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Kruse RC, Rudolph L, Negaard M. Asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts. PM R 2024; 16:563-569. [PMID: 37799012 DOI: 10.1002/pmrj.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/09/2023] [Accepted: 09/30/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND The hindfoot region is commonly injured in gymnasts, and musculoskeletal ultrasound can be used to identify structural abnormalities in this region. Although prior studies have shown that sonographic abnormalities may not correlate with symptomatic pathology, the presence of asymptomatic sonographic abnormalities of the hindfoot in Division I collegiate gymnasts has not been evaluated. OBJECTIVE To identify and describe commonly seen asymptomatic sonographic abnormalities of the hindfoot region in Division I collegiate gymnasts. DESIGN Cross-sectional study. SETTING Tertiary care academic medical center. PARTICIPANTS 39 Division I NCAA men's and women's collegiate gymnasts without current hindfoot pain or history of hindfoot injury. INTERVENTIONS Diagnostic musculoskeletal ultrasound of the hindfoot region. MAIN OUTCOME MEASURES Sonographic appearance of the hindfoot region, specifically the plantar fascia, plantar fad pad, and Achilles tendon. RESULTS A total of 37 of 39 gymnasts included in the study were found to have at least one asymptomatic sonographic abnormality of the hindfoot region. A total of 28.2% of athletes were found to have sonographic abnormalities within the Achilles tendon, with Doppler flow being the most common finding, and 35.8% of athletes were found to have a Haglund's deformity. However, only 7% of athletes with a Haglund's deformity demonstrated abnormal sonographic findings within the tendon. Sonographic abnormalities of the plantar fascia and plantar fat pad were seen in 30.7% and 69.2% of athletes, respectively. CONCLUSIONS Asymptomatic sonographic abnormalities of the hindfoot region are common in collegiate gymnasts. Clinicians should use clinical judgment when interpreting these findings as they may not represent symptomatic pathology.
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Affiliation(s)
- Ryan C Kruse
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa, USA
| | | | - Matthew Negaard
- Department of Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
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Tian Y, Nayak KS. New clinical opportunities of low-field MRI: heart, lung, body, and musculoskeletal. MAGMA (NEW YORK, N.Y.) 2024; 37:1-14. [PMID: 37902898 PMCID: PMC10876830 DOI: 10.1007/s10334-023-01123-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/28/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023]
Abstract
Contemporary whole-body low-field MRI scanners (< 1 T) present new and exciting opportunities for improved body imaging. The fundamental reason is that the reduced off-resonance and reduced SAR provide substantially increased flexibility in the design of MRI pulse sequences. Promising body applications include lung parenchyma imaging, imaging adjacent to metallic implants, cardiac imaging, and dynamic imaging in general. The lower cost of such systems may make MRI favorable for screening high-risk populations and population health research, and the more open configurations allowed may prove favorable for obese subjects and for pregnant women. This article summarizes promising body applications for contemporary whole-body low-field MRI systems, with a focus on new platforms developed within the past 5 years. This is an active area of research, and one can expect many improvements as MRI physicists fully explore the landscape of pulse sequences that are feasible, and as clinicians apply these to patient populations.
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Affiliation(s)
- Ye Tian
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, 3740 McClintock Ave, EEB 406, Los Angeles, CA, 90089-2564, USA.
| | - Krishna S Nayak
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, 3740 McClintock Ave, EEB 406, Los Angeles, CA, 90089-2564, USA
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Kim S, Jo Y, Im GH, Lee C, Oh C, Kook G, Kim SG, Lee HJ. Miniaturized MR-compatible ultrasound system for real-time monitoring of acoustic effects in mice using high-resolution MRI. Neuroimage 2023; 276:120201. [PMID: 37269955 DOI: 10.1016/j.neuroimage.2023.120201] [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: 03/18/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023] Open
Abstract
Visualization of focused ultrasound in high spatial and temporal resolution is crucial for accurately and precisely targeting brain regions noninvasively. Magnetic resonance imaging (MRI) is the most widely used noninvasive tool for whole-brain imaging. However, focused ultrasound studies employing high-resolution (> 9.4 T) MRI in small animals are limited by the small size of the radiofrequency (RF) volume coil and the noise sensitivity of the image to external systems such as bulky ultrasound transducers. This technical note reports a miniaturized ultrasound transducer system packaged directly above a mouse brain for monitoring ultrasound-induced effects using high-resolution 9.4 T MRI. Our miniaturized system integrates MR-compatible materials with electromagnetic (EM) noise reduction techniques to demonstrate echo-planar imaging (EPI) signal changes in the mouse brain at various ultrasound acoustic intensities. The proposed ultrasound-MRI system will enable extensive research in the expanding field of ultrasound therapeutics.
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Affiliation(s)
- Subeen Kim
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, South Korea
| | - Yehhyun Jo
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, South Korea
| | - Geun Ho Im
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon 16419, South Korea
| | - Chanhee Lee
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon 16419, South Korea
| | - Chaerin Oh
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, South Korea
| | - Geon Kook
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, South Korea
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon 16419, South Korea; Department of Biomedical Engineering, Sungkyunkwan University, Suwon 16419, South Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon 16419, South Korea.
| | - Hyunjoo J Lee
- School of Electrical Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon 34141, South Korea; KAIST Institute for Nano Century (KINC), Daejeon 34141, South Korea.
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Kaniewska M, Deininger-Czermak E, Lohezic M, Ensle F, Guggenberger R. Deep Learning Convolutional Neural Network Reconstruction and Radial k-Space Acquisition MR Technique for Enhanced Detection of Retropatellar Cartilage Lesions of the Knee Joint. Diagnostics (Basel) 2023; 13:2438. [PMID: 37510182 PMCID: PMC10378433 DOI: 10.3390/diagnostics13142438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES To assess diagnostic performance of standard radial k-space (PROPELLER) MRI sequences and compare with accelerated acquisitions combined with a deep learning-based convolutional neural network (DL-CNN) reconstruction for evaluation of the knee joint. METHODS Thirty-five patients undergoing MR imaging of the knee at 1.5 T were prospectively included. Two readers evaluated image quality and diagnostic confidence of standard and DL-CNN accelerated PROPELLER MR sequences using a four-point Likert scale. Pathological findings of bone, cartilage, cruciate and collateral ligaments, menisci, and joint space were analyzed. Inter-reader agreement (IRA) for image quality and diagnostic confidence was assessed using intraclass coefficients (ICC). Cohen's Kappa method was used for evaluation of IRA and consensus between sequences in assessing different structures. In addition, image quality was quantitatively evaluated by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) measurements. RESULTS Mean acquisition time of standard vs. DL-CNN sequences was 10 min 3 s vs. 4 min 45 s. DL-CNN sequences showed significantly superior image quality and diagnostic confidence compared to standard MR sequences. There was moderate and good IRA for assessment of image quality in standard and DL-CNN sequences with ICC of 0.524 and 0.830, respectively. Pathological findings of the knee joint could be equally well detected in both sequences (κ-value of 0.8). Retropatellar cartilage could be significantly better assessed on DL-CNN sequences. SNR and CNR was significantly higher for DL-CNN sequences (both p < 0.05). CONCLUSIONS In MR imaging of the knee, DL-CNN sequences showed significantly higher image quality and diagnostic confidence compared to standard PROPELLER sequences, while reducing acquisition time substantially. Both sequences perform comparably in the detection of knee-joint pathologies, while DL-CNN sequences are superior for evaluation of retropatellar cartilage lesions.
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Affiliation(s)
- Malwina Kaniewska
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (USZ), Raemistrasse 100, 8091 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University of Zurich (UZH), Raemistrasse 100, 8091 Zurich, Switzerland
| | - Eva Deininger-Czermak
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (USZ), Raemistrasse 100, 8091 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University of Zurich (UZH), Raemistrasse 100, 8091 Zurich, Switzerland
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, 8152 Zurich, Switzerland
| | - Maelene Lohezic
- Advanced Technology, Science and Technology Organization, GE HealthCare, 8152 Zurich, Switzerland
| | - Falko Ensle
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (USZ), Raemistrasse 100, 8091 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University of Zurich (UZH), Raemistrasse 100, 8091 Zurich, Switzerland
| | - Roman Guggenberger
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich (USZ), Raemistrasse 100, 8091 Zurich, Switzerland
- Institute of Diagnostic and Interventional Radiology, University of Zurich (UZH), Raemistrasse 100, 8091 Zurich, Switzerland
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Keller G, Estler A, Herrmann J, Afat S, Othman AE, Nickel D, Koerzdoerfer G, Springer F. Prospective intraindividual comparison of a standard 2D TSE MRI protocol for ankle imaging and a deep learning-based 2D TSE MRI protocol with a scan time reduction of 48. LA RADIOLOGIA MEDICA 2023; 128:347-356. [PMID: 36807027 PMCID: PMC10020308 DOI: 10.1007/s11547-023-01604-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/24/2023] [Indexed: 02/23/2023]
Abstract
PURPOSE Magnetic resonance imaging (MRI) scan time remains a limited and valuable resource. This study evaluates the diagnostic performance of a deep learning (DL)-based accelerated TSE study protocol compared to a standard TSE study protocol in ankle MRI. MATERIAL AND METHODS Between October 2020 and July 2021 forty-seven patients were enrolled in this study for an intraindividual comparison of a standard TSE study protocol and a DL TSE study protocol either on a 1.5 T or a 3 T scanner. Two radiologists evaluated the examinations regarding structural pathologies and image quality categories (5-point-Likert-scale; 1 = "non diagnostic", 5 = "excellent"). RESULTS Both readers showed almost perfect/perfect agreement of DL TSE with standard TSE in all analyzed structural pathologies (0.81-1.00) with a median "good" or "excellent" rating (4-5/5) in all image quality categories in both 1.5 T and 3 T MRI. The reduction of total acquisition time of DL TSE compared to standard TSE was 49% in 1.5 T and 48% in 3 T MRI to a total acquisition time of 5 min 41 s and 5 min 46 s. CONCLUSION In ankle MRI the new DL-based accelerated TSE study protocol delivers high agreement with standard TSE and high image quality, while reducing the acquisition time by 48%.
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Affiliation(s)
- Gabriel Keller
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
| | - Arne Estler
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Judith Herrmann
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Ahmed E Othman
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Universitätsklink für Neuroradiologie, Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Allee Am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Gregor Koerzdoerfer
- MR Applications Predevelopment, Siemens Healthcare GmbH, Allee Am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Fabian Springer
- Department of Diagnostic and Interventional Radiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Department of Diagnostic Radiology, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany
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Wessling D, Herrmann J, Afat S, Nickel D, Othman AE, Almansour H, Gassenmaier S. Reduction in Acquisition Time and Improvement in Image Quality in T2-Weighted MR Imaging of Musculoskeletal Tumors of the Extremities Using a Novel Deep Learning-Based Reconstruction Technique in a Turbo Spin Echo (TSE) Sequence. Tomography 2022; 8:1759-1769. [PMID: 35894013 PMCID: PMC9326558 DOI: 10.3390/tomography8040148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/23/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background: The aim of this study was to assess the technical feasibility and the impact on image quality and acquisition time of a deep learning-accelerated fat-saturated T2-weighted turbo spin echo sequence in musculoskeletal imaging of the extremities. Methods: Twenty-three patients who underwent MRI of the extremities were prospectively included. Standard T2w turbo inversion recovery magnitude (TIRMStd) imaging was compared to a deep learning-accelerated T2w TSE (TSEDL) sequence. Image analysis of 23 patients with a mean age of 60 years (range 30−86) was performed regarding image quality, noise, sharpness, contrast, artifacts, lesion detectability and diagnostic confidence. Pathological findings were documented measuring the maximum diameter. Results: The analysis showed a significant improvement for the T2 TSEDL with regard to image quality, noise, contrast, sharpness, lesion detectability, and diagnostic confidence, as compared to T2 TIRMStd (each p < 0.001). There were no differences in the number of detected lesions. The time of acquisition (TA) could be reduced by 52−59%. Interrater agreement was almost perfect (κ = 0.886). Conclusion: Accelerated T2 TSEDL was technically feasible and superior to conventionally applied T2 TIRMStd. Concurrently, TA could be reduced by 52−59%. Therefore, deep learning-accelerated MR imaging is a promising and applicable method in musculoskeletal imaging.
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Affiliation(s)
- Daniel Wessling
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, 72076 Tuebingen, Germany; (D.W.); (J.H.); (H.A.); (S.G.)
| | - Judith Herrmann
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, 72076 Tuebingen, Germany; (D.W.); (J.H.); (H.A.); (S.G.)
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, 72076 Tuebingen, Germany; (D.W.); (J.H.); (H.A.); (S.G.)
- Correspondence:
| | - Dominik Nickel
- MR Application Predevelopment, Siemens Healthcare GmbH, 91052 Erlangen, Germany;
| | - Ahmed E. Othman
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Mainz, 55131 Mainz, Germany;
| | - Haidara Almansour
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, 72076 Tuebingen, Germany; (D.W.); (J.H.); (H.A.); (S.G.)
| | - Sebastian Gassenmaier
- Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, 72076 Tuebingen, Germany; (D.W.); (J.H.); (H.A.); (S.G.)
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Ilbey S, Jungmann PM, Fischer J, Jung M, Bock M, Özen AC. Single point imaging with radial acquisition and compressed sensing. Magn Reson Med 2022; 87:2685-2696. [PMID: 35037292 DOI: 10.1002/mrm.29156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/26/2021] [Accepted: 12/23/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE To accelerate the Pointwise Encoding Time Reduction with Radial Acquisition (PETRA) sequence using compressed sensing while preserving the image quality for high-resolution MRI of tissue with ultra-short T 2 ∗ values. METHODS Compressed sensing was introduced in the PETRA sequence (csPETRA) to accelerate the time-consuming single point acquisition of the k-space center data. Random undersampling was applied to achieve acceleration factors up to Acc = 32. Phantom and in vivo images of the knee joint of six volunteers were measured at 3T using csPETRA sequence with Acc = 4, 8, 12, 16, 24, and 32. Images were compared against fully sampled PETRA data (Acc = 1) for structural similarity and normalized-mean-square-error. Qualitative and semi-quantitative analyses were performed to assess the effect of the acceleration on image artifacts, image quality, and delineation of anatomical structures at the knee. RESULTS Even at high acceleration factors of Acc = 16 no aliasing artifacts were observed, and the anatomical details were preserved compared with the fully sampled data. The normalized-mean-square-error was less than 1% for Acc = 16, in which single point imaging acquisition time was reduced from 165 to 10 s, reducing the total scan time from 7.8 to 5.2 min. Semi-quantitative analyses suggest that Acc = 16 yields comparable diagnostic quality as the fully sampled data for knee imaging at a scan time of 5.2 min. CONCLUSION csPETRA allows for ultra-short T 2 ∗ imaging of the knee joint in clinically acceptable scan times while maintaining the image quality of original non-accelerated PETRA sequence.
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Affiliation(s)
- Serhat Ilbey
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Pia M Jungmann
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Department of Radiology, Cantonal Hospital Grisons, Chur, Switzerland
| | - Johannes Fischer
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Jung
- Department of Diagnostic and Interventional Radiology, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bock
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ali Caglar Özen
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Kim S, Park C, Kim KS, Jeong HS, Lee SM. Clinical feasibility of simultaneous multislice acceleration in knee MRI. Clin Imaging 2021; 82:216-223. [PMID: 34896934 DOI: 10.1016/j.clinimag.2021.11.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/13/2021] [Accepted: 11/27/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To find the best simultaneous multislice (SMS) accelerated setting for clinical application in knee MRI. MATERIAL AND METHODS Thirty-three patients (mean age, 54 years; 21 women) who underwent knee MRI (conventional/SMS sequences) between June and October 2020 were enrolled. Two radiologists retrospectively evaluated sagittal T1- and T2-weighted conventional (2-fold parallel acquisition technique [PAT-2]) and SMS (SMS-2 [PAT-2 with 2-fold SMS], SMS-3, and SMS-4) images. For qualitative analysis, artifacts (zebra/residual aliasing) and diagnostic confidence for internal derangement of knee (bone marrow, cartilage, meniscus, anterior cruciate ligament, and synovium abnormalities) were evaluated. For quantitative analysis, contrast-to-noise ratios of bone marrow, meniscus, joint effusion, and ligament were evaluated. RESULTS Compared to PAT-2 (2 min 32 s), mean acquisition time was reduced by 47% in SMS-2; 64%, SMS-3; and 70%, SMS-4. In qualitative analysis, zebra artifacts were only seen on T2-weighted SMS images. The more SMS was applied, the more zebra and residual aliasing artifacts were seen and the lower diagnostic confidence was for internal derangement. However, qualitative analysis showed acceptable image quality in SMS-2 and SMS-3 images, but not in SMS-4 images. In quantitative analysis, SMS-4 images showed the lowest contrast-to-noise ratios and there were no significant differences among PAT-2, SMS-2, and SMS-3 images. CONCLUSION Applying SMS-3 to knee MRI reduced scan time and showed acceptable image quality compared to conventional (PAT-2). However, when evaluating SMS images, radiologists should know that when more SMS is applied, more zebra and residual aliasing artifacts appear.
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Affiliation(s)
- Shinyoung Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Chankue Park
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
| | | | - Hee Seok Jeong
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Sang-Min Lee
- Department Orthopedic Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
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Schick F, Pieper CC, Kupczyk P, Almansour H, Keller G, Springer F, Mürtz P, Endler C, Sprinkart AM, Kaufmann S, Herrmann J, Attenberger UI. 1.5 vs 3 Tesla Magnetic Resonance Imaging: A Review of Favorite Clinical Applications for Both Field Strengths-Part 1. Invest Radiol 2021; 56:680-691. [PMID: 34324464 DOI: 10.1097/rli.0000000000000812] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
ABSTRACT Whole-body magnetic resonance imaging (MRI) systems with a field strength of 3 T have been offered by all leading manufacturers for approximately 2 decades and are increasingly used in clinical diagnostics despite higher costs. Technologically, MRI systems operating at 3 T have reached a high standard in recent years, as well as the 1.5-T devices that have been in use for a longer time. For modern MRI systems with 3 T, more complexity is required, especially for the magnet and the radiofrequency (RF) system (with multichannel transmission). Many clinical applications benefit greatly from the higher field strength due to the higher signal yield (eg, imaging of the brain or extremities), but there are also applications where the disadvantages of 3 T might outweigh the advantages (eg, lung imaging or examinations in the presence of implants). This review describes some technical features of modern 1.5-T and 3-T whole-body MRI systems, and reports on the experience of using both types of devices in different clinical settings, with all sections written by specialist radiologists in the respective fields.This first part of the review includes an overview of the general physicotechnical aspects of both field strengths and elaborates the special conditions of diffusion imaging. Many relevant aspects in the application areas of musculoskeletal imaging, abdominal imaging, and prostate diagnostics are discussed.
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Affiliation(s)
- Fritz Schick
- From the Section of Experimental Radiology, Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen
| | | | - Patrick Kupczyk
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Haidara Almansour
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Gabriel Keller
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Fabian Springer
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Petra Mürtz
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Christoph Endler
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Alois M Sprinkart
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
| | - Sascha Kaufmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Judith Herrmann
- Department of Radiology, Diagnostic, and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - Ulrike I Attenberger
- Clinic for Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn
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Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
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Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
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Rapid Musculoskeletal MRI in 2021: Value and Optimized Use of Widely Accessible Techniques. AJR Am J Roentgenol 2021; 216:704-717. [DOI: 10.2214/ajr.20.22901] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Collick BD, Behzadnezhad B, Hurley SA, Mathew NK, Behdad N, Lindsay SA, Robb F, Stormont RS, McMillan AB. Rapid development of application-specific flexible MRI receive coils. Phys Med Biol 2020; 65:19NT01. [PMID: 32975219 PMCID: PMC8064628 DOI: 10.1088/1361-6560/abaffb] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Over the last 30 years, there have been dramatic changes in phased array coil technology leading to increasing channel density and parallel imaging functionality. Current receiver array coils are rigid and often mismatched to patient's size. Recently there has been a move towards flexible coil technology, which is more conformal to the human anatomy. Despite the advances of so-called flexible surface coil arrays, these coils are still relatively rigid and limited in terms of design conformability, compromising signal-to-noise ratio (SNR) for flexibility, and are not designed for optimum parallel imaging performance. The purpose of this study is to report on the development and characterization of a 15-channel flexible foot and ankle coil, rapidly designed and constructed using highly decoupled radio-frequency (RF) coil elements. Coil performance was evaluated by performing SNR and g-factor measurements. In vivo testing was performed in a healthy volunteer using both the 15-channel coil and a commercially available 8-channel foot coil. The highly decoupled elements used in this design allow for extremely rapid development and prototyping of application-specific coils for different patient sizes (adult vs child) with minimal additional design consideration in terms of coil overlap and geometry. Image quality was comparable to a commercially available RF coil.
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Affiliation(s)
- B D Collick
- Department of Radiology, University of Wisconsin, Madison, WI 53705, United States of America. Author B D Collick and author B Behzadnezhad contributed equally to this work
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13
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Zhang K, Crum RJ, Samuelsson K, Cadet E, Ayeni OR, de Sa D. In-Office Needle Arthroscopy: A Systematic Review of Indications and Clinical Utility. Arthroscopy 2019; 35:2709-2721. [PMID: 31416656 DOI: 10.1016/j.arthro.2019.03.045] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/13/2019] [Accepted: 03/16/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE This review explores the current literature regarding both the clinical indications and utility of minimally invasive in-office needle arthroscopy (IONA) relative to conventional imaging modalities. METHODS In compliance with R-AMSTAR (Revised Assessment of Multiple Systematic Reviews) and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, 3 databases (MEDLINE, Embase, and PubMed) were searched in July 2018, in addition to the conference abstract databases of 5 prominent meetings between 2013 and 2018, for studies using IONA for diagnostic purposes. Study quality was assessed with the Methodological Index for Non-Randomized Studies (MINORS) criteria. RESULTS Among 932 conference abstracts and 369 studies identified, 11 publications involving 404 patients (395 knees and 9 shoulders) were included, with 9 clinical studies and 2 cost analyses. The median Methodological Index for Non-Randomized Studies (MINORS) score was 9 for noncomparative and 23 for comparative studies. Among the 9 clinical studies, IONA had a superior sensitivity, specificity, positive predictive value, and negative predictive value to magnetic resonance imaging (MRI) in the evaluation of knee osteoarthritis, anterior cruciate ligament insufficiency, and meniscal tears. IONA was comparable or inferior to MRI in the same parameters for the diagnosis of osteochondral defects and rotator cuff tears. In the 2 cost analyses, IONA had lower costs when used in place of MRI for treatment algorithms involving medial meniscal tears and rotator cuff tears but not lateral meniscal tears. CONCLUSIONS IONA holds potential for cost savings and improved diagnostic accuracy relative to MRI, primarily for intra-articular meniscal, ligamentous, and chondral defects of the knee. However, its current indications for use in other joints are limited to rotator cuff tears in the shoulder, making its diagnostic value in other joints much more limited. The current quality and breadth of evidence are significantly lacking, with numerous practical shortcomings. To improve acceptance of IONA, priority should be placed on establishing defined protocols, indications, contraindications, and patient perspectives for the procedure. LEVEL OF EVIDENCE Level IV, systematic review of Level II, III, and IV studies.
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Affiliation(s)
- Kailai Zhang
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Raphael J Crum
- Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A
| | | | - Edwin Cadet
- Raleigh Orthopaedic Clinic, Raleigh, North Carolina, U.S.A
| | | | - Darren de Sa
- Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada.
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14
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S. B, Campbell R. Challenges of imaging injured Paralympic Athletes. Eur J Radiol 2018; 108:283-287. [DOI: 10.1016/j.ejrad.2018.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/14/2018] [Accepted: 07/19/2018] [Indexed: 11/24/2022]
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Covey DC, Sandoval KE, Riffenburgh RH. Contrast-Enhanced MRI Evaluation of Bone-Patellar Tendon-Bone and Hamstring ACL Autograft Healing in Humans: A Prospective Randomized Study. Orthop J Sports Med 2018; 6:2325967118800298. [PMID: 30349838 PMCID: PMC6194935 DOI: 10.1177/2325967118800298] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Gadopentetate dimeglumine–enhanced magnetic resonance imaging (MRI), or gadolinium-enhanced MRI, was used to prospectively study the postoperative course of bone–patellar tendon–bone (BPTB) and combined semitendinosus and gracilis (STG) tendon autografts following arthroscopically assisted reconstruction of the anterior cruciate ligament (ACL) in humans. Gadopentetate dimeglumine is a contrast agent that has been shown to enhance the signal of vascularized tissue when examined by MRI. Purpose: To prospectively determine and compare the pattern and timing of autograft revascularization following arthroscopically assisted ACL reconstruction by BPTB or STG autografts. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 73 patients (63 males, 10 females) with ACL tears who were scheduled to undergo reconstruction consented to participate in this study. The patients were randomized to receive arthroscopically assisted reconstruction of the ACL employing either BPTB or STG autografts. Gadolinium-enhanced MRI scans were scheduled at 3-month intervals during the first postoperative year to assess the integrity, timing, and pattern of enhancement of the ACL graft. The temporal sequence and morphologic characteristics of imaged signals were compared for both types of ACL reconstructions. Results: Based on all knees with 1 exception, there were no statistically significant differences in gadopentetate dimeglumine–mediated graft enhancement grade observed between BPTB and STG autografts. Conclusion: The results suggest that autograft revascularization probably varies in intensity and location during the time course of graft healing. The interval signal changes observed 3 to 9 months, but especially 6 to 9 months, postoperatively are due to increased contrast uptake as a reflection of ongoing neovascularization during the process of ligamentization.
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Affiliation(s)
- Dana Curtis Covey
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, California, USA
| | - Korina Erin Sandoval
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, California, USA
| | - Robert H Riffenburgh
- Biostatistics Division, Clinical Investigation Department, Naval Medical Center San Diego, San Diego, California, USA.,Department of Mathematics and Statistics, San Diego State University, San Diego, California, USA
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16
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Basa RM, Podadera JM, Burland G, Johnson KA. High field magnetic resonance imaging anatomy of feline carpal ligaments is comparable to plastinated specimen anatomy. Vet Radiol Ultrasound 2018; 59:597-606. [DOI: 10.1111/vru.12667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/25/2018] [Accepted: 04/28/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Rachel M. Basa
- Sydney School of Veterinary Science; Faculty of Science; University of Sydney; New South Wales 2006 Australia
| | - Juan M. Podadera
- Sydney School of Veterinary Science; Faculty of Science; University of Sydney; New South Wales 2006 Australia
| | - Gavin Burland
- Sydney School of Veterinary Science; Faculty of Science; University of Sydney; New South Wales 2006 Australia
| | - Kenneth A. Johnson
- Sydney School of Veterinary Science; Faculty of Science; University of Sydney; New South Wales 2006 Australia
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17
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Comparative study of fat-suppression techniques for hip arthroplasty MR imaging. Skeletal Radiol 2017; 46:1209-1217. [PMID: 28540521 DOI: 10.1007/s00256-017-2670-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/18/2017] [Accepted: 05/02/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The goal of this study was to evaluate different fat-suppressed fluid-sensitive sequences in association with different metal artifacts reduction techniques (MARS) to determine which combination allows better fat suppression around metallic hip implants. METHODS An experimental study using an MRI fat-water phantom quantitatively evaluated contrast shift induced by metallic hip implant for different fat-suppression techniques and MARS. Then a clinical study with patients addressed to MRI unit for painful hip prosthesis compared these techniques in terms of fat suppression quality and diagnosis confidence. RESULTS Among sequences without MARS, both T2 Dixon and short tau inversion recuperation (STIR) had significantly lower contrast shift (p < 0.05), Dixon offering the best fat suppression. Adding MARS (view-angle tilting or slice-encoding for metal artifact correction (SEMAC)) to STIR gave better results than Dixon alone, and also better than SPAIR and fat saturation with MARS (p < 0.05). There were no statistically significant differences between STIR with view-angle tilting and STIR with SEMAC in terms of fat suppression quality. CONCLUSIONS STIR sequence is the preferred fluid-sensitive MR sequence in patients with metal implant. In combination with MARS (view-angle tilting or SEMAC), STIR appears to be the best option for high-quality fat suppression.
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18
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Roth TD, Ladd LM, Kempton LB. Fracture Healing and Imaging Evaluation. CURRENT RADIOLOGY REPORTS 2017. [DOI: 10.1007/s40134-017-0221-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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19
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Ashinsky BG, Fishbein KW, Carter EM, Lin PC, Pleshko N, Raggio CL, Spencer RG. Multiparametric Classification of Skin from Osteogenesis Imperfecta Patients and Controls by Quantitative Magnetic Resonance Microimaging. PLoS One 2016; 11:e0157891. [PMID: 27416032 PMCID: PMC4944933 DOI: 10.1371/journal.pone.0157891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 06/05/2016] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study is to evaluate the ability of quantitative magnetic resonance imaging (MRI) to discriminate between skin biopsies from individuals with osteogenesis imperfecta (OI) and skin biopsies from individuals without OI. Skin biopsies from nine controls (unaffected) and nine OI patients were imaged to generate maps of five separate MR parameters, T1, T2, km, MTR and ADC. Parameter values were calculated over the dermal region and used for univariate and multiparametric classification analysis. A substantial degree of overlap of individual MR parameters was observed between control and OI groups, which limited the sensitivity and specificity of univariate classification. Classification accuracies ranging between 39% and 67% were found depending on the variable of investigation, with T2 yielding the best accuracy of 67%. When several MR parameters were considered simultaneously in a multivariate analysis, the classification accuracies improved up to 89% for specific combinations, including the combination of T2 and km. These results indicate that multiparametric classification by quantitative MRI is able to detect differences between the skin of OI patients and of unaffected individuals, which motivates further study of quantitative MRI for the clinical diagnosis of OI.
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Affiliation(s)
- Beth G. Ashinsky
- Laboratory of Clinical Investigation, Magnetic Resonance Imaging and Spectroscopy Section, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Kenneth W. Fishbein
- Laboratory of Clinical Investigation, Magnetic Resonance Imaging and Spectroscopy Section, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
| | - Erin M. Carter
- Kathryn O. and Alan C. Greenberg Center for Skeletal Dysplasias, Hospital for Special Surgery, New York, New York, United States of America
| | - Ping-Chang Lin
- Core Imaging Facility for Small Animals, GRU Cancer Center, Augusta University Augusta, Georiga, United States of America
| | - Nancy Pleshko
- Department of Bioengineering, College of Engineering, Temple University, Philadelphia, United States of America
| | - Cathleen L. Raggio
- Kathryn O. and Alan C. Greenberg Center for Skeletal Dysplasias, Hospital for Special Surgery, New York, New York, United States of America
- Department of Orthopaedics, Hospital for Special Surgery, New York, New York, United States of America
| | - Richard G. Spencer
- Laboratory of Clinical Investigation, Magnetic Resonance Imaging and Spectroscopy Section, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, United States of America
- * E-mail:
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20
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Roberts CC, Kransdorf MJ, Beaman FD, Adler RS, Amini B, Appel M, Bernard SA, Fries IB, Germano IM, Greenspan BS, Holly LT, Kubicky CD, Lo SSM, Mosher TJ, Sloan AE, Tuite MJ, Walker EA, Ward RJ, Wessell DE, Weissman BN. ACR Appropriateness Criteria Follow-Up of Malignant or Aggressive Musculoskeletal Tumors. J Am Coll Radiol 2016; 13:389-400. [PMID: 26922595 DOI: 10.1016/j.jacr.2015.12.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 02/07/2023]
Abstract
Appropriate imaging modalities for the follow-up of malignant or aggressive musculoskeletal tumors include radiography, MRI, CT, (18)F-2-fluoro-2-deoxy-D-glucose PET/CT, (99m)Tc bone scan, and ultrasound. Clinical scenarios reviewed include evaluation for metastatic disease to the lung in low- and high-risk patients, for osseous metastatic disease in asymptomatic and symptomatic patients, for local recurrence of osseous tumors with and without significant hardware present, and for local recurrence of soft tissue tumors. The timing for follow-up of pulmonary metastasis surveillance is also reviewed. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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Affiliation(s)
| | | | | | - Ronald S Adler
- New York University Center for Musculoskeletal Care, New York, New York
| | - Behrang Amini
- University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Marc Appel
- Warwick Valley Orthopedic Surgery, Warwick, New York, American Academy of Orthopaedic Surgeons
| | - Stephanie A Bernard
- Penn State University Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Ian Blair Fries
- Bone, Spine and Hand Surgery, Chartered, Brick, New Jersey, American Academy of Orthopaedic Surgeons
| | | | | | - Langston T Holly
- University of California Los Angeles Medical Center, Los Angeles, California
| | | | - Simon Shek-Man Lo
- University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio
| | - Timothy J Mosher
- Penn State University Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Andrew E Sloan
- University Hospital Case Medical Center, Cleveland, Ohio
| | | | - Eric A Walker
- Penn State University Milton S. Hershey Medical Center, Hershey, Pennsylvania
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21
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Lohrke J, Frenzel T, Endrikat J, Alves FC, Grist TM, Law M, Lee JM, Leiner T, Li KC, Nikolaou K, Prince MR, Schild HH, Weinreb JC, Yoshikawa K, Pietsch H. 25 Years of Contrast-Enhanced MRI: Developments, Current Challenges and Future Perspectives. Adv Ther 2016; 33:1-28. [PMID: 26809251 PMCID: PMC4735235 DOI: 10.1007/s12325-015-0275-4] [Citation(s) in RCA: 220] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Indexed: 12/17/2022]
Abstract
UNLABELLED In 1988, the first contrast agent specifically designed for magnetic resonance imaging (MRI), gadopentetate dimeglumine (Magnevist(®)), became available for clinical use. Since then, a plethora of studies have investigated the potential of MRI contrast agents for diagnostic imaging across the body, including the central nervous system, heart and circulation, breast, lungs, the gastrointestinal, genitourinary, musculoskeletal and lymphatic systems, and even the skin. Today, after 25 years of contrast-enhanced (CE-) MRI in clinical practice, the utility of this diagnostic imaging modality has expanded beyond initial expectations to become an essential tool for disease diagnosis and management worldwide. CE-MRI continues to evolve, with new techniques, advanced technologies, and novel contrast agents bringing exciting opportunities for more sensitive, targeted imaging and improved patient management, along with associated clinical challenges. This review aims to provide an overview on the history of MRI and contrast media development, to highlight certain key advances in the clinical development of CE-MRI, to outline current technical trends and clinical challenges, and to suggest some important future perspectives. FUNDING Bayer HealthCare.
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Affiliation(s)
- Jessica Lohrke
- MR and CT Contrast Media Research, Bayer HealthCare, Berlin, Germany
| | - Thomas Frenzel
- MR and CT Contrast Media Research, Bayer HealthCare, Berlin, Germany
| | - Jan Endrikat
- Global Medical Affairs Radiology, Bayer HealthCare, Berlin, Germany
- Saarland University Hospital, Homburg, Germany
| | | | - Thomas M Grist
- Radiology, Medical Physics and Biomedical Engineering, University of Wisconsin, Madison, WI, USA
| | - Meng Law
- Radiology and Neurological Surgery, University of South California, Keck School of Medicine, USC University Hospital, Los Angeles, CA, USA
| | - Jeong Min Lee
- College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Tim Leiner
- Radiology, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Kun-Cheng Li
- Radiology, Xuan Wu Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Konstantin Nikolaou
- Radiology, Ludwig-Maximilians University, University Hospitals, Munich, Germany
| | - Martin R Prince
- Radiology, Weill Cornell Medical College, New York, NY, USA
- Columbia College of Physicians and Surgeons, New York, NY, USA
| | | | | | - Kohki Yoshikawa
- Graduate Division of Medical Health Sciences, Graduate School of Komazawa University, Tokyo, Japan
| | - Hubertus Pietsch
- MR and CT Contrast Media Research, Bayer HealthCare, Berlin, Germany.
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Abstract
OBJECTIVE Imaging of hip cartilage is challenging because of its limited thickness and complex geometry and therefore requires advanced MRI techniques. However, cartilage abnormalities are found in a number of disease entities, and their diagnosis may impact patient management. This article will provide pertinent information about the motivation to image hip cartilage, which imaging techniques to use, and how to analyze cartilage; finally, we will discuss disease entities with regional cartilage lesions, including the typical MRI findings. CONCLUSION Because the detection and quantification of regional cartilage abnormalities are critical for guidance of operative and nonoperative management of hip disorders, radiologists should be familiar with imaging and analysis techniques for assessing hip cartilage.
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23
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Bittersohl B, Kircher J, Miese FR, Dekkers C, Habermeyer P, Fröbel J, Antoch G, Krauspe R, Zilkens C. T2* mapping and delayed gadolinium-enhanced magnetic resonance imaging in cartilage (dGEMRIC) of humeral articular cartilage--a histologically controlled study. J Shoulder Elbow Surg 2015; 24:1644-52. [PMID: 25958213 DOI: 10.1016/j.jse.2015.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 02/27/2015] [Accepted: 03/07/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Cartilage biochemical imaging modalities that include the magnetic resonance imaging (MRI) techniques of T2* mapping (sensitive to water content and collagen fiber network) and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC, sensitive to the glycosaminoglycan content) can be effective instruments for early diagnosis and reliable follow-up of cartilage damage. The purpose of this study was to provide T2* mapping and dGEMRIC values in various histologic grades of cartilage degeneration in humeral articular cartilage. METHODS A histologically controlled in vitro study was conducted that included human humeral head cartilage specimens with various histologic grades of cartilage degeneration. High-resolution, 3-dimensional (3D) T2* mapping and dGEMRIC were performed that enabled the correlation of MRI and histology data. Cartilage degeneration was graded according to the Mankin score, which evaluates surface morphology, cellularity, toluidine blue staining, and tidemark integrity. SPSS software was used for statistical analyses. RESULTS Both MRI mapping values decreased significantly (P < .001) with increasing cartilage degeneration. Spearman rank analysis revealed a significant correlation (correlation coefficients ranging from -0.315 to 0.784; P < .001) between the various histologic parameters and the T2* and T1Gd mapping values. CONCLUSION This study demonstrates the feasibility of 3D T2* and dGEMRIC to identify various histologic grades of cartilage damage of humeral articular cartilage. With regard to the advantages of these mapping techniques with high image resolution and the ability to accomplish a 3D biochemically sensitive imaging, we consider that these imaging techniques can make a positive contribution to the currently evolving science and practice of cartilage biochemical imaging.
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Affiliation(s)
- Bernd Bittersohl
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Jörn Kircher
- Klinik Fleetinsel Hamburg, Clinic for Orthopedic Surgery, Hamburg, Germany.
| | - Falk R Miese
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Christin Dekkers
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Peter Habermeyer
- ATOS-Klinik Heidelberg, Department of Shoulder and Elbow Surgery, Heidelberg, Germany
| | - Julia Fröbel
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Düsseldorf, Düsseldorf, Germany
| | - Rüdiger Krauspe
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
| | - Christoph Zilkens
- Medical Faculty, Department of Orthopaedics, University Düsseldorf, Düsseldorf, Germany
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Guha A, Wyatt C, Karampinos DC, Nardo L, Link TM, Majumdar S. Spatial variations in magnetic resonance-based diffusion of articular cartilage in knee osteoarthritis. Magn Reson Imaging 2015; 33:1051-1058. [PMID: 26119421 DOI: 10.1016/j.mri.2015.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 05/15/2015] [Accepted: 06/10/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate a pulse sequence combining stimulated echo diffusion preparation with a 3D segmented spoiled gradient echo (SPGR) acquisition for diffusion tensor imaging (DTI) of knee cartilage in healthy and osteoarthritis (OA) populations for early diagnosis and characterization of OA. METHODS Diffusion-weighted images of 40 subjects (20 healthy, 20 OA) at baseline and 20 subjects (10 healthy, 10 OA) at one year were obtained. The subjects were classified according to Kellgren Lawrence (KL) and whole organ magnetic resonance imaging scoring (WORMS) method acquired at 3 T. Cartilage full thickness and laminar mean diffusivity (MD) and fractional anisotropy (FA) values were quantified. The reproducibility of MD and FA values was assessed in five healthy human subjects based on test-retest scans. RESULTS In general, the full thickness MD values were higher in subjects with knee OA compared to healthy controls in both the baseline and follow up cohort. Laminar analysis MD and FA results were significantly different (p<0.05) between the bone-articular and articular layer with the articular layer having higher MD and lower FA value compared to the bone layer. The global reproducibility error was 6.5% for MD and 11.6% for FA. CONCLUSION The diffusion-weighted stimulated echo-based sequence may be used as a valuable tool for early diagnosis and characterization of knee OA at 3 T in the future.
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Affiliation(s)
- Aditi Guha
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA.
| | - Cory Wyatt
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Lorenzo Nardo
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
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25
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Hunter DJ, Altman RD, Cicuttini F, Crema MD, Duryea J, Eckstein F, Guermazi A, Kijowski R, Link TM, Martel-Pelletier J, Miller CG, Mosher TJ, Ochoa-Albíztegui RE, Pelletier JP, Peterfy C, Raynauld JP, Roemer FW, Totterman SM, Gold GE. OARSI Clinical Trials Recommendations: Knee imaging in clinical trials in osteoarthritis. Osteoarthritis Cartilage 2015; 23:698-715. [PMID: 25952343 DOI: 10.1016/j.joca.2015.03.012] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 02/02/2023]
Abstract
Significant advances have occurred in our understanding of the pathogenesis of knee osteoarthritis (OA) and some recent trials have demonstrated the potential for modification of the disease course. The purpose of this expert opinion, consensus driven exercise is to provide detail on how one might use and apply knee imaging in knee OA trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for magnetic resonance imaging (MRI)); commonly encountered problems (including positioning, hardware and coil failures, sequences artifacts); quality assurance (QA)/control procedures; measurement methods; measurement performance (reliability, responsiveness, validity); recommendations for trials; and research recommendations.
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Affiliation(s)
- D J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia; Rheumatology Department, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
| | - R D Altman
- Department of Medicine, Division of Rheumatology and Immunology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - F Cicuttini
- School of Public health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne 3004, Australia
| | - M D Crema
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, Hospital do Coração (HCor) and Teleimagem, São Paulo, SP, Brazil
| | - J Duryea
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Brazil
| | - F Eckstein
- Institute of Anatomy, Paracelsus Medical University Salzburg & Nuremberg, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - R Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - T M Link
- Department of Radiology and Biomedical Imaging, UCSF, San Francisco, USA
| | - J Martel-Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | | | - T J Mosher
- Department of Radiology, Penn State University, Hershey, PA, USA; Department of Orthopaedic Surgery, Penn State University, Hershey, PA, USA
| | - R E Ochoa-Albíztegui
- Department of Radiology, The American British Cowdray Medical Center, Mexico City, Mexico
| | - J-P Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - C Peterfy
- Spire Sciences, Inc., Boca Raton, Florida, USA
| | - J-P Raynauld
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada
| | - F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - G E Gold
- Department of Radiology, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA; Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
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26
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Krupa K, Bekiesińska-Figatowska M. Artifacts in magnetic resonance imaging. Pol J Radiol 2015; 80:93-106. [PMID: 25745524 PMCID: PMC4340093 DOI: 10.12659/pjr.892628] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 10/29/2014] [Indexed: 01/13/2023] Open
Abstract
Artifacts in magnetic resonance imaging and foreign bodies within the patient's body may be confused with a pathology or may reduce the quality of examinations. Radiologists are frequently not informed about the medical history of patients and face postoperative/other images they are not familiar with. A gallery of such images was presented in this manuscript. A truncation artifact in the spinal cord could be misinterpreted as a syrinx. Motion artifacts caused by breathing, cardiac movement, CSF pulsation/blood flow create a ghost artifact which can be reduced by patient immobilization, or cardiac/respiratory gating. Aliasing artifacts can be eliminated by increasing the field of view. An artificially hyperintense signal on FLAIR images can result from magnetic susceptibility artifacts, CSF/vascular pulsation, motion, but can also be found in patients undergoing MRI examinations while receiving supplemental oxygen. Metallic and other foreign bodies which may be found on and in patients' bodies are the main group of artifacts and these are the focus of this study: e.g. make-up, tattoos, hairbands, clothes, endovascular embolization, prostheses, surgical clips, intraorbital and other medical implants, etc. Knowledge of different types of artifacts and their origin, and of possible foreign bodies is necessary to eliminate them or to reduce their negative influence on MR images by adjusting acquisition parameters. It is also necessary to take them into consideration when interpreting the images. Some proposals of reducing artifacts have been mentioned. Describing in detail the procedures to avoid or limit the artifacts would go beyond the scope of this paper but technical ways to reduce them can be found in the cited literature.
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Affiliation(s)
- Katarzyna Krupa
- Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland
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Ateshian GA, Henak CR, Weiss JA. Toward patient-specific articular contact mechanics. J Biomech 2014; 48:779-86. [PMID: 25698236 DOI: 10.1016/j.jbiomech.2014.12.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
The mechanics of contacting cartilage layers is fundamentally important to understanding the development, homeostasis and pathology of diarthrodial joints. Because of the highly nonlinear nature of both the materials and the contact problem itself, numerical methods such as the finite element method are typically incorporated to obtain solutions. Over the course of five decades, we have moved from an initial qualitative understanding of articular cartilage material behavior to the ability to perform complex, three-dimensional contact analysis, including multiphasic material representations. This history includes the development of analytical and computational contact analysis methods that now provide the ability to perform highly nonlinear analyses. Numerical implementations of contact analysis based on the finite element method are rapidly advancing and will soon enable patient-specific analysis of joint contact mechanics using models based on medical image data. In addition to contact stress on the articular surfaces, these techniques can predict variations in strain and strain through the cartilage layers, providing the basis to predict damage and failure. This opens up exciting areas for future research and application to patient-specific diagnosis and treatment planning applied to a variety of pathologies that affect joint function and cartilage homeostasis.
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Affiliation(s)
- Gerard A Ateshian
- Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA
| | - Corinne R Henak
- Department of Biomedical Engineering, Cornell University, Ithaca, NY 14850, USA
| | - Jeffrey A Weiss
- Department of Bioengineering, Department of Orthopaedics, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA
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28
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Hesper T, Hosalkar HS, Bittersohl D, Welsch GH, Krauspe R, Zilkens C, Bittersohl B. T2* mapping for articular cartilage assessment: principles, current applications, and future prospects. Skeletal Radiol 2014; 43:1429-45. [PMID: 24643762 DOI: 10.1007/s00256-014-1852-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 02/08/2014] [Accepted: 02/17/2014] [Indexed: 02/02/2023]
Abstract
With advances in joint preservation surgery that are intended to alter the course of osteoarthritis by early intervention, accurate and reliable assessment of the cartilage status is critical. Biochemically sensitive MRI techniques can add robust biomarkers for disease onset and progression, and therefore, could be meaningful assessment tools for the diagnosis and follow-up of cartilage abnormalities. T2* mapping could be a good alternative because it would combine the benefits of biochemical cartilage evaluation with remarkable features including short imaging time and the ability of high-resolution three-dimensional cartilage evaluation-without the need for contrast media administration or special hardware. Several in vitro and in vivo studies, which have elaborated on the potential of cartilage T2* assessment in various cartilage disease patterns and grades of degeneration, have been reported. However, much remains to be understood and certain unresolved questions have become apparent with these studies that are crucial to the further application of this technique. This review summarizes the principles of the technique and current applications of T2* mapping for articular cartilage assessment. Limitations of recent studies are discussed and the potential implications for patient care are presented.
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Affiliation(s)
- Tobias Hesper
- Department of Orthopaedics Medical Faculty, University Düsseldorf, Düsseldorf, Germany
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29
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Bachschmidt TJ, Sutter R, Jakob PM, Pfirrmann CWA, Nittka M. Knee implant imaging at 3 Tesla using high-bandwidth radiofrequency pulses. J Magn Reson Imaging 2014; 41:1570-80. [PMID: 25155582 DOI: 10.1002/jmri.24729] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 08/04/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To investigate the impact of high-bandwidth radiofrequency (RF) pulses used in turbo spin echo (TSE) sequences or combined with slice encoding for metal artifact correction (SEMAC) on artifact reduction at 3 Tesla in the knee in the presence of metal. METHODS Local transmit/receive coils feature increased maximum B1 amplitude, reduced SAR exposition and thus enable the application of high-bandwidth RF pulses. Susceptibility-induced through-plane distortion scales inversely with the RF bandwidth and the view angle, hence blurring, increases for higher RF bandwidths, when SEMAC is used. These effects were assessed for a phantom containing a total knee arthroplasty. TSE and SEMAC sequences with conventional and high RF bandwidths and different contrasts were tested on eight patients with different types of implants. To realize scan times of 7 to 9 min, SEMAC was always applied with eight slice-encoding steps and distortion was rated by two radiologists. RESULTS A local transmit/receive knee coil enables the use of an RF bandwidth of 4 kHz compared with 850 Hz in conventional sequences. Phantom scans confirm the relation of RF bandwidth and through-plane distortion, which can be reduced up to 79%, and demonstrate the increased blurring for high-bandwidth RF pulses. In average, artifacts in this RF mode are rated hardly visible for patients with joint arthroplasties, when eight SEMAC slice-encoding steps are applied, and for patients with titanium fixtures, when TSE is used. CONCLUSION The application of high-bandwidth RF pulses by local transmit coils substantially reduces through-plane distortion artifacts at 3 Tesla.
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Affiliation(s)
- Theresa J Bachschmidt
- Department of Experimental Physics 5, University of Wuerzburg, Wuerzburg, Germany.,Magnetic Resonance, Siemens AG, Erlangen, Germany
| | - Reto Sutter
- Department of Radiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland.,University of Zurich, Faculty of Medicine, Zurich, Switzerland
| | - Peter M Jakob
- Department of Experimental Physics 5, University of Wuerzburg, Wuerzburg, Germany
| | - Christian W A Pfirrmann
- Department of Radiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland.,University of Zurich, Faculty of Medicine, Zurich, Switzerland
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Abstract
MRI has been established as an essential tool for accurate diagnosis in patients with musculoskeletal trauma. Its major advantages include excellent soft tissue contrast, high spatial resolution and lack of ionizing radiation. Although plain radiographs remain the basic tool for diagnosis and treatment planning in bone fractures assisted by CT in pelvic, spine and large joints injuries, there are specific circumstances that require MRI. For instance, tendinous, ligamentous, intraarticular structures such as the cartilage and menisci, and intramedullary injury are seen mostly with MRI. Volumetric 3D techniques are now commercially available and provide higher spatial resolution which improves anatomic detail, allows multiplanar reformations and reduces the acquisition time. Newer applications on quantitative rather than morphologic imaging, such as relaxometry and diffusion tensor imaging, may be of paramount importance in treatment planning in the near future. Software improvements reduce metal induced artefacts, allowing thus imaging of the postoperative patient with metallic implants. A tendency towards a structured reporting pattern and standardised medical communication needs to be further explored for the benefit of orthopaedic surgeons, radiologists and patients.
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31
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Henak CR, Anderson AE, Weiss JA. Subject-specific analysis of joint contact mechanics: application to the study of osteoarthritis and surgical planning. J Biomech Eng 2013; 135:021003. [PMID: 23445048 PMCID: PMC3705883 DOI: 10.1115/1.4023386] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 01/03/2013] [Accepted: 01/18/2013] [Indexed: 11/08/2022]
Abstract
Advances in computational mechanics, constitutive modeling, and techniques for subject-specific modeling have opened the door to patient-specific simulation of the relationships between joint mechanics and osteoarthritis (OA), as well as patient-specific preoperative planning. This article reviews the application of computational biomechanics to the simulation of joint contact mechanics as relevant to the study of OA. This review begins with background regarding OA and the mechanical causes of OA in the context of simulations of joint mechanics. The broad range of technical considerations in creating validated subject-specific whole joint models is discussed. The types of computational models available for the study of joint mechanics are reviewed. The types of constitutive models that are available for articular cartilage are reviewed, with special attention to choosing an appropriate constitutive model for the application at hand. Issues related to model generation are discussed, including acquisition of model geometry from volumetric image data and specific considerations for acquisition of computed tomography and magnetic resonance imaging data. Approaches to model validation are reviewed. The areas of parametric analysis, factorial design, and probabilistic analysis are reviewed in the context of simulations of joint contact mechanics. Following the review of technical considerations, the article details insights that have been obtained from computational models of joint mechanics for normal joints; patient populations; the study of specific aspects of joint mechanics relevant to OA, such as congruency and instability; and preoperative planning. Finally, future directions for research and application are summarized.
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Affiliation(s)
- Corinne R. Henak
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84112;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84112
| | - Andrew E. Anderson
- Department of Bioengineering,University of Utah,Salt Lake City, UT;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108;Department of Physical Therapy,University of Utah,Salt Lake City, UT 84108
| | - Jeffrey A. Weiss
- Department of Bioengineering,University of Utah,Salt Lake City, UT 84108;Scientific Computing and Imaging Institute,University of Utah,Salt Lake City, UT 84108;Department of Orthopaedics,University of Utah,Salt Lake City, UT 84108e-mail:
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