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Zhang Y, Cheng Z, Peng H, Ma W, Zhang R, Ma J, Gao S, Li W, Xu Y. Factors influencing diffusion tensor imaging of knee cartilage in children ages 6-12 years: a prospective study. Pediatr Radiol 2024:10.1007/s00247-024-05965-x. [PMID: 38910223 DOI: 10.1007/s00247-024-05965-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 06/25/2024]
Abstract
BACKGROUND Magnetic resonance diffusion tensor imaging (DTI) has recently been used to evaluate the developing cartilage of children, but the influencing factors have not been well studied. OBJECTIVE The objective of this study was to investigate the influence of the diffusion gradient strength (b value), diffusion gradient direction, age and sex on knee cartilage DTI in healthy children aged 6-12 years. MATERIALS AND METHODS A total of 30 healthy child volunteers, with an average age of 8.9 ± 1.6 (mean ± standard deviation) years, were enrolled in this study. They were categorized into three groups according to their age range: 6-8 years, 8-10 years and 10-12 years, ensuring equal sex distribution in each group (5 boys and 5 girls). These volunteers underwent routine left knee joint magnetic resonance imaging (MRI) and serial DTI scans. DTI parameters were altered as follows: when b value = 600 s/mm2, diffusion gradient direction was set to 6, 15, 25, 35 and 45; and when diffusion gradient direction = 25, b value was set to 300, 600, 900 and 1200 s/mm2. The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were separately acquired using image post-processing techniques. The correlation between various b values, diffusion gradient directions, age and sex on the one hand and FA and ADC values on the other, was investigated. RESULTS (1) When diffusion gradient direction was fixed and the b value was varied, both FA and ADC exhibited a decreasing trend as the b value increased (P < 0.001). (2) When the b value was fixed and diffusion gradient direction was varied, the FA of knee cartilage showed a decreasing trend with increasing diffusion gradient direction (P < 0.001). (3) The FA value increased with age (P < 0.05). CONCLUSION The b value, diffusion gradient direction value and age exert a significant impact on both FA and ADC values in MR DTI of knee cartilage in children aged 6-12 years. In order to obtain a stable DTI, it is recommended to select a b value ≥ 600 s/mm2 and a diffusion gradient direction ≥ 25 during scanning.
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Affiliation(s)
- Yilu Zhang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Zhuo Cheng
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Hailun Peng
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Wei Ma
- Department of Radiology, The People's Hospital of Yubei District of Chongqing City, Yubei District, Chongqing, China
| | - Rui Zhang
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Junya Ma
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Sijie Gao
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Wei Li
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China
| | - Ye Xu
- Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatric Metabolism and Inflammatory Diseases, 136 Zhongshan Er Lu, Yuzhong District, Chongqing, 400000, China.
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Luo KL, Santos L, Tokaria R, Jambawalikar S, Duong PT, Raya JG, Mostoufi-Moab S, Jaramillo D. Generalizing Diffusion Tensor Imaging of the Physis and Metaphysis. J Magn Reson Imaging 2024. [PMID: 38757966 DOI: 10.1002/jmri.29455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/02/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Current methods to predict height potential are inaccurate. Predicting height by using MRI of the physeal cartilage has shown promise but the applicability of this technique in different imaging setups has not been well-evaluated. PURPOSE To assess variability in diffusion tensor imaging of the physis and metaphysis (DTI-P/M) of the distal femur between different scanners, imaging parameters, tractography software, and resolution. STUDY TYPE Prospective. POPULATION/SUBJECTS Eleven healthy subjects (five males and six females ages 10-16.94). FIELD STRENGTH/SEQUENCE 3 T; DTI single shot echo planar sequences. ASSESSMENT Physeal DTI tract measurements of the distal femur were compared between different scanners, imaging parameters, tractography settings, interpolation correction, and tractography software. STATISTICAL TESTS Bland-Altman, Spearman correlation, linear regression, and Shapiro-Wilk tests. Threshold for statistical significance was set at P = 0.05. RESULTS DTI tract values consistently showed low variability with different imaging and analysis settings. Vendor to vendor comparison exhibited strong correlation (ρ = 0.93) and small but significant bias (bias -5.76, limits of agreement [LOA] -24.31 to 12.78). Strong correlation and no significant difference were seen between technical replicates of the General Electric MRI scanner (ρ = 1, bias 0.17 [LOA -1.5 to 1.2], P = 0.42) and the Siemens MRI scanner (ρ = 0.89, bias = 0.56, P = 0.71). Different voxel sizes (1 × 1 × 2 mm3 vs. 2 × 2 × 3 mm3) did not significantly affect DTI values (bias = 1.4 [LOA -5.7 to 8.4], P = 0.35) but maintained a strong correlation (ρ = 0.82). Gap size (0 mm vs. 0.6 mm) significantly affects tract volume (bias = 1.8 [LOA -5.4 to 1.8]) but maintains a strong correlation (ρ = 0.93). Comparison of tractography algorithms generated significant differences in tract number, length, and volume while maintaining correlation (ρ = 0.86, 0.99, 0.93, respectively). Comparison of interobserver variability between different tractography software also revealed significant differences while maintaining high correlation (ρ = 0.85-0.98). DATA CONCLUSION DTI of the pediatric physis cartilage shows high reproducibility between different imaging and analytic parameters. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Katherine L Luo
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Santos
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Rumana Tokaria
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Phuong T Duong
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
| | - José G Raya
- New York University Langone Medical Center, New York, New York, USA
| | | | - Diego Jaramillo
- Department of Radiology, Columbia University Irving Medical Center, New York, New York, USA
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Santos L, Hsu HY, Nelson RR, Sullivan B, Shin J, Fung M, Lebel MR, Jambawalikar S, Jaramillo D. Impact of Deep Learning Denoising Algorithm on Diffusion Tensor Imaging of the Growth Plate on Different Spatial Resolutions. Tomography 2024; 10:504-519. [PMID: 38668397 PMCID: PMC11054892 DOI: 10.3390/tomography10040039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/29/2024] Open
Abstract
To assess the impact of a deep learning (DL) denoising reconstruction algorithm applied to identical patient scans acquired with two different voxel dimensions, representing distinct spatial resolutions, this IRB-approved prospective study was conducted at a tertiary pediatric center in compliance with the Health Insurance Portability and Accountability Act. A General Electric Signa Premier unit (GE Medical Systems, Milwaukee, WI) was employed to acquire two DTI (diffusion tensor imaging) sequences of the left knee on each child at 3T: an in-plane 2.0 × 2.0 mm2 with section thickness of 3.0 mm and a 2 mm3 isovolumetric voxel; neither had an intersection gap. For image acquisition, a multi-band DTI with a fat-suppressed single-shot spin-echo echo-planar sequence (20 non-collinear directions; b-values of 0 and 600 s/mm2) was utilized. The MR vendor-provided a commercially available DL model which was applied with 75% noise reduction settings to the same subject DTI sequences at different spatial resolutions. We compared DTI tract metrics from both DL-reconstructed scans and non-denoised scans for the femur and tibia at each spatial resolution. Differences were evaluated using Wilcoxon-signed ranked test and Bland-Altman plots. When comparing DL versus non-denoised diffusion metrics in femur and tibia using the 2 mm × 2 mm × 3 mm voxel dimension, there were no significant differences between tract count (p = 0.1, p = 0.14) tract volume (p = 0.1, p = 0.29) or tibial tract length (p = 0.16); femur tract length exhibited a significant difference (p < 0.01). All diffusion metrics (tract count, volume, length, and fractional anisotropy (FA)) derived from the DL-reconstructed scans, were significantly different from the non-denoised scan DTI metrics in both the femur and tibial physes using the 2 mm3 voxel size (p < 0.001). DL reconstruction resulted in a significant decrease in femorotibial FA for both voxel dimensions (p < 0.01). Leveraging denoising algorithms could address the drawbacks of lower signal-to-noise ratios (SNRs) associated with smaller voxel volumes and capitalize on their better spatial resolutions, allowing for more accurate quantification of diffusion metrics.
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Affiliation(s)
- Laura Santos
- Radiology Department, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Hao-Yun Hsu
- Radiology Department, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Ronald R. Nelson
- Radiology Department, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Brendan Sullivan
- Radiology Department, Columbia University Irving Medical Center, New York, NY 10032, USA
| | | | | | | | - Sachin Jambawalikar
- Radiology Department, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Diego Jaramillo
- Radiology Department, Columbia University Irving Medical Center, New York, NY 10032, USA
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Duong PT, Santos L, Hsu HY, Jambawalikar S, Mutasa S, Nguyen MK, Guariento A, Jaramillo D. Deep Learning-Assisted Diffusion Tensor Imaging for Evaluation of the Physis and Metaphysis. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:756-765. [PMID: 38321313 PMCID: PMC11031540 DOI: 10.1007/s10278-024-00993-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/17/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024]
Abstract
Diffusion tensor imaging of physis and metaphysis can be used as a biomarker to predict height change in the pediatric population. Current application of this technique requires manual segmentation of the physis which is time-consuming and introduces interobserver variability. UNET Transformers (UNETR) can be used for automatic segmentation to optimize workflow. Three hundred and eighty-five DTI scans from 191 subjects with mean age of 12.6 years ± 2.01 years were retrospectively used for training and validation. The mean Dice correlation coefficient was 0.81 for the UNETR model and 0.68 for the UNET. Manual extraction and segmentation took 15 min per volume, whereas both deep learning segmentation techniques took < 1 s per volume and were deterministic, always producing the same result for a given input. Intraclass correlation coefficient (ICC) for ROI-derived femur diffusion metrics was excellent for tract count (0.95), volume (0.95), and FA (0.97), and good for tract length (0.87). The results support the hypothesis that a hybrid UNETR model can be trained to replace the manual segmentation of physeal DTI images, therefore automating the process.
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Affiliation(s)
- Phuong T Duong
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA.
| | - Laura Santos
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Hao-Yun Hsu
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Michael K Nguyen
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Diego Jaramillo
- Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA
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Kvist O, Santos LA, De Luca F, Jaramillo D. Can diffusion tensor imaging unlock the secrets of the growth plate? BJR Open 2024; 6:tzae005. [PMID: 38558926 PMCID: PMC10978376 DOI: 10.1093/bjro/tzae005] [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: 10/16/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
"How tall will I be?" Every paediatrician has been asked this during their career. The growth plate is the main site of longitudinal growth of the long bones. The chondrocytes in the growth plate have a columnar pattern detectable by diffusion tensor imaging (DTI). DTI shows the diffusion of water in a tissue and whether it is iso- or anisotropic. By detecting direction and magnitude of diffusion, DTI gives information about the microstructure of the tissue. DTI metrics include tract volume, length, and number, fractional anisotropy (FA), and mean diffusivity. DTI metrics, particularly tract volume, provide quantitative data regarding skeletal growth and, in conjunction with the fractional anisotropy, be used to determine whether a growth plate is normal. Tractography is a visual display of the diffusion, depicting its direction and amplitude. Tractography gives a more qualitative visualization of cellular orientation in a tissue and reflects the activity in the growth plate. These two components of DTI can be used to assess the growth plate without ionizing radiation or pain. Further refinements in DTI will improve prediction of post-imaging growth and growth plate closure, and assessment of the positive and negative effect of treatments like cis-retinoic acid and growth hormone administration.
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Affiliation(s)
- Ola Kvist
- Department of Paediatric Radiology, Karolinska University Hospital, Stockholm, 171 64, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, 171 77, Sweden
| | - Laura A Santos
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY 100 32, United States
| | - Francesca De Luca
- Department of Radiology, Karolinska University Hospital, Stockholm, 171 64, Sweden
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, 171 65, Sweden
| | - Diego Jaramillo
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY 100 32, United States
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Santos LA, Sullivan B, Kvist O, Jambawalikar S, Mostoufi-Moab S, Raya JM, Nguyen J, Marin D, Delgado J, Tokaria R, Nelson RR, Kammen B, Jaramillo D. Diffusion tensor imaging of the physis: the ABC's. Pediatr Radiol 2023; 53:2355-2368. [PMID: 37658251 DOI: 10.1007/s00247-023-05753-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
The physis, or growth plate, is the primary structure responsible for longitudinal growth of the long bones. Diffusion tensor imaging (DTI) is a technique that depicts the anisotropic motion of water molecules, or diffusion. When diffusion is limited by cellular membranes, information on tissue microstructure can be acquired. Tractography, the visual display of the direction and magnitude of water diffusion, provides qualitative visualization of complex cellular architecture as well as quantitative diffusion metrics that appear to indirectly reflect physeal activity. In the growing bones, DTI depicts the columns of cartilage and new bone in the physeal-metaphyseal complex. In this "How I do It", we will highlight the value of DTI as a clinical tool by presenting DTI tractography of the physeal-metaphyseal complex of children and adolescents during normal growth, illustrating variation in qualitative and quantitative tractography metrics with age and skeletal location. In addition, we will present tractography from patients with physeal dysfunction caused by growth hormone deficiency and physeal injury due to trauma, chemotherapy, and radiation therapy. Furthermore, we will delineate our process, or "DTI pipeline," from image acquisition to data interpretation.
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Affiliation(s)
- Laura A Santos
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA.
| | - Brendan Sullivan
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA
| | - Ola Kvist
- Pediatric Radiology Department, Karolinska University Hospital, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Sachin Jambawalikar
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA
| | | | - Jose M Raya
- New York University Langone Health, New York, NY, USA
| | - Jie Nguyen
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Diana Marin
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA
| | - Jorge Delgado
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Rumana Tokaria
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA
| | - Ronald R Nelson
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA
| | - Bamidele Kammen
- University of California San Francisco, San Francisco, CA, USA
| | - Diego Jaramillo
- Department of Radiology, Columbia University Irvine Medical Center, New York, NY, USA
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Kvist O, Dorniok T, Sanmartin Berglund J, Nilsson O, Flodmark CE, Diaz S. DTI assessment of the maturing growth plate of the knee in adolescents and young adults. Eur J Radiol 2023; 162:110759. [PMID: 36931119 DOI: 10.1016/j.ejrad.2023.110759] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE To assess the growth plates of the knee in a healthy population of young adults and adolescents using DTI, and to correlate the findings with chronological age and skeletal maturation. METHODS A prospective, cross-sectional study to assess the tibial and femoral growth plates with DTI in 155 healthy volunteers aged between 14.0 and 21 years old. Echo-planar DTI with 15 directions and b value of 0 and 600 s/mm2 was performed on a 3 T whole-body scanner. RESULTS A relationship was observed between chronological age and most DTI metrics (fractional anisotropy, mean diffusivity, and radial diffusivity), tract length and volume. (No significant relationship could be seen for axonal diffusivity and tract length.) Subdivision according to skeletal maturation showed the greatest tract lengths and volumes seen in stage 4b and not 4a. The intra-observer agreement was significant (P = 0.01) for all the measured variables, but agreement varied (femur 0.53 - 0.98; tibia 0.58 - 0.98). Spearman's correlation showed a significant correlation for age (P = 0.05; P = 0.01) as well as for the fractional anisotropy value within all variables in both femur and tibia. Tract number and volume had a similar correlation with most variables, especially the DTI metrics, and would seem to be interchangeable. CONCLUSION The current study indicates that DTI metrics could be a tool to assess the skeletal maturation process of the growth plate and its activity. Tractography seems promising to assess the activity of the growth plate in a younger population but must be used with caution in the more mature growth plate.
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Affiliation(s)
- Ola Kvist
- Department of Paediatric Radiology, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.
| | - Torsten Dorniok
- Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.
| | | | - Ola Nilsson
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; School of Medical Sciences and Department of Paediatrics, Örebro University and University Hospital, Örebro, Sweden.
| | - Carl-Erik Flodmark
- Department of Clinical Sciences in Malmö, Lunds University, Lund, Sweden.
| | - Sandra Diaz
- Department of Paediatric Radiology, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden; Department of Radiology, Lunds University, Lund, Sweden.
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Kvist O, Damberg P, Dou Z, Berglund JS, Flodmark C, Nilsson O, Diaz S. Magnetic resonance and diffusion tensor imaging of the adolescent rabbit growth plate of the knee. Magn Reson Med 2023; 89:331-342. [PMID: 36110062 PMCID: PMC9826331 DOI: 10.1002/mrm.29432] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To assess the ability of MRI-DTI to evaluate growth plate morphology and activity compared with that of histomorphometry and micro-CT in rabbits. METHODS The hind limbs of female rabbits aged 16, 20, and 24 wk (n = 4 per age group) were studied using a 9.4T MRI scanner with a multi-gradient echo 3D sequence and DTI in 14 directions (b-value = 984 s/mm2 ). After MRI, the right and left hind limb were processed for histological analysis and micro-CT, respectively. The Wilcoxon signed-rank test was used to evaluate the height and volume of the growth plate. Intraclass correlation and Pearson correlation coefficient were used to evaluate the association between DTI metrics and age. RESULTS The growth plate height and volume were similar for all modalities at each time point and age. Age was correlated with all tractography and DTI metrics in both the femur and tibia. A correlation was also observed between all the metrics at both sites. Tract number and volume declined with age; however, tract length did not show any changes. The fractional anisotropy color map showed lateral diffusion centrally in the growth plate and perpendicular diffusion in the hypertrophic zone, as verified by histology and micro-CT. CONCLUSION MRI-DTI may be useful for evaluating the growth plates.
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Affiliation(s)
- Ola Kvist
- Department of Paediatric RadiologyKarolinska University Hospital
StockholmSweden,Department of Women's and Children's HealthKarolinska InstituteStockholmSweden
| | - Peter Damberg
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Zelong Dou
- Department of Women's and Children's HealthKarolinska InstituteStockholmSweden
| | | | | | - Ola Nilsson
- Department of Women's and Children's HealthKarolinska InstituteStockholmSweden,School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Sandra Diaz
- Department of Paediatric RadiologyKarolinska University Hospital
StockholmSweden,Department of Women's and Children's HealthKarolinska InstituteStockholmSweden,Department of RadiologyLunds UniversityLundSweden
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Jaramillo D, Duong P, Nguyen JC, Mostoufi-Moab S, Nguyen MK, Moreau A, Barrera CA, Hong S, Raya JG. Diffusion Tensor Imaging of the Knee to Predict Childhood Growth. Radiology 2022; 303:655-663. [PMID: 35315716 PMCID: PMC9131176 DOI: 10.1148/radiol.210484] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 12/15/2021] [Accepted: 01/19/2022] [Indexed: 01/16/2023]
Abstract
Background Accurate and precise methods to predict growth remain lacking. Diffusion tensor imaging (DTI) depicts the columnar structure of the physis and metaphyseal spongiosa and provides measures of tract volume and length that may help predict growth. Purpose To validate physeal DTI metrics as predictors of height velocity (1-year height gain from time of MRI examination) and total height gain (height gain from time of MRI examination until growth stops) and compare the prediction accuracy with bone age-based models. Materials and Methods Femoral DTI studies (b values = 0 and 600 sec/mm2; directions = 20) of healthy children who underwent MRI of the knee between February 2012 and December 2016 were retrospectively analyzed. Children with height measured at MRI and either 1 year later (height velocity) or after growth cessation (total height gain, mean = 34 months from MRI) were included. Physeal DTI tract volume and length were correlated with height velocity and total height gain. Multilinear regression was used to assess the potential of DTI metrics in the prediction of both parameters. Bland-Altman plots were used to compare root mean square error (RMSE) and bias in height prediction using DTI versus bone age methods. Results Eighty-nine children (mean age, 13 years ± 3 [SD]; 47 boys) had height velocity measured, and 70 (mean age, 14 years ± 1; 36 girls) had total height gain measured. Tract volumes correlated with height velocity (r2 = 0.49) and total height gain (r2 = 0.46) (P < .001 for both) after controlling for age and sex. Tract volume was the strongest predictor for height velocity and total height gain. An optimal multilinear model including tract volume improved prediction of height velocity (R2 = 0.63, RMSE = 1.7 cm) and total height gain (R2 = 0.59, RMSE = 1.8 cm) compared with bone age-based methods (height velocity: R2 = 0.32, RMSE = 2.9 cm; total height gain: R2 = 0.42, RMSE = 5.0 cm). Conclusion Models using tract volume derived from diffusion tensor imaging may perform better than bone age-based models in children for the prediction of height velocity and total height gain. © RSNA, 2022.
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Affiliation(s)
- Diego Jaramillo
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Phuong Duong
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Jie C. Nguyen
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Sogol Mostoufi-Moab
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Michael K. Nguyen
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Andrew Moreau
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Christian A. Barrera
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - Shijie Hong
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
| | - José G. Raya
- From the Department of Radiology, Columbia University Medical Center,
630 W 168th St, MC 28, New York, NY 10032 (D.J., P.D.); Department of Radiology
(J.C.N., M.K.N., S.H.) and Division of Oncology (S.M.M., A.M.),
Children’s Hospital of Philadelphia, Philadelphia, Pa; Department of
Radiology, Massachusetts General Hospital, Boston, Mass (C.A.B.); and Department
of Radiology, NYU Grossman School of Medicine, New York, NY (J.G.R.)
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10
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Shen J, Zhao Q, Qi Y, Cofer G, Johnson GA, Wang N. Tractography of Porcine Meniscus Microstructure Using High-Resolution Diffusion Magnetic Resonance Imaging. Front Endocrinol (Lausanne) 2022; 13:876784. [PMID: 35620393 PMCID: PMC9127075 DOI: 10.3389/fendo.2022.876784] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 04/04/2022] [Indexed: 11/23/2022] Open
Abstract
To noninvasively evaluate the three-dimensional collagen fiber architecture of porcine meniscus using diffusion MRI, meniscal specimens were scanned using a 3D diffusion-weighted spin-echo pulse sequence at 7.0 T. The collagen fiber alignment was revealed in each voxel and the complex 3D collagen network was visualized for the entire meniscus using tractography. The proposed automatic segmentation methods divided the whole meniscus to different zones (Red-Red, Red-White, and White-White) and different parts (anterior, body, and posterior). The diffusion tensor imaging (DTI) metrics were quantified based on the segmentation results. The heatmap was generated to investigate the connections among different regions of meniscus. Strong zonal-dependent diffusion properties were demonstrated by DTI metrics. The fractional anisotropy (FA) value increased from 0.13 (White-White zone) to 0.26 (Red-Red zone) and the radial diffusivity (RD) value changed from 1.0 × 10-3 mm2/s (White-White zone) to 0.7 × 10-3 mm2/s (Red-Red zone). Coexistence of both radial and circumferential collagen fibers in the meniscus was evident by diffusion tractography. Weak connections were found between White-White zone and Red-Red zone in each part of the meniscus. The anterior part and posterior part were less connected, while the body part showed high connections to both anterior part and posterior part. The tractography based on diffusion MRI may provide a complementary method to study the integrity of meniscus and nondestructively visualize the 3D collagen fiber architecture.
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Affiliation(s)
- Jikai Shen
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
- School of Life Sciences, Westlake University, Hangzhou, China
| | - Qi Zhao
- Physical Education Institute, Jimei University, Xiamen, China
| | - Yi Qi
- Department of Radiology, Duke University School of Medicine, Durham, NC, United States
| | - Gary Cofer
- Department of Radiology, Duke University School of Medicine, Durham, NC, United States
| | - G. Allan Johnson
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
- Department of Radiology, Duke University School of Medicine, Durham, NC, United States
| | - Nian Wang
- Department of Radiology, Duke University School of Medicine, Durham, NC, United States
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neurosciences Research Institute, Indiana University, Indianapolis, IN, United States
- *Correspondence: Nian Wang,
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11
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Pasha S, Rajapaske CR, Reddy R, Diebo B, Knott P, Jones BC, Kumar D, Zhu W, Lou E, Shapira N, Noel P, Ho-Fung V, Jaramillo D. Quantitative imaging of the spine in adolescent idiopathic scoliosis: shifting the paradigm from diagnostic to comprehensive prognostic evaluation. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2021; 31:1273-1285. [PMID: 33517495 DOI: 10.1007/s00590-021-02883-8] [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: 10/14/2020] [Accepted: 01/18/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE We aimed to provide a perspective review of the available quantitative imaging modalities of the spine for prognostic evaluation of the adolescent idiopathic scoliosis (AIS). METHODS A technical description of the current imaging technologies for quantitative assessment of the pediatric spine with scoliosis was provided, and the pros and cons of each method were discussed. Imaging modalities that quantify the overall 3D alignment of the spine as well as the structural specification of the spinal bone, intervertebral disc, endplates, and ligaments as it pertains to development and progression of the idiopathic spinal deformities in adolescents were discussed. RESULTS Low-dose and microdose stereoradiography, ultrasound, and rasterstereography provide quantitative imaging of the 3D spinal alignment with low or no radiation in standing posture which allows repetitive imaging for early detection of the curve development. Quantitative magnetic resonance imaging, including ultrashort dual-echo time and T1-rho can provide quantitative assessment of the spinal tissues relevant to development of idiopathic spinal deformity in pediatric population. New computed tomography scans that uses dual-energy can provides high-resolution measure of the current-state of the bone quality and morphology as well as the osteogenic properties of the bone by quantitative evaluation of the bone marrow. CONCLUSION The presented imaging modalities can provide a wide spectrum of quantifiable information relevant to development and progression of the spinal deformity. Clinical application of these technologies can change the paradigm in clinical assessment of the pediatric scoliosis by improving our understanding of the pathogenesis of the idiopathic scoliosis.
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Affiliation(s)
- Saba Pasha
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA.
| | - Chamith R Rajapaske
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Ravinder Reddy
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Bassel Diebo
- State University of New York Downstate Medical Center, New York, USA
| | - Patrick Knott
- Rosalind Franklin University of Medicine and Science, Chicago, USA
| | - Brandon C Jones
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Dushyant Kumar
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Winnie Zhu
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Edmond Lou
- Department of Electrical Computer Engineering, University of Alberta, Edmonton, Canada
| | - Nadav Shapira
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Peter Noel
- Department of Radiology, University of Pennsylvania, Philadelphia, USA
| | - Victor Ho-Fung
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, USA
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12
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Affiliation(s)
- Nancy A Chauvin
- Department of Pediatric Radiology, Penn State Health Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, PA.
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13
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Duong P, Mostoufi-Moab S, Raya JG, Jaimes C, Delgado J, Jaramillo D. Imaging Biomarkers of the Physis: Cartilage Volume on MRI vs. Tract Volume and Length on Diffusion Tensor Imaging. J Magn Reson Imaging 2020; 52:544-551. [PMID: 32039525 DOI: 10.1002/jmri.27076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Current methods to predict height and growth failure are imprecise. MRI measures of physeal cartilage are promising biomarkers for growth. PURPOSE In the physis, to assess how 3D MRI volume measurements, and diffusion tensor imaging (DTI) measurements (tract volume and length) correlate with growth parameters and detect differences in growth. We compared patients exposed to cis-retinoic acid, which causes physeal damage and growth failure, with normal subjects. STUDY TYPE Case-control. POPULATION Twenty pediatric neuroblastoma survivors treated with cis-retinoic acid and 20 age- and sex-matched controls. FIELD STRENGTH/SEQUENCE 3T; DTI and 3D double-echo steady-state (DESS) sequences. ASSESSMENT On distal femoral MR studies, physeal 3D volume and DTI tract measurements were calculated and compared to height. STATISTICAL TESTS We used partial Spearman correlation, analysis of covariance, logistic regression, Wald test, and the intraclass correlation coefficient (ICC). RESULTS The height percentile correlated most strongly with DTI tract volumes (r = 0.74), followed by mean tract length (r = 0.53) and 3D volume (r = 0.40) (all P < 0.02). Only tract volumes and lengths correlated with annualized growth velocity. Relative to controls, patients showed smaller tract volumes (8.00 cc vs. 13.71 cc, P < 0.01), shorter tract lengths (5.92 mm vs 6.99 mm, P = 0.03), and smaller ratios of 3D cartilage volume to tract length; but no difference (4.51 cc vs 4.85 cc) in 3D MRI volumes. The 10 patients with the lowest height percentiles had smaller tract volumes (5.07 cc vs. 10.93 cc, P < 0.01), but not significantly different 3D MRI volumes. Tract volume is associated with abnormal growth, with an accuracy of 75%. DATA CONCLUSION DTI tract volume of the physis/metaphysis predicts abnormal growth better than physeal cartilage volumetric measurement and correlates best with height percentile and growth velocity. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 2 J. Magn. Reson. Imaging 2020;52:544-551.
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Affiliation(s)
- Phuong Duong
- Department of Radiology, Columbia University Medical Center, New York, New York, USA
| | - Sogol Mostoufi-Moab
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - José G Raya
- Department of Radiology, NYU Langone Medical Center, New York, New York, USA
| | - Camilo Jaimes
- Department of Radiology, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Jorge Delgado
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Diego Jaramillo
- Department of Radiology, Columbia University Medical Center, New York, New York, USA
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14
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Wang N, Mirando AJ, Cofer G, Qi Y, Hilton MJ, Johnson GA. Characterization complex collagen fiber architecture in knee joint using high-resolution diffusion imaging. Magn Reson Med 2020; 84:908-919. [PMID: 31962373 DOI: 10.1002/mrm.28181] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/02/2020] [Accepted: 01/03/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the complex fiber orientations and 3D collagen fiber network of knee joint connective tissues, including ligaments, muscle, articular cartilage, and meniscus using high spatial and angular resolution diffusion imaging. METHODS Two rat knee joints were scanned using a modified 3D diffusion-weighted spin echo pulse sequence with the isotropic spatial resolution of 45 μm at 9.4T. The b values varied from 250 to 1250 s/mm2 with 31 diffusion encoding directions for 1 rat knee. The b value was fixed to 1000 s/mm2 with 147 diffusion encoding directions for the second knee. Both the diffusion tensor imaging (DTI) model and generalized Q-sampling imaging (GQI) method were used to investigate the fiber orientation distributions and tractography with the validation of polarized light microscopy. RESULTS To better resolve the crossing fibers, the b value should be great than or equal to 1000 s/mm2 . The tractography results were comparable between the DTI model and GQI method in ligament and muscle. However, the tractography exhibited apparent difference between DTI and GQI in connective tissues with more complex collagen fibers network, such as cartilage and meniscus. In articular cartilage, there were numerous crossing fibers found in superficial zone and transitional zone. Tractography generated with GQI also resulted in more intact tracts in articular cartilage than DTI. CONCLUSION High-resolution diffusion imaging with GQI method can trace the complex collagen fiber orientations and architectures of the knee joint at microscopic resolution.
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Affiliation(s)
- Nian Wang
- Center for In Vivo Microscopy, Duke University School of Medicine, Durham, North Carolina.,Department of Radiology, Duke University School of Medicine, Durham, North Carolina
| | - Anthony J Mirando
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Gary Cofer
- Center for In Vivo Microscopy, Duke University School of Medicine, Durham, North Carolina
| | - Yi Qi
- Center for In Vivo Microscopy, Duke University School of Medicine, Durham, North Carolina
| | - Matthew J Hilton
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina.,Department of Cell Biology, Duke University School of Medicine, Durham, North Carolina
| | - G Allan Johnson
- Center for In Vivo Microscopy, Duke University School of Medicine, Durham, North Carolina.,Department of Radiology, Duke University School of Medicine, Durham, North Carolina
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