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Mononen ME, Liukkonen MK, Turunen MJ. X-ray with finite element analysis is a viable alternative for MRI to predict knee osteoarthritis: Data from the Osteoarthritis Initiative. J Orthop Res 2024; 42:1964-1973. [PMID: 38650428 DOI: 10.1002/jor.25861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/29/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Magnetic resonance imaging (MRI) offers superior soft tissue contrast compared to clinical X-ray imaging methods, while also providing accurate three-dimensional (3D) geometries, it could be reasoned to be the best imaging modality to create 3D finite element (FE) geometries of the knee joint. However, MRI may not necessarily be superior for making tissue-level FE simulations of internal stress distributions within knee joint, which can be utilized to calculate subject-specific risk for the onset and development of knee osteoarthritis (KOA). Specifically, MRI does not provide any information about tissue stiffness, as the imaging is usually performed with the patient lying on their back. In contrast, native X-rays taken while the patient is standing indirectly reveal information of the overall health of the knee that is not seen in MRI. To determine the feasibility of X-ray workflow to generate FE models based on the baseline information (clinical image data and subject characteristics), we compared MRI and X-ray-based simulations of volumetric cartilage degenerations (N = 1213) against 8-year follow-up data. The results suggest that X-ray-based predictions of KOA are at least as good as MRI-based predictions for subjects with no previous knee injuries. This finding may have important implications for preventive care, as X-ray imaging is much more accessible than MRI.
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Affiliation(s)
- Mika E Mononen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Mimmi K Liukkonen
- Department of Clinical Radiology, Kuopio University Hospital, The Wellbeing Services County of North Savo, Kuopio, Finland
| | - Mikael J Turunen
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Science Service Center, Kuopio University Hospital, The Wellbeing Services County of North Savo, Kuopio, Finland
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2
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Lin S, Lu J, Chen Q, Jiang H, Lou C, Lin C, Wang W, Lin J, Pan X, Xue X. Plantamajoside suppresses the activation of NF-κB and MAPK and ameliorates the development of osteoarthritis. Int Immunopharmacol 2023; 115:109582. [PMID: 36584575 DOI: 10.1016/j.intimp.2022.109582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/29/2022]
Abstract
Osteoarthritis (OA) is a common degenerative bone and joint disorder characterized by progressive cartilage degeneration and secondary synovial inflammation. It is a common chronic joint disorder that affects people of all ages (especially the old). Plantamajoside is a phenylpropanoside derived from plantain. It has a variety of biological properties, including antioxidant, anti-malignant cell proliferation, and anti-inflammatory properties. In this study, the latent mechanism of plantamajoside was explored by slowing the in-vivo and in-vitro progression of osteoarthritis. The results revealed that plantamajoside pre-conditioning inhibited IL-1β induced pro-inflammatory factors like COX-2, iNOS, IL-6, and TNF-α. Moreover, plantamajoside also reversed the IL-1 β mediated type II collagen and aggrecan degradation within the extracellular matrix (ECM). The protective effects of plantamajoside have been attributed to the inhibition of both MAPK and NF-κB pathways. Furthermore, our in-vivo research found that plantamajoside could slow the progression of OA in mice. Finally, all findings point to plantamajoside as a potential anti-OA therapeutic candidate.
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Affiliation(s)
- Shida Lin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jiajie Lu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Qiaoxue Chen
- Department of Emergency Medicine, The First Affiliate Hospital of Guang Zhou Medical University, Guangzhou, Guangdong 510120, China
| | - Hongyi Jiang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chao Lou
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Chihao Lin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Weidan Wang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China; Key Laboratory of Orthopaedics of Zhejiang Province, Wenzhou, Zhejiang Province, China; The Second School of Medicine, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Jian Lin
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiaoyun Pan
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xinghe Xue
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
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Mélou C, Pellen-Mussi P, Jeanne S, Novella A, Tricot-Doleux S, Chauvel-Lebret D. Osteoarthritis of the Temporomandibular Joint: A Narrative Overview. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010008. [PMID: 36676632 PMCID: PMC9866170 DOI: 10.3390/medicina59010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
Background and Objectives: This study reviewed the literature to summarize the current and recent knowledge of temporomandibular joint osteoarthritis (TMJOA). Methods: Through a literature review, this work summarizes many concepts related to TMJOA. Results: Although many signaling pathways have been investigated, the etiopathogenesis of TMJOA remains unclear. Some clinical signs are suggestive of TMJOA; however, diagnosis is mainly based on radiological findings. Treatment options include noninvasive, minimally invasive, and surgical techniques. Several study models have been used in TMJOA studies because there is no gold standard model. Conclusion: More research is needed to develop curative treatments for TMJOA, which could be tested with reliable in vitro models, and to explore tissue engineering to regenerate damaged temporomandibular joints.
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Affiliation(s)
- Caroline Mélou
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
- CHU Rennes, Pôle d’Odontologie, 35033 Rennes, France
- UFR Odontologie, 35043 Rennes, France
| | - Pascal Pellen-Mussi
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
| | - Sylvie Jeanne
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
- CHU Rennes, Pôle d’Odontologie, 35033 Rennes, France
- UFR Odontologie, 35043 Rennes, France
| | - Agnès Novella
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
| | - Sylvie Tricot-Doleux
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
| | - Dominique Chauvel-Lebret
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
- CHU Rennes, Pôle d’Odontologie, 35033 Rennes, France
- UFR Odontologie, 35043 Rennes, France
- Correspondence: ; Tel.: +33-2-23-23-43-64; Fax: +33-2-23-23-43-93
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Ciliberti FK, Cesarelli G, Guerrini L, Gunnarsson AE, Forni R, Aubonnet R, Recenti M, Jacob D, Jónsson H, Cangiano V, Islind AS, Gambacorta M, Gargiulo P. The role of bone mineral density and cartilage volume to predict knee cartilage degeneration. Eur J Transl Myol 2022; 32. [PMID: 35766481 PMCID: PMC9295173 DOI: 10.4081/ejtm.2022.10678] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 12/02/2022] Open
Abstract
Knee Osteoarthritis (OA) is a highly prevalent condition affecting knee joint that causes loss of physical function and pain. Clinical treatments are mainly focused on pain relief and limitation of disabilities; therefore, it is crucial to find new paradigms assessing cartilage conditions for detecting and monitoring the progression of OA. The goal of this paper is to highlight the predictive power of several features, such as cartilage density, volume and surface. These features were extracted from the 3D reconstruction of knee joint of forty-seven different patients, subdivided into two categories: degenerative and non-degenerative. The most influent parameters for the degeneration of the knee cartilage were determined using two machine learning classification algorithms (logistic regression and support vector machine); later, box plots, which depicted differences between the classes by gender, were presented to analyze several of the key features’ trend. This work is part of a strategy that aims to find a new solution to assess cartilage condition based on new-investigated features.
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Affiliation(s)
| | - Giuseppe Cesarelli
- Department of Chemical, Materials and Production Engineering (DICMaPI), University of Naples Federico II, Naples.
| | - Lorena Guerrini
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik.
| | | | - Riccardo Forni
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland; Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi" (DEI), University of Bologna, Cesena.
| | - Romain Aubonnet
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik.
| | - Marco Recenti
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik.
| | - Deborah Jacob
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik.
| | - Halldór Jónsson
- Department of Orthopaedics, Landspitali, University Hospital of Iceland, Reykjavik, Iceland; Medical Faculty, University of Iceland, Reykjavik.
| | - Vincenzo Cangiano
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik.
| | | | | | - Paolo Gargiulo
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland; Department of Science, Landspitali, University Hospital of Iceland, Reykjavik.
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Ciliberti FK, Guerrini L, Gunnarsson AE, Recenti M, Jacob D, Cangiano V, Tesfahunegn YA, Islind AS, Tortorella F, Tsirilaki M, Jónsson H, Gargiulo P, Aubonnet R. CT- and MRI-Based 3D Reconstruction of Knee Joint to Assess Cartilage and Bone. Diagnostics (Basel) 2022; 12:diagnostics12020279. [PMID: 35204370 PMCID: PMC8870751 DOI: 10.3390/diagnostics12020279] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/10/2022] [Accepted: 01/20/2022] [Indexed: 02/01/2023] Open
Abstract
For the observation of human joint cartilage, X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) are the main diagnostic tools to evaluate pathologies or traumas. The current work introduces a set of novel measurements and 3D features based on MRI and CT data of the knee joint, used to reconstruct bone and cartilages and to assess cartilage condition from a new perspective. Forty-seven subjects presenting a degenerative disease, a traumatic injury or no symptoms or trauma were recruited in this study and scanned using CT and MRI. Using medical imaging software, the bone and cartilage of the knee joint were segmented and 3D reconstructed. Several features such as cartilage density, volume and surface were extracted. Moreover, an investigation was carried out on the distribution of cartilage thickness and curvature analysis to identify new markers of cartilage condition. All the extracted features were used with advanced statistics tools and machine learning to test the ability of our model to predict cartilage conditions. This work is a first step towards the development of a new gold standard of cartilage assessment based on 3D measurements.
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Affiliation(s)
- Federica Kiyomi Ciliberti
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
- Department of Electrical, Information Engineering and Applied Mathematics, University of Salerno, 84084 Salerno, Italy;
| | - Lorena Guerrini
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
- Laboratory of Cellular and Molecular Engineering “Silvio Cavalcanti”, Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi” (DEI), University of Bologna, 47521 Cesena, Italy
| | - Arnar Evgeni Gunnarsson
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
| | - Marco Recenti
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
| | - Deborah Jacob
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
| | - Vincenzo Cangiano
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
| | | | | | - Francesco Tortorella
- Department of Electrical, Information Engineering and Applied Mathematics, University of Salerno, 84084 Salerno, Italy;
| | - Mariella Tsirilaki
- Department of Radiology, Landspitali, University Hospital of Iceland, 101 Reykjavik, Iceland;
| | - Halldór Jónsson
- Department of Orthopaedics, Landspitali, University Hospital of Iceland, 101 Reykjavik, Iceland;
- Medical Faculty, University of Iceland, 101 Reykjavik, Iceland
| | - Paolo Gargiulo
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
- Department of Science, Landspitali, University Hospital of Iceland, 101 Reykjavik, Iceland
- Correspondence:
| | - Romain Aubonnet
- Institute of Biomedical and Neural Engineering, Reykjavik University, 101 Reykjavik, Iceland; (F.K.C.); (L.G.); (A.E.G.); (M.R.); (D.J.); (V.C.); (R.A.)
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The Use of Scoring Hip Osteoarthritis with MRI as an Assessment Tool for Physiotherapeutic Treatment in Patients with Osteoarthritis of the Hip. J Clin Med 2021; 11:jcm11010017. [PMID: 35011758 PMCID: PMC8745579 DOI: 10.3390/jcm11010017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/12/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022] Open
Abstract
Rehabilitation programs are considered effective at reducing the impact of osteoarthritis (OA) of the hip; however, studies using reliable measures related to OA biomarkers to assess the effects of rehabilitation are lacking. The objective of this study was to investigate whether an MRI-based (Magnetic Resonance Imaging-based), semi-quantitative system for an OA severity assessment is feasible for the evaluation of the structural changes in the joint observed during a long-term physiotherapy program in patients with hip OA. The study group consisted of 37 adult OA patients who participated in a 12-month physiotherapy program. The Scoring hip osteoarthritis with MRI (SHOMRI) system was used to evaluate the severity of structural changes related to hip OA. Hip disability and the osteoarthritis outcome score (HOOS) and the core set of performance-based tests recommended by Osteoarthritis Research Society International were used for functional assessment. SHOMRI showed excellent inter- and intra-rater agreement, proving to be a reliable method for the evaluation of hip abnormalities. At the 12-month follow-up no statistically significant changes were observed within the hip joint; however, a trend of structural progression was detected. There was a negative correlation between most of the SHOMRI and HOOS subscales at baseline and the 12-month follow-up. Although SHOMRI provides a reliable assessment of the hip joint in patients with OA it showed a limited value in detecting significant changes over time in the patients receiving physiotherapy over a 12-month period.
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Jogi SP, Thaha R, Rajan S, Mahajan V, Venugopal VK, Singh A, Mehndiratta A. Model for in-vivo estimation of stiffness of tibiofemoral joint using MR imaging and FEM analysis. J Transl Med 2021; 19:310. [PMID: 34281578 PMCID: PMC8287773 DOI: 10.1186/s12967-021-02977-1] [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: 03/13/2021] [Accepted: 07/04/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Appropriate structural and material properties are essential for finite-element-modeling (FEM). In knee FEM, structural information could extract through 3D-imaging, but the individual subject's tissue material properties are inaccessible. PURPOSE The current study's purpose was to develop a methodology to estimate the subject-specific stiffness of the tibiofemoral joint using finite-element-analysis (FEA) and MRI data of knee joint with and without load. METHODS In this study, six Magnetic Resonance Imaging (MRI) datasets were acquired from 3 healthy volunteers with axially loaded and unloaded knee joint. The strain was computed from the tibiofemoral bone gap difference (ΔmBGFT) using the knee MR images with and without load. The knee FEM study was conducted using a subject-specific knee joint 3D-model and various soft-tissue stiffness values (1 to 50 MPa) to develop subject-specific stiffness versus strain models. RESULTS Less than 1.02% absolute convergence error was observed during the simulation. Subject-specific combined stiffness of weight-bearing tibiofemoral soft-tissue was estimated with mean values as 2.40 ± 0.17 MPa. Intra-subject variability has been observed during the repeat scan in 3 subjects as 0.27, 0.12, and 0.15 MPa, respectively. All subject-specific stiffness-strain relationship data was fitted well with power function (R2 = 0.997). CONCLUSION The current study proposed a generalized mathematical model and a methodology to estimate subject-specific stiffness of the tibiofemoral joint for FEM analysis. Such a method might enhance the efficacy of FEM in implant design optimization and biomechanics for subject-specific studies. Trial registration The institutional ethics committee (IEC), Indian Institute of Technology, Delhi, India, approved the study on 20th September 2017, with reference number P-019; it was a pilot study, no clinical trail registration was recommended.
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Affiliation(s)
- Sandeep Panwar Jogi
- Centre for Biomedical Engineering, Indian Institute of Technology, Delhi, New Delhi, 110016, India.,Amity University Haryana, Gurgaon, 122413, India
| | - Rafeek Thaha
- Centre for Biomedical Engineering, Indian Institute of Technology, Delhi, New Delhi, 110016, India
| | - Sriram Rajan
- Mahajan Imaging Centre, New Delhi, 110016, India
| | | | | | - Anup Singh
- Centre for Biomedical Engineering, Indian Institute of Technology, Delhi, New Delhi, 110016, India.,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology, Delhi, New Delhi, 110016, India. .,Department of Biomedical Engineering, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Gao KT, Pedoia V, Young KA, Kogan F, Koff MF, Gold GE, Potter HG, Majumdar S. Multiparametric MRI characterization of knee articular cartilage and subchondral bone shape in collegiate basketball players. J Orthop Res 2021; 39:1512-1522. [PMID: 32910520 PMCID: PMC8359246 DOI: 10.1002/jor.24851] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/31/2020] [Accepted: 09/02/2020] [Indexed: 02/04/2023]
Abstract
Magnetic resonance imaging (MRI) is commonly used to evaluate the morphology of the knee in athletes with high-knee impact; however, complex repeated loading of the joint can lead to biochemical and structural degeneration that occurs before visible morphological changes. In this study, we utilized multiparametric quantitative MRI to compare morphology and composition of articular cartilage and subchondral bone shape between young athletes with high-knee impact (basketball players; n = 40) and non-knee impact (swimmers; n = 25). We implemented voxel-based relaxometry to register all cases to a single reference space and performed a localized compositional analysis of T 1ρ - and T 2 -relaxation times on a voxel-by-voxel basis. Additionally, statistical shape modeling was employed to extract differences in subchondral bone shape between the two groups. Evaluation of cartilage composition demonstrated a significant prolongation of relaxation times in the medial femoral and tibial compartments and in the posterolateral femur of basketball players in comparison to relaxation times in the same cartilage compartments of swimmers. The compositional analysis also showed depth-dependent differences with prolongation of the superficial layer in basketball players. For subchondral bone shape, three total modes were found to be significantly different between groups and related to the relative sizes of the tibial plateaus, intercondylar eminences, and the curvature and concavity of the patellar lateral facet. In summary, this study identified several characteristics associated with a high-knee impact which may expand our understanding of local degenerative patterns in this population.
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Affiliation(s)
- Kenneth T. Gao
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Valentina Pedoia
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Feliks Kogan
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Matthew F. Koff
- Department of Radiology and ImagingHospital for Special SurgeryNew York CityNew YorkUSA
| | - Garry E. Gold
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Hollis G. Potter
- Department of Radiology and ImagingHospital for Special SurgeryNew York CityNew YorkUSA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical ImagingUniversity of CaliforniaSan FranciscoCaliforniaUSA
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Baer K, Kieser S, Schon B, Rajendran K, Ten Harkel T, Ramyar M, Löbker C, Bateman C, Butler A, Raja A, Hooper G, Anderson N, Woodfield T. Spectral CT imaging of human osteoarthritic cartilage via quantitative assessment of glycosaminoglycan content using multiple contrast agents. APL Bioeng 2021; 5:026101. [PMID: 33834156 PMCID: PMC8018795 DOI: 10.1063/5.0035312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/22/2021] [Indexed: 01/06/2023] Open
Abstract
Detection of early osteoarthritis to stabilize or reverse the damage to articular cartilage would improve patient function, reduce disability, and limit the need for joint replacement. In this study, we investigated nondestructive photon-processing spectral computed tomography (CT) for the quantitative measurement of the glycosaminoglycan (GAG) content compared to destructive histological and biochemical assay techniques in normal and osteoarthritic tissues. Cartilage-bone cores from healthy bovine stifles were incubated in 50% ioxaglate (Hexabrix®) or 100% gadobenate dimeglumine (MultiHance®). A photon-processing spectral CT (MARS) scanner with a CdTe-Medipix3RX detector imaged samples. Calibration phantoms of ioxaglate and gadobenate dimeglumine were used to determine iodine and gadolinium concentrations from photon-processing spectral CT images to correlate with the GAG content measured using a dimethylmethylene blue assay. The zonal distribution of GAG was compared between photon-processing spectral CT images and histological sections. Furthermore, discrimination and quantification of GAG in osteoarthritic human tibial plateau tissue using the same contrast agents were demonstrated. Contrast agent concentrations were inversely related to the GAG content. The GAG concentration increased from 25 μg/ml (85 mg/ml iodine or 43 mg/ml gadolinium) in the superficial layer to 75 μg/ml (65 mg/ml iodine or 37 mg/ml gadolinium) in the deep layer of healthy bovine cartilage. Deep zone articular cartilage could be distinguished from subchondral bone by utilizing the material decomposition technique. Photon-processing spectral CT images correlated with histological sections in healthy and osteoarthritic tissues. Post-imaging material decomposition was able to quantify the GAG content and distribution throughout healthy and osteoarthritic cartilage using Hexabrix® and MultiHance® while differentiating the underlying subchondral bone.
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Affiliation(s)
| | - Sandra Kieser
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE), Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
| | | | | | | | - Mohsen Ramyar
- Department of Radiology, University of Otago Christchurch, Christchurch 8011, New Zealand
| | | | - Christopher Bateman
- Department of Radiology, University of Otago Christchurch, Christchurch 8011, New Zealand
| | | | | | | | - Nigel Anderson
- Department of Radiology, University of Otago Christchurch, Christchurch 8011, New Zealand
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Bhattarai A, Pouran B, Mäkelä JTA, Shaikh R, Honkanen MKM, Prakash M, Kröger H, Grinstaff MW, Weinans H, Jurvelin JS, Töyräs J. Dual contrast in computed tomography allows earlier characterization of articular cartilage over single contrast. J Orthop Res 2020; 38:2230-2238. [PMID: 32525582 DOI: 10.1002/jor.24774] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 05/14/2020] [Accepted: 05/28/2020] [Indexed: 02/04/2023]
Abstract
Cationic computed tomography contrast agents are more sensitive for detecting cartilage degeneration than anionic or non-ionic agents. However, osteoarthritis-related loss of proteoglycans and increase in water content contrarily affect the diffusion of cationic contrast agents, limiting their sensitivity. The quantitative dual-energy computed tomography technique allows the simultaneous determination of the partitions of iodine-based cationic (CA4+) and gadolinium-based non-ionic (gadoteridol) agents in cartilage at diffusion equilibrium. Normalizing the cationic agent partition at diffusion equilibrium with that of the non-ionic agent improves diagnostic sensitivity. We hypothesize that this sensitivity improvement is also prominent during early diffusion time points and that the technique is applicable during contrast agent diffusion. To investigate the validity of this hypothesis, osteochondral plugs (d = 8 mm, N = 33), extracted from human cadaver (n = 4) knee joints, were immersed in a contrast agent bath (a mixture of CA4+ and gadoteridol) and imaged using the technique at multiple time points until diffusion equilibrium. Biomechanical testing and histological analysis were conducted for reference. Quantitative dual-energy computed tomography technique enabled earlier determination of cartilage proteoglycan content over single contrast. The correlation coefficient between human articular cartilage proteoglycan content and CA4+ partition increased with the contrast agent diffusion time. Gadoteridol normalized CA4+ partition correlated significantly (P < .05) with Mankin score at all time points and with proteoglycan content after 4 hours. The technique is applicable during diffusion, and normalization with gadoteridol partition improves the sensitivity of the CA4+ contrast agent.
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Affiliation(s)
- Abhisek Bhattarai
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Behdad Pouran
- Department of Orthopaedic, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Janne T A Mäkelä
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Rubina Shaikh
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Miitu K M Honkanen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Mithilesh Prakash
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Heikki Kröger
- Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
| | - Mark W Grinstaff
- Departments of Biomedical Engineering, Chemistry, and Medicine, Boston University, Boston, Massachusetts
| | - Harrie Weinans
- Department of Orthopaedic, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Biomechanical Engineering, Faculty of Mechanical, Maritime, and Materials Engineering, Delft University of Technology (TU Delft), Delft, The Netherlands.,Department of Rheumatology, University Medical Center, Utrecht, The Netherlands
| | - Jukka S Jurvelin
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland.,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
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11
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Hancin EC, Borja AJ, Nikpanah M, Raynor WY, Haldar D, Werner TJ, Morris MA, Saboury B, Alavi A, Gholamrezanezhad A. PET/MR Imaging in Musculoskeletal Precision Imaging - Third wave after X-Ray and MR. PET Clin 2020; 15:521-534. [DOI: 10.1016/j.cpet.2020.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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12
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Watkins LE, Rubin EB, Mazzoli V, Uhlrich SD, Desai AD, Black M, Ho GK, Delp SL, Levenston ME, Beaupré GS, Gold GE, Kogan F. Rapid volumetric gagCEST imaging of knee articular cartilage at 3 T: evaluation of improved dynamic range and an osteoarthritic population. NMR IN BIOMEDICINE 2020; 33:e4310. [PMID: 32445515 PMCID: PMC7347437 DOI: 10.1002/nbm.4310] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/03/2020] [Accepted: 03/20/2020] [Indexed: 05/22/2023]
Abstract
Chemical exchange saturation transfer of glycosaminoglycans, gagCEST, is a quantitative MR technique that has potential for assessing cartilage proteoglycan content at field strengths of 7 T and higher. However, its utility at 3 T remains unclear. The objective of this work was to implement a rapid volumetric gagCEST sequence with higher gagCEST asymmetry at 3 T to evaluate its sensitivity to osteoarthritic changes in knee articular cartilage and in comparison with T2 and T1ρ measures. We hypothesize that gagCEST asymmetry at 3 T decreases with increasing severity of osteoarthritis (OA). Forty-two human volunteers, including 10 healthy subjects and 32 subjects with medial OA, were included in the study. Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed for all subjects, and Kellgren-Lawrence grading was performed for OA volunteers. Healthy subjects were scanned consecutively at 3 T to assess the repeatability of the volumetric gagCEST sequence at 3 T. For healthy and OA subjects, gagCEST asymmetry and T2 and T1ρ relaxation times were calculated for the femoral articular cartilage to assess sensitivity to OA severity. Volumetric gagCEST imaging had higher gagCEST asymmetry than single-slice acquisitions (p = 0.015). The average scan-rescan coefficient of variation was 6.8%. There were no significant differences in average gagCEST asymmetry between younger and older healthy controls (p = 0.655) or between healthy controls and OA subjects (p = 0.310). T2 and T1ρ relaxation times were elevated in OA subjects (p < 0.001 for both) compared with healthy controls and both were moderately correlated with total KOOS scores (rho = -0.181 and rho = -0.332 respectively). The gagCEST technique developed here, with volumetric scan times under 10 min and high gagCEST asymmetry at 3 T, did not vary significantly between healthy subjects and those with mild-moderate OA. This further supports a limited utility for gagCEST imaging at 3 T for assessment of early changes in cartilage composition in OA.
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Affiliation(s)
| | - Elka B Rubin
- Radiology, Stanford University, Stanford, California, USA
| | | | - Scott D Uhlrich
- Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Arjun D Desai
- Electrical Engineering, Stanford University, Stanford, California, USA
| | - Marianne Black
- Radiology, Stanford University, Stanford, California, USA
- Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Gabe K Ho
- Bioengineering, Stanford University, Stanford, California, USA
| | - Scott L Delp
- Bioengineering, Stanford University, Stanford, California, USA
- Mechanical Engineering, Stanford University, Stanford, California, USA
- Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Marc E Levenston
- Bioengineering, Stanford University, Stanford, California, USA
- Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Gary S Beaupré
- Bioengineering, Stanford University, Stanford, California, USA
- Veteran Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Garry E Gold
- Bioengineering, Stanford University, Stanford, California, USA
- Radiology, Stanford University, Stanford, California, USA
- Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Feliks Kogan
- Radiology, Stanford University, Stanford, California, USA
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13
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Detection of early cartilage degeneration in the tibiotalar joint using 3 T gagCEST imaging: a feasibility study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:249-260. [PMID: 32725359 PMCID: PMC8018923 DOI: 10.1007/s10334-020-00868-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To establish and optimize a stable 3 Tesla (T) glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging protocol for assessing the articular cartilage of the tibiotalar joint in healthy volunteers and patients after a sustained injury to the ankle. METHODS Using Bloch-McConnell simulations, we optimized the sequence protocol for a 3 T MRI scanner for maximum gagCEST effect size within a clinically feasible time frame of less than 07:30 min. This protocol was then used to analyze the gagCEST effect of the articular cartilage of the tibiotalar joint of 17 healthy volunteers and five patients with osteochondral lesions of the talus following ankle trauma. Reproducibility was tested with the intraclass correlation coefficient. RESULTS The mean magnetization transfer ratio asymmetry (MTRasym), i.e., the gagCEST effect size, was significantly lower in patients than in healthy volunteers (0.34 ± 1.9% vs. 1.49 ± 0.11%; p < 0.001 [linear mixed model]). Intra- and inter-rater reproducibility was excellent with an average measure intraclass correlation coefficient (ICC) of 0.97 and a single measure ICC of 0.91 (p < 0.01). DISCUSSION In this feasibility study, pre-morphological tibiotalar joint cartilage damage was quantitatively assessable on the basis of the optimized 3 T gagCEST imaging protocol that allowed stable quantification gagCEST effect sizes across a wide range of health and disease in clinically feasible acquisition times.
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14
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Tarabin N, Gehrmann S, Mori V, Oezel L, Wollschläger L, Rommelfanger G, Frenken M, Abrar D, Schleich C. Assessment of Articular Cartilage Disorders After Distal Radius Fracture Using Biochemical and Morphological Nonenhanced Magnetic Resonance Imaging. J Hand Surg Am 2020; 45:619-625. [PMID: 32291096 DOI: 10.1016/j.jhsa.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 12/27/2019] [Accepted: 02/11/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess radiocarpal articular cartilage after distal radius fracture, with and without intra-articular extension, compared with healthy controls using multiparametric, nonenhanced magnetic resonance imaging (MRI). METHODS In this prospective study, multiparametric MRI of the radiocarpal articular cartilage was performed in 26 participants (16 males and 10 females; mean age, 39.5 ± 14.7 years; range, 20-70 years) using 3T MRI. The cohort consisted of 14 patients with a distal radius fracture and 12 healthy volunteers. The radiocarpal articular cartilage was assessed using morphological (Double Echo Steady-State [DESS] and True Fast Imaging With Steady-State Precession [TrueFISP]) and biochemical (T2∗) MRI sequences without an intravenous contrast agent. The modified Outerbridge classification system for morphological analyses and region-of-interest biochemical analysis were applied to assess the degree of articular cartilage damage in each patient. RESULTS Morphological articular cartilage assessment showed no difference between the DESS sequence and the reference standard, TrueFISP. In the morphological (DESS and TrueFISP) and biochemical (T2∗) assessments, patients with intra-articular fractures did not show articular cartilage damage different from those with extra-articular fractures. Greater articular cartilage degradation was observed after distal radius fracture compared with controls. CONCLUSIONS Posttraumatic radiocarpal articular cartilage damage did not differ between fractures with intra-articular and extra-articular extension, but patients with fractures had notably higher articular cartilage degradation compared with healthy controls. Magnetic resonance imaging using advanced multiparametric sequences may facilitate accurate, noninvasive assessment of articular cartilage changes after distal radius fracture without the need for a contrast agent. TYPE OF STUDY/LEVEL OF EVIDENCE Diagnostic IV.
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Affiliation(s)
- Nahla Tarabin
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Sebastian Gehrmann
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Valentina Mori
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Lisa Oezel
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Lena Wollschläger
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Golnessa Rommelfanger
- Department of Orthopedics and Trauma Surgery, University Hospital, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Daniel Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
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15
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Mukherjee S, Nazemi M, Jonkers I, Geris L. Use of Computational Modeling to Study Joint Degeneration: A Review. Front Bioeng Biotechnol 2020; 8:93. [PMID: 32185167 PMCID: PMC7058554 DOI: 10.3389/fbioe.2020.00093] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/31/2020] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis (OA), a degenerative joint disease, is the most common chronic condition of the joints, which cannot be prevented effectively. Computational modeling of joint degradation allows to estimate the patient-specific progression of OA, which can aid clinicians to estimate the most suitable time window for surgical intervention in osteoarthritic patients. This paper gives an overview of the different approaches used to model different aspects of joint degeneration, thereby focusing mostly on the knee joint. The paper starts by discussing how OA affects the different components of the joint and how these are accounted for in the models. Subsequently, it discusses the different modeling approaches that can be used to answer questions related to OA etiology, progression and treatment. These models are ordered based on their underlying assumptions and technologies: musculoskeletal models, Finite Element models, (gene) regulatory models, multiscale models and data-driven models (artificial intelligence/machine learning). Finally, it is concluded that in the future, efforts should be made to integrate the different modeling techniques into a more robust computational framework that should not only be efficient to predict OA progression but also easily allow a patient’s individualized risk assessment as screening tool for use in clinical practice.
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Affiliation(s)
- Satanik Mukherjee
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.,Biomechanics Section, KU Leuven, Leuven, Belgium
| | - Majid Nazemi
- GIGA in silico Medicine, University of Liège, Liège, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Liesbet Geris
- Prometheus, Division of Skeletal Tissue Engineering, KU Leuven, Leuven, Belgium.,Biomechanics Section, KU Leuven, Leuven, Belgium.,GIGA in silico Medicine, University of Liège, Liège, Belgium
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16
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Kogan F, Broski SM, Yoon D, Gold GE. Applications of PET-MRI in musculoskeletal disease. J Magn Reson Imaging 2019; 48:27-47. [PMID: 29969193 DOI: 10.1002/jmri.26183] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/19/2018] [Indexed: 12/26/2022] Open
Abstract
New integrated PET-MRI systems potentially provide a complete imaging modality for diagnosis and evaluation of musculoskeletal disease. MRI is able to provide excellent high-resolution morphologic information with multiple contrast mechanisms that has made it the imaging modality of choice in evaluation of many musculoskeletal disorders. PET offers incomparable abilities to provide quantitative information about molecular and physiologic changes that often precede structural and biochemical changes. In combination, hybrid PET-MRI can enhance imaging of musculoskeletal disorders through early detection of disease as well as improved diagnostic sensitivity and specificity. The purpose of this article is to review emerging applications of PET-MRI in musculoskeletal disease. Both clinical applications of malignant musculoskeletal disease as well as new opportunities to incorporate the molecular capabilities of nuclear imaging into studies of nononcologic musculoskeletal disease are discussed. Lastly, we discuss some of the technical considerations and challenges of PET-MRI as they specifically relate to musculoskeletal disease. LEVEL OF EVIDENCE 5 TECHNICAL EFFICACY: Stage 3 J. Magn. Reson. Imaging 2018;48:27-47.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | | | - Daehyun Yoon
- 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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17
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Bruno F, Arrigoni F, Palumbo P, Natella R, Maggialetti N, Reginelli A, Splendiani A, Di Cesare E, Brunese L, Guglielmi G, Giovagnoni A, Masciocchi C, Barile A. New advances in MRI diagnosis of degenerative osteoarthropathy of the peripheral joints. Radiol Med 2019; 124:1121-1127. [PMID: 30771216 DOI: 10.1007/s11547-019-01003-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/04/2019] [Indexed: 12/31/2022]
Abstract
Degenerative osteoarthropathy is one of the leading causes of the pain and disability from musculoskeletal disease in the adult population. Magnetic resonance imaging (MRI) allows optimal visualization of all tissues involved in degenerative osteoarthritis disease process, mainly the articular cartilage. In addition to qualitative and semiquantitative morphologic assessment, several MRI-based advanced techniques have been developed to allow characterization and quantification of the biochemical cartilage composition. These include quantitative analysis and several compositional techniques (T1 and T2 relaxometry measurements and mapping, sodium imaging, delayed gadolinium-enhanced MRI of cartilage dGEMRIC, glycosaminoglycan-specific chemical exchange saturation transfer gagCEST, diffusion-weighted imaging DWI and diffusion tensor imaging DTI). These compositional MRI techniques may have the potential to serve as quantitative, reproducible, noninvasive and objective endpoints for OA assessment, particularly in diagnosis of early and pre-radiographic stages of the disease and in monitoring disease progression and treatment effects over time.
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Affiliation(s)
- Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Maggialetti
- Department Life and Health "V. Tiberio", University of Molise, Campobasso, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Luca Brunese
- Department Life and Health "V. Tiberio", University of Molise, Campobasso, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, University of Foggia, Foggia, Italy
| | - Andrea Giovagnoni
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
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18
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Method for Segmentation of Knee Articular Cartilages Based on Contrast-Enhanced CT Images. Ann Biomed Eng 2018; 46:1756-1767. [PMID: 30132213 DOI: 10.1007/s10439-018-2081-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/20/2018] [Indexed: 12/22/2022]
Abstract
Segmentation of contrast-enhanced computed tomography (CECT) images enables quantitative evaluation of morphology of articular cartilage as well as the significance of the lesions. Unfortunately, automatic segmentation methods for CECT images are currently lacking. Here, we introduce a semiautomated technique to segment articular cartilage from in vivo CECT images of human knee. The segmented cartilage geometries of nine knee joints, imaged using a clinical CT-scanner with an intra-articular contrast agent, were compared with manual segmentations from CT and magnetic resonance (MR) images. The Dice similarity coefficients (DSCs) between semiautomatic and manual CT segmentations were 0.79-0.83 and sensitivity and specificity values were also high (0.76-0.86). When comparing semiautomatic and manual CT segmentations, mean cartilage thicknesses agreed well (intraclass correlation coefficient = 0.85-0.93); the difference in thickness (mean ± SD) was 0.27 ± 0.03 mm. Differences in DSC, when MR segmentations were compared with manual and semiautomated CT segmentations, were statistically insignificant. Similarly, differences in volume were not statistically significant between manual and semiautomatic CT segmentations. Semiautomation decreased the segmentation time from 450 ± 190 to 42 ± 10 min per joint. The results reveal that the proposed technique is fast and reliable for segmentation of cartilage. Importantly, this is the first study presenting semiautomated segmentation of cartilage from CECT images of human knee joint with minimal user interaction.
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19
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Kogan F, Fan AP, Monu U, Iagaru A, Hargreaves BA, Gold GE. Quantitative imaging of bone-cartilage interactions in ACL-injured patients with PET-MRI. Osteoarthritis Cartilage 2018; 26:790-796. [PMID: 29656143 PMCID: PMC6037170 DOI: 10.1016/j.joca.2018.04.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/10/2018] [Accepted: 04/04/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate changes in bone metabolism by positron emission tomography (PET), as well as spatial relationships between bone metabolism and magnetic resonance imaging (MRI) quantitative markers of early cartilage degradation, in anterior cruciate ligament (ACL)-reconstructed knees. DESIGN Both knees of 15 participants with unilateral reconstructed ACL tears and unaffected contralateral knees were scanned using a simultaneous 3.0T PET-MRI system following injection of 18F-sodium fluoride (18F-NaF). The maximum pixel standardized uptake value (SUVmax) in the subchondral bone and the average T2 relaxation time in cartilage were measured in each knee in eight knee compartments. We tested differences in SUVmax and cartilage T2 relaxation times between the ACL-injured knee and the contralateral control knee as well as spatial relationships between these bone and cartilage changes. RESULTS Significantly increased subchondral bone 18F-NaF SUVmax and cartilage T2 times were observed in the ACL-reconstructed knees (median [inter-quartile-range (IQR)]: 5.0 [5.8], 36.8 [3.6] ms) compared to the contralateral knees (median [IQR]: 1.9 [1.4], 34.4 [3.8] ms). A spatial relationship between the two markers was also seen. Using the contralateral knee as a control, we observed a significant correlation of r = 0.59 between the difference in subchondral bone SUVmax (between injured and contralateral knees) and the adjacent cartilage T2 (between the two knees) [P < 0.001], with a slope of 0.49 ms/a.u. This correlation and slope were higher in deep layers (r = 0.73, slope = 0.60 ms/a.u.) of cartilage compared to superficial layers (r = 0.40, slope = 0.43 ms/a.u.). CONCLUSIONS 18F-NaF PET-MR imaging enables detection of increased subchondral bone metabolism in ACL-reconstructed knees and may serve as an important marker of early osteoarthritis (OA) progression. Spatial relationships observed between early OA changes across bone and cartilage support the need to study whole-joint disease mechanisms in OA.
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Affiliation(s)
- F Kogan
- Department of Radiology, Stanford University, Stanford, CA, USA.
| | - A P Fan
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - U Monu
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - A Iagaru
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - B A Hargreaves
- Department of Radiology, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA; Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - G E Gold
- Department of Radiology, Stanford University, Stanford, CA, USA; Department of Bioengineering, Stanford University, Stanford, CA, USA; Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
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20
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Lansdown DA, Wang K, Cotter E, Davey A, Cole BJ. Relationship Between Quantitative MRI Biomarkers and Patient-Reported Outcome Measures After Cartilage Repair Surgery: A Systematic Review. Orthop J Sports Med 2018; 6:2325967118765448. [PMID: 29662912 PMCID: PMC5898666 DOI: 10.1177/2325967118765448] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Treatment of articular cartilage injuries remains a clinical challenge, and the optimal tools to monitor and predict clinical outcomes are unclear. Quantitative magnetic resonance imaging (qMRI) allows for a noninvasive biochemical evaluation of cartilage and may offer advantages in monitoring outcomes after cartilage repair surgery. Hypothesis qMRI sequences will correlate with early pain and functional measures. Study Design Systematic review; Level of evidence, 3. Methods A PubMed search was performed with the following search terms: knee AND (cartilage repair OR cartilage restoration OR cartilage surgery) AND (delayed gadolinium-enhanced MRI OR t1-rho OR T2 mapping OR dgemric OR sodium imaging OR quantitative imaging). Studies were included if correlation data were included on quantitative imaging results and patient outcome scores. Results Fourteen articles were included in the analysis. Eight studies showed a significant relationship between quantitative cartilage imaging and patient outcome scores, while 6 showed no relationship. T2 mapping was examined in 11 studies, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in 4 studies, sodium imaging in 2 studies, glycosaminoglycan chemical exchange saturation transfer (gagCEST) in 1 study, and diffusion-weighted imaging in 1 study. Five studies on T2 mapping showed a correlation between T2 relaxation times and clinical outcome scores. Two dGEMRIC studies found a correlation between T1 relaxation times and clinical outcome scores. Conclusion Multiple studies on T2 mapping, dGEMRIC, and diffusion-weighted imaging showed significant correlations with patient-reported outcome measures after cartilage repair surgery, although other studies showed no significant relationship. qMRI sequences may offer a noninvasive method to monitor cartilage repair tissue in a clinically meaningful way, but further refinements in imaging protocols and clinical interpretation are necessary to improve utility.
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Affiliation(s)
- Drew A Lansdown
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Kevin Wang
- Department of Orthopaedic Surgery, Sports Medicine & Shoulder Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Eric Cotter
- Department of Orthopaedic Surgery, Sports Medicine & Shoulder Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Annabelle Davey
- Department of Orthopaedic Surgery, Sports Medicine & Shoulder Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Brian J Cole
- Department of Orthopaedic Surgery, Sports Medicine & Shoulder Surgery, Rush University Medical Center, Chicago, Illinois, USA
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21
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Nelson BB, Kawcak CE, Barrett MF, McIlwraith CW, Grinstaff MW, Goodrich LR. Recent advances in articular cartilage evaluation using computed tomography and magnetic resonance imaging. Equine Vet J 2018; 50:564-579. [DOI: 10.1111/evj.12808] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/09/2018] [Indexed: 12/18/2022]
Affiliation(s)
- B. B. Nelson
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - C. E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. F. Barrett
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
- Department of Environmental and Radiological Health Sciences Colorado State University Fort Collins Colorado USA
| | - C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. W. Grinstaff
- Departments of Biomedical Engineering, Chemistry and Medicine Boston University Boston Massachusetts USA
| | - L. R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
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Stem Cells for Cartilage Repair: Preclinical Studies and Insights in Translational Animal Models and Outcome Measures. Stem Cells Int 2018. [PMID: 29535784 PMCID: PMC5832141 DOI: 10.1155/2018/9079538] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Due to the restricted intrinsic capacity of resident chondrocytes to regenerate the lost cartilage postinjury, stem cell-based therapies have been proposed as a novel therapeutic approach for cartilage repair. Moreover, stem cell-based therapies using mesenchymal stem cells (MSCs) or induced pluripotent stem cells (iPSCs) have been used successfully in preclinical and clinical settings. Despite these promising reports, the exact mechanisms underlying stem cell-mediated cartilage repair remain uncertain. Stem cells can contribute to cartilage repair via chondrogenic differentiation, via immunomodulation, or by the production of paracrine factors and extracellular vesicles. But before novel cell-based therapies for cartilage repair can be introduced into the clinic, rigorous testing in preclinical animal models is required. Preclinical models used in regenerative cartilage studies include murine, lapine, caprine, ovine, porcine, canine, and equine models, each associated with its specific advantages and limitations. This review presents a summary of recent in vitro data and from in vivo preclinical studies justifying the use of MSCs and iPSCs in cartilage tissue engineering. Moreover, the advantages and disadvantages of utilizing small and large animals will be discussed, while also describing suitable outcome measures for evaluating cartilage repair.
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Effect of intra-articular injection of intermediate-weight hyaluronic acid on hip and knee cartilage: in-vivo evaluation using T2 mapping. Eur Radiol 2018; 28:2345-2355. [PMID: 29318429 DOI: 10.1007/s00330-017-5186-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/16/2017] [Accepted: 11/07/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We used T2 mapping to quantify the effect of intra-articular hyaluronic acid administration (IAHAA) on cartilage with correlation to clinical symptoms. METHODS One hundred two patients with clinical and MRI diagnosis of hip or knee grade I-III chondropathy were prospectively included. All patients received a standard MRI examination of the affected hip/knee (one joint/patient) and T2-mapping multiecho sequence for cartilage evaluation. T2 values of all slices were averaged and used for analysis. One month after MR evaluation 72 patients (38 males; mean age 51±10 years) underwent IAHAA. As a control group, 30 subjects (15 males; 51 ± 9 years) were not treated. MR and WOMAC evaluation was performed at baseline and after 3, 9, and 15 months in all patients. RESULTS T2 mapping in hyaluronic acid (HA) patients showed a significant increase in T2 relaxation times from baseline to the first time point after therapy in knees (40.7 ± 9.8 ms vs. 45.8 ± 8.6 ms) and hips (40.9 ± 9.7 ms; 45.9 ± 9.5 ms) (p < 0.001). At the 9- and 15-month evaluations, T2 relaxation dropped to values similar to the baseline ones (p < 0.001 vs. 3 month). The correlation between T2 increase and pain reduction after IAHAA was statistically significant (r = 0.54, p < 0.01) in patients with grade III chondropathy. CONCLUSIONS T2 mapping can be used to evaluate the effect over time of IAHAA in patients with hip and knee chondropathy. KEY POINTS • T2 relaxation times change over time after hyaluronic acid intra-articular administration • T2 relaxation times of the medial femoral condyle correlate with WOMAC variation • T2 relaxation times are different between Outerbridge I and II-III.
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Kogan F, Levine E, Chaudhari AS, Monu UD, Epperson K, Oei EHG, Gold GE, Hargreaves BA. Simultaneous bilateral-knee MR imaging. Magn Reson Med 2017; 80:529-537. [PMID: 29250856 DOI: 10.1002/mrm.27045] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/19/2017] [Accepted: 11/21/2017] [Indexed: 12/23/2022]
Abstract
PURPOSE To demonstrate and evaluate the scan time and quantitative accuracy of simultaneous bilateral-knee imaging compared with single-knee acquisitions. METHODS Hardware modifications and safety testing was performed to enable MR imaging with two 16-channel flexible coil arrays. Noise covariance and sensitivity-encoding g-factor maps for the dual-coil-array configuration were computed to evaluate coil cross-talk and noise amplification. Ten healthy volunteers were imaged on a 3T MRI scanner with both dual-coil-array bilateral-knee and single-coil-array single-knee configurations. Two experienced musculoskeletal radiologists compared the relative image quality between blinded image pairs acquired with each configuration. Differences in T2 relaxation time measurements between dual-coil-array and single-coil-array acquisitions were compared with the standard repeatability of single-coil-array measurements using a Bland-Altman analysis. RESULTS The mean g-factors for the dual-coil-array configuration were low for accelerations up to 6 in the right-left direction, and minimal cross-talk was observed between the two coil arrays. Image quality ratings of various joint tissues showed no difference in 89% (95% confidence interval: 85-93%) of rated image pairs, with only small differences ("slightly better" or "slightly worse") in image quality observed. The T2 relaxation time measurements between the dual-coil-array configuration and the single-coil configuration showed similar limits of agreement and concordance correlation coefficients (limits of agreement: -0.93 to 1.99 ms; CCC: 0.97 (95% confidence interval: 0.96-0.98)), to the repeatability of single-coil-array measurements (limits of agreement: -2.07 to 1.96 ms; CCC: 0.97 (95% confidence interval: 0.95-0.98)). CONCLUSION A bilateral coil-array setup can image both knees simultaneously in similar scan times as conventional unilateral knee scans, with comparable image quality and quantitative accuracy. This has the potential to improve the value of MRI knee evaluations. Magn Reson Med 80:529-537, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Evan Levine
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Akshay S Chaudhari
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Uchechukwuka D Monu
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Kevin Epperson
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Orthopedic Surgery, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA
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25
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Herzog MM, Driban JB, Cattano NM, Cameron KL, Tourville TW, Marshall SW, Pietrosimone B. Risk of Knee Osteoarthritis Over 24 Months in Individuals Who Decrease Walking Speed During a 12-Month Period: Data from the Osteoarthritis Initiative. J Rheumatol 2017; 44:1265-1270. [PMID: 28572470 PMCID: PMC6061917 DOI: 10.3899/jrheum.170093] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To assess the association between change in walking speed over a 12-month period and risk of developing radiographic knee osteoarthritis (rKOA) over a 24-month period. METHODS We included participants without rKOA from the Osteoarthritis Initiative. Change in walking speed was determined from a 20-m walk assessment, calculated using walking speed at 12-month followup minus baseline speed and/or 24-month followup walking speed minus 12-month speed. Incident rKOA was defined as progressing to Kellgren-Lawrence arthritis grading scale ≥ 2 within 24 months (i.e., incidence between 12 and 36 mos or 24 and 48 mos). Self-reported significant knee injury during the exposure period, age, body mass index (BMI), and Physical Activity Scale for the Elderly (PASE) score were adjusted for analytically. RESULTS We included 2638 observations among 1460 unique participants (58% women; aged 59 ± 9 yrs, range 45-79). The mean change in walking speed over 12 months was 0.001 ± 0.13 m/s (range -0.6271 to 1.4968). About 5% of the sample (n = 122) developed rKOA over a 24-month period. After controlling for significant knee injury, age, BMI, and PASE score, we found an 8% relative increase in risk of developing rKOA for every 0.1 m/s decrease in walking speed over a 12-month period (risk ratio 1.08, 95% CI 1.00-1.15, p = 0.05). CONCLUSION Evaluating change in speed over a 12-month period using a 20-m walk test may be useful in identifying individuals at increased risk of developing rKOA over the subsequent 24 months. Identification of patients at high risk for developing rKOA would allow medical providers to implement early interventions to maximize joint health.
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Affiliation(s)
- Mackenzie M Herzog
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA.
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill.
| | - Jeffrey B Driban
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Nicole M Cattano
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Kenneth L Cameron
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Timothy W Tourville
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Stephen W Marshall
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Brian Pietrosimone
- From the Department of Epidemiology, Gillings School of Global Public Health, and the Injury Prevention Research Center, and the Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Division of Rheumatology, Tufts Medical Center, Boston, Massachusetts; Department of Sports Medicine, West Chester University, West Chester, Pennsylvania; Keller Army Community Hospital, West Point, New York; Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA
- M.M. Herzog, MPH, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, University of North Carolina at Chapel Hill; J.B. Driban, PhD, Division of Rheumatology, Tufts Medical Center; N.M. Cattano, PhD, Department of Sports Medicine, West Chester University; K.L. Cameron, PhD, Keller Army Community Hospital; T.W. Tourville, PhD, Department of Rehabilitation and Movement Science, University of Vermont; S.W. Marshall, PhD, Department of Epidemiology, Gillings School of Global Public Health, and Injury Prevention Research Center, and Department of Exercise and Sport Science, University of North Carolina at Chapel Hill; B. Pietrosimone, PhD, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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Lakin BA, Snyder BD, Grinstaff MW. Assessing Cartilage Biomechanical Properties: Techniques for Evaluating the Functional Performance of Cartilage in Health and Disease. Annu Rev Biomed Eng 2017; 19:27-55. [DOI: 10.1146/annurev-bioeng-071516-044525] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Benjamin A. Lakin
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
| | - Brian D. Snyder
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215
- Orthopedic Center, Children's Hospital, Boston, Massachusetts 02115
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
- Department of Chemistry, Boston University, Boston, Massachusetts 02215
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27
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Kogan F, Fan AP, McWalter E, Oei E, Quon A, Gold GE. PET/MRI of metabolic activity in osteoarthritis: A feasibility study. J Magn Reson Imaging 2017; 45:1736-1745. [PMID: 27796082 PMCID: PMC5761655 DOI: 10.1002/jmri.25529] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 10/10/2016] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To evaluate positron emission tomography / magnetic resonance imaging (PET/MRI) knee imaging to detect and characterize osseous metabolic abnormalities and correlate PET radiotracer uptake with osseous abnormalities and cartilage degeneration observed on MRI. MATERIALS AND METHODS Both knees of 22 subjects with knee pain or injury were scanned at one timepoint, without gadolinium, on a hybrid 3.0T PET-MRI system following injection of 18 F-fluoride or 18 F-fluorodeoxyglucose (FDG). A musculoskeletal radiologist identified volumes of interest (VOIs) around bone abnormalities on MR images and scored bone marrow lesions (BMLs) and osteophytes using a MOAKS scoring system. Cartilage appearance adjacent to bone abnormalities was graded with MRI-modified Outerbridge classifications. On PET standardized uptake values (SUV) maps, VOIs with SUV greater than 5 times the SUV in normal-appearing bone were identified as high-uptake VOI (VOIHigh ). Differences in 18 F-fluoride uptake between bone abnormalities, BML, and osteophyte grades and adjacent cartilage grades on MRI were identified using Mann-Whitney U-tests. RESULTS SUVmax in all subchondral bone lesions (BML, osteophytes, sclerosis) was significantly higher than that of normal-appearing bone on MRI (P < 0.001 for all). Of the 172 high-uptake regions on 18 F-fluoride PET, 63 (37%) corresponded to normal-appearing subchondral bone on MRI. Furthermore, many small grade 1 osteophytes (40 of 82 [49%]), often described as the earliest signs of osteoarthritis (OA), did not show high uptake. Lastly, PET SUVmax in subchondral bone adjacent to grade 0 cartilage was significantly lower compared to that of grades 1-2 (P < 0.05) and grades 3-4 cartilage (P < 0.001). CONCLUSION PET/MRI can simultaneously assess multiple early metabolic and morphologic markers of knee OA across multiple tissues in the joint. Our findings suggest that PET/MR may detect metabolic abnormalities in subchondral bone, which appear normal on MRI. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;45:1736-1745.
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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
| | - Emily McWalter
- Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, Canada
| | - Edwin Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Andrew Quon
- 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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28
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Badar F, Xia Y. Image interpolation improves the zonal analysis of cartilage T2 relaxation in MRI. Quant Imaging Med Surg 2017; 7:227-237. [PMID: 28516048 DOI: 10.21037/qims.2017.03.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND This project aimed to investigate the improvement in the detection of osteoarthritis (OA) in cartilage by the interpolation of T2 images, in the situation when the native MRI resolution is insufficient to resolve the depth-dependent T2 characteristics in articular cartilage (AC). METHODS Eighteen intact canine knee joints that were healthy or had mild (contralateral) or severe OA were T2-imaged in a 7T/20 cm MRI system at 200 µm/pixel resolution (macro-MRI). Two image analysis methods were used to interpolate the images to 100 µm/pixel, i.e., by Fourier-transforming the time-domain FID (Free Induction Decay) signal using the Varian NMR software and by interpolating the 2D T2 image using the ImageJ software. RESULTS The T2 profiles from 30 individual ROI of each healthy [6], mild [6] and OA [6] cartilage at 200 µm and the interpolated 100 µm resolutions were subdivided into two equal-thickness regions and three-equal thickness regions based on clinical MRI protocols. A new method divided the T2 profiles into three-unequal thickness zones according to the T2 profiles at 17.6 µm/pixel from the same cartilage imaged in a 7 Tesla/9 cm µMRI system. Both interpolation methods improved the depth-dependent T2 images/profiles in macro-MRI. The unequal zone division in T2 had better OA sensitivity than the equal zone division. The three-equal zone division of T2 profiles had better OA sensitivity than the two-equal zone division. The statistical significant difference between the healthy and mild OA cartilage is detected (P=0.0018) only by the unequal zone division method at 100 µm resolution. CONCLUSIONS Data interpolation improves the T2 sensitivity in MRI of cartilage OA. Unequal division of tissue thickness enables better early stage of OA detection than the equal division.
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Affiliation(s)
- Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
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29
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Bangerter NK, Taylor MD, Tarbox GJ, Palmer AJ, Park DJ. Quantitative techniques for musculoskeletal MRI at 7 Tesla. Quant Imaging Med Surg 2016; 6:715-730. [PMID: 28090448 DOI: 10.21037/qims.2016.12.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Whole-body 7 Tesla MRI scanners have been approved solely for research since they appeared on the market over 10 years ago, but may soon be approved for selected clinical neurological and musculoskeletal applications in both the EU and the United States. There has been considerable research work on musculoskeletal applications at 7 Tesla over the past decade, including techniques for ultra-high resolution morphological imaging, 3D T2 and T2* mapping, ultra-short TE applications, diffusion tensor imaging of cartilage, and several techniques for assessing proteoglycan content in cartilage. Most of this work has been done in the knee or other extremities, due to technical difficulties associated with scanning areas such as the hip and torso at 7 Tesla. In this manuscript, we first provide some technical context for 7 Tesla imaging, including challenges and potential advantages. We then review the major quantitative MRI techniques being applied to musculoskeletal applications on 7 Tesla whole-body systems.
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Affiliation(s)
- Neal K Bangerter
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA;; Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Meredith D Taylor
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Grayson J Tarbox
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Antony J Palmer
- Department of Orthopaedics, University of Oxford, Oxford, UK
| | - Daniel J Park
- Department of Orthopaedics, University of Oxford, Oxford, UK
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30
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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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31
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Oinas J, Rieppo L, Finnilä MAJ, Valkealahti M, Lehenkari P, Saarakkala S. Imaging of Osteoarthritic Human Articular Cartilage using Fourier Transform Infrared Microspectroscopy Combined with Multivariate and Univariate Analysis. Sci Rep 2016; 6:30008. [PMID: 27445254 PMCID: PMC4956759 DOI: 10.1038/srep30008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 06/29/2016] [Indexed: 12/16/2022] Open
Abstract
The changes in chemical composition of human articular cartilage (AC) caused by osteoarthritis (OA) were investigated using Fourier transform infrared microspectroscopy (FTIR-MS). We demonstrate the sensitivity of FTIR-MS for monitoring compositional changes that occur with OA progression. Twenty-eight AC samples from tibial plateaus were imaged with FTIR-MS. Hyperspectral images of all samples were combined for K-means clustering. Partial least squares regression (PLSR) analysis was used to compare the spectra with the OARSI grade (histopathological grading of OA). Furthermore, the amide I and the carbohydrate regions were used to estimate collagen and proteoglycan contents, respectively. Spectral peak at 1338 cm(-1) was used to estimate the integrity of the collagen network. The layered structure of AC was revealed using the carbohydrate region for clustering. Statistically significant correlation was observed between the OARSI grade and the collagen integrity in the superficial (r = -0.55) and the deep (r = -0.41) zones. Furthermore, PLSR models predicted the OARSI grade from the superficial (r = 0.94) and the deep (r = 0.77) regions of the AC with high accuracy. Obtained results suggest that quantitative and qualitative changes occur in the AC composition during OA progression, and these can be monitored by the use of FTIR-MS.
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Affiliation(s)
- J Oinas
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Finland
| | - L Rieppo
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Finland
| | - M A J Finnilä
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Finland.,Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - M Valkealahti
- Medical Research Center, University of Oulu and Oulu University Hospital, Finland.,Department of Surgery, Oulu University Hospital, Finland
| | - P Lehenkari
- Medical Research Center, University of Oulu and Oulu University Hospital, Finland.,Department of Surgery, Oulu University Hospital, Finland.,Research Group of Cancer and Translational Medicine, Faculty of Medicine, University of Oulu, Finland
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Finland
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Zhuang Z, Lee JH, Badar F, Xu J, Xia Y. The influences of different spatial resolutions on the characteristics of T2 relaxation times in articular cartilage: A coarse-graining study of the microscopic magnetic resonance imaging data. Microsc Res Tech 2016; 79:754-65. [PMID: 27297720 DOI: 10.1002/jemt.22694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 11/09/2022]
Abstract
Microscopic magnetic resonance imaging (µMRI) T2 data from canine cartilage at different tibial locations were analyzed to investigate the influences of spatial resolution and pixel position on the T2 sensitivity to osteoarthritis (OA). Five experimental factors were investigated: inaccurate pixel position, different pixel resolutions, different specimen orientations in the magnetic field, topographical variations over the tibial surface, and different OA stages. A number of significant trends were identified in this analysis, which shows the subtle but substantial influences to our abilities of detecting OA due to T2 changes. In particular, any deviation in locating the cartilage pixels may result in erratic values near the cartilage surface. Significant differences were found in T2 values between nearly any two comparison-groups under all resolutions both in the meniscus-covered and -uncovered areas, which were also showed interaction between the OA degradation stages. This multiresolution project should help to improve the detection sensitivities of MRI toward cartilage degeneration. Microsc. Res. Tech. 79:754-765, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Zhiguo Zhuang
- Department of Radiology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China.,Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan
| | - Ji Hyun Lee
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan
| | - Jianrong Xu
- Department of Radiology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, Michigan
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Quantitative imaging of excised osteoarthritic cartilage using spectral CT. Eur Radiol 2016; 27:384-392. [DOI: 10.1007/s00330-016-4374-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 02/29/2016] [Accepted: 04/18/2016] [Indexed: 12/23/2022]
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34
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Kogan F, Hargreaves BA, Gold GE. Volumetric multislice gagCEST imaging of articular cartilage: Optimization and comparison with T1rho. Magn Reson Med 2016; 77:1134-1141. [PMID: 26923108 DOI: 10.1002/mrm.26200] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 02/12/2016] [Accepted: 02/12/2016] [Indexed: 12/28/2022]
Abstract
PURPOSE To develop and optimize a multislice glycosaminoglycan (GAG) chemical exchange saturation transfer (GagCEST) sequence for volumetric imaging of articular cartilage, and to validate the sequence against T1ρ relaxation times in whole joint imaging of tibiotalar cartilage. METHODS Ex vivo experiments were used to observe the effect of the number of partitions and shot TR on signal-to-noise ratio and measured GagCESTasym . GagCEST imaging of the entire tibiotalar joint was also performed on 10 healthy subjects. The measured GagCESTasym was compared and correlated with T1ρ relaxation times. RESULTS Ex vivo studies showed a higher average GagCESTasym from articular cartilage on multislice acquisitions acquired with two or more partitions than observed with a single-slice acquisition. In healthy human subjects, an average GagCESTasym of 8.8 ± 0.7% was observed. A coefficient of variation of GagCESTasym across slices of less than 15% was seen for all subjects. Across subjects, a Pearson correlation coefficient of -0.58 was observed between the measured gagCESTasym and T1ρ relaxation times. CONCLUSIONS We demonstrated the feasibility and optimization of multislice GagCEST mapping of articular cartilage. Volumetric analysis and decreased scan times will help to advance the clinical utility of GagCEST imaging of articular cartilage. Magn Reson Med 77:1134-1141, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Brian A Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Electrical Engineering, Stanford University, Stanford, California, USA
| | - Garry E Gold
- Department of Radiology, Stanford University, Stanford, California, USA.,Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Orthopedic Surgery, Stanford University, Stanford, California, USA
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