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Kamp B, Radke KL, Knet M, Strunk R, Gallinnis PJ, Nagel AM, Filler TJ, Antoch G, Abrar DB, Frenken M, Wittsack HJ, Müller-Lutz A. Sodium MRI of the Lumbar Intervertebral Discs of the Human Spine: An Ex Vivo Study. J Magn Reson Imaging 2024. [PMID: 38963154 DOI: 10.1002/jmri.29521] [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: 03/05/2024] [Revised: 06/18/2024] [Accepted: 06/18/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Lower back pain affects 75%-85% of people at some point in their lives. The detection of biochemical changes with sodium (23Na) MRI has potential to enable an earlier and more accurate diagnosis. PURPOSE To measure 23Na relaxation times and apparent tissue sodium concentration (aTSC) in ex-vivo intervertebral discs (IVDs), and to investigate the relationship between aTSC and histological Thompson grade. STUDY TYPE Ex-vivo. SPECIMEN Thirty IVDs from the lumbar spines of 11 human body donors (4 female, 7 male, mean age 86 ± 8 years). FIELD STRENGTH/SEQUENCE 3 T; density-adapted 3D radial sequence (DA-3D-RAD). ASSESSMENT IVD 23Na longitudinal (T1), short and long transverse (T2s* and T2l*) relaxation times and the proportion of the short transverse relaxation (ps) were calculated for one IVD per spine sample (11 IVDs). Furthermore, aTSCs were calculated for all IVDs. The degradation of the IVDs was assessed via histological Thompson grading. STATISTICAL TESTS A Kendall Tau correlation (τ) test was performed between the aTSCs and the Thompson grades. The significance level was set to P < 0.05. RESULTS Mean 23Na relaxation parameters of a subset of 11 IVDs were T1 = 9.8 ± 1.3 msec, T2s* = 0.7 ± 0.1 msec, T2l* = 7.3 ± 1.1 msec, and ps = 32.7 ± 4.0%. A total of 30 IVDs were examined, of which 3 had Thompson grade 1, 4 had grade 2, 5 had grade 3, 5 had grade 4, and 13 had grade 5. The aTSC decreased with increasing degradation, being 274.6 ± 18.9 mM for Thompson grade 1 and 190.5 ± 29.5 mM for Thompson grade 5. The correlation between whole IVD aTSC and Thompson grade was significant and strongly negative (τ = -0.56). DATA CONCLUSION This study showed a significant correlation between aTSC and degenerative IVD changes. Consequently, aTSC has potential to be useful as an indicator of degenerative spinal changes. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Marek Knet
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Rosanna Strunk
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Patrik J Gallinnis
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, 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
| | - Timm J Filler
- Institute of Anatomy I, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Daniel B Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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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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Yin Y, Song Y, Jia Y, Xia J, Bai R, Kong X. Sodium Dynamics in the Cellular Environment. J Am Chem Soc 2023; 145:10522-10532. [PMID: 37104830 DOI: 10.1021/jacs.2c13271] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Sodium ions are essential for the functions of biological cells, and they are maintained at the balance between intra- and extracellular environments. The quantitative assessment of intra- and extracellular sodium as well as its dynamics can provide crucial physiological information on a living system. 23Na nuclear magnetic resonance (NMR) is a powerful and noninvasive technique to probe the local environment and dynamics of sodium ions. However, due to the complex relaxation behavior of the quadrupolar nucleus in the intermediate-motion regime and because of the heterogeneous compartments and diverse molecular interactions in the cellular environment, the understanding of the 23Na NMR signal in biological systems is still at the early stage. In this work, we characterize the relaxation and diffusion of sodium ions in the solutions of proteins and polysaccharides, as well as in the in vitro samples of living cells. The multi-exponential behavior of 23Na transverse relaxation has been analyzed according to the relaxation theory to derive the crucial information related to the ionic dynamics and molecular binding in the solutions. The bi-compartment model of transverse relaxation and diffusion measurements can corroborate each other to quantify the fractions of intra- and extracellular sodium. We show that 23Na relaxation and diffusion can be used to monitor the viability of human cells, which offers versatile NMR metrics for in vivo studies.
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Affiliation(s)
- Yu Yin
- Department of Chemistry, Zhejiang University, 310027 Hangzhou, P. R. China
| | - Yifan Song
- Department of Chemistry, Zhejiang University, 310027 Hangzhou, P. R. China
| | - Yinhang Jia
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, P. R. China
| | - Juntao Xia
- Department of Chemistry, Zhejiang University, 310027 Hangzhou, P. R. China
| | - Ruiliang Bai
- Key Laboratory of Biomedical Engineering of Education Ministry, College of Biomedical Engineering and Instrument Science, Zhejiang University, 310027 Hangzhou, Zhejiang, P. R. China
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, 310029 Hangzhou, China
- Department of Physical Medicine and Rehabilitation, Sir Run Run Shaw Hospital, Zhejiang University, 310016 Hangzhou, China
| | - Xueqian Kong
- Department of Chemistry, Zhejiang University, 310027 Hangzhou, P. R. China
- Department of Physical Medicine and Rehabilitation, Sir Run Run Shaw Hospital, Zhejiang University, 310016 Hangzhou, China
- Institute of Translational Medicine, Shanghai Jiao Tong University, 200240 Shanghai, P. R. China
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Evaluation of Sodium Relaxation Times and Concentrations in the Achilles Tendon Using MRI. Int J Mol Sci 2022; 23:ijms231810890. [PMID: 36142810 PMCID: PMC9501448 DOI: 10.3390/ijms231810890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022] Open
Abstract
Sodium magnetic resonance imaging (MRI) can be used to evaluate the change in the proteoglycan content in Achilles tendons (ATs) of patients with different AT pathologies by measuring the 23Na signal-to-noise ratio (SNR). As 23Na SNR alone is difficult to compare between different studies, because of the high influence of hardware configurations and sequence settings on the SNR, we further set out to measure the apparent tissue sodium content (aTSC) in the AT as a better comparable parameter. Ten healthy controls and one patient with tendinopathy in the AT were examined using a clinical 3 Tesla (T) MRI scanner in conjunction with a dual tuned 1H/23Na surface coil to measure 23Na SNR and aTSC in their ATs. 23Na T1 and T2* of the AT were also measured for three controls to correct for different relaxation behavior. The results were as follows: 23Na SNR = 11.7 ± 2.2, aTSC = 82.2 ± 13.9 mM, 23Na T1 = 20.4 ± 2.4 ms, 23Na T2s* = 1.4 ± 0.4 ms, and 23Na T2l* = 13.9 ± 0.8 ms for the whole AT of healthy controls with significant regional differences. These are the first reported aTSCs and 23Na relaxation times for the AT using sodium MRI and may serve for future comparability in different studies regarding examinations of diseased ATs with sodium MRI.
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Chemical Exchange Saturation Transfer for Lactate-Weighted Imaging at 3 T MRI: Comprehensive In Silico, In Vitro, In Situ, and In Vivo Evaluations. Tomography 2022; 8:1277-1292. [PMID: 35645392 PMCID: PMC9149919 DOI: 10.3390/tomography8030106] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 01/22/2023] Open
Abstract
Based on in silico, in vitro, in situ, and in vivo evaluations, this study aims to establish and optimize the chemical exchange saturation transfer (CEST) imaging of lactate (Lactate-CEST—LATEST). To this end, we optimized LATEST sequences using Bloch−McConnell simulations for optimal detection of lactate with a clinical 3 T MRI scanner. The optimized sequences were used to image variable lactate concentrations in vitro (using phantom measurements), in situ (using nine human cadaveric lower leg specimens), and in vivo (using four healthy volunteers after exertional exercise) that were then statistically analyzed using the non-parametric Friedman test and Kendall Tau-b rank correlation. Within the simulated Bloch−McConnell equations framework, the magnetization transfer ratio asymmetry (MTRasym) value was quantified as 0.4% in the lactate-specific range of 0.5−1 ppm, both in vitro and in situ, and served as the imaging surrogate of the lactate level. In situ, significant differences (p < 0.001) and strong correlations (τ = 0.67) were observed between the MTRasym values and standardized intra-muscular lactate concentrations. In vivo, a temporary increase in the MTRasym values was detected after exertional exercise. In this bench-to-bedside comprehensive feasibility study, different lactate concentrations were detected using an optimized LATEST imaging protocol in vitro, in situ, and in vivo at 3 T, which prospectively paves the way towards non-invasive quantification and monitoring of lactate levels across a broad spectrum of diseases.
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Fast, Accurate, and Robust T2 Mapping of Articular Cartilage by Neural Networks. Diagnostics (Basel) 2022; 12:diagnostics12030688. [PMID: 35328240 PMCID: PMC8947694 DOI: 10.3390/diagnostics12030688] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/25/2022] [Accepted: 03/09/2022] [Indexed: 12/31/2022] Open
Abstract
For T2 mapping, the underlying mono-exponential signal decay is traditionally quantified by non-linear Least-Squares Estimation (LSE) curve fitting, which is prone to outliers and computationally expensive. This study aimed to validate a fully connected neural network (NN) to estimate T2 relaxation times and to assess its performance versus LSE fitting methods. To this end, the NN was trained and tested in silico on a synthetic dataset of 75 million signal decays. Its quantification error was comparatively evaluated against three LSE methods, i.e., traditional methods without any modification, with an offset, and one with noise correction. Following in-situ acquisition of T2 maps in seven human cadaveric knee joint specimens at high and low signal-to-noise ratios, the NN and LSE methods were used to estimate the T2 relaxation times of the manually segmented patellofemoral cartilage. In-silico modeling at low signal-to-noise ratio indicated significantly lower quantification error for the NN (by medians of 6−33%) than for the LSE methods (p < 0.001). These results were confirmed by the in-situ measurements (medians of 10−35%). T2 quantification by the NN took only 4 s, which was faster than the LSE methods (28−43 s). In conclusion, NNs provide fast, accurate, and robust quantification of T2 relaxation times.
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7
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Kamp B, Frenken M, Henke JM, Abrar DB, Nagel AM, Gast LV, Oeltzschner G, Wilms LM, Nebelung S, Antoch G, Wittsack HJ, Müller-Lutz A. Quantification of Sodium Relaxation Times and Concentrations as Surrogates of Proteoglycan Content of Patellar CARTILAGE at 3T MRI. Diagnostics (Basel) 2021; 11:diagnostics11122301. [PMID: 34943538 PMCID: PMC8700247 DOI: 10.3390/diagnostics11122301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022] Open
Abstract
Sodium MRI has the potential to depict cartilage health accurately, but synovial fluid can influence the estimation of sodium parameters of cartilage. Therefore, this study aimed to reduce the impact of synovial fluid to render the quantitative compositional analyses of cartilage tissue technically more robust. Two dedicated protocols were applied for determining sodium T1 and T2* relaxation times. For each protocol, data were acquired from 10 healthy volunteers and one patient with patellar cartilage damage. Data recorded with multiple repetition times for T1 measurement and multi-echo data acquired with an additional inversion recovery pulse for T2* measurement were analysed using biexponential models to differentiate longitudinal relaxation components of cartilage (T1,car) and synovial fluid (T1,syn), and short (T2s*) from long (T2l*) transversal relaxation components. Sodium relaxation times and concentration estimates in patellar cartilage were successfully determined: T1,car = 14.5 ± 0.7 ms; T1,syn = 37.9 ± 2.9 ms; c(T1-protocol) = 200 ± 48 mmol/L; T2s* = 0.4 ± 0.1 ms; T2l* = 12.6 ± 0.7 ms; c(T2*-protocol) = 215 ± 44 mmol/L for healthy volunteers. In conclusion, a robust determination of sodium relaxation times is possible at a clinical field strength of 3T to quantify sodium concentrations, which might be a valuable tool to determine cartilage health.
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Affiliation(s)
- Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
- Correspondence:
| | - Jan M. Henke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
- Clinic of Nuclear Medicine, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
| | - Daniel B. Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Armin M. Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91054 Erlangen, Germany; (A.M.N.); (L.V.G.)
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, D-69120 Heidelberg, Germany
| | - Lena V. Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91054 Erlangen, Germany; (A.M.N.); (L.V.G.)
| | - Georg Oeltzschner
- Russell H. Morgan Department for Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205-2196, USA;
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205-2196, USA
| | - Lena M. Wilms
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
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Said O, Schock J, Abrar DB, Schad P, Kuhl C, Nolte T, Knobe M, Prescher A, Truhn D, Nebelung S. In-Situ Cartilage Functionality Assessment Based on Advanced MRI Techniques and Precise Compartmental Knee Joint Loading through Varus and Valgus Stress. Diagnostics (Basel) 2021; 11:diagnostics11081476. [PMID: 34441410 PMCID: PMC8391314 DOI: 10.3390/diagnostics11081476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 12/05/2022] Open
Abstract
Stress MRI brings together mechanical loading and MRI in the functional assessment of cartilage and meniscus, yet lacks basic scientific validation. This study assessed the response-to-loading patterns of cartilage and meniscus incurred by standardized compartmental varus and valgus loading of the human knee joint. Eight human cadaveric knee joints underwent imaging by morphologic (i.e., proton density-weighted fat-saturated and 3D water-selective) and quantitative (i.e., T1ρ and T2 mapping) sequences, both unloaded and loaded to 73.5 N, 147.1 N, and 220.6 N of compartmental pressurization. After manual segmentation of cartilage and meniscus, morphometric measures and T2 and T1ρ relaxation times were quantified. CT-based analysis of joint alignment and histologic and biomechanical tissue measures served as references. Under loading, we observed significant decreases in cartilage thickness (p < 0.001 (repeated measures ANOVA)) and T1ρ relaxation times (p = 0.001; medial meniscus, lateral tibia; (Friedman test)), significant increases in T2 relaxation times (p ≤ 0.004; medial femur, lateral tibia; (Friedman test)), and adaptive joint motion. In conclusion, varus and valgus stress MRI induces meaningful changes in cartilage and meniscus secondary to compartmental loading that may be assessed by cartilage morphometric measures as well as T2 and T1ρ mapping as imaging surrogates of tissue functionality.
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Affiliation(s)
- Oliver Said
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (O.S.); (P.S.); (C.K.); (T.N.); (D.T.); (S.N.)
| | - Justus Schock
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany;
- Correspondence:
| | - Daniel Benjamin Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany;
| | - Philipp Schad
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (O.S.); (P.S.); (C.K.); (T.N.); (D.T.); (S.N.)
| | - Christiane Kuhl
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (O.S.); (P.S.); (C.K.); (T.N.); (D.T.); (S.N.)
| | - Teresa Nolte
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (O.S.); (P.S.); (C.K.); (T.N.); (D.T.); (S.N.)
| | - Matthias Knobe
- Department of Orthopedic and Trauma Surgery, Lucerne Cantonal Hospital, 6000, Lucerne, Switzerland;
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, 52074 Aachen, Germany;
| | - Daniel Truhn
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (O.S.); (P.S.); (C.K.); (T.N.); (D.T.); (S.N.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (O.S.); (P.S.); (C.K.); (T.N.); (D.T.); (S.N.)
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Huppertz MS, Schock J, Radke KL, Abrar DB, Post M, Kuhl C, Truhn D, Nebelung S. Longitudinal T2 Mapping and Texture Feature Analysis in the Detection and Monitoring of Experimental Post-Traumatic Cartilage Degeneration. Life (Basel) 2021; 11:life11030201. [PMID: 33807740 PMCID: PMC8000874 DOI: 10.3390/life11030201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Traumatic cartilage injuries predispose articulating joints to focal cartilage defects and, eventually, posttraumatic osteoarthritis. Current clinical-standard imaging modalities such as morphologic MRI fail to reliably detect cartilage trauma and to monitor associated posttraumatic degenerative changes with oftentimes severe prognostic implications. Quantitative MRI techniques such as T2 mapping are promising in detecting and monitoring such changes yet lack sufficient validation in controlled basic research contexts. Material and Methods: 35 macroscopically intact cartilage samples obtained from total joint replacements were exposed to standardized injurious impaction with low (0.49 J, n = 14) or high (0.98 J, n = 14) energy levels and imaged before and immediately, 24 h, and 72 h after impaction by T2 mapping. Contrast, homogeneity, energy, and variance were quantified as features of texture on each T2 map. Unimpacted controls (n = 7) and histologic assessment served as reference. Results: As a function of impaction energy and time, absolute T2 values, contrast, and variance were significantly increased, while homogeneity and energy were significantly decreased. Conclusion: T2 mapping and texture feature analysis are sensitive diagnostic means to detect and monitor traumatic impaction injuries of cartilage and associated posttraumatic degenerative changes and may be used to assess cartilage after trauma to identify “cartilage at risk”.
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Affiliation(s)
- Marc Sebastian Huppertz
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (M.S.H.); (M.P.); (C.K.); (D.T.)
| | - Justus Schock
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany; (J.S.); (K.L.R.); (D.B.A.)
| | - Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany; (J.S.); (K.L.R.); (D.B.A.)
| | - Daniel Benjamin Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany; (J.S.); (K.L.R.); (D.B.A.)
| | - Manuel Post
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (M.S.H.); (M.P.); (C.K.); (D.T.)
| | - Christiane Kuhl
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (M.S.H.); (M.P.); (C.K.); (D.T.)
| | - Daniel Truhn
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, 52074 Aachen, Germany; (M.S.H.); (M.P.); (C.K.); (D.T.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany; (J.S.); (K.L.R.); (D.B.A.)
- Correspondence:
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Differentiating rheumatoid and psoriatic arthritis: a systematic analysis of high-resolution magnetic resonance imaging features-preliminary findings. Skeletal Radiol 2021; 50:531-541. [PMID: 32845377 PMCID: PMC7811987 DOI: 10.1007/s00256-020-03588-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/07/2020] [Accepted: 08/16/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Because of overlapping phenotypical presentations, the diagnostic differentiation of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) remains challenging. Thus, this study aimed to examine the diagnostic value of distinct imaging features obtained by high-resolution 3-T MRI for the diagnostic differentiation. MATERIALS AND METHODS Seventeen patients with PsA and 28 patients with RA were imaged at high resolution using 3-T MRI scanners and a dedicated 16-channel hand coil. All images were analyzed according to the outcome measures in rheumatology clinical trials' (OMERACT) RAMRIS (Rheumatoid Arthritis Magnetic Resonance Imaging Score) and PsAMRIS (Psoriatic Arthritis Magnetic Resonance Imaging Score) for the presence and intensity of synovitis, flexor tenosynovitis, bone edema, bone erosion, periarticular inflammation, bone proliferation, and joint space narrowing. Next, odds ratios (OR) were calculated to determine the strength of the associations between these imaging features, demographic characteristics, and the outcome RA vs. PsA. RESULTS PsA could be differentiated from RA by extracapsular inflammatory changes (PsAMRIS sub-score "periarticular inflammation"), with low odds for the presence of RA (OR of 0.06, p < 0.01) at all metacarpophalangeal (MCP) joints. A prediction model informed by the items that were strongest associated with the presence of RA or PsA demonstrated excellent differentiating capability with an area under the curve of 98.1%. CONCLUSION High-resolution imaging is beneficial for the identification of relevant imaging features that may assist the clinical differentiation of inflammatory conditions of the hand. At the MCP level, extracapsular inflammatory changes were strongly associated with PsA and may consequently allow the imaging differentiation of PsA and RA.
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Hayes AJ, Melrose J. Aggrecan, the Primary Weight-Bearing Cartilage Proteoglycan, Has Context-Dependent, Cell-Directive Properties in Embryonic Development and Neurogenesis: Aggrecan Glycan Side Chain Modifications Convey Interactive Biodiversity. Biomolecules 2020; 10:E1244. [PMID: 32867198 PMCID: PMC7564073 DOI: 10.3390/biom10091244] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/19/2020] [Accepted: 08/23/2020] [Indexed: 02/06/2023] Open
Abstract
This review examines aggrecan's roles in developmental embryonic tissues, in tissues undergoing morphogenetic transition and in mature weight-bearing tissues. Aggrecan is a remarkably versatile and capable proteoglycan (PG) with diverse tissue context-dependent functional attributes beyond its established role as a weight-bearing PG. The aggrecan core protein provides a template which can be variably decorated with a number of glycosaminoglycan (GAG) side chains including keratan sulphate (KS), human natural killer trisaccharide (HNK-1) and chondroitin sulphate (CS). These convey unique tissue-specific functional properties in water imbibition, space-filling, matrix stabilisation or embryonic cellular regulation. Aggrecan also interacts with morphogens and growth factors directing tissue morphogenesis, remodelling and metaplasia. HNK-1 aggrecan glycoforms direct neural crest cell migration in embryonic development and is neuroprotective in perineuronal nets in the brain. The ability of the aggrecan core protein to assemble CS and KS chains at high density equips cartilage aggrecan with its well-known water-imbibing and weight-bearing properties. The importance of specific arrangements of GAG chains on aggrecan in all its forms is also a primary morphogenetic functional determinant providing aggrecan with unique tissue context dependent regulatory properties. The versatility displayed by aggrecan in biodiverse contexts is a function of its GAG side chains.
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Affiliation(s)
- Anthony J Hayes
- Bioimaging Research Hub, Cardiff School of Biosciences, Cardiff University, Cardiff CF10 3AX, Wales, UK
| | - James Melrose
- Raymond Purves Laboratory, Institute of Bone and Joint Research, Kolling Institute of Medical Research, Northern Sydney Local Health District, Royal North Shore Hospital, St. Leonards 2065, NSW, Australia
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney 2052, NSW, Australia
- Sydney Medical School, Northern, The University of Sydney, Faculty of Medicine and Health at Royal North Shore Hospital, St. Leonards 2065, NSW, Australia
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