's elastic modulus showed significant inverse correlations with UTE-Adiab-T1ρ in transition (R= - 0.52) and tensile tendon zone (R=- 0.60). UTE-T1 did not show significant correlations with the elastic modulus. UTE-MRI and elastic modulus were significantly lower in the tensile tendon compared with the enthesis regions This study highlights the potential of the UTE-Adiab-T1ρ technique for the non-invasive evaluation of tendons and enthuses.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA; Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA.
| | - Amir Masoud Afsahi
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Dina Moazamian
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Alecio F Lombardi
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Lena Kakos
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Erik Dorthe
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA
| | - Daryll Dlima
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA.
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11
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Zhang X, de Moura HL, Monga A, Zibetti MVW, Kijowski R, Regatte RR. Repeatability of Quantitative Knee Cartilage T 1 , T 2 , and T 1ρ Mapping With 3D-MRI Fingerprinting. J Magn Reson Imaging 2023:10.1002/jmri.29068. [PMID: 37885320 PMCID: PMC11045656 DOI: 10.1002/jmri.29068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Three-dimensional MR fingerprinting (3D-MRF) techniques have been recently described for simultaneous multiparametric mapping of knee cartilage. However, investigation of repeatability remains limited. PURPOSE To assess the intra-day and inter-day repeatabilities of knee cartilage T1 , T2 , and T1ρ maps using a 3D-MRF sequence for simultaneous measurement. STUDY TYPE Prospective. SUBJECTS Fourteen healthy subjects (35.4 ± 9.3 years, eight males), scanned on Day 1 and Day 7. FIELD STRENGTH/SEQUENCE 3 T/3D-MRF, T1 , T2 , and T1ρ maps. ASSESSMENT The acquisition of 3D-MRF cartilage (simultaneous acquisition of T1 , T2 , and T1ρ maps) were acquired using a dictionary pattern-matching approach. Conventional cartilage T1 , T2 , and T1ρ maps were acquired using variable flip angles and a modified 3D-Turbo-Flash sequence with different echo and spin-lock times, respectively, and were fitted using mono-exponential models. Each sequence was acquired on Day 1 and Day 7 with two scans on each day. STATISTICAL TESTS The mean and SD for cartilage T1 , T2 , and T1ρ were calculated in five manually segmented regions of interest (ROIs), including lateral femur, lateral tibia, medial femur, medial tibia, and patella cartilages. Intra-subject and inter-subject repeatabilities were assessed using coefficient of variation (CV) and intra-class correlation coefficient (ICC), respectively, on the same day and among different days. Regression and Bland-Altman analysis were performed to compare maps between the conventional and 3D-MRF sequences. RESULTS The CV in all ROIs was lower than 7.4%, 8.4%, and 7.5% and the ICC was higher than 0.56, 0.51, and 0.52 for cartilage T1 , T2 , and T1ρ , respectively. The MRF results had a good agreement with the conventional methods with a linear regression slope >0.61 and R2 > 0.59. CONCLUSION The 3D-MRF sequence had high intra-subject and inter-subject repeatabilities for simultaneously measuring knee cartilage T1 , T2 , and T1ρ with good agreement with conventional sequences. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Xiaoxia Zhang
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Hector L. de Moura
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Anmol Monga
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Marcelo V. W. Zibetti
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Richard Kijowski
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Ravinder R. Regatte
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
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12
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O'Sullivan O, Ladlow P, Steiner K, Kuyser D, Ali O, Stocks J, Valdes AM, Bennett AN, Kluzek S. Knee MRI biomarkers associated with structural, functional and symptomatic changes at least a year from ACL injury - A systematic review. OSTEOARTHRITIS AND CARTILAGE OPEN 2023; 5:100385. [PMID: 37547184 PMCID: PMC10400916 DOI: 10.1016/j.ocarto.2023.100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Osteoarthritis (OA) results from various aetiologies, including joint morphology, biomechanics, inflammation, and injury. The latter is implicated in post-traumatic OA, which offers a paradigm to identify potential biomarkers enabling early identification and intervention. This review aims to describe imaging features associated with structural changes or symptoms at least one year following injury. Methodology A systematic review was conducted using PRISMA guidance, prospectively registered on PROSPERO (CRD42022371838). Three independent reviewers screened titles and abstracts, followed by full-texts, performed data extraction, and risk of bias assessments (Newcastle-Ottawa Scale). Inclusion criteria included imaging studies involving human participants aged 18-45 who had sustained a significant knee injury at least a year previously. A narrative synthesis was performed using synthesis without meta-analysis methodology. Results Six electronic databases and conference proceedings were searched, identifying 11 studies involving 776 participants. All studies included participants suffering an anterior cruciate ligament (ACL) injury and utilised MRI. Different, and not directly comparable, techniques were used. MRI features could be broadly divided into structural, including joint position and morphology, and compositional. Promising biomarkers for diagnosing and predicting osteoarthritis include T1rho and T2 relaxation time techniques, bone morphology changes and radiomic modelling. Discussion As early as 12 months after injury, differences in tibia position, bone morphology, presence of effusion and synovitis, and cartilage/subchondral bone composition can be detected, some of which are linked with worse patient-reported or radiological progression. Standardisation, including MR strength, position, sequence, scoring and comparators, is required to utilise clinical and research OA imaging biomarkers fully.
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Affiliation(s)
- Oliver O'Sullivan
- Academic Unit of Injury, Recovery and Inflammation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- Academic Department of Military Rehabilitation (ADMR), Defence Medical Rehabilitation Centre (DMRC), Stanford Hall, Loughborough, UK
| | - Peter Ladlow
- Academic Department of Military Rehabilitation (ADMR), Defence Medical Rehabilitation Centre (DMRC), Stanford Hall, Loughborough, UK
- Department of Health, University of Bath, Bath, UK
| | - Kat Steiner
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | | | | | - Joanne Stocks
- Academic Unit of Injury, Recovery and Inflammation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Ana M. Valdes
- Nottingham NIHR Biomedical Research Centre, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
| | | | - Stefan Kluzek
- Academic Unit of Injury, Recovery and Inflammation Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
- Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, University of Nottingham, Nottingham, UK
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13
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Liao TC, Bird A, Samaan MA, Pedoia V, Majumdar S, Souza RB. Persistent underloading of patellofemoral joint following hamstring autograft ACL reconstruction is associated with cartilage health. Osteoarthritis Cartilage 2023; 31:1265-1273. [PMID: 37116856 DOI: 10.1016/j.joca.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVE To determine the longitudinal changes of patellofemoral joint (PFJ) contact pressure following anterior cruciate ligament reconstruction (ACLR). To identify the associations between PFJ contact pressure and cartilage health. DESIGN Forty-nine subjects with hamstring autograft ACLR (27 males; age 28.8 [standard deviation, 8.3] years) and 19 controls (12 males; 30.7 [4.6] years) participated. A sagittal plane musculoskeletal model was used to estimate PFJ contact pressure. A combined T1ρ/T2 magnetic resonance sequence was obtained. Assessments were performed preoperatively, at 6 months, 1, 2, and 3 years postoperatively in ACLR subjects and once for controls. Repeated Analysis of Variance (ANOVA) was used to compare peak PFJ contact pressure between ACLR and contralateral knees, and t-tests to compare with control knees. Statistical parametric mapping was used to evaluate the associations between PFJ contact pressure and cartilage relaxation concurrently and longitudinally. RESULTS No changes in peak PFJ contact pressure were found within ACLR knees over 3 years (preoperative to 3 years, 0.36 [CI, -0.08, 0.81] MPa), but decreased over time in the contralateral knees (0.75 [0.32, 1.18] MPa). When compared to the controls, ACLR knees exhibited lower PFJ contact pressure at all time points (at baseline, -0.64 [-1.25, -0.03] MPa). Within ACLR knees, lower PFJ contact pressure at 6 months was associated with elevated T2 times (r = -0.47 to -0.49, p = 0.021-0.025). CONCLUSIONS Underloading of the PFJ following ACLR persists for up to 3 years and has concurrent and future consequences in cartilage health. The non-surgical knees exhibited normal contact pressure initially but decreased over time achieving limb symmetry.
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Affiliation(s)
- Tzu-Chieh Liao
- Department of Physical Therapy, University of Michigan-Flint, Flint, MI, USA; Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
| | - Alyssa Bird
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA
| | - Michael A Samaan
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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14
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Lee W, Miller EY, Zhu H, Schneider SE, Reiter DA, Neu CP. Multi-frame biomechanical and relaxometry analysis during in vivo loading of the human knee by spiral dualMRI and compressed sensing. Magn Reson Med 2023; 90:995-1009. [PMID: 37213087 PMCID: PMC10330244 DOI: 10.1002/mrm.29690] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/27/2023] [Accepted: 04/14/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE Knee cartilage experiences repetitive loading during physical activities, which is altered during the pathogenesis of diseases like osteoarthritis. Analyzing the biomechanics during motion provides a clear understanding of the dynamics of cartilage deformation and may establish essential imaging biomarkers of early-stage disease. However, in vivo biomechanical analysis of cartilage during rapid motion is not well established. METHODS We used spiral displacement encoding with stimulated echoes (DENSE) MRI on in vivo human tibiofemoral cartilage during cyclic varus loading (0.5 Hz) and used compressed sensing on the k-space data. The applied compressive load was set for each participant at 0.5 times body weight on the medial condyle. Relaxometry methods were measured on the cartilage before (T1ρ , T2 ) and after (T1ρ ) varus load. RESULTS Displacement and strain maps showed a gradual shift of displacement and strain in time. Compressive strain was observed in the medial condyle cartilage and shear strain was roughly half of the compressive strain. Male participants had more displacement in the loading direction compared to females, and T1ρ values did not change after cyclic varus load. Compressed sensing reduced the scanning time up to 25% to 40% when comparing the displacement maps and substantially lowered the noise levels. CONCLUSION These results demonstrated the ease of which spiral DENSE MRI could be applied to clinical studies because of the shortened imaging time, while quantifying realistic cartilage deformations that occur through daily activities and that could serve as biomarkers of early osteoarthritis.
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Affiliation(s)
- Woowon Lee
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - Emily Y. Miller
- Biomedical Engineering Program, University of Colorado Boulder, Boulder, CO, USA
| | - Hongtian Zhu
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - Stephanie E. Schneider
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
| | - David A. Reiter
- Department of Radiology & Imaging Sciences, Emory University, Atlanta, GA, USA
| | - Corey P. Neu
- Paul M. Rady Department of Mechanical Engineering, University of Colorado Boulder, Boulder, CO, USA
- Biomedical Engineering Program, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
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15
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Armitano-Lago C, Davis-Wilson HC, Evans-Pickett A, Lisee C, Kershner CE, Blackburn T, Franz JR, Kiefer AW, Nissman D, Pietrosimone B. Gait Variability Structure Linked to Worse Cartilage Composition Post-ACL Reconstruction. Med Sci Sports Exerc 2023; 55:1499-1506. [PMID: 36940200 PMCID: PMC10363223 DOI: 10.1249/mss.0000000000003174] [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] [Indexed: 03/21/2023]
Abstract
INTRODUCTION Aberrant gait variability has been observed after anterior cruciate ligament reconstruction (ACLR), yet it remains unknown if gait variability is associated with early changes in cartilage composition linked to osteoarthritis development. Our purpose was to determine the association between femoral articular cartilage T1ρ magnetic resonance imaging relaxation times and gait variability. METHODS T1ρ magnetic resonance imaging and gait kinematics were collected in 22 ACLR participants (13 women; 21 ± 4 yr old; 7.52 ± 1.43 months post-ACLR). Femoral articular cartilage from the ACLR and uninjured limbs were segmented into anterior, central, and posterior regions from the weight-bearing portions of the medial and lateral condyles. Mean T1ρ relaxation times were extracted from each region and interlimb ratios (ILR) were calculated (i.e., ACLR/uninjured limb). Greater T1ρ ILR values were interpreted as less proteoglycan density (worse cartilage composition) in the injured limb compared with the uninjured limb. Knee kinematics were collected at a self-selected comfortable walking speed on a treadmill with an eight-camera three-dimensional motion capture system. Frontal and sagittal plane kinematics were extracted, and sample entropy was used to calculate kinematic variability structure (KV structure ). Pearson's product-moment correlations were conducted to determine the associations between T1ρ and KV structure variables. RESULTS Lesser frontal plane KV structure was associated with greater mean T1ρ ILR in the anterior lateral ( r = - 0.44, P = 0.04) and anterior medial condyles ( r = - 0.47, P = 0 .03). Lesser sagittal plane KV structure was associated with greater mean T1ρ ILR in the anterior lateral condyle ( r = - 0.47, P = 0.03). CONCLUSIONS The association between less KV structure and worse femoral articular cartilage proteoglycan density suggests a link between less variable knee kinematics and deleterious changes joint tissue changes. The findings suggest that less knee kinematic variability structure is a mechanism linking aberrant gait to early osteoarthritis development.
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Affiliation(s)
- Cortney Armitano-Lago
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Hope C. Davis-Wilson
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Alyssa Evans-Pickett
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Caroline Lisee
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Cassidy E. Kershner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Troy Blackburn
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Jason R. Franz
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam W. Kiefer
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Daniel Nissman
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
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16
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Zhang M, Liu C, Lin H, Wang H, Qin L, Zhang Z, Liu C, Lu Y, Yan F, Zhang Y, Wei H. Age-Related Changes in the Spatial Variation of Magnetic Susceptibility of Human Articular Cartilage. J Magn Reson Imaging 2023; 58:198-207. [PMID: 36322382 DOI: 10.1002/jmri.28513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND Quantitative susceptibility mapping (QSM) has shown great potential for revealing the layer structure of articular cartilage based on the laminar susceptibility difference at different depths. However, more information is needed on the effects of age on the spatial distribution of magnetic susceptibility in human cartilage. PURPOSE To assess the ability of QSM to quantify the age-related differences in depth-wise cartilage susceptibility values in healthy populations. STUDY TYPE Prospective. POPULATION A total of 94 healthy asymptomatic subjects in three age cohorts: 19-30 (n = 36, 20 males), 31-50 (n = 45, 27 males), and 51-66 years (n = 13, 7 males). FIELD STRENGTH/SEQUENCE 3D gradient echo sequences at 3.0 T. ASSESSMENT Four cartilage compartments were analyzed, including the central lateral/medial femur (cLF/cMF) and the lateral/medial tibia (LT/MT). The spatial susceptibility profile and the corresponding 95% confidence interval (CI) of each age cohort were obtained as functions of the normalized distance from the bone-cartilage interface to the cartilage surface (cartilage depth from 0.0 to 1.0). STATISTICAL TESTS The relationship between age and cartilage thickness of each cartilage subregion was tested by Pearson correlation with P < 0.05 considered significant. Cartilage depths with separations of 95% CIs were considered to have significant susceptibility differences between two age cohorts with a Bonferroni-corrected P < 0.05. RESULTS The cartilage thickness did not change significantly with age (P value range: 0.06-0.85). Susceptibilities were significantly higher in the 51-66-year-olds compared with the 31-50-year-olds in the deep layer of cMF (cartilage depth: 0.0-0.22) and LT (0.05-0.28). Susceptibilities were significantly higher in the 51-66-year-olds compared with the 19-30-year-olds near the cartilage-bone interface of cMF (0.0-0.34), cLF (0.0-0.28), and LT (0.0-0.58). There were also significantly higher susceptibilities in the 31-50-year-olds compared with the 19-30-year-olds in the deeper regions of cMF (0.26-0.57), cLF (0.0-0.40), and LT (0.07-0.80). DATA CONCLUSION Age-related susceptibility changes in the deeper regions of knee cartilage were observed using QSM. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ming Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chenglei Liu
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huimin Lin
- Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hanqi Wang
- Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Le Qin
- Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiyong Zhang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA
| | - Yong Lu
- Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyao Zhang
- School of Information and Science and Technology, ShanghaiTech University, Shanghai, China
| | - Hongjiang Wei
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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Xie D, Tanaka M, Pedoia V, Li AK, Facchetti L, Neumann J, Lartey R, Souza RB, Link TM, Ma CB, Li X. Baseline cartilage T1ρ and T2 predicted patellofemoral joint cartilage lesion progression and patient-reported outcomes after ACL reconstruction. J Orthop Res 2023; 41:1310-1319. [PMID: 36268873 PMCID: PMC10413330 DOI: 10.1002/jor.25473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/25/2022] [Accepted: 10/18/2022] [Indexed: 02/04/2023]
Abstract
This study aims to determine if baseline T1ρ and T2 will predict cartilage morphological lesion progression in the patellofemoral joint (PFJ) and patient-reported outcomes at 2-year after anterior cruciate ligament (ACL) reconstruction (ACLR). Thirty-nine ACL-injured patients were studied at baseline and two-year after ACLR. 3 T MR T1ρ and T2 images and Knee Injury and Osteoarthritis Outcome Score (KOOS) were acquired at both time points. Voxel-based relaxometry (VBR) technique was used to detect local cartilage abnormalities. Patients were divided into progression and non-progression groups based on changes of the whole-organ magnetic resonance imaging scoring (WORMS) grading of cartilage in PFJ from baseline to 2-year, and into lower (more pain) and higher (less pain) KOOS pain groups based on 2-year KOOS pain scores, separately. Voxel-based analyses of covariance were used to compare T1ρ and T2 values at baseline between the defined groups. Using VBR analysis, the progression group at 2-year showed higher T1ρ and T2 compared with the non-progression group at baseline, with the medial femoral condyle showing the largest areas with significant differences. At two-year, 56% of patients were able to recover with respect to KOOS pain. The lower KOOS pain group at 2-year showed significantly elevated T1ρ and T2 in the patella at baseline compared with the higher KOOS pain group. In conclusion, baseline T1ρ and T2 mapping, combined with VBR analysis, may help identify ACLR patients at high risk of developing progressive PFJ cartilage lesions and worse clinical symptoms 2-year after surgery.
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Affiliation(s)
- Dongxing Xie
- Program of Advanced Musculoskeletal Imaging, Department of
Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland,
Ohio, USA
- Department of Orthopaedics, Xiangya Hospital, Central South
University, Changsha, Hunan, China
| | - Matthew Tanaka
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, San Francisco, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, San Francisco, California, USA
| | - Alan K. Li
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, San Francisco, California, USA
| | - Luca Facchetti
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, San Francisco, California, USA
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, San Francisco, California, USA
| | - Richard Lartey
- Program of Advanced Musculoskeletal Imaging, Department of
Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland,
Ohio, USA
| | - Richard B. Souza
- Department of Physical Therapy and Rehabilitation Science,
University of California, San Francisco, San Francisco, California, USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University
of California, San Francisco, San Francisco, California, USA
| | - C. Benjamin Ma
- Department of Orthopaedic Surgery, University of
California, San Francisco, San Francisco, California, USA
| | - Xiaojuan Li
- Program of Advanced Musculoskeletal Imaging, Department of
Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland,
Ohio, USA
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18
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Axford A, Grist JT. Editorial for "Age-Dependent Changes in Knee Cartilage T 1 , T 2 , and T 1p Simultaneously Measured Using MRI Fingerprinting". J Magn Reson Imaging 2023; 57:1813-1814. [PMID: 36173385 DOI: 10.1002/jmri.28458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Aaron Axford
- Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, UK
| | - James T Grist
- Oxford Centre for Clinical Magnetic Resonance Research, University of Oxford, Oxford, UK
- Department of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, UK
- Department of Radiology, Oxford University Hospitals, Oxford, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- University of Bologna Alama Mata Studorium, Bologna, Italy
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Kijowski R, Sharafi A, Zibetti MV, Chang G, Cloos MA, Regatte RR. Age-Dependent Changes in Knee Cartilage T 1 , T 2 , and T 1p Simultaneously Measured Using MRI Fingerprinting. J Magn Reson Imaging 2023; 57:1805-1812. [PMID: 36190187 PMCID: PMC10067532 DOI: 10.1002/jmri.28451] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Magnetic resonance fingerprinting (MRF) techniques have been recently described for simultaneous multiparameter cartilage mapping of the knee although investigation of their ability to detect early cartilage degeneration remains limited. PURPOSE To investigate age-dependent changes in knee cartilage T1 , T2 , and T1p relaxation times measured using a three-dimensional (3D) MRF sequence in healthy volunteers. STUDY TYPE Prospective. SUBJECTS The study group consisted of 24 healthy asymptomatic human volunteers (15 males with mean age 34.9 ± 14.4 years and 9 females with mean age 44.5 ± 13.1 years). FIELD STRENGTH/SEQUENCE A 3.0 T gradient-echo-based 3D-MRF sequence was used to simultaneously create proton density-weighted images and T1 , T2 , and T1p maps of knee cartilage. ASSESSMENT Mean global cartilage and regional cartilage (lateral femur, lateral tibia, medial femur, medial tibia, and patella) T1 , T2 , and T1ρ relaxation times of the knee were measured. STATISTICAL TESTS Kruskal-Wallis tests were used to compared cartilage T1 , T2 , and T1ρ relaxation times between different age groups, while Spearman correlation coefficients was used to determine the association between age and cartilage T1 , T2 , and T1ρ relaxation times. The value of P < 0.05 was considered statistically significant. RESULTS Higher age groups showed higher global and regional cartilage T1 , T2 , and T1ρ . There was a significant difference between age groups in global cartilage T2 and T1ρ but no significant difference (P = 0.13) in global cartilage T1. Significant difference was also present between age groups in cartilage T2 and T1ρ for medial femur cartilage and medial tibia cartilage. There were significant moderate correlations between age and T2 and T1ρ for global cartilage (R2 = 0.63-0.64), medial femur cartilage (R2 = 0.50-0.56), and medial tibia cartilage (R2 = 0.54-0.66). CONCLUSION Cartilage T2 and T1p relaxation times simultaneously measured using a 3D-MRF sequence in healthy volunteers showed age-dependent changes in knee cartilage, primarily within the medial compartment.
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Affiliation(s)
- Richard Kijowski
- Bernard and Irene Schwartz Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Azadeh Sharafi
- Bernard and Irene Schwartz Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Marcelo V.W. Zibetti
- Bernard and Irene Schwartz Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Gregory Chang
- Bernard and Irene Schwartz Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Martijn A. Cloos
- Center of Advanced Imaging, University of Queensland, Brisbane, QLD, Australia
- ARC Training Center for Innovation in Biomedical Imaging Technology, University of Queensland, Brisbane, QLD, Australia
| | - Ravinder R. Regatte
- Bernard and Irene Schwartz Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, 10016, USA
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20
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Tolkkinen K, Mailhiot SE, Selent A, Mankinen O, Henschel H, Nieminen MT, Hanni M, Kantola AM, Liimatainen T, Telkki VV. SPICY: a method for single scan rotating frame relaxometry. Phys Chem Chem Phys 2023; 25:13164-13169. [PMID: 37129427 PMCID: PMC10171246 DOI: 10.1039/d2cp05988f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
T 1ρ is an NMR relaxation mode that is sensitive to low frequency molecular motions, making it an especially valuable tool in biomolecular research. Here, we introduce a new method, SPICY, for measuring T1ρ relaxation times. In contrast to conventional T1ρ experiments, in which the sequence is repeated many times to determine the T1ρ time, the SPICY sequence allows determination of T1ρ within a single scan, shortening the experiment time remarkably. We demonstrate the method using 1H T1ρ relaxation dispersion experiments. Additionally, we combine the sequence with spatial encoding to produce 1D images in a single scan. We show that T1ρ relaxation times obtained using the single scan approach are in good agreement with those obtained using the traditional experiments.
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Affiliation(s)
| | | | - Anne Selent
- NMR Research Unit, University of Oulu, Oulu, Finland.
| | - Otto Mankinen
- NMR Research Unit, University of Oulu, Oulu, Finland.
| | - Henning Henschel
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Miika T Nieminen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Matti Hanni
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Anu M Kantola
- NMR Research Unit, University of Oulu, Oulu, Finland.
| | - Timo Liimatainen
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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21
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Zu Z, Adelnia F, Harkins K, Wang F, Ostenson J, Gore JC. Correction of errors in estimates of T 1ρ at low spin-lock amplitudes in the presence of B 0 and B 1 inhomogeneities. NMR IN BIOMEDICINE 2023; 36:e4951. [PMID: 37070215 PMCID: PMC10619883 DOI: 10.1002/nbm.4951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/06/2023]
Abstract
Relaxation rates R1ρ in the rotating frame measured by spin-lock methods at very low locking amplitudes (≤ 100 Hz) are sensitive to the effects of water diffusion in intrinsic gradients and may provide information on tissue microvasculature, but accurate estimates are challenging in the presence of B0 and B1 inhomogeneities. Although composite pulse preparations have been developed to compensate for nonuniform fields, the transverse magnetization comprises different components and the spin-lock signals measured do not decay exponentially as a function of locking interval at low locking amplitudes. For example, during a typical preparation sequence, some of the magnetization in the transverse plane is nutated to the Z-axis and later tipped back, and so does not experience R1ρ relaxation. As a result, if the spin-lock signals are fit to a monoexponential decay with locking interval, there are residual errors in quantitative estimates of relaxation rates R1ρ and their dispersion with weak locking fields. We developed an approximate theoretical analysis to model the behaviors of the different components of the magnetization, which provides a means to correct these errors. The performance of this correction approach was evaluated both through numerical simulations and on human brain images at 3 T, and compared with a previous correction method using matrix multiplication. Our correction approach has better performance than the previous method at low locking amplitudes. Through careful shimming, the correction approach can be applied in studies using low spin-lock amplitudes to assess the contribution of diffusion to R1ρ dispersion and to derive estimates of microvascular sizes and spacings. The results of imaging eight healthy subjects suggest that R1ρ dispersion in human brain at low locking fields arises from diffusion among inhomogeneities that generate intrinsic gradients on a scale of capillaries (~7.4 ± 0.5 μm).
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Affiliation(s)
- Zhongliang Zu
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Fatemeh Adelnia
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Kevin Harkins
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Feng Wang
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jason Ostenson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John C. Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Deparment of Physics and Astronomy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Biomedical Engineering, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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22
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Histological Findings and T2 Relaxation Time in Canine Menisci of Elderly Dogs—An Ex Vivo Study in Stifle Joints. Vet Sci 2023; 10:vetsci10030182. [PMID: 36977221 PMCID: PMC10053884 DOI: 10.3390/vetsci10030182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 03/03/2023] Open
Abstract
Osteoarthritis is a chronic disease that often affects the canine stifle joint. Due to their biomechanical function, the menisci in the canine stifle play an important role in osteoarthritis. They compensate for the incongruence in the joint and distribute and minimize compressive loads, protecting the hyaline articular cartilage from damage. Meniscal degeneration favors the development and progression of stifle joint osteoarthritis. Qualitative magnetic resonance imaging (MRI) is the current golden standard for detecting meniscal changes, but it has limitations in detecting early signs of meniscal degeneration. A quantitative MRI offers new options for detecting early structural changes. T2 mapping can especially visualize structural changes such as altered collagen structures and water content, as well as deviations in proteoglycan content. This study evaluated T2 mapping and performed a histological scoring of menisci in elderly dogs that had no or only low radiographic osteoarthritis grades. A total of 16 stifles from 8 older dogs of different sex and breed underwent ex vivo magnet resonance imaging, including a T2 mapping pulse sequence with multiple echoes. A histological analysis of corresponding menisci was performed using a modified scoring system. The mean T2 relaxation time was 18.2 ms and the mean histological score was 4.25. Descriptive statistics did not reveal a correlation between T2 relaxation time and histological score. Ex vivo T2 mapping of canine menisci did not demonstrate histological changes, suggesting that early meniscal degeneration can be present in the absence of radiological signs of osteoarthritis, including no significant changes in T2 relaxation time.
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23
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Wang P. Adiabatically prepared spin-lock could reduce the R 1ρ dispersion. Quant Imaging Med Surg 2023; 13:763-775. [PMID: 36819267 PMCID: PMC9929376 DOI: 10.21037/qims-21-959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
Background R1ρ (or spin-lock) imaging is prone to artifacts arising from field inhomogeneities that may impact the R1ρ quantification. Previous research has proposed two types of method to manage the artifacts in continuous-wave constant amplitude spin-lock, one is based on the composite block pulses to compensate for the field imperfections, another category uses adiabatic pulses in the R1ρ pre-pulse to excite and reverse the magnetization (named adiabatic prepared approach). Although both methods have proved their efficiency in alleviating artifacts, we observed that the adiabatic pulse approach could produce much lower R1ρ dispersion in human knee cartilage than the block pulse method (characterized by the R1ρ difference ∆R1ρ =11.4 Hz (from spin-lock field 50 to 500 Hz) for the block pulse method vs. ∆R1ρ =4.5 Hz for the adiabatic pulse approach). Prompted by this observation, the purpose of this study was to investigate the underlying factors that may affect the R1ρ dispersion through numerical simulations based on the two-pool exchanging Bloch-McConnell equations. Methods The effects of free water pool size Pa (from 0.80 to 0.95), chemical exchange rate kb (from the bound to free water pool, ranged from 500 to 3,000 Hz), adiabatic pulse duration Tp (from 5.0 to 25 ms), and the chemical shift of the bound pool ppmb (from 1.0 to 5.0 ppm) were examined on the degree of the R1ρ dispersion for the two R1ρ imaging methods. Results In general, the greater the ppmb, kb, Tp, and the smaller Pa, the more significant difference in R1ρ dispersion between the block and adiabatic approaches, with the dispersion curve of the adiabatic method becoming flatter. Conclusions The adiabatic prepared approach may compromise the R1ρ dispersion, the effect is determined by the combination of the tissue and radiofrequency (RF) pulse properties. It is suggested that care should be taken when using the adiabatically prepared approach to study R1ρ dispersion.
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Pala S, Hänninen NE, Nykänen O, Liimatainen T, Nissi MJ. New methods for robust continuous wave T 1ρ relaxation preparation. NMR IN BIOMEDICINE 2023; 36:e4834. [PMID: 36115012 PMCID: PMC10078184 DOI: 10.1002/nbm.4834] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 06/15/2023]
Abstract
Measurement of the longitudinal relaxation time in the rotating frame of reference (T1ρ ) is sensitive to the fidelity of the main imaging magnetic field (B0 ) and that of the RF pulse (B1 ). The purpose of this study was to introduce methods for producing continuous wave (CW) T1ρ contrast with improved robustness against field inhomogeneities and to compare the sensitivities of several existing and the novel T1ρ contrast generation methods with the B0 and B1 field inhomogeneities. Four hard-pulse and four adiabatic CW-T1ρ magnetization preparations were investigated. Bloch simulations and experimental measurements at different spin-lock amplitudes under ideal and non-ideal conditions, as well as theoretical analysis of the hard-pulse preparations, were conducted to assess the sensitivity of the methods to field inhomogeneities, at low (ω1 << ΔB0 ) and high (ω1 >> ΔB0 ) spin-locking field strengths. In simulations, previously reported single-refocus and new triple-refocus hard-pulse and double-refocus adiabatic preparation schemes were found to be the most robust. The mean normalized absolute deviation between the experimentally measured relaxation times under ideal and non-ideal conditions was found to be smallest for the refocused preparation schemes and broadly in agreement with the sensitivities observed in simulations. Experimentally, all refocused preparations performed better than those that were non-refocused. The findings promote the use of the previously reported hard-pulse single-refocus ΔB0 and B1 insensitive T1ρ as a robust method with minimal RF energy deposition. The double-refocus adiabatic B1 insensitive rotation-4 CW-T1ρ preparation offers further improved insensitivity to field variations, but because of the extra RF deposition, may be preferred for ex vivo applications.
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Affiliation(s)
- Swetha Pala
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
| | - Nina E. Hänninen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
| | - Olli Nykänen
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
| | - Timo Liimatainen
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
- Department of RadiologyOulu University HospitalOuluFinland
| | - Mikko J. Nissi
- Department of Applied PhysicsUniversity of Eastern FinlandKuopioFinland
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
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25
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PET Imaging in Osteoarthritis. PET Clin 2023; 18:21-29. [DOI: 10.1016/j.cpet.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Wilczynski E, Sasson E, Eliav U, Navon G, Nevo U. Quantitative Magnetization EXchange MRI Measurement of Liver Fibrosis Model in Rodents. J Magn Reson Imaging 2023; 57:285-295. [PMID: 35521943 PMCID: PMC10084184 DOI: 10.1002/jmri.28228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Quantitative MRI can elucidate the complex microstructural changes in liver disease. The Magnetization EXchange (MEX) method estimates macromolecular fraction, such as collagen, and can potentially aid in this task. HYPOTHESIS MEX sequence, and its derived quantitative macromolecular fraction, should correlate with collagen deposition in rodents liver fibrosis model. STUDY TYPE Prospective. ANIMAL MODEL Sixteen adults Sprague-Dawley rats and 13 adults C57BL/6 strain mice given carbon tetrachloride (CCl4 ) twice weekly for 6 or 8 weeks. FIELD STRENGTH/SEQUENCE A 7 T scanner. MEX sequence (selective suppression and magnetization exchange), spin-echo and gradient-echo scans. ASSESSMENT Macromolecular fraction (F) and T1 were extracted for each voxel and for livers' regions of interest, additional to calculating the percentage of F > 0.1 pixels in F maps (high-F). Histology included staining with hematoxylin and eosin, picrosirius red and Masson trichrome, and inflammation scoring. Quantitative collagen percentage calculated using automatic spectral-segmentation of the staining. STATISTICAL TESTS Comparing CCl4 -treated groups and controls using Welch's t-test and paired t-test between different time points. Pearson's correlation used between ROI MEX parameters or high-F fraction, and quantitative histology. F or T1 , and inflammation scores were tested with one-sided t-test. P < 0.05 was deemed significant. RESULTS Rats: F values were significantly different after 6 weeks of treatment (0.10 ± 0.02) compared to controls (0.080 ± 0.003). After 8 weeks, F significantly increased (0.11 ± 0.02) in treated animals, while controls are not significant (0.0814 ± 0.0008, P = 0.079). F correlated with quantitative histology (R = 0.87), and T1 was significantly different between inflammation scores (1: 1332 ± 224 msec, 2: 2007 ± 464 msec). Mice: F was significantly higher (0.062 ± 0.006) in treatment group compared to controls (0.042 ± 0.006). F and high-F fraction correlated with quantitative histology (R = 0.88; R = 0.84). T1 was significantly different between inflammation scores (1:1366 ± 99 msec; 2:1648 ± 45 msec). DATA CONCLUSION MEX extracted parameters are sensitive to collagen deposition and inflammation and are correlated with histology results of mouse and rat liver fibrosis model. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Ella Wilczynski
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Sasson
- School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Uzi Eliav
- School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Gil Navon
- School of Chemistry, Faculty of Exact Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Uri Nevo
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Faculty of Life Sciences, Tel Aviv University, Tel Aviv, Israel
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27
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Sharafi A, Zibetti MVW, Chang G, Cloos M, Regatte RR. 3D magnetic resonance fingerprinting for rapid simultaneous T1, T2, and T1ρ volumetric mapping of human articular cartilage at 3 T. NMR IN BIOMEDICINE 2022; 35:e4800. [PMID: 35815660 PMCID: PMC9669203 DOI: 10.1002/nbm.4800] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 05/25/2023]
Abstract
Quantitative MRI can detect early biochemical changes in cartilage; however, the conventional techniques only measure one parameter (e.g., T1 , T2 , and T1ρ ) at a time while also being comparatively slow. We implemented a 3D magnetic resonance fingerprinting (3D-MRF) technique for simultaneous, volumetric mapping of T1 , T2 , and T1ρ in knee articular cartilage in under 9 min. It is evaluated on 11 healthy volunteers (mean age: 53 ± 9 years), five mild knee osteoarthritis (OA) patients (Kellgren-Lawrence (KL) score: 2, mean age: 60 ± 4 years), and the National Institute of Standards and Technology (NIST)/International Society for Magnetic Resonance in Medicine (ISMRM) system phantom. Proton density image, and T1 , T2, T1ρ relaxation times, and B1 + were estimated in the NIST/ISMRM system phantom as well as in the human knee medial and lateral femur, medial and lateral tibia, and patellar cartilage. The repeatability and reproducibility of the proposed technique were assessed in the phantom using analysis of the Bland-Altman plots. The intrasubject repeatability was assessed with the coefficient of variation (CV) and root mean square CV (rmsCV). The Mann-Whitney U test was used to assess the difference between healthy subjects and mild knee OA patients. The Bland-Altman plots in the NIST/ISMRM phantom demonstrated an average difference of 0.001% ± 015%, 1.2% ± 7.1%, and 0.47% ± 3% between two scans from the same 3-T scanner (repeatability), and 0.002% ± 015%, 0.62% ± 10.5%, and 0.97% ± 14% between the scans acquired on two different 3-T scanners (reproducibility) for T1 , T2 , and T1ρ , respectively. The in vivo knee study showed excellent repeatability with rmsCV less than 1%, 2%, and 1% for T1 , T2 , and T1ρ , respectively. T1ρ relaxation time in the mild knee OA patients was significantly higher (p < 0.05) than in healthy subjects. The proposed 3D-MRF sequence is fast, reproducible, robust to B1 + inhomogeneity, and can simultaneously measure the T1 , T2 , T1ρ , and B1 + volumetric maps of the knee joint in a single scan within a clinically feasible scan time.
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Affiliation(s)
- Azadeh Sharafi
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Marcelo V. W. Zibetti
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Gregory Chang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Martijn Cloos
- Center of Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Ravinder R. Regatte
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, NY 10016, USA
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Ma Y, Jang H, Jerban S, Chang EY, Chung CB, Bydder GM, Du J. Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications. APPLIED PHYSICS REVIEWS 2022; 9:041303. [PMID: 36467869 PMCID: PMC9677812 DOI: 10.1063/5.0086459] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/12/2022] [Indexed: 05/25/2023]
Abstract
Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T2s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T2s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included.
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Affiliation(s)
- Yajun Ma
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California 92037, USA
| | | | | | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Jiang Du
- Author to whom correspondence should be addressed:. Tel.: (858) 246-2248, Fax: (858) 246-2221
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29
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Pang Y. A self-compensated spin-locking scheme for quantitative R 1ρ dispersion MR imaging in ordered tissues. Magn Reson Imaging 2022; 94:112-118. [PMID: 36181969 DOI: 10.1016/j.mri.2022.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/01/2022] [Accepted: 09/25/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To propose a self-compensated spin-locking (SL) method for quantitative R1ρ dispersion imaging in ordered tissues. METHODS Two pairs of antiphase rotary-echo SL pulses were proposed in a new scheme with each pairs sandwiching one refocusing RF pulse. This proposed SL method was evaluated by Bloch simulations and experimental studies relative to three prior schemes. Quantitative R1ρR dispersion imaging studies with constant SL duration (TSL = 40 ms) were carried out on an agarose (1-4% w/v) phantom and one in vivo human knee at 3 T, using six SL RF strengths ranging from 50 to 1000 Hz. The performances of these SL schemes were characterized with an average coefficient of variation (CV) of the signal intensities in agarose gels and the sum of squared errors (SSE) for quantifying in vivo R1ρ dispersion of the femoral and tibial cartilage. RESULTS The simulations demonstrate that the proposed SL scheme was less prone to B0 and B1 field inhomogeneities. This theoretical prediction was supported by fewer image banding artifacts and less signal fluctuation signified by a reduced CV (%) on the phantom without R1ρ dispersion (i.e., 4.04 ± 1.36 vs. 18.87 ± 4.46 or 6.66 ± 2.92 or 5.71 ± 2.05 for others), and further by mostly decreased SSE (*10-3) for characterizing R1ρ dispersion of the femoral (i.e., 0.3 vs. 1.2 or 0.4 or 0.1) and tibial (i.e., 0.4 vs. 7.2 or 3.2 or 2.8) cartilage. CONCLUSION The proposed SL scheme is less sensitive to B0 and B1 field artifacts for a wide range of SL RF strengths and thus more suitable for quantitative R1ρ dispersion imaging in ordered tissues.
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Affiliation(s)
- Yuxi Pang
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
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30
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Wu M, Ma YJ, Liu M, Xue Y, Gong L, Wei Z, Jerban S, Jang H, Chang DG, Chang EY, Ma L, Du J. Quantitative assessment of articular cartilage degeneration using 3D ultrashort echo time cones adiabatic T 1ρ (3D UTE-Cones-AdiabT 1ρ) imaging. Eur Radiol 2022; 32:6178-6186. [PMID: 35357540 PMCID: PMC9388581 DOI: 10.1007/s00330-022-08722-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To evaluate articular cartilage degeneration using quantitative three-dimensional ultrashort-echo-time cones adiabatic-T1ρ (3D UTE-Cones-AdiabT1ρ) imaging. METHODS Sixty-six human subjects were recruited for this study. Kellgren-Lawrence (KL) grade and Whole-Organ Magnetic-Resonance-Imaging Score (WORMS) were evaluated by two musculoskeletal radiologists. The human subjects were categorized into three groups, namely normal controls (KL0), doubtful-minimal osteoarthritis (OA) (KL1-2), and moderate-severe OA (KL3-4). WORMS were regrouped to encompass the extent of lesions and the depth of lesions. The UTE-Cones-AdiabT1ρ values were obtained using 3D UTE-Cones data acquisitions preceded by seven paired adiabatic full passage pulses that corresponded to seven spin-locking times (TSLs) of 0, 12, 24, 36, 48, 72, and 96 ms. The performance of the UTE-Cones-AdiabT1ρ technique in evaluating the degeneration of knee cartilage was assessed via the ANOVA comparisons with subregional analysis and Spearman's correlation coefficient as well as the receiver-operating-characteristic (ROC) curve. RESULTS UTE-Cones-AdiabT1ρ showed significant positive correlations with KL grade (r = 0.15, p < 0.05) and WORMS (r = 0.57, p < 0.05). Higher UTE-Cones-AdiabT1ρ values were observed in both larger and deeper lesions in the cartilage. The differences in UTE-Cones-AdiabT1ρ values among different extent and depth groups of cartilage lesions were all statistically significant (p < 0.05). Subregional analyses showed that the correlations between UTE-Cones-AdiabT1ρ and WORMS varied with the location of cartilage. The AUC value of UTE-Cones-AdiabT1ρ for mild cartilage degeneration (WORMS=1) was 0.8. The diagnostic threshold value of UTE-Cones-AdiabT1ρ for mild cartilage degeneration was 39.4 ms with 80.8% sensitivity. CONCLUSIONS The 3D UTE-Cones-AdiabT1ρ sequence can be useful in quantitative evaluation of articular cartilage degeneration. KEY POINTS • The 3D UTE-Cones-AdiabT1ρ sequence can distinguish mild cartilage degeneration from normal cartilage with a diagnostic threshold value of 39.4 ms for mild cartilage degeneration with 80.8% sensitivity. • Higher UTE-Cones-AdiabT1ρ values were observed in both larger and deeper lesions in the articular cartilage. • UTE-Cones-AdiabT1ρ is a promising biomarker for quantitative evaluation of early cartilage degeneration.
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Affiliation(s)
- Mei Wu
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Mouyuan Liu
- Imaging Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Yanping Xue
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Lillian Gong
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Zhao Wei
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Hyungseok Jang
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
| | - Douglas G Chang
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Liheng Ma
- Imaging Department, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong, China
| | - Jiang Du
- Department of Radiology, University of California San Diego, 9452 Medical Center Dr., San Diego, CA, 92037, USA.
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Shinohara M, Akagi R, Watanabe A, Kato Y, Sato Y, Morikawa T, Iwasaki J, Nakagawa K, Akatsu Y, Ohtori S, Sasho T. Time-Dependent Change in Cartilage Repair Tissue Evaluated by Magnetic Resonance Imaging up to 2 years after Atelocollagen-Assisted Autologous Cartilage Transplantation: Data from the CaTCh Study. Cartilage 2022; 13:19476035221109227. [PMID: 35815923 PMCID: PMC9277438 DOI: 10.1177/19476035221109227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To elucidate the time course of magnetic resonance imaging (MRI)-based morphological and qualitative outcomes after an atelocollagen-assisted autologous chondrocyte implantation (ACI) and to analyze the correlation between arthroscopic and MRI-based assessment. DESIGN We included ACI recipients from a multicenter registration study (CaTCh [Cartilage Treatment in Chiba] study). Morphological (3-dimensional magnetic resonance observation of cartilage repair tissue: 3D-MOCART, MOCART2.0) and qualitative assessment (T2- and T1rho-mapping) by MRI were conducted at 6, 12, and 24 months post-implantation. Global T2 and T1rho indices (T2 and T1rho in repair tissue divided by T2 and T1rho in normal cartilage) were calculated. Arthroscopic second-look assessment was performed in 4 and 15 knees at 12 and 24 months post-implantation, respectively. RESULTS The 3D-MOCART over 12 months witnessed significant patient improvement, but some presented subchondral bone degeneration as early as 6 months. The MOCART2.0 improved from 57.5 to 71.3 between 6 and 24 months (P = 0.02). The global T2 index decreased from 1.7 to 1.2 between 6 and 24 months (P < 0.001). The global T1rho index decreased from 1.5 to 1.3 between 6 and 24 months (P = 0.004). Normal or nearly normal ICRS-CRA (cartilage repair assessment scale developed by the International Cartilage Repair Society) grades were achieved in 86% and 93% of the lesions at 12 and 24 months, respectively. Better ICRS-CRA grade corresponded to better MOCART2.0, with no trend in the T2 and T1rho values. CONCLUSIONS Atelocollagen-assisted ACI improved the MRI-based morphological and qualitative outcomes until 24 months post-surgery, and normal or nearly normal grades were achieved in most lesions by arthroscopic assessment. MRI assessment may be an alternative to arthroscopic assessment.
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Affiliation(s)
- Masashi Shinohara
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Chiba University, Chiba, Japan,Ryuichiro Akagi, Department of Orthopaedic
Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou,
Chiba 260-8677, Japan.
| | - Atsuya Watanabe
- Department of Orthopaedic Surgery,
Eastern Chiba Medical Center, Togane, Japan
| | - Yuki Kato
- Department of Sports Medicine, Kameda
Medical Center, Kamogawa, Japan
| | - Yusuke Sato
- Department of Orthopaedic Surgery,
Eastern Chiba Medical Center, Togane, Japan
| | - Tsuguo Morikawa
- Department of Orthopaedic Surgery,
Chiba Medical Center, Chiba, Japan
| | - Junichi Iwasaki
- Department of Orthopaedic Surgery,
Chiba Medical Center, Chiba, Japan
| | - Koichi Nakagawa
- Department of Orthopaedic Surgery, Toho
University Sakura Medical Center, Sakura, Japan
| | - Yorikazu Akatsu
- Department of Orthopaedic Surgery, Toho
University Sakura Medical Center, Sakura, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery,
Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takahisa Sasho
- Department of Musculoskeletal Disease
and Pain, Center for Preventive Medical Sciences, Chiba University, Chiba,
Japan
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32
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Peng Q, Wu C, Kim J, Li X. Efficient phase-cycling strategy for high-resolution 3D gradient-echo quantitative parameter mapping. NMR IN BIOMEDICINE 2022; 35:e4700. [PMID: 35068007 DOI: 10.1002/nbm.4700] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 06/05/2023]
Abstract
Magnetization-prepared (MP) gradient-echo (GRE) sequences suffer from signal contaminations from T1 recovery during the readout train, which can be eliminated by paired RF phase cycling (PC) at the cost of doubling the scan time. The objective of this study was to develop and validate a novel unpaired PC strategy to eliminate the time penalty for high-resolution quantitative parameter mapping in 3D MP-GRE sequences. Based on the observation that the contaminating T1 recovery signal along the GRE readout train is independent of magnetization preparation, its impact can be eliminated using a novel curve-fitting approach with complex-valued data without needing paired PC acquisitions. Four new unpaired PC schemes were compared with two traditional paired PC schemes in both phantom and in vivo human knee studies at 3 T using a MP angle-modulated partitioned k-space spoiled gradient-echo snapshots (MAPSS) T1ρ mapping sequence. In the phantom study, all methods resulted in consistent T1ρ measurements (∆T1ρ < 0.5%) at the center slice when B0 /B1 values were uniform. Results were not consistent when off-center slices with nonideal B0 /B1 were included. Two unpaired PC schemes had comparable or significantly improved quantitative accuracy and scan-rescan reproducibility compared with the paired PC schemes. There was no significant T1ρ quantitative variability increase or spatial fidelity loss using the new unpaired PC schemes. Unpaired PC schemes also had different T1ρ spectral responses at different B0 frequency offsets, which can potentially be exploited to reduce sensitivity to B0 field inhomogeneities. The human knee study results were consistent with the phantom study findings. In conclusion, an unpaired PC strategy potentially allows more accurate quantitative parameter mapping with halved scan time compared with the paired PC approach to eliminate signal contaminations from T1 recovery. It therefore offers additional flexibility in SNR optimization, spatial resolution improvement, and choice of imaging sampling points to obtain more accurate quantitative parameter mapping.
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Affiliation(s)
- Qi Peng
- GRUSS Magnetic Resonance Research Center (MRRC), Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Can Wu
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jeehun Kim
- Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, Ohio, USA
| | - Xiaojuan Li
- Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, Ohio, USA
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33
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Quantitative evaluation of the tibiofemoral joint cartilage by T2 mapping in patients with acute anterior cruciate ligament injury vs contralateral knees: results from the subacute phase using data from the NACOX study cohort. Osteoarthritis Cartilage 2022; 30:987-997. [PMID: 35421548 DOI: 10.1016/j.joca.2022.02.623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Immediate cartilage structural alterations in the acute phase after an anterior cruciate ligament (ACL) rupture may be a precursor to posttraumatic osteoarthritis (PTOA) development. Our aim was to describe changes in cartilage matrix in the subacute phase of the acutely ACL-injured knee compared to the contralateral uninjured knee. DESIGN Participants (n = 118) aged 15-40 years with an acute ACL injury were consecutively included in subacute phase after acute ACL-injury and underwent MRI (mean 29 days post trauma) of both knees. Mean T2 relaxation times, T2 spatial coefficient of variation and cartilage thickness were determined for different regions of the tibiofemoral cartilage. Differences between the acutely ACL-injured and uninjured knee were evaluated using Wilcoxon signed-rank test. RESULTS T2 relaxation time in injured knees was increased in multiple cartilage regions from both medial and lateral compartment compared to contralateral knees, mostly in medial trochlea and posterior tibia (P-value<0.001). In the same sites of injured knees, we observed significantly thinner cartilage. Moreover, injured knees presented shorter T2 relaxation time in superficial cartilage on lateral central femur and trochlea (P-value<0.001), and decreased T2 spatial coefficient of variation in lateral trochlea and load bearing regions of medial-central femoral condyle and central tibia in both compartments. CONCLUSION Small but statistically significant differences were observed in the subacute phase between ACL-injured and uninjured knee in cartilage T2 relaxation time and cartilage thickness. Future longitudinal observations of the same cohort will allow for better understanding of early development of PTOA. TRIAL REGISTRATION NUMBER NCT02931084.
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34
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Roemer FW, Guermazi A, Demehri S, Wirth W, Kijowski R. Imaging in Osteoarthritis. Osteoarthritis Cartilage 2022; 30:913-934. [PMID: 34560261 DOI: 10.1016/j.joca.2021.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis with major implications on both individual and public health care levels. The field of joint imaging, and particularly magnetic resonance imaging (MRI), has evolved rapidly due to the application of technical advances to the field of clinical research. This narrative review will provide an introduction to the different aspects of OA imaging aimed at an audience of scientists, clinicians, students, industry employees, and others who are interested in OA but who do not necessarily focus on OA. The current role of radiography and recent advances in measuring joint space width will be discussed. The status of cartilage morphology assessment and evaluation of cartilage biochemical composition will be presented. Advances in quantitative three-dimensional morphologic cartilage assessment and semi-quantitative whole-organ assessment of OA will be reviewed. Although MRI has evolved as the most important imaging method used in OA research, other modalities such as ultrasound, computed tomography, and metabolic imaging play a complementary role and will also be discussed.
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Affiliation(s)
- F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Ave, Boston, MA, 02118, USA; Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Maximiliansplatz 3, Erlangen, 91054, Germany.
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Ave, Boston, MA, 02118, USA; Department of Radiology, VA Boston Healthcare System, 1400 VFW Pkwy, Suite 1B105, West Roxbury, MA, 02132, USA
| | - S Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolf Street, Park 311, Baltimore, MD, 21287, USA
| | - W Wirth
- Institute of Anatomy, Paracelsus Medical University Salzburg, Salzburg, Austria, Nüremberg, Germany; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria; Chondrometrics, GmbH, Freilassing, Germany
| | - R Kijowski
- Department of Radiology, New York University Grossmann School of Medicine, 550 1st Avenue, 3nd Floor, New York, NY, 10016, USA
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35
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Aleksiev M, Krämer M, Brisson NM, Maggioni MB, Duda GN, Reichenbach JR. High-resolution CINE imaging of active guided knee motion using continuously acquired golden-angle radial MRI and rotary sensor information. Magn Reson Imaging 2022; 92:161-168. [PMID: 35777685 DOI: 10.1016/j.mri.2022.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/13/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
To explore and extend on dynamic imaging of joint motion, an MRI-safe device guiding knee motion with an attached rotary encoder was used in MRI measurements of multiple knee flexion-extension cycles using radial gradient echo imaging with the golden-angle as azimuthal angle increment. Reproducibility of knee motion was investigated. Real-time and CINE mode anatomical images were reconstructed for different knee flexion angles by synchronizing the encoder information with the MRI data, and performing flexion angle selective gating across multiple motion cycles. When investigating the influence of the rotation angle window width on reconstructed CINE images, it was found that angle windows between 0.5° and 3° exhibited acceptable image sharpness without suffering from significant motion-induced blurring. Furthermore, due to flexible retrospective image reconstruction afforded by the radial golden-angle imaging, the number of motion cycles included in the reconstruction could be retrospectively reduced to investigate the corresponding influence of acquisition time on image quality. Finally, motion reproducibility between motion cycles and accuracy of the flexion angle selective gating were sufficient to acquire whole-knee 3D dynamic imaging with a retrospectively gated 3D cone UTE sequence.
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Affiliation(s)
- Martin Aleksiev
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Germany
| | - Martin Krämer
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Germany; Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Germany.
| | - Nicholas M Brisson
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Germany.
| | - Marta B Maggioni
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Germany.
| | - Georg N Duda
- Julius Wolff Institute, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Germany.
| | - Jürgen R Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Friedrich Schiller University Jena, Germany.
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36
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Lindner D, Chechik Y, Beer Y, Tal S, Lysyy O, Blumenfeld-Katzir T, Ben-Eliezer N, Agar G. T2 Mapping Values in Postmeniscectomy Knee Articular Cartilage after Running: Early Signs of Osteoarthritis? J Knee Surg 2022; 35:739-749. [PMID: 33111272 DOI: 10.1055/s-0040-1718596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Loading on the joints during running may have a deleterious effect on post-partial meniscectomy knee cartilage, leading to osteoarthritis. Utilizing T2-mapping measurements before and after running may enable the observation of changes in the articular cartilage of the postmeniscectomy knees compared with healthy knees. After medial partial meniscectomy, 12 volunteers underwent magnetic resonance imaging (MRI) of the both knees, before and immediately after 30 minutes of running. Quantitative assessment of articular cartilage was performed using a T2-mapping technique. In the medial compartment of the operated knees, significantly lower T2 values were found in anterior tibial plateau (pre- vs. postrun: 33.85 vs. 30.45 ms; p = 0.003) and central tibial plateau (33.33 vs. 30.63 ms; p = 0.007). Similar differences were found in lateral regions of central femur (post- vs. prerun: 35.86 vs. 40.35 ms; p = 0.015), posterior femur (34.89 vs. 37.73 ms; p = 0.001), and anterior tibia (24.66 vs. 28.70 ms, p = 0.0004). In lateral compartment, postrun values were significantly lower in operated compared with healthy knees, in central femur (34.89 vs. 37.59 ms; p = 0.043), posterior femoral (36.88 vs. 39.36 ms; p = 0.017), anterior tibia (24.66 vs. 30.20 ms; p = 0.009), and posterior tibia (28.84 vs. 33.17 ms; p = 0.006). No statistical difference was found while comparing postrun to prerun healthy knees. Lower T2 values were found in operated knees after 30 minutes of running. These changes were seen in medial and lateral compartments. We suspect that running may subject the articular cartilage to excessive loads in the post-partial meniscectomy knee, loads that in healthy knee do not cause any changes.
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Affiliation(s)
- Dror Lindner
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yigal Chechik
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yiftah Beer
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sigal Tal
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Radiology, Shamir Medical Center, Zerifin, Israel
| | - Oleg Lysyy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Radiology, Shamir Medical Center, Zerifin, Israel
| | | | - Noam Ben-Eliezer
- Department of Biomedical Engineering, Tel-Aviv University, Tel Aviv, Israel
| | - Gabriel Agar
- Department of Orthopedics, Shamir Medical Center, Zerifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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37
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Sharafi A, Zibetti MVW, Chang G, Cloos MA, Regatte RR. Simultaneous bilateral T 1 , T 2 , and T 1ρ relaxation mapping of the hip joint with magnetic resonance fingerprinting. NMR IN BIOMEDICINE 2022; 35:e4651. [PMID: 34825750 PMCID: PMC9233946 DOI: 10.1002/nbm.4651] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
Quantitative MRI can detect early biochemical changes in cartilage, but its bilateral use in clinical routines is challenging. The aim of this prospective study was to demonstrate the feasibility of magnetic resonance fingerprinting for bilateral simultaneous T1 , T2 , and T1ρ mapping of the hip joint. The study population consisted of six healthy volunteers with no known trauma or pain in the hip. Monoexponential T1 , T2 , and T1ρ relaxation components were assessed in femoral lateral, superolateral, and superomedial, and inferior, as well as acetabular, superolateral, and superomedial subregions in left and right hip cartilage. Aligned ranked nonparametric factorial analysis was used to assess the side's impact on the subregions. Kruskal-Wallis and Wilcoxon tests were used to compare subregions, and coefficient of variation to assess repeatability. Global averages of T1 (676.0 ± 45.4 and 687.6 ± 44.5 ms), T2 (22.5 ± 2.6 and 22.1 ± 2.5 ms), and T1ρ (38.2 ± 5.5 and 38.2 ± 5.5 ms) were measured in the left and right hip, and articular cartilage, respectively. The Kruskal-Wallis test showed a significant difference between different subregions' relaxation times regardless of the hip side (p < 0.001 for T1 , p = 0.012 for T2 , and p < 0.001 for T1ρ ). The Wilcoxon test showed that T1 of femoral layers was significantly (p < 0.003) higher than that for acetabular cartilage. The experiments showed excellent repeatability with CVrms of 1%, 2%, and 4% for T1 , T2 , and T1ρ, respectively. It was concluded that bilateral T1 , T2 , and T1ρ relaxation times, as well as B1+ maps, can be acquired simultaneously from hip joints using the proposed MRF sequence.
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Affiliation(s)
- Azadeh Sharafi
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Marcelo V. W. Zibetti
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Gregory Chang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Martijn A. Cloos
- Center of Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Ravinder R. Regatte
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
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T 2 MRI at 3T of cartilage and menisci in patients with hyperuricemia: initial findings. Skeletal Radiol 2022; 51:607-618. [PMID: 34287675 DOI: 10.1007/s00256-021-03861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare and evaluate T2 values of compartmental femorotibial cartilage and subregional menisci in patients with hyperuricemia at 3T. MATERIALS AND METHODS Thirty-two subjects were included in this study and subdivided into two subgroups: 15 healthy controls (3 females, 12 males; mean age = 45.3 ± 10.9 years), 17 patients with hyperuricemia (2 females, 15 males; mean age = 44.4 ± 12.7 years). All subjects were assessed on a 3T MR scanner using an 8-channel phased-array knee coil (transmit-receive). Wilcoxon rank sum test and analysis of covariance (ANCOVA) were performed to determine whether there were any statistically significant differences in T2 values of compartmental femorotibial cartilage and subregional menisci between the two subgroups. RESULTS Lateral tibial cartilage (48.6 ± 3.5 ms) in healthy subgroup had significantly lower (p < 0.05) T2 values than all subcompartments of femorotibial cartilage in hyperuricemia subgroup. Medial tibial cartilage (56.5 ± 4.3 ms) in hyperuricemia subgroup had significantly higher (p < 0.05) T2 values than all subcompartments of femorotibial cartilage except medial tibial cartilage in healthy subgroup. Medial anterior horn of meniscus (39.4 ± 2.9 ms) in healthy subgroup had significantly lower (p < 0.05) T2 values than all subregional menisci except both medial anterior horn and medial body segment of meniscus in hyperuricemia subgroup. CONCLUSION T2 values in certain compartmental femorotibial cartilage and subregional menisci in patients with hyperuricemia are evidently and abnormally heightened compared with those in healthy subjects, to which special attention should be paid when diagnosing and treating the patients with hyperuricemia in the clinical setting. The LT cartilage had significantly lower T2 values (48.6 ± 3.5 ms) in healthy subgroup compared to all compartmental femorotibial cartilage in cohort with HU. MF cartilage had significantly lower T2 values (51.6 ± 2.9 ms) in healthy subgroup compared to both LF (54.4 ± 4.1 ms) and MT (56.5 ± 4.3 ms) in cohort with HU. MT cartilage had significantly higher T2 values (56.5 ± 4.3 ms) in cohort with HU subgroup compared to LF (52.5 ± 3.0 ms) in healthy subgroup. T2 mapping may be promising and potential sensitive discriminator of understanding and examining the early compositional and structural change in proteoglycan-collagen matrix of human femorotibial cartilage in patients with hyperuricemia.
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Joseph GB, McCulloch CE, Sohn JH, Pedoia V, Majumdar S, Link TM. AI MSK clinical applications: cartilage and osteoarthritis. Skeletal Radiol 2022; 51:331-343. [PMID: 34735607 DOI: 10.1007/s00256-021-03909-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 02/02/2023]
Abstract
The advancements of artificial intelligence (AI) for osteoarthritis (OA) applications have been rapid in recent years, particularly innovations of deep learning for image classification, lesion detection, cartilage segmentation, and prediction modeling of future knee OA development. This review article focuses on AI applications in OA research, first describing machine learning (ML) techniques and workflow, followed by how these algorithms are used for OA classification tasks through imaging and non-imaging-based ML models. Deep learning applications for OA research, including analysis of both radiographs for automatic detection of OA severity, and MR images for detection of cartilage/meniscus lesions and cartilage segmentation for automatic T2 quantification will be described. In addition, information on ML models that identify individuals at high risk of OA development will be provided. The future vision of machine learning applications in imaging of OA and cartilage hinges on implementation of AI for optimizing imaging protocols, quantitative assessment of cartilage, and automated analysis of disease burden yielding a faster and more efficient workflow for a radiologist with a higher level of reproducibility and precision. It may also provide risk assessment tools for individual patients, which is an integral part of precision medicine.
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Affiliation(s)
- Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA.
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Jae Ho Sohn
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, 185 Berry St, Suite 350, San Francisco, CA, 94158, USA
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Bjornsen E, Schwartz TA, Lisee C, Blackburn T, Lalush D, Nissman D, Spang J, Pietrosimone B. Loading during Midstance of Gait Is Associated with Magnetic Resonance Imaging of Cartilage Composition Following Anterior Cruciate Ligament Reconstruction. Cartilage 2022; 13:19476035211072220. [PMID: 35098719 PMCID: PMC9137315 DOI: 10.1177/19476035211072220] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE A complex association exists between aberrant gait biomechanics and posttraumatic knee osteoarthritis (PTOA) development. Previous research has primarily focused on the link between peak loading during the loading phase of stance and joint tissue changes following anterior cruciate ligament reconstruction (ACLR). However, the associations between loading and cartilage composition at other portions of stance, including midstance and late stance, is unclear. The objective of this study was to explore associations between vertical ground reaction force (vGRF) at each 1% increment of stance phase and tibiofemoral articular cartilage magnetic resonance imaging (MRI) T1ρ relaxation times following ACLR. DESIGN Twenty-three individuals (47.82% female, 22.1 ±4.1 years old) with unilateral ACLR participated in a gait assessment and T1ρ MRI collection at 12.25 ± 0.61 months post-ACLR. T1ρ relaxation times were calculated for the articular cartilage of the weightbearing medial and lateral femoral (MFC, LFC) and tibial (MTC, LTC) condyles. Separate bivariate, Pearson product moment correlation coefficients (r) were used to estimate strength of associations between T1ρ MRI relaxation times in the medial and lateral tibiofemoral articular cartilage with vGRF across the entire stance phase. RESULTS Greater vGRF during midstance (46%-56% of stance phase) was associated with greater T1ρ MRI relaxation times in the MFC (r ranging between 0.43 and 0.46). CONCLUSIONS Biomechanical gait profiles that include greater vGRF during midstance are associated with MRI estimates of lesser proteoglycan density in the MFC. Inability to unload the ACLR limb during midstance may be linked to joint tissue changes associated with PTOA development.
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Affiliation(s)
- Elizabeth Bjornsen
- Human Movement Science Curriculum, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Elizabeth Bjornsen, Human Movement Science Curriculum, The University of North Carolina at Chapel Hill, Fetzer Hall, 210 South Road, Chapel Hill, NC 27599, USA.
| | - Todd A. Schwartz
- Department of Biostatistics, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Caroline Lisee
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Troy Blackburn
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David Lalush
- Joint Department of Biomedical Engineering, North Carolina State University and The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Daniel Nissman
- Department of Radiology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeffrey Spang
- Department of Orthopaedics, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian Pietrosimone
- Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Babel H, Omoumi P, Cosendey K, Stanovici J, Cadas H, Jolles BM, Favre J. An Expert-Supervised Registration Method for Multiparameter Description of the Knee Joint Using Serial Imaging. J Clin Med 2022; 11:jcm11030548. [PMID: 35160002 PMCID: PMC8837137 DOI: 10.3390/jcm11030548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/21/2022] [Indexed: 01/25/2023] Open
Abstract
As knee osteoarthritis is a disease of the entire joint, our pathophysiological understanding could be improved by the characterization of the relationships among the knee components. Diverse quantitative parameters can be characterized using magnetic resonance imaging (MRI) and computed tomography (CT). However, a lack of methods for the coordinated measurement of multiple parameters hinders global analyses. This study aimed to design an expert-supervised registration method to facilitate multiparameter description using complementary image sets obtained by serial imaging. The method is based on three-dimensional tissue models positioned in the image sets of interest using manually placed attraction points. Two datasets, with 10 knees CT-scanned twice and 10 knees imaged by CT and MRI were used to assess the method when registering the distal femur and proximal tibia. The median interoperator registration errors, quantified using the mean absolute distance and Dice index, were ≤0.45 mm and ≥0.96 unit, respectively. These values differed by less than 0.1 mm and 0.005 units compared to the errors obtained with gold standard methods. In conclusion, an expert-supervised registration method was introduced. Its capacity to register the distal femur and proximal tibia supports further developments for multiparameter description of healthy and osteoarthritic knee joints, among other applications.
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Affiliation(s)
- Hugo Babel
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
| | - Patrick Omoumi
- Service of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland;
- Department of Radiology, Cliniques Universitaires St Luc-UC Louvain, BE-1200 Brussels, Belgium
| | - Killian Cosendey
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
| | - Julien Stanovici
- Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland;
| | - Hugues Cadas
- Unité Facultaire d’Anatomie et de Morphologie, University of Lausanne (UNIL), CH-1005 Lausanne, Switzerland;
| | - Brigitte M. Jolles
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
- Institute of Microengineering, Ecole Polytechnique Fédérale Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
- Correspondence:
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Chen Y, Li L, Le N, Chang EY, Huang W, Ma YJ. On the fat saturation effect in quantitative ultrashort TE MR imaging. Magn Reson Med 2022; 87:2388-2397. [PMID: 34985141 DOI: 10.1002/mrm.29149] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the effect of fat saturation (FatSat) on quantitative UTE imaging of variable knee tissues on a 3T scanner. METHODS Three quantitative UTE imaging techniques, including the UTE multi-echo sequence for T 2 ∗ measurement, the adiabatic T1ρ prepared UTE sequence for T1ρ measurement, and the magnetization transfer (MT)-prepared UTE sequence for MT ratio (MTR) and macromolecular proton fraction (MMF) measurements were used in this study. Twelve samples of cartilage and twelve samples of meniscus, as well as six whole knee cadaveric specimens, were imaged with the three above-mentioned UTE sequences with and without FatSat. The difference, correlation, and agreement between the UTE measurements with and without FatSat were calculated to investigate the effects of FatSat on quantification. RESULTS Fat was well-suppressed using all three UTE sequences when FatSat was deployed. For the small sample study, the quantification difference ratio (QDR) values of all the measured biomarkers ranged from 0.7% to 12.6%, whereas for the whole knee joint specimen study, the QDR values ranged from 0.2% to 12.0%. Except for T1ρ in muscle and MMF in meniscus (p > 0.05), most of the measurements showed statistical differences for T1ρ , MTR, and MMF (p < 0.05) between FatSat and non-FatSat scans. Most of the measurements for T 2 ∗ showed no significant differences (p > 0.05). Strong correlations were found for all the biomarkers between measurements with and without FatSat. CONCLUSION The UTE biomarkers showed good correlation and agreement with some slight differences between the scans with and without FatSat.
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Affiliation(s)
- Yanjun Chen
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.,Department of Radiology, University of California, San Diego, California, USA
| | - Liang Li
- Department of Radiology, University of California, San Diego, California, USA.,Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Nicole Le
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Wenhua Huang
- Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Ya-Jun Ma
- Department of Radiology, University of California, San Diego, California, USA
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43
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Yang Z, Xie C, Ou S, Zhao M, Lin Z. Cutoff points of T1 rho/T2 mapping relaxation times distinguishing early-stage and advanced osteoarthritis. Arch Med Sci 2022; 18:1004-1015. [PMID: 35832709 PMCID: PMC9266714 DOI: 10.5114/aoms/140714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The histopathology grading system is the gold standard post-operative method to evaluate cartilage degeneration in knee osteoarthritis (OA). Magnetic resonance imaging (MRI) T1 rho/T2 mapping imaging can be used for preoperative detection. An association between histopathology and T1 rho/T2 mapping relaxation times was suggested in previous research. However, the cutoff point was not determined among different histopathology grades. Our study aimed to determine the cutoff point of T1 rho/T2 mapping. MATERIAL AND METHODS T1 rho/T2 mapping images were acquired from 80 samples before total knee replacements. Then the histopathology grading system was applied. RESULTS The mean T1 rho/T2 mapping relaxation times of 80 samples were 39.17 ms and 37.98 ms respectively. Significant differences were found in T1 rho/T2 mapping values between early-stage and advanced OA (p < 0.001). The cutoff point for T1 rho was 33 ms with a sensitivity of 94.12 (95% CI: 80-99.3) and a specificity of 91.30 (95% CI: 79.2-97.6). The cutoff point for T2 mapping was suggested as 35.04 ms with a sensitivity of 88.24 (95% CI: 72.5-96.7) and specificity of 97.83 (95% CI: 88.5-99.9). After bootstrap simulation, the 95% CI of the T1 rho/T2 mapping cutoff point was estimated as 29.36 to 36.32 ms and 34.8 to 35.04 ms respectively. The area under the PR curve of T1 rho/T2 mapping was 0.972 (95% CI: 0.925-0.992) and 0.949 (95% CI: 0.877-0.989) respectively. CONCLUSIONS The cutoff point of T1 rho relaxation times, which was suggested as 33 ms, could be used to distinguish early-stage and advanced OA.
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Affiliation(s)
- Zhijian Yang
- Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chao Xie
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Songwen Ou
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Minning Zhao
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaowei Lin
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Cutcliffe HC, Kottamasu PK, McNulty AL, Goode AP, Spritzer CE, DeFrate LE. Mechanical metrics may show improved ability to predict osteoarthritis compared to T1rho mapping. J Biomech 2021; 129:110771. [PMID: 34627074 PMCID: PMC8744537 DOI: 10.1016/j.jbiomech.2021.110771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/01/2023]
Abstract
Changes in cartilage structure and composition are commonly observed during the progression of osteoarthritis (OA). Importantly, quantitative magnetic resonance imaging (MRI) methods, such as T1rho relaxation imaging, can noninvasively provide in vivo metrics that reflect changes in cartilage composition and therefore have the potential for use in early OA detection. Changes in cartilage mechanical properties are also hallmarks of OA cartilage; thus, measurement of cartilage mechanical properties may also be beneficial for earlier OA detection. However, the relative predictive ability of compositional versus mechanical properties in detecting OA has yet to be determined. Therefore, we developed logistic regression models predicting OA status in an ex vivo environment using several mechanical and compositional metrics to assess which metrics most effectively predict OA status. Specifically, in this study the compositional metric analyzed was the T1rho relaxation time, while the mechanical metrics analyzed were the stiffness and recovery (defined as a measure of how quickly cartilage returns to its original shape after loading) of the cartilage. Cartilage recovery had the best predictive ability of OA status both alone and in a multivariate model including the T1rho relaxation time. These findings highlight the potential of cartilage recovery as a non-invasive marker of in vivo cartilage health and motivate future investigation of this metric clinically.
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Affiliation(s)
- Hattie C Cutcliffe
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States
| | - Pavan K Kottamasu
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States
| | - Amy L McNulty
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Pathology, Duke University School of Medicine, Durham, NC 27710, United States
| | - Adam P Goode
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC 27710, United States; Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC 27710, United States
| | - Charles E Spritzer
- Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States; Department of Radiology, Duke University School of Medicine, Durham, NC 27710, United States
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC 27710, United States; Department of Biomedical Engineering, Duke University, Durham, NC 27708, United States; Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC 27708, United States.
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Zhao Q, Ridout RP, Shen J, Wang N. Effects of Angular Resolution and b Value on Diffusion Tensor Imaging in Knee Joint. Cartilage 2021; 13:295S-303S. [PMID: 33843284 PMCID: PMC8804734 DOI: 10.1177/19476035211007909] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To investigate the influences of the diffusion gradient directions (angular resolution) and the strength of the diffusion gradient (b value) on diffusion tensor imaging (DTI) metrics and tractography of various connective tissues in knee joint. DESIGN Two rat knee joints were scanned on a preclinical 9.4-T system using a 3-dimensional diffusion-weighted spin echo pulse sequence. One protocol with b value of 500, 1500, and 2500 s/mm2 were acquired separately using 43 diffusion gradient directions. The other protocol with b value of 1000 s/mm2 was performed using 147 diffusion gradient directions. The in-plane resolution was 45 µm isotropic. Fractional anisotropy (FA) and mean diffusivity (MD) were compared at different angular resolution. Tractography was quantitatively evaluated at different b values and angular resolutions in cartilage, ligament, meniscus, and growth plate. RESULTS The ligament showed higher FA value compared with growth plate and cartilage. The FA values were largely overestimated at the angular resolution of 6. Compared with FA, MD showed less sensitivity to the angular resolution. The fiber tracking was failed at low angular resolution (6 diffusion gradient directions) or high b value (2500 s/mm2). The quantitative measurements of tract length and track volume were strongly dependent on angular resolution and b value. CONCLUSIONS To obtain consistent DTI outputs and tractography in knee joint, the scan may require a proper b value (ranging from 500 to 1500 s/mm2) and sufficient angular resolution (>14) with signal-to-noise ratio >10.
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Affiliation(s)
- Qi Zhao
- School of Psychology, Shanghai
University of Sport, Shanghai, China
| | - Rees P. Ridout
- Pratt School of Engineering, Duke
University, Durham, NC, USA
| | - Jikai Shen
- Pratt School of Engineering, Duke
University, Durham, NC, USA
| | - Nian Wang
- Department of Radiology, Duke
University School of Medicine, Durham, NC, USA,Department of Radiology and Imaging
Sciences, Indiana University School of Medicine, Indianapolis, IN, USA,Nian Wang, Department of Radiology and
Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN 46202,
USA.
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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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Alsayyad MAI, Ali Shehata KA, Khattab RT. Role of adding T2 mapping sequence to the routine MR imaging protocol in the assessment of articular knee cartilage in osteoarthritis. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-021-00453-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This work aims at elucidating the role of adding complementary T2 mapping to the routine 1.5 Tesla MRI protocol in the articular knee cartilage assessment for early detection of osteoarthritis, and also, comparing the articular cartilage thickness and T2 relaxation times between the case and control groups regarding knee compartments affection.
Results
Both sensitivities and specificities were 73.3% and 100%, respectively, for the standard MR protocol alone and 96.7% and 90% after adding the T2 mapping to the standard MR protocol that leads to significant sensitivity improvement. A comparison between patients and controls as regards T2 values showed a highly statistically significant difference (independent T test, p <0.001).
Conclusion
A combination of both morphological and T2 mapping MRI, together with clinical evaluation represents a desirable multimodal approach to the diagnosis of osteoarthritis. In the early detection of osteoarthritis, adding T2 mapping sequence to the standard MR protocol at 1.5 Tesla improved sensitivity from 73.3 to 96.7%.
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Lisee C, Spang JT, Loeser R, Longobardi L, Lalush D, Nissman D, Schwartz T, Hu D, Pietrosimone B. Tibiofemoral articular cartilage composition differs based on serum biochemical profiles following anterior cruciate ligament reconstruction. Osteoarthritis Cartilage 2021; 29:1732-1740. [PMID: 34536530 DOI: 10.1016/j.joca.2021.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/31/2021] [Accepted: 09/08/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Biochemical joint changes contribute to posttraumatic osteoarthritis (PTOA) development following anterior cruciate ligament reconstruction (ACLR). The purpose of this longitudinal cohort study was to compare tibiofemoral cartilage composition between ACLR patients with different serum biochemical profiles. We hypothesized that profiles of increased inflammation (monocyte chemoattractant protein-1 [MCP-1]), type-II collagen turnover (type-II collagen breakdown [C2C]:synthesis [CPII]), matrix degradation (matrix metalloproteinase-3 [MMP-3] and cartilage oligomeric matrix protein [COMP]) preoperatively to 6-months post-ACLR would be associated with greater tibiofemoral cartilage T1ρ relaxation times 12-months post-ACLR. DESIGN Serum was collected from 24 patients (46% female, 22.1 ± 4.2 years old, 24.0 ± 2.6 kg/m2 body mass index [BMI]) preoperatively (6.4 ± 3.6 days post injury) and 6-months post-ACLR. T1ρ Magnetic Resonance Imaging (MRI) was collected for medial and lateral tibiofemoral articular cartilage at 12-months post-ACLR. A k-means cluster analysis was used to identify profiles based on biomarker changes over time and T1ρ relaxation times were compared between cluster groups controlling for sex, age, BMI, concomitant injury (either meniscal or chondral pathology), and Marx Score. RESULTS One cluster exhibited increases in MCP-1 and COMP while the other demonstrated decreases in MCP-1 and COMP preoperatively to 6-months post-ACLR. The cluster group with increases in MCP-1 and COMP demonstrated greater lateral tibial (adjusted mean difference = 3.88, 95% confidence intervals [1.97-5.78]) and femoral (adjusted mean difference = 12.71, 95% confidence intervals [0.41-23.81]) T1ρ relaxation times. CONCLUSION Profiles of increased serum levels of inflammation and matrix degradation markers preoperatively to 6-months post-ACLR are associated with MRI changes consistent with lesser lateral tibiofemoral cartilage proteoglycan density 12-months post-ACLR.
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Affiliation(s)
- C Lisee
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC, USA.
| | - J T Spang
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - R Loeser
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA
| | - L Longobardi
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - D Lalush
- Joint Department of Biomedical Engineering, North Carolina State University and University of North Carolina at Chapel Hill, Raleigh, NC, USA
| | - D Nissman
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill NC, USA
| | - T Schwartz
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA
| | - D Hu
- Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - B Pietrosimone
- Department of Exercise and Sports Science, University of North Carolina at Chapel Hill, NC, USA
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Tibrewala R, Pedoia V, Lee J, Kinnunen C, Popovic T, Zhang AL, Link TM, Souza RB, Majumdar S. Automatic hip abductor muscle fat fraction estimation and association with early OA cartilage degeneration biomarkers. J Orthop Res 2021; 39:2376-2387. [PMID: 33368579 DOI: 10.1002/jor.24974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 08/19/2020] [Accepted: 12/21/2020] [Indexed: 02/04/2023]
Abstract
The aim of this study was to develop an automatic segmentation method for hip abductor muscles and find their fat fraction associations with early stage hip osteoarthritis (OA) cartilage degeneration biomarkers. This Institutional Review Board approved, Health Insurance Portability and Accountability Act compliant prospective study recruited 61 patients with evidence of hip OA or Femoroacetabular Impingement (FAI). Magnetic resonance (MR) images were acquired for cartilage segmentation, T1ρ and T2 relaxation times computation and grading of cartilage lesion scores. A 3D V-Net (Dice loss, Adam optimizer, learning rate = 1e-4 , batch size = 3) was trained to segment the three muscles (gluteus medius, gluteus minimus, and tensor fascia latae). The V-Net performance was measured using Dice, distance maps between manual and automatic masks, and Bland-Altman plots of the fat fractions and volumes. Associations between muscle fat fraction and T1ρ , T2 relaxation times values were found using voxel based relaxometry (VBR). A p < 0.05 was considered significant. The V-Net had a Dice of 0.90, 0.88, and 0.91 (GMed, GMin, and TFL). The VBR results found associations of fat fraction of all three muscles in early stage OA and FAI patients with T1ρ , T2 relaxation times. Using an automatic, validated segmentation model, the associations derived between OA biomarkers and muscle fat fractions provide insight into early changes that occur in OA, and show that hip abductor muscle fat is associated with markers of cartilage degeneration.
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Affiliation(s)
- Radhika Tibrewala
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Jinhee Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Carla Kinnunen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Tijana Popovic
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Alan L Zhang
- Department of Orthopedics, University of California at San Francisco, San Francisco, San Francisco, California, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Richard B Souza
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA.,Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
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50
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Chalian M, Li X, Guermazi A, Obuchowski NA, Carrino JA, Oei EH, Link TM. The QIBA Profile for MRI-based Compositional Imaging of Knee Cartilage. Radiology 2021; 301:423-432. [PMID: 34491127 PMCID: PMC8574057 DOI: 10.1148/radiol.2021204587] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
MRI-based cartilage compositional analysis shows biochemical and microstructural changes at early stages of osteoarthritis before changes become visible with structural MRI sequences and arthroscopy. This could help with early diagnosis, risk assessment, and treatment monitoring of osteoarthritis. Spin-lattice relaxation time constant in rotating frame (T1ρ) and T2 mapping are the MRI techniques best established for assessing cartilage composition. Only T2 mapping is currently commercially available, which is sensitive to water, collagen content, and orientation of collagen fibers, whereas T1ρ is more sensitive to proteoglycan content. Clinical application of cartilage compositional imaging is limited by high variability and suboptimal reproducibility of the biomarkers, which was the motivation for creating the Quantitative Imaging Biomarkers Alliance (QIBA) Profile for cartilage compositional imaging by the Musculoskeletal Biomarkers Committee of the QIBA. The profile aims at providing recommendations to improve reproducibility and to standardize cartilage compositional imaging. The QIBA Profile provides two complementary claims (summary statements of the technical performance of the quantitative imaging biomarkers that are being profiled) regarding the reproducibility of biomarkers. First, cartilage T1ρ and T2 values are measurable at 3.0-T MRI with a within-subject coefficient of variation of 4%-5%. Second, a measured increase or decrease in T1ρ and T2 of 14% or more indicates a minimum detectable change with 95% confidence. If only an increase in T1ρ and T2 values is expected (progressive cartilage degeneration), then an increase of 12% represents a minimum detectable change over time. The QIBA Profile provides recommendations for clinical researchers, clinicians, and industry scientists pertaining to image data acquisition, analysis, and interpretation and assessment procedures for T1ρ and T2 cartilage imaging and test-retest conformance. This special report aims to provide the rationale for the proposed claims, explain the content of the QIBA Profile, and highlight the future needs and developments for MRI-based cartilage compositional imaging for risk prediction, early diagnosis, and treatment monitoring of osteoarthritis.
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Affiliation(s)
- Majid Chalian
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Xiaojuan Li
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Ali Guermazi
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Nancy A. Obuchowski
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - John A. Carrino
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Edwin H. Oei
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Thomas M. Link
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - for the RSNA QIBA MSK Biomarker Committee
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
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