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Villarreal CX, Shen X, Alhulail AA, Buffo NM, Zhou X, Pogue E, Özen AC, Chiew M, Sawiak S, Emir U, Chan DD. An accelerated PETALUTE MRI sequence for in vivo quantification of sodium content in human articular cartilage at 3T. Skeletal Radiol 2024:10.1007/s00256-024-04774-5. [PMID: 39153083 DOI: 10.1007/s00256-024-04774-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 08/09/2024] [Accepted: 08/11/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE In this work, we evaluate the sodium magnetic resonance imaging (MRI) capabilities of a three-dimensional (3D) dual-echo ultrashort echo time (UTE) sequence with a novel rosette petal trajectory (PETALUTE), in comparison to the 3D density-adapted (DA) radial spokes UTE sequence in human articular cartilage in the knee. MATERIALS AND METHODS We scanned five healthy subjects using a 3D dual-echo PETALUTE acquisition and two comparable implementations of 3D DA-radial spokes acquisitions, one matching the number of k-space projections (Radial - Matched Spokes) and the other matching the total number of samples (Radial - Matched Samples) acquired in k-space. RESULTS The PETALUTE acquisition enabled equivalent sodium quantification in articular cartilage volumes of interest (168.8 ± 29.9 mM, mean ± standard deviation) to those derived from the 3D radial acquisitions (171.62 ± 28.7 mM and 149.8 ± 22.2 mM, respectively). We achieved a 41% shorter scan time of 2:06 for 3D PETALUTE, compared to 3:36 for 3D radial acquisitions. We also evaluated the feasibility of further acceleration of the PETALUTE sequence through retrospective compressed sensing with 2 × and 4 × acceleration of the first echo and showed structural similarity of 0.89 ± 0.03 and 0.87 ± 0.03 when compared to non-retrospectively accelerated reconstruction. CONCLUSION We demonstrate improved scan time with equivalent performance using a 3D dual-echo PETALUTE sequence compared to the 3D DA-radial sequence for sodium MRI of articular cartilage.
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Affiliation(s)
- Cameron X Villarreal
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Xin Shen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, 94158, USA
| | - Ahmad A Alhulail
- Department of Radiology and Medical Imaging, Prince Sattam Bin Abdulaziz University, 16278, Al-Kharj, Saudi Arabia
| | - Nicholas M Buffo
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA
| | - Xiaopeng Zhou
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Evan Pogue
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Ali Caglar Özen
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Medical Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Mark Chiew
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Physical Sciences, Sunnybrook Research Institute, Toronto, Canada
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Stephen Sawiak
- Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, UK
| | - Uzay Emir
- College of Health and Human Sciences, Purdue University, West Lafayette, IN, 47907, USA
- Department of Radiology, School of Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Deva D Chan
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
- School of Mechanical Engineering, Purdue University, West Lafayette, IN, 47907, USA.
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Villarreal CX, Shen X, Alhulail AA, Buffo NM, Zhou X, Ozen AC, Chiew M, Sawiak S, Emir U, Chan DD. An Accelerated PETALUTE MRI Sequence for In Vivo Quantification of Sodium Content in Human Articular Cartilage at 3T. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.02.24305807. [PMID: 38746343 PMCID: PMC11092686 DOI: 10.1101/2024.05.02.24305807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
In this work, we demonstrate the sodium magnetic resonance imaging (MRI) capabilities of a three-dimensional (3D) dual-echo ultrashort echo time (UTE) sequence with a novel rosette petal trajectory (PETALUTE), in comparison to the 3D density-adapted (DA) radial spokes UTE sequence. We scanned five healthy subjects using a 3D dual-echo PETALUTE acquisition and two comparable implementations of 3D DA-radial spokes acquisitions, one matching the number of k-space projections (Radial-Matched Trajectories) and the other matching the total number of samples (Radial-Matched Samples) acquired in k-space. The PETALUTE acquisition enabled equivalent sodium quantification in articular cartilage volumes of interest (168.8 ± 29.9 mM) to those derived from the 3D radial acquisitions (171.62 ± 28.7 mM and 149.8 ± 22.2 mM, respectively). We achieved a shorter scan time of 2:06 for 3D PETALUTE, compared to 3:36 for 3D radial acquisitions. We also evaluated the feasibility of further acceleration of the PETALUTE sequence through retrospective compressed sensing with 2× and 4× acceleration of the first echo and showed structural similarity of 0.89 ± 0.03 and 0.87 ± 0.03 when compared to non-retrospectively accelerated reconstruction. Together, these results demonstrate improved scan time with equivalent performance of the PETALUTE sequence compared to the 3D DA-radial sequence for sodium MRI of articular cartilage.
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Reichert S, Schepkin V, Kleimaier D, Zöllner FG, Schad LR. Comparison of triple quantum (TQ) TPPI and inversion recovery TQ TPPI pulse sequences at 9.4 and 21.1 T. NMR IN BIOMEDICINE 2024; 37:e5106. [PMID: 38263738 DOI: 10.1002/nbm.5106] [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: 10/24/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 01/25/2024]
Abstract
PURPOSE Both sodium T1 triple quantum (TQ) signal and T1 relaxation pathways have a unique sensitivity to the sodium molecular environment. In this study an inversion recovery time proportional phase increment (IRTQTPPI) pulse sequence was investigated for simultaneous and reliable quantification of sodium TQ signal and bi-exponential T1 relaxation times. METHODS The IRTQTPPI sequence combines inversion recovery TQ filtering and time proportional phase increment. The reliable and reproducible results were achieved by the pulse sequence optimized in three ways: (1) optimization of the nonlinear fit for the determination of both T1-TQ signal and T1 relaxation times; (2) suppression of unwanted signals by assessment of four different phase cycles; (3) nonlinear sampling during evolution time for optimal scan time without any compromises in fit accuracy. The relaxation times T1 and T2 and the TQ signals from IRTQTPPI and TQTPPI were compared between 9.4 and 21.1 T. The motional environment of the sodium nuclei was evaluated by calculation of correlation times and nuclear quadrupole interaction strengths. RESULTS Reliable measurements of the T1-TQ signals and T1 bi-exponential relaxation times were demonstrated. The fit parameters for all four phase cycles were in good agreement with one another, with a negligible influence of unwanted signals. The agar samples yielded normalized T1-TQ signals from 3% to 16% relative to single quantum (SQ) signals at magnetic fields of both 9.4 and 21.1 T. In comparison, the normalized T2-TQ signal was in the range 15%-35%. The TQ/SQ signal ratio was decreased at 21.1 T as compared with 9.4 T for both T1 and T2 relaxation pathways. The bi-exponential T1 relaxation time separation ranged from 15 to 18 ms at 9.4 T and 15 to 21 ms at 21.1 T. The T2 relaxation time separation was larger, ranging from 28 to 35 ms at 9.4 T and 37 to 40 ms at 21.1 T. CONCLUSION The IRTQTPPI sequence, while providing a less intensive TQ signal than TQTPPI, allows a simultaneous and reliable quantification of both the T1-TQ signal and T1 relaxation times. The unique sensitivities of the T1 and T2 relaxation pathways to different types of molecular motion provide a deeper understanding of the sodium MR environment.
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Affiliation(s)
- Simon Reichert
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Cooperative Core Facility Animal Scanner ZI, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Victor Schepkin
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida, USA
| | - Dennis Kleimaier
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Frank G Zöllner
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Cooperative Core Facility Animal Scanner ZI, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lothar R Schad
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Giovannetti G, Flori A, Martini N, Cademartiri F, Aquaro GD, Pingitore A, Frijia F. Hardware and Software Setup for Quantitative 23Na Magnetic Resonance Imaging at 3T: A Phantom Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:2716. [PMID: 38732822 PMCID: PMC11085578 DOI: 10.3390/s24092716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024]
Abstract
Magnetic resonance (MR) with sodium (23Na) is a noninvasive tool providing quantitative biochemical information regarding physiology, cellular metabolism, and viability, with the potential to extend MR beyond anatomical proton imaging. However, when using clinical scanners, the low detectable 23Na signal and the low 23Na gyromagnetic ratio require the design of dedicated radiofrequency (RF) coils tuned to the 23Na Larmor frequency and sequences, as well as the development of dedicated phantoms for testing the image quality, and an MR scanner with multinuclear spectroscopy (MNS) capabilities. In this work, we propose a hardware and software setup for evaluating the potential of 23Na magnetic resonance imaging (MRI) with a clinical scanner. In particular, the reliability of the proposed setup and the reproducibility of the measurements were verified by multiple acquisitions from a 3T MR scanner using a homebuilt RF volume coil and a dedicated sequence for the imaging of a phantom specifically designed for evaluating the accuracy of the technique. The final goal of this study is to propose a setup for standardizing clinical and research 23Na MRI protocols.
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Affiliation(s)
- Giulio Giovannetti
- Institute of Clinical Physiology, National Council of Research, Via G. Moruzzi 1, 56124 Pisa, Italy; (G.G.); (A.P.)
| | - Alessandra Flori
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.F.)
| | - Nicola Martini
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.F.)
| | - Filippo Cademartiri
- Department of Radiology, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy;
| | - Giovanni Donato Aquaro
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, 56126 Pisa, Italy;
| | - Alessandro Pingitore
- Institute of Clinical Physiology, National Council of Research, Via G. Moruzzi 1, 56124 Pisa, Italy; (G.G.); (A.P.)
| | - Francesca Frijia
- Bioengineering Unit, Fondazione G. Monasterio CNR-Regione Toscana, 56124 Pisa, Italy; (A.F.)
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Gast LV, Platt T, Nagel AM, Gerhalter T. Recent technical developments and clinical research applications of sodium ( 23Na) MRI. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2023; 138-139:1-51. [PMID: 38065665 DOI: 10.1016/j.pnmrs.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 12/18/2023]
Abstract
Sodium is an essential ion that plays a central role in many physiological processes including the transmembrane electrochemical gradient and the maintenance of the body's homeostasis. Due to the crucial role of sodium in the human body, the sodium nucleus is a promising candidate for non-invasively assessing (patho-)physiological changes. Almost 10 years ago, Madelin et al. provided a comprehensive review of methods and applications of sodium (23Na) MRI (Madelin et al., 2014) [1]. More recent review articles have focused mainly on specific applications of 23Na MRI. For example, several articles covered 23Na MRI applications for diseases such as osteoarthritis (Zbyn et al., 2016, Zaric et al., 2020) [2,3], multiple sclerosis (Petracca et al., 2016, Huhn et al., 2019) [4,5] and brain tumors (Schepkin, 2016) [6], or for imaging certain organs such as the kidneys (Zollner et al., 2016) [7], the brain (Shah et al., 2016, Thulborn et al., 2018) [8,9], and the heart (Bottomley, 2016) [10]. Other articles have reviewed technical developments such as radiofrequency (RF) coils for 23Na MRI (Wiggins et al., 2016, Bangerter et al., 2016) [11,12], pulse sequences (Konstandin et al., 2014) [13], image reconstruction methods (Chen et al., 2021) [14], and interleaved/simultaneous imaging techniques (Lopez Kolkovsky et al., 2022) [15]. In addition, 23Na MRI topics have been covered in review articles with broader topics such as multinuclear MRI or ultra-high-field MRI (Niesporek et al., 2019, Hu et al., 2019, Ladd et al., 2018) [16-18]. During the past decade, various research groups have continued working on technical improvements to sodium MRI and have investigated its potential to serve as a diagnostic and prognostic tool. Clinical research applications of 23Na MRI have covered a broad spectrum of diseases, mainly focusing on the brain, cartilage, and skeletal muscle (see Fig. 1). In this article, we aim to provide a comprehensive summary of methodological and hardware developments, as well as a review of various clinical research applications of sodium (23Na) MRI in the last decade (i.e., published from the beginning of 2013 to the end of 2022).
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Affiliation(s)
- Lena V Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Tanja Platt
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Nischal N, Iyengar KP, Herlekar D, Botchu R. Imaging of Cartilage and Chondral Defects: An Overview. Life (Basel) 2023; 13:life13020363. [PMID: 36836719 PMCID: PMC9960762 DOI: 10.3390/life13020363] [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: 12/24/2022] [Revised: 01/15/2023] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
A healthy articular cartilage is paramount to joint function. Cartilage defects, whether acute or chronic, are a significant source of morbidity. This review summarizes various imaging modalities used for cartilage assessment. While radiographs are insensitive, they are still widely used to indirectly assess cartilage. Ultrasound has shown promise in the detection of cartilage defects, but its efficacy is limited in many joints due to inadequate visualization. CT arthrography has the potential to assess internal derangements of joints along with cartilage, especially in patients with contraindications to MRI. MRI remains the favored imaging modality to assess cartilage. The conventional imaging techniques are able to assess cartilage abnormalities when cartilage is already damaged. The newer imaging techniques are thus targeted at detecting biochemical and structural changes in cartilage before an actual visible irreversible loss. These include, but are not limited to, T2 and T2* mapping, dGEMRI, T1ρ imaging, gagCEST imaging, sodium MRI and integrated PET with MRI. A brief discussion of the advances in the surgical management of cartilage defects and post-operative imaging assessment is also included.
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Affiliation(s)
- Neha Nischal
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham B31 2AP, UK
- Department of Radiology, Holy Family Hospital, New Delhi 110025, India
| | | | - Deepak Herlekar
- Department of Orthopaedics, University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal LA9 7RG, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham B31 2AP, UK
- Correspondence:
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Banjar M, Horiuchi S, Gedeon DN, Yoshioka H. Review of Quantitative Knee Articular Cartilage MR Imaging. Magn Reson Med Sci 2021; 21:29-40. [PMID: 34471014 PMCID: PMC9199985 DOI: 10.2463/mrms.rev.2021-0052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Osteoarthritis (OA) is one of the most prevalent disorders in today’s society, resulting in significant socio-economic costs and morbidity. MRI is widely used as a non-invasive imaging tool for OA of the knee. However, conventional knee MRI has limitations to detect subtle early cartilage degeneration before morphological changes are visually apparent. Novel MRI pulse sequences for cartilage assessment have recently received increased attention due to newly developed compositional MRI techniques, including: T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), sodium MRI, diffusion-weighted imaging (DWI)/ diffusion tensor imaging (DTI), ultrashort TE (uTE), and glycosaminoglycan specific chemical exchange saturation transfer (gagCEST) imaging. In this article, we will first review these quantitative assessments. Then, we will discuss the variations of quantitative values of knee articular cartilage with cartilage layer (depth)- and angle (regional)-dependent approaches. Multiple MRI sequence techniques can discern qualitative differences in knee cartilage. Normal articular hyaline cartilage has a zonal variation in T2 relaxation times with increasing T2 values from the subchondral bone to the articular surface. T1rho values were also higher in the superficial layer than in the deep layer in most locations in the medial and lateral femoral condyles, including the weight-bearing portion. Magic angle effect on T2 mapping is clearly observed in the both medial and lateral femoral condyles, especially within the deep layers. One of the limitations for clinical use of these compositional assessments is a long scan time. Recent new approaches with compressed sensing (CS) and MR fingerprinting (MRF) have potential to provide accurate and fast quantitative cartilage assessments.
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Affiliation(s)
- Mai Banjar
- Medical Imaging Department, King Abdullah Medical Complex Jeddah
| | - Saya Horiuchi
- Department of Radiology, St Luke's International Hospital
| | - David N Gedeon
- Department of Radiological Sciences, University of California, Irvine
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine
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Assessment of Low-Grade Focal Cartilage Lesions in the Knee With Sodium MRI at 7 T: Reproducibility and Short-Term, 6-Month Follow-up Data. Invest Radiol 2021; 55:430-437. [PMID: 32011573 DOI: 10.1097/rli.0000000000000652] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Several articles have investigated potential of sodium (Na) magnetic resonance imaging (MRI) for the in vivo evaluation of cartilage health, but so far no study tested its feasibility for the evaluation of focal cartilage lesions of grade 1 or 2 as defined by the International Cartilage Repair Society. The aims of this study were to evaluate the ability of Na-MRI to differentiate between early focal lesions and normal-appearing cartilage, to evaluate within-subject reproducibility of Na-MRI, and to monitor longitudinal changes in participants with low-grade, focal chondral lesions. MATERIALS AND METHODS Thirteen participants (mean age, 50.1 ± 10.9 years; 7 women, 6 men) with low-grade, focal cartilage lesions in the weight-bearing region of femoral cartilage were included in this prospective cohort study. Participants were assessed at baseline, 1 week, 3 months, and 6 months using morphological MRI at 3 T and 7 T, compositional Na-MRI at 7 T, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Na signal intensities corrected for coil sensitivity and partial volume effect (Na-cSI) were calculated in the lesion, and in weight-bearing and non-weight-bearing regions of healthy femoral cartilage. Coefficients of variation, repeated measures analysis of covariance models, and Pearson correlation coefficients were calculated to evaluate within-subject reproducibility as well as cross-sectional and longitudinal changes in Na-cSI values. RESULTS The mean coefficients of variation of Na-cSI values between the baseline and 1-week follow-up were 5.1% or less in all cartilage regions. Significantly lower Na-cSI values were observed in lesion than in weight-bearing and non-weight-bearing regions at all time points (all P values ≤ 0.002). Although a significant decrease from baseline Na-cSI values in lesion was found at 3-month visit (P = 0.015), no substantial change was observed at 6 months. KOOS scores have improved in all subscales at 3 months and 6 months visit, with a significant increase observed only in the quality of life subscale (P = 0.004). CONCLUSIONS In vivo Na-MRI is a robust and reproducible method that allows to differentiate between low-grade, focal cartilage lesions and normal-appearing articular cartilage, which supports the concept that compositional cartilage changes can be found early, before the development of advanced morphological changes visible at clinical 3-T MRI.
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Müller-Lutz A, Kamp B, Nagel AM, Ljimani A, Abrar D, Schleich C, Wollschläger L, Nebelung S, Wittsack HJ. Sodium MRI of human articular cartilage of the wrist: a feasibility study on a clinical 3T MRI scanner. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:241-248. [PMID: 32500389 DOI: 10.1007/s10334-020-00856-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To measure sodium relaxation times and concentrations in human wrists on a clinical magnetic resonance imaging (MRI) scanner with a density-adapted radial sequence. MATERIALS AND METHODS Sodium MRI of human wrists was conducted on a 3T MR system using a dual-tuned 1H/23Na surface coil. We performed two studies with 10 volunteers each investigating either sodium T1 (study 1) or sodium T2* (study 2) relaxation times in the radiocarpal joint (RCJ) and midcarpal joint (MCJ). Sodium concentrations of both regions were determined. RESULTS No differences for transversal of longitudinal relaxation times were found between RCJ and MCJ (T2,s*(RCJ) = (0.9 ± 0.4) ms; T2,s*(MCJ) = (0.9 ± 0.3) ms; T2,l*(RCJ) = (14.9 ± 0.9) ms; T2,l*(MCJ) = (13.9 ± 1.1) ms; T1(RCJ) = (19.0 ± 2.4) ms; T1(MCJ) = (18.5 ± 2.1) ms). Sodium concentrations were (157.7 ± 28.4) mmol/l for study 1 and (159.8 ± 29.1) mmol/l for study 2 in the RCJ, and (172.7 ± 35.6) mmol/l for study 1 and (163.4 ± 26.3) mmol/l for study 2 in the MCJ. CONCLUSION We successfully determined sodium relaxation times and concentrations of the human wrist on a 3T MRI scanner.
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Affiliation(s)
- Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Division of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Alexandra Ljimani
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Daniel Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Lena Wollschläger
- Department of Orthopedics and Trauma Surgery, Medical Faculty, University Hospital Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
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Gerhalter T, Gast LV, Marty B, Uder M, Carlier PG, Nagel AM. Assessing the variability of 23 Na MRI in skeletal muscle tissue: Reproducibility and repeatability of tissue sodium concentration measurements in the lower leg at 3 T. NMR IN BIOMEDICINE 2020; 33:e4279. [PMID: 32125054 DOI: 10.1002/nbm.4279] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/10/2019] [Accepted: 01/27/2020] [Indexed: 06/10/2023]
Abstract
The goal of this study was to evaluate the reproducibility and repeatability of tissue sodium concentration (TSC) measurements using 23 Na MRI in skeletal muscle tissue. 23 Na MRI was performed at 3 T on the right lower leg of eight healthy volunteers (aged 28 ± 4 years). The examinations were repeated at the same site after ~ 22 weeks to assess the variability over a medium-term period. Additionally, they were scanned at a second site shortly before or shortly after the first visit (within 3 weeks) to evaluate the inter-site reproducibility. Moreover, we analysed the effect of B0 correction on the variability. Coefficients of variations (CVs) from mean TSC values as well as Bland-Altman plots were used to assess intra-site repeatability and inter-site reproducibility. In phantom measurements, the B0 correction improved the quantitative accuracy. We observed differences of up to 4.9 mmol/L between the first and second visit and a difference of up to 3.7 mmol/L between the two different sites. The CV for the medium-term repeatability was 15% and the reproducibility CV was 9%. The Bland-Altman plots indicated high agreement between the visits in all muscle regions. The systematic bias of -0.68 mmol/L between site X and Y (P = 0.03) was slightly reduced to -0.64 mmol/L after B0 correction (P = 0.04). This work shows that TSC measurements in healthy skeletal muscle tissue can be performed with good repeatability and reproducibility, which is of importance for future longitudinal or multicentre studies.
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Affiliation(s)
- Teresa Gerhalter
- Institute of Radiology, University Hospital Erlangen, FAU, Erlangen, Germany
- NMR laboratory, Institute of Myology, Paris, France
- NMR laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Lena V Gast
- Institute of Radiology, University Hospital Erlangen, FAU, Erlangen, Germany
| | - Benjamin Marty
- NMR laboratory, Institute of Myology, Paris, France
- NMR laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Michael Uder
- Institute of Radiology, University Hospital Erlangen, FAU, Erlangen, Germany
| | - Pierre G Carlier
- NMR laboratory, Institute of Myology, Paris, France
- NMR laboratory, CEA/DRF/IBFJ/MIRCen, Paris, France
| | - Armin M Nagel
- Institute of Radiology, University Hospital Erlangen, FAU, Erlangen, Germany
- Division of Medical Physics in Radiology,, DKFZ, Heidelberg, Germany
- Institute of Medical Physics FAU, Erlangen, Germany
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Riemer F, McHugh D, Zaccagna F, Lewis D, McLean MA, Graves MJ, Gilbert FJ, Parker GJ, Gallagher FA. Measuring tissue sodium concentration: Cross-vendor repeatability and reproducibility of 23 Na-MRI across two sites. J Magn Reson Imaging 2019; 50:1278-1284. [PMID: 30859655 PMCID: PMC6767101 DOI: 10.1002/jmri.26705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Sodium MRI (23 Na-MRI)-derived biomarkers such as total sodium concentration (TSC) have the potential to provide information on tumor cellularity and the changes in tumor microstructure that occur following therapy. PURPOSE To evaluate the repeatability and reproducibility of TSC measurements in the brains of healthy volunteers, providing evidence for the technical validation of 23 Na-MRI-derived biomarkers. STUDY TYPE Prospective multicenter study. SUBJECTS Eleven volunteers (32 ± 6 years; eight males, three females) were scanned twice at each of two sites. FIELD STRENGTH/SEQUENCE Comparable 3D-cones 23 Na-MRI ultrashort echo time acquisitions at 3T. ASSESSMENT TSC values, quantified from calibration phantoms placed in the field of view, were obtained from white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF), based on automated segmentation of coregistered 1 H T1 -weighted images and hand-drawn regions of interest by two readers. STATISTICAL TESTS Coefficients of variation (CoVs) from mean TSC values were used to assess intrasite repeatability and intersite reproducibility. RESULTS Mean GM TSC concentrations (52.1 ± 7.1 mM) were ∼20% higher than for WM (41.8 ± 6.7 mM). Measurements were highly repeatable at both sites with mean scan-rescan CoVs between volunteers and regions of 2% and 4%, respectively. Mean intersite reproducibility CoVs were 3%, 3%, and 6% for WM, GM, and CSF, respectively. DATA CONCLUSION These results demonstrate technical validation of sodium MRI-derived biomarkers in healthy volunteers. We also show that comparable 23 Na imaging of the brain can be implemented across different sites and scanners with excellent repeatability and reproducibility. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1278-1284.
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Affiliation(s)
- Frank Riemer
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Damien McHugh
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
- Division of Neuroscience & Experimental PsychologyThe University of ManchesterManchesterUK
| | - Fulvio Zaccagna
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Daniel Lewis
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Mary A. McLean
- Cancer Research UK Cambridge InstituteUniversity of CambridgeCambridgeUK
| | | | - Fiona J. Gilbert
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
| | - Geoff J.M. Parker
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
- Division of Neuroscience & Experimental PsychologyThe University of ManchesterManchesterUK
- Bioxydyn Ltd.ManchesterUK
| | - Ferdia A. Gallagher
- Department of RadiologyUniversity of CambridgeCambridgeUK
- CRUK & EPSRC Cancer Imaging Centre in Cambridge & ManchesterUK
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12
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Martín Noguerol T, Raya JG, Wessell DE, Vilanova JC, Rossi I, Luna A. Functional MRI for evaluation of hyaline cartilage extracelullar matrix, a physiopathological-based approach. Br J Radiol 2019; 92:20190443. [PMID: 31433668 DOI: 10.1259/bjr.20190443] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
MRI of articular cartilage (AC) integrity has potential to become a biomarker for osteoarthritis progression. Traditional MRI sequences evaluate AC morphology, allowing for the measurement of thickness and its change over time. In the last two decades, more advanced, dedicated MRI cartilage sequences have been developed aiming to assess AC matrix composition non-invasively and detect early changes in cartilage not captured on morphological sequences. T2-mapping and T1ρ sequences can be used to estimate the relaxation times of water inside the AC. These sequences have been introduced into clinical protocols and show promising results for cartilage assessment. Extracelullar matrix can also be assessed using diffusion-weighted imaging and diffusion tensor imaging as the movement of water is limited by the presence of extracellular matrix in AC. Specific techniques for glycosaminoglycans (GAG) evaluation, such as delayed gadolinium enhanced MRI of cartilage or Chemical Exchange Saturation Transfer imaging of GAG, as well as sodium imaging have also shown utility in the detection of AC damage. This manuscript provides an educational update on the physical principles behind advanced AC MRI techniques as well as a comprehensive review of the strengths and weaknesses of each approach. Current clinical applications and potential future applications of these techniques are also discussed.
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Affiliation(s)
| | - Jose G Raya
- Department of Radiology, NYU School of Medicine, NY, USA
| | | | - Joan C Vilanova
- Department of Radiology, Clínica Girona. Institute Diagnostic Imaging (IDI), University of Girona, Girona, Spain
| | | | - Antonio Luna
- MRI unit, Radiology department, Health Time, Jaén, Spain
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13
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Trattnig S, Raudner M, Schreiner M, Roemer F, Bohndorf K. [Biochemical cartilage imaging-update 2019]. Radiologe 2019; 59:742-749. [PMID: 31187160 DOI: 10.1007/s00117-019-0558-x] [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] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cartilage imaging using magnetic resonance imaging (MRI) is increasingly used for early detection of cartilage damage. Biochemical MR methods to assess cartilage damage are essential for optimal treatment planning. PURPOSE The aim of this review is to provide an update on advanced cartilage imaging based on biochemical MR techniques. The clinical applications and additional benefits compared to conventional MRI are presented. MATERIALS AND METHODS A literature search of PubMed regarding the clinical applications of various biochemical MR methods and morphological MR imaging was performed. RESULTS While T2 mapping can be easily implemented on clinical routine MR scanners, the T1rho method is technically more demanding and is not available on all MR scanners. dGEMRIC, which can be performed with all field strengths, is now severely restricted due to the recent decision of the European Medical Agency (EMA) to withdraw linear gadolinium contrast agents from the market because of proven gadolinium deposition in the brain. Sodium imaging is the most sensitive MRI method for glycosaminoglycan (GAG), but is limited to 7 T. In addition to early diagnosis of cartilage degeneration before morphological changes are visible, biochemical MRI offers predictive markers, e.g., effect of lifestyle changes or assessing results of cartilage repair surgery. CONCLUSION Cartilage imaging based on biochemical MRI allows a shift from qualitative to quantitative MRI. Biochemical MRI plays an increasingly important role in the early diagnosis of cartilage degeneration for monitoring of disease-modifying drugs and as predictive imaging biomarker in clinical diagnostics. In cartilage repair, monitoring of the efficacy of different cartilage repair surgery techniques to develop hyaline-like cartilage can be performed with biochemical MRI.
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Affiliation(s)
- S Trattnig
- Exzellenzzentrum für Hochfeld MR, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Lazarettgasse 14, 1090, Wien, Österreich.
| | - M Raudner
- Exzellenzzentrum für Hochfeld MR, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Lazarettgasse 14, 1090, Wien, Österreich
| | - M Schreiner
- Universitätsklinik für Orthopädie und Unfallchirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - F Roemer
- Radiologisches Institut, Universitätsklinikum Erlangen, Maximiliansplatz 3, 91054, Erlangen, Deutschland
| | - K Bohndorf
- Exzellenzzentrum für Hochfeld MR, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Lazarettgasse 14, 1090, Wien, Österreich
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14
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Duarte A, Ruiz A, Ferizi U, Bencardino J, Abramson SB, Samuels J, Krasnokutsky-Samuels S, Raya JG. Diffusion tensor imaging of articular cartilage using a navigated radial imaging spin-echo diffusion (RAISED) sequence. Eur Radiol 2018; 29:2598-2607. [PMID: 30382348 DOI: 10.1007/s00330-018-5780-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/27/2018] [Accepted: 09/19/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To validate a radial imaging spin-echo diffusion tensor (RAISED) sequence for high-resolution diffusion tensor imaging (DTI) of articular cartilage at 3 T. METHODS The RAISED sequence implementation is described, including the used non-linear motion correction algorithm. The robustness to eddy currents was tested on phantoms, and accuracy of measurement was assessed with measurements of temperature-dependent diffusion of free water. Motion correction was validated by comparing RAISED with single-shot diffusion-weighted echo-planar imaging (EPI) measures. DTI was acquired in asymptomatic subjects (n = 6) and subjects with doubtful (Kellgren-Lawrence [KL] grade 1, n = 9) and mild (KL = 2, n = 9) symptomatic knee osteoarthritis (OA). MD and FA values without correction, and after all corrections, were calculated. A test-retest evaluation of the DTI acquisition on three asymptomatic and three OA subjects was also performed. RESULTS The root mean squared coefficient of variation of the global test-restest reproducibility was 3.54% for MD and 5.34% for FA. MD was significantly increased in both femoral condyles (7-9%) of KL 1 and in the medial (11-17%) and lateral (10-12%) compartments of KL 2 subjects. Averaged FA presented a trend of lower values with increasing KL grade, which was significant for the medial femoral condyle (-11%) of KL 1 and all three compartments in KL 2 subjects (-18 to -11%). Group differences in MD and FA were only significant after motion correction. CONCLUSION The RAISED sequence with the proposed reconstruction framework provides reproducible assessment of DTI parameters in vivo at 3 T and potentially the early stages of the disease in large regions of interest. KEY POINTS • DTI of articular cartilage is feasible at 3T with a multi-shot RAISED sequence with non-linear motion correction. • RAISED sequence allows estimation of the diffusion indices MD and FA with test-retest errors below 4% (MD) and 6% (FA). • RAISED-based measurement of DTI of articular cartilage with non-linear motion correction holds potential to differentiate healthy from OA subjects.
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Affiliation(s)
- Alejandra Duarte
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Amparo Ruiz
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Uran Ferizi
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Jenny Bencardino
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Steven B Abramson
- Division of Rheumatology, Department of Medicine, New York University Langone Health, New York, NY, USA
| | - Jonathan Samuels
- Division of Rheumatology, Department of Medicine, New York University Langone Health, New York, NY, USA
| | | | - José G Raya
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA.
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Blunck Y, Moffat BA, Kolbe SC, Ordidge RJ, Cleary JO, Johnston LA. Zero-gradient-excitation ramped hybrid encoding (zG RF -RHE) sodium MRI. Magn Reson Med 2018; 81:1172-1180. [PMID: 30252156 DOI: 10.1002/mrm.27484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/28/2018] [Accepted: 07/14/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE Fast bi-exponential transverse signal decay compounds sodium image quality. This work aims at enhancing image characteristics using a special case of ramped hybrid encoding (RHE). Zero-gradient-excitation (zGRF )-RHE provides (1) gradient-free excitation for high flip angle, artifact-free excitation profiles and (2) gradient ramping during dead-time for the optimization of encoding time (tenc ) to reduce T2 * signal decay influence during acquisition. METHODS Radial zGRF -RHE and standard radial UTE were investigated over a range of receiver bandwidths in simulations, phantom and in vivo brain experiments. Central k-space in zGRF -RHE was acquired through single point measurements at the minimum achievable TE. T2 * blurring artifacts and image SNR and CNR were assessed. RESULTS zGRF -RHE enabled 90° flip angle artifact-free excitation, whereas gradient pre-ramping provided greater tenc efficiency for any readout bandwidths. Experiments confirmed simulation results, revealing sharper edge characteristics particularly at short readout durations (TRO ). Significant SNR improvements of up to 4.8% were observed for longer TRO . CONCLUSION zGRF -RHE allows for artifact-free high flip angle excitation with time-efficient encoding improving on image characteristics. This hybrid encoding concept with gradient pre-ramping is trajectory independent and can be introduced in any center-out UTE trajectory design.
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Affiliation(s)
- Yasmin Blunck
- Department of Biomedical Engineering, University of Melbourne, Parkville, Australia
| | - Bradford A Moffat
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia
| | - Scott C Kolbe
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia
| | - Roger J Ordidge
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia
| | - Jon O Cleary
- Department of Medicine and Radiology, University of Melbourne, Parkville, Australia.,Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom
| | - Leigh A Johnston
- Department of Biomedical Engineering, University of Melbourne, Parkville, Australia
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16
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MacKay JW, Low SBL, Smith TO, Toms AP, McCaskie AW, Gilbert FJ. Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis. Osteoarthritis Cartilage 2018; 26:1140-1152. [PMID: 29550400 DOI: 10.1016/j.joca.2017.11.018] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/16/2017] [Accepted: 11/14/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess reliability and discriminative validity of cartilage compositional magnetic resonance imaging (MRI) in knee osteoarthritis (OA). DESIGN The study was carried out per PRISMA recommendations. We searched MEDLINE and EMBASE (1974 - present) for eligible studies. We performed qualitative synthesis of reliability data. Where data from at least two discrimination studies were available, we estimated pooled standardized mean difference (SMD) between subjects with and without OA. Discrimination analyses compared controls and subjects with mild OA (Kellgren-Lawrence (KL) grade 1-2), severe OA (KL grade 3-4) and OA not otherwise specified (NOS) where not possible to stratify. We assessed quality of the evidence using Quality Appraisal of Diagnostic Reliability (QAREL) and Quality Assessment of Diagnostic Accuracy (QUADAS-2) tools. RESULTS Fifty-eight studies were included in the reliability analysis and 26 studies were included in the discrimination analysis, with data from a total of 2,007 knees. Intra-observer, inter-observer and test-retest reliability of compositional techniques were excellent with most intraclass correlation coefficients >0.8 and coefficients of variation <10%. T1rho and T2 relaxometry were significant discriminators between subjects with mild OA and controls, and between subjects with OA (NOS) and controls (P < 0.001). T1rho showed best discrimination for mild OA (SMD [95% CI] = 0.73 [0.40 to 1.06], P < 0.001) and OA (NOS) (0.60 [0.41 to 0.80], P < 0.001). Quality of evidence was moderate for both parts of the review. CONCLUSIONS Cartilage compositional MRI techniques are reliable and, in the case of T1rho and T2 relaxometry, can discriminate between subjects with OA and controls.
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Affiliation(s)
- J W MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK.
| | - S B L Low
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK.
| | - T O Smith
- School of Health Sciences, University of East Anglia, Norwich, UK.
| | - A P Toms
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK.
| | - A W McCaskie
- Division of Trauma & Orthopaedics, Department of Surgery, University of Cambridge, Cambridge UK.
| | - F J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, UK.
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17
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Nelson BB, Kawcak CE, Barrett MF, McIlwraith CW, Grinstaff MW, Goodrich LR. Recent advances in articular cartilage evaluation using computed tomography and magnetic resonance imaging. Equine Vet J 2018; 50:564-579. [DOI: 10.1111/evj.12808] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/09/2018] [Indexed: 12/18/2022]
Affiliation(s)
- B. B. Nelson
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - C. E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. F. Barrett
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
- Department of Environmental and Radiological Health Sciences Colorado State University Fort Collins Colorado USA
| | - C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. W. Grinstaff
- Departments of Biomedical Engineering, Chemistry and Medicine Boston University Boston Massachusetts USA
| | - L. R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
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18
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Blunck Y, Josan S, Taqdees SW, Moffat BA, Ordidge RJ, Cleary JO, Johnston LA. 3D‐multi‐echo radial imaging of
23
Na (3D‐MERINA) for time‐efficient multi‐parameter tissue compartment mapping. Magn Reson Med 2017; 79:1950-1961. [DOI: 10.1002/mrm.26848] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/30/2017] [Accepted: 07/03/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Yasmin Blunck
- Biomedical Engineering, University of Melbourne, Parkville, Australia.,Melbourne Brain Centre Imaging Unit, Anatomy and Neuroscience, University of Melbourne, Parkville, Australia
| | | | - Syeda Warda Taqdees
- Biomedical Engineering, University of Melbourne, Parkville, Australia.,Melbourne Brain Centre Imaging Unit, Anatomy and Neuroscience, University of Melbourne, Parkville, Australia
| | - Bradford A Moffat
- Melbourne Brain Centre Imaging Unit, Anatomy and Neuroscience, University of Melbourne, Parkville, Australia
| | - Roger J Ordidge
- Melbourne Brain Centre Imaging Unit, Anatomy and Neuroscience, University of Melbourne, Parkville, Australia
| | - Jon O Cleary
- Melbourne Brain Centre Imaging Unit, Anatomy and Neuroscience, University of Melbourne, Parkville, Australia
| | - Leigh A Johnston
- Biomedical Engineering, University of Melbourne, Parkville, Australia.,Melbourne Brain Centre Imaging Unit, Anatomy and Neuroscience, University of Melbourne, Parkville, Australia
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19
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Madelin G, Xia D, Brown R, Babb J, Chang G, Krasnokutsky S, Regatte RR. Longitudinal study of sodium MRI of articular cartilage in patients with knee osteoarthritis: initial experience with 16-month follow-up. Eur Radiol 2017; 28:133-142. [PMID: 28687914 DOI: 10.1007/s00330-017-4956-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate the potential of sodium MRI to detect changes over time of apparent sodium concentration (ASC) in articular cartilage in patients with knee osteoarthritis (OA). METHODS The cartilage of 12 patients with knee OA were scanned twice over a period of approximately 16 months with two sodium MRI sequences at 7 T: without fluid suppression (radial 3D) and with fluid suppression by adiabatic inversion recovery (IR). Changes between baseline and follow-up of mean and standard deviation of ASC (in mM), and their rate of change (in mM/day), were measured in the patellar, femorotibial medial and lateral cartilage regions for each subject. A matched-pair Wilcoxon signed rank test was used to assess significance of the changes. RESULTS Changes in mean and in standard deviation of ASC, and in their respective rate of change over time, were only statistically different when data was acquired with the fluid-suppressed sequence. A significant decrease (p = 0.001) of approximately 70 mM in mean ASC was measured between the two IR scans. CONCLUSION Quantitative sodium MRI with fluid suppression by adiabatic IR at 7 T has the potential to detect a decrease of ASC over time in articular cartilage of patients with knee osteoarthritis. KEY POINTS • Sodium MRI can detect apparent sodium concentration (ASC) in cartilage • Longitudinal study: sodium MRI can detect changes in ASC over time • Potential for follow-up studies of cartilage degradation in knee osteoarthritis.
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Affiliation(s)
- Guillaume Madelin
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA.
| | - Ding Xia
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - Ryan Brown
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - James Babb
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - Gregory Chang
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
| | - Svetlana Krasnokutsky
- Department of Medicine, Rheumatology Division, New York University School of Medicine, 305 Second Avenue, New York, NY, 10003, USA
| | - Ravinder R Regatte
- Department of Radiology, Center for Biomedical Imaging, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY, 10016, USA
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20
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Shi C, Zhang D, Xiao Z, Wang L, Ma R, Chen H, Luo L. Ultrahigh b-values MRI in normal human prostate: Initial research on reproducibility and age-related differences. J Magn Reson Imaging 2017; 46:801-812. [PMID: 28267238 DOI: 10.1002/jmri.25629] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 12/27/2016] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To investigate the reproducibility of diffusion-weighted imaging (DWI) with ultrahigh b-values, and analyze the age-related differences in normal prostates. MATERIALS AND METHODS In all, 67 healthy participants were divided into three age groups (group A, 15-30 years; group B, 31-50 years; group C, ≥51 years), and underwent DWI scanning twice with 15 b-factors from 0 to 3000 at 3.0T. Triexponential fits were applied to calculate the molecular diffusion coefficient (D), the pseudo-diffusion coefficient (D*), the ultrahigh apparent diffusion coefficient (ADCuh ), and perfusion fraction (f). The interobserver and short-term interscan reproducibility were evaluated, and the change in these parameters with age were assessed. RESULTS The D, ADCuh , and f values presented good to excellent reproducibility. With increasing age, a trend of increasing D values was observed, with significant difference in both peripheral zone (PZ, P = 0.01) and central gland (CG, P = 0.01) of normal prostate tissue. The f value increased in the CG beginning at 50 years of age while the ADCuh value decreased in the PZ after 50 years of age; all of them showed significant differences between groups A and C and groups B and C (P = 0.01/0.01). CONCLUSION The D, ADCuh , and f values have good to excellent reproducibility in the normal prostate, and these values change with age. The ultrahigh b-values magnetic resonance imaging (MRI) can provide additional information (ADCuh ), which is different from the IVIM (intravoxel incoherent motion)-derived parameters. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:801-812.
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Affiliation(s)
- Changzheng Shi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, P.R. China
| | - Dong Zhang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, P.R. China
| | - Zeyu Xiao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, P.R. China
| | - Li Wang
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, P.R. China
| | - Rong Ma
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, P.R. China
| | - Hanwei Chen
- Department of Radiology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong, P.R. China
| | - Liangping Luo
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, P.R. China
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22
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Link TM, Neumann J, Li X. Prestructural cartilage assessment using MRI. J Magn Reson Imaging 2016; 45:949-965. [PMID: 28019053 DOI: 10.1002/jmri.25554] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/25/2016] [Indexed: 12/20/2022] Open
Abstract
Cartilage loss is irreversible, and to date, no effective pharmacotherapies are available to protect or regenerate cartilage. Quantitative prestructural/compositional MR imaging techniques have been developed to characterize the cartilage matrix quality at a stage where abnormal findings are early and potentially reversible, allowing intervention to halt disease progression. The goal of this article is to critically review currently available technologies, present the basic concept behind these techniques, but also to investigate their suitability as imaging biomarkers including their validity, reproducibility, risk prediction and monitoring of therapy. Moreover, we highlighted important clinical applications. This review article focuses on the currently most relevant and clinically applicable technologies, such as T2 mapping, T2*, T1ρ, delayed gadolinium enhanced MRI of cartilage (dGEMRIC), sodium imaging and glycosaminoglycan chemical exchange saturation transfer (gagCEST). To date, most information is available for T2 and T1ρ mapping. dGEMRIC has also been used in multiple clinical studies, although it requires Gd contrast administration. Sodium imaging and gagCEST are promising technologies but are dependent on high field strength and sophisticated software and hardware. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2017;45:949-965.
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Affiliation(s)
- Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
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23
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Bangerter NK, Tarbox GJ, Taylor MD, Kaggie JD. Quantitative sodium magnetic resonance imaging of cartilage, muscle, and tendon. Quant Imaging Med Surg 2016; 6:699-714. [PMID: 28090447 DOI: 10.21037/qims.2016.12.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sodium magnetic resonance imaging (MRI), or imaging of the 23Na nucleus, has been under exploration for several decades, and holds promise for potentially revealing additional biochemical information about the health of tissues that cannot currently be obtained from conventional hydrogen (or proton) MRI. This additional information could serve as an important complement to conventional MRI for many applications. However, despite these exciting possibilities, sodium MRI is not yet used routinely in clinical practice, and will likely remain strictly in the domain of exploratory research for the coming decade. This paper begins with a technical overview of sodium MRI, including the nuclear magnetic resonance (NMR) signal characteristics of the sodium nucleus, the challenges associated with sodium MRI, and the specialized pulse sequences, hardware, and reconstruction techniques required. Various applications of sodium MRI for quantitative analysis of the musculoskeletal system are then reviewed, including the non-invasive assessment of cartilage degeneration in vivo, imaging of tendinopathy, applications in the assessment of various muscular pathologies, and assessment of muscle response to exercise.
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Affiliation(s)
- Neal K Bangerter
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA;; Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Grayson J Tarbox
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Meredith D Taylor
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
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Demehri S, Guermazi A, Kwoh CK. Diagnosis and Longitudinal Assessment of Osteoarthritis: Review of Available Imaging Techniques. Rheum Dis Clin North Am 2016; 42:607-620. [PMID: 27742017 DOI: 10.1016/j.rdc.2016.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Osteoarthritis (OA) is a major chronic and global health care problem. Recent technological advances in imaging and postprocessing techniques have enhanced the understanding and characterization of the pathophysiology of this chronic and prevalent disease. Although plain radiograph remains the modality of choice for initial assessment of OA, recent studies have shown that advanced cross-sectional imaging can improve the early detection, grading, structural damage quantification, and risk stratification of OA. This article discusses the currently available evidence regarding both the conventional and novel imaging modalities that can be used for evaluation of patients with OA and its longitudinal assessment.
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Affiliation(s)
- Shadpour Demehri
- Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, 601 North Caroline Street, JHOC 5165, Baltimore, MD 21287, USA.
| | - Ali Guermazi
- Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA
| | - C Kent Kwoh
- Division of Rheumatology, University of Arizona Arthritis Center, University of Arizona, Tucson, AZ, USA
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Zbýň Š, Mlynárik V, Juras V, Szomolanyi P, Trattnig S. Evaluation of cartilage repair and osteoarthritis with sodium MRI. NMR IN BIOMEDICINE 2016; 29:206-15. [PMID: 25810325 DOI: 10.1002/nbm.3280] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/20/2015] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
The growing need for early diagnosis and higher specificity than that which can be achieved with morphological MRI is a driving force in the application of methods capable of probing the biochemical composition of cartilage tissue, such as sodium imaging. Unlike morphological imaging, sodium MRI is sensitive to even small changes in cartilage glycosaminoglycan content, which plays a key role in cartilage homeostasis. Recent advances in high- and ultrahigh-field MR systems, gradient technology, phase-array radiofrequency coils, parallel imaging approaches, MRI acquisition strategies and post-processing developments have resulted in many clinical in vivo sodium MRI studies of cartilage, even at 3 T. Sodium MRI has great promise as a non-invasive tool for cartilage evaluation. However, further hardware and software improvements are necessary to complete the translation of sodium MRI into a clinically feasible method for 3-T systems. This review is divided into three parts: (i) cartilage composition, pathology and treatment; (ii) sodium MRI; and (iii) clinical sodium MRI studies of cartilage with a focus on the evaluation of cartilage repair tissue and osteoarthritis.
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Affiliation(s)
- Štefan Zbýň
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Vladimír Mlynárik
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
| | - Vladimir Juras
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Pavol Szomolanyi
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Siegfried Trattnig
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna/Vienna General Hospital, Vienna, Austria
- CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
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26
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Lee JS, Xia D, Madelin G, Regatte RR. Sodium inversion recovery MRI on the knee joint at 7 T with an optimal control pulse. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2016; 262:33-41. [PMID: 26705907 PMCID: PMC4716894 DOI: 10.1016/j.jmr.2015.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/13/2015] [Accepted: 12/05/2015] [Indexed: 06/05/2023]
Abstract
In the field of sodium magnetic resonance imaging (MRI), inversion recovery (IR) is a convenient and popular method to select sodium in different environments. For the knee joint, IR has been used to suppress the signal from synovial fluids, which improves the correlation between the sodium signal and the concentration of glycosaminoglycans (GAGs) in cartilage tissues. For the better inversion of the magnetization vector under the spatial variations of the B0 and B1 fields, the IR sequence usually employ adiabatic pulses as the inversion pulse. On the other hand, it has been shown that RF shapes robust against the variations of the B0 and B1 fields can be generated by numerical optimization based on optimal control theory. In this work, we compare the performance of fluid-suppressed sodium MRI on the knee joint in vivo, between one implemented with an adiabatic pulse in the IR sequence and the other with the adiabatic pulse replaced by an optimal-control shaped pulse. While the optimal-control pulse reduces the RF power deposited to the body by 58%, the quality of fluid suppression and the signal level of sodium within cartilage are similar between two implementations.
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Affiliation(s)
- Jae-Seung Lee
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, United States.
| | - Ding Xia
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, United States
| | - Guillaume Madelin
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, United States
| | - Ravinder R Regatte
- Department of Radiology, New York University Langone Medical Center, New York, NY 10016, United States
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Conventional and novel imaging modalities in osteoarthritis: current state of the evidence. Curr Opin Rheumatol 2015; 27:295-303. [PMID: 25803224 DOI: 10.1097/bor.0000000000000163] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Imaging modalities are currently an inseparable part of osteoarthritis diagnosis. In this review, we describe the current state of evidence regarding conventional and novel imaging modalities in evaluation of osteoarthritis. Modalities including radiography (qualitative and semi-quantitative assessments), ultrasonography, computed tomography [CT; conventional multidetector CT (MDCT), cone-beam CT (CBCT) and four-dimensional CT (4DCT)], MRI (MRI; semi-quantitative, quantitative and compositional) and PET and their applications are reviewed. RECENT FINDINGS Radiography is the modality of choice for initial assessment of osteoarthritis. However, due to its low sensitivity and specificity, numerous recent investigations have proposed MRI as a powerful addition to detect and grade osteoarthritis features, which are not apparent in radiography. Semi-quantitative MRI measurements are feasible to perform in routine clinical practice. Quantitative and compositional MRI measurements have extended the amount of information an MRI examination can provide regarding the three-dimensional shape and tissue composition of articular cartilage. 4DCT and CBCT are introduced as imaging examinations that may reveal biomechanical cartilage abnormalities in osteoarthritis joint by dynamic and weight-bearing evaluations, respectively. Recent PET studies may unveil the underlying metabolic activities that can be associated with osteoarthritis. SUMMARY In addition to the established role of radiographs, MRI is the advanced modality of choice for detection and quantification of various osteoarthritis features. 4DCT and CBCT may have specified applications when diagnosis of underlying motion abnormality or dynamic changes in weight-bearing situation is suspected. Future studies should elucidate the specific clinical applications of ultrasonography and PET.
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Guermazi A, Alizai H, Crema MD, Trattnig S, Regatte RR, Roemer FW. Compositional MRI techniques for evaluation of cartilage degeneration in osteoarthritis. Osteoarthritis Cartilage 2015; 23:1639-53. [PMID: 26050864 DOI: 10.1016/j.joca.2015.05.026] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 04/26/2015] [Accepted: 05/25/2015] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA), a leading cause of disability, affects 27 million people in the United States and its prevalence is rising along with the rise in obesity. So far, biomechanical or behavioral interventions as well as attempts to develop disease-modifying OA drugs have been unsuccessful. This may be partly due to antiquated imaging outcome measures such as radiography, which are still endorsed by regulatory agencies such as the United States Food and Drug Administration (FDA) for use in clinical trials. Morphological magnetic resonance imaging (MRI) allows unparalleled multi-feature assessment of the OA joint. Furthermore, advanced MRI techniques also enable evaluation of the biochemical or ultrastructural composition of articular cartilage relevant to OA research. These compositional MRI techniques have the potential to supplement clinical MRI sequences in identifying cartilage degeneration at an earlier stage than is possible today using morphologic sequences only. The purpose of this narrative review is to describe compositional MRI techniques for cartilage evaluation, which include T2 mapping, T2* Mapping, T1 rho, dGEMRIC, gagCEST, sodium imaging and diffusion weighted imaging (DWI). We also reviewed relevant clinical studies that have utilized these techniques for the study of OA. The different techniques are complementary. Some focus on isotropy or the collagen network (e.g., T2 mapping) and others are more specific in regard to tissue composition, e.g., gagCEST or dGEMRIC that convey information on the GAG concentration. The application and feasibility of these techniques is also discussed, as they will play an important role in implementation in larger clinical trials and eventually clinical practice.
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Affiliation(s)
- A Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
| | - H Alizai
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - M D Crema
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Department of Radiology, Hospital do Coração and Teleimagem, São Paulo, Brazil
| | - S Trattnig
- Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - R R Regatte
- Department of Radiology, New York University Langone Medical Center, New York, NY, USA
| | - F W Roemer
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA; Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Department of Radiology, University of Erlangen, Erlangen, Germany
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Repeatability Investigation of Reduced Field-of-View Diffusion-Weighted Magnetic Resonance Imaging on Thyroid Glands. J Comput Assist Tomogr 2015; 39:334-9. [PMID: 25700226 DOI: 10.1097/rct.0000000000000227] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the repeatability of the quantitative magnetic resonance imaging (MRI) metric (apparent diffusion coefficient [ADC]) derived from reduced field-of-view diffusion-weighted (rFOV DWI) on thyroid glands in a clinical setting. MATERIALS AND METHODS Ten healthy human volunteers were enrolled in MRI studies performed on a 3-T MRI scanner. Each volunteer was designed to undergo 3 longitudinal examinations (2 weeks apart) with 2 repetitive sessions within each examination, which included rFOV and conventional full field-of-view (fFOV) DWI scans. Diffusion-weighted images were assessed and scored based on image characteristics. Apparent diffusion coefficient values of thyroid glands from all participants were calculated based on regions of interest. Repeatability analysis was performed based on the framework proposed by the Quantitative Imaging Biomarker Alliance, generating 4 repeatability metrics: within-participant variance ((Equation is included in full-text article.)), repeatability coefficients, intraclass correlation coefficient, and within-participant coefficient of variation. Student t test was used to compare the performance difference between rFOV and fFOV DWI. RESULTS The overall image quality from rFOV DWI was significantly higher than that from fFOV DWI (P = 0.04). The ADC values calculated from rFOV DWI were significantly lower than corresponding values from fFOV DWI (P < 0.001). There was no significant difference in ADC values across sessions and examinations in either rFOV or fFOV DWI (P > 0.05). Reduced field-of-view DWI had lower values of (Equation is included in full-text article.), repeatability coefficient, and within-participant coefficient of variation and had a higher value of intraclass correlation coefficient compared with fFOV DWI across either sessions or examinations. CONCLUSIONS This study demonstrated that rFOV DWI produced more superior-quality DWI images and more repeatable ADC measurements compared with fFOV DWI, thus providing a feasible quantitative imaging tool for investigating thyroid glands in clinical settings.
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Hontoir F, Clegg P, Nisolle JF, Tew S, Vandeweerd JM. Magnetic resonance compositional imaging of articular cartilage: What can we expect in veterinary medicine? Vet J 2015; 205:11-20. [PMID: 26021889 DOI: 10.1016/j.tvjl.2015.04.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 02/25/2015] [Accepted: 04/28/2015] [Indexed: 10/23/2022]
Abstract
Since cartilage has limited ability to repair itself, it is useful to determine its biochemical composition early in clinical cases. It is also important to assess cartilage content in research animals in longitudinal studies in vivo. In recent years, compositional imaging techniques using magnetic resonance imaging (MRI) have been developed to assess the biochemical composition of cartilage. This article describes MR compositional imaging techniques, and discusses their use and interpretation. Technical concerns still limit the use of some techniques for research and clinical use, especially in veterinary medicine. Glycosaminoglycan chemical-exchange saturation transfer and sodium imaging are better used with high field magnets, which have limited availability. Long acquisition times are sometimes required, for instance in T1rho (ρ) and diffusion-weighted imaging, and necessitate general anaesthesia. Even in human medicine, some techniques such as ultra-short echo T2 are not fully validated, and nearly all techniques require validation for veterinary research and clinical practice. Delayed gadolinium-enhanced MRI of cartilage and T2 mapping appear to be the most applicable methods for compositional imaging of animal cartilage. Combining T2 mapping and T1ρ allows for the assessment of proteoglycans and the collagen network, respectively.
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Affiliation(s)
- Fanny Hontoir
- Integrated Veterinary Research Unit (IVRU), Department of Veterinary Medicine, Faculty of Sciences, University of Namur, Rue de Bruxelles 61, Namur 5000, Belgium
| | - Peter Clegg
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Leahurst Campus, University of Liverpool, Neston, UK
| | | | - Simon Tew
- Department of Musculoskeletal Biology, Faculty of Health and Life Sciences, Leahurst Campus, University of Liverpool, Neston, UK
| | - Jean-Michel Vandeweerd
- Integrated Veterinary Research Unit (IVRU), Department of Veterinary Medicine, Faculty of Sciences, University of Namur, Rue de Bruxelles 61, Namur 5000, Belgium.
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31
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Raya JG. Techniques and applications of in vivo diffusion imaging of articular cartilage. J Magn Reson Imaging 2015; 41:1487-504. [PMID: 25865215 DOI: 10.1002/jmri.24767] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/11/2014] [Indexed: 01/07/2023] Open
Abstract
Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity and to the collagen architecture through the fractional anisotropy. However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (∼40 ms at 3 Tesla) and the high resolution needed (0.5-0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications.
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Affiliation(s)
- José G Raya
- Department Radiology, New York University Langone Medical Center, New York, New York, USA
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32
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Comparison of quantitative and semiquantitative dynamic contrast-enhanced MRI with respect to their correlation to delayed gadolinium-enhanced MRI of the cartilage in patients with early rheumatoid arthritis. J Comput Assist Tomogr 2015; 39:64-9. [PMID: 25340588 DOI: 10.1097/rct.0000000000000164] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the correlation between semiquantitative and quantitative dynamic contrast-enhanced (DCE) parameters with delayed gadolinium-enhanced magnetic resonance imaging (MRI) of the cartilage (dGEMRIC). METHODS Fifteen patients with early rheumatoid arthritis (RA) from the ArthroMark cohort were investigated at a 3-T MRI scanner. The metacarpophalangeal (MCP) joint of the index finger was examined with DCE-MRI and dGEMRIC. Semiquantitative and quantitative DCE perfusion parameters were calculated. The RA MRI score of the second MCP joint and the joint space width were measured. RESULTS Significant correlations were noted between both semiquantitative and quantitative DCE parameters and the RA MRI score of the second MCP joint. There was a significant negative correlation between DCE parameters and dGEMRIC. No association between joint space width and DCE parameters was observed. CONCLUSIONS Semiquantitative and quantitative analyses of perfusion are applicable to show that cartilage damage correlates with the inflammation activity despite the absence of joint space narrowing.
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Kijowski R, Chaudhary R. Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am 2014; 22:649-69. [PMID: 25442027 DOI: 10.1016/j.mric.2014.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Osteoarthritis is characterized by a decrease in the proteoglycan content and disruption of the highly organized collagen fiber network of articular cartilage. Various quantitative magnetic resonance imaging techniques have been developed for noninvasive assessment of the proteoglycan and collagen components of cartilage. These techniques have been extensively used in clinical practice to detect early cartilage degeneration and in osteoarthritis research studies to monitor disease-related and treatment-related changes in cartilage over time. This article reviews the role of quantitative magnetic resonance imaging in evaluating the composition and ultrastructure of the articular cartilage of the knee joint.
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Affiliation(s)
- Richard Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA.
| | - Rajeev Chaudhary
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA
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Jordan CD, Monu UD, McWalter EJ, Watkins RD, Chen W, Bangerter NK, Hargreaves BA, Gold GE. Variability of CubeQuant T1ρ, quantitative DESS T2, and cones sodium MRI in knee cartilage. Osteoarthritis Cartilage 2014; 22:1559-67. [PMID: 25278065 PMCID: PMC4185151 DOI: 10.1016/j.joca.2014.06.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/20/2014] [Accepted: 06/03/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To measure the variability of T1ρ relaxation times using CubeQuant, T2 relaxation times using quantitative double echo in steady state (DESS), and normalized sodium signals using 3D cones sodium magnetic resonance imaging (MRI) of knee cartilage in vivo at 3 T. DESIGN Eight healthy subjects were scanned at 3 T at baseline, 1 day, 5 months, and 1 year. Ten regions of interest (ROIs) of knee cartilage were segmented in the medial and lateral compartments of each subject's knee. T1ρ and T2 relaxation times and normalized sodium signals were measured and the root-mean-square coefficient of variation (CVRMS) was calculated. Intra-subject variability was measured over short, moderate and long-term, as well as intra-observer and inter-observer variability. RESULTS The average intra-subject CVRMS measurements over short, moderate, and long-term time periods were 4.6%, 6.1%, and 6.0% for the T1ρ measurements, 6.4%, 9.3%, and 10.7% for the T2 measurements and 11.3%, 11.6%, and 12.9% for the sodium measurements, respectively. The average CVRMS measurements for intra-observer and inter-observer segmentation were 3.8% and 5.7% for the T1ρ measurements, 4.7% and 6.7% for the T2 measurements, and 8.1% and 11.4% for the sodium measurements, respectively. CONCLUSIONS These CVRMS measurements are substantially lower than previously measured changes expected in patients with advanced osteoarthritis compared to healthy volunteers, suggesting that CubeQuant T1ρ, quantitative DESS T2 and 3D cones sodium measurements are sufficiently sensitive for in vivo cartilage studies.
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Affiliation(s)
- Caroline D. Jordan
- Radiology, Stanford University, Stanford, CA, United States,Bioengineering, Stanford University, Stanford CA, United States
| | - Uchechukwuka D. Monu
- Radiology, Stanford University, Stanford, CA, United States,Electrical Engineering, Stanford University, Stanford CA, United States
| | | | | | - Weitian Chen
- GE Applied Science Laboratory, Menlo Park, CA, United States
| | - Neal K. Bangerter
- Electrical & Computer Engineering, Brigham Young University, Provo, UT, United States
| | - Brian A. Hargreaves
- Radiology, Stanford University, Stanford, CA, United States,Bioengineering, Stanford University, Stanford CA, United States,Electrical Engineering, Stanford University, Stanford CA, United States
| | - Garry E. Gold
- Radiology, Stanford University, Stanford, CA, United States,Bioengineering, Stanford University, Stanford CA, United States,Orthopaedic Surgery, Stanford University, Stanford, CA, United States
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35
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Oei EHG, van Tiel J, Robinson WH, Gold GE. Quantitative radiologic imaging techniques for articular cartilage composition: toward early diagnosis and development of disease-modifying therapeutics for osteoarthritis. Arthritis Care Res (Hoboken) 2014; 66:1129-41. [PMID: 24578345 DOI: 10.1002/acr.22316] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 02/18/2014] [Indexed: 12/19/2022]
Affiliation(s)
- Edwin H G Oei
- Stanford University, Stanford, California; Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Abstract
Magnetic resonance imaging (MRI) has become an increasingly important imaging technique in osteoarthritis (OA) research, and is widely used in the ongoing endeavor to understand the pathogenesis of OA and to develop structure and disease-modifying OA drugs. MRI offers semiquantitative, quantitative and compositional evaluation of knee OA, and enables visualization of tissues that are not seen by radiography, including but not limited to cartilage, meniscus, bone marrow lesions, synovitis, and muscles. It is now recognized that contrast-enhanced MRI enables more accurate evaluation of synovitis than MRI without contrast. Because of its ability to visualize multiple pain-related tissue pathology in three dimensions, MRI is the best modality for imaging of OA.
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Roemer FW, Eckstein F, Hayashi D, Guermazi A. The role of imaging in osteoarthritis. Best Pract Res Clin Rheumatol 2014; 28:31-60. [PMID: 24792944 DOI: 10.1016/j.berh.2014.02.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Osteoarthritis (OA) is the most prevalent joint disorder with no approved disease-modifying treatment available. The importance of imaging in assessing all joint structures involved in the disease process, including articular cartilage, meniscus, subarticular bone marrow, and synovium for diagnosis, prognostication, and follow-up, has been well recognized. In daily clinical practice, conventional radiography is still the most commonly used imaging technique for the evaluation of a patient with known or suspected OA and radiographic outcome measures are still the only approved end point by regulatory authorities in clinical trials. The ability of magnetic resonance imaging (MRI) to visualize all joint structures in three-dimensional fashion including tissue ultrastructure has markedly deepened our understanding of the natural history of the disease. This article describes the roles and limitations of different imaging modalities for clinical practice and research in OA, with a focus on radiography and MRI and an emphasis on the knee joint.
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Affiliation(s)
- Frank W Roemer
- Department of Radiology, Quantitative Imaging Center (QIC), Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA; Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054 Erlangen, Germany; Department of Radiology, Klinikum Augsburg, Augsburg, Stenglinstr 2, 86156 Augsburg, Germany.
| | - Felix Eckstein
- Institute of Anatomy, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.
| | - Daichi Hayashi
- Department of Radiology, Quantitative Imaging Center (QIC), Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA; Department of Radiology, Bridgeport Hospital, Yale University School of Medicine, 267 Grant Street, Bridgeport, CT 06610, USA.
| | - Ali Guermazi
- Department of Radiology, Quantitative Imaging Center (QIC), Boston University School of Medicine, 820 Harrison Avenue, FGH Building, 3rd Floor, Boston, MA 02118, USA.
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Madelin G, Lee JS, Regatte RR, Jerschow A. Sodium MRI: methods and applications. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2014; 79:14-47. [PMID: 24815363 PMCID: PMC4126172 DOI: 10.1016/j.pnmrs.2014.02.001] [Citation(s) in RCA: 148] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/12/2014] [Indexed: 05/11/2023]
Abstract
Sodium NMR spectroscopy and MRI have become popular in recent years through the increased availability of high-field MRI scanners, advanced scanner hardware and improved methodology. Sodium MRI is being evaluated for stroke and tumor detection, for breast cancer studies, and for the assessment of osteoarthritis and muscle and kidney functions, to name just a few. In this article, we aim to present an up-to-date review of the theoretical background, the methodology, the challenges, limitations, and current and potential new applications of sodium MRI.
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Affiliation(s)
- Guillaume Madelin
- New York University Langone Medical Center, Department of Radiology, Center for Biomedical Imaging, New York, NY 10016, USA
| | - Jae-Seung Lee
- New York University Langone Medical Center, Department of Radiology, Center for Biomedical Imaging, New York, NY 10016, USA; Chemistry Department, New York University, 100 Washington Square East, New York, NY 10003, USA
| | - Ravinder R Regatte
- New York University Langone Medical Center, Department of Radiology, Center for Biomedical Imaging, New York, NY 10016, USA
| | - Alexej Jerschow
- Chemistry Department, New York University, 100 Washington Square East, New York, NY 10003, USA.
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Zbýň Š, Mlynárik V, Juras V, Szomolanyi P, Trattnig S. Sodium MR Imaging of Articular Cartilage Pathologies. CURRENT RADIOLOGY REPORTS 2014; 2:41. [PMID: 24683524 PMCID: PMC3963441 DOI: 10.1007/s40134-014-0041-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Many studies have proved that noninvasive sodium MR imaging can directly determine the cartilage GAG content, which plays a central role in cartilage homeostasis. New technical developments in the recent decade have helped to transfer this method from in vitro to pre-clinical in vivo studies. Sodium imaging has already been applied for the evaluation of cartilage and repair tissue in patients after various cartilage repair surgery techniques and in patients with osteoarthritis. These studies showed that this technique could be helpful not only for assessment of the cartilage status, but also predictive for osteoarthritis. However, due to the low detectable sodium MR signal in cartilage, sodium imaging is still challenging, and further hardware and software improvements are necessary for translating sodium MR imaging into clinical practice, preferably to 3T MR systems.
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Affiliation(s)
- Štefan Zbýň
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Vladimír Mlynárik
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Vladimir Juras
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Pavol Szomolanyi
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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Garnov N, Gründer W, Thörmer G, Trampel R, Turner R, Kahn T, Busse H. In vivo MRI analysis of depth-dependent ultrastructure in human knee cartilage at 7 T. NMR IN BIOMEDICINE 2013; 26:1412-1419. [PMID: 23801556 DOI: 10.1002/nbm.2968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 02/26/2013] [Accepted: 04/01/2013] [Indexed: 06/02/2023]
Abstract
Signal intensities of T2-weighted magnetic resonance images depend on the local fiber arrangement in hyaline cartilage. The aims of this study were to determine whether angle-sensitive MRI at 7 T can be used to quantify the cartilage ultrastructure of the knee in vivo and to assess potential differences with age. Ten younger (21-30) and ten older (55-76 years old) healthy volunteers were imaged with a T2-weighted spin-echo sequence in a 7 T whole-body MRI. A "fascicle" model was assumed to describe the depth-dependent fiber arrangement of cartilage. The R/T boundary positions between radial and transitional zones were assessed from intensity profiles in small regions of interest in the femur and tibia, and normalized to cartilage thickness using logistic curve fits. The quality of our highly resolved (0.3 × 0.3 × 1.0 mm(3)) MR cartilage images were high enough for quantitative analysis (goodness of fit R(2) = 0.91 ± 0.09). Between younger and older subjects, normalized positions of the R/T boundary, with value 0 at the bone-cartilage interface and 1 at the cartilage surface, were significantly (p < 0.05) different in femoral (0.51 ± 0.12 versus 0.41 ± 0.10), but not in tibial cartilage (0.65 ± 0.11 versus 0.57 ± 0.09, p = 0.119). Within both age groups, differences between femoral and tibial R/T boundaries were significant. Using a fascicle model and angle-sensitive MRI, the depth-dependent anisotropic fiber arrangement of knee cartilage could be assessed in vivo from a single 7 T MR image. The derived quantitative parameter, thickness of the radial zone, may serve as an indicator of the structural integrity of cartilage. This method may potentially be suitable to detect and monitor early osteoarthritis because the progressive disintegration of the anisotropic network is also indicative of arthritic changes in cartilage.
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Affiliation(s)
- Nikita Garnov
- Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, Leipzig, Germany
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Mosher TJ, Walker EA, Petscavage-Thomas J, Guermazi A. Osteoarthritis year 2013 in review: imaging. Osteoarthritis Cartilage 2013; 21:1425-35. [PMID: 23891696 DOI: 10.1016/j.joca.2013.07.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 06/24/2013] [Accepted: 07/13/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To review recent original research publications related to imaging of osteoarthritis (OA) and identify emerging trends and significant advances. METHODS Relevant articles were identified through a search of the PubMed database using the query terms "OA" in combination with "imaging", "radiography", "MRI", "ultrasound", "computed tomography", and "nuclear medicine"; either published or in press between March 2012 and March 2013. Abstracts were reviewed to exclude review articles, case reports, and studies not focused on imaging using routine clinical imaging measures. RESULTS Initial query yielded 932 references, which were reduced to 328 citations following the initial review. MRI (118 references) and radiography (129 refs) remain the primary imaging modalities in OA studies, with fewer reports using computed tomography (CT) (35 refs) and ultrasound (23 refs). MRI parametric mapping techniques remain an active research area (33 refs) with growth in T2*- and T1-rho mapping publications compared to prior years. Although the knee is the major joint studied (210 refs) there is interest in the hip (106 refs) and hand (29 refs). Imaging continues to focus on evaluation of cartilage (173 refs) and bone (119 refs). CONCLUSION Imaging plays a major role in OA research with publications continuing along traditional lines of investigation. Translational and clinical research application of compositional MRI techniques is becoming more common driven in part by the availability of T2 mapping data from the Osteoarthritis Initiative (OAI). New imaging techniques continue to be developed with a goal of identifying methods with greater specificity and responsiveness to changes in the joint, and novel functional neuroimaging techniques to study central pain. Publications related to imaging of OA continue to be heavily focused on quantitative and semiquantitative MRI evaluation of the knee with increasing application of compositional MRI techniques in the hip.
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Affiliation(s)
- T J Mosher
- Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA.
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Chang G, Deniz CM, Honig S, Egol K, Regatte RR, Zhu Y, Sodickson DK, Brown R. MRI of the hip at 7T: feasibility of bone microarchitecture, high-resolution cartilage, and clinical imaging. J Magn Reson Imaging 2013; 39:1384-93. [PMID: 24115554 DOI: 10.1002/jmri.24305] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 06/18/2013] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To demonstrate the feasibility of performing bone microarchitecture, high-resolution cartilage, and clinical imaging of the hip at 7T. MATERIALS AND METHODS This study had Institutional Review Board approval. Using an 8-channel coil constructed in-house, we imaged the hips of 15 subjects on a 7T magnetic resonance imaging (MRI) scanner. We applied: 1) a T1-weighted 3D fast low angle shot (3D FLASH) sequence (0.23 × 0.23 × 1-1.5 mm(3) ) for bone microarchitecture imaging; 2) T1-weighted 3D FLASH (water excitation) and volumetric interpolated breath-hold examination (VIBE) sequences (0.23 × 0.23 × 1.5 mm(3) ) with saturation or inversion recovery-based fat suppression for cartilage imaging; 3) 2D intermediate-weighted fast spin-echo (FSE) sequences without and with fat saturation (0.27 × 0.27 × 2 mm) for clinical imaging. RESULTS Bone microarchitecture images allowed visualization of individual trabeculae within the proximal femur. Cartilage was well visualized and fat was well suppressed on FLASH and VIBE sequences. FSE sequences allowed visualization of cartilage, the labrum (including cartilage and labral pathology), joint capsule, and tendons. CONCLUSION This is the first study to demonstrate the feasibility of performing a clinically comprehensive hip MRI protocol at 7T, including high-resolution imaging of bone microarchitecture and cartilage, as well as clinical imaging.
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Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, New York, New York, USA
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Newbould RD, Miller SR, Upadhyay N, Rao AW, Swann P, Gold GE, Strachan RK, Matthews PM, Taylor PC, Brown AP. T1-weighted sodium MRI of the articulator cartilage in osteoarthritis: a cross sectional and longitudinal study. PLoS One 2013; 8:e73067. [PMID: 23940822 PMCID: PMC3733834 DOI: 10.1371/journal.pone.0073067] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 07/16/2013] [Indexed: 11/23/2022] Open
Abstract
Structural magnetic resonance imaging (MRI) has shown great utility in diagnosing soft tissue burden in osteoarthritis (OA), though MRI measures of cartilage integrity have proven more elusive. Sodium MRI can reflect the proteoglycan content of cartilage; however, it requires specialized hardware, acquisition sequences, and long imaging times. This study was designed to assess the potential of a clinically feasible sodium MRI acquisition to detect differences in the knee cartilage of subjects with OA versus healthy controls (HC), and to determine whether longitudinal changes in sodium content are observed at 3 and 6 months. 28 subjects with primary knee OA and 19 HC subjects age and gender matched were enrolled in this ethically-approved study. At baseline, 3 and 6 months subjects underwent structural MRI and a 0.4ms echo time 3D T1-weighted sodium scan as well as the knee injury and osteoarthritis outcome score (KOOS) and knee pain by visual analogue score (VAS). A standing radiograph of the knee was taken for Kellgren-Lawrence (K-L) scoring. A blinded reader outlined the cartilage on the structural images which was used to determine median T1-weighted sodium concentrations in each region of interest on the co-registered sodium scans. VAS, K-L, and KOOS all significantly separated the OA and HC groups. OA subjects had higher T1-weighted sodium concentrations, most strongly observed in the lateral tibial, lateral femoral and medial patella ROIs. There were no significant changes in cartilage volume or sodium concentration over 6 months. This study has shown that a clinically-feasible sodium MRI at a moderate 3T field strength and imaging time with fluid attenuation by T1 weighting significantly separated HCs from OA subjects.
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Affiliation(s)
- Rexford D Newbould
- Imanova Centre for Imaging Sciences, Hammersmith Hospital, Imperial College London, London, United Kingdom.
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Palmer AJR, Brown CP, McNally EG, Price AJ, Tracey I, Jezzard P, Carr AJ, Glyn-Jones S. Non-invasive imaging of cartilage in early osteoarthritis. Bone Joint J 2013; 95-B:738-46. [PMID: 23723266 DOI: 10.1302/0301-620x.95b6.31414] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Treatment for osteoarthritis (OA) has traditionally focused on joint replacement for end-stage disease. An increasing number of surgical and pharmaceutical strategies for disease prevention have now been proposed. However, these require the ability to identify OA at a stage when it is potentially reversible, and detect small changes in cartilage structure and function to enable treatment efficacy to be evaluated within an acceptable timeframe. This has not been possible using conventional imaging techniques but recent advances in musculoskeletal imaging have been significant. In this review we discuss the role of different imaging modalities in the diagnosis of the earliest changes of OA. The increasing number of MRI sequences that are able to non-invasively detect biochemical changes in cartilage that precede structural damage may offer a great advance in the diagnosis and treatment of this debilitating condition.
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Affiliation(s)
- A J R Palmer
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington OX3 7LD, UK
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Buchbender C, Schneider M, Ostendorf B. Magnetresonanztomographie und Hybridbildgebung in der Rheumatologie. Z Rheumatol 2013; 72:137-44. [DOI: 10.1007/s00393-012-1068-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Osteoarthritis: a review of strengths and weaknesses of different imaging options. Rheum Dis Clin North Am 2013; 39:567-91. [PMID: 23719076 DOI: 10.1016/j.rdc.2013.02.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Slowing of radiographic joint space narrowing represents the only recommended imaging-based outcome measure to assess structural disease progression in osteoarthritis (OA) clinical trials. There are no effective disease-modifying OA drugs. The ability of magnetic resonance (MR) to image structures within the knee and to visualize cartilage morphology and composition gives MR imaging a critical role in understanding the natural history of the disease and in the search for therapies. In this article, the roles and limitations of conventional radiography and MR imaging, focusing on knee OA, and the use of other modalities in clinical practice and OA research are described.
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Guermazi A, Hayashi D, Eckstein F, Hunter DJ, Duryea J, Roemer FW. Imaging of Osteoarthritis. Rheum Dis Clin North Am 2013; 39:67-105. [DOI: 10.1016/j.rdc.2012.10.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Advanced MR methods at ultra-high field (7 Tesla) for clinical musculoskeletal applications. Eur Radiol 2012; 22:2338-46. [DOI: 10.1007/s00330-012-2508-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Revised: 05/02/2012] [Accepted: 05/04/2012] [Indexed: 12/16/2022]
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Chang G, Madelin G, Sherman OH, Strauss EJ, Xia D, Recht MP, Jerschow A, Regatte RR. Improved assessment of cartilage repair tissue using fluid-suppressed ²³Na inversion recovery MRI at 7 Tesla: preliminary results. Eur Radiol 2012; 22:1341-9. [PMID: 22350437 DOI: 10.1007/s00330-012-2383-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 12/05/2011] [Accepted: 12/07/2011] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To evaluate cartilage repair and native tissue using a three-dimensional (3D), radial, ultra-short echo time (UTE) (23)Na MR sequence without and with an inversion recovery (IR) preparation pulse for fluid suppression at 7 Tesla (T). METHODS This study had institutional review board approval. We recruited 11 consecutive patients (41.5 ± 11.8 years) from an orthopaedic surgery practice who had undergone a knee cartilage restoration procedure. The subjects were examined postoperatively (median = 26 weeks) with 7-T MRI using: proton-T2 (TR/TE = 3,000 ms/60 ms); sodium UTE (TR/TE = 100 ms/0.4 ms); fluid-suppressed, sodium UTE adiabatic IR. Cartilage sodium concentrations in repair tissue ([Na(+)](R)), adjacent native cartilage ([Na(+)](N)), and native cartilage within the opposite, non-surgical compartment ([Na(+)](N2)) were calculated using external NaCl phantoms. RESULTS For conventional sodium imaging, mean [Na(+)](R), [Na(+)](N), [Na(+)](N2) were 177.8 ± 54.1 mM, 170.1 ± 40.7 mM, 172.2 ± 30 mM respectively. Differences in [Na(+)](R) versus [Na(+)](N) (P = 0.59) and [Na(+)](N) versus [Na(+)](N2) (P = 0.89) were not significant. For sodium IR imaging, mean [Na(+)](R), [Na(+)](N), [Na(+)](N2) were 108.9 ± 29.8 mM, 204.6 ± 34.7 mM, 249.9 ± 44.6 mM respectively. Decreases in [Na(+)](R) versus [Na(+)](N) (P = 0.0.0000035) and [Na(+)](N) versus [Na(+)](N2) (P = 0.015) were significant. CONCLUSIONS Sodium IR imaging at 7 T can suppress the signal from free sodium within synovial fluid. This may allow improved assessment of [Na(+)] within cartilage repair and native tissue. KEY POINTS • NaIR magnetic resonance imaging can suppress signal from sodium within synovial fluid. • NaIR MRI thus allows assessment of sodium concentration within cartilage tissue alone. • This may facilitate more accurate assessment of repair tissue composition and quality.
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Affiliation(s)
- Gregory Chang
- Quantitative Multinuclear Musculoskeletal Imaging Group, Center for Biomedical Imaging, Department of Radiology, NYU Langone Medical Center, 660 First Avenue, New York, NY 10016, USA.
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