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Wu H, Wang X, Wang G, Yuan G, Jia W, Tian L, Zheng Y, Ding W, Pei J. Advancing Scaffold-Assisted Modality for In Situ Osteochondral Regeneration: A Shift From Biodegradable to Bioadaptable. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024:e2407040. [PMID: 39104283 DOI: 10.1002/adma.202407040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/10/2024] [Indexed: 08/07/2024]
Abstract
Over the decades, the management of osteochondral lesions remains a significant yet unmet medical challenge without curative solutions to date. Owing to the complex nature of osteochondral units with multi-tissues and multicellularity, and inherently divergent cellular turnover capacities, current clinical practices often fall short of robust and satisfactory repair efficacy. Alternative strategies, particularly tissue engineering assisted with biomaterial scaffolds, achieve considerable advances, with the emerging pursuit of a more cost-effective approach of in situ osteochondral regeneration, as evolving toward cell-free modalities. By leveraging endogenous cell sources and innate regenerative potential facilitated with instructive scaffolds, promising results are anticipated and being evidenced. Accordingly, a paradigm shift is occurring in scaffold development, from biodegradable and biocompatible to bioadaptable in spatiotemporal control. Hence, this review summarizes the ongoing progress in deploying bioadaptable criteria for scaffold-based engineering in endogenous osteochondral repair, with emphases on precise control over the scaffolding material, degradation, structure and biomechanics, and surface and biointerfacial characteristics, alongside their distinguished impact on the outcomes. Future outlooks of a highlight on advanced, frontier materials, technologies, and tools tailoring precision medicine and smart healthcare are provided, which potentially paves the path toward the ultimate goal of complete osteochondral regeneration with function restoration.
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Affiliation(s)
- Han Wu
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite & Center of Hydrogen Science, School of Materials Science & Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Xuejing Wang
- Interdisciplinary Research Center of Biology & Catalysis, School of Life Sciences, Northwestern Polytechnical University, Xi'an, 710072, China
| | - Guocheng Wang
- Research Center for Human Tissues and Organs Degeneration, Shenzhen Institute of Advanced Technology, Chinese Academy of Science, Shenzhen, Guangdong, 518055, China
| | - Guangyin Yuan
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite & Center of Hydrogen Science, School of Materials Science & Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Weitao Jia
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Liangfei Tian
- Key Laboratory of Biomedical Engineering of Ministry of Education, Zhejiang Provincial Key Laboratory of Cardio-Cerebral Vascular Detection Technology and Medicinal Effectiveness Appraisal, Department of Biomedical Engineering, Zhejiang University, Hangzhou, 310027, China
| | - Yufeng Zheng
- School of Materials Science and Engineering, Peking University, Beijing, 100871, China
| | - Wenjiang Ding
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite & Center of Hydrogen Science, School of Materials Science & Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Jia Pei
- National Engineering Research Center of Light Alloy Net Forming & State Key Laboratory of Metal Matrix Composite & Center of Hydrogen Science, School of Materials Science & Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
- Institute of Medical Robotics & National Engineering Research Center for Advanced Magnetic Resonance Technologies for Diagnosis and Therapy, Shanghai Jiao Tong University, Shanghai, 200240, China
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Sarai H, Schmutz B, Schuetz M. Potential pitfalls of lateral radiographic assessment of the nail position in the distal femur. Arch Orthop Trauma Surg 2022; 142:1531-1538. [PMID: 33704560 DOI: 10.1007/s00402-021-03851-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/01/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Antegrade nailing of proximal femur fractures is a widely accepted treatment that relies on lateral radiographs to assess distal nail positioning. However, the distal femur is trapezoidal in cross section, consequently standard lateral radiographs may be insufficient. This study aimed to utilise 3D modelling to virtually assess the accuracy of lateral radiographs in defining the position of a femoral nail in the distal femur, specifically considering distal cortical encroachment. MATERIALS AND METHODS Three-dimensional models of a commonly used nail, were positioned in 3D models of 63 femora, generated from CT scans. Lateral projections, representative of lateral radiographs, were generated and measurements of the closest point distance between the distal nail and anterior inner cortex were recorded. Axial slices through the model at the same distal position were produced for any nails located in the canal's anterior 1/5th and used to quantify the shortest nail to anterior cortex distance. RESULTS A significant (p = 0.000) difference exists between the positions of the nail in the lateral projection (- 1.7 ± 1.24 mm) compared with axial position (- 0.23 ± 1.41 mm) with reference to the inner cortical surface. In the lateral projection, 30 nails were located in the canal's anterior 1/5th, of these, 14 nails were identified in the axial position as perforating the inner cortex, with four also perforating the outer cortex surface. CONCLUSION Femoral nails are often anteriorly located in the distal femur and reviewed using lateral radiographs. However, this research demonstrates that owing to the geometry of the distal femur, a lateral radiograph may be inadequate for determining the true position of a femoral nail within the distal femur. Accurately assessing the position of femoral nails may help to address and prevent thigh pain, and iatrogenic fracture or perforation which have been associated with anterior positioning.
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Affiliation(s)
- Harminder Sarai
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Australia
| | - Beat Schmutz
- Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Australia. .,Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, 4029, Australia.
| | - Michael Schuetz
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, QLD, 4029, Australia.,Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Australia.,Department of Orthopaedics and Trauma Service, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia
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Jerban S, Alenezi S, Afsahi AM, Ma Y, Du J, Chung CB, Chang EY. MRI-based mechanical competence assessment of bone using micro finite element analysis (micro-FEA): Review. Magn Reson Imaging 2022; 88:9-19. [PMID: 35091024 PMCID: PMC8988995 DOI: 10.1016/j.mri.2022.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 12/09/2021] [Accepted: 01/20/2022] [Indexed: 12/18/2022]
Abstract
Areal bone mineral density (aBMD) from dual-energy x-ray absorptiometry (DEXA) and volumetric bone mineral density (vBMD) have demonstrated limited capabilities in the evaluation of bone mechanical competence and prediction of bone fracture. Predicting the macroscopic mechanical behavior of the bone structure has been challenging because of the heterogeneous and anisotropic nature of bone, such as the dependencies on loading direction, anatomical location, and sample dimensions. Magnetic resonance imaging (MRI) has been introduced as a promising modality that can be coupled with finite element analysis (FEA) for the assessment of bone mechanical competence. This review article describes studies investigating MRI-based micro-FEA as a potential non-invasive method to predict bone mechanical competence and facilitate bone fracture risk estimation without exposure to ionizing radiation. Specifically, the steps, applications, and future potential of FEA using indirect and direct bone imaging are discussed.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, CA, USA.
| | - Salem Alenezi
- Research and Laboratories Sector, Saudi Food and Drug Authority, Saudi Arabia
| | | | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA; Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, CA, USA; Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, CA, USA; Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA.
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Barkaoui A, Ait Oumghar I, Ben Kahla R. Review on the use of medical imaging in orthopedic biomechanics: finite element studies. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING: IMAGING & VISUALIZATION 2021. [DOI: 10.1080/21681163.2021.1888317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Abdelwahed Barkaoui
- Laboratoire des Énergies Renouvelables et Matériaux Avancés, Université Internationale de Rabat, Sala Al Jadida Morocco
| | - Imane Ait Oumghar
- Laboratoire des Énergies Renouvelables et Matériaux Avancés, Université Internationale de Rabat, Sala Al Jadida Morocco
- Aix Marseille Univ, CNRS, ISM, Inst Movement Sci, Marseille, France
| | - Rabeb Ben Kahla
- Laboratoire de Systémes et de Mécanique Appliquée, Ecole Polytechnique de Tunis, Université de Carthage, Tunis, Tunisia
- Ecole Nationale d’Ingénieurs de Tunis, Université de Tunis el Manar, Campus Universitaire, Tunis, Tunisia
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The relationship between orthopedic clinical imaging and bone strength prediction. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2021. [DOI: 10.1016/j.medntd.2021.100060] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Jerban S, Ma Y, Wei Z, Jang H, Chang EY, Du J. Quantitative Magnetic Resonance Imaging of Cortical and Trabecular Bone. Semin Musculoskelet Radiol 2020; 24:386-401. [PMID: 32992367 DOI: 10.1055/s-0040-1710355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Bone is a composite material consisting of mineral, organic matrix, and water. Water in bone can be categorized as bound water (BW), which is bound to bone mineral and organic matrix, or as pore water (PW), which resides in Haversian canals as well as in lacunae and canaliculi. Bone is generally classified into two types: cortical bone and trabecular bone. Cortical bone is much denser than trabecular bone that is surrounded by marrow and fat. Magnetic resonance (MR) imaging has been increasingly used for noninvasive assessment of both cortical bone and trabecular bone. Bone typically appears as a signal void with conventional MR sequences because of its short T2*. Ultrashort echo time (UTE) sequences with echo times 100 to 1,000 times shorter than those of conventional sequences allow direct imaging of BW and PW in bone. This article summarizes several quantitative MR techniques recently developed for bone evaluation. Specifically, we discuss the use of UTE and adiabatic inversion recovery prepared UTE sequences to quantify BW and PW, UTE magnetization transfer sequences to quantify collagen backbone protons, UTE quantitative susceptibility mapping sequences to assess bone mineral, and conventional sequences for high-resolution imaging of PW as well as the evaluation of trabecular bone architecture.
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Affiliation(s)
- Saeed Jerban
- Department of Radiology, University of California, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California
| | - Zhao Wei
- Department of Radiology, University of California, San Diego, California
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California
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Alizai H, Chang G, Regatte RR. MR Imaging of the Musculoskeletal System Using Ultrahigh Field (7T) MR Imaging. PET Clin 2019; 13:551-565. [PMID: 30219187 DOI: 10.1016/j.cpet.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
MR imaging is an indispensable instrument for the diagnosis of musculoskeletal diseases. In vivo MR imaging at 7T offers many advantages, including increased signal-to-noise ratio, higher spatial resolution, improved spectral resolution for spectroscopy, improved sensitivity for X-nucleus imaging, and decreased image acquisition times. There are also however technical challenges of imaging at a higher field strength compared with 1.5 and 3T MR imaging systems. We discuss the many potential opportunities as well as the challenges presented by 7T MR imaging systems and highlight recent developments in in vivo research imaging of musculoskeletal applications in general and cartilage, skeletal muscle, and bone in particular.
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Affiliation(s)
- Hamza Alizai
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA.
| | - Gregory Chang
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
| | - Ravinder R Regatte
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
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Rajapakse CS, Chang G. Micro-Finite Element Analysis of the Proximal Femur on the Basis of High-Resolution Magnetic Resonance Images. Curr Osteoporos Rep 2018; 16:657-664. [PMID: 30232586 PMCID: PMC6234089 DOI: 10.1007/s11914-018-0481-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE OF REVIEW Hip fractures have catastrophic consequences. The purpose of this article is to review recent developments in high-resolution magnetic resonance imaging (MRI)-guided finite element analysis (FEA) of the hip as a means to determine subject-specific bone strength. RECENT FINDINGS Despite the ability of DXA to predict hip fracture, the majority of fractures occur in patients who do not have BMD T scores less than - 2.5. Therefore, without other detection methods, these individuals go undetected and untreated. Of methods available to image the hip, MRI is currently the only one capable of depicting bone microstructure in vivo. Availability of microstructural MRI allows generation of patient-specific micro-finite element models that can be used to simulate real-life loading conditions and determine bone strength. MRI-based FEA enables radiation-free approach to assess hip fracture strength. With further validation, this technique could become a potential clinical tool in managing hip fracture risk.
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Affiliation(s)
- Chamith S Rajapakse
- Departments of Radiology and Orthopaedic Surgery, University of Pennsylvania, 3400 Spruce Street, 1 Founders Building, Philadelphia, PA, 19104, USA.
| | - Gregory Chang
- Department of Radiology, New York University, 426 1st Avenue, New York, NY, 10010, USA
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Freitas L, Amorim T, Humbert L, Fonollá R, Flouris AD, Metsios GS, Jamurtas AZ, Koutedakis Y. Cortical and trabecular bone analysis of professional dancers using 3D-DXA: a case–control study. J Sports Sci 2018; 37:82-89. [DOI: 10.1080/02640414.2018.1483178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Laura Freitas
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sports, University of Porto, Porto, Portugal
| | - Tânia Amorim
- Centre of Research, Education, Innovation and Intervention in Sport, Faculty of Sports, University of Porto, Porto, Portugal
- The Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | | | - Roger Fonollá
- Musculoskeletal Unit, Galgo Medical, Barcelona, Spain
| | - Andreas D. Flouris
- School of Sports and Exercise Sciences, University of Thessaly, Trikala, Greece
| | - George S. Metsios
- The Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- School of Sports and Exercise Sciences, University of Thessaly, Trikala, Greece
| | | | - Yiannis Koutedakis
- The Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
- School of Sports and Exercise Sciences, University of Thessaly, Trikala, Greece
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11
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Kogan F, Fan AP, Gold GE. Potential of PET-MRI for imaging of non-oncologic musculoskeletal disease. Quant Imaging Med Surg 2016; 6:756-771. [PMID: 28090451 DOI: 10.21037/qims.2016.12.16] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Early detection of musculoskeletal disease leads to improved therapies and patient outcomes, and would benefit greatly from imaging at the cellular and molecular level. As it becomes clear that assessment of multiple tissues and functional processes are often necessary to study the complex pathogenesis of musculoskeletal disorders, the role of multi-modality molecular imaging becomes increasingly important. New positron emission tomography-magnetic resonance imaging (PET-MRI) systems offer to combine high-resolution MRI with simultaneous molecular information from PET to study the multifaceted processes involved in numerous musculoskeletal disorders. In this article, we aim to outline the potential clinical utility of hybrid PET-MRI to these non-oncologic musculoskeletal diseases. We summarize current applications of PET molecular imaging in osteoarthritis (OA), rheumatoid arthritis (RA), metabolic bone diseases and neuropathic peripheral pain. Advanced MRI approaches that reveal biochemical and functional information offer complementary assessment in soft tissues. Additionally, we discuss technical considerations for hybrid PET-MR imaging including MR attenuation correction, workflow, radiation dose, and quantification.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Audrey P Fan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA; Department of Bioengineering, Stanford University, Stanford, California, USA; Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
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12
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Chang G, Honig S, Liu Y, Chen C, Chu KK, Rajapakse CS, Egol K, Xia D, Saha PK, Regatte RR. 7 Tesla MRI of bone microarchitecture discriminates between women without and with fragility fractures who do not differ by bone mineral density. J Bone Miner Metab 2015; 33:285-93. [PMID: 24752823 PMCID: PMC4363287 DOI: 10.1007/s00774-014-0588-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 03/17/2014] [Indexed: 01/23/2023]
Abstract
Osteoporosis is a disease of poor bone quality. Bone mineral density (BMD) has limited ability to discriminate between subjects without and with poor bone quality, and assessment of bone microarchitecture may have added value in this regard. Our goals were to use 7 T MRI to: (1) quantify and compare distal femur bone microarchitecture in women without and with poor bone quality (defined clinically by presence of fragility fractures); and (2) determine whether microarchitectural parameters could be used to discriminate between these two groups. This study had institutional review board approval, and we obtained written informed consent from all subjects. We used a 28-channel knee coil to image the distal femur of 31 subjects with fragility fractures and 25 controls without fracture on a 7 T MRI scanner using a 3-D fast low angle shot sequence (0.234 mm × 0.234 mm × 1 mm, parallel imaging factor = 2, acquisition time = 7 min 9 s). We applied digital topological analysis to quantify parameters of bone microarchitecture. All subjects also underwent standard clinical BMD assessment in the hip and spine. Compared to controls, fracture cases demonstrated lower bone volume fraction and markers of trabecular number, plate-like structure, and plate-to-rod ratio, and higher markers of trabecular isolation, rod disruption, and network resorption (p < 0.05 for all). There were no differences in hip or spine BMD T-scores between groups (p > 0.05). In receiver-operating-characteristics analyses, microarchitectural parameters could discriminate cases and controls (AUC = 0.66-0.73, p < 0.05). Hip and spine BMD T-scores could not discriminate cases and controls (AUC = 0.58-0.64, p ≥ 0.08). We conclude that 7 T MRI can detect bone microarchitectural deterioration in women with fragility fractures who do not differ by BMD. Microarchitectural parameters might some day be used as an additional tool to detect patients with poor bone quality who cannot be detected by dual-energy X-ray absorptiometry (DXA).
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Affiliation(s)
- Gregory Chang
- Department of Radiology, NYU Langone Medical Center, Center for Musculoskeletal Care, 333 E. 38th Street, 6th Floor, Room 6-210, New York, NY, 10016, USA,
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Chang G, Honig S, Brown R, Deniz CM, Egol KA, Babb JS, Regatte RR, Rajapakse CS. Finite element analysis applied to 3-T MR imaging of proximal femur microarchitecture: lower bone strength in patients with fragility fractures compared with control subjects. Radiology 2014; 272:464-74. [PMID: 24689884 DOI: 10.1148/radiol.14131926] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To determine the feasibility of using finite element analysis applied to 3-T magnetic resonance (MR) images of proximal femur microarchitecture for detection of lower bone strength in subjects with fragility fractures compared with control subjects without fractures. MATERIALS AND METHODS This prospective study was institutional review board approved and HIPAA compliant. Written informed consent was obtained. Postmenopausal women with (n = 22) and without (n = 22) fragility fractures were matched for age and body mass index. All subjects underwent standard dual-energy x-ray absorptiometry. Images of proximal femur microarchitecture were obtained by using a high-spatial-resolution three-dimensional fast low-angle shot sequence at 3 T. Finite element analysis was applied to compute elastic modulus as a measure of strength in the femoral head and neck, Ward triangle, greater trochanter, and intertrochanteric region. The Mann-Whitney test was used to compare bone mineral density T scores and elastic moduli between the groups. The relationship (R(2)) between elastic moduli and bone mineral density T scores was assessed. RESULTS Patients with fractures showed lower elastic modulus than did control subjects in all proximal femur regions (femoral head, 8.51-8.73 GPa vs 9.32-9.67 GPa; P = .04; femoral neck, 3.11-3.72 GPa vs 4.39-4.82 GPa; P = .04; Ward triangle, 1.85-2.21 GPa vs 3.98-4.13 GPa; P = .04; intertrochanteric region, 1.62-2.18 GPa vs 3.86-4.47 GPa; P = .006-.007; greater trochanter, 0.65-1.21 GPa vs 1.96-2.62 GPa; P = .01-.02), but no differences in bone mineral density T scores. There were weak relationships between elastic moduli and bone mineral density T scores in patients with fractures (R(2) = 0.25-0.31, P = .02-.04), but not in control subjects. CONCLUSION Finite element analysis applied to high-spatial-resolution 3-T MR images of proximal femur microarchitecture can allow detection of lower elastic modulus, a marker of bone strength, in subjects with fragility fractures compared with control subjects. MR assessment of proximal femur strength may provide information about bone quality that is not provided by dual-energy x-ray absorptiometry.
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Affiliation(s)
- Gregory Chang
- From the Department of Radiology, Center for Musculoskeletal Care (G.C.), Osteoporosis Center, Hospital for Joint Diseases (S.H.), Department of Orthopaedic Surgery, Hospital for Joint Diseases (K.A.E.), and Department of Radiology, Center for Biomedical Imaging (G.C., R.B., C.M.D., J.S.B., R.R.R.), NYU Langone Medical Center, 550 First Avenue, New York, NY 10016; and Department of Radiology, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA (C.S.R.)
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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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