1
|
Abbasi-Rad S, Norris DG. Adiabatic null passage for on-resonance magnetization transfer preparation. Magn Reson Med 2024; 91:133-148. [PMID: 37598419 DOI: 10.1002/mrm.29835] [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: 05/06/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023]
Abstract
PURPOSE We propose a novel RF pulse providing an adiabatic null passage (ANP) for magnetization transfer preparation with improved insensitivity toB 1 + $$ {\mathrm{B}}_1^{+} $$ and B0 inhomogeneities and mitigated direct saturation and T2 effects. METHOD The phase modulation function of a 6-ms time-resampled frequency offset-corrected pulse was modified to achieve zero flip angle at the end of the pulse. The spectral response was simulated, and its insensitivity to B0 andB 1 + $$ {\mathrm{B}}_1^{+} $$ was investigated and compared with a phase-inverted (12 ¯ $$ \overline{2} $$ 1-1 ¯ $$ \overline{1} $$ 21 ¯ $$ \overline{1} $$ ) binomial pulse. The proposed pulse was implemented in a 2D-EPI pulse sequence to generate magnetization transfer (MT) contrast and MT ratio (MTR) maps. In vivo experiments were performed on 3 healthy participants with power-matched settings for ANP and the binomial pulse with the following parameters: 6-ms binomial pulse with a flip angle of 107° (shortest element) and pulse repetition period (PRP) of TRslice = 59 ms, three experiments with 6-ms ANP and constant MT used overdrive factor (OF)/PRP values of 1/TRslice ,2 $$ \sqrt{2} $$ /2TRslice , and3 $$ \sqrt{3} $$ /3TRslice . RESULTS At gray matter (white matter) in vivo, the MTR decreased from 61% (64%) at OF = 1 to 38% (42%) applying ANP with an OF =3 $$ \sqrt{\mathsf{3}} $$ and PRP = 3 TRslice , demonstrating the mitigation of T2 /direct effect by 22% (22%). Bloch-McConnell simulations gave similar values. In vivo experiments showed significant improvement in the MTR values for areas with high B0 inhomogeneity. CONCLUSION ANP pulse was shown to be advantageous over its binomial counterpart in providing MT contrast by mitigating the T2 effect and direct saturation of the liquid pool as well as reduced sensitivity toB 1 + $$ {\mathrm{B}}_1^{+} $$ and B0 inhomogeneity.
Collapse
Affiliation(s)
- Shahrokh Abbasi-Rad
- Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, Netherlands
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
- Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - David G Norris
- Donders Institute for Brain, Cognition and Behaviour, Donders Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, Netherlands
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Essen, Germany
| |
Collapse
|
2
|
Choi HG, Kang YS, Kim JS, Lee HS, Lee YS. Meniscal and Cartilage Changes on Serial MRI After Medial Opening-Wedge High Tibial Osteotomy. Orthop J Sports Med 2021; 9:23259671211047904. [PMID: 34881345 PMCID: PMC8647275 DOI: 10.1177/23259671211047904] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/05/2021] [Indexed: 02/01/2023] Open
Abstract
Background: Assessments of the effects of realignment using opening-wedge high tibial osteotomy (OWHTO) on the medial, lateral, and patellofemoral compartments have been limited to cartilage evaluations. Purpose/Hypothesis: The purpose was to evaluate the effects of OWHTO on the meniscus and cartilage of each compartment as a cooperative unit (meniscochondral unit) using serial magnetic resonance imaging (MRI). It was hypothesized that (1) favorable changes in the meniscochondral unit would occur in the medial compartment and (2) that changes in the patellofemoral and lateral compartments would be negligible. Study Design: Case series; Level of evidence, 4. Methods: Included were 36 knees that underwent OWHTO from March 2014 to February 2016 and had postoperative serial MRI. The MRI was performed at 19.9 ± 7.4 and 52.3 ± 8.3 months postoperatively, and the cartilage and meniscal changes were evaluated by highlighting the regions of interest. We evaluated the T2 relaxation times of each cartilage and meniscal area, the cross-sectional area of the menisci, and the extrusion of the medial meniscus (MM). The meniscochondral unit was assessed using subgroup analyses according to the status of the MM. Results: Significant decreases were seen in T2 relaxation times in the medial femoral condyle (MFC) (P < .001) and medial tibial plateau (MTP) (P = .050), and significant increases were seen in the lateral femoral condyle (LFC) (P = .036). The change was more prominent in the MFC compared with the MTP and LFC (P = .003). No significant changes were observed in the lateral tibial plateau, patella, or trochlear groove. The area of the lateral meniscus (body and posterior horn) was decreased compared with preoperative MRI (P < .001 for both). The extent of MM extrusion decreased between the preoperative, first follow-up, and second follow-up MRIs (P < .001). Conclusion: OWHTO affected the medial compartment positively, the lateral compartment negatively, and the patellofemoral compartment negligibly. The effects were more prominent and consistent in the medial than in the lateral compartment.
Collapse
Affiliation(s)
- Han Gyeol Choi
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Orthopaedic Surgery, Nalgae Hospital, Seoul, Republic of Korea
| | - Yu Suhn Kang
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joo Sung Kim
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Han Sang Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yong Seuk Lee
- Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| |
Collapse
|
3
|
Juras V, Szomolanyi P, Janáčová V, Kirner A, Angele P, Trattnig S. Differentiation of Cartilage Repair Techniques Using Texture Analysis from T 2 Maps. Cartilage 2021; 13:718S-728S. [PMID: 34269072 PMCID: PMC8808785 DOI: 10.1177/19476035211029698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/07/2021] [Accepted: 06/07/2021] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate texture features from T2 maps as a marker for distinguishing the maturation of repair tissue after 2 different cartilage repair procedures. DESIGN Seventy-nine patients, after either microfracture (MFX) or matrix-associated chondrocyte transplantation (MACT), were examined on a 3-T magnetic resonance (MR) scanner with morphological and quantitative (T2 mapping) MR sequences 2 years after surgery. Twenty-one texture features from a gray-level co-occurrence matrix (GLCM) were extracted. The texture feature difference between 2 repair types was assessed individually for the femoral condyle and trochlea/anterior condyle using linear regression models. The stability and reproducibility of texture features for focal cartilage were calculated using intra-observer variability and area under curve from receiver operating characteristics. RESULTS There was no statistical significance found between MFX and MACT for T2 values (P = 0.96). There was, however, found a statistical significance between MFX and MACT in femoral condyle in GLCM features autocorrelation (P < 0.001), sum of squares (P = 0.023), sum average (P = 0.005), sum variance (P = 0.0048), and sum entropy (P = 0.05); and in anterior condyle/trochlea homogeneity (P = 0.02) and dissimilarity (P < 0.001). CONCLUSION Texture analysis using GLCM provides a useful extension to T2 mapping for the characterization of cartilage repair tissue by increasing its sensitivity to tissue structure. Some texture features were able to distinguish between repair tissue after different cartilage repair procedures, as repair tissue texture (and hence, probably collagen organization) 24 months after MACT more closely resembled healthy cartilage than did MFX repair tissue.
Collapse
Affiliation(s)
- Vladimir Juras
- High-Field MR Centre, Department of
Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna,
Austria
| | - Pavol Szomolanyi
- High-Field MR Centre, Department of
Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna,
Austria
- Institute of Measurement Science,
Slovak Academy of Sciences, Bratislava, Slovakia
| | - Veronika Janáčová
- High-Field MR Centre, Department of
Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna,
Austria
| | | | | | - Siegfried Trattnig
- High-Field MR Centre, Department of
Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna,
Austria
- CD laboratory for Clinical Molecular MR
imaging, Vienna, Austria
- Austrian Cluster for Tissue
Regeneration, Vienna, Austria
- Institute for Clinical Molecular MRI in
the Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria
| |
Collapse
|
4
|
Xue YP, Ma YJ, Wu M, Jerban S, Wei Z, Chang EY, Du J. Quantitative 3D Ultrashort Echo Time Magnetization Transfer Imaging for Evaluation of Knee Cartilage Degeneration In Vivo. J Magn Reson Imaging 2021; 54:1294-1302. [PMID: 33894091 DOI: 10.1002/jmri.27659] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Recent studies suggest that macromolecular fraction (MMF) derived from three-dimensional ultrashort echo time magnetization transfer (UTE-MT) imaging is insensitive to the magic angle effect. However, its clinical use in osteoarthritis (OA) remains to be investigated. PURPOSE To investigate the feasibility of 3D UTE-MT-derived MMF in differentiating normal from degenerated cartilage. STUDY TYPE Prospective. SUBJECTS Sixty-two participants (54.8 ± 16.7 years, 30 females) with and without OA, plus two healthy volunteers (mean age 35.0 years) for reproducibility test. FIELD STRENGTH/SEQUENCE 3 T/UTE-MT sequence. ASSESSMENT A 3D UTE-MT sequence was employed to calculate MMF based on a two-pool model. Kellgren-Lawrence (KL) grade and Whole-Organ Magnetic Resonance Imaging Score (WORMS) were evaluated by three experienced musculoskeletal radiologists. KL grade was condensed into three groups: KL0, KL1-2, and KL3-4. WORMS was regrouped based on extent of lesion (extent group) and depth of lesion (depth group), respectively. The performance of MMF at evaluating the degeneration of cartilage was assessed via Spearman's correlation coefficient and the area under the curve (AUC) calculated according to the receiver-operating characteristic curve. STATISTICAL TESTS After normality check, one-way analysis of variance was used to evaluate the performance. Tukey-Kramer test was performed for post hoc testing. RESULTS MMF showed significant negative correlations with KL grade (r = -0.53, P < 0.05) and WORMS (r = -0.49, P < 0.05). Significantly lower MMFs were found in subjects with greater KL grade (11.8 ± 0.8% for KL0; 10.9 ± 0.9% for KL1-2; 10.6 ± 1.1% for KL3-4; P < 0.05) and in cartilage with greater extent (12.1 ± 1.6% for normal cartilage; 10.9 ± 1.6% for regional lesions; 9.6 ± 1.7% for diffuse lesions; P < 0.05) and depth (12.1 ± 1.6% for normal cartilage; 10.6 ± 1.6% for partial-thickness lesions; 8.8 ± 1.7% for full-thickness lesions; P < 0.05) of lesions. AUC values of MMF for doubtful-minimal OA (KL1-2) and mild cartilage degradation (WORMS1-2) were 0.8 and 0.7, respectively. DATA CONCLUSION This study highlights the clinical potential of MMF in the detection of early OA. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY STAGE: 2.
Collapse
Affiliation(s)
- Yan-Ping Xue
- Department of Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.,Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Ya-Jun Ma
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Mei Wu
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Zhao Wei
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| | - Eric Y Chang
- Department of Radiology, University of California San Diego, La Jolla, California, USA.,Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
5
|
Aringhieri G, Zampa V, Tosetti M. Musculoskeletal MRI at 7 T: do we need more or is it more than enough? Eur Radiol Exp 2020; 4:48. [PMID: 32761480 PMCID: PMC7410909 DOI: 10.1186/s41747-020-00174-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022] Open
Abstract
Ultra-high field magnetic resonance imaging (UHF-MRI) provides important diagnostic improvements in musculoskeletal imaging. The higher signal-to-noise ratio leads to higher spatial and temporal resolution which results in improved anatomic detail and higher diagnostic confidence. Several methods, such as T2, T2*, T1rho mapping, delayed gadolinium-enhanced, diffusion, chemical exchange saturation transfer, and magnetisation transfer techniques, permit a better tissue characterisation. Furthermore, UHF-MRI enables in vivo measurements by low-γ nuclei (23Na, 31P, 13C, and 39K) and the evaluation of different tissue metabolic pathways. European Union and Food and Drug Administration approvals for clinical imaging at UHF have been the first step towards a more routinely use of this technology, but some drawbacks are still present limiting its widespread clinical application. This review aims to provide a clinically oriented overview about the application of UHF-MRI in the different anatomical districts and tissues of musculoskeletal system and its pros and cons. Further studies are needed to consolidate the added value of the use of UHF-MRI in the routine clinical practice and promising efforts in technology development are already in progress.
Collapse
Affiliation(s)
- Giacomo Aringhieri
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento, 36, Pisa, Italy.
| | - Virna Zampa
- Diagnostic and Interventional Radiology, University Hospital of Pisa, Via paradisa, 2, Pisa, Italy
| | | |
Collapse
|
6
|
Kim MS, Chun CH, Wang JH, Kim JG, Kang SB, Yoo JD, Chon JG, Kim MK, Moon CW, Chang CB, Song IS, Ha JK, Choi NY, In Y. Microfractures Versus a Porcine-Derived Collagen-Augmented Chondrogenesis Technique for Treating Knee Cartilage Defects: A Multicenter Randomized Controlled Trial. Arthroscopy 2020; 36:1612-1624. [PMID: 31785390 DOI: 10.1016/j.arthro.2019.11.110] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/01/2019] [Accepted: 11/16/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the clinical efficacy and safety of treating patients with a cartilage defect of the knee with microfractures and porcine-derived collagen-augmented chondrogenesis technique (C-ACT). METHODS One hundred participants were randomly assigned to the control group (n = 48, microfracture) or the investigational group (n = 52, C-ACT). Clinical and magnetic resonance imaging (MRI) outcomes were assessed 12 and 24 months postoperatively for efficacy and adverse events. Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) assessment was used to analyze cartilage tissue repair. MRI outcomes for 50% defect filling and repaired tissue/reference cartilage (RT/RC) ratio were quantified using T2 mapping. Clinical outcomes were assessed using the visual analogue scale (VAS) for pain and 20% improvement, minimal clinically important difference (MCID), and patient acceptable symptom state for Knee Injury and Osteoarthritis Outcome Score (KOOS) and the International Knee Documentation Committee score. RESULTS MOCART scores in the investigation group showed improved defect repair and filling (P = .0201), integration with the border zone (P = .0062), and effusion (P = .0079). MRI outcomes showed that the odds ratio (OR) for ≥50% defect filling at 12 months was statistically higher in the investigation group (OR 3.984, P = .0377). Moreover, the likelihood of the RT/RC OR becoming ≥1 was significantly higher (OR 11.37, P = .0126) in the investigation group. At 24 months postoperatively, the OR for the VAS 20% improvement rate was significantly higher in the investigational group (OR 2.808, P = .047). Twenty-three patients (52.3%) in the control group and 35 (77.8%) in the investigation group demonstrated more than the MCID of KOOS pain from baseline to 1 year postoperatively, with a significant difference between groups (P = .0116). CONCLUSION In this multicenter randomized trial, the addition of C-ACT resulted in better filling of cartilage defect of the knee joint. LEVEL OF EVIDENCE Level Ⅰ, Multicenter Randomized Controlled Trial.
Collapse
Affiliation(s)
- Man Soo Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Churl Hong Chun
- Department of Orthopaedic Surgery, Wonkwang University Hospital, College of Medicine, Wonkwang University, Iksan, Korea
| | - Joon Ho Wang
- Department of Orthopaedic Surgery, Samsung Medical Center, College of Medicine, Sungkyunkwan University of School of Medicine, Seoul, Korea
| | - Jin Goo Kim
- Department of Orthopedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Seung-Baik Kang
- Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Doo Yoo
- Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Je-Gyun Chon
- Department of Orthopaedic Surgery, Daejeon Sun Hospital, Daejeon, Korea
| | - Myung Ku Kim
- Department of Orthopaedic Surgery, Inha University Hospital, College of Medicine, Inha University, Incheon, Korea
| | - Chan Woong Moon
- Department of Orthopaedic Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
| | - Chong Bum Chang
- Department of Orthopaedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - In Soo Song
- Department of Orthopaedic Surgery, Daejeon Sun Hospital, Daejeon, Korea
| | - Jeong Ku Ha
- Department of Orthopedic Surgery, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Nam Yong Choi
- Department of Orthopaedic Surgery, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong In
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| |
Collapse
|
7
|
Yang J, Shao H, Ma Y, Wan L, Zhang Y, Jiang J, Du J, Tang G. Quantitative ultrashort echo time magnetization transfer (UTE-MT) for diagnosis of early cartilage degeneration: comparison with UTE-T2* and T2 mapping. Quant Imaging Med Surg 2020; 10:171-183. [PMID: 31956540 DOI: 10.21037/qims.2019.12.04] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background To investigate the feasibility of using quantitative ultrashort echo time magnetization transfer (UTE-MT) technique in diagnosing early cartilage degeneration and to compare the technique's diagnostic efficacy with UTE-T2* mapping and T2 mapping. Methods Twenty human anterolateral condyle specimens with degeneration were obtained from volunteers undergoing total knee arthroplasty (TKA); they then underwent magnetic resonance (MR) scan on a clinical 3.0T scanner (GE, MR750). Seventy-two regions of interest (ROI) were manually drawn on specimens for UTE-MT, UTE-T2*, and T2 measurement, and the corresponding cartilage-bone regions were further divided into degeneration classifications of normal (n=11, Mankin scores 0-1), mild (n=28, Mankin scores 2-5), moderate (n=21, Mankin scores 6-9), and severe (n=12, Mankin scores 10-14) based on histological measures of degeneration (i.e., Mankin scores) as a reference standard. Differences among groups and correlations between quantitative MR parameters and Mankin scores were assessed using analysis of variance (ANOVA), Tamhane-T2, LSD, Kruskal-Wallis tests, and Spearman's correlation coefficient. The receiver-operating characteristic (ROC) curve was used to compare the diagnostic efficacy of different quantitative MR parameters for the detection of mild cartilage degeneration. Results The UTE magnetization transfer ratio (UTE-MTR) in the normal group was significantly different from the mild group (P=0.021), moderate group (P<0.001), and severe group (P<0.001). Significant differences were observed in the T2* values between both the normal group and the moderate group (P<0.032), and between the normal group and the severe group (P<0.001). For T2 values, the only significant difference was observed between the severe group and the normal group (P=0.011). The UTE-MTR, UTE-T2*, and T2 values were all significantly correlated with Mankin scores: UTE-MTR values were strongly (r=-0.678, P<0.001) correlated, UTE-T2* values were markedly correlated (r=-0.501, P<0.001), and T2 values were weakly correlated (r=0.337, P=0.004) correlated with Mankin scores. The diagnostic efficacy of UTE-MTR (AUC =0.828, P=0.002) was better than UTE T2* mapping and T2 mapping (AUC =0.604, P=0.318; AUC =0.644, P=0.165, respectively) for the diagnosis of early cartilage degeneration. Conclusions UTE-MTR values were strongly correlated with histological grades of cartilage degeneration, and its diagnostic efficacy was better than both UTE T2* mapping and T2 mapping in detecting early cartilage degeneration. Once the clinical potential of the technique has been confirmed, UTE-MT may provide a promising imaging biomarker with potential application in a more comprehensive diagnosis and monitoring of cartilage degeneration.
Collapse
Affiliation(s)
- Jiawei Yang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Hongda Shao
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Lidi Wan
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yixuan Zhang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Junjie Jiang
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| |
Collapse
|
8
|
Aydın M, Yorubulut M, Başarır K, Arıkan M, Binnet MS. Matrix induced autologous chondrocyte implantation in the knee: Comparison between osteochondritis dissecans and osteonecrosis and effect of chondrocyte thickness on prognosis. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2020; 54:66-73. [PMID: 32175899 DOI: 10.5152/j.aott.2020.01.347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was compare the clinical success of treatments for avascular necrosis and osteochondritis dissecans in cases who underwent matrix autologous chondrocyte implantations, and evaluate cartilage thickness on the clinical outcomes after implantation. METHODS A total of 37 patients (29 men, and 8 women; mean age: 23.8 years (16-38)) were treated prospectively with a two-stage matrix autologous chondrocyte implantation (avascular necrosis, n=21; osteochondritis dissecans, n=18). Clinical improvements and follows-up were assessed based on the patients' International Cartilage Repair Society (ICRS) scores with simultaneous cartilage thickness measurement using short-TI inversion recovery magnetic resonance imaging. The patients were divided into four subgroups based on their clinical scores, as group D <65 points, Group C 65-83 points, Group B 84-90 and Group A ≥90. RESULTS The mean ICRS score was 28.33±7.14 in the preoperative period in the avascular necrosis group, which increased to 70.88±12.61 at 60 months; while the mean ICRS score increased from 29.75±7.15 preoperatively to 87.58±12.83 at 60 months in the osteochondritis dissecans group. A statistically significant difference in the ICRS scores was noted between the two groups, and also between the ICRS scores and cartilage thicknesses of the subgroups (p<0.05). CONCLUSION Our study results revealed that greater clinical improvement was achieved in patients with osteochondritis dissecans undergoing matrix autologous chondrocyte implantation than in those with avascular necrosis. In addition, cartilage thickness greater than 3.7 mm following an autologous chondrocyte transplantation showed excellent clinical improvement. LEVEL OF EVIDENCE Level III, Therapeutic Study.
Collapse
Affiliation(s)
- Murat Aydın
- Department of Orthopedics and Traumatology, Amasya Merzifon Public Hospital Medicine, Amasya, Turkey
| | - Mehmet Yorubulut
- Department of Radiology, Primer Medical Imaging Center, Ankara, Turkey
| | - Kerem Başarır
- Department of Orthopaedics and Traumatology, Ankara University, School of Medicine, Ankara, Turkey
| | - Murat Arıkan
- Department of Orthopaedics and Traumatology, Oncology Training and Research Hospital, Ankara, Turkey
| | - Mehmet Serdar Binnet
- Department of Orthopaedics and Traumatology, Ankara University, School of Medicine, Ankara, Turkey
| |
Collapse
|
9
|
Martín Noguerol T, Raya JG, Wessell DE, Vilanova JC, Rossi I, Luna A. Functional MRI for evaluation of hyaline cartilage extracelullar matrix, a physiopathological-based approach. Br J Radiol 2019; 92:20190443. [PMID: 31433668 DOI: 10.1259/bjr.20190443] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
MRI of articular cartilage (AC) integrity has potential to become a biomarker for osteoarthritis progression. Traditional MRI sequences evaluate AC morphology, allowing for the measurement of thickness and its change over time. In the last two decades, more advanced, dedicated MRI cartilage sequences have been developed aiming to assess AC matrix composition non-invasively and detect early changes in cartilage not captured on morphological sequences. T2-mapping and T1ρ sequences can be used to estimate the relaxation times of water inside the AC. These sequences have been introduced into clinical protocols and show promising results for cartilage assessment. Extracelullar matrix can also be assessed using diffusion-weighted imaging and diffusion tensor imaging as the movement of water is limited by the presence of extracellular matrix in AC. Specific techniques for glycosaminoglycans (GAG) evaluation, such as delayed gadolinium enhanced MRI of cartilage or Chemical Exchange Saturation Transfer imaging of GAG, as well as sodium imaging have also shown utility in the detection of AC damage. This manuscript provides an educational update on the physical principles behind advanced AC MRI techniques as well as a comprehensive review of the strengths and weaknesses of each approach. Current clinical applications and potential future applications of these techniques are also discussed.
Collapse
Affiliation(s)
| | - Jose G Raya
- Department of Radiology, NYU School of Medicine, NY, USA
| | | | - Joan C Vilanova
- Department of Radiology, Clínica Girona. Institute Diagnostic Imaging (IDI), University of Girona, Girona, Spain
| | | | - Antonio Luna
- MRI unit, Radiology department, Health Time, Jaén, Spain
| |
Collapse
|
10
|
Waldenmeier L, Evers C, Uder M, Janka R, Hennig FF, Pachowsky ML, Welsch GH. Using Cartilage MRI T2-Mapping to Analyze Early Cartilage Degeneration in the Knee Joint of Young Professional Soccer Players. Cartilage 2019; 10:288-298. [PMID: 29448816 PMCID: PMC6585295 DOI: 10.1177/1947603518756986] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate and characterize the appearance of articular cartilage in the tibiofemoral joint of young professional soccer players using T2-relaxation time evaluation on magnetic resonance imaging (MRI). DESIGN In this study, we included 57 male adolescents from the youth academy of a professional soccer team. The MRI scans were acquired of the knee joint of the supporting leg. An "early unloading" (minute 0) and "late unloading" (minute 28) T2-sequence was included in the set of images. Quantitative T2-analysis was performed in the femorotibial joint cartilage in 4 slices with each 10 regions of interest (ROIs). Statistical evaluation, using Wilcoxon signed-rank tests, was primarily performed to compare the T2 values of the "early unloading" and "late unloading." RESULTS When comparing "early unloading" with "late unloading," our findings showed a significant increase of T2-relaxation times in the weightbearing femoral cartilage of the medial (P < 0.001) and lateral (P < 0.001) compartment of the knee and in the tibial cartilage of the medial compartment (P < 0.001). CONCLUSION In this study, alterations of the cartilage were found with a maximum in the medial condyle where the biomechanical load of the knee joint is highest, as well as where most of the chronic cartilage lesions occur. To avoid chronic damage, special focus should be laid on this region.
Collapse
Affiliation(s)
- Leonie Waldenmeier
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Evers
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital of Erlangen, Erlangen, Germany
| | - Rolf Janka
- Department of Radiology, University Hospital of Erlangen, Erlangen, Germany
| | | | - Milena L. Pachowsky
- Department of Trauma Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - Götz Hannes Welsch
- UKE Athleticum, University Hospital Hamburg-Eppendorf, Hamburg, Germany,Götz Hannes Welsch, UKE Athleticum, University Hospital Hamburg-Eppendorf, Building East 48, Martinistraße 52, Hamburg, 20246, Germany.
| |
Collapse
|
11
|
Feasibility of T2 Mapping and Magnetic Transfer Ratio for Diagnosis of Intervertebral Disc Degeneration at the Cervicothoracic Junction: A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6396073. [PMID: 31187047 PMCID: PMC6521330 DOI: 10.1155/2019/6396073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 04/09/2019] [Indexed: 11/18/2022]
Abstract
Background Intervertebral disc degeneration (IDD) at the cervicothoracic junction of spine is clinically relevant, however, little attention had been paid. T2 mapping and magnetic transfer ratio (MTR) are useful magnetic resonance imaging (MRI) techniques to quantitatively evaluate IDD, revealing the biochemical changes within the intervertebral disc. To compare T2 mapping with MTR imaging regarding their accuracy to quantitatively diagnose intervertebral disc degeneration at the cervicothoracic junction, influences of anatomical level, gender, age, and Pfirrmann grade of T2 relaxation time values and MTR values were evaluated. Methods Sixty-seven patients with neck and upper back pain were included and examined with both T2 mapping and MTR imaging. The Pfirrmann grade, T2 relaxation time values, and MTR value of each disc between C7 and T3 were measured. Differences were investigated among different segmental levels, genders, age ranges, and Pfirrmann grades. The diagnostic accuracy of both MRI techniques was compared using the receiver operating characteristic (ROC) curves. Results No significant difference was detected comparing T2 relaxation time values or MTR values among different anatomical levels, genders, and segmental levels. And we generally found that T2 relaxation time values decreased, while MTR value increased with increasing age. Importantly, we demonstrated the significant correlation between either T2 relaxation time values or MTR value and Pfirrmann grade. Conclusion We proved the better accuracy of T2 mapping over MTR imaging to quantitatively evaluate the intervertebral disc degeneration of the cervicothoracic junction.
Collapse
|
12
|
Bruno F, Arrigoni F, Palumbo P, Natella R, Maggialetti N, Reginelli A, Splendiani A, Di Cesare E, Brunese L, Guglielmi G, Giovagnoni A, Masciocchi C, Barile A. New advances in MRI diagnosis of degenerative osteoarthropathy of the peripheral joints. Radiol Med 2019; 124:1121-1127. [PMID: 30771216 DOI: 10.1007/s11547-019-01003-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/04/2019] [Indexed: 12/31/2022]
Abstract
Degenerative osteoarthropathy is one of the leading causes of the pain and disability from musculoskeletal disease in the adult population. Magnetic resonance imaging (MRI) allows optimal visualization of all tissues involved in degenerative osteoarthritis disease process, mainly the articular cartilage. In addition to qualitative and semiquantitative morphologic assessment, several MRI-based advanced techniques have been developed to allow characterization and quantification of the biochemical cartilage composition. These include quantitative analysis and several compositional techniques (T1 and T2 relaxometry measurements and mapping, sodium imaging, delayed gadolinium-enhanced MRI of cartilage dGEMRIC, glycosaminoglycan-specific chemical exchange saturation transfer gagCEST, diffusion-weighted imaging DWI and diffusion tensor imaging DTI). These compositional MRI techniques may have the potential to serve as quantitative, reproducible, noninvasive and objective endpoints for OA assessment, particularly in diagnosis of early and pre-radiographic stages of the disease and in monitoring disease progression and treatment effects over time.
Collapse
Affiliation(s)
- Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Maggialetti
- Department Life and Health "V. Tiberio", University of Molise, Campobasso, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Luca Brunese
- Department Life and Health "V. Tiberio", University of Molise, Campobasso, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, University of Foggia, Foggia, Italy
| | - Andrea Giovagnoni
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
| |
Collapse
|
13
|
Kamei N, Ochi M, Adachi N, Ishikawa M, Yanada S, Levin LS, Kamei G, Kobayashi T. The safety and efficacy of magnetic targeting using autologous mesenchymal stem cells for cartilage repair. Knee Surg Sports Traumatol Arthrosc 2018; 26:3626-3635. [PMID: 29549388 DOI: 10.1007/s00167-018-4898-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 03/12/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE A new cell delivery system using magnetic force, termed magnetic targeting, was developed for the accumulation of locally injected cells in a lesion. The aim of this study was to assess the safety and efficacy of mesenchymal stem cell (MSC) magnetic targeting in patients with a focal articular cartilage defect in the knee. METHODS MSC magnetic targeting for five patients was approved by the Ministry of Health Labour and Welfare of Japan. Autologous bone marrow MSCs were cultured and subsequently magnetized with ferucarbotran. The 1.0-T compact magnet was attached to a suitable position around the knee joint to allow the magnetic force to be as perpendicular to the surface of the lesion as possible. Then 1 × 107 MSCs were injected into the knee joint. The magnet was maintained in the same position for 10 min after the MSC injection. The primary endpoint was the occurrence of any adverse events. The secondary endpoints were efficacy assessed by magnetic resonance imaging (MRI) T2 mapping and clinical outcomes using the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation and the Knee Injury and Osteoarthritis Outcome Score (KOOS). RESULTS No serious adverse events were observed during the treatment or in the follow-up period. Swelling of the treated knee joint was observed from the day after surgery in three of the five patients. The swelling resolved within 2 weeks in two patients. MRI showed that the cartilage defect areas were almost completely filled with cartilage-like tissue. MOCART scores were significantly higher 48 weeks postoperatively than preoperatively (74.8 ± 10.8 vs 27.0 ± 16.8, p = 0.042). Arthroscopy in three patients showed complete coverage of their cartilage defects. Clinical outcome scores were significantly better 48 weeks postoperatively than preoperatively for the IKDC Subjective Knee Evaluation (74.8 ± 17.7 vs 46.9 ± 17.7, p = 0.014) and knee-related quality-of-life (QOL) in the KOOS (53.8 ± 26.4 vs 22.5 ± 30.8, p = 0.012). CONCLUSION Magnetic targeting of MSCs was safely performed and showed complete coverage of the defects with cartilage-like tissues and significant improvement in clinical outcomes 48 weeks after treatment. The magnetic targeting of MSCs is useful as a minimally invasive treatment for cartilage repair. LEVEL OF EVIDENCE IV.
Collapse
Affiliation(s)
- Naosuke Kamei
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.,Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Mitsuo Ochi
- Hiroshima University, Higashihiroshima, Japan.
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
| | - Masakazu Ishikawa
- Department of Orthopaedic Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan
| | | | - L Scott Levin
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Goki Kamei
- Department of Orthopaedic Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Takaaki Kobayashi
- Department of Orthopaedic Surgery, Tsuchiya General Hospital, Hiroshima, Japan
| |
Collapse
|
14
|
Hornakova L, Juras V, Kubovy P, Hadraba D, Gerych D, Stursa P, Deligianni X, Bieri O, Trattnig S, Jelen K. In vivo assessment of time dependent changes of T2* in medial meniscus under loading at 3T: A preliminary study. J Appl Biomed 2018. [DOI: 10.1016/j.jab.2017.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
|
15
|
Morphological and compositional monitoring of a new cell-free cartilage repair hydrogel technology - GelrinC by MR using semi-quantitative MOCART scoring and quantitative T2 index and new zonal T2 index calculation. Osteoarthritis Cartilage 2015; 23:2224-2232. [PMID: 26187572 DOI: 10.1016/j.joca.2015.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/24/2015] [Accepted: 07/07/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate cartilage repair tissue (RT) using MOCART scoring for morphological and T2 mapping for biochemical assessment following implantation of GelrinC, a biosynthetic, biodegradable hydrogel implant. DESIGN MR imaging (1.5/3T) was performed on 21 patients at six sites. Standard protocols were used for MOCART evaluation at 1 week (baseline) 1, 3, 6, 12, 18 and 24 months. Multi-echo SE was used for T2 mapping. Global (T2 in RT divided by T2 in normal cartilage) and zonal T2 index (deep T2 divided by superficial T2) of RT were calculated. RESULTS Average MOCART score was 71.8 (95% CI 62.2 to 81.3) at six, 75.2 (95% CI 62.8 to 87.5) at twelve, 71.8 (95% CI 55.4 to 88.2) at eighteen and 84.4 (95% CI 77.7 to 91.0) at twenty-four months. The global T2 index ranged between 0.8 and 1.2 (normal healthy cartilage) in 1/11 (9%) patients at baseline, 8/12 (67%) at 12 months, 11/13 (85%) at 18 months and 13/16 (81%) at 24 months. The zonal T2 index for RT was <20% difference to the zonal T2 index for normal cartilage in: 6/12 patients (50%) at 12 months, 7/13 (53.8%) at 18 months and 10/16 (63.5%) at 24 months. The standard deviation for T2 showed a significant decrease over the study. CONCLUSIONS The increase of MOCART scores over follow-up indicates improving cartilage repair tissue. Global and zonal T2 repair values at 24 months reached normal cartilage in 81% and 63.5% of the patients respectively, reflecting collagen organization similar to hyaline cartilage.
Collapse
|
16
|
Guermazi A, Roemer FW, Alizai H, Winalski CS, Welsch G, Brittberg M, Trattnig S. State of the Art: MR Imaging after Knee Cartilage Repair Surgery. Radiology 2015; 277:23-43. [DOI: 10.1148/radiol.2015141146] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
17
|
Hontoir F, Clegg P, Nisolle JF, Tew S, Vandeweerd JM. Magnetic resonance compositional imaging of articular cartilage: What can we expect in veterinary medicine? Vet J 2015; 205:11-20. [PMID: 26021889 DOI: 10.1016/j.tvjl.2015.04.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 02/25/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
Abstract
Since cartilage has limited ability to repair itself, it is useful to determine its biochemical composition early in clinical cases. It is also important to assess cartilage content in research animals in longitudinal studies in vivo. In recent years, compositional imaging techniques using magnetic resonance imaging (MRI) have been developed to assess the biochemical composition of cartilage. This article describes MR compositional imaging techniques, and discusses their use and interpretation. Technical concerns still limit the use of some techniques for research and clinical use, especially in veterinary medicine. Glycosaminoglycan chemical-exchange saturation transfer and sodium imaging are better used with high field magnets, which have limited availability. Long acquisition times are sometimes required, for instance in T1rho (ρ) and diffusion-weighted imaging, and necessitate general anaesthesia. Even in human medicine, some techniques such as ultra-short echo T2 are not fully validated, and nearly all techniques require validation for veterinary research and clinical practice. Delayed gadolinium-enhanced MRI of cartilage and T2 mapping appear to be the most applicable methods for compositional imaging of animal cartilage. Combining T2 mapping and T1ρ allows for the assessment of proteoglycans and the collagen network, respectively.
Collapse
Affiliation(s)
- Fanny Hontoir
- Integrated Veterinary Research Unit (IVRU), Department of Veterinary Medicine, Faculty of Sciences, University of Namur, Rue de Bruxelles 61, Namur 5000, Belgium
| | - Peter Clegg
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Leahurst Campus, University of Liverpool, Neston, UK
| | | | - Simon Tew
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Leahurst Campus, University of Liverpool, Neston, UK
| | - Jean-Michel Vandeweerd
- Integrated Veterinary Research Unit (IVRU), Department of Veterinary Medicine, Faculty of Sciences, University of Namur, Rue de Bruxelles 61, Namur 5000, Belgium.
| |
Collapse
|
18
|
Kaneko Y, Nozaki T, Yu H, Chang A, Kaneshiro K, Schwarzkopf R, Hara T, Yoshioka H. Normal T2 map profile of the entire femoral cartilage using an angle/layer-dependent approach. J Magn Reson Imaging 2015; 42:1507-16. [PMID: 25917977 DOI: 10.1002/jmri.24936] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 04/14/2015] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To create standard T2 map profiles from the entire femoral cartilage of healthy volunteers in order to assess regional variations using an angular and layer-dependent approach. MATERIALS AND METHODS Twenty healthy knees were evaluated using 3T sagittal images of a T2 mapping sequence. Manual segmentation of the entire femoral cartilage was performed slice-by-slice by two raters using MatLab. Inter- and intrarater reliabilities were calculated using intraclass correlation coefficient (ICC) and Bland-Altman analysis. T2 values were analyzed with respect to specific locations (medial condyle, trochlea, and lateral condyle), angles to B0 , and layers of cartilage (whole, deep, and superficial). RESULTS Inter- and intrarater reliability obtained from the entire femoral cartilage was excellent (ICC = 0.84, 0.86, respectively). The ICCs around the trochlea were lower than those of the medial and lateral condyle. Both the inter- and intrarater Bland-Altman plots indicated larger differences in pixel count are seen as the size of the angular segment becomes larger. T2 values were significantly higher in the superficial layer compared to the deep layer at each femoral compartment (P < 0.001). A magic angle effect was clearly observed, especially within the whole and deep layer over the medial and lateral femoral condyles, except for the superficial layer at the medial condyle. CONCLUSION The normal T2 map profiles of the entire femoral cartilage showed variations in ICCs by location and in T2 values by angles and layers. These profiles can be useful for diagnosis of early cartilage degeneration in a specific angle and layer of each condyle and trochlea.
Collapse
Affiliation(s)
- Yasuhito Kaneko
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Taiki Nozaki
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Hon Yu
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA.,John Tu and Thomas Yuen Center for Functional Onco-Imaging, University of California, Irvine, Orange, California, USA
| | - Andrew Chang
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Kayleigh Kaneshiro
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Ran Schwarzkopf
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California, USA
| | - Takeshi Hara
- Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| |
Collapse
|
19
|
Tao H, Li H, Hua Y, Chen Z, Feng X, Chen S. Quantitative magnetic resonance imaging (MRI) evaluation of cartilage repair after microfracture treatment for full-thickness cartilage defect models in rabbit knee joints: correlations with histological findings. Skeletal Radiol 2015; 44:393-402. [PMID: 25425345 DOI: 10.1007/s00256-014-2062-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 09/04/2014] [Accepted: 11/11/2014] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate repair tissue (RT) after microfracture treatment for full-thickness cartilage defect models using quantitative MRI and investigate the correlations between MRI and histological findings. MATERIALS AND METHODS The animal experiment was approved by the Animal Care and Use Committee of our college. Thirty-six full-thickness cartilage defect models in rabbit knee joints were assigned to the microfracture or joint debridement group (as control). Each group consisted of 3-week, 5-week, and 7-week subgroups. MR imaging, including a three-dimensional double-echo steady-state sequence (3D-DESS), and T2 mapping were performed at 3, 5, and 7 weeks postoperatively. The thickness and T2 indices of RT were calculated. After MRI scans at each time point, operation sites were removed to make hematoxylin-eosin (H&E)-stained sections. Histological results were evaluated using the modified O'Driscoll score system. Comparisons were made between the two groups with respect to the MRI and histological findings, and correlation analysis was performed within each group. RESULTS The thickness index and histological O'Driscoll score of RT in the two groups increased over time, while the T2 index decreased. The thickness index and histological O'Driscoll score of the microfracture group were higher than in the joint debridement group at each time point. The T2 index of the microfracture group was lower than in the joint debridement group at 3 weeks (P = 0.006), while it was higher than in the joint debridement group at 5 and 7 weeks (P = 0.025 and 0.025). The thickness index was positively correlated with the histological O'Driscoll score in both groups (microfracture: r s = 0.745, P < 0.001; joint debridement: r s = 0.680, P = 0.002). The T2 index was negatively correlated with the histological O'Driscoll score in both groups (microfracture: r s = -0.715, P = 0.002; joint debridement: r s = -0.826, P < 0.001). CONCLUSION Significant improvement over time after microfracture can be expected on the basis of the quantitative MRI finding and histological O'Driscoll score. MRI was correlated with the histological O'Driscoll score, which indicated that quantitative MRI 3D-DESS and T2 mapping could evaluate cartilage repair after microfracture as an effective noninvasive tool.
Collapse
Affiliation(s)
- Hongyue Tao
- Department of Radiology, Huashan Hospital, Fudan University, 12 Wulumuqizhong Road, 200040, Shanghai, China
| | | | | | | | | | | |
Collapse
|
20
|
Barker JW, Han PK, Choi SH, Bae KT, Park SH. Investigation of inter-slice magnetization transfer effects as a new method for MTR imaging of the human brain. PLoS One 2015; 10:e0117101. [PMID: 25664938 PMCID: PMC4321840 DOI: 10.1371/journal.pone.0117101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/17/2014] [Indexed: 11/18/2022] Open
Abstract
We present a new method for magnetization transfer (MT) ratio imaging in the brain that requires no separate saturation pulse. Interslice MT effects that are inherent to multi-slice balanced steady-state free precession (bSSFP) imaging were controlled via an interslice delay time to generate MT-weighted (0 s delay) and reference images (5–8 s delay) for MT ratio (MTR) imaging of the brain. The effects of varying flip angle and phase encoding (PE) order were investigated experimentally in normal, healthy subjects. Values of up to ∼50% and ∼40% were observed for white and gray matter MTR. Centric PE showed larger MTR, higher SNR, and better contrast between white and gray matter than linear PE. Simulations of a two-pool model of MT agreed well with in vivo MTR values. Simulations were also used to investigate the effects of varying acquisition parameters, and the effects of varying flip angle, PE steps, and interslice delay are discussed. Lastly, we demonstrated reduced banding with a non-balanced SSFP-FID sequence and showed preliminary results of interslice MTR imaging of meningioma.
Collapse
Affiliation(s)
- Jeffrey W. Barker
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Paul Kyu Han
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Seung Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, South Korea
| | - Kyongtae Ty Bae
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Sung-Hong Park
- Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- * E-mail:
| |
Collapse
|
21
|
Kijowski R, Chaudhary R. Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am 2014; 22:649-69. [PMID: 25442027 DOI: 10.1016/j.mric.2014.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Osteoarthritis is characterized by a decrease in the proteoglycan content and disruption of the highly organized collagen fiber network of articular cartilage. Various quantitative magnetic resonance imaging techniques have been developed for noninvasive assessment of the proteoglycan and collagen components of cartilage. These techniques have been extensively used in clinical practice to detect early cartilage degeneration and in osteoarthritis research studies to monitor disease-related and treatment-related changes in cartilage over time. This article reviews the role of quantitative magnetic resonance imaging in evaluating the composition and ultrastructure of the articular cartilage of the knee joint.
Collapse
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
| |
Collapse
|
22
|
Comparison of biochemical cartilage imaging techniques at 3 T MRI. Osteoarthritis Cartilage 2014; 22:1732-42. [PMID: 25278082 DOI: 10.1016/j.joca.2014.04.020] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 04/11/2014] [Accepted: 04/22/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To prospectively compare chemical-exchange saturation-transfer (CEST) with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 mapping to assess the biochemical cartilage properties of the knee. METHOD Sixty-nine subjects were prospectively included (median age, 42 years; male/female = 32/37) in three cohorts: 10 healthy volunteers, 40 patients with clinically suspected cartilage lesions, and 19 patients about 1 year after microfracture therapy. T2 mapping, dGEMRIC, and CEST were performed at a 3 T MRI unit using a 15-channel knee coil. Parameter maps were evaluated using region-of-interest analysis of healthy cartilage, areas of chondromalacia and repair tissue. Differentiation of damaged from healthy cartilage was assessed using receiver-operating characteristic (ROC) analysis. RESULTS Chondromalacia grade 2-3 had significantly higher CEST values (P = 0.001), lower dGEMRIC (T1-) values (P < 0.001) and higher T2 values (P < 0.001) when compared to the normal appearing cartilage. dGEMRIC and T2 mapping correlated moderately negative (Spearman coefficient r = -0.56, P = 0.0018) and T2 mapping and CEST moderately positive (r = 0.5, P = 0.007), while dGEMRIC and CEST did not significantly correlate (r = -0.311, P = 0.07). The repair tissue revealed lower dGEMRIC values (P < 0.001) and higher CEST values (P < 0.001) with a significant negative correlation (r = -0.589, P = 0.01), whereas T2 values were not different (P = 0.54). In healthy volunteers' cartilage, CEST and dGEMRIC showed moderate positive correlation (r = 0.56), however not reaching significance (P = 0.09). ROC-analysis demonstrated non-significant differences of T2 mapping vs CEST (P = 0.14), CEST vs dGEMRIC (P = 0.89), and T2 mapping vs dGEMRIC (P = 0.12). CONCLUSION CEST is able to detect normal and damaged cartilage and is non-inferior in distinguishing both when compared to dGEMRIC and T2 mapping.
Collapse
|
23
|
Zuo H, Yao W, Qu N, Yang S, Wang J, Cui X. Quantitative evaluation in combination with nonquantitative evaluation in early patellar cartilage osteoarthritis at 3.0 T. Clin Interv Aging 2014; 9:1133-43. [PMID: 25075182 PMCID: PMC4106963 DOI: 10.2147/cia.s65871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose To evaluate quantitative T1 and T2 relaxation times and magnetization transfer ratios (MTRs) in the early diagnosis of patellar cartilage osteoarthritis (OA) and to quantify and possibly refine the current Kellgren-Lawrence score criteria. Materials and methods A total of 92 cases of knee joints with 40 normal volunteers and 30 patients with OA were prospectively evaluated. The knee joints with OA were divided into mild and moderate groups according to the Kellgren-Lawrence score criteria. The discriminative analysis method was used to analyze the accuracy of the original grouped cases correctly classified by age, sex, T1 relaxation times, T2 relaxation times, and MTR values. Linear regression analysis was used between T1 relaxation time, T2 relaxation time, and MTR values. Results The mean T1 relaxation times decreased with the severity of OA, and a significant difference was only found between the normal and moderate OA groups (P<0.05). The mean T2 relaxation times increased, and significant differences were found between the normal and mild OA groups and the normal and moderate OA groups (P<0.001). The MTR values were 35.8%±4.2%, 36.1%±3.2%, and 35.4%±3.8%, respectively. There were no significant differences between the normal and OA groups. In addition, T1 relaxation times were positively correlated with MTR values (P<0.01). A discriminative analysis using a synthesis of all the influential factors indicated a high accuracy rate (93.9%) for the correct classification of the original grouped cases. Conclusion Quantitative T1 and T2 relaxation times were useful in the diagnosis of early OA; T2 relaxation times were more relatively sensitive. The functional usefulness of MTR values may be limited. T1 relaxation times positively correlated with MTR values. Multiple quantitative parameters, combined with some relative nonquantitative clinical parameters and Kellgren-Lawrence scores, may be useful in the early stage of OA and provide better information for clinical treatment and follow-up.
Collapse
Affiliation(s)
- Houdong Zuo
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Weiwu Yao
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Nan Qu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Shixun Yang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, People's Republic of China
| | - Jianhua Wang
- Department of Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xiaojiang Cui
- Department of Surgery, Department of Obstetrics and Gynecology, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| |
Collapse
|
24
|
|
25
|
Cartilage repair surgery: outcome evaluation by using noninvasive cartilage biomarkers based on quantitative MRI techniques? BIOMED RESEARCH INTERNATIONAL 2014; 2014:840170. [PMID: 24877139 PMCID: PMC4024422 DOI: 10.1155/2014/840170] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [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.
Collapse
|
26
|
Schick F. [Contrast in static images in clinical magnetic resonance imaging. Part 2: Sequences for various contrast weightings and applications]. Radiologe 2014; 53:709-21; quiz 722. [PMID: 23949439 DOI: 10.1007/s00117-013-2534-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The second part of this educational article focuses on sequence techniques in magnetic resonance imaging (MRI) and on suitable parameter sets for different contrast weightings. The content is based on the recently published part 1 of this educational article providing a survey on tissue properties relevant for most important contrast mechanisms. Characteristics of contrast weightings are presented in exemplary images recorded from healthy volunteers. Typical clinical applications of the most commonly used contrast weightings are described and discussed. Sequences for the following contrast weightings are included: proton density (density of hydrogen in small mobile molecules), relaxation times T1 and T2, chemical shift (water and fat), effects of magnetic susceptibility, restricted diffusion of water molecules and magnetization transfer between macromolecules and water molecules.
Collapse
Affiliation(s)
- F Schick
- Sektion für Experimentelle Radiologie, Abteilung für Diagnostische und Interventionelle Radiologie, Eberhard Karls Universität Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Deutschland.
| |
Collapse
|
27
|
Baum T, Joseph G, Karampinos D, Jungmann P, Link T, Bauer J. Cartilage and meniscal T2 relaxation time as non-invasive biomarker for knee osteoarthritis and cartilage repair procedures. Osteoarthritis Cartilage 2013; 21:1474-84. [PMID: 23896316 PMCID: PMC3929642 DOI: 10.1016/j.joca.2013.07.012] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 06/21/2013] [Accepted: 07/17/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this work was to review the current literature on cartilage and meniscal T2 relaxation time. METHODS Electronic searches in PubMed were performed to identify relevant studies about T2 relaxation time measurements as non-invasive biomarker for knee osteoarthritis (OA) and cartilage repair procedures. RESULTS Initial osteoarthritic changes include proteoglycan loss, deterioration of the collagen network, and increased water content within the articular cartilage and menisci. T2 relaxation time measurements are affected by these pathophysiological processes. It was demonstrated that cartilage and meniscal T2 relaxation time values were significantly increased in subjects with compared to those without radiographic OA and focal knee lesions, respectively. Subjects with OA risk factors such as overweight/obesity showed significantly greater cartilage T2 values than normal controls. Elevated cartilage and meniscal T2 relaxation times were found in subjects with vs without knee pain. Increased cartilage T2 at baseline predicted morphologic degeneration in the cartilage, meniscus, and bone marrow over 3 years. Furthermore, cartilage repair tissue could be non-invasively assessed by using T2 mapping. Reproducibility errors for T2 measurements were reported to be smaller than the T2 differences in healthy and diseased cartilage indicating that T2 relaxation time may be a reliable discriminatory biomarker. CONCLUSIONS Cartilage and meniscal T2 mapping may be suitable as non-invasive biomarker to diagnose early stages of knee OA and to monitor therapy of OA.
Collapse
Affiliation(s)
- T. Baum
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany,Address correspondence and reprint requests to: T. Baum, Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany. Tel: 49-89-4140-2621; Fax: 49-89-4140-4834
| | - G.B. Joseph
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - D.C. Karampinos
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - P.M. Jungmann
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| | - T.M. Link
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - J.S. Bauer
- Institut für Radiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany,Abteilung für Neuroradiologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany
| |
Collapse
|
28
|
Ellermann J, Ling W, Nissi MJ, Arendt E, Carlson CS, Garwood M, Michaeli S, Mangia S. MRI rotating frame relaxation measurements for articular cartilage assessment. Magn Reson Imaging 2013; 31:1537-43. [PMID: 23993794 DOI: 10.1016/j.mri.2013.06.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 06/03/2013] [Accepted: 06/08/2013] [Indexed: 12/20/2022]
Abstract
In the present work we introduced two MRI rotating frame relaxation methods, namely adiabatic T1ρ and Relaxation Along a Fictitious Field (RAFF), along with an inversion-prepared Magnetization Transfer (MT) protocol for assessment of articular cartilage. Given the inherent sensitivity of rotating frame relaxation methods to slow molecular motions that are relevant in cartilage, we hypothesized that adiabatic T1ρ and RAFF would have higher sensitivity to articular cartilage degradation as compared to laboratory frame T2 and MT. To test this hypothesis, a proteoglycan depletion model was used. Relaxation time measurements were performed at 0 and 48h in 10 bovine patellar specimens, 5 of which were treated with trypsin and 5 untreated controls were stored under identical conditions in isotonic saline for 48h. Relaxation times measured at 48h were longer than those measured at 0h in both groups. The changes in T2 and MT relaxation times after 48h were approximately 3 times larger in the trypsin treated specimens as compared to the untreated group, whereas increases of adiabatic T1ρ and RAFF were 4 to 5 fold larger. Overall, these findings demonstrate a higher sensitivity of adiabatic T1ρ and RAFF to the trypsin-induced changes in bovine patellar cartilage as compared to the commonly used T2 and MT. Since adiabatic T1ρ and RAFF are advantageous for human applications as compared to standard continuous-wave T1ρ methods, adiabatic T1ρ and RAFF are promising tools for assessing cartilage degradation in clinical settings.
Collapse
Affiliation(s)
- Jutta Ellermann
- Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, USA.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Kotecha M, Klatt D, Magin RL. Monitoring cartilage tissue engineering using magnetic resonance spectroscopy, imaging, and elastography. TISSUE ENGINEERING PART B-REVIEWS 2013; 19:470-84. [PMID: 23574498 DOI: 10.1089/ten.teb.2012.0755] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A key technical challenge in cartilage tissue engineering is the development of a noninvasive method for monitoring the composition, structure, and function of the tissue at different growth stages. Due to its noninvasive, three-dimensional imaging capabilities and the breadth of available contrast mechanisms, magnetic resonance imaging (MRI) techniques can be expected to play a leading role in assessing engineered cartilage. In this review, we describe the new MR-based tools (spectroscopy, imaging, and elastography) that can provide quantitative biomarkers for cartilage tissue development both in vitro and in vivo. Magnetic resonance spectroscopy can identify the changing molecular structure and alternations in the conformation of major macromolecules (collagen and proteoglycans) using parameters such as chemical shift, relaxation rates, and magnetic spin couplings. MRI provides high-resolution images whose contrast reflects developing tissue microstructure and porosity through changes in local relaxation times and the apparent diffusion coefficient. Magnetic resonance elastography uses low-frequency mechanical vibrations in conjunction with MRI to measure soft tissue mechanical properties (shear modulus and viscosity). When combined, these three techniques provide a noninvasive, multiscale window for characterizing cartilage tissue growth at all stages of tissue development, from the initial cell seeding of scaffolds to the development of the extracellular matrix during construct incubation, and finally, to the postimplantation assessment of tissue integration in animals and patients.
Collapse
Affiliation(s)
- Mrignayani Kotecha
- Department of Bioengineering, University of Illinois at Chicago , Chicago, Illinois
| | | | | |
Collapse
|
30
|
Nieminen MT, Nissi MJ, Mattila L, Kiviranta I. Evaluation of chondral repair using quantitative MRI. J Magn Reson Imaging 2013; 36:1287-99. [PMID: 23165732 DOI: 10.1002/jmri.23644] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 02/17/2012] [Indexed: 01/30/2023] Open
Abstract
Various quantitative magnetic resonance imaging (qMRI) biomarkers, including but not limited to parametric MRI mapping, semiquantitative evaluation, and morphological assessment, have been successfully applied to assess cartilage repair in both animal and human studies. Through the interaction between interstitial water and constituent macromolecules the compositional and structural properties of cartilage can be evaluated. In this review a comprehensive view of a variety of quantitative techniques, particularly those involving parametric mapping, and their relationship to the properties of cartilage repair is presented. Some techniques, such as T2 relaxation time mapping and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), are well established, while the full potential of more recently introduced techniques remain to be demonstrated. A combination of several MRI techniques is necessary for a comprehensive characterization of chondral repair.
Collapse
Affiliation(s)
- Miika T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | | | | | | |
Collapse
|
31
|
Magnetisation transfer MR imaging of the kidney: evaluation at 3.0 T in association with renal function. Eur Radiol 2013; 23:2315-9. [DOI: 10.1007/s00330-013-2841-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 02/15/2013] [Accepted: 02/25/2013] [Indexed: 10/26/2022]
|
32
|
[Imaging of postarthroscopic complications after knee injuries]. Radiologe 2012; 52:1012-22. [PMID: 23154847 DOI: 10.1007/s00117-012-2408-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The most common joint injuries in professional and recreational sports participants and also in the total population are knee injuries. Arthroscopy is indicated if this modality will improve the patient outcome and potential long-term complications can be avoided. Although uncommon, complications following arthroscopy are mostly evaluated by magnetic resonance imaging (MRI). For planning further therapy strategies following postarthroscopic complications, e.g. if anterior cruciate ligament (ACL) reconstruction is required, digital radiographs and computed tomography (CT) are helpful. This article provides an overview of the different procedures for surgical treatment which are a prerequisite for the analysis of postarthroscopic images. In addition typical complications after treatment of meniscal and chondral injuries as well as after ACL reconstruction are described and typical signs in MRI, radiography and CT are explained in detail.
Collapse
|
33
|
Theologis AA, Schairer WW, Carballido-Gamio J, Majumdar S, Li X, Ma CB. Longitudinal analysis of T1ρ and T2 quantitative MRI of knee cartilage laminar organization following microfracture surgery. Knee 2012; 19:652-7. [PMID: 22018879 PMCID: PMC3652011 DOI: 10.1016/j.knee.2011.09.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 08/18/2011] [Accepted: 09/12/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To quantitate longitudinally the radiographic properties of different layers of repaired tissue following microfracture (MFx) surgery using T(1ρ) and T(2) magnetic resonance imaging (MRI). DESIGN 10 patients underwent MFx surgery to treat symptomatic focal cartilage defects (FCD). Sagittal three-dimensional (3D) water excitation high-spatial resolution (HR) spoiled gradient recalled (SPGR) for quantitative T(1ρ) and T(2) mapping were acquired for each patient 3-6 months and 1 year after surgery. Cartilage compartments were segmented on HR-SPGR images, and T(1ρ) and T(2) maps were registered to the HR-SPGR images. T(1ρ) and T(2) values for the full thickness of deep and superficial layers of repaired tissue (RT) and normal cartilage (NC) were calculated, and compared within and between respective time points. A p-value <0.05 is considered statistically significant. RESULTS The majority of FCD were found in the MFC. The average surface area of the lesions did not differ significantly overtime. At 3-6 months, RT had significantly higher full thickness T(1ρ) and T(2) values relative to NC. At 1 year, this significant difference was only observed for T(1ρ) values. At 3-6 months follow-up, the RT's superficial layer had significantly higher T(1ρ) and T(2) values than the deep layer of the RT and the superficial layer of NC. At 12 months, the superficial layer of the RT had significantly higher T(1ρ) values than the RT's deep layer and the NC's superficial layer. CONCLUSION T(1ρ) and T(2) MRI are feasible methods for quantitatively and noninvasively monitoring the maturation of repaired tissue following microfracture surgery over time.
Collapse
Affiliation(s)
- Alexander A. Theologis
- School of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA,Musculoskeletal Quantitative Imaging Research, Department of Radiology, UCSF, San Francisco, CA, USA,Department of Orthopaedic Surgery, UCSF, San Francisco, CA, USA
| | - William W. Schairer
- School of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA,Musculoskeletal Quantitative Imaging Research, Department of Radiology, UCSF, San Francisco, CA, USA
| | - Julio Carballido-Gamio
- Musculoskeletal Quantitative Imaging Research, Department of Radiology, UCSF, San Francisco, CA, USA
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology, UCSF, San Francisco, CA, USA
| | - Xiaojuan Li
- Musculoskeletal Quantitative Imaging Research, Department of Radiology, UCSF, San Francisco, CA, USA
| | - C. Benjamin Ma
- Department of Orthopaedic Surgery, UCSF, San Francisco, CA, USA,Corresponding author at: University of California, San Francisco School of Medicine, Department of Orthopaedic Surgery, Mission Bay Ortho Institute, 1500 Owens Street, San Francisco, CA 94158. Tel.: +1 415 353 2808; fax: +1 415 885 9643. (C.B. Ma)
| |
Collapse
|
34
|
Rosenkrantz AB, Storey P, Gilet AG, Niver BE, Babb JS, Hajdu CH, Lee VS. Magnetization Transfer Contrast–prepared MR Imaging of the Liver: Inability to Distinguish Healthy from Cirrhotic Liver. Radiology 2012; 262:136-43. [DOI: 10.1148/radiol.11111043] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
35
|
Abstract
The newer magnetic resonance (MR) imaging methods can give insights into the initiation, progression, and eventual treatment of osteoarthritis. Sodium imaging is specific for changes in proteoglycan (PG) content without the need for an exogenous contrast agent. T1ρ imaging is sensitive to early PG depletion. Delayed gadolinium-enhanced MR imaging has high resolution and sensitivity. T2 mapping is straightforward and is sensitive to changes in collagen and water content. Ultrashort echo time MR imaging examines the osteochondral junction. Magnetization transfer provides improved contrast between cartilage and fluid. Diffusion-weighted imaging may be a valuable tool in postoperative imaging.
Collapse
|
36
|
Bieri O, Ganter C, Welsch GH, Trattnig S, Mamisch TC, Scheffler K. Fast diffusion-weighted steady state free precession imaging of in vivo knee cartilage. Magn Reson Med 2011; 67:691-700. [PMID: 21858861 DOI: 10.1002/mrm.23061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 02/02/2023]
Abstract
Quantification of molecular diffusion with steady state free precession (SSFP) is complicated by the fact that diffusion effects accumulate over several repetition times (TR) leading to complex signal dependencies on transverse and longitudinal magnetization paths. This issue is commonly addressed by setting TR > T(2), yielding strong attenuation of all higher modes, except of the shortest ones. As a result, signal attenuation from diffusion becomes T(2) independent but signal-to-noise ratio (SNR) and sequence efficiency are remarkably poor. In this work, we present a new approach for fast in vivo steady state free precession diffusion-weighted imaging of cartilage with TR << T(2) offering a considerable increase in signal-to-noise ratio and sequence efficiency. At a first glance, prominent coupling between magnetization paths seems to complicate quantification issues in this limit, however, it is observed that diffusion effects become rather T(2) (ΔD ≈ 1/10 ΔT(2)) but not T(1) independent (ΔD ≈ 1/2 ΔT(1)) for low flip angles α ≈ 10 - 15°. As a result, fast high-resolution (0.35 × 0.35 - 0.50 × 0.50 mm(2) in-plane resolution) quantitative diffusion-weighted imaging of human articular cartilage is demonstrated at 3.0 T in a clinical setup using estimated T(1) and T(2) or a combination of measured T(1) and estimated T(2) values.
Collapse
Affiliation(s)
- O Bieri
- Division of Radiological Physics, Department of Medical Radiology, University of Basel Hospital, Basel, Switzerland.
| | | | | | | | | | | |
Collapse
|
37
|
Battaglia M, Vannini F, Buda R, Cavallo M, Ruffilli A, Monti C, Galletti S, Giannini S. Arthroscopic autologous chondrocyte implantation in osteochondral lesions of the talus: mid-term T2-mapping MRI evaluation. Knee Surg Sports Traumatol Arthrosc 2011; 19:1376-84. [PMID: 21503808 DOI: 10.1007/s00167-011-1509-x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 03/31/2011] [Indexed: 02/06/2023]
Abstract
PURPOSE Autologous chondrocyte implantation (ACI) in the ankle has become an established procedure to treat osteochondral lesions. However, a non-invasive method able to provide information on the nature of the repair tissue is needed. Recently, MRI T2 mapping was identified as a method capable of qualitatively characterizing articular cartilage. The aim of this study was to evaluate the mid-term results of a series of patients arthroscopically treated by ACI and investigate the nature of the repair tissue by MRI T2 mapping. METHODS Twenty patients, aged 35 ± 8 years, with an osteochondral lesion of the talus, underwent ACI and were evaluated at 5 ± 1 years' follow-up clinically (AOFAS score) and by the MRI T2-mapping sequence. MRI images were acquired using a protocol proposed by the International Cartilage Repair Society, evaluated by the MOCART score and completed by the T2-mapping sequence. Healthy volunteers, mean age 29 ± 6 years, were enrolled, and their T2 map values were used as a control. Their MRI results were then correlated with the clinical score. RESULTS The AOFAS score increased from 59 ± 16 pre-operatively to 84 ± 18 at follow-up (P < 0.0005). Patients with more than 4 years' follow-up were found to have the most satisfactory results. On the basis of the controls, healthy hyaline cartilage tissue showed a T2 map value of 35-45 ms. A mean T2 map value compatible with normal hyaline cartilage was found in all the cases treated, covering a mean percentage of 69% ± 22 of the repaired lesion area. CONCLUSIONS ACI was able to provide durable results that improved over time. Because of its ability to detect cartilage quality, the MRI T2-mapping sequence integrated with the Mocart score is a valid, non-invasive technique in evaluating the nature of the repair tissue in the ankle joint. LEVEL OF EVIDENCE Therapeutic study, Level IV.
Collapse
Affiliation(s)
- Milva Battaglia
- Service of Ecography and Radiology, Rizzoli Orthopaedic Institute, Bologna, Italy
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Bildgebung postarthroskopischer Komplikationen nach Knieverletzungen. ARTHROSKOPIE 2011. [DOI: 10.1007/s00142-011-0642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
39
|
Holtzman DJ, Theologis AA, Carballido-Gamio J, Majumdar S, Li X, Benjamin C. T(1ρ) and T(2) quantitative magnetic resonance imaging analysis of cartilage regeneration following microfracture and mosaicplasty cartilage resurfacing procedures. J Magn Reson Imaging 2011; 32:914-23. [PMID: 20882622 DOI: 10.1002/jmri.22300] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To examine T(1ρ) (T1rho) and T(2) quantitative magnetic resonance imaging (MRI) in evaluating cartilage regeneration following microfracture (MFx) and mosaicplasty (MOS) cartilage resurfacing procedures. MATERIALS AND METHODS Eighteen patients underwent MFx and eight patients underwent MOS to treat symptomatic focal cartilage defects. Quantitative T(1ρ) and T(2) maps were acquired at 3-6 months and 1 year after surgery. The area of resurfacing was identified, and T(1ρ) and T(2) values for the regenerated tissue (RT) and normal cartilage (NC) were acquired. RT/NC ratios were calculated to standardize absolute T(1ρ) and T(2) values. Data were prospective, cross-sectional, and nonrandomized. RESULTS T(1ρ) and T(2) showed good reanalysis reproducibility for RT and NC. Significant differences between RT and NC were present following MFx at 3-6 months for T(1ρ) and T(2) values as well as following MOS at 3-6 months and 1 year for T(1ρ) values. Following MFx, the T(2) RT/NC ratio was significantly different between 3-6 months and 1 year (P = 0.02), while the T(1ρ) RT/NC ratio approached significance (P = 0.07). Following MOS, the T(1ρ) and T(2) RT/NC ratios were not significantly different between the two timepoints. CONCLUSION T(1ρ) and T(2) MRI are complementary and reproducible methods for quantitatively and noninvasively monitoring regeneration of RT following MFx and MOS.
Collapse
Affiliation(s)
- Daniel J Holtzman
- School of Medicine, University of California, San Francisco (UCSF), San Francisco, California 94158, USA
| | | | | | | | | | | |
Collapse
|
40
|
Trattnig S, Winalski CS, Marlovits S, Jurvelin JS, Welsch GH, Potter HG. Magnetic Resonance Imaging of Cartilage Repair: A Review. Cartilage 2011; 2:5-26. [PMID: 26069565 PMCID: PMC4300792 DOI: 10.1177/1947603509360209] [Citation(s) in RCA: 45] [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: 01/30/2023] Open
Abstract
Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression. Cartilage repair surgery, no matter the technique, requires a noninvasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue. This goal is best fulfilled by magnetic resonance imaging (MRI). The present article provides an overview of the current state of the art of MRI of cartilage repair. In the first 2 sections, preclinical and clinical MRI of cartilage repair tissue are described with a focus on morphological depiction of cartilage and the use of functional (biochemical) MR methodologies for the visualization of the ultrastructure of cartilage repair. In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.
Collapse
Affiliation(s)
- Siegfried Trattnig
- MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria,Siegfried Trattnig, MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria
| | | | - Stephan Marlovits
- Trauma Surgery Department, Medical University of Vienna, Vienna, Austria
| | - Jukka S. Jurvelin
- Department of Physics and Mathematics, University of Eastern Finland, Kuopio, Finland
| | - Goetz H. Welsch
- MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria,Department of Trauma Surgery, University Hospital of Erlangen, Erlangen, Germany
| | | |
Collapse
|
41
|
Welsch GH, Apprich S, Zbyn S, Mamisch TC, Mlynarik V, Scheffler K, Bieri O, Trattnig S. Biochemical (T2, T2* and magnetisation transfer ratio) MRI of knee cartilage: feasibility at ultra-high field (7T) compared with high field (3T) strength. Eur Radiol 2010; 21:1136-43. [PMID: 21153551 DOI: 10.1007/s00330-010-2029-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 10/15/2010] [Accepted: 10/18/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study compares the performance and the reproducibility of quantitative T2, T2* and the magnetisation transfer ratio (MTR) of articular cartilage at 7T and 3T. METHODS Axial MRI of the patella was performed in 17 knees of healthy volunteers (25.8 ± 5.7 years) at 3T and 7T using a comparable surface coil and whole-body MR systems from the same vendor, side-by-side. Thirteen knee joints were assessed once, and four knee joints were measured three times to assess reproducibility. T2 relaxation was prepared by a multi-echo, spin-echo sequence and T2* relaxation by a multi-echo, gradient-echo sequence. MTR was based on a magnetisation transfer-sensitized, steady-state free precession approach. Statistical analysis-of-variance and coefficient-of-variation (CV) were prepared. RESULTS For T2 and T2*, global values were significantly lower at 7T compared with 3T; the zonal evaluation revealed significantly less pronounced stratification at 7T (p < 0.05). MTR provided higher values at 7T (p < 0.05). CV, indicating reproducibility, showed slightly lower values at 7T, but only for T2 and T2*. CONCLUSION Although lower T2 and T2* relaxation times were expected at 7T, the differences in stratification between the field strengths were reported for the first time. The assessment of MT is feasible at 7T, but requires further investigation.
Collapse
Affiliation(s)
- Goetz H Welsch
- MR Center, Department of Radiology, Medical University of Vienna, Lazarettgasse 14, Vienna, A-1090, Austria.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Longitudinal evaluation of cartilage repair tissue after microfracture using T2-mapping: a case report with arthroscopic and MRI correlation. Knee Surg Sports Traumatol Arthrosc 2010; 18:1545-50. [PMID: 20505925 DOI: 10.1007/s00167-010-1161-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2009] [Accepted: 04/19/2010] [Indexed: 02/01/2023]
Abstract
A man sustained a left knee injury which led to full-thickness chondral defects of the trochlear groove and lateral femoral condyle. Both areas were treated with microfractures and evaluated at 5 months and 2 years with standard MRI scans, T2 relaxation maps, and arthroscopy. At 5-months post-microfracture repair, the patient complained of recurrent anterior knee pain. While standard MRI imaging was inconclusive with regards to a potential recurrent defect at the trochlear groove microfracture area, T2 relaxation maps established the integrity of the surface layer which was confirmed by arthroscopic evaluation. At 2 years, imaging studies revealed repair tissue loss with low T2 values at the trochlear repair site. The failure of the trochlear site and the integrity of the lateral femoral condyle repair sites were confirmed by arthroscopy. This case report is the first one to provide a correlation of T2 mapping MRI findings with arthroscopic confirmation in the context of microfracture repairs. The study provides evidence for the clinical utility of T2 relaxation maps for the postoperative assessment of microfractures and raises the potential for T2 mapping MRI as a tool to evaluate these repair procedures.
Collapse
|
43
|
Mid-term results of Autologous Matrix-Induced Chondrogenesis for treatment of focal cartilage defects in the knee. Knee Surg Sports Traumatol Arthrosc 2010; 18:1456-64. [PMID: 20127072 DOI: 10.1007/s00167-010-1042-3] [Citation(s) in RCA: 205] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2009] [Accepted: 01/02/2010] [Indexed: 12/20/2022]
Abstract
Articular cartilage defects heal poorly. Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen scaffold and fibrin glue. The purpose of this prospective study was to evaluate the medium-term results of this enhanced microfracture technique for the treatment of chondral lesions of the knee. Thirty-two chondral lesions in 27 patients were treated with AMIC. Within the context of clinical follow-up, these patients were evaluated for up to 5 years after the intervention. Five different scores (Meyer score, Tegner score, Lysholm score, ICRS score, Cincinnati score) as well as radiographs were used for outcome analysis. Articular resurfacing was assessed by magnetic resonance imaging (MRI). The average age of patients (11 females, 16 males; mean body mass index 26, range 20-32) was 37 years (range 16-50 years). The mean defect size of the chondral lesions was 4.2 cm(2) (range 1.3-8.8 cm(2)). All defects were classified as grade IV according to the Outerbridge classification. The follow-up period was between 24 and 62 months with a mean of 37 months. Twenty out of 23 individuals (87%) questioned were subjectively highly satisfied with the results after surgery. Significant improvement (P < 0.05) of all scores was observed as early as 12 months after AMIC, and further increased values were notable up to 24 months postoperatively. MRI analysis showed moderate to complete filling with a normal to incidentally hyperintense signal in most cases. Results did not show a clinical impact of patient's age at the time of operation, body mass index and number of previous operations (n.s.). In contrast, males showed significant higher values in the ICRS score compared to their female counterparts. AMIC is an effective and safe method of treating symptomatic full-thickness chondral defects of the knee in appropriately selected cases. However, further studies with long-term follow-up are needed to determine whether the grafted area will maintain structural and functional integrity over time.
Collapse
|
44
|
Validity of T2 mapping in characterization of the regeneration tissue by bone marrow derived cell transplantation in osteochondral lesions of the ankle. Eur J Radiol 2010; 80:e132-9. [PMID: 20801594 DOI: 10.1016/j.ejrad.2010.08.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 07/28/2010] [Accepted: 08/02/2010] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Bone marrow derived cell transplantation (BMDCT) has been recently suggested as a possible surgical technique to repair osteochondral lesions. To date, no qualitative MRI studies have evaluated its efficacy. The aim of our study is to investigate the validity of MRI T2-mapping sequence in characterizing the reparative tissue obtained and its ability to correlate with clinical results. METHODS AND MATERIALS 20 patients with an osteochondral lesion of the talus underwent BMDCT and were evaluated at 2 years follow up using MRI T2-mapping sequence. 20 healthy volunteers were recruited as controls. MRI images were acquired using a protocol suggested by the International Cartilage Repair Society, MOCART scoring system and T2 mapping. Results were then correlated with AOFAS clinical score. RESULTS AOFAS score increased from 66.8±14.5 pre-operatively to 91.2±8.3 (p<0.0005) at 2 years follow-up. T2-relaxation time value of 35-45 ms was derived from healthy ankles evaluation and assumed as normal hyaline cartilage value and used as a control. Regenerated tissue with a T2-relaxation time value comparable to hyaline cartilage was found in all the cases treated, covering a mean of 78% of the repaired lesion area. A high clinical score was related directly to isointense signal in DPFSE fat sat (p=0.05), and percentage of regenerated hyaline cartilage (p=0.05), inversely to the percentage of regenerated fibrocartilage. Lesion's depth negatively related to the integrity of the repaired tissue's surface (tau=-0.523, p=0.007), and to the percentage of regenerated hyaline cartilage (rho=-0.546, p=0.013). CONCLUSIONS Because of its ability to detect cartilage's quality and to correlate to the clinical score, MRI T2-mapping sequence integrated with Mocart score represent a valid, non-invasive technique for qualitative cartilage assessment after regenerative surgical procedures.
Collapse
|
45
|
Bittersohl B, Hosalkar HS, Kim YJ, Werlen S, Trattnig S, Siebenrock KA, Mamisch TC. T1 assessment of hip joint cartilage following intra-articular gadolinium injection: A pilot study. Magn Reson Med 2010; 64:1200-7. [DOI: 10.1002/mrm.22472] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
46
|
TAKAYAMA Y, HATAKENAKA M, YOSHIURA T, OKAZAKI K, NISHIKAWA K, OKUAKI T, ZIMINE I, HONDA H. A Simplified Method of T1ρ Mapping in Clinical Assessment of Knee Joint. Magn Reson Med Sci 2010; 9:209-15. [DOI: 10.2463/mrms.9.209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
47
|
T2 and T2* mapping in patients after matrix-associated autologous chondrocyte transplantation: initial results on clinical use with 3.0-Tesla MRI. Eur Radiol 2009; 20:1515-23. [DOI: 10.1007/s00330-009-1669-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 09/24/2009] [Accepted: 10/05/2009] [Indexed: 01/30/2023]
|
48
|
Carballido-Gamio J, Stahl R, Blumenkrantz G, Romero A, Majumdar S, Link TM. Spatial analysis of magnetic resonance T1rho and T2 relaxation times improves classification between subjects with and without osteoarthritis. Med Phys 2009; 36:4059-67. [PMID: 19810478 DOI: 10.1118/1.3187228] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Studies have shown that functional analysis of knee cartilage based on magnetic resonance (MR) relaxation times is a valuable tool in the understanding of osteoarthritis (OA). In this work, the regional spatial distribution of knee cartilage T1rho, and T2 relaxation times based on texture and laminar analyses was studied to investigate if they provide additional insight compared to global mean values in the study of OA. METHODS Knee cartilage of 36 subjects, 19 healthy controls and 17 with mild OA, was divided into 16 compartments. T1rho and T2 relaxation times were studied with first order statistics, eight texture parameters with four different orientations using gray-level co-occurrence matrices and by subdividing each compartment into two different layers: Deep and superficial. Receiver operating characteristic curve analysis was performed to evaluate the potential of each technique to correctly classify the populations. RESULTS Although the deep and superficial cartilage layers had in general significantly different T1rho and T2 relaxation times, they performed similarly in terms of subject discrimination. The subdivision of lateral and medial femoral compartments into weight-bearing and non-weight-bearing regions did not improve discrimination. Also it was found that the most sensitive region was the patella and that T1rho discriminated better than T2. The most important finding was that with respect to global mean values, laminar and texture analyses improved subject discrimination. CONCLUSIONS Results of this study suggest that spatially assessing MR images of the knee cartilage relaxation times using laminar and texture analyses could lead to better and probably earlier identification of cartilage matrix abnormalities in subjects with OA.
Collapse
|
49
|
Quirbach S, Trattnig S, Marlovits S, Zimmermann V, Domayer S, Dorotka R, Mamisch TC, Bohndorf K, Welsch GH. Initial results of in vivo high-resolution morphological and biochemical cartilage imaging of patients after matrix-associated autologous chondrocyte transplantation (MACT) of the ankle. Skeletal Radiol 2009; 38:751-60. [PMID: 19296100 DOI: 10.1007/s00256-009-0682-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2009] [Revised: 02/22/2009] [Accepted: 03/02/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to use morphological as well as biochemical (T2 and T2* relaxation times and diffusion-weighted imaging (DWI)) magnetic resonance imaging (MRI) for the evaluation of healthy cartilage and cartilage repair tissue after matrix-associated autologous chondrocyte transplantation (MACT) of the ankle joint. MATERIALS AND METHODS Ten healthy volunteers (mean age, 32.4 years) and 12 patients who underwent MACT of the ankle joint (mean age, 32.8 years) were included. In order to evaluate possible maturation effects, patients were separated into short-term (6-13 months) and long-term (20-54 months) follow-up cohorts. MRI was performed on a 3.0-T magnetic resonance (MR) scanner using a new dedicated eight-channel foot-and-ankle coil. Using high-resolution morphological MRI, the magnetic resonance observation of cartilage repair tissue (MOCART) score was assessed. For biochemical MRI, T2 mapping, T2* mapping, and DWI were obtained. Region-of-interest analysis was performed within native cartilage of the volunteers and control cartilage as well as cartilage repair tissue in the patients subsequent to MACT. RESULTS The overall MOCART score in patients after MACT was 73.8. T2 relaxation times (approximately 50 ms), T2* relaxation times (approximately 16 ms), and the diffusion constant for DWI (approximately 1.3) were comparable for the healthy volunteers and the control cartilage in the patients after MACT. The cartilage repair tissue showed no significant difference in T2 and T2* relaxation times (p > or = 0.05) compared to the control cartilage; however, a significantly higher diffusivity (approximately 1.5; p < 0.05) was noted in the cartilage repair tissue. CONCLUSION The obtained results suggest that besides morphological MRI and biochemical MR techniques, such as T2 and T2* mapping, DWI may also deliver additional information about the ultrastructure of cartilage and cartilage repair tissue in the ankle joint using high-field MRI, a dedicated multichannel coil, and sophisticated sequences.
Collapse
Affiliation(s)
- Sebastian Quirbach
- MR Center--High-Field MR, Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
The discipline of musculoskeletal radiology has evolved into a major imaging subspecialty in the years since the first use of x-rays to diagnose fractures. Musculoskeletal radiology expertise has experienced enormous developments in diagnostic sensitivity and specificity and in image-guided treatment options, in addition to technologic advances far beyond x-rays. Advances in cross-sectional imaging such as CT and MR imaging and educational and research endeavors have contributed further to the growth of musculoskeletal radiology as a distinct subspecialty.
Collapse
Affiliation(s)
- Carolyn M Sofka
- Department of Radiology and Imaging, Hospital for Special Surgery, NY 10021, USA.
| | | |
Collapse
|