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Khoury MA, Chamari K, Tabben M, Alkhelaifi K, Papacostas E, Fermín TM, Laupheimer M, D'Hooghe P. Response to Comments by Zhao et al. Regarding "Knee Osteoarthritis: Clinical and MRI Outcomes After Multiple Intra-Articular Injections With Expanded Autologous Adipose-Derived Stromal Cells or Platelet-Rich Plasma". Cartilage 2024; 15:202-203. [PMID: 37882052 DOI: 10.1177/19476035231201056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023] Open
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Parillo M, Mallio CA, Dekkers IA, Rovira À, van der Molen AJ, Quattrocchi CC. Late/delayed gadolinium enhancement in MRI after intravenous administration of extracellular gadolinium-based contrast agents: is it worth waiting? MAGMA 2024; 37:151-168. [PMID: 38386150 DOI: 10.1007/s10334-024-01151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/17/2024] [Accepted: 01/30/2024] [Indexed: 02/23/2024]
Abstract
The acquisition of images minutes or even hours after intravenous extracellular gadolinium-based contrast agents (GBCA) administration ("Late/Delayed Gadolinium Enhancement" imaging; in this review, further termed LGE) has gained significant prominence in recent years in magnetic resonance imaging. The major limitation of LGE is the long examination time; thus, it becomes necessary to understand when it is worth waiting time after the intravenous injection of GBCA and which additional information comes from LGE. LGE can potentially be applied to various anatomical sites, such as heart, arterial vessels, lung, brain, abdomen, breast, and the musculoskeletal system, with different pathophysiological mechanisms. One of the most popular clinical applications of LGE regards the assessment of myocardial tissue thanks to its ability to highlight areas of acute myocardial damage and fibrotic tissues. Other frequently applied clinical contexts involve the study of the urinary tract with magnetic resonance urography and identifying pathological abdominal processes characterized by high fibrous stroma, such as biliary tract tumors, autoimmune pancreatitis, or intestinal fibrosis in Crohn's disease. One of the current areas of heightened research interest revolves around the possibility of non-invasively studying the dynamics of neurofluids in the brain (the glymphatic system), the disruption of which could underlie many neurological disorders.
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Affiliation(s)
- Marco Parillo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy
- Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 200, 00128, Rome, Italy
| | - Carlo Augusto Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
- Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Autonomous University of Barcelona and Hospital Vall d'Hebron, Passeig Vall d'Hebron, Barcelona, Spain
| | - Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Restuccia R, Ruggieri D, Magaudda L, Talotta R. The preventive and therapeutic role of physical activity in knee osteoarthritis. Reumatismo 2022; 74. [PMID: 35506320 DOI: 10.4081/reumatismo.2022.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/18/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this narrative review is to discuss the results of studies investigating the role of physical activity in knee osteoarthritis (OA). We also formulated two evidence-based exercise programs that could be prescribed to patients with symptomatic knee OA or after joint replacement. The PubMed and Google Scholar databases were searched for articles related to knee OA and physical activity. A total of 86 papers written in English and published from 1957 to 2021 were selected. Adapted physical activity, even at high intensity, does not appear to trigger or exacerbate knee OA; on the contrary, it may prevent obesity or lower limb muscle weakness, both of which are considered predisposing factors for the disease. In patients already diagnosed with knee OA, scientific evidence suggests that both land-based and aquatic activities combining aerobics, strength, and endurance programs are safe and effective. Physical interventions tailored to the patient may also accelerate recovery time after knee arthroplasty. Knee OA is a painful and disabling rheumatic disease that is very common in the elderly population. Pharmacotherapy has a modest effect in controlling disease progression, possibly due to the still limited understanding of OA pathogenesis. Non-pharmacologic interventions, including dietary and lifestyle changes and physical activity, may be more effective and safer than drugs in preventing or treating knee OA.
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Affiliation(s)
- R Restuccia
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina.
| | - D Ruggieri
- Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - L Magaudda
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina, Italy; Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - R Talotta
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina.
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Šprláková-Puková A, Štouračová A, Repko M, Koriťáková E, Tintěra J, Dostál M, Otaševič T. Prospective Multiparametric Magnetic Resonance Monitoring of Changes in Lesions of Hyaline Cartilage of the Knee Joint After Treatment by Microfractures and Implantation of Biological Collagen Type I Matrix Implants . Acad Radiol 2021; 28:1133-1141. [PMID: 32620530 DOI: 10.1016/j.acra.2020.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/12/2020] [Accepted: 05/20/2020] [Indexed: 11/27/2022]
Abstract
RATIONALE AND OBJECTIVES This study's aims were to depict changes in cartilage quality after surgical intervention using magnetic resonance (MR) examination and in content of glycosaminoglycans chains (GAGs) after two types of surgeries - chondral defect treatment by microfractures and scaffold implantation in combination with microfractures. MATERIALS AND METHODS Twenty-five patients were studied: 14 with implants, 11 with microfractures. MR examination was made before surgery and 6, 12, and 18 months thereafter. Qualitative changes in cartilage were observed by means of delayed gadolinium enhanced magnetic resonance imaging of cartilage sequence using Gd-DTPA2- and Gd-DOTA. In each examination, GAGs content was determined at three locations: the defect, its surroundings, and a non-load-bearing reference area. RESULTS Measured indices showed no statistically significant differences in changes within the defect area when comparing the two treatment types at individual time points of 6, 12, and 18 months. In the case of microfracture treatment, more substantial decrease in GAGs concentration occurred at month 6, whereas the greatest decline occurred at month 12 when using an implant. Change in GAGs content and decline in cartilage quality were substantial also in the reference area and close surroundings. CONCLUSIONS Hyaline cartilage behaves as a unified whole, and change in GAGs content was marked also in locations with no morphological damage. Over the monitored period, no statistically significant difference between treatment types was noted as measured by GAGs content in the defect or its close surroundings. dGEMRIC is suitable for monitoring cartilage quality even if use of Gd-DTPA2- is not possible, because comparable results were achieved using Gd-DOTA.
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Zhang Q, Guo W, Chen Y, Zhao Q, Liu Z, Wang W. The Glycosaminoglycan Content of Hip Cartilage in Osteonecrosis of Femoral Head: Evaluation with Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage. Cartilage 2021; 12:70-75. [PMID: 30282478 PMCID: PMC7755965 DOI: 10.1177/1947603518803732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Hip cartilage quality is essential for the success of joint-preserving surgery for osteonecrosis. This study aimed to characterize cartilage changes in osteonecrosis of femoral head (ONFH) using delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC). DESIGN Fifteen asymptomatic (control) and 60 ONFH subjects were included in this study. The ONFH subjects were stratified in accordance with the Association Research Circulation Osseous (ARCO) classification (n = 15 hips per ARCO stage). All participant hips were investigated using dGEMRIC and theT1Gd data were collected and analyzed. RESULTS T1Gd value was significantly lower in the ONFH group (365.1 ± 90.5 ms; range 200-498 ms) compared with the control group (546.1 ± 26.0 ms; range 504-580 ms) (P < 0.001). The T1Gd values of ARCO stage I-IV ONFH were 460.2 ± 17.3 ms (439-498 ms), 408.9 ± 43.4 ms (337-472 ms), 359.9 ± 34.5 ms (303-412 ms), 231.5 ± 15.1 ms (200-253 ms), respectively. Decreased T1Gd value was found to correlate significantly with increased ONFH severity (P < 0.001). T1Gd value in collapse stage was significantly lower than that of noncollapse stage (295.7 ± 70.3 ms [range 200-412 ms] vs. 434.6 ± 41.7 ms [range 337-498 ms]; P < 0.001). CONCLUSIONS dGEMRIC identified hip cartilage as abnormal in ONFH, even at early-stage, as represented by decreased T1Gd, and this was further aggravated by ONFH collapse.
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Affiliation(s)
- Qidong Zhang
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Wanshou Guo
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Yan Chen
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Qichao Zhao
- Department of Radiology, China-Japan Friendship Hospital, Beijing, China
| | - Zhaohui Liu
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Weiguo Wang
- Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China,Weiguo Wang, Department of Orthopaedic Surgery, Beijing Key Lab Immune-Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Yinghua Street 2#, Chaoyang District, Beijing, 100029, China.
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Shi B, Huang H. Computational technology for nasal cartilage-related clinical research and application. Int J Oral Sci 2020; 12:21. [PMID: 32719336 PMCID: PMC7385163 DOI: 10.1038/s41368-020-00089-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 02/05/2023] Open
Abstract
Surgeons need to understand the effects of the nasal cartilage on facial morphology, the function of both soft tissues and hard tissues and nasal function when performing nasal surgery. In nasal cartilage-related surgery, the main goals for clinical research should include clarification of surgical goals, rationalization of surgical methods, precision and personalization of surgical design and preparation and improved convenience of doctor-patient communication. Computational technology has become an effective way to achieve these goals. Advances in three-dimensional (3D) imaging technology will promote nasal cartilage-related applications, including research on computational modelling technology, computational simulation technology, virtual surgery planning and 3D printing technology. These technologies are destined to revolutionize nasal surgery further. In this review, we summarize the advantages, latest findings and application progress of various computational technologies used in clinical nasal cartilage-related work and research. The application prospects of each technique are also discussed.
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Affiliation(s)
- Bing Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 610041, Chengdu, China
| | - Hanyao Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 610041, Chengdu, China.
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Brinkhof S, Ali Haghnejad A, Ito K, Markenroth Bloch K, Klomp D. Uncompromised MRI of knee cartilage while incorporating sensitive sodium MRI. NMR Biomed 2019; 32:e4173. [PMID: 31502337 PMCID: PMC6900061 DOI: 10.1002/nbm.4173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
Sodium imaging is able to assess changes in ion content, linked to glycosaminoglycan content, which is important to guide orthopeadic procedures such as articular cartilage repair. Sodium imaging is ideally performed using double tuned RF coils, to combine high resolution morphological imaging with biochemical information from sodium imaging to assess ion content. The proton image quality of such coils is often harshly degraded, with up to 50% of SNR or severe acceleration loss as compared to single tuned coils. Reasons are that the number of proton receive channels often severely reduced and double tuning will degrade the intrinsic sensitivity of the RF coil on at least one of the nuclei. However, the aim of this work was to implement a double-tuned sodium/proton knee coil setup without deterioration of the proton signal whilst being able to achieve acquisition of high SNR sodium images. A double-tuned knee coil was constructed as a shielded birdcage optimized for sodium and compromised for proton. To exclude any compromise, the proton part of the birdcage is used for transmit only and interfaced to RF amplifiers that can fully mitigate the reduced efficiency. In addition, a 15 channel single tuned proton receiver coil was embedded within the double-resonant birdcage to maintain optimal SNR and acceleration for proton imaging. To validate the efficiency of our coil, the designed coil was compared with the state-of-the-art single-tuned alternative at 7 T. B1+ corrected SNR maps were used to compare both coils on proton performance and g-factor maps were used to compare both coils on acceleration possibilities. The newly constructed double-tuned coil was shown to have comparable proton quality and acceleration possibilities to the single-tuned alternative while also being able to acquire high SNR sodium images.
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Affiliation(s)
- S. Brinkhof
- Department of RadiologyUniversity Medical Center UtrechtUtrechtNetherlands
| | | | - K. Ito
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, Netherlands
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenNetherlands
| | | | - D.W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtNetherlands
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Jin LH, Choi BH, Kim YJ, Oh HJ, Kim BJ, Yin XY, Min BH. Nondestructive Assessment of Glycosaminoglycans in Engineered Cartilages Using Hexabrix-Enhanced Micro-Computed Tomography. Tissue Eng Regen Med 2018; 15:311-319. [PMID: 30603556 PMCID: PMC6171677 DOI: 10.1007/s13770-018-0117-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/12/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022] Open
Abstract
It is very useful to evaluate the content and 3D distribution of extracellular matrix non-destructively in tissue engineering. This study evaluated the feasibility of using micro-computed tomography (µCT) with Hexabrix to measure quantitatively sulfated glycosaminoglycans (GAGs) of engineered cartilage. Rabbit chondrocytes at passage 2 were used to produce artificial cartilages in polyglycolic acid scaffolds in vitro. Engineered cartilages were incubated with Hexabrix 320 for 20 min and analyzed via µCT scanning. The number of voxels in the 2D and 3D scanning images were counted to estimate the amount of sulfated GAGs. The optimal threshold value for quantification was determined by regression analysis. The 2D µCT images of an engineered cartilage showed positive correlation with the histological image of Safranin-O staining. Quantitative data obtained with the 3D µCT images of 14 engineered cartilages showed strong correlation with sulfated GAGs contents obtained by biochemical analysis (R2 = 0.883, p < 0.001). Repeated exposure of engineered cartilages to Hexabrix 320 and µCT scanning did not significantly affect cell viability, total DNA content, or the total content of sulfated GAGs. We conclude that µCT imaging using Hexabrix 320 provides high spatial resolution and sensitivity to assess the content and 3D distribution of sulfated GAGs in engineered cartilages. It is expected to be a valuable tool to evaluate the quality of engineered cartilage for commercial development in the future.
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Affiliation(s)
- Long Hao Jin
- Department of Orthopedic Surgery, School of Medicine, Ajou University, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
- Present Address: Department of Orthopedic Surgery, Yanbian University Hospital, Yanji, China
| | - Byung Hyune Choi
- Department of Biomedical Sciences, College of Medicine, Inha University, 100 Inha-ro, Nam-gu, Incheon, 22212 Korea
| | - Young Jick Kim
- Cell Therapy Center, Ajou University Medical Center, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
| | - Hyun Ju Oh
- Cell Therapy Center, Ajou University Medical Center, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
- Department of Molecular Science and Technology, Ajou University, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
| | - Byoung Ju Kim
- Cell Therapy Center, Ajou University Medical Center, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
- Department of Molecular Science and Technology, Ajou University, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
| | - Xiang Yun Yin
- Department of Orthopedic Surgery, School of Medicine, Ajou University, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
- Cell Therapy Center, Ajou University Medical Center, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
| | - Byoung-Hyun Min
- Department of Orthopedic Surgery, School of Medicine, Ajou University, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
- Cell Therapy Center, Ajou University Medical Center, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
- Department of Molecular Science and Technology, Ajou University, 206 World Cup-ro, Yeongtong-gu, Suwon, 16499 Korea
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Bischofberger AS, Fürst AE, Torgerson PR, Carstens A, Hilbe M, Kircher P. Use of a 3-Telsa magnet to perform delayed gadolinium-enhanced magnetic resonance imaging of the distal interphalangeal joint of horses with and without naturally occurring osteoarthritis. Am J Vet Res 2018; 79:287-298. [PMID: 29466042 DOI: 10.2460/ajvr.79.3.287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) features of healthy hyaline cartilage of the distal interphalangeal joint (DIPJ) of horses, to determine whether dGEMRIC can be used to differentiate various stages of naturally occurring osteoarthritis of the DIPJ, and to correlate relaxation times determined by dGEMRIC with the glycosaminoglycan concentration, water content, and macroscopic and histologic findings of hyaline cartilage of DIPJs with and without osteoarthritis. SAMPLE 1 cadaveric forelimb DIPJ from each of 12 adult warmblood horses. PROCEDURES T1-weighted cartilage relaxation times were obtained for predetermined sites of the DIPJ before (T1preGd) and after (T1postGd) intra-articular gadolinium administration. Corresponding cartilage sites underwent macroscopic, histologic, and immunohistochemical evaluation, and cartilage glycosaminoglycan concentration and water content were determined. Median T1preGd and T1postGd were correlated with macroscopic, histologic, and biochemical data. Mixed generalized linear models were created to evaluate the effects of cartilage site, articular surface, and macroscopic and histologic scores on relaxation times. RESULTS 122 cartilage specimens were analyzed. Median T1postGd was lower than the median T1preGd for normal and diseased cartilage. Both T1preGd and T1postGd were correlated with macroscopic and histologic scores, whereby T1preGd increased and T1postGd decreased as osteoarthritis progressed. There was topographic variation of T1preGd and T1postGd within the DIPJ. Cartilage glycosaminoglycan concentration and water content were significantly correlated with T1preGd and macroscopic and histologic scores but were not correlated with T1postGd. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dGEMRIC relaxation times varied for DIPJs with various degrees of osteoarthritis. These findings may help facilitate early detection of osteoarthritis.
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Nelson BB, Kawcak CE, Barrett MF, McIlwraith CW, Grinstaff MW, Goodrich LR. Recent advances in articular cartilage evaluation using computed tomography and magnetic resonance imaging. Equine Vet J 2018; 50:564-579. [DOI: 10.1111/evj.12808] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/09/2018] [Indexed: 12/18/2022]
Affiliation(s)
- B. B. Nelson
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - C. E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. F. Barrett
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
- Department of Environmental and Radiological Health Sciences Colorado State University Fort Collins Colorado USA
| | - C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. W. Grinstaff
- Departments of Biomedical Engineering, Chemistry and Medicine Boston University Boston Massachusetts USA
| | - L. R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
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Brinkhof S, Nizak R, Khlebnikov V, Prompers JJ, Klomp DWJ, Saris DBF. Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T. Eur Radiol 2018; 28:2874-81. [PMID: 29383528 DOI: 10.1007/s00330-017-5277-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/18/2017] [Accepted: 12/21/2017] [Indexed: 12/04/2022]
Abstract
Objectives The purpose was to implement a fast 3D glycosaminoglycan Chemical Exchange Saturation Transfer (gagCEST) sequence at 7 T, test stability and reproducibility in cartilage in the knee in healthy volunteers, and evaluate clinical applicability in cartilage repair patients. Methods Experiments were carried out on a 7-T scanner using a volume transmit coil and a 32-channel receiver wrap-around knee coil. The 3D gagCEST measurement had an acquisition time of 7 min. Signal stability and reproducibility of the GAG effect were assessed in eight healthy volunteers. Clinical applicability of the method was demonstrated in five patients before cartilage repair surgery. Results Coefficient of variation of the gagCEST signal was 1.9%. The reproducibility of the GAG effect measurements was good in the medial condyle (ICC = 0.87) and excellent in the lateral condyle (ICC = 0.97). GAG effect measurements in healthy cartilage ranged from 2.6%-12.4% compared with 1.3%-5.1% in damaged cartilage. Difference in GAG measurement between healthy cartilage and damaged cartilage was significant (p < 0.05). Conclusions A fast 3D gagCEST sequence was applied at 7 T for use in cartilage in the knee, acquired within a clinically feasible scan time of 7 min. We demonstrated that the method has high stability, reproducibility and clinical applicability. Key Points • gagCEST measurements are stable and reproducible • A non-invasive GAG measurement with gagCEST can be acquired in 7 min • gagCEST is able to discriminate between healthy and damaged cartilage Electronic supplementary material The online version of this article (10.1007/s00330-017-5277-y) contains supplementary material, which is available to authorized users.
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Wan FY, Yue JA, Guo WS, Ma LY, Yan R, Zhang QD, Cheng LM. Glycosaminoglycan Content of the Lateral Compartment Cartilage in Knees Conforming to the Indications for Oxford Medial Unicompartmental Knee Arthroplasty. Chin Med J (Engl) 2018; 131:194-199. [PMID: 29336368 PMCID: PMC5776850 DOI: 10.4103/0366-6999.222321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: The quality of the lateral compartment cartilage is important to preoperative evaluation and prognostic prediction of unicompartmental knee arthroplasty (UKA). Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) enables noninvasive assessment of glycosaminoglycan (GAG) content in cartilage. This study aimed to determine the GAG content of the lateral compartment cartilage in knees scheduled to undergo Oxford medial UKA. Methods: From December 2016 to May 2017, twenty patients (20 osteoarthritic knees) conforming to the indications for Oxford medial UKA were included as the osteoarthritis (OA) group, and 20 healthy volunteers (20 knees) paired by sex, knee side, age (±3 years), and body mass index (BMI) (±3 kg/m2) were included as the control group. The GAG contents of the weight-bearing femoral cartilage (wbFC), the posterior non-weight-bearing femoral cartilage (pFC), the lateral femoral cartilage (FC), and tibial cartilage (TC) were detected using dGEMRIC. The dGEMRIC indices (T1Gd) were calculated in the middle three consecutive slices of the lateral compartment. Paired t-tests were used to compare the T1Gd in each region of interest between the OA group and control group. Results: The average age and BMI in the two groups were similar. In the OA group, T1Gd of FC and TC was 386.7 ± 50.7 ms and 429.6 ± 59.9 ms, respectively. In the control group, T1Gd of FC and TC was 397.5 ± 52.3 ms and 448.6 ± 62.5 ms, respectively. The respective T1Gd of wbFC and pFC was 380.0 ± 47.8 ms and 391.0 ± 66.3 ms in the OA group and 400.3 ± 51.5 ms and 393.6 ± 57.9 ms in the control group. Although the T1Gd of wbFC and TC tended to be lower in the OA group than the control group, there was no significant difference between groups in the T1Gd in any of the analyzed cartilage regions (P value of wbFC, pFC, FC, and TC was 0.236, 0.857, 0.465, and 0.324, respectively). Conclusions: The GAG content of the lateral compartment cartilage in knees conforming to indications for Oxford medial UKA is similar with those of age- and BMI-matched participants without OA.
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Affiliation(s)
- Fu-Yin Wan
- Department of Bone and Joint Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China
| | - Ju-An Yue
- Department of Bone and Joint, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Wan-Shou Guo
- Department of Bone and Joint Surgery, Peking University China-Japan Friendship School of Clinical Medicine; Department of Bone and Joint Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Lu-Yao Ma
- Department of Bone and Joint Surgery, Peking University China-Japan Friendship School of Clinical Medicine, Beijing 100029, China
| | - Ran Yan
- Department of Radiology, China-Japan Friendship Hospital, Beijing 100029, China
| | - Qi-Dong Zhang
- Department of Bone and Joint Surgery, China-Japan Friendship Hospital, Beijing 100029, China
| | - Li-Ming Cheng
- Department of Bone and Joint Surgery, China-Japan Friendship Hospital, Beijing 100029, China
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Xing D, Wang Q, Yang Z, Hou Y, Zhang W, Chen Y, Lin J. Mesenchymal stem cells injections for knee osteoarthritis: a systematic overview. Rheumatol Int 2017; 38:1399-1411. [DOI: 10.1007/s00296-017-3906-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/05/2017] [Indexed: 02/06/2023]
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15
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Abstract
MRI remains the optimal imaging modality to evaluate cartilage injuries in the athlete. As these injuries have no intrinsic healing capacity, early and accurate noninvasive diagnosis remains integral to determining the most appropriate treatment option in this class of patients. Although surgical success depends primarily on clinical outcomes, MRI evaluation can provide pertinent information regarding the status of the surgical repair and the progression of cartilage disease.
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Affiliation(s)
- Christopher M Coleman
- Department of Radiology, University of Colorado Hospital, 12605 East 16th Avenue, Aurora, CO 80045, USA.
| | - Jonathan A Flug
- Department of Radiology, University of Colorado Hospital, 12605 East 16th Avenue, Aurora, CO 80045, USA
| | - Nancy Major
- Department of Radiology, University of Colorado Hospital, 12605 East 16th Avenue, Aurora, CO 80045, USA
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16
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Wei W, Lambach B, Jia G, Flanigan D, Chaudhari AM, Wei L, Rogers A, Payne J, Siston RA, Knopp MV. Assessing the effect of football play on knee articular cartilage using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Magn Reson Imaging 2017; 39:149-156. [DOI: 10.1016/j.mri.2017.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/09/2017] [Accepted: 01/09/2017] [Indexed: 11/28/2022]
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17
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Schmaranzer F, Haefeli PC, Hanke MS, Liechti EF, Werlen SF, Siebenrock KA, Tannast M. How Does the dGEMRIC Index Change After Surgical Treatment for FAI? A Prospective Controlled Study: Preliminary Results. Clin Orthop Relat Res 2017; 475:1080-1099. [PMID: 27709422 PMCID: PMC5339130 DOI: 10.1007/s11999-016-5098-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI). QUESTIONS/PURPOSES (1) How does the mean acetabular and femoral dGEMRIC index change after surgery for FAI at 1-year followup compared with a similar group of patients with FAI treated without surgery? (2) Does the regional distribution of the acetabular and femoral dGEMRIC index change for the two groups over time? (3) Is there a correlation between the baseline dGEMRIC index and the change of patient-reported outcome measures (PROMs) at 1-year followup? (4) Among those treated surgically, can dGEMRIC indices distinguish between intact and degenerated cartilage? METHODS We performed a prospective, comparative, nonrandomized, longitudinal study. At the time of enrollment, the patients' decision whether to undergo surgery or choose nonoperative treatment was not made yet. Thirty-nine patients (40 hips) who underwent either joint-preserving surgery for FAI (20 hips) or nonoperative treatment (20 hips) were included. The two groups did not differ regarding Tönnis osteoarthritis score, preoperative PROMs, or baseline dGEMRIC indices. There were more women (60% versus 30%, p = 0.003) in the nonoperative group and patients were older (36 ± 8 years versus 30 ± 8 years, p = 0.026) and had lower alpha angles (65° ± 10° versus 73° ± 12°, p = 0.022) compared with the operative group. We used a 3.0-T scanner and a three-dimensional dual flip-angle gradient-echo technique for the dGEMRIC technique for the baseline and the 1-year followup measurements. dGEMRIC indices of femoral and acetabular cartilage were measured separately on the initial and followup radial dGEMRIC reformats in direct comparison with morphologic radial images. Regions of interest were placed manually peripherally and centrally within the cartilage based on anatomic landmarks at the clockface positions. The WOMAC, the Hip disability and Osteoarthritis Outcome Score, and the modified Harris hip score were used as PROMs. Among those treated surgically, the intraoperative damage according to the Beck grading was recorded and compared with the baseline dGEMRIC indices. RESULTS Although both the operative and the nonoperative groups experienced decreased dGEMRIC indices, the declines were more pronounced in the operative group (-96 ± 112 ms versus -16 ± 101 ms on the acetabular side and -96 ± 123 ms versus -21 ± 83 ms on the femoral side in the operative and nonoperative groups, respectively; p < 0.001 for both). Patients undergoing hip arthroscopy and surgical hip dislocation experienced decreased dGEMRIC indices; the decline in femoral dGEMRIC indices was more pronounced in hips after surgical hip dislocation (-120 ± 137 ms versus -61 ± 89 ms, p = 0.002). In the operative group a decline in dGEMRIC indices was observed in 43 of 44 regions over time. In the nonoperative group a decline in dGEMRIC indices was observed in four of 44 regions over time. The strongest correlation among patients treated surgically was found between the change in WOMAC and baseline dGEMRIC indices for the entire joint (R = 0.788, p < 0.001). Among those treated nonoperatively, no correlation between baseline dGEMRIC indices and change in PROMs was found. In the posterosuperior quadrant, the dGEMRIC index was higher for patients with intact cartilage compared with hips with chondral lesions (592 ± 203 ms versus 444 ± 205 ms, p < 0.001). CONCLUSIONS We found a decline in acetabular, femoral, and regional dGEMRIC indices for the surgically treated group at 1-year followup despite an improvement in all PROMs. We observed a similar but less pronounced decrease in the dGEMRIC index in symptomatic patients without surgical treatment indicating continuous cartilage degeneration. Although treatment of FAI is intended to alter the forces acting across the hip by eliminating impingement, its effects on cartilage biology are not clear. dGEMRIC provides a noninvasive method of assessing these effects. Longer term studies will be needed to determine whether the matrix changes of the bradytrophic cartilage seen here are permanent or clinically important. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Florian Schmaranzer
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010 Switzerland
| | - Pascal C. Haefeli
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010 Switzerland
| | - Markus S. Hanke
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010 Switzerland
| | - Emanuel F. Liechti
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010 Switzerland
| | | | - Klaus A. Siebenrock
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010 Switzerland
| | - Moritz Tannast
- Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, Bern, 3010 Switzerland
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Wei W, Lambach B, Jia G, Kaeding C, Flanigan D, Knopp MV. A Phase I clinical trial of the knee to assess the correlation of gagCEST MRI, delayed gadolinium-enhanced MRI of cartilage and T2 mapping. Eur J Radiol 2017; 90:220-224. [PMID: 28583638 DOI: 10.1016/j.ejrad.2017.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/14/2017] [Accepted: 02/18/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE Osteoarthritis (OA) is associated with the loss of glycosaminoglycan (GAG) during disease progression, which can be detected by glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) MRI. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is considered one of the standard methods for GAG quantification in vivo. This Phase I study assessed the correlation between gagCEST MRI and dGEMRIC in determining cartilage GAG concentration. Standard T2 mapping was used as a comparator with the two other methods. MATERIALS AND METHODS Eight athletic volunteers with no known knee diseases were recruited in this study. The sagittal images of both knees in each volunteer were obtained by a 3T MRI system. GAG concentration was calculated based on fixed charge density (FCD) within articular cartilage as calculated by T1 values obtained from dGEMRIC sequences. Magnetization transfer ratio asymmetry (MTRasym) of the CEST spectrum at 1ppm was determined with gagCEST MRI. T2 values were calculated using a multi-echo turbo spin echo (TSE) sequence. The Pearson correlations among MTRasym were calculated from gagCEST analysis. RESULTS There was moderate correlation (correlation coefficient r=0.55) between dGEMRIC and gagCEST MRI results. T2 had a low correlation (r=-0.30) with gagCEST and no correlation with dGEMRIC (r=0.003). Both gagCEST and dGEMRIC were able to distinguish between high GAG concentration cartilage compartments (higher than 210mM) and low GAG cartilage compartments (lower than 210mM). CONCLUSION dGEMRIC was shown to be a more accurate and sensitive clinical imaging tool in evaluating cartilage GAG levels in vivo. While GagCEST showed less sensitivity to GAG concentration variations than dGEMRIC, further improvements may yet enable gagCEST to be a clinically robust methodology.
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Affiliation(s)
- Wenbo Wei
- Wright Center of Innovation in Biomedical Imaging and Department of Radiology, The Ohio State University, Columbus, OH, United States
| | - Becky Lambach
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, United States
| | - Guang Jia
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA, United States
| | - Christopher Kaeding
- Department of Orthopedics, The Ohio State University, Columbus, OH, United States
| | - David Flanigan
- Department of Orthopedics, The Ohio State University, Columbus, OH, United States
| | - Michael V Knopp
- Wright Center of Innovation in Biomedical Imaging and Department of Radiology, The Ohio State University, Columbus, OH, United States.
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19
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Abstract
Cartilage loss is irreversible, and to date, no effective pharmacotherapies are available to protect or regenerate cartilage. Quantitative prestructural/compositional MR imaging techniques have been developed to characterize the cartilage matrix quality at a stage where abnormal findings are early and potentially reversible, allowing intervention to halt disease progression. The goal of this article is to critically review currently available technologies, present the basic concept behind these techniques, but also to investigate their suitability as imaging biomarkers including their validity, reproducibility, risk prediction and monitoring of therapy. Moreover, we highlighted important clinical applications. This review article focuses on the currently most relevant and clinically applicable technologies, such as T2 mapping, T2*, T1ρ, delayed gadolinium enhanced MRI of cartilage (dGEMRIC), sodium imaging and glycosaminoglycan chemical exchange saturation transfer (gagCEST). To date, most information is available for T2 and T1ρ mapping. dGEMRIC has also been used in multiple clinical studies, although it requires Gd contrast administration. Sodium imaging and gagCEST are promising technologies but are dependent on high field strength and sophisticated software and hardware. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2017;45:949-965.
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Affiliation(s)
- Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
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20
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Chandrasekaran S, Vemula SP, Lindner D, Lodhia P, Suarez-Ahedo C, Domb BG. Preoperative Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) for Patients Undergoing Hip Arthroscopy: Indices Are Predictive of Magnitude of Improvement in Two-Year Patient-Reported Outcomes. J Bone Joint Surg Am 2015; 97:1305-15. [PMID: 26290081 DOI: 10.2106/jbjs.n.01253] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) has been used in the detection of chondropathy. Our study aimed to determine whether dGEMRIC indices are predictive of two-year patient-reported outcomes and pain scores following hip arthroscopy. METHODS Between August 2008 and April 2012, sixty-five patients (seventy-four hips) underwent primary hip arthroscopy with preoperative dGEMRIC and a minimum of two years of follow-up. Exclusion criteria were previous hip surgery, slipped capital femoral epiphysis, inflammatory arthropathy, Legg-Calvé-Perthes disease, and arthritis of >1 Tönnis grade. Patients were classified in two groups on the basis of a dGEMRIC cutoff of 323 msec, which was one standard deviation (SD) below the study cohort mean dGEMRIC index of 426 msec. Patient-reported outcome tools used included the modified Harris hip score (mHHS), the Nonarthritic Hip Score (NAHS), the Hip Outcome Score Activities of Daily Living (HOS-ADL), and the Hip Outcome Score Sport-Specific Subscale (HOS-SSS) as well as a visual analog scale (VAS) for pain and a patient satisfaction score. RESULTS There were sixty-four hips that met the inclusion criteria; fifty-two (81.3%) had a minimum of two years of follow-up. Twelve of the sixty-four hips had a dGEMRIC index of <323 msec (Group 1), and fifty-two hips had a dGEMRIC index of ≥323 msec (Group 2). There was no significant difference between the groups with respect to age, sex, and body mass index. There was no significant difference between the groups in mean preoperative patient-reported outcome scores and the VAS for pain. At the two-year follow-up, Group 1 had significant improvement in the mHHS, whereas Group 2 demonstrated significant improvement in all patient-reported outcome scores and the VAS. The improvement in all patient-reported outcome scores was significantly larger for Group 2 compared with Group 1. There was no significant difference in patient satisfaction between groups and no significant correlation between dGEMRIC indices and the patient-reported outcome measures. CONCLUSIONS Patients with a dGEMRIC index of ≥323 msec (less than one SD below the cohort mean) demonstrated significantly greater improvement in patient-reported outcome scores and the VAS for pain after hip arthroscopy.
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Affiliation(s)
- Sivashankar Chandrasekaran
- American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: . E-mail address for S.P. Vemula: . E-mail address for D. Lindner: . E-mail address for P. Lodhia: . E-mail address for C. Suarez-Ahedo: . E-mail address for B.G. Domb:
| | - S Pavan Vemula
- American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: . E-mail address for S.P. Vemula: . E-mail address for D. Lindner: . E-mail address for P. Lodhia: . E-mail address for C. Suarez-Ahedo: . E-mail address for B.G. Domb:
| | - Dror Lindner
- American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: . E-mail address for S.P. Vemula: . E-mail address for D. Lindner: . E-mail address for P. Lodhia: . E-mail address for C. Suarez-Ahedo: . E-mail address for B.G. Domb:
| | - Parth Lodhia
- American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: . E-mail address for S.P. Vemula: . E-mail address for D. Lindner: . E-mail address for P. Lodhia: . E-mail address for C. Suarez-Ahedo: . E-mail address for B.G. Domb:
| | - Carlos Suarez-Ahedo
- American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: . E-mail address for S.P. Vemula: . E-mail address for D. Lindner: . E-mail address for P. Lodhia: . E-mail address for C. Suarez-Ahedo: . E-mail address for B.G. Domb:
| | - Benjamin G Domb
- American Hip Institute, 1010 Executive Court, Suite 250, Westmont, IL 60559. E-mail address for S. Chandrasekaran: . E-mail address for S.P. Vemula: . E-mail address for D. Lindner: . E-mail address for P. Lodhia: . E-mail address for C. Suarez-Ahedo: . E-mail address for B.G. Domb:
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21
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Wei B, Zong M, Yan C, Mao F, Guo Y, Yao Q, Xu Y, Wang L. Use of quantitative MRI for the detection of progressive cartilage degeneration in a mini-pig model of osteoarthritis caused by anterior cruciate ligament transection. J Magn Reson Imaging 2015; 42:1032-8. [PMID: 25656460 DOI: 10.1002/jmri.24862] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/16/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To investigate the progression of cartilage degeneration using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 mapping in a mini-pig model of osteoarthritis (OA) caused by anterior cruciate ligament transection (ACLT). METHODS Twelve mini-pigs underwent ACLT in the left knee and were monitored by dGEMRIC (T1, gadolinium [Gd]) and T2 mapping after 2, 4, or 6 weeks (n = 4 each). No ACLT surgery was performed in four healthy control mini-pigs, which were also monitored by dGEMRIC and T2 mapping. Cartilage samples from the weight-bearing regions of the left medial femoral condyles were collected for macroscopic, histological, immunohistochemical, and biochemical analysis. Correlations between biochemical contents and T1,Gd and T2 values were evaluated using Pearson correlation analysis. RESULTS T1,Gd values were gradually reduced and T2 values increased over time. Cartilage surfaces showed roughness at 4 weeks and additional defects at 6 weeks. Glycosaminoglycan (GAG) distribution and content gradually reduced over time (P < 0.05), and collagen distribution and anisotropy were obviously changed at 6 weeks. However, collagen content did not differ significantly among postoperative timepoints. GAG content was positively related to T1,Gd values (r = 0.888; P < 0.001) and negatively related to T2 values (r = -0.865; P < 0.001). Collagen content had no discernible correlation with T1,Gd or T2 values. CONCLUSION dGEMRIC and T2 mapping can monitor the progression of cartilage degeneration in a mini-pig model of ACLT-induced OA, permitting early detection of OA.
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Affiliation(s)
- Bo Wei
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Min Zong
- Department of Radiology, the First Affiliated Hospital, Nanjing Medical University, Nanjing, 210006, People's Republic of China
| | - Chao Yan
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Fengyong Mao
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yang Guo
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Qingqiang Yao
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yan Xu
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Liming Wang
- Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
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22
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Abstract
Osteoarthritis is characterized by a decrease in the proteoglycan content and disruption of the highly organized collagen fiber network of articular cartilage. Various quantitative magnetic resonance imaging techniques have been developed for noninvasive assessment of the proteoglycan and collagen components of cartilage. These techniques have been extensively used in clinical practice to detect early cartilage degeneration and in osteoarthritis research studies to monitor disease-related and treatment-related changes in cartilage over time. This article reviews the role of quantitative magnetic resonance imaging in evaluating the composition and ultrastructure of the articular cartilage of the knee joint.
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Affiliation(s)
- Richard Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA.
| | - Rajeev Chaudhary
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA
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Siclari A, Mascaro G, Kaps C, Boux E. A 5-year follow-up after cartilage repair in the knee using a platelet-rich plasma-immersed polymer-based implant. Open Orthop J 2014; 8:346-54. [PMID: 25352927 PMCID: PMC4209503 DOI: 10.2174/1874325001408010346] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/12/2014] [Accepted: 09/17/2014] [Indexed: 12/11/2022] Open
Abstract
The aim of our study was to analyze the clinical outcome after repair of cartilage defects of the knee with subchondral drilling and resorbable polymer-based implants immersed with autologous platelet-rich plasma (PRP). Fifty-two patients with focal chondral defects were treated with subchondral drilling, followed by covering with a polyglycolic acid - hyaluronan (PGA-HA) implant (chondrotissue®) immersed with autologous PRP. At 5-year follow-up, patients' situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation. The KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline. Subgroup analysis showed that there were no differences in the clinical outcome regarding defect size and localization as well as degenerative condition of the knee. Cartilage repair was complete in 20 out of 21 patients at 4-year follow-up as shown by magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation leads to a lasting improvement of the patients' situation.
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Affiliation(s)
- Alberto Siclari
- Struttura Complessa di Ortopedia e Traumatologia, Ospedale degli Infermi di Biella ASLBI, Biella, Italy
| | - Gennaro Mascaro
- Servizio di Immunoematologia e Medicina Trasfusionale, Ospedale degli Infermi di Biella ASLBI, Biella, Italy
| | - Christian Kaps
- TransTissue Technologies GmbH, Berlin, Germany ; Tissue Engineering Laboratory, Charité Campus Mitte, Charité-University Medicine Berlin, Berlin, Germany
| | - Eugenio Boux
- Struttura Complessa di Ortopedia e Traumatologia, Ospedale degli Infermi di Biella ASLBI, Biella, Italy
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24
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Pittschieler E, Szomolanyi P, Schmid-Schwap M, Weber M, Egerbacher M, Traxler H, Trattnig S. Delayed gadolinium-enhanced MRI of the fibrocartilage disc of the temporomandibular joint--a feasibility study. Magn Reson Imaging 2014; 32:1223-9. [PMID: 25131629 DOI: 10.1016/j.mri.2014.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 07/09/2014] [Accepted: 08/08/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To 1) test the feasibility of delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) at 3 T in the temporomandibular joint (TMJ) and 2) to determine the optimal delay for measurements of the TMJ disc after i.v. contrast agent (CA) administration. DESIGN MRI of the right and left TMJ of six asymptomatic volunteers was performed at 3 T using a dedicated coil. 2D inversion recovery (2D-IR) sequences were performed at 4 time points covering 120 minutes and 3D gradient-echo (3D GRE) dual flip-angle sequences were performed at 14 time points covering 130 minutes after the administration of 0.2 mmol/kg of Gd-diethylenetriamine pentaacetic acid ion (Gd-DTPA)(2-), i.e., 0.4 mL of Magnevist™ per kg body weight. Pair-wise tests were used to assess differences between pre-and post-contrast T1 values. RESULTS 2D-IR sequences showed a statistically significant drop (p<0.001) in T1 values after i.v. CA administration. The T1 drop of 50% was reached 60 minutes after bolus injection in the TMJ disc. The 3D GRE dual flip-angle sequences confirmed these results and show plateau of T1 after 60 minutes. CONCLUSIONS T1(Gd) maps calculated from dGEMRIC data allow in vivo assessment of the fibrocartilage disc of the TMJ. The recommended measurement time for dGEMRIC in the TMJ after i.v. CA administration is from 60 to 120 minutes.
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Jungmann PM, Baum T, Bauer JS, Karampinos DC, Erdle B, Link TM, Li X, Trattnig S, Rummeny EJ, Woertler K, Welsch GH. Cartilage repair surgery: outcome evaluation by using noninvasive cartilage biomarkers based on quantitative MRI techniques? Biomed Res Int 2014; 2014:840170. [PMID: 24877139 DOI: 10.1155/2014/840170] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 03/25/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND New quantitative magnetic resonance imaging (MRI) techniques are increasingly applied as outcome measures after cartilage repair. OBJECTIVE To review the current literature on the use of quantitative MRI biomarkers for evaluation of cartilage repair at the knee and ankle. METHODS Using PubMed literature research, studies on biochemical, quantitative MR imaging of cartilage repair were identified and reviewed. RESULTS Quantitative MR biomarkers detect early degeneration of articular cartilage, mainly represented by an increasing water content, collagen disruption, and proteoglycan loss. Recently, feasibility of biochemical MR imaging of cartilage repair tissue and surrounding cartilage was demonstrated. Ultrastructural properties of the tissue after different repair procedures resulted in differences in imaging characteristics. T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), and diffusion weighted imaging (DWI) are applicable on most clinical 1.5 T and 3 T MR scanners. Currently, a standard of reference is difficult to define and knowledge is limited concerning correlation of clinical and MR findings. The lack of histological correlations complicates the identification of the exact tissue composition. CONCLUSIONS A multimodal approach combining several quantitative MRI techniques in addition to morphological and clinical evaluation might be promising. Further investigations are required to demonstrate the potential for outcome evaluation after cartilage repair.
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