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Fritz V, Eisele S, Martirosian P, Machann J, Schick F. A straightforward procedure to build a non-toxic relaxometry phantom with desired T1 and T2 times at 3T. MAGMA (NEW YORK, N.Y.) 2024; 37:899-907. [PMID: 38733487 PMCID: PMC11452426 DOI: 10.1007/s10334-024-01166-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE To prepare and analyze soy-lecithin-agar gels for non-toxic relaxometry phantoms with tissue-like relaxation times at 3T. METHODS Phantoms mimicking the relaxation times of various tissues (gray and white matter, kidney cortex and medulla, spleen, muscle, liver) were built and tested with a clinical 3T whole-body MR scanner. Simple equations were derived to calculate the appropriate concentrations of soy lecithin and agar in aqueous solutions to achieve the desired relaxation times. Phantoms were tested for correspondence between measurements and calculated T1 and T2 values, reproducibility, spatial homogeneity, and temporal stability. T1 and T2 mapping techniques and a 3D T1-weighted sequence with high spatial resolution were applied. RESULTS Except for the liver relaxation phantom, all phantoms were successfully and reproducibly produced. Good agreement was found between the targeted and measured relaxation times. The percentage deviations from the targeted relaxation times were less than 3% for T1 and less than 6.5% for T2. In addition, the phantoms were homogeneous and had little to no air bubbles. However, the phantoms were unstable over time: after a storage period of 4 weeks, mold growth and also changes in relaxation times were detected in almost all phantoms. CONCLUSION Soy-lecithin-agar gels are a non-toxic material for the construction of relaxometry phantoms with tissue-like relaxation times. They are easy to prepare, inexpensive and allow independent adjustment of T1 and T2. However, there is still work to be done to improve the long-term stability of the phantoms.
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Affiliation(s)
- Victor Fritz
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, Tübingen, Germany.
- German Center for Diabetes Research (DZD), Neuherberg, Germany.
| | - Sabine Eisele
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Petros Martirosian
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
| | - Jürgen Machann
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen, Tübingen, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Fritz Schick
- Section of Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany
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Eckstein F, Walter-Rittel TC, Chaudhari AS, Brisson NM, Maleitzke T, Duda GN, Wisser A, Wirth W, Winkler T. The design of a sample rapid magnetic resonance imaging (MRI) acquisition protocol supporting assessment of multiple articular tissues and pathologies in knee osteoarthritis. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100505. [PMID: 39183946 PMCID: PMC11342198 DOI: 10.1016/j.ocarto.2024.100505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/21/2024] [Indexed: 08/27/2024] Open
Abstract
Objective This expert opinion paper proposes a design for a state-of-the-art magnetic resonance image (MRI) acquisition protocol for knee osteoarthritis clinical trials in early and advanced disease. Semi-quantitative and quantitative imaging endpoints are supported, partly amendable to automated analysis. Several (peri-) articular tissues and pathologies are covered, including synovitis. Method A PubMed literature search was conducted, with focus on the past 5 years. Further, osteoarthritis imaging experts provided input. Specific MRI sequences, orientations, spatial resolutions and parameter settings were identified to align with study goals. We strived for implementation on standard clinical scanner hardware, with a net acquisition time ≤30 min. Results Short- and long-term longitudinal MRIs should be obtained at ≥1.5T, if possible without hardware changes during the study. We suggest a series of gradient- and spin-echo-sequences, supporting MOAKS, quantitative analysis of cartilage morphology and T2, and non-contrast-enhanced depiction of synovitis. These sequences should be properly aligned and positioned using localizer images. One of the sequences may be repeated in each participant (re-test), optimally at baseline and follow-up, to estimate within-study precision. All images should be checked for quality and protocol-adherence as soon as possible after acquisition. Alternative approaches are suggested that expand on the structural endpoints presented. Conclusions We aim to bridge the gap between technical MRI acquisition guides and the wealth of imaging literature, proposing a balance between image acquisition efficiency (time), safety, and technical/methodological diversity. This approach may entertain scientific innovation on tissue structure and composition assessment in clinical trials on disease modification of knee osteoarthritis.
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Affiliation(s)
- Felix Eckstein
- Research Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Thula Cannon Walter-Rittel
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Radiology, Berlin, Germany
| | | | - Nicholas M. Brisson
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin Movement Diagnostics (BeMoveD), Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Tazio Maleitzke
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Trauma Orthopaedic Research Copenhagen Hvidovre (TORCH), Department of Orthopaedic Surgery, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Georg N. Duda
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Berlin Movement Diagnostics (BeMoveD), Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
| | - Anna Wisser
- Research Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Wolfgang Wirth
- Research Program for Musculoskeletal Imaging, Center for Anatomy & Cell Biology, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
- Chondrometrics GmbH, Freilassing, Germany
| | - Tobias Winkler
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Center for Musculoskeletal Surgery, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany
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Mechó S, Palomar-Garcia A, Wong M, Gallego JC, López F, Valle X, Ruperez F, Pruna R, González JR, Rodas G. Characterization of acute effects of football competition on hamstring muscles by muscle functional MRI techniques. PLoS One 2024; 19:e0308328. [PMID: 39190697 DOI: 10.1371/journal.pone.0308328] [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: 03/22/2024] [Accepted: 07/22/2024] [Indexed: 08/29/2024] Open
Abstract
Muscle functional MRI identifies changes in metabolic activity in each muscle and provides a quantitative index of muscle activation and damage. No previous studies have analyzed the hamstrings activation over a football match. This study aimed at detecting different patterns of hamstring muscles activation after a football game, and to examine inter- and intramuscular differences (proximal-middle-distal) in hamstring muscles activation using transverse relaxation time (T2)-weighted magnetic resonance images. Eleven healthy football players were recruited for this study. T2 relaxation time mapping-MRI was performed before (2 hours) and immediately after a match (on average 13 min). The T2 values of each hamstring muscle at the distal, middle, and proximal portions were measured. The primary outcome measure was the increase in T2 relaxation time value after a match. Linear mixed models were used to detect differences pre and postmatch. MRI examination showed that there was no obvious abnormality in the shape and the conventional T2 weighted signal of the hamstring muscles after a match. On the other hand, muscle functional MRI T2 analysis revealed that T2 relaxation time significantly increased at distal and middle portions of the semitendinosus muscle (p = 0.0003 in both cases). By employing T2 relaxation time mapping, we have identified alterations within the hamstring muscles being the semitendinosus as the most engaged muscle, particularly within its middle and distal thirds. This investigation underscores the utility of T2 relaxation time mapping in evaluating muscle activation patterns during football matches, facilitating the detection of anomalous activation patterns that may warrant injury reduction interventions.
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Affiliation(s)
- Sandra Mechó
- Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | | | - Manuel Wong
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Juan C Gallego
- Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Francesc López
- Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Xavier Valle
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Ferran Ruperez
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Ricard Pruna
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Juan R González
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Gil Rodas
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
- Sports Medicine Unit, Hospital Clinic and Sant Joan de Déu, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
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De Moura HL, Monga A, Zhang X, Zibetti MVW, Keerthivasan MB, Regatte RR. Feasibility of 3D MRI fingerprinting for rapid knee cartilage T 1, T 2, and T 1ρ mapping at 0.55T: Comparison with 3T. NMR IN BIOMEDICINE 2024:e5250. [PMID: 39169559 DOI: 10.1002/nbm.5250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/11/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024]
Abstract
Low-field strength scanners present an opportunity for more inclusive imaging exams and bring several challenges including lower signal-to-noise ratio (SNR) and longer scan times. Magnetic resonance fingerprinting (MRF) is a rapid quantitative multiparametric method that can enable multiple quantitative maps simultaneously. To demonstrate the feasibility of an MRF sequence for knee cartilage evaluation in a 0.55T system we performed repeatability and accuracy experiments with agar-gel phantoms. Additionally, five healthy volunteers (age 32 ± 4 years old, 2 females) were scanned at 3T and 0.55T. The MRI acquisition protocols include a stack-of-stars T1ρ-enabled MRF sequence, a VIBE sequence with variable flip angles (VFA) for T1 mapping, and fat-suppressed turbo flash (TFL) sequences for T2 and T1ρ mappings. Double-Echo steady-state (DESS) sequence was also used for cartilage segmentation. Acquisitions were performed at two different field strengths, 0.55T and 3T, with the same sequences but protocols were slightly different to accommodate differences in signal-to-noise ratio and relaxation times. Cartilage segmentation was done using five compartments. T1, T2, and T1ρ values were measured in the knee cartilage using both MRF and conventional relaxometry sequences. The MRF sequence demonstrated excellent repeatability in a test-retest experiment with model agar-gel phantoms, as demonstrated with correlation and Bland-Altman plots. Underestimation of T1 values was observed on both field strengths, with the average global difference between reference values and the MRF being 151 ms at 0.55T and 337 ms at 3T. At 0.55T, MRF measurements presented significant biases but strong correlations with the reference measurements. Although a larger error was present in T1 measurements, MRF measurements trended similarly to the conventional measurements for human subjects and model agar-gel phantoms.
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Affiliation(s)
- Hector L De Moura
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Anmol Monga
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Xiaoxia Zhang
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Marcelo V W Zibetti
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | | | - Ravinder R Regatte
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
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Heiss R, Weber MA, Balbach EL, Hinsen M, Geissler F, Nagel AM, Ladd ME, Arkudas A, Horch RE, Gall C, Uder M, Roemer FW. Variation in cartilage T2 and T2* mapping of the wrist: a comparison between 3- and 7-T MRI. Eur Radiol Exp 2023; 7:80. [PMID: 38093075 PMCID: PMC10719234 DOI: 10.1186/s41747-023-00394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND To analyze regional variations in T2 and T2* relaxation times in wrist joint cartilage and the triangular fibrocartilage complex (TFCC) at 3 and 7 T and to compare values between field strengths. METHODS Twenty-five healthy controls and 25 patients with chronic wrist pain were examined at 3 and 7 T on the same day using T2- and T2*-weighted sequences. Six different regions of interest (ROIs) were evaluated for cartilage and 3 ROIs were evaluated at the TFCC based on manual segmentation. Paired t-tests were used to compare T2 and T2* values between field strengths and between different ROIs. Spearman's rank correlation was calculated to assess correlations between T2 and T2* time values at 3 and 7 T. RESULTS T2 and T2* time values of the cartilage differed significantly between 3 and 7 T for all ROIs (p ≤ 0.045), with one exception: at the distal lunate, no significant differences in T2 values were observed between field strengths. T2* values differed significantly between 3 and 7 T for all ROIs of the TFCC (p ≤ 0.001). Spearman's rank correlation between 3 and 7 T ranged from 0.03 to 0.62 for T2 values and from 0.01 to 0.48 for T2* values. T2 and T2* values for cartilage varied across anatomic locations in healthy controls at both 3 and 7 T. CONCLUSION Quantitative results of T2 and T2* mapping at the wrist differ between field strengths, with poor correlation between 3 and 7 T. Local variations in cartilage T2 and T2* values are observed in healthy individuals. RELEVANCE STATEMENT T2 and T2* mapping are feasible for compositional imaging of the TFCC and the cartilage at the wrist at both 3 and 7 T, but the clinical interpretation remains challenging due to differences between field strengths and variations between anatomic locations. KEY POINTS •Field strength and anatomic locations influence T2 and T2* values at the wrist. •T2 and T2* values have a poor correlation between 3 and 7 T. •Local reference values are needed for each anatomic location for reliable interpretation.
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Affiliation(s)
- Rafael Heiss
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany.
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany
| | - Eva L Balbach
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Maximilian Hinsen
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Frederik Geissler
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Armin M Nagel
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Faculty of Medicine and Faculty of Physics and Astronomy, Heidelberg University, Im Neuenheimer Feld 226, 69120, Heidelberg, Germany
| | - Andreas Arkudas
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Raymund E Horch
- Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstraße 12, 91054, Erlangen, Germany
| | - Christine Gall
- Institute for Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Waldstraße 6, 91054, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
| | - Frank W Roemer
- Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054, Erlangen, Germany
- Boston University School of Medicine, 72 E Concord St, Boston, MA, 02118, USA
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Phua CS, Moffat B, Paul E, Ang M, Law M, Bertram K, Hutton E. Quantitative analysis of MR T2 relaxation times in neck muscles. Magn Reson Imaging 2023; 103:156-161. [PMID: 37517766 DOI: 10.1016/j.mri.2023.07.013] [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: 03/12/2023] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023]
Abstract
T2 relaxation times (T2 times) are different between resting and exercised muscles and between muscles of healthy subjects and subjects with muscle pathology. However, studies specifically focusing on neck muscles are lacking. Furthermore, normative neck muscle T2 times are not well defined and methodology used to analyse T2 times in neck muscles is not robust. We analysed T2 times in key neck muscles and explored factors affecting variability between muscles. 20 healthy subjects were recruited. Two circular regions of interest (ROIs) were drawn in two mutually exclusive regions within neck muscles on T2 weighted images and values averaged. ROI measurements were performed by a co-investigator, supervised by a neuro-radiologist. For the first ten subjects, measurements were done from C1-T1. For the remaining subjects, ROIs were drawn at two pre-determined levels. Two MRIs were repeated at 31 degrees acquisition to evaluate the effect of muscle fibre orientation. ROI values were translated into T2 times. Results showed semispinalis capitis had the longest T2 times (range 46.88-51.42 ms), followed by splenius capitis (range 47.37-48.33 ms), trapezius (range 45.27-47.46 ms), levator scapulae (range 43.17-45.63 ms) and sternocleidomastoid (range 38.45-42.91 ms). T2 times did not vary along length of muscles and were unaffected by muscle fibre orientation (P > 0.05). T2 times of splenius capitis correlated significantly with age at C2/C3 and C5/C6 levels and trapezius at C7/T1 level. Gender did not influence relaxation times (P > 0.05). In conclusion, results of normative neck muscle T2 time values and factors influencing the T2 times could serve as a reference for future MR analysis of neck muscles. The methodology used may also be useful for related studies of neck muscles.
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Affiliation(s)
- Chun Seng Phua
- Alfred Health, Department of Neurology, Melbourne, Australia; Monash University, Department of Neurosciences, Melbourne, Australia; Universiti Teknologi Mara, Selangor, Malaysia.
| | - Bradford Moffat
- Melbourne Brain Centre Imaging Unit, University of Melbourne, Melbourne, Australia
| | - Eldho Paul
- Alfred Health, Department of Neurology, Melbourne, Australia; Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
| | - Megan Ang
- Alfred Health, Department of Radiology, Melbourne, Australia
| | - Meng Law
- Monash University, Department of Neurosciences, Melbourne, Australia; Alfred Health, Department of Radiology, Melbourne, Australia
| | - Kelly Bertram
- Alfred Health, Department of Neurology, Melbourne, Australia; Monash University, Department of Neurosciences, Melbourne, Australia
| | - Elspeth Hutton
- Alfred Health, Department of Neurology, Melbourne, Australia; Monash University, Department of Neurosciences, Melbourne, Australia
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Link TM, Joseph GB, Li X. MRI-based T 1rho and T 2 cartilage compositional imaging in osteoarthritis: what have we learned and what is needed to apply it clinically and in a trial setting? Skeletal Radiol 2023; 52:2137-2147. [PMID: 37000230 PMCID: PMC11409322 DOI: 10.1007/s00256-023-04310-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 04/01/2023]
Abstract
Cartilage MRI-based T1rho and T2 compositional measurements have been developed to characterize cartilage matrix quality and diagnose cartilage damage before irreversible defects are found, allowing intervention at an early, potentially reversible disease stage. Over the last 2 decades, this technology was investigated in numerous studies and was validated using specimen studies and arthroscopy; and longitudinal studies documented its ability to predict progression of degenerative disease and radiographic osteoarthritis (OA). While T1rho and T2 measurements have shown promise in early disease stages, several hurdles have been encountered to apply this technology clinically. These include (i) challenges with cartilage segmentation, (ii) long image acquisition times, (iii) a lack of standardization of imaging, and (iv) an absence of reference databases and definitions of abnormal cut-off values. Progress has been made by developing deep-learning based automatic cartilage segmentation and faster imaging methods, enabling the feasibility of T1rho and T2 imaging for clinical and scientific trial applications. Also, the Radiological Society of North America (RSNA) Quantitative Imaging Biomarker Alliance mechanism was used to establish standardized profiles for compositional T1rho and T2 imaging, and multi-center feasibility testing is work in progress. The last hurdles are the development of reference databases and establishing a definition of normal versus abnormal cartilage T1rho and T2 values. Finally, effective treatments for prevention and slowing progression of OA are required in order to establish T1rho and T2 as imaging biomarkers for initiating and monitoring therapies, analogous to the role of dual X-ray absorptiometry (DXA) bone mineral density measurements in the management of osteoporosis. KEY POINTS: • T1rho and T2 cartilage measurements have been validated in characterizing cartilage degenerative change using histology and arthroscopy as a reference. • They have also been shown to predict progression of cartilage degeneration and incidence of radiographic OA. • Advances have been made to facilitate clinical and trial application of T1rho and T2 by improved standardization of imaging and by establishing deep learning-based automatic cartilage segmentation. • Effective treatments with disease-modifying OA specific drugs may establish T1rho and T2 cartilage compositional measurements as biomarkers to initiate and monitor treatment.
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Affiliation(s)
- Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, 400 Parnassus Ave, A-367, San Francisco, CA, 94143, USA.
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, 400 Parnassus Ave, A-367, San Francisco, CA, 94143, USA
| | - Xiaojuan Li
- Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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Zibetti MVW, De Moura HL, Keerthivasan MB, Regatte RR. Optimizing variable flip angles in magnetization-prepared gradient-echo sequences for efficient 3D-T1ρ mapping. Magn Reson Med 2023; 90:1465-1483. [PMID: 37288538 PMCID: PMC10524308 DOI: 10.1002/mrm.29740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/24/2023] [Accepted: 05/17/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To optimize the choice of the flip angles of magnetization-prepared gradient-echo sequences for improved accuracy, precision, and speed of 3D-T1ρ mapping. METHODS We propose a new optimization approach for finding variable flip-angle values that improve magnetization-prepared gradient-echo sequences used for 3D-T1ρ mapping. This new approach can improve the accuracy and SNR, while reducing filtering effects. We demonstrate the concept in the three different versions of the magnetization-prepared gradient-echo sequences that are typically used for 3D-T1ρ mapping and evaluate their performance in model agarose phantoms (n = 4) and healthy volunteers (n = 5) for knee joint imaging. We also tested the optimization with sequence parameters targeting faster acquisitions. RESULTS Our results show that optimized variable flip angle can improve the accuracy and the precision of the sequences, seen as a reduction of the mean of normalized absolute difference from about 5%-6% to 3%-4% in model phantoms and from 15%-16% to 11%-13% in the knee joint, and improving SNR from about 12-28 to 22-32 in agarose phantoms and about 7-14 to 13-17 in healthy volunteers. The optimization can also compensate for the loss in quality caused by making the sequence faster. This results in sequence configurations that acquire more data per unit of time with SNR and mean of normalized absolute difference measurements close to its slower versions. CONCLUSION The optimization of the variable flip angle can be used to increase accuracy and precision, and to improve the speed of the typical imaging sequences used for quantitative 3D-T1ρ mapping of the knee joint.
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Affiliation(s)
- Marcelo V W Zibetti
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | - Hector L. De Moura
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | | | - Ravinder R. Regatte
- Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
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Frenken M, Radke KL, Schäfer ELE, Valentin B, Wilms LM, Abrar DB, Nebelung S, Martirosian P, Wittsack HJ, Müller-Lutz A. Insights into the Age Dependency of Compositional MR Biomarkers Quantifying the Health Status of Cartilage in Metacarpophalangeal Joints. Diagnostics (Basel) 2023; 13:diagnostics13101746. [PMID: 37238230 DOI: 10.3390/diagnostics13101746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: We aim to investigate age-related changes in cartilage structure and composition in the metacarpophalangeal (MCP) joints using magnetic resonance (MR) biomarkers. (2) Methods: The cartilage tissue of 90 MCP joints from 30 volunteers without any signs of destruction or inflammation was examined using T1, T2, and T1ρ compositional MR imaging techniques on a 3 Tesla clinical scanner and correlated with age. (3) Results: The T1ρ and T2 relaxation times showed a significant correlation with age (T1ρ: Kendall-τ-b = 0.3, p < 0.001; T2: Kendall-τ-b = 0.2, p = 0.01). No significant correlation was observed for T1 as a function of age (T1: Kendall-τ-b = 0.12, p = 0.13). (4) Conclusions: Our data show an increase in T1ρ and T2 relaxation times with age. We hypothesize that this increase is due to age-related changes in cartilage structure and composition. In future examinations of cartilage using compositional MRI, especially T1ρ and T2 techniques, e.g., in patients with osteoarthritis or rheumatoid arthritis, the age of the patients should be taken into account.
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Affiliation(s)
- Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Emilia Louisa Ernestine Schäfer
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Birte Valentin
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Lena Marie Wilms
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Daniel Benjamin Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Aachen, D-52074 Aachen, Germany
| | - Petros Martirosian
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Tübingen, D-72076 Tübingen, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Hospital of Dusseldorf, D-40225 Dusseldorf, Germany
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10
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Cao G, Gao S, Xiong B. Application of quantitative T1, T2 and T2* mapping magnetic resonance imaging in cartilage degeneration of the shoulder joint. Sci Rep 2023; 13:4558. [PMID: 36941288 PMCID: PMC10027866 DOI: 10.1038/s41598-023-31644-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/15/2023] [Indexed: 03/23/2023] Open
Abstract
To investigate and compare the values of 3.0 T MRI T1, T2 and T2* mapping quantification techniques in evaluating cartilage degeneration of the shoulder joint. This study included 123 shoulder joints of 119 patients, which were scanned in 3.0 T MRI with axial Fat Suppression Proton Density Weighted Image (FS-PDWI), sagittal fat suppression T2 Weighted Image (FS-T2WI), coronal T1Weighted Image (T1WI), FS-PDWI, cartilage-specific T1, T2 and T2* mapping sequences. Basing on MRI images, the shoulder cartilage was classified into grades 0 1, 2, 3 and 4 according to the International Cartilage Regeneration & Joint Preservation Society (ICRS). The grading of shoulder cartilage was based on MRI images with ICRS as reference, and did not involve arthroscopy or histology.The T1, T2 and T2* relaxation values in the superior, middle and inferior bands of shoulder articular cartilage were measured at all grades, and the differences in various indicators between groups were analyzed and compared using a single-factor ANOVA test. The correlation between T1, T2 and T2* relaxation values and MRI-based grading was analyzed by SPSS software. There were 46 shoulder joints with MRI-based grade 0 in healthy control group (n = 46), while 49 and 28 shoulder joints with grade 1-2 (mild degeneration subgroup) and grade 3-4 (severe degeneration subgroup) in patient group (n = 73), accounting for 63.6% and 36.4%, respectively. The T1, T2 and T2* relaxation values of the superior, middle and inferior bands of shoulder articular cartilage were significantly and positively correlated with the MRI-based grading (P < 0.01). MRI-basedgrading of shoulder cartilage was markedly associated with age (r = 0.766, P < 0.01). With the aggravation of cartilage degeneration, T1, T2 and T2* relaxation values showed an upward trend (all P < 0.01), and T1, T2 and T2* mapping could distinguish cartilage degeneration at all levels (all P < 0.01). The T1, T2 and T2* relaxation values were significantly different between normal group and mild degeneration subgroup, normal group and severe degeneration subgroup, mild degeneration subgroup and severe degeneration subgroup (all P < 0.05). Quantitative T1, T2 and T2* mapping can quantify the degree of shoulder cartilage degeneration. All these MRI mapping quantification techniques can be used as critical supplementary sequences to assess shoulder cartilage degeneration, among which T2 mapping has the highest value.
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Affiliation(s)
- Guijuan Cao
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, 430022, Wuhan, Hubei, China
- Department of Radiology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shubo Gao
- Department of Radiology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bin Xiong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue #1277, 430022, Wuhan, Hubei, China.
- Department of Interventional Radiology, The First Affiliated Hospital of Guangzhou Medical University, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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11
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Li X, Roemer FW, Cicuttini F, MacKay JW, Turmezei T, Link TM. Early knee OA definition-what do we know at this stage? An imaging perspective. Ther Adv Musculoskelet Dis 2023; 15:1759720X231158204. [PMID: 36937824 PMCID: PMC10017942 DOI: 10.1177/1759720x231158204] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023] Open
Abstract
While criteria for early-stage knee osteoarthritis (OA) in a primary care setting have been proposed, the role of imaging has been limited to radiography using the standard Kellgren-Lawrence classification. Standardized imaging and interpretation are critical with radiographs, yet studies have also shown that even early stages of radiographic OA already demonstrate advanced damage to knee joint tissues such as cartilage, menisci, and bone marrow. Morphological magnetic resonance imaging (MRI) shows degenerative damage earlier than radiographs and definitions for OA using MRI have been published though no accepted definition of early OA based on MRI is currently available. The clinical significance of structural abnormalities has also not been well defined, and the differentiation between normal aging and structural OA development remains a challenge. Compositional MRI of cartilage provides information on biochemical, degenerative changes within the cartilage matrix before cartilage defects occur and when cartilage damage is potentially reversible. Studies have shown that cartilage composition can predict cartilage loss and radiographic OA. However, while this technology is most promising for characterizing early OA it has currently limited clinical application. Better standardization of compositional MRI is required, which is currently work in progress. Finally, there has been renewed interest in computed tomography (CT) for assessing early knee OA as new techniques such as weight bearing and spectral CT are available, which may provide information on joint loading, cartilage, and bone and potentially have a role in better characterizing early OA. In conclusion, while imaging may have a limited role in diagnosing early OA in a primary care setting, there are advanced imaging technologies available, which detect early degeneration and may thus significantly alter management as new therapeutic modalities evolve.
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Affiliation(s)
- Xiaojuan Li
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Frank W. Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Flavia Cicuttini
- Musculoskeletal Unit, Monash University and Rheumatology, Alfred Hospital, Melbourne, VIC, Australia
| | - Jamie W. MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 400 Parnassus Ave, A-367, San Francisco, CA 94143, USA
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12
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Lee HY, Bin SI, Kim JM, Lee BS, Kim SM, Lee SJ. Nonextruded Grafts Result in Better Cartilage Quality After Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping. Am J Sports Med 2023; 51:404-412. [PMID: 36607167 DOI: 10.1177/03635465221143373] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Several studies have reported that graft extrusion after meniscal allograft transplantation (MAT) is associated with deterioration of surgical outcomes. However, no study has investigated the effect of graft extrusion on the articular cartilage using objective quantitative methods. PURPOSE/HYPOTHESIS This study aimed to investigate the influence of graft extrusion on the chondroprotective effect of lateral MAT on knee articular cartilage. We hypothesized that MAT without graft extrusion would result in better cartilage quality than MAT with graft extrusion. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Altogether, 105 patients who underwent isolated lateral MAT were divided into the extrusion and nonextrusion groups based on postoperative 3-month magnetic resonance imaging. Quantitative T2 mapping was performed on pre- and postoperative magnetic resonance imaging at midterm follow-up (mean ± SD, 3.2 ± 0.7 years). The weightbearing area of the femoral and tibial plateau articular cartilage was divided into 6 segments (F1, F2, F3, TP1, TP2, and TP3) from the anterior to posterior direction according to the meniscal coverage area. Each segment was further segmented into superficial and deep layers for zonal analysis. Longitudinal change in cartilage T2 value was compared between the groups. Lysholm scores were used to evaluate clinical function. RESULTS The mean T2 value of the nonextrusion group showed a significant improvement in 14 of 18 segments after lateral MAT, whereas the extrusion group demonstrated no statistically significant change. The biochemical properties of cartilage tissue as judged by quantitative T2 mapping indicated improvement in the nonextrusion group as compared with the extrusion group in the F2, TP2, and TP3 segments overall; the deep layers of the F1, F2, and TP2 segments; and the superficial layer of the TP3 segment (P < .05). CONCLUSION This study shows that the nonextruded graft results in better cartilage properties of the knee joint after lateral MAT as compared with the extruded graft at midterm follow-up.
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Affiliation(s)
- Hyo Yeol Lee
- Department of Orthopaedic Surgery, Eulji Medical Center Daejeon Hospital, Eulji University College of Medicine, Daejeon, Republic of Korea.,Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seong-Il Bin
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jong-Min Kim
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Bum-Sik Lee
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seung-Min Kim
- Department of Orthopaedic Surgery, Wonkwang University Sanbon Hospital, College of Medicine, Wonkwang University, Gunpo, Republic of Korea
| | - Seon-Jong Lee
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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13
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Eck BL, Yang M, Elias JJ, Winalski CS, Altahawi F, Subhas N, Li X. Quantitative MRI for Evaluation of Musculoskeletal Disease: Cartilage and Muscle Composition, Joint Inflammation, and Biomechanics in Osteoarthritis. Invest Radiol 2023; 58:60-75. [PMID: 36165880 PMCID: PMC10198374 DOI: 10.1097/rli.0000000000000909] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
ABSTRACT Magnetic resonance imaging (MRI) is a valuable tool for evaluating musculoskeletal disease as it offers a range of image contrasts that are sensitive to underlying tissue biochemical composition and microstructure. Although MRI has the ability to provide high-resolution, information-rich images suitable for musculoskeletal applications, most MRI utilization remains in qualitative evaluation. Quantitative MRI (qMRI) provides additional value beyond qualitative assessment via objective metrics that can support disease characterization, disease progression monitoring, or therapy response. In this review, musculoskeletal qMRI techniques are summarized with a focus on techniques developed for osteoarthritis evaluation. Cartilage compositional MRI methods are described with a detailed discussion on relaxometric mapping (T 2 , T 2 *, T 1ρ ) without contrast agents. Methods to assess inflammation are described, including perfusion imaging, volume and signal changes, contrast-enhanced T 1 mapping, and semiquantitative scoring systems. Quantitative characterization of structure and function by bone shape modeling and joint kinematics are described. Muscle evaluation by qMRI is discussed, including size (area, volume), relaxometric mapping (T 1 , T 2 , T 1ρ ), fat fraction quantification, diffusion imaging, and metabolic assessment by 31 P-MR and creatine chemical exchange saturation transfer. Other notable technologies to support qMRI in musculoskeletal evaluation are described, including magnetic resonance fingerprinting, ultrashort echo time imaging, ultrahigh-field MRI, and hybrid MRI-positron emission tomography. Challenges for adopting and using qMRI in musculoskeletal evaluation are discussed, including the need for metal artifact suppression and qMRI standardization.
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Affiliation(s)
- Brendan L. Eck
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Imaging Instute, Cleveland Clinic, Cleveland, OH, USA
| | - Mingrui Yang
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - John J. Elias
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Department of Research, Cleveland Clinic Akron General, Akron, OH, USA
| | - Carl S. Winalski
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Imaging Instute, Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Faysal Altahawi
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Imaging Instute, Cleveland Clinic, Cleveland, OH, USA
| | - Naveen Subhas
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Imaging Instute, Cleveland Clinic, Cleveland, OH, USA
| | - Xiaojuan Li
- Program of Advanced Musculoskeletal Imaging, Cleveland Clinic, Cleveland, OH, USA
- Imaging Instute, Cleveland Clinic, Cleveland, OH, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
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14
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Nieminen MT, Casula V, Nissi MJ. Compositional MRI of articular cartilage - current status and the way forward. Osteoarthritis Cartilage 2022; 30:633-635. [PMID: 35093515 DOI: 10.1016/j.joca.2022.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/27/2021] [Accepted: 01/10/2022] [Indexed: 02/02/2023]
Affiliation(s)
- M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - V Casula
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M J Nissi
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
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15
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Antoniou A, Georgiou L, Christodoulou T, Panayiotou N, Ioannides C, Zamboglou N, Damianou C. MR relaxation times of agar-based tissue-mimicking phantoms. J Appl Clin Med Phys 2022; 23:e13533. [PMID: 35415875 PMCID: PMC9121050 DOI: 10.1002/acm2.13533] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/29/2021] [Indexed: 12/31/2022] Open
Abstract
Agar gels were previously proven capable of accurately replicating the acoustical and thermal properties of real tissue and widely used for the construction of tissue-mimicking phantoms (TMPs) for focused ultrasound (FUS) applications. Given the current popularity of magnetic resonance-guided FUS (MRgFUS), we have investigated the MR relaxation times T1 and T2 of different mixtures of agar-based phantoms. Nine TMPs were constructed containing agar as the gelling agent and various concentrations of silicon dioxide and evaporated milk. An agar-based phantom doped with wood powder was also evaluated. A series of MR images were acquired in a 1.5 T scanner for T1 and T2 mapping. T2 was predominantly affected by varying agar concentrations. A trend toward decreasing T1 with an increasing concentration of evaporated milk was observed. The addition of silicon dioxide decreased both relaxation times of pure agar gels. The proposed phantoms have great potential for use with the continuously emerging MRgFUS technology. The MR relaxation times of several body tissues can be mimicked by adjusting the concentration of ingredients, thus enabling more accurate and realistic MRgFUS studies.
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Affiliation(s)
- Anastasia Antoniou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Leonidas Georgiou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | | | - Natalie Panayiotou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Cleanthis Ioannides
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Nikolaos Zamboglou
- Department of Interventional Radiology, German Oncology Center, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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16
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T 2 MRI at 3T of cartilage and menisci in patients with hyperuricemia: initial findings. Skeletal Radiol 2022; 51:607-618. [PMID: 34287675 DOI: 10.1007/s00256-021-03861-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare and evaluate T2 values of compartmental femorotibial cartilage and subregional menisci in patients with hyperuricemia at 3T. MATERIALS AND METHODS Thirty-two subjects were included in this study and subdivided into two subgroups: 15 healthy controls (3 females, 12 males; mean age = 45.3 ± 10.9 years), 17 patients with hyperuricemia (2 females, 15 males; mean age = 44.4 ± 12.7 years). All subjects were assessed on a 3T MR scanner using an 8-channel phased-array knee coil (transmit-receive). Wilcoxon rank sum test and analysis of covariance (ANCOVA) were performed to determine whether there were any statistically significant differences in T2 values of compartmental femorotibial cartilage and subregional menisci between the two subgroups. RESULTS Lateral tibial cartilage (48.6 ± 3.5 ms) in healthy subgroup had significantly lower (p < 0.05) T2 values than all subcompartments of femorotibial cartilage in hyperuricemia subgroup. Medial tibial cartilage (56.5 ± 4.3 ms) in hyperuricemia subgroup had significantly higher (p < 0.05) T2 values than all subcompartments of femorotibial cartilage except medial tibial cartilage in healthy subgroup. Medial anterior horn of meniscus (39.4 ± 2.9 ms) in healthy subgroup had significantly lower (p < 0.05) T2 values than all subregional menisci except both medial anterior horn and medial body segment of meniscus in hyperuricemia subgroup. CONCLUSION T2 values in certain compartmental femorotibial cartilage and subregional menisci in patients with hyperuricemia are evidently and abnormally heightened compared with those in healthy subjects, to which special attention should be paid when diagnosing and treating the patients with hyperuricemia in the clinical setting. The LT cartilage had significantly lower T2 values (48.6 ± 3.5 ms) in healthy subgroup compared to all compartmental femorotibial cartilage in cohort with HU. MF cartilage had significantly lower T2 values (51.6 ± 2.9 ms) in healthy subgroup compared to both LF (54.4 ± 4.1 ms) and MT (56.5 ± 4.3 ms) in cohort with HU. MT cartilage had significantly higher T2 values (56.5 ± 4.3 ms) in cohort with HU subgroup compared to LF (52.5 ± 3.0 ms) in healthy subgroup. T2 mapping may be promising and potential sensitive discriminator of understanding and examining the early compositional and structural change in proteoglycan-collagen matrix of human femorotibial cartilage in patients with hyperuricemia.
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17
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Williams JR, Neal K, Alfayyadh A, Lennon K, Capin JJ, Khandha A, Manal K, Potter HG, Snyder-Mackler L, Buchanan TS. Knee cartilage T 2 relaxation times 3 months after ACL reconstruction are associated with knee gait variables linked to knee osteoarthritis. J Orthop Res 2022; 40:252-259. [PMID: 33783867 PMCID: PMC8481340 DOI: 10.1002/jor.25043] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/05/2021] [Accepted: 03/24/2021] [Indexed: 02/04/2023]
Abstract
Osteoarthritis development after ACL reconstruction (ACLR) is not well understood. Investigators have examined associations between knee biomechanical alterations and quantitative MRI (qMRI) variables, reflective of cartilage health, 12-60 months following ACLR; however, none have done so early after surgery. As part of an exploratory study, 45 individuals (age, 23 ± 7 years) underwent motion analysis during walking and qMRI 3 months after ACLR. For each limb, peak knee adduction moment (pKAM) and peak knee flexion moment (pKFM) were determined using inverse dynamics and peak medial compartment force was calculated using a neuromusculoskeletal model. T2 relaxation times in the medial compartment and linear regressions were used to determine the associations between gait variables and deep and superficial cartilage T2 relaxation times in six regions. pKAM was positively associated with deep layer T2 relaxation times within the femoral central and posterior regions when examined in the involved limb and from an interlimb difference perspective (involved limb - uninvolved limb). After adjusting for age, the association between interlimb difference of pKAM and interlimb difference of deep layer T2 relaxation times in the tibial central region became significant (p = .043). Interlimb difference of pKFM was negatively associated with interlimb difference of deep layer T2 relaxation times within the femoral central and posterior regions. These associations suggest that degenerative pathways leading to osteoarthritis may be detectable as early as 3 months after reconstruction. Preventative therapeutic techniques may need to be employed early in the rehabilitation process to prevent cartilage degradation.
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Affiliation(s)
- Jack R. Williams
- Department of Mechanical Engineering, University of
Delaware, Newark, DE
| | - Kelsey Neal
- Department of Mechanical Engineering, University of
Delaware, Newark, DE
| | | | - Kendra Lennon
- Department of Physical Therapy, University of Delaware,
Newark, DE
| | - Jacob J. Capin
- Biomechanics and Movement Science, University of Delaware,
Newark, DE,Department of Physical Therapy, University of Delaware,
Newark, DE,Physical Therapy Program, Department of Physical Medicine
and Rehabilitation, University of Colorado, Aurora, CO,Eastern Colorado VA Geriatric Research Education and
Clinical Center (GRECC), Aurora, CO
| | - Ashutosh Khandha
- Department of Biomedical Engineering, University of
Delaware, Newark, DE
| | - Kurt Manal
- Kinesiology and Applied Physiology, University of Delaware,
Newark, DE
| | - Hollis G. Potter
- Department of Radiology and Imaging, Hospital for Special
Surgery, New York, NY
| | - Lynn Snyder-Mackler
- Biomechanics and Movement Science, University of Delaware,
Newark, DE,Department of Physical Therapy, University of Delaware,
Newark, DE,Department of Biomedical Engineering, University of
Delaware, Newark, DE
| | - Thomas S. Buchanan
- Department of Mechanical Engineering, University of
Delaware, Newark, DE,Biomechanics and Movement Science, University of Delaware,
Newark, DE,Department of Biomedical Engineering, University of
Delaware, Newark, DE
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18
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Crowder HA, Mazzoli V, Black MS, Watkins LE, Kogan F, Hargreaves BA, Levenston ME, Gold GE. Characterizing the transient response of knee cartilage to running: Decreases in cartilage T 2 of female recreational runners. J Orthop Res 2021; 39:2340-2352. [PMID: 33483997 PMCID: PMC8295402 DOI: 10.1002/jor.24994] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/20/2020] [Accepted: 01/19/2021] [Indexed: 02/04/2023]
Abstract
Cartilage transmits and redistributes biomechanical loads in the knee joint during exercise. Exercise-induced loading alters cartilage hydration and is detectable using quantitative magnetic resonance imaging (MRI), where T2 relaxation time (T2 ) is influenced by cartilage collagen composition, fiber orientation, and changes in the extracellular matrix. This study characterized short-term transient responses of healthy knee cartilage to running-induced loading using bilateral scans and image registration. Eleven healthy female recreational runners (33.73 ± 4.22 years) and four healthy female controls (27.25 ± 1.38 years) were scanned on a 3T GE MRI scanner with quantitative 3D double-echo in steady-state before running over-ground (runner group) or resting (control group) for 40 min. Subjects were scanned immediately post-activity at 5-min intervals for 60 min. T2 times were calculated for femoral, tibial, and patellar cartilage at each time point and analyzed using a mixed-effects model and Bonferroni post hoc. There were immediate decreases in T2 (mean ± SEM) post-run in superficial femoral cartilage of at least 3.3% ± 0.3% (p = .002) between baseline and Time 0 that remained for 25 min, a decrease in superficial tibial cartilage T2 of 2.9% ± 0.4% (p = .041) between baseline and Time 0, and a decrease in superficial patellar cartilage T2 of 3.6% ± 0.3% (p = .020) 15 min post-run. There were decreases in the medial posterior region of superficial femoral cartilage T2 of at least 5.3 ± 0.2% (p = .022) within 5 min post-run that remained at 60 min post-run. These results increase understanding of transient responses of healthy cartilage to repetitive, exercise-induced loading and establish preliminary recommendations for future definitive studies of cartilage response to running.
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Affiliation(s)
- Hollis A. Crowder
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA,Department of Radiology, Stanford University, Stanford, California, USA
| | - Valentina Mazzoli
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Marianne S. Black
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Lauren E. Watkins
- Department of Radiology, Stanford University, Stanford, California, USA,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA,Department of Bioengineering, Stanford University, Stanford, California, USA,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Marc E. Levenston
- Department of Mechanical Engineering, Stanford University, Stanford, California, USA,Department of Radiology, Stanford University, Stanford, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
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Radiomics Feature Analysis of Cartilage and Subchondral Bone in Differentiating Knees Predisposed to Posttraumatic Osteoarthritis after Anterior Cruciate Ligament Reconstruction from Healthy Knees. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4351499. [PMID: 34552985 PMCID: PMC8452399 DOI: 10.1155/2021/4351499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022]
Abstract
Objectives To introduce a new implementation of radiomics analysis for cartilage and subchondral bone of the knee and to compare the performance of the proposed models to classic T2 relaxation time in distinguishing knees predisposed to posttraumatic osteoarthritis (PTOA) after anterior cruciate ligament reconstruction (ACLR) and healthy controls. Methods 114 patients following ACLR after at least 2 years and 43 healthy controls were reviewed and allocated to training (n = 110) and testing (n = 47) cohorts. Radiomics models are built for cartilage and subchondral bone regions of different compartments: lateral femur (LF), lateral tibia (LT), medial femur (MF), and medial tibia (MT) and combined models of four compartments on T2 mapping images. The model performance of discrimination between patients and controls was illustrated with the receiver operating characteristic curve and compared with a classic T2 value-based model. Results The T2 value model of cartilage yielded moderate predictive performance in discerning patients and controls, with an AUC of 0.731 (95% confidence interval, 0.556–0.875) in the testing cohort, while the radiomics signature of cartilage and subchondral bone of different compartments demonstrated excellent performance, with AUCs of 0.864–0.979. Furthermore, the combined model reported an even better performance, with AUCs of 0.977 (95% confidence interval, 0.919–1.000) for the cartilage and 0.934 (95% confidence interval, 0.865–0.994) for the subchondral bone in the testing cohort. Conclusion The radiomics features of the cartilage and subchondral bone may be able to provide powerful tools with more sensitive detection than T2 values in differentiating knees at risk for PTOA after ACLR from healthy knees.
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Sveinsson B, Chaudhari AS, Zhu B, Koonjoo N, Torriani M, Gold GE, Rosen MS. Synthesizing Quantitative T2 Maps in Right Lateral Knee Femoral Condyles from Multicontrast Anatomic Data with a Conditional Generative Adversarial Network. Radiol Artif Intell 2021; 3:e200122. [PMID: 34617020 PMCID: PMC8489449 DOI: 10.1148/ryai.2021200122] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 04/11/2021] [Accepted: 05/03/2021] [Indexed: 04/09/2023]
Abstract
PURPOSE To develop a proof-of-concept convolutional neural network (CNN) to synthesize T2 maps in right lateral femoral condyle articular cartilage from anatomic MR images by using a conditional generative adversarial network (cGAN). MATERIALS AND METHODS In this retrospective study, anatomic images (from turbo spin-echo and double-echo in steady-state scans) of the right knee of 4621 patients included in the 2004-2006 Osteoarthritis Initiative were used as input to a cGAN-based CNN, and a predicted CNN T2 was generated as output. These patients included men and women of all ethnicities, aged 45-79 years, with or at high risk for knee osteoarthritis incidence or progression who were recruited at four separate centers in the United States. These data were split into 3703 (80%) for training, 462 (10%) for validation, and 456 (10%) for testing. Linear regression analysis was performed between the multiecho spin-echo (MESE) and CNN T2 in the test dataset. A more detailed analysis was performed in 30 randomly selected patients by means of evaluation by two musculoskeletal radiologists and quantification of cartilage subregions. Radiologist assessments were compared by using two-sided t tests. RESULTS The readers were moderately accurate in distinguishing CNN T2 from MESE T2, with one reader having random-chance categorization. CNN T2 values were correlated to the MESE values in the subregions of 30 patients and in the bulk analysis of all patients, with best-fit line slopes between 0.55 and 0.83. CONCLUSION With use of a neural network-based cGAN approach, it is feasible to synthesize T2 maps in femoral cartilage from anatomic MRI sequences, giving good agreement with MESE scans.See also commentary by Yi and Fritz in this issue.Keywords: Cartilage Imaging, Knee, Experimental Investigations, Quantification, Vision, Application Domain, Convolutional Neural Network (CNN), Deep Learning Algorithms, Machine Learning Algorithms© RSNA, 2021.
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Affiliation(s)
- Bragi Sveinsson
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
| | - Akshay S. Chaudhari
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
| | - Bo Zhu
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
| | - Neha Koonjoo
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
| | - Martin Torriani
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
| | - Garry E. Gold
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
| | - Matthew S. Rosen
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology, Massachusetts General Hospital, Harvard Medical School,
149 13th St, Suite 2301, Boston, MA 02129 (B.S., B.Z., N.K., M.S.R.);
Division of Musculoskeletal Imaging and Intervention, Department of Radiology,
Massachusetts General Hospital, Harvard Medical School, Boston, Mass (M.T.);
Department of Radiology, Stanford University, Stanford, Calif (A.S.C., G.E.G.);
and Department of Physics, Harvard University, Cambridge, Mass (M.S.R.)
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21
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Chaudhari AS, Grissom MJ, Fang Z, Sveinsson B, Lee JH, Gold GE, Hargreaves BA, Stevens KJ. Diagnostic Accuracy of Quantitative Multicontrast 5-Minute Knee MRI Using Prospective Artificial Intelligence Image Quality Enhancement. AJR Am J Roentgenol 2021; 216:1614-1625. [PMID: 32755384 PMCID: PMC8862596 DOI: 10.2214/ajr.20.24172] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
BACKGROUND. Potential approaches for abbreviated knee MRI, including prospective acceleration with deep learning, have achieved limited clinical implementation. OBJECTIVE. The objective of this study was to evaluate the interreader agreement between conventional knee MRI and a 5-minute 3D quantitative double-echo steady-state (qDESS) sequence with automatic T2 mapping and deep learning super-resolutionaugmentation and to compare the diagnostic performance of the two methods regarding findings from arthroscopic surgery. METHODS. Fifty-one patients with knee pain underwent knee MRI that included an additional 3D qDESS sequence with automatic T2 mapping. Fourier interpolation was followed by prospective deep learning super resolution to enhance qDESS slice resolution twofold. A musculoskeletal radiologist and a radiology resident performed independent retrospective evaluations of articular cartilage, menisci, ligaments, bones, extensor mechanism, and synovium using conventional MRI. Following a 2-month washout period, readers reviewed qDESS images alone followed by qDESS with the automatic T2 maps. Interreader agreement between conventional MRI and qDESS was computed using percentage agreement and Cohen kappa. The sensitivity and specificity of conventional MRI, qDESS alone, and qDESS plus T2 mapping were compared with arthroscopic findings using exact McNemar tests. RESULTS. Conventional MRI and qDESS showed 92% agreement in evaluating all tissues. Kappa was 0.79 (95% CI, 0.76-0.81) across all imaging findings. In 43 patients who underwent arthroscopy, sensitivity and specificity were not significantly different (p = .23 to > .99) between conventional MRI (sensitivity, 58-93%; specificity, 27-87%) and qDESS alone (sensitivity, 54-90%; specificity, 23-91%) for cartilage, menisci, ligaments, and synovium. For grade 1 cartilage lesions, sensitivity and specificity were 33% and 56%, respectively, for conventional MRI; 23% and 53% for qDESS (p = .81); and 46% and 39% for qDESS with T2 mapping (p = .80). For grade 2A lesions, values were 27% and 53% for conventional MRI, 26% and 52% for qDESS (p = .02), and 58% and 40% for qDESS with T2 mapping (p < .001). CONCLUSION. The qDESS method prospectively augmented with deep learning showed strong interreader agreement with conventional knee MRI and near-equivalent diagnostic performance regarding arthroscopy. The ability of qDESS to automatically generate T2 maps increases sensitivity for cartilage abnormalities. CLINICAL IMPACT. Using prospective artificial intelligence to enhance qDESS image quality may facilitate an abbreviated knee MRI protocol while generating quantitative T2 maps.
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Affiliation(s)
- Akshay S Chaudhari
- Department of Radiology, Lucas Center for Imaging, Stanford University, 1201 Welch Rd, PS 055B, Stanford, CA 94305
| | | | | | - Bragi Sveinsson
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA
- Department of Radiology, Harvard Medical School, Boston, MA
| | - Jin Hyung Lee
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA
- Department of Bioengineering, Stanford University, Stanford, CA
- Department of Neurosurgery, Stanford University, Stanford, CA
- Department of Electrical Engineering, Stanford University, Stanford, CA
| | - Garry E Gold
- Department of Radiology, Lucas Center for Imaging, Stanford University, 1201 Welch Rd, PS 055B, Stanford, CA 94305
- Department of Bioengineering, Stanford University, Stanford, CA
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
| | - Brian A Hargreaves
- Department of Radiology, Lucas Center for Imaging, Stanford University, 1201 Welch Rd, PS 055B, Stanford, CA 94305
- Department of Bioengineering, Stanford University, Stanford, CA
- Department of Electrical Engineering, Stanford University, Stanford, CA
| | - Kathryn J Stevens
- Department of Radiology, Lucas Center for Imaging, Stanford University, 1201 Welch Rd, PS 055B, Stanford, CA 94305
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA
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22
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Peuna A, Thevenot J, Saarakkala S, Nieminen MT, Lammentausta E. Machine learning classification on texture analyzed T2 maps of osteoarthritic cartilage: oulu knee osteoarthritis study. Osteoarthritis Cartilage 2021; 29:859-869. [PMID: 33631317 DOI: 10.1016/j.joca.2021.02.561] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 01/04/2021] [Accepted: 02/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To introduce local binary pattern (LBP) texture analysis to cartilage osteoarthritis (OA) research and compare the performance of different classification systems in discrimination of OA subjects from healthy controls using gray-level co-occurrence matrix (GLCM) and LBP texture data. Classification algorithms were used to reduce the dimensionality of texture data into a likelihood of subject belonging to the reference class. METHOD T2 relaxation time mapping with multi-slice multi-echo spin echo sequence was performed for eighty symptomatic OA patients and 63 asymptomatic controls on a 3T clinical MRI scanner. Relaxation time maps were subjected to GLCM and LBP texture analysis, and classification algorithms were deployed with an in-house developed software. Implemented algorithms were K nearest neighbors, support vector machine, and neural network classifier. RESULTS LBP and GLCM discerned OA patients from controls with a significant difference in all studied regions. Classification models comprising GLCM and LBP showed high accuracy in classing OA patients and controls. The best performance was obtained with a multilayer perceptron type classifier with an overall accuracy of 90.2 %. CONCLUSION LBP texture analysis complements prior results with GLCM, and together LBP and GLCM serve as significant input data for classification algorithms trained for OA assessment. Presented algorithms are adaptable to versatile OA evaluations also for future gradational or predictive approaches.
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Affiliation(s)
- A Peuna
- Department of Medical Imaging, Central Finland Central Hospital, Jyväskylä, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - J Thevenot
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - E Lammentausta
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
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23
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Verschueren J, Van Langeveld SJ, Dragoo JL, Bierma-Zeinstra SMA, Reijman M, Gold GE, Oei EHG. T2 relaxation times of knee cartilage in 109 patients with knee pain and its association with disease characteristics. Acta Orthop 2021; 92:335-340. [PMID: 33538221 PMCID: PMC8231385 DOI: 10.1080/17453674.2021.1882131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Quantitative T2 mapping MRI of cartilage has proven value for the assessment of early osteoarthritis changes in research. We evaluated knee cartilage T2 relaxation times in a clinical population with knee complaints and its association with patients and disease characteristics and clinical symptoms.Patients and methods - In this cross-sectional study, T2 mapping knee scans of 109 patients with knee pain who were referred for an MRI by an orthopedic surgeon were collected. T2 relaxation times were calculated in 6 femoral and tibial regions of interest of full-thickness tibiofemoral cartilage. Its associations with age, sex, BMI, duration of complaints, disease onset (acute/chronic), and clinical symptoms were assessed with multivariate regression analysis. Subgroups were created of patients with abnormalities expected to cause predominantly medial or lateral tibiofemoral cartilage changes.Results - T2 relaxation times increased statistically significantly with higher age and BMI. In patients with expected medial cartilage damage, the medial femoral T2 values were significantly higher than the lateral; in patients with expected lateral cartilage damage the lateral tibial T2 values were significantly higher. A traumatic onset of knee complaints was associated with an acute elevation. No significant association was found with clinical symptoms.Interpretation - Our study demonstrates age, BMI, and type of injury-dependent T2 relaxation times and emphasizes the importance of acknowledging these variations when performing T2 mapping in a clinical population.
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Affiliation(s)
- Joost Verschueren
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Stephan J Van Langeveld
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Jason L Dragoo
- Department of Orthopedic Surgery, University of Colorado, Denver, CO, USA
| | - Sita M A Bierma-Zeinstra
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Garry E Gold
- Department of Radiology, Stanford University Medical Center, CA, USA
- Department of Bioengineering, Stanford University Medical Center, CA, USA
- Department of Orthopedic Surgery, Stanford University Medical Center, CA, USA
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
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24
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Verschueren J, Eijgenraam SM, Klein S, Poot DHJ, Bierma-Zeinstra SMA, Hernandez Tamames JA, Wielopolski PA, Reijman M, Oei EHG. T 2 mapping of healthy knee cartilage: multicenter multivendor reproducibility. Quant Imaging Med Surg 2021; 11:1247-1255. [PMID: 33816164 DOI: 10.21037/qims-20-674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background T2 mapping is increasingly used to quantify cartilage degeneration in knee osteoarthritis (OA), yet reproducibility studies in a multicenter setting are limited. The purpose of this study was to determine the longitudinal reproducibility and multicenter variation of cartilage T2 mapping, using various MRI equipment and acquisition protocols. Methods In this prospective multicenter study, four traveling, healthy human subjects underwent T2 mapping twice at five different centers with a 6-month-interval. Centers had various MRI scanners, field strengths, and T2 mapping acquisition protocols. Mean T2 values were calculated in six cartilage regions of interest (ROIs) as well as an average value per patient. A phantom was scanned once at each center. To evaluate longitudinal reproducibility, intraclass correlation coefficients (ICC), root-mean-square coefficient of variation (RMS-CV), and a Bland-Altman plot were used. To assess the variation of in vivo and phantom T2 values across centers, ANOVA was performed. Results ICCs of the T2 mapping measurements per ROI and the ROI's combined ranged from 0.73 to 0.91, indicating good to excellent longitudinal reproducibility. RMS-CVs ranged from 1.1% to 1.5% (per ROI) and 0.6% to 1.6% (ROIs combined) across the centers. A Bland-Altman plot did not reveal a systematic error. Evident, but consistent, discrepancies in T2 values were observed across centers, both in vivo and in the phantom. Conclusions The results of this study suggest that T2 mapping can be used to longitudinal assess cartilage degeneration in multicenter studies. Given the differences in absolute cartilage T2 values across centers, absolute T2 values derived from various centers in multicenter multivendor trials should not be pooled.
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Affiliation(s)
- Joost Verschueren
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Susanne M Eijgenraam
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Stefan Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Dirk H J Poot
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of Medical Informatics, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands.,Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Juan A Hernandez Tamames
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Piotr A Wielopolski
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
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Multi-vendor multi-site T 1ρ and T 2 quantification of knee cartilage. Osteoarthritis Cartilage 2020; 28:1539-1550. [PMID: 32739341 PMCID: PMC8094841 DOI: 10.1016/j.joca.2020.07.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 07/03/2020] [Accepted: 07/22/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop 3D T1ρ and T2 imaging based on the same sequence structure on MR systems from multiple vendors, and to evaluate intra-site repeatability and inter-site inter-vendor reproducibility of T1ρ and T2 measurements of knee cartilage. METHODS 3D magnetization-prepared angle-modulated partitioned k-space spoiled gradient echo snapshots (3D MAPSS) were implemented on MR systems from Siemens, GE and Philips. Phantom and human subject data were collected at four sites using 3T MR systems from the three vendors with harmonized protocols. Phantom data were collected by means of different positioning of the coil. Volunteers were scanned and rescanned after repositioning. Two traveling volunteers were scanned at all sites. Data were transferred to one site for centralized processing. RESULTS Intra-site average coefficient of variations (CVs) ranged from 1.09% to 3.05% for T1ρ and 1.78-3.30% for T2 in phantoms, and 1.60-3.93% for T1ρ and 1.44-4.08% for T2 in volunteers. Inter-site average CVs were 5.23% and 6.45% for MAPSS T1ρ and T2, respectively in phantoms, and 8.14% and 10.06% for MAPSS T1ρ and T2, respectively, In volunteers. CONCLUSION This study showed promising results of multi-site, multi-vendor reproducibility of T1ρ and T2 values in knee cartilage. These quantitative measures may be applied in large-scale multi-site, multi-vendor trials with controlled sequence structure and scan parameters and centralized data processing.
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Chaudhari AS, Kogan F, Pedoia V, Majumdar S, Gold GE, Hargreaves BA. Rapid Knee MRI Acquisition and Analysis Techniques for Imaging Osteoarthritis. J Magn Reson Imaging 2020; 52:1321-1339. [PMID: 31755191 PMCID: PMC7925938 DOI: 10.1002/jmri.26991] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) of the knee is a major source of disability that has no known treatment or cure. Morphological and compositional MRI is commonly used for assessing the bone and soft tissues in the knee to enhance the understanding of OA pathophysiology. However, it is challenging to extend these imaging methods and their subsequent analysis techniques to study large population cohorts due to slow and inefficient imaging acquisition and postprocessing tools. This can create a bottleneck in assessing early OA changes and evaluating the responses of novel therapeutics. The purpose of this review article is to highlight recent developments in tools for enhancing the efficiency of knee MRI methods useful to study OA. Advances in efficient MRI data acquisition and reconstruction tools for morphological and compositional imaging, efficient automated image analysis tools, and hardware improvements to further drive efficient imaging are discussed in this review. For each topic, we discuss the current challenges as well as potential future opportunities to alleviate these challenges. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Center of Digital Health Innovation (CDHI), University of California San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Center of Digital Health Innovation (CDHI), University of California San Francisco, San Francisco, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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Identification of locations susceptible to osteoarthritis in patients with anterior cruciate ligament reconstruction: Combining knee joint computational modelling with follow-up T 1ρ and T 2 imaging. Clin Biomech (Bristol, Avon) 2020; 79:104844. [PMID: 31439361 DOI: 10.1016/j.clinbiomech.2019.08.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/28/2019] [Accepted: 08/07/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Finite element modelling can be used to evaluate altered loading conditions and failure locations in knee joint tissues. One limitation of this modelling approach has been experimental comparison. The aims of this proof-of-concept study were: 1) identify areas susceptible to osteoarthritis progression in anterior cruciate ligament reconstructed patients using finite element modelling; 2) compare the identified areas against changes in T2 and T1ρ values between 1-year and 3-year follow-up timepoints. METHODS Two patient-specific finite element models of knee joints with anterior cruciate ligament reconstruction were created. The knee geometry was based on clinical magnetic resonance imaging and joint loading was obtained via motion capture. We evaluated biomechanical parameters linked with cartilage degeneration and compared the identified risk areas against T2 and T1ρ maps. FINDINGS The risk areas identified by the finite element models matched the follow-up magnetic resonance imaging findings. For Patient 1, excessive values of maximum principal stresses and shear strains were observed in the posterior side of the lateral tibial and femoral cartilage. For Patient 2, high values of maximum principal stresses and shear strains of cartilage were observed in the posterior side of the medial joint compartment. For both patients, increased T2 and T1ρ values between the follow-up times were observed in the same areas. INTERPRETATION Finite element models with patient-specific geometries and motions and relatively simple material models of tissues were able to identify areas susceptible to post-traumatic knee osteoarthritis. We suggest that the methodology presented here may be applied in large cohort studies.
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Eijgenraam SM, Chaudhari AS, Reijman M, Bierma-Zeinstra SMA, Hargreaves BA, Runhaar J, Heijboer FWJ, Gold GE, Oei EHG. Time-saving opportunities in knee osteoarthritis: T 2 mapping and structural imaging of the knee using a single 5-min MRI scan. Eur Radiol 2020; 30:2231-2240. [PMID: 31844957 PMCID: PMC7062657 DOI: 10.1007/s00330-019-06542-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/09/2019] [Accepted: 10/23/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To assess the discriminative power of a 5-min quantitative double-echo steady-state (qDESS) sequence for simultaneous T2 measurements of cartilage and meniscus, and structural knee osteoarthritis (OA) assessment, in a clinical OA population, using radiographic knee OA as reference standard. METHODS Fifty-three subjects were included and divided over three groups based on radiographic and clinical knee OA: 20 subjects with no OA (Kellgren-Lawrence grade (KLG) 0), 18 with mild OA (KLG2), and 15 with moderate OA (KLG3). All patients underwent a 5-min qDESS scan. We measured T2 relaxation times in four cartilage and four meniscus regions of interest (ROIs) and performed structural OA evaluation with the MRI Osteoarthritis Knee Score (MOAKS) using qDESS with multiplanar reformatting. Between-group differences in T2 values and MOAKS were calculated using ANOVA. Correlations of the reference standard (i.e., radiographic knee OA) with T2 and MOAKS were assessed with correlation analyses for ordinal variables. RESULTS In cartilage, mean T2 values were 36.1 ± SD 4.3, 40.6 ± 5.9, and 47.1 ± 4.3 ms for no, mild, and moderate OA, respectively (p < 0.001). In menisci, mean T2 values were 15 ± 3.6, 17.5 ± 3.8, and 20.6 ± 4.7 ms for no, mild, and moderate OA, respectively (p < 0.001). Statistically significant correlations were found between radiographic OA and T2 and between radiographic OA and MOAKS in all ROIs (p < 0.05). CONCLUSION Quantitative T2 and structural assessment of cartilage and meniscus, using a single 5-min qDESS scan, can distinguish between different grades of radiographic OA, demonstrating the potential of qDESS as an efficient tool for OA imaging. KEY POINTS • Quantitative T2values of cartilage and meniscus as well as structural assessment of the knee with a single 5-min quantitative double-echo steady-state (qDESS) scan can distinguish between different grades of knee osteoarthritis (OA). • Quantitative and structural qDESS-based measurements correlate significantly with the reference standard, radiographic degree of OA, for all cartilage and meniscus regions. • By providing quantitative measurements and diagnostic image quality in one rapid MRI scan, qDESS has great potential for application in large-scale clinical trials in knee OA.
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Affiliation(s)
- Susanne M Eijgenraam
- Deptartment of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, Room Nd-547, 3015, GD, Rotterdam, The Netherlands
- Deptartment of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Max Reijman
- Deptartment of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sita M A Bierma-Zeinstra
- Deptartment of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Deptartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Brian A Hargreaves
- Deptartment of Radiology, Stanford University, Stanford, CA, USA
- Deptartment of Electrical Engineering, Stanford University, Stanford, CA, USA
- Deptartment of Bioengineering, Stanford University, Stanford, CA, USA
| | - Jos Runhaar
- Deptartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Frank W J Heijboer
- Deptartment of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Garry E Gold
- Deptartment of Radiology, Stanford University, Stanford, CA, USA
- Deptartment of Bioengineering, Stanford University, Stanford, CA, USA
- Deptartment of Orthopedic Surgery, Stanford University, Stanford, CA, USA
| | - Edwin H G Oei
- Deptartment of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, Room Nd-547, 3015, GD, Rotterdam, The Netherlands.
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Lansdown DA, Ma CB. Clinical Utility of Advanced Imaging of the Knee. J Orthop Res 2020; 38:473-482. [PMID: 31498473 DOI: 10.1002/jor.24462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/17/2019] [Indexed: 02/04/2023]
Abstract
Advanced imaging modalities, including computed tomography, magnetic resonance imaging (MRI), and dynamic fluoroscopic imaging, allow for a comprehensive evaluation of the knee joint. Compositional sequences for MRI can allow for an evaluation of the biochemical properties of cartilage, meniscus, and ligament that offer further insight into pathology that may not be apparent on conventional clinical imaging. Advances in image processing, shape modeling, and dynamic studies also offer a novel way to evaluate common conditions and to monitor patients after treatment. The purpose of this article is to review advanced imaging modalities of the knee and their current and anticipated future applications to clinical practice. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:473-482, 2020.
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Affiliation(s)
- Drew A Lansdown
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California
| | - C Benjamin Ma
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California
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Johnson CP, Thedens DR, Kruger SJ, Magnotta VA. Three-Dimensional GRE T 1ρ mapping of the brain using tailored variable flip-angle scheduling. Magn Reson Med 2020; 84:1235-1249. [PMID: 32052489 DOI: 10.1002/mrm.28198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/07/2020] [Accepted: 01/13/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To introduce a new approach called tailored variable flip-angle (VFA) scheduling for SNR-efficient 3D T1ρ mapping of the brain using a magnetization-prepared gradient-echo sequence. METHODS Simulations were used to assess the relative SNR efficiency, quantitative accuracy, and spatial blurring of tailored VFA scheduling for T1ρ mapping of brain tissue compared with magnetization-prepared angle-modulated partitioned k-space spoiled gradient-echo snapshots (MAPSS), a state-of-the-art technique for accurate 3D gradient-echo T1ρ mapping. Simulations were also used to calculate optimal imaging parameters for tailored VFA scheduling versus MAPSS, without and with nulling of CSF. Four participants were imaged at 3T MRI to demonstrate the feasibility of tailored VFA scheduling for T1ρ mapping of the brain. Using MAPSS as a reference standard, in vivo data were used to validate the relative SNR efficiency and quantitative accuracy of the new approach. RESULTS Tailored VFA scheduling can provide a 2-fold to 4-fold gain in the SNR of the resulting T1ρ map as compared with MAPSS when using identical sequence parameters while limiting T1ρ quantification errors to 2% or less. In vivo whole-brain 3D T1ρ maps acquired with tailored VFA scheduling had superior SNR efficiency than is achievable with MAPSS, and the SNR efficiency improved with a greater number of views per segment. CONCLUSIONS Tailored VFA scheduling is an SNR-efficient GRE technique for 3D T1ρ mapping of the brain that provides increased flexibility in choice of imaging parameters compared with MAPSS, which may benefit a variety of applications.
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Affiliation(s)
- Casey P Johnson
- Veterinary Clinical Sciences Department, University of Minnesota, Saint Paul, MN, USA.,Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | | | | | - Vincent A Magnotta
- Department of Radiology, University of Iowa, Iowa City, IA, USA.,Department of Psychiatry, University of Iowa, Iowa City, IA, USA.,Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
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Apprich SR, Schreiner MM, Szomolanyi P, Welsch GH, Koller UK, Weber M, Windhager R, Trattnig S. Potential predictive value of axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage defects over a mean follow-up of four years. Osteoarthritis Cartilage 2020; 28:215-222. [PMID: 31678665 DOI: 10.1016/j.joca.2019.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/20/2019] [Accepted: 10/16/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective was to demonstrate the potential of axial T2 mapping for quantification of untreated early-stage patellar cartilage lesions over time and to assess its capability as a potential predictive marker for future progression. STUDY DESIGN & METHODS Thirty patients (mean age, 36.7 ± 11.1 years; 16 males), with early-stage patellar cartilage defects (≤ICRS grade 2) at baseline and no treatment during follow up (4.0 ± 1.6 years) were enrolled. Morphological cartilage changes over time were subdivided into a Progression, Non-Progression Group and Regression Group. Quantitative analysis of cartilage defects and healthy reference was performed by means of global and zonal T2 mapping (deep and superficial cartilage T2 values) at both time points. Statistical evaluation included analysis of variance (ANOVA), paired t Test's and ROC analysis. RESULTS The Progression Group (N = 11) had significantly higher global T2 values at baseline (57.4 ± 7.8 ms) than patients without (N = 17) (40.6 ± 6.9 ms) (P < 0.01). Furthermore the Non-Progression Group showed only a minor increase in global T2 relaxation times to 43.1 ± 7.9 ms (P = 0.07) at follow up, whereas in the progression group global (68,7 ± 19 ms: P = 0.02) and superficial T2 values (65,8 ± 8.2-79.8 ± 24.4 ms; P = 0.03) increased significantly. T2 values for healthy reference cartilage remained stable. In 2 patients an improvement in ICRS grading was observed (Regression Group) with decreasing T2 values. The ROC analysis showed an area under the curve of 0.92 (95%CI 0.82-1.0). At a cut-off value of 47.15 ms, we found a sensitivity of 92% (false-positive rate of 18%) for future progression of cartilage defects. CONCLUSIONS This study provides evidence regarding the possible potential of axial T2 mapping as a tool for quantification and prediction of patellar cartilage defect progression in untreated defects.
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Affiliation(s)
- S R Apprich
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - M M Schreiner
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - P Szomolanyi
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia.
| | - G H Welsch
- UKE Athleticum, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
| | - U K Koller
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria.
| | - R Windhager
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - S Trattnig
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Austria.
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Emerging quantitative MR imaging biomarkers in inflammatory arthritides. Eur J Radiol 2019; 121:108707. [PMID: 31707169 DOI: 10.1016/j.ejrad.2019.108707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/14/2019] [Accepted: 10/09/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE To review quantitative magnetic resonance imaging (qMRI) methods for imaging inflammation in connective tissues and the skeleton in inflammatory arthritis. This review is designed for a broad audience including radiologists, imaging technologists, rheumatologists and other healthcare professionals. METHODS We discuss the use of qMRI for imaging skeletal inflammation from both technical and clinical perspectives. We consider how qMRI can be targeted to specific aspects of the pathological process in synovium, cartilage, bone, tendons and entheses. Evidence for the various techniques from studies of both adults and children with inflammatory arthritis is reviewed and critically appraised. RESULTS qMRI has the potential to objectively identify, characterize and quantify inflammation of the connective tissues and skeleton in both adult and pediatric patients. Measurements of tissue properties derived using qMRI methods can serve as imaging biomarkers, which are potentially more reproducible and informative than conventional MRI methods. Several qMRI methods are nearing transition into clinical practice and may inform diagnosis and treatment decisions, with the potential to improve patient outcomes. CONCLUSIONS qMRI enables specific assessment of inflammation in synovium, cartilage, bone, tendons and entheses, and can facilitate a more consistent, personalized approach to diagnosis, characterisation and monitoring of disease.
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Abstract
OBJECTIVE To study the experimental influences to the measurement of cartilage thickness by magnetic resonance imaging (MRI). DESIGN The complete thicknesses of healthy and trypsin-degraded cartilage were measured at high-resolution MRI under different conditions, using two intensity-based imaging sequences (ultra-short echo [UTE] and multislice-multiecho [MSME]) and 3 quantitative relaxation imaging sequences (T1, T2, and T1ρ). Other variables included different orientations in the magnet, 2 soaking solutions (saline and phosphate buffered saline [PBS]), and external loading. RESULTS With cartilage soaked in saline, UTE and T1 methods yielded complete and consistent measurement of cartilage thickness, while the thickness measurement by T2, T1ρ, and MSME methods were orientation dependent. The effect of external loading on cartilage thickness is also sequence and orientation dependent. All variations in cartilage thickness in MRI could be eliminated with the use of a 100 mM PBS or imaged by UTE sequence. CONCLUSIONS The appearance of articular cartilage and the measurement accuracy of cartilage thickness in MRI can be influenced by a number of experimental factors in ex vivo MRI, from the use of various pulse sequences and soaking solutions to the health of the tissue. T2-based imaging sequence, both proton-intensity sequence and quantitative relaxation sequence, similarly produced the largest variations. With adequate resolution, the accurate measurement of whole cartilage tissue in clinical MRI could be utilized to detect differences between healthy and osteoarthritic cartilage after compression.
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Affiliation(s)
- Nian Wang
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA,Center for In Vivo Microscopy, Department of Radiology, Duke University, Durham, NC, USA
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA,Yang Xia, PhD, Department of Physics, Oakland University, 276 Hannah Hall, Rochester, MI 48309, USA.
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Do dGEMRIC and T2 Imaging Correlate With Histologic Cartilage Degeneration in an Experimental Ovine FAI Model? Clin Orthop Relat Res 2019; 477:990-1003. [PMID: 30507833 PMCID: PMC6494333 DOI: 10.1097/corr.0000000000000593] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Biochemical MRI of hip cartilage such as delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) and T2 mapping is increasingly used to judge cartilage quality in the assessment of femoroacetabular impingement (FAI). The current evidence is sparse about which of these techniques yields a stronger correlation with histologic cartilage degeneration because of the difficulty in validating biochemical MRI techniques against histology in the clinical setting. Recently, an experimental ovine FAI model was established that induces chondrolabral damage and offers a validated platform to address these limitations. QUESTIONS/PURPOSES In a sheep model, we asked: (1) Do dGEMRIC and/or T2 values of acetabular and femoral cartilage correlate with histologic cartilage degeneration as assessed with the Mankin score? (2) Do simultaneously measured dGEMRIC and T2 values correlate in an experimental ovine FAI model? METHODS We performed an experimental pilot study on five female Swiss Alpine sheep (10 hips) that underwent postmortem MRI, including biochemical cartilage sequences, after a staged FAI correction had been performed on one side. No surgery was performed on the contralateral side, which served as a healthy control. In these sheep, an extraarticular intertrochanteric varus osteotomy was performed to rotate the naturally aspherical ovine femoral head into the acetabulum to induce cam-type FAI and chondrolabral damage comparable to human beings. After a 70-day ambulation period, femoral osteochondroplasty was performed and all sheep were euthanized after a total observation period of 210 days. Before they were euthanized, the sheep received a contrast agent and roamed and walked for at least 45 minutes. Hips were prepared to fit in a knee coil and MRI was performed at 3 T including a three-dimensional (3-D) dGEMRIC sequence, a two-dimensional (2-D) radial T2 mapping sequence, and a 2-D radial proton density-weighted sequence for morphologic cartilage assessment. Using specifically developed software, the 3-D dGEMRIC images and T2 maps were coregistered on the 2-D morphologic radial images. This enabled us to simultaneously measure dGEMRIC and T2 values using the identical regions of interest. dGEMRIC and T2 values of the acetabular and femoral cartilage were measured circumferentially using anatomic landmarks. After MRI, bone-cartilage samples were taken from the acetabulum and the femur and stained with toluidine blue for assessment of the histologic cartilage degeneration using the Mankin score, which was assessed in consensus by two observers. Spearman's rank correlation coefficient was used to (1) correlate dGEMRIC values and T2 values with the histologic Mankin score of femoroacetabular cartilage; and to (2) correlate dGEMRIC values and T2 values of femoroacetabular cartilage. RESULTS A moderate to fair correlation between overall dGEMRIC values of the acetabular cartilage (R = -0.430; p = 0.003) and the femoral cartilage (R = -0.334; p = 0.003) versus the histologic Mankin score was found. A moderate correlation (R = -0.515; p = 0.010) was found among peripheral dGEMRIC values of the acetabulum, the superior femoral cartilage (R = -0.500; p = 0.034), and the histologic Mankin score, respectively. No correlation between overall and regional femoroacetabular T2 values and the histologic Mankin scores was found. No correlation between overall and regional femoroacetabular dGEMRIC values and T2 values was found. CONCLUSIONS In this recently established sheep model, we found dGEMRIC values correlated well with histologic evidence of cartilage degeneration in the hip. This combination of a robust animal model and an accurate imaging technique appears to offer a noninvasive means to study the natural course of FAI and to compare the effectiveness of potential surgical options to treat it. CLINICAL RELEVANCE This translational study supports the continuing use of dGEMRIC as a biomarker for prearthritic cartilage degeneration with the ultimate goal to identify patients who will benefit most from corrective FAI surgery. The value of T2 imaging of hip cartilage warrants further investigation.
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Atkinson HF, Birmingham TB, Moyer RF, Yacoub D, Kanko LE, Bryant DM, Thiessen JD, Thompson RT. MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:182. [PMID: 31039785 PMCID: PMC6492327 DOI: 10.1186/s12891-019-2547-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls. Methods We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments. Results 55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p < 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p < 0.001). Conclusions T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation. Electronic supplementary material The online version of this article (10.1186/s12891-019-2547-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hayden F Atkinson
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. .,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada. .,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada. .,Musculoskeletal Rehabilitation, Elborn College, University of Western Ontario, London, Ontario, N6G 1H1, Canada.
| | - Rebecca F Moyer
- Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.,School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Yacoub
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Lauren E Kanko
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Dianne M Bryant
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Jonathan D Thiessen
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
| | - R Terry Thompson
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
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Eijgenraam SM, Bovendeert FAT, Verschueren J, van Tiel J, Bastiaansen-Jenniskens YM, Wesdorp MA, Nasserinejad K, Meuffels DE, Guenoun J, Klein S, Reijman M, Oei EHG. T 2 mapping of the meniscus is a biomarker for early osteoarthritis. Eur Radiol 2019; 29:5664-5672. [PMID: 30888480 PMCID: PMC6719322 DOI: 10.1007/s00330-019-06091-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/30/2019] [Accepted: 02/08/2019] [Indexed: 12/24/2022]
Abstract
Purpose To evaluate in vivo T2 mapping as quantitative, imaging-based biomarker for meniscal degeneration in humans, by studying the correlation between T2 relaxation time and degree of histological degeneration as reference standard. Methods In this prospective validation study, 13 menisci from seven patients with radiographic knee osteoarthritis (median age 67 years, three males) were included. Menisci were obtained during total knee replacement surgery. All patients underwent pre-operative magnetic resonance imaging using a 3-T MR scanner which included a T2 mapping pulse sequence with multiple echoes. Histological analysis of the collected menisci was performed using the Pauli score, involving surface integrity, cellularity, matrix organization, and staining intensity. Mean T2 relaxation times were calculated in meniscal regions of interest corresponding with the areas scored histologically, using a multi-slice multi-echo postprocessing algorithm. Correlation between T2 mapping and histology was assessed using a generalized least squares model fit by maximum likelihood. Results The mean T2 relaxation time was 22.4 ± 2.7 ms (range 18.5–27). The median histological score was 10, IQR 7–11 (range 4–13). A strong correlation between T2 relaxation time and histological score was found (rs = 0.84, CI 95% 0.64–0.93). Conclusion In vivo T2 mapping of the human meniscus correlates strongly with histological degeneration, suggesting that T2 mapping enables the detection and quantification of early compositional changes of the meniscus in knee OA. Key Points • Prospective histology-based study showed that in vivo T2mapping of the human meniscus correlates strongly with histological degeneration. • Meniscal T2mapping allows detection and quantifying of compositional changes, without need for contrast or special MRI hardware. • Meniscal T2mapping provides a biomarker for early OA, potentially allowing early treatment strategies and prevention of OA progression. Electronic supplementary material The online version of this article (10.1007/s00330-019-06091-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Susanne M Eijgenraam
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, room Nd-547, 3015 GD, Rotterdam, The Netherlands.,Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Frans A T Bovendeert
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.,Department of Orthopedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands
| | - Joost Verschueren
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jasper van Tiel
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | | | - Marinus A Wesdorp
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Kazem Nasserinejad
- Department of Hematology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Duncan E Meuffels
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jamal Guenoun
- Department of Radiology, Cambridge University Hospitals, Cambridge, UK
| | - Stefan Klein
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, room Nd-547, 3015 GD, Rotterdam, The Netherlands.,Department of Medical Informatics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Dr. Molewaterplein 40, room Nd-547, 3015 GD, Rotterdam, The Netherlands.
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Pang Y, Palmieri-Smith RM, Malyarenko DI, Swanson SD, Chenevert TL. A unique anisotropic R 2 of collagen degeneration (ARCADE) mapping as an efficient alternative to composite relaxation metric (R 2 -R 1 ρ ) in human knee cartilage study. Magn Reson Med 2019; 81:3763-3774. [PMID: 30793790 DOI: 10.1002/mrm.27621] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/11/2018] [Accepted: 11/09/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Anisotropic transverse R2 (1/T2 ) relaxation of water proton is sensitive to cartilage degenerative changes. The purpose is to develop an efficient method to extract this relaxation metric in clinical studies. METHODS Anisotropic R2 can be measured inefficiently by standard R2 mapping after removing an isotropic contribution obtained from R1 ρ mapping. In the proposed method, named as a unique anisotropic R2 of collagen degeneration (ARCADE) mapping, an assumed uniform isotropic R2 was estimated at magic angle locations in the deep cartilage, and an anisotropic R2 was thus isolated in a single T2W sagittal image. Five human knees from 4 volunteers were studied with standard R2 and R1 ρ mappings at 3T, and anisotropic R2 derived from ARCADE on the T2W (TE = 48.8 ms) image from R2 mapping was compared with the composite relaxation (R2 - R1 ρ ) using statistical analysis including Student's t-test and Pearson's correlation coefficient. RESULTS Anisotropic R2 (1/s) from ARCADE was highly positively correlated with but not significantly different from standard R2 - R1 ρ (1/s) in the segmented deep (r = 0.83 ± 0.06; 8.3 ± 2.9 vs. 7.3 ± 1.9, P = .50) and the superficial (r = 0.82 ± 0.05; 3.5 ± 2.4 vs. 4.5 ± 1.6, P = .39) zones. However, after eliminating systematic errors by the normalization in terms of zonal contrast, anisotropic R2 was significantly higher (60.2 ± 18.5% vs. 38.4 ± 16.6%, P < .01) than R2 - R1 ρ as predicted. CONCLUSION The proposed anisotropic R2 mapping could be an efficient alternative to the conventional approach, holding great promise in providing both high-resolution morphological and more sensitive transverse relaxation imaging from a single T2W scan in a clinical setting.
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Affiliation(s)
- Yuxi Pang
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Riann M Palmieri-Smith
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan.,Department of Orthopedic Surgery, University of Michigan, Ann Arbor, Michigan
| | | | - Scott D Swanson
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
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38
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Hayashi D, Roemer FW, Guermazi A. Imaging of Osteoarthritis by Conventional Radiography, MR Imaging, PET–Computed Tomography, and PET–MR Imaging. PET Clin 2019; 14:17-29. [DOI: 10.1016/j.cpet.2018.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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39
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Zibetti MVW, Baboli R, Chang G, Otazo R, Regatte RR. Rapid compositional mapping of knee cartilage with compressed sensing MRI. J Magn Reson Imaging 2018; 48:1185-1198. [PMID: 30295344 PMCID: PMC6231228 DOI: 10.1002/jmri.26274] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
More than a decade after the introduction of compressed sensing (CS) in MRI, researchers are still working on ways to translate it into different research and clinical applications. The greatest advantage of CS in MRI is the reduced amount of k-space data needed to reconstruct images, which can be exploited to reduce scan time or to improve spatial resolution and volumetric coverage. Efficient data acquisition using CS is extremely important for compositional mapping of the musculoskeletal system in general and knee cartilage mapping techniques in particular. High-resolution quantitative information about tissue biochemical composition could be obtained in just a few minutes using CS MRI. However, in order to make this goal a reality, some issues still need to be addressed. In this article we review the current state of the art of CS methods for rapid compositional mapping of knee cartilage. Specifically, data acquisition strategies, image reconstruction algorithms, and data fitting models are discussed. Different CS studies for T2 and T1ρ mapping of knee cartilage are reviewed, with illustrative results. Future directions, opportunities, and challenges of rapid compositional mapping techniques are also discussed. Level of Evidence: 4 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2018;47:1185-1198.
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Affiliation(s)
- Marcelo V W Zibetti
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Rahman Baboli
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Gregory Chang
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Ricardo Otazo
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Ravinder R Regatte
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
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40
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McPhee KC, Wilman AH. T
1
and T
2
quantification from standard turbo spin echo images. Magn Reson Med 2018; 81:2052-2063. [DOI: 10.1002/mrm.27495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/10/2018] [Accepted: 07/23/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Kelly C. McPhee
- Department of Physics University of Alberta Edmonton Alberta Canada
- Department of Biomedical Engineering University of Alberta Edmonton Alberta Canada
| | - Alan H. Wilman
- Department of Physics University of Alberta Edmonton Alberta Canada
- Department of Biomedical Engineering University of Alberta Edmonton Alberta Canada
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41
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Hayashi D, Roemer FW, Guermazi A. Imaging of osteoarthritis-recent research developments and future perspective. Br J Radiol 2018; 91:20170349. [PMID: 29271229 DOI: 10.1259/bjr.20170349] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In osteoarthritis research, imaging plays an important role in clinical trials and epidemiological observational studies. In this narrative review article, we will describe recent developments in imaging of osteoarthritis in the research arena, mainly focusing on literature evidence published within the past 3 years (2014-2017). We will primarily focus on MRI including advanced imaging techniques that are not currently commonly used in routine clinical practice, although radiography, ultrasound and nuclear medicine (radiotracer) imaging will also be discussed. Research efforts to uncover the disease process of OA as well as to discover a disease modifying OA drug continue. MRI continues to play a large role in these endeavors, while compositional MRI techniques will increasingly become important due to their ability to assess "premorphologic" biochemical changes of articular cartilage and other tissues in and around joints. Radiography remain the primary imaging modality for defining inclusion/exclusion criteria as well as an outcome measure in OA clinical trials, despite known limitations for visualization of OA features. Compositional MRI techniques show promise for predicting structural and clinical outcomes in OA research. Ultrasound can be a useful adjunct to radiography and MRI particularly for evaluation of hand OA. Newer imaging techniques such as hybrid PET/MRI may have a potential but require further research and validation.
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Affiliation(s)
- Daichi Hayashi
- 1 Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine , Boston, MA , USA.,2 Department of Radiology, Stony Brook University School of Medicine , Stony Brook, NY , USA
| | - Frank W Roemer
- 1 Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine , Boston, MA , USA.,3 Department of Radiology, University of Erlangen-Nuremberg , Erlangen , Germany
| | - Ali Guermazi
- 1 Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine , Boston, MA , USA
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42
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Mars M, Chelli M, Tbini Z, Ladeb F, Gharbi S. MRI T2 Mapping of Knee Articular Cartilage Using Different Acquisition Sequences and Calculation Methods at 1.5 Tesla. Med Princ Pract 2018; 27:443-450. [PMID: 29895028 PMCID: PMC6243913 DOI: 10.1159/000490796] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 06/12/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study aims to determine how magnetic resonance imaging (MRI) acquisition techniques and calculation methods affect T2 values of knee cartilage at 1.5 tesla and to identify sequences that can be used for high-resolution T2 mapping in short scanning times. MATERIALS AND METHODS This study was performed on phantom and 29 patients who underwent MRI of the knee joint at 1.5 tesla. The protocol includes T2 mapping sequences based on Single-Echo Spin Echo (SESE), Multi-Echo Spin Echo (MESE), Fast Spin Echo (FSE) and Turbo Gradient Spin Echo (TGSE). The T2 relaxation times were quantified and evaluated using three calculation methods (MapIt, Syngo Offline and mono-exponential fit). signal-to-noise ratios (SNR) were measured in all sequences. All statistical analyses were performed using the t-test. RESULTS The average T2 values in phantom were 41.7 ± 13.8 ms for SESE, 43.2 ± 14.4 ms for MESE, 42.4 ± 14.1 ms for FSE and 44 ± 14.5 ms for TGSE. In the patient study, the mean differences were 6.5 ± 8.2 ms, 7.8 ± 7.6 ms and 8.4 ± 14.2 ms for MESE, FSE and TGSE compared to SESE, respectively; these statistical results were not significantly different (p > 0.05). The comparison between the three calculation methods showed no significant difference (p > 0.05). The t-test showed no significant difference between SNR values for all sequences. CONCLUSION T2 values depend not only on the sequence type but also on the calculation method. None of the sequences revealed significant differences compared to the SESE reference sequence. TGSE with its short scanning time can be used for high-resolution T2 mapping.
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Affiliation(s)
- Mokhtar Mars
- Tunis University EL Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
- *Mokhtar Mars, 29 Rue Imam Chafai La Petite Ariana, Jaafar, 2083 Tunis (Tunisia), E-Mail
| | - Mouna Chelli
- Tunis University EL Manar, Faculty of Medicine of Tunis, Department of Radiology, Kassab Institute of Orthopedics, Ksar Saïd, Tunis, Tunisia
| | - Zeineb Tbini
- Tunis University EL Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
| | - Fethi Ladeb
- Tunis University EL Manar, Faculty of Medicine of Tunis, Department of Radiology, Kassab Institute of Orthopedics, Ksar Saïd, Tunis, Tunisia
| | - Souha Gharbi
- Tunis University EL Manar, Higher Institute of Medical Technologies of Tunis, Research Laboratory of Biophysics and Medical Technologies, Tunis, Tunisia
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Kogan F, Levine E, Chaudhari AS, Monu UD, Epperson K, Oei EHG, Gold GE, Hargreaves BA. Simultaneous bilateral-knee MR imaging. Magn Reson Med 2017; 80:529-537. [PMID: 29250856 DOI: 10.1002/mrm.27045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 12/23/2022]
Abstract
PURPOSE To demonstrate and evaluate the scan time and quantitative accuracy of simultaneous bilateral-knee imaging compared with single-knee acquisitions. METHODS Hardware modifications and safety testing was performed to enable MR imaging with two 16-channel flexible coil arrays. Noise covariance and sensitivity-encoding g-factor maps for the dual-coil-array configuration were computed to evaluate coil cross-talk and noise amplification. Ten healthy volunteers were imaged on a 3T MRI scanner with both dual-coil-array bilateral-knee and single-coil-array single-knee configurations. Two experienced musculoskeletal radiologists compared the relative image quality between blinded image pairs acquired with each configuration. Differences in T2 relaxation time measurements between dual-coil-array and single-coil-array acquisitions were compared with the standard repeatability of single-coil-array measurements using a Bland-Altman analysis. RESULTS The mean g-factors for the dual-coil-array configuration were low for accelerations up to 6 in the right-left direction, and minimal cross-talk was observed between the two coil arrays. Image quality ratings of various joint tissues showed no difference in 89% (95% confidence interval: 85-93%) of rated image pairs, with only small differences ("slightly better" or "slightly worse") in image quality observed. The T2 relaxation time measurements between the dual-coil-array configuration and the single-coil configuration showed similar limits of agreement and concordance correlation coefficients (limits of agreement: -0.93 to 1.99 ms; CCC: 0.97 (95% confidence interval: 0.96-0.98)), to the repeatability of single-coil-array measurements (limits of agreement: -2.07 to 1.96 ms; CCC: 0.97 (95% confidence interval: 0.95-0.98)). CONCLUSION A bilateral coil-array setup can image both knees simultaneously in similar scan times as conventional unilateral knee scans, with comparable image quality and quantitative accuracy. This has the potential to improve the value of MRI knee evaluations. Magn Reson Med 80:529-537, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Evan Levine
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Akshay S Chaudhari
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Uchechukwuka D Monu
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Kevin Epperson
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Orthopedic Surgery, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
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44
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Chaudhari AS, Black MS, Eijgenraam S, Wirth W, Maschek S, Sveinsson B, Eckstein F, Oei EHG, Gold GE, Hargreaves BA. Five-minute knee MRI for simultaneous morphometry and T 2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double-echo in steady-state at 3T. J Magn Reson Imaging 2017; 47:1328-1341. [PMID: 29090500 DOI: 10.1002/jmri.25883] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 10/14/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Biomarkers for assessing osteoarthritis activity necessitate multiple MRI sequences with long acquisition times. PURPOSE To perform 5-minute simultaneous morphometry (thickness/volume measurements) and T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS). STUDY TYPE Prospective. SUBJECTS Fifteen healthy volunteers for morphometry and T2 measurements, and 15 patients (five each Kellgren-Lawrence grades 0/2/3) for MOAKS assessment. FIELD STRENGTH/SEQUENCE A 5-minute double-echo steady-state (DESS) sequence was evaluated for generating quantitative and semiquantitative osteoarthritis biomarkers at 3T. ASSESSMENT Flip angle simulations evaluated tissue signals and sensitivity of T2 measurements. Morphometry and T2 reproducibility was compared against morphometry-optimized and relaxometry-optimized sequences. Repeatability was assessed by scanning five volunteers twice. MOAKS reproducibility was compared to MOAKS derived from a clinical knee MRI protocol by two readers. STATISTICAL TESTS Coefficients of variation (CVs), concordance confidence intervals (CCI), and Wilcoxon signed-rank tests compared morphometry and relaxometry measurements with their reference standards. DESS MOAKS positive percent agreement (PPA), negative percentage agreement (NPA), and interreader agreement was calculated using the clinical protocol as a reference. Biomarker variations between Kellgren-Lawrence groups were evaluated using Wilcoxon rank-sum tests. RESULTS Cartilage thickness (P = 0.65), cartilage T2 (P = 0.69), and meniscus T2 (P = 0.06) did not significantly differ from their reference standard (with a 20° DESS flip angle). DESS slightly overestimated meniscus volume (P < 0.001). Accuracy and repeatability CVs were <3.3%, except the meniscus T2 accuracy (7.6%). DESS MOAKS had substantial interreader agreement and high PPA/NPA values of 87%/90%. Bone marrow lesions and menisci had slightly lower PPAs. Cartilage and meniscus T2 , and MOAKS (cartilage surface area, osteophytes, cysts, and total score) was higher in Kellgren-Lawrence groups 2 and 3 than group 0 (P < 0.05). DATA CONCLUSION The 5-minute DESS sequence permits MOAKS assessment for a majority of tissues, along with repeatable and reproducible simultaneous cartilage and meniscus T2 relaxometry and morphometry measurements. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1328-1341.
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Affiliation(s)
- Akshay S Chaudhari
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Marianne S Black
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Susanne Eijgenraam
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Wolfgang Wirth
- Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Susanne Maschek
- Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Bragi Sveinsson
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University Salzburg and Nuremberg, Salzburg, Austria.,Chondrometrics GmbH, Ainring, Germany
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
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45
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Weidlich D, Schlaeger S, Kooijman H, Börnert P, Kirschke JS, Rummeny EJ, Haase A, Karampinos DC. T 2 mapping with magnetization-prepared 3D TSE based on a modified BIR-4 T 2 preparation. NMR IN BIOMEDICINE 2017; 30:e3773. [PMID: 28777496 DOI: 10.1002/nbm.3773] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 06/07/2023]
Abstract
The purpose of this work was to investigate the performance of the modified BIR-4 T2 preparation for T2 mapping and propose a method to remove T2 quantification errors in the presence of large B1 and B0 offsets. The theoretical investigation of the magnetization evolution during the T2 preparation in the presence of B1 and B0 offsets showed deviations from a mono-exponential T2 decay (two parameter fit). A three parameter fit was used to improve T2 accuracy. Furthermore, a two parameter fit with an additional saturation preparation scan was proposed to improve T2 accuracy and precision. These three fitting methods were compared based on simulations, phantom measurements and an in vivo healthy volunteer study of the neck musculature using a 3D TSE readout. The results based upon the pure two parameter fit overestimated T2 in regions with high B0 offsets (up to 40% in phantoms). The three parameter fit T2 values were robust to B0 offsets but with higher standard deviation (up to 40% in simulations). The two parameter fit with the saturation preparation yielded high robustness towards B0 offsets with a noise performance comparable to that of the two parameter fit. In the volunteer study the T2 values obtained by the pure two parameter fit showed a dependence on the field inhomogeneities, whereas the T2 values from the proposed fitting approach were shown to be insensitive to B0 offsets. The proposed method enabled accurate and precise T2 mapping in the presence of large B1 and B0 offsets.
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Affiliation(s)
- Dominik Weidlich
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Sarah Schlaeger
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
- Section for Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | | | | | - Jan S Kirschke
- Section for Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Ernst J Rummeny
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Axel Haase
- Institute of Medical Engineering, Technical University Munich, Garching, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
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46
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Peuna A, Hekkala J, Haapea M, Podlipská J, Guermazi A, Saarakkala S, Nieminen MT, Lammentausta E. Variable angle gray level co-occurrence matrix analysis of T2
relaxation time maps reveals degenerative changes of cartilage in knee osteoarthritis: Oulu knee osteoarthritis study. J Magn Reson Imaging 2017; 47:1316-1327. [DOI: 10.1002/jmri.25881] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/10/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Arttu Peuna
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Joonas Hekkala
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
| | - Marianne Haapea
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Jana Podlipská
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology; Boston University School of Medicine; Boston Massachusetts USA
| | - Simo Saarakkala
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Miika T. Nieminen
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Eveliina Lammentausta
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
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47
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Sharafi A, Chang G, Regatte RR. Biexponential T 2 relaxation estimation of human knee cartilage in vivo at 3T. J Magn Reson Imaging 2017; 47:809-819. [PMID: 28561955 DOI: 10.1002/jmri.25778] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/15/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate biexponential T2 relaxation mapping of human knee cartilage in vivo in clinically feasible scan times. MATERIALS AND METHODS T2 -weighted magnetic resonance (MR) images were acquired from eight healthy volunteers using a standard 3T clinical scanner. A 3D Turbo-Flash sequence was modified to enable T2 -weighted imaging with different echo times. Series of T2 -weighted images were fitted using mono- and biexponential models with two- and four-parametric nonlinear approaches, respectively. RESULTS Biexponential relaxation of T2 was detected in the knee cartilage in five regions of interest in all eight healthy volunteers. Short/long relaxation components of T2 were estimated to be 8.27 ± 0.68 / 45.35 ± 3.79 msec with corresponding fractions of 41.3 ± 1.1% / 58.6 ± 4.6%, respectively. The monoexponential relaxation of T2 was measured to be 26.9 ± 2.27 msec. The experiments showed good repeatability with coefficient of variation root mean square (CVrms ) < 18% in all regions. The only difference in gender was observed in medial tibial cartilage, where the biexponential T2 in female volunteers was significantly higher compared to male volunteers (P = 0.014). Significant differences were observed in T2 relaxation between different regions on interest. CONCLUSION Biexponential relaxation of T2 was observed in the human knee cartilage in vivo. The short and long components are thought to be related to the tightly bound and loosely bound macromolecular water compartments. These preliminary results of biexponential T2 analysis could potentially be used to increase the specificity for detection of early osteoarthritis by measuring different water compartments and their fractions. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:809-819.
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Affiliation(s)
- Azadeh Sharafi
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Gregory Chang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ravinder R Regatte
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York, USA
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48
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Cluster analysis of quantitative MRI T 2 and T 1ρ relaxation times of cartilage identifies differences between healthy and ACL-injured individuals at 3T. Osteoarthritis Cartilage 2017; 25:513-520. [PMID: 27720806 PMCID: PMC5359021 DOI: 10.1016/j.joca.2016.09.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/07/2016] [Accepted: 09/22/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To identify focal lesions of elevated MRI T2 and T1ρ relaxation times in articular cartilage of an ACL-injured group using a novel cluster analysis technique. MATERIALS AND METHODS Eighteen ACL-injured patients underwent 3T MRI T2 and T1ρ relaxometry at baseline, 6 months and 1 year and six healthy volunteers at baseline, 1 day and 1 year. Clusters of contiguous pixels above or below T2 and T1ρ intensity and area thresholds were identified on a projection map of the 3D femoral cartilage surface. The total area of femoral cartilage plate covered by clusters (%CA) was split into areas above (%CA+) and below (%CA-) the thresholds and the differences in %CA(+ or -) over time in the ACL-injured group were determined using the Wilcoxon signed rank test. RESULTS %CA+ was greater in the ACL-injured patients than the healthy volunteers at 6 months and 1 year with average %CA+ of 5.2 ± 4.0% (p = 0.0054) and 6.6 ± 3.7% (p = 0.0041) for T2 and 6.2 ± 7.1% (p = 0.063) and 8.2 ± 6.9% (p = 0.042) for T1ρ, respectively. %CA- at 6 months and 1 year was 3.0 ± 1.8% (p > 0.1) and 5.9 ± 5.0% (p > 0.1) for T2 and 4.4 ± 4.9% (p > 0.1) and 4.5 ± 4.6% (p > 0.1) for T1ρ, respectively. CONCLUSION With the proposed cluster analysis technique, we have quantified cartilage lesion coverage and demonstrated that the ACL-injured group had greater areas of elevated T2 and T1ρ relaxation times as compared to healthy volunteers.
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49
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Rehnitz C, Klaan B, Do T, Barié A, Kauczor HU, Weber MA. Feasibility of gadoteric acid for delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at the wrist and knee and comparison with Gd-DTPA. J Magn Reson Imaging 2017; 46:1433-1440. [DOI: 10.1002/jmri.25688] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/10/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Christoph Rehnitz
- Department of Diagnostic and Interventional Radiology; University Hospital Heidelberg; Germany
| | - Bastian Klaan
- Department of Diagnostic and Interventional Radiology; University Hospital Heidelberg; Germany
| | - Thuy Do
- Department of Diagnostic and Interventional Radiology; University Hospital Heidelberg; Germany
| | - Alexander Barié
- Department of Orthopedics and Trauma Surgery; University Hospital Heidelberg; Germany
| | - Hans-Ulrich Kauczor
- Department of Diagnostic and Interventional Radiology; University Hospital Heidelberg; Germany
| | - Marc-André Weber
- Department of Diagnostic and Interventional Radiology; University Hospital Heidelberg; Germany
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50
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Eagle S, Potter HG, Koff MF. Morphologic and quantitative magnetic resonance imaging of knee articular cartilage for the assessment of post-traumatic osteoarthritis. J Orthop Res 2017; 35:412-423. [PMID: 27325163 DOI: 10.1002/jor.23345] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Orthopedic trauma, such as anterior cruciate ligament (ACL) disruption, is a common source of osteoarthritis in the knee. Magnetic resonance imaging (MRI) is a non-invasive multi-planar imaging modality commonly used to evaluate hard and soft tissues of diarthrodial joints following traumatic injury. The contrast provided by generated images enables the evaluation of bone marrow lesions as well as delamination and degeneration of articular cartilage. We will provide background information about MRI signal generation and decay (T1 and T2 values), the utility of morphologic MRI, and the quantitative MRI techniques of T1ρ , T2 , and T2 * mapping, to evaluate subjects with traumatic knee injuries, such as ACL rupture. Additionally, we will provide information regarding the dGEMRIC, sodium, and gagCEST imaging techniques. Finally, the description and utility of newer post hoc analysis techniques, such as texture analysis, will be given. Continued development and refinement of these advanced MRI techniques will facilitate their clinical translation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:412-423, 2017.
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Affiliation(s)
- Sonja Eagle
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Hollis G Potter
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Matthew F Koff
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
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