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Tschopp M, Pfirrmann CWA, Brunner F, Fucentese SF, Galley J, Stern C, Sutter R, Catanzaro S, Kühne N, Rosskopf AB. Morphological and Quantitative Parametric MRI Follow-up of Cartilage Changes Before and After Intra-articular Injection Therapy in Patients With Mild to Moderate Knee Osteoarthritis: A Randomized, Placebo-Controlled Trial. Invest Radiol 2024; 59:646-655. [PMID: 38421679 DOI: 10.1097/rli.0000000000001067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Intra-articular injections are routinely used for conservative treatment of knee osteoarthritis (OA). The detailed comparative therapeutic effects of these injections on cartilage tissue are still unclear. OBJECTIVE The aim of this study was to detect and compare knee cartilage changes after intra-articular injection of glucocorticoid, hyaluronic acid, or platelet-rich plasma (PRP) to placebo using quantitative (T2 and T2* mapping) and morphological magnetic resonance imaging parameters in patients with mild or moderate osteoarthritis. MATERIALS AND METHODS In a double-blinded, placebo-controlled, single-center trial, knees with mild or moderate osteoarthritis (Kellgren-Lawrence grade 1-3) were randomly assigned to an intra-articular injection with 1 of these substances: glucocorticoid, hyaluronic acid, PRP, or placebo. Cartilage degeneration on baseline and follow-up magnetic resonance imaging scans (after 3 and 12 months) was assessed by 2 readers using quantitative T2 and T2* times (milliseconds) and morphological parameters (modified Outerbridge grading, subchondral bone marrow edema, subchondral cysts, osteophytes). RESULTS One hundred twenty knees (30 knees per treatment group) were analyzed with a median patient age of 60 years (interquartile range, 54.0-68.0 years). Interreader reliability was good for T2 (ICC, 0.76; IQR, 0.68-0.83) and T2* (ICC, 0.83; IQR, 0.76-0.88) measurements. Morphological parameters showed no significant changes between all groups after 3 and 12 months. T2 mapping after 12 months showed the following significant ( P = 0.001-0.03) changes between groups in 6 of 14 compartments: values after PRP injection decreased compared with glucocorticoid in 4 compartments (complete medial femoral condyle and central part of lateral condyle) and compared with placebo in 2 compartments (anterior and central part of medial tibial plateau); values after glucocorticoid injection decreased compared with placebo in 1 compartment (central part of medial tibial plateau). No significant changes were seen for T2 and T2* times after 3 months and T2* times after 12 months. No correlation was found between T2/T2* times and Kellgren-Lawrence grade, age, body mass index, or pain (Spearman ρ, -0.23 to 0.18). CONCLUSIONS Platelet-rich plasma injection has a positive long-term effect on cartilage quality in the medial femoral compartment compared to glucocorticoid, resulting in significantly improved T2 values after 12 months. For morphological cartilage parameters, injections with glucocorticoid, PRP, or hyaluronic acid showed no better effect in the short or long term compared with placebo.
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Affiliation(s)
- Marcel Tschopp
- From the Department of Physical Medicine and Rheumatology, Balgrist University Hospital, Zurich, Switzerland (M.T., F.B.); Orthopedic Surgery, Balgrist University Hospital, Zurich, Switzerland (S.F.F.); University of Zurich, Faculty of Medicine, Zurich, Switzerland (C.W.A.P., F.B., S.F.F., J.G., C.S., R.S., A.B.R.); Radiology, Balgrist University Hospital, Zurich, Switzerland (C.W.A.P., J.G., C.S., R.S., A.B.R.); and Unit for Clinical and Applied Research (UCAR), Balgrist Campus, Zurich, Switzerland (S.C., N.K.)
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Argentieri EC, Pekmezian A, Wach A, Zhu A, Bansal S, Breighner RE, Leatherman ER, Potter HG, Maher SA, Koff MF. Baseline-to-loaded changes in regional tibial cartilage thickness, T1ρ and T2: Utilization of an MRI compatible loading device. J Orthop Res 2024. [PMID: 39177306 DOI: 10.1002/jor.25956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 08/24/2024]
Abstract
The objective of the study was to evaluate tibial cartilage thickness (TCT), T1ρ and T2 values within both loaded and baseline configurations in a cadaveric knee model using a 3D bone based tibial coordinate system. Ten intact cadaveric knees were mounted into an magnetic resonance imaging (MRI) compatible loading device. Morphologic and quantitative MRI (qMRI) images were acquired with the knee in a baseline configuration and after application of 50% body weight. The morphologic images were evaluated for cartilage degeneration using a modified Noyes scoring system. A 3D bone-based tibial coordinate system was utilized to evaluate regional changes of tibial T1ρ, T2, and cartilage thickness values among regions covered and uncovered by the meniscus. Inter-regional differences in medial and lateral MRI outcomes were found between loaded and baseline configurations. Cartilage regions covered by the meniscus demonstrated disparate qMRI and TCT results as compared to cartilage regions not covered by the meniscus. The regions covered by meniscus experienced a ~3.5%, ~0.5%, and ~5.5% reduction of T1ρ (p < 0.05, medial and lateral compartments), T2 and TCT, respectively, in both compartments while regions not covered by the meniscus experienced larger reductions of ~10%, ~2%, and ~10.5% reduction of T1ρ (p < 0.05, medial and lateral compartments), T2 and TCT (p < 0.05, lateral compartment only), respectively, in both compartments. T1ρ and T2 decreases following application of 50% body weight load were substantially larger in the tibial regions with modified Noyes grade 3 (n = 2) compared to either healthy regions (n = 85, p < 0.0.003) or regions with modified Noyes grade 2 (n = 13, p < 0.004). Interregional differences in MRI outcomes reflect variations in structure and function, and largely followed a pattern in cartilage regions that were covered or not covered by the meniscus. Results of the current study suggest that ΔT1ρ and ΔT2 values may be sensitive to superficial fissuring, more than baseline or loaded T1ρ or T2 values, or TCT alone, however future studies with additional specimens, with greater variability in OA grade distribution, may further emphasize the current findings.
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Affiliation(s)
- Erin C Argentieri
- Department of Radiology and Imaging, MRI Laboratory, Hospital for Special Surgery, New York City, New York, USA
| | - Ashley Pekmezian
- Department of Biomechanics, Hospital for Special Surgery, New York City, New York, USA
| | - Arden Wach
- Department of Biomechanics, Hospital for Special Surgery, New York City, New York, USA
| | - Andrew Zhu
- Weill Cornell Medicine, Weill Cornell Medical College, New York City, New York, USA
| | - Sonia Bansal
- Department of Biomechanics, Hospital for Special Surgery, New York City, New York, USA
| | - Ryan E Breighner
- Department of Biomechanics, Hospital for Special Surgery, New York City, New York, USA
| | - Erin R Leatherman
- Department of Mathematics and Statistics, Kenyon College, Gambier, Ohio, USA
| | - Hollis G Potter
- Department of Radiology and Imaging, MRI Laboratory, Hospital for Special Surgery, New York City, New York, USA
| | - Suzanne A Maher
- Department of Biomechanics, Hospital for Special Surgery, New York City, New York, USA
| | - Matthew F Koff
- Department of Radiology and Imaging, MRI Laboratory, Hospital for Special Surgery, New York City, New York, USA
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Rovedo P, Meine H, Hucker P, Taghizadeh E, Izadpanah K, Zaitsev M, Lange T. Time-Resolved Quantification of Patellofemoral Cartilage Deformation in Response to Loading and Unloading via Dynamic MRI With Prospective Motion Correction. J Magn Reson Imaging 2024; 60:175-183. [PMID: 37668040 DOI: 10.1002/jmri.28986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/16/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND In vivo cartilage deformation has been studied by static magnetic resonance imaging (MRI) with in situ loading, but knowledge about strain dynamics after load onset and release is scarce. PURPOSE To measure the dynamics of patellofemoral cartilage deformation and recovery in response to in situ loading and unloading by using MRI with prospective motion correction. STUDY TYPE Prospective. SUBJECTS Ten healthy male volunteers (age: [31.4 ± 3.2] years). FIELD STRENGTH/SEQUENCE T1-weighted RF-spoiled 2D gradient-echo sequence with a golden angle radial acquisition scheme, augmented with prospective motion correction, at 3 T. ASSESSMENT In situ knee loading was realized with a flexion angle of approximately 40° using an MR-compatible pneumatic loading device. The loading paradigm consisted of 2 minutes of unloaded baseline followed by a 5-minute loading bout with 50% body weight and an unloading period of 38 minutes. The cartilage strain was assessed as the mean distance between patellar and femoral bone-cartilage interfaces as a percentage of the initial (pre-load) distance. STATISTICAL TESTS Wilcoxon signed-rank tests (significance level: P < 0.05), Pearson correlation coefficient (r). RESULTS The cartilage compression and recovery behavior was characterized by a viscoelastic response. The elastic compression ([-12.5 ± 3.1]%) was significantly larger than the viscous compression ([-7.6 ± 1.5]%) and the elastic recovery ([10.5 ± 2.1]%) was significantly larger than the viscous recovery ([6.1 ± 1.8]%). There was a significant residual offset strain ([-3.6 ± 2.3]%) across the cohort. A significant negative correlation between elastic compression and elastic recovery was observed (r = -0.75). DATA CONCLUSION The in vivo cartilage compression and recovery time course in response to loading was successfully measured via dynamic MRI with prospective motion correction. The clinical relevance of the strain characteristics needs to be assessed in larger subject and patient cohorts. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Philipp Rovedo
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans Meine
- Medical Image Computing Group, Department of Informatics, University of Bremen, Bremen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Patrick Hucker
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elham Taghizadeh
- Medical Image Computing Group, Department of Informatics, University of Bremen, Bremen, Germany
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Kaywan Izadpanah
- Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Maxim Zaitsev
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lange
- Division of Medical Physics, Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Voronkova E, Melnikov I, Manzhurtsev A, Bozhko O, Vorobyev D, Akhadov T, Menshchikov P. T 2 Mapping of Patellar Cartilage After a Single First-Time Episode of Traumatic Lateral Patellar Dislocation. J Magn Reson Imaging 2024; 59:865-876. [PMID: 37316971 DOI: 10.1002/jmri.28857] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND In most cases, lateral patellar dislocation (LPD) is accompanied by chondral injury and may initiate gradual degeneration of patellar cartilage, which might be detected with a T2 mapping, a well-established method for cartilage lesions assessment. PURPOSE To examine short-term consequences of single first-time LPD in teenagers by T2 mapping of the patellar-cartilage state. STUDY TYPE Prospective. POPULATION 95 patients (mean age: 15.1 ± 2.3; male/female: 46/49) with first-time, complete, traumatic LPD and 51 healthy controls (mean age: 14.7 ± 2.2, male/female: 29/22). FIELD STRENGTH/SEQUENCE 3.0 T; axial T2 mapping acquired using a 2D turbo spin-echo sequence. ASSESSMENT MRI examination was conducted 2-4 months after first LPD. T2 values were calculated in manually segmented cartilage area via averaging over three middle level slices in six cartilage regions: deep, intermediate, superficial layers, and medial lateral parts. STATISTICAL TESTS ANOVA analysis with Tukey's multiple comparison test, one-vs.-rest logistic regression analysis. The threshold of significance was set at P < 0.05. RESULTS In lateral patellar cartilage, a significant increase in T2 values was found in deep and intermediate layers in both patient groups with mild (deep: 34.7 vs. 31.3 msec, intermediate: 38.7 vs. 34.6 msec, effect size = 0.55) and severe (34.8 vs. 31.3 msec, 39.1 vs. 34.6 msec, 0.55) LPD consequences as compared to controls. In the medial facet, only severe cartilage damage showed significant prolongation of T2 times in the deep layer (34.3 vs. 30.7 msec, 0.55). No significant changes in T2 values were found in the lateral superficial layer (P = 0.99), whereas mild chondromalacia resulted in a significant decrease of T2 in the medial superficial layer (41.0 vs. 43.8 msec, 0.55). DATA CONCLUSION The study revealed substantial difference in T2 changes after LPD between medial and lateral areas of patellar cartilage. EVIDENCE LEVEL 2 TECHNICAL EFFICACY STAGE: 2.
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Affiliation(s)
- Elena Voronkova
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
| | - Ilya Melnikov
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Andrei Manzhurtsev
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
| | - Olga Bozhko
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Denis Vorobyev
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Tolib Akhadov
- Clinical and Research Institute of Emergency Pediatric Surgery and Trauma, Moscow, Russian Federation
| | - Petr Menshchikov
- Emanuel Institute of Biochemical Physics, Russian Academy of Sciences, Moscow, Russian Federation
- LLC Philips, Moscow, Russian Federation
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Roth C, Hirsch FW, Sorge I, Kiess W, Jurkutat A, Witt M, Böker E, Gräfe D. Preclinical Cartilage Changes of the Knee Joint in Adolescent Competitive Volleyball Players: A Prospective T2 Mapping Study. ROFO-FORTSCHR RONTG 2023; 195:913-923. [PMID: 37224866 DOI: 10.1055/a-2081-3245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To investigate the potential effects of volleyball as a competitive sport in adolescence on the cartilage of knee joints using T2 mapping in MRI and identification of preclinical cartilage changes. Volleyball as an impact sport often leads to damage of the knee joint cartilage in adulthood. As T2 mapping is widely available and highly capable of detecting cartilage changes prior to conventional MRI sequences, such a detection may allow adolescent volleyball players to change their training regime before structural damage can occur to the cartilage and pose the risk of osteoarthritis. MATERIALS AND METHODS Comparative study of the patellar, femoral, and tibial cartilage of 60 knee joints using T2 mapping on 3 T MRI. In each case, both knees of 15 adolescent competitive volleyball athletes were compared with 15 controls. RESULTS In the group of competitive athletes, more focal cartilage changes were detected in the medial facet of the patellofemoral cartilage and in the medial femoral condyle of the knee joint cartilage (p = .01 and p <.05, respectively). Furthermore, the latter showed a diffused increase in maximal T2 mapping values (p <.04 right and p = .05 left). The distribution of changes seems to further depend on the player's position. CONCLUSION In adolescent volleyball players in competitive sports, T2 mapping demonstrates early cartilage changes in both the patellofemoral and medial femoral cartilages. The distribution of lesions depends on the player's position. Since the cascade from T2 relaxation time increase to conspicuous cartilage damage is well established, early counter-regulation (e. g., adapted training profile, targeted physiotherapy, and appropriate muscle building training) has the potential to prevent later damage. KEY POINTS · Volleyball as a competitive sport in adolescence leads to preclinical knee cartilage changes.. · Cartilage changes are both focal and diffuse.. · Jumping-intensive player positions seem to show more patellofemoral and running-intensive more condylar cartilage changes.. · Early detection of these changes could prevent progression to cartilage damage through adapted training.. CITATION FORMAT · Roth C, Hirsch F, Sorge I et al. Preclinical Cartilage Changes of the Knee Joint in Adolescent Competitive Volleyball Players: A Prospective T2 Mapping Study. Fortschr Röntgenstr 2023; 195: 913 - 923.
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Affiliation(s)
- Christian Roth
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
| | | | - Ina Sorge
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
| | - Wieland Kiess
- Department of Pediatrics, Leipzig University Hospital for Children and Adolescents, Leipzig, Germany
| | - Anne Jurkutat
- Department of Pediatrics, Leipzig University Hospital for Children and Adolescents, Leipzig, Germany
| | - Maren Witt
- Sports Biomechanics, Leipzig University Faculty of Sport Science, Leipzig, Germany
| | - Eva Böker
- Sports Biomechanics, Leipzig University Faculty of Sport Science, Leipzig, Germany
| | - Daniel Gräfe
- Department of Pediatric Radiology, University Hospital Leipzig, Germany
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Ece B, Yigit H, Ergun E, Koseoglu EN, Karavas E, Aydin S, Kosar PN. Quantitative Analysis of Supraspinatus Tendon Pathologies via T2/T2* Mapping Techniques with 1.5 T MRI. Diagnostics (Basel) 2023; 13:2534. [PMID: 37568898 PMCID: PMC10417426 DOI: 10.3390/diagnostics13152534] [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: 06/02/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this study was to quantitatively assess supraspinatus tendon pathologies with T2/T2* mapping techniques, which are sensitive to biochemical changes. Conventional magnetic resonance imaging (MRI) and T2/T2* mapping techniques were applied to 41 patients with shoulder pathology, and there were also 20 asymptomatic cases included. The patients were divided into two groups: tendinosis and rupture. The supraspinatus tendon was divided into medial, middle, and lateral sub-regions, and the T2/T2* values were measured in both the coronal and sagittal planes for intergroup comparison. Intra-class and inter-class correlation coefficients (ICCs) were calculated to assess test reproducibility. Receiver operating characteristic (ROC) analysis was used to determine the cut-off value in each group. A total of 61 patients (27 males and 34 females)-including 20 asymptomatic individuals, 20 with tendinosis, and 21 with rupture-were evaluated using T2/T2* mapping techniques. In the rupture group, there were significant differences in the values of the lateral region (p < 0.001), as well as in the middle and medial regions (p < 0.05) of the supraspinatus tendon compared to the tendinosis and asymptomatic groups. These were determined using both T2* and T2 mapping in both the coronal and sagittal plane measurements. In the tendinosis group, there were significant differences in the values of the lateral region with T2* mapping (p < 0.001) in both the coronal and sagittal planes, and also with the T2 mapping in the coronal plane (p < 0.05) compared to the asymptomatic groups. The cut-off values for identifying supraspinatus pathology ranged from 85% to 90% for T2 measurements and above 90% for T2* measurements in both planes of the lateral section. The ICC values showed excellent reliability (ICC > 0.75) for all groups. In conclusion, T2 and T2* mapping techniques with 1.5 T MRI can be used to assess tendon rupture and tendinosis pathologies in the supraspinatus tendon. For an accurate evaluation, measurements from the lateral region in both the coronal and sagittal planes are more decisive.
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Affiliation(s)
- Bunyamin Ece
- Department of Radiology, Kastamonu University, 37150 Kastamonu, Turkey
| | - Hasan Yigit
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
| | - Elif Ergun
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
| | - Enver Necip Koseoglu
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
| | - Erdal Karavas
- Department of Radiology, Bandırma Onyedi Eylül University, 10200 Bandırma, Turkey;
| | - Sonay Aydin
- Department of Radiology, Erzincan University, 24100 Erzincan, Turkey;
| | - Pinar Nercis Kosar
- Department of Radiology, Health Sciences University, Ankara Education and Research Hospital, 06100 Ankara, Turkey; (H.Y.); (E.E.); (E.N.K.); (P.N.K.)
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Kuhn S, Bustin A, Lamri-Senouci A, Rumac S, Ledoux JB, Colotti R, Bastiaansen JAM, Yerly J, Favre J, Omoumi P, van Heeswijk RB. Improved accuracy and precision of fat-suppressed isotropic 3D T2 mapping MRI of the knee with dictionary fitting and patch-based denoising. Eur Radiol Exp 2023; 7:25. [PMID: 37211577 DOI: 10.1186/s41747-023-00339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/15/2023] [Indexed: 05/23/2023] Open
Abstract
PURPOSE To develop an isotropic three-dimensional (3D) T2 mapping technique for the quantitative assessment of the composition of knee cartilage with high accuracy and precision. METHODS A T2-prepared water-selective isotropic 3D gradient-echo pulse sequence was used to generate four images at 3 T. These were used for three T2 map reconstructions: standard images with an analytical T2 fit (AnT2Fit); standard images with a dictionary-based T2 fit (DictT2Fit); and patch-based-denoised images with a dictionary-based T2 fit (DenDictT2Fit). The accuracy of the three techniques was first optimized in a phantom study against spin-echo imaging, after which knee cartilage T2 values and coefficients of variation (CoV) were assessed in ten subjects in order to establish accuracy and precision in vivo. Data given as mean ± standard deviation. RESULTS After optimization in the phantom, whole-knee cartilage T2 values of the healthy volunteers were 26.6 ± 1.6 ms (AnT2Fit), 42.8 ± 1.8 ms (DictT2Fit, p < 0.001 versus AnT2Fit), and 40.4 ± 1.7 ms (DenDictT2Fit, p = 0.009 versus DictT2Fit). The whole-knee T2 CoV reduced from 51.5% ± 5.6% to 30.5 ± 2.4 and finally to 13.1 ± 1.3%, respectively (p < 0.001 between all). The DictT2Fit improved the data reconstruction time: 48.7 ± 11.3 min (AnT2Fit) versus 7.3 ± 0.7 min (DictT2Fit, p < 0.001). Very small focal lesions were observed in maps generated with DenDictT2Fit. CONCLUSIONS Improved accuracy and precision for isotropic 3D T2 mapping of knee cartilage were demonstrated by using patch-based image denoising and dictionary-based reconstruction. KEY POINTS • Dictionary T2 fitting improves the accuracy of three-dimensional (3D) knee T2 mapping. • Patch-based denoising results in high precision in 3D knee T2 mapping. • Isotropic 3D knee T2 mapping enables the visualization of small anatomical details.
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Affiliation(s)
- Simon Kuhn
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Aurélien Bustin
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Department of Cardiovascular Imaging, Hôpital Cardiologique du Haut-Lévêque, CHU de Bordeaux, France
- IHU LIRYC, Electrophysiology and Heart Modeling Institute, INSERM U1045, Centre de Recherche Cardio-Thoracique de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Aicha Lamri-Senouci
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Simone Rumac
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jean-Baptiste Ledoux
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for BioMedical Imaging (CIBM), Lausanne, Switzerland
| | - Roberto Colotti
- Biomedical Data Science Center (BDSC), Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jessica A M Bastiaansen
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Department of Diagnostic, Interventional and Pediatric Radiology (DIPR), Bern University Hospital, University of Bern, Inselspital, Switzerland
- Translation Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Jérôme Yerly
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- Center for BioMedical Imaging (CIBM), Lausanne, Switzerland
| | - Julien Favre
- Department of Musculoskeletal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
- The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
| | - Patrick Omoumi
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
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Wu J, Wu C, Cai Z, Gu H, Liu L, Xia C, Lui S, Gong Q, Song B, Ai H. Ultra-small superparamagnetic iron oxide nanoparticles for intra-articular targeting of cartilage in early osteoarthritis. Regen Biomater 2023; 10:rbad052. [PMID: 37397872 PMCID: PMC10307945 DOI: 10.1093/rb/rbad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 07/04/2023] Open
Abstract
Early diagnosis of osteoarthritis (OA) is critical for effective cartilage repair. However, lack of blood vessels in articular cartilage poses a barrier to contrast agent delivery and subsequent diagnostic imaging. To address this challenge, we proposed to develop ultra-small superparamagnetic iron oxide nanoparticles (SPIONs, 4 nm) that can penetrate into the matrix of articular cartilage, and further modified with the peptide ligand WYRGRL (particle size, 5.9 nm), which allows SPIONs to bind to type II collagen in the cartilage matrix and increase the retention of probes. Type II collagen in the cartilage matrix is gradually lost with the progression of OA, consequently, the binding of peptide-modified ultra-small SPIONs to type II collagen in the OA cartilage matrix is less, thus presenting different magnetic resonance (MR) signals in OA group from the normal ones. By introducing the AND logical operation, damaged cartilage can be differentiated from the surrounding normal tissue on T1 and T2 AND logical map of MR images, and this was also verified in histology studies. Overall, this work provides an effective strategy for delivering nanosized imaging agents to articular cartilage, which could potentially be used to diagnosis joint-related diseases such as osteoarthritis.
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Affiliation(s)
- Jun Wu
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu 610207, China
- Medical Imaging Key Laboratory of Sichuan Province, School of Medical Imaging, North Sichuan Medical College, Nanchong 637000, China
| | - Changqiang Wu
- Correspondence address. Tel: +86 28 85413991, E-mail: (H.A.); (C.W.)
| | - Zhongyuan Cai
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Haojie Gu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Li Liu
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Chunchao Xia
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Su Lui
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), Frontiers Science Center for Disease-Related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, China
- Functional and Molecular Imaging Key Laboratory of Sichuan Province, Key Laboratory of Transplant Engineering and Immunology, NHC, Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610064, China
- Department of Radiology, West China Xiamen Hospital of Sichuan University, Fujian, Xiamen 361000, China
| | - Bin Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
- Department of Radiology, Sanya People’s Hospital, Hainan, Sanya 572000, China
| | - Hua Ai
- Correspondence address. Tel: +86 28 85413991, E-mail: (H.A.); (C.W.)
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9
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Abstract
PURPOSE OF REVIEW Imaging plays a pivotal role for diagnosis, follow-up and stratification of osteoarthritis patients in clinical trials and research. We aim to present an overview of currently available and emerging imaging techniques for osteoarthritis assessment and provide insight into relevant benefits and pitfalls of the different modalities. RECENT FINDINGS Although radiography is considered sufficient for a structural diagnosis of osteoarthritis and is commonly used to define eligibility of patients for participation in clinical trials, it has inherent limitations based on the projectional nature of the technique and inherent challenges regarding reproducibility in longitudinal assessment. MRI has changed our understanding of the disease from 'wear and tear' of cartilage to a whole organ disorder. MRI assessment of structural changes of osteoarthritis includes semi-quantitative, quantitative and compositional evaluation. Ultrasound is helpful in evaluating the degree of synovitis and has value in the assessment particularly of the patella-femoral joint. Recent development of computed tomography technology including weight-bearing systems has led to broader application of this technology in a research context. SUMMARY Advances in MRI technology have resulted in a significant improvement in understanding osteoarthritis as a multitissue disease.
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Affiliation(s)
- Majid Chalian
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Frank W Roemer
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine
- Department of Radiology, VA Boston Healthcare System, Boston, Massachusetts, USA
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10
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Comparison of meniscal T1rho- and T2*-relaxation times in professional female volleyball players and healthy controls using 3T MRI: A pilot study. Eur J Radiol 2022; 155:110503. [DOI: 10.1016/j.ejrad.2022.110503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 08/22/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022]
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11
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Roemer FW, Guermazi A, Demehri S, Wirth W, Kijowski R. Imaging in Osteoarthritis. Osteoarthritis Cartilage 2022; 30:913-934. [PMID: 34560261 DOI: 10.1016/j.joca.2021.04.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis with major implications on both individual and public health care levels. The field of joint imaging, and particularly magnetic resonance imaging (MRI), has evolved rapidly due to the application of technical advances to the field of clinical research. This narrative review will provide an introduction to the different aspects of OA imaging aimed at an audience of scientists, clinicians, students, industry employees, and others who are interested in OA but who do not necessarily focus on OA. The current role of radiography and recent advances in measuring joint space width will be discussed. The status of cartilage morphology assessment and evaluation of cartilage biochemical composition will be presented. Advances in quantitative three-dimensional morphologic cartilage assessment and semi-quantitative whole-organ assessment of OA will be reviewed. Although MRI has evolved as the most important imaging method used in OA research, other modalities such as ultrasound, computed tomography, and metabolic imaging play a complementary role and will also be discussed.
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Affiliation(s)
- F W Roemer
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Ave, Boston, MA, 02118, USA; Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Maximiliansplatz 3, Erlangen, 91054, Germany.
| | - A Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Ave, Boston, MA, 02118, USA; Department of Radiology, VA Boston Healthcare System, 1400 VFW Pkwy, Suite 1B105, West Roxbury, MA, 02132, USA
| | - S Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 600 N. Wolf Street, Park 311, Baltimore, MD, 21287, USA
| | - W Wirth
- Institute of Anatomy, Paracelsus Medical University Salzburg, Salzburg, Austria, Nüremberg, Germany; Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Paracelsus Medical University Salzburg, Strubergasse 21, 5020, Salzburg, Austria; Chondrometrics, GmbH, Freilassing, Germany
| | - R Kijowski
- Department of Radiology, New York University Grossmann School of Medicine, 550 1st Avenue, 3nd Floor, New York, NY, 10016, USA
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12
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El-Liethy NE, Kamal HA. Advanced compositional imaging T2 mapping sequence in detection of stages of medial knee joint compartments articular cartilage degeneration. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [DOI: 10.1186/s43055-020-00395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The predictive value of the new imaging sequences, especially T2 mapping in assessment of articular cartilage abnormalities of the medial knee compartments in patients with medial knee pain. The purpose of this study is to evaluate the additional value of T2 mapping over using a baseline standard knee MRI to detect cartilage lesions of the medial compartments in patients representing with medial knee pain.
Results
The study included 60 patients presented with medial knee pain, where divided into two groups ; control group (20 volunteers) with age range from 19 to 41 years old 26.80 ± 8.05 (mean ± SD) and patients (40 candidates) with age range from 13 to 57 years old with a mean age 33.00 ± 14.1 (mean ± SD).
Conclusion
On adding T2 mapping sequence to the routine MRI of the knee, the sensitivity for detecting knee cartilage lesions was increased, especially in the detection of early cartilage degeneration at the medial compartment.
Compositional MR imaging including T2 mapping plays an important role in the assessment of early and potentially reversible cartilage damage especially among the young population.
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13
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Janssen M, Peters M, Steijvers-Peeters E, Szomolanyi P, Jutten E, van Rhijn L, Peterson L, Lindahl A, Trattnig S, Emans P. 7-Tesla MRI Evaluation of the Knee, 25 Years after Cartilage Repair Surgery: The Influence of Intralesional Osteophytes on Biochemical Quality of Cartilage. Cartilage 2021; 13:767S-779S. [PMID: 34836478 PMCID: PMC8808805 DOI: 10.1177/19476035211060506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE To evaluate the morphological and biochemical quality of cartilage transplants and surrounding articular cartilage of patients 25 years after perichondrium transplantation (PT) and autologous chondrocyte transplantation (ACT) as measured by ultra-high-field 7-Tesla (7T) magnetic resonance imaging (MRI) and to present these findings next to clinical outcome. DESIGN Seven PT patients and 5 ACT patients who underwent surgery on the femoral condyle between 1986 and 1996 were included. Patient-reported outcome measures (PROMs) were assessed by the clinical questionnaires: Knee injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and Visual Analogue Scale (VAS) for knee pain. The morphological (MOCART score) and biochemical quality (glycosaminoglycans [GAGs] content and collagen integrity) of cartilage transplants and surrounding articular cartilage were analyzed by 7T MRI. The results of the PT and ACT patients were compared. Finally, a detailed morphological analysis of the grafts alone was performed. RESULTS No statistically significant difference was found for the PROMs and MOCART scores of PT and ACT patients. Evaluation of the graft alone showed poor repair tissue quality and high prevalence of intralesional osteophyte formation in both the PT and ACT patients. Penetration of the graft surface by the intralesional osteophyte was related to biochemically damaged opposing tibial cartilage; GAG content was significantly lower in patients with an osteophyte penetrating the graft surface. CONCLUSIONS Both PT and ACT patients have a high incidence of intralesional osteophyte formation 25 years after surgery. The resulting biochemical damage to the opposing tibial cartilage might be dependent on osteophyte morphology.
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Affiliation(s)
- M.P.F. Janssen
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands,M.P.F. Janssen, Department of Orthopaedic
Surgery, CAPHRI School for Public Health and Primary Care, Maastricht University
Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
| | - M.J.M. Peters
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| | | | - P. Szomolanyi
- High-Field MR Center, Department of
Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna,
Austria
| | - E.M.C. Jutten
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| | - L.W. van Rhijn
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
| | - L. Peterson
- Department of Laboratory Medicine,
Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
| | - A. Lindahl
- Sahlgrenska Academy, University of
Gothenburg, Gothenburg, Sweden
| | - S. Trattnig
- High-Field MR Center, Department of
Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna,
Austria
| | - P.J. Emans
- Department of Orthopaedic Surgery,
CAPHRI School for Public Health and Primary Care, Maastricht University Medical
Center+, Maastricht, The Netherlands
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14
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Zhao Z, Ge H, Xiang W, Bai G. Exploration of MRI T2 Mapping Image Application in Articular Disc Displacement of the Temporomandibular Joint in Adolescents. Int J Gen Med 2021; 14:6077-6084. [PMID: 34594131 PMCID: PMC8478363 DOI: 10.2147/ijgm.s330116] [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: 07/22/2021] [Accepted: 09/16/2021] [Indexed: 01/27/2023] Open
Abstract
Purpose To explore the application of magnetic resonance imaging (MRI) T2 mapping technique in clinical practice through morphological and quantitative analysis of T2 mapping sequences in adolescents with temporomandibular disorders (TMDs) and control groups comprising healthy participants. Patients and Methods A total of 45 and 63 patients, who had articular disc displacement with and without reduction, respectively, were assigned to the experimental groups, and 57 participants with normal articular discs of the temporomandibular joint were considered as the control group. All participants in the three groups underwent MRI. T2 mapping was performed in the oblique sagittal plane. The regions of interest (ROIs) for the T2 relaxation time maps of the disc were selected manually. The performance of morphological and structural changes and quantitative parameters in MRI T2 mapping image artifacts were statistically compared. Results In the control group, the mean T2 value was 39.284 ±5.634 ms, in the group of disc displacement with reduction, the mean T2 value was 33.634 ±4.235 ms, and in the group of disc displacement without reduction, the mean T2 value was 30.982 ±3.205 ms. The T2 mapping values of the experimental groups, together with different morphological structures, were significantly lower than were those of the control group. Conclusion MRI T2 mapping enables a more accurate evaluation of TMD severity. Sequentially, it helps provide a more reliable medical imaging basis for classifying diagnosis and evaluation in clinical practice.
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Affiliation(s)
- Zhoujing Zhao
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, People's Republic of China
| | - Huaizhi Ge
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, People's Republic of China
| | - Wei Xiang
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, People's Republic of China
| | - Guanghui Bai
- Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, People's Republic of China
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15
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Fernquest S, Palmer A, Gammer B, Hirons E, Kendrick B, Taylor A, De Berker H, Bangerter N, Carr A, Glyn-Jones S. Compositional MRI of the Hip: Reproducibility, Effect of Joint Unloading, and Comparison of T2 Relaxometry with Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage. Cartilage 2021; 12:418-430. [PMID: 30971110 PMCID: PMC8461155 DOI: 10.1177/1947603519841670] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Our aim was to compare T2 with delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) in the hip and assess the reproducibility and effect of joint unloading on T2 mapping. DESIGN Ten individuals at high risk of developing hip osteoarthritis (SibKids) underwent contemporaneous T2 mapping and dGEMRIC in the hip (10 hips). Twelve healthy volunteers underwent T2 mapping of both hips (24 hips) at time points 25, 35, 45, and 55 minutes post offloading. Acetabular and femoral cartilage was manually segmented into regions of interest. The relationship between T2 and dGEMRIC values from anatomically corresponding regions of interests was quantified using Pearson's correlation. The reproducibility of image analysis for T2 and dGEMRIC, and reproducibility of image acquisition for T2, was quantified using the intraclass correlation coefficient (ICC), root mean square coefficient of variance (RMSCoV), smallest detectable difference (SDD), and Bland-Altman plots. The paired t test was used to determine if difference existed in T2 values at different unloading times. RESULTS T2 values correlated most strongly with dGEMRIC values in diseased cartilage (r = -0.61, P = <0.001). T2 image analysis (segmentation) reproducibility was ICC = 0.96 to 0.98, RMSCoV = 3.5% to 5.2%, and SDD = 2.2 to 3.5 ms. T2 values at 25 minutes unloading were not significantly different to longer unloading times (P = 0.132). SDD for T2 image acquisition reproducibility was 7.1 to 7.4 ms. CONCLUSIONS T2 values in the hip correlate well with dGEMRIC in areas of cartilage damage. T2 shows high reproducibility and values do not change beyond 25 minutes of joint unloading.
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Affiliation(s)
- Scott Fernquest
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK,Scott Fernquest, Botnar Research Centre, Old Road, Oxford OX3 7LD, UK.
| | - Antony Palmer
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Bonnie Gammer
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Emma Hirons
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Benjamin Kendrick
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Adrian Taylor
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Henry De Berker
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Neal Bangerter
- Electrical and Computer Engineering Department, Brigham Young University, Provo, UT, USA
| | - Andrew Carr
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Sion Glyn-Jones
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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16
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Radiomics Feature Analysis of Cartilage and Subchondral Bone in Differentiating Knees Predisposed to Posttraumatic Osteoarthritis after Anterior Cruciate Ligament Reconstruction from Healthy Knees. BIOMED RESEARCH INTERNATIONAL 2021; 2021:4351499. [PMID: 34552985 PMCID: PMC8452399 DOI: 10.1155/2021/4351499] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022]
Abstract
Objectives To introduce a new implementation of radiomics analysis for cartilage and subchondral bone of the knee and to compare the performance of the proposed models to classic T2 relaxation time in distinguishing knees predisposed to posttraumatic osteoarthritis (PTOA) after anterior cruciate ligament reconstruction (ACLR) and healthy controls. Methods 114 patients following ACLR after at least 2 years and 43 healthy controls were reviewed and allocated to training (n = 110) and testing (n = 47) cohorts. Radiomics models are built for cartilage and subchondral bone regions of different compartments: lateral femur (LF), lateral tibia (LT), medial femur (MF), and medial tibia (MT) and combined models of four compartments on T2 mapping images. The model performance of discrimination between patients and controls was illustrated with the receiver operating characteristic curve and compared with a classic T2 value-based model. Results The T2 value model of cartilage yielded moderate predictive performance in discerning patients and controls, with an AUC of 0.731 (95% confidence interval, 0.556–0.875) in the testing cohort, while the radiomics signature of cartilage and subchondral bone of different compartments demonstrated excellent performance, with AUCs of 0.864–0.979. Furthermore, the combined model reported an even better performance, with AUCs of 0.977 (95% confidence interval, 0.919–1.000) for the cartilage and 0.934 (95% confidence interval, 0.865–0.994) for the subchondral bone in the testing cohort. Conclusion The radiomics features of the cartilage and subchondral bone may be able to provide powerful tools with more sensitive detection than T2 values in differentiating knees at risk for PTOA after ACLR from healthy knees.
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17
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Xu X, Gao J, Liu S, Chen L, Chen M, Yu X, Ma N, Zhang J, Chen X, Zhong L, Yu L, Xu L, Guo Q, Ding J. Magnetic resonance imaging for non-invasive clinical evaluation of normal and regenerated cartilage. Regen Biomater 2021; 8:rbab038. [PMID: 34408910 PMCID: PMC8369076 DOI: 10.1093/rb/rbab038] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/06/2021] [Accepted: 06/16/2021] [Indexed: 02/07/2023] Open
Abstract
With the development of tissue engineering and regenerative medicine, it is much desired to establish bioimaging techniques to monitor the real-time regeneration efficacy in vivo in a non-invasive way. Herein, we tried magnetic resonance imaging (MRI) to evaluate knee cartilage regeneration after implanting a biomaterial scaffold seeded with chondrocytes, namely, matrix-induced autologous chondrocyte implantation (MACI). After summary of the T2 mapping and the T1-related delayed gadolinium-enhanced MRI imaging of cartilage (dGEMRIC) in vitro and in vivo in the literature, these two MRI techniques were tried clinically. In this study, 18 patients were followed up for 1 year. It was found that there was a significant difference between the regeneration site and the neighboring normal site (control), and the difference gradually diminished with regeneration time up to 1 year according to both the quantitative T1 and T2 MRI methods. We further established the correlation between the quantitative evaluation of MRI and the clinical Lysholm scores for the first time. Hence, the MRI technique was confirmed to be a feasible semi-quantitative yet non-invasive way to evaluate the in vivo regeneration of knee articular cartilage.
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Affiliation(s)
- Xian Xu
- Department of Radiology, The Second Medical Center & National Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Jingming Gao
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, No. 2005 Songhu Road, Yangpu District, Shanghai 200438, China
| | - Shuyun Liu
- Institute of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries of PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Liang Chen
- Institute for Medical Device Control, National Institutes for Food and Drug Control, No. 31 Huatuo Road, Daxing District, Beijing 102629, China
| | - Min Chen
- Department of Radiology, The Second Medical Center & National Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Xiaoye Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, No. 2005 Songhu Road, Yangpu District, Shanghai 200438, China
| | - Ning Ma
- Institute of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries of PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Jun Zhang
- Department of Radiology, The Second Medical Center & National Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Xiaobin Chen
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, No. 2005 Songhu Road, Yangpu District, Shanghai 200438, China
| | - Lisen Zhong
- Department of Radiology, The Second Medical Center & National Clinical Research Center of Geriatric Diseases, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Lin Yu
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, No. 2005 Songhu Road, Yangpu District, Shanghai 200438, China
| | - Liming Xu
- Institute for Medical Device Control, National Institutes for Food and Drug Control, No. 31 Huatuo Road, Daxing District, Beijing 102629, China
| | - Quanyi Guo
- Institute of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma and War Injuries of PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China
| | - Jiandong Ding
- State Key Laboratory of Molecular Engineering of Polymers, Department of Macromolecular Science, Fudan University, No. 2005 Songhu Road, Yangpu District, Shanghai 200438, China
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18
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Lockard CA, Nolte PC, Gawronski KMB, Elrick BP, Goldenberg BT, Horan MP, Dornan GJ, Ho CP, Millett PJ. Quantitative T2 mapping of the glenohumeral joint cartilage in asymptomatic shoulders and shoulders with increasing severity of rotator cuff pathology. Eur J Radiol Open 2021; 8:100329. [PMID: 33644264 PMCID: PMC7895706 DOI: 10.1016/j.ejro.2021.100329] [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: 12/16/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 02/02/2023] Open
Abstract
Glenohumeral cartilage T2 values were correlated to increasing rotator cuff pathology severity. Massive tear versus lesser injury differences were most evident in superior humeral cartilage. Sagittal T2 mapping best captures superior humeral head cartilage change in massive tear patients.
Purpose To examine the relationship between glenohumeral cartilage T2 mapping values and rotator cuff pathology. Method Fifty-nine subjects (age 48.2 ± 13.5 years, 15 asymptomatic volunteers and 10 tendinosis, 13 partial-thickness tear, 8 full-thickness tear, and 13 massive tear patients) underwent glenohumeral cartilage T2 mapping. The humeral head cartilage was segmented in the sagittal and coronal planes. The glenoid cartilage was segmented in the coronal plane. Group means for each region were calculated and compared between the groups. Results Massive tear group T2 values were significantly higher than the asymptomatic group values for the humeral head cartilage included in the sagittal (45 ± 7 versus 32 ± 4 ms, p < .001) and coronal (44 ± 6 versus 38 ± 1 ms, p = 0.01) plane images. Mean T2 was also significantly higher for massive than full-thickness tears (45 ± 7 versus 38 ± 5 ms, p = 0.02), massive than partial-thickness tears (45 ± 7 versus 34 ± 4 ms, p < 0.001), and massive tears than tendinosis (45 ± 7 versus 35 ± 4 ms, p = 0.001) in the sagittal-images humeral head region and significantly higher for massive tears than asymptomatic shoulders (44 ± 6 versus 38 ± 1 ms, p = 0.01) in the coronal-images humeral head region. Conclusion Humeral head cartilage T2 values were significantly positively correlated with rotator cuff pathology severity. Massive rotator cuff tear patients demonstrated significantly higher superior humeral head cartilage T2 mapping values relative to subjects with no/lesser degrees of rotator cuff pathology.
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Key Words
- Cartilage
- Cuff tear arthropathy
- FS, fat suppressed
- GCor, glenoid, coronal plane
- HH, humeral head
- HHCor, humeral head, coronal plane
- HHSag, humeral head, sagittal plane
- MRI, magnetic resonance imaging
- Magnetic resonance imaging
- PD, proton density
- RC, rotator cuff
- ROI, region of interest
- Rotator cuff
- SPACE, sampling perfection with application-optimized contrasts using different flip angle evolution
- Shoulder
- T2, transverse relaxation time
- TSE, turbo spin echo
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Affiliation(s)
- Carly A Lockard
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Philip-C Nolte
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Karissa M B Gawronski
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Bryant P Elrick
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Brandon T Goldenberg
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Marilee P Horan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Grant J Dornan
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA
| | - Peter J Millett
- Steadman Philippon Research Institute, 181 W Meadow Dr, Ste 1000, Vail, CO 81657, USA.,The Steadman Clinic, 181 W Meadow Dr, Ste 400, Vail, CO 81657, USA
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19
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Matcuk GR, Jones IA, McIntyre JA, Burt R, Hwang D, Cen S, Schein AJ, Vangsness CT. Evaluation of Knee Cartilage Diurnal, Activity, and BMI-Related Variations Using Quantitative T2 Mapping MRI and Fitbit Activity Tracking. J Knee Surg 2021; 34:251-257. [PMID: 31434143 DOI: 10.1055/s-0039-1695000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The aim of this study is to evaluate diurnal variation in knee cartilage 3 Tesla magnetic resonance imaging (MRI) T2 mapping relaxation times, as well as activity- and body mass index (BMI)-dependent variability, using quantitative analysis of T2 values from segmented regions of the weight-bearing articular surfaces of the medial and lateral femoral condyles and tibial plateaus. Ten healthy volunteers' daily activity (steps) were tracked with Fitbit pedometers. Sagittal MRI T2 maps were obtained in the morning and afternoon on days 2 and 3. Mean T2 values were analyzed for variation related to the number of steps taken (activity), time of day (diurnal variation), and BMI using mixed effect model. Significant (albeit small) differences in the medial femoral and medial tibial cartilage regions were identified between morning and afternoon scans (diurnal variation). Daily activity did not result in significant changes and increasing BMI only demonstrated a slight increase in T2 values for the lateral tibial plateau. These findings suggest that it may be necessary to control diurnal variation when using quantitative MRI T2 mapping to assess articular cartilage longitudinally in healthy participants. Further investigation is needed to confirm these findings and determine if they also apply to symptomatic patients.
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Affiliation(s)
- George R Matcuk
- Department of Radiology, University of Southern California, Los Angeles, California
| | - Ian A Jones
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California
| | - J Alex McIntyre
- School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
| | - Robert Burt
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Darryl Hwang
- Department of Radiology, University of Southern California, Los Angeles, California
| | - Steven Cen
- Department of Radiology, University of Southern California, Los Angeles, California
| | - Aaron J Schein
- Department of Radiology, University of Southern California, Los Angeles, California
| | - C Thomas Vangsness
- Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California
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20
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Serrao EM, Kessler DA, Carmo B, Beer L, Brindle KM, Buonincontri G, Gallagher FA, Gilbert FJ, Godfrey E, Graves MJ, McLean MA, Sala E, Schulte RF, Kaggie JD. Magnetic resonance fingerprinting of the pancreas at 1.5 T and 3.0 T. Sci Rep 2020; 10:17563. [PMID: 33067515 PMCID: PMC7567885 DOI: 10.1038/s41598-020-74462-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
Magnetic resonance imaging of the pancreas is increasingly used as an important diagnostic modality for characterisation of pancreatic lesions. Pancreatic MRI protocols are mostly qualitative due to time constraints and motion sensitivity. MR Fingerprinting is an innovative acquisition technique that provides qualitative data and quantitative parameter maps from a single free-breathing acquisition with the potential to reduce exam times. This work investigates the feasibility of MRF parameter mapping for pancreatic imaging in the presence of free-breathing exam. Sixteen healthy participants were prospectively imaged using MRF framework. Regions-of-interest were drawn in multiple solid organs including the pancreas and T1 and T2 values determined. MRF T1 and T2 mapping was performed successfully in all participants (acquisition time:2.4-3.6 min). Mean pancreatic T1 values were 37-43% lower than those of the muscle, spleen, and kidney at both 1.5 and 3.0 T. For these organs, the mean pancreatic T2 values were nearly 40% at 1.5 T and < 12% at 3.0 T. The feasibility of MRF at 1.5 T and 3 T was demonstrated in the pancreas. By enabling fast and free-breathing quantitation, MRF has the potential to add value during the clinical characterisation and grading of pathological conditions, such as pancreatitis or cancer.
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Affiliation(s)
- Eva M Serrao
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Dimitri A Kessler
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Bruno Carmo
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Lucian Beer
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | | | - Ferdia A Gallagher
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Edmund Godfrey
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
| | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mary A McLean
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | - Evis Sala
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Cancer Research UK, Cambridge, UK
| | | | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge Biomedical Campus, Box 218, Cambridge, CB2 0QQ, UK.
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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21
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Synthetic MRI is not yet ready for morphologic and functional assessment of patellar cartilage at 1.5Tesla. Diagn Interv Imaging 2020; 102:181-187. [PMID: 33032959 DOI: 10.1016/j.diii.2020.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/21/2020] [Accepted: 09/04/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to compare morphologic assessment and relaxometry of patellar hyaline cartilage between conventional sequences (fast spin-echo [FSE] T2-weighted fat-saturated and T2-mapping) and synthetic T2 short-TI inversion recovery (STIR) and T2 maps at 1.5T magnetic resonance imaging (MRI). METHOD The MRI examinations of the knee obtained at 1.5T in 49 consecutive patients were retrospectively studied. There were 21 men and 28 women with a mean age of 45±17.7 (SD) years (range: 18-88 years). Conventional and synthetic acquisitions were performed, including T2-weighted fat-saturated and T2-mapping sequences. Two radiologists independently compared patellar cartilage T2-relaxation time on conventional T2-mapping and synthetic T2-mapping images. A third radiologist evaluated the patellar cartilage morphology on conventional and synthetic T2-weighted images. The presence of artifacts was also assessed. Interobserver agreement for quantitative variables was assessed using intraclass correlation coefficient (ICC). RESULTS In vitro, conventional and synthetic T2 maps yielded similar mean T2 values 58.5±2.3 (SD) ms and 58.8±2.6 (SD) ms, respectively (P=0.414) and 6% lower than the expected experimental values (P=0.038). Synthetic images allowed for a 15% reduction in examination time compared to conventional images. On conventional sequences, patellar chondropathy was identified in 35 patients (35/49; 71%) with a mean chondropathy grade of 4.8±4.8 (SD). On synthetic images, 28 patients (28/49; 57%) were diagnosed with patellar chondropathy, with a significant 14% difference (P=0.009) and lower chondropathy scores (3.7±4.9 [SD]) compared to conventional images. Motion artifacts were more frequently observed on synthetic images (18%) than on conventional ones (6%). The interobserver agreement was excellent for both conventional and synthetic T2 maps (ICC>0.83). Mean cartilage T2 values were significantly greater on synthetic images (36.2±3.8 [SD] ms; range: 29-46ms) relative to conventional T2 maps (31.8±4.1 [SD] ms; range: 26-49ms) (P<0.0001). CONCLUSION Despite a decrease in examination duration, synthetic images convey lower diagnostic performance for chondropathy, greater prevalence of motion artifacts, and an overestimation of T2 values compared to conventional MRI sequences.
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Lee D, Hong KT, Lim TS, Lee E, Lee YH, Park JS, Kim W, Oh JH, Choi JA, Song Y. Alterations in articular cartilage T2 star relaxation time following mechanical disorders: in vivo canine supraspinatus tendon resection models. BMC Musculoskelet Disord 2020; 21:424. [PMID: 32615950 PMCID: PMC7331159 DOI: 10.1186/s12891-020-03447-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background The role of altered joint mechanics on cartilage degeneration in in vivo models has not been studied successfully due to a lack of pre-injury information. We aimed 1) to develop an accurate in vivo canine model to measure the changes in joint loading and T2 star (T2*) relaxation time before and after unilateral supraspinatus tendon resections, and 2) to find the relationship between regional variations in articular cartilage loading patterns and T2* relaxation time distributions. Methods Rigid markers were implanted in the scapula and humerus of tested dogs. The movement of the shoulder bones were measured by a motion tracking system during normal gaits. In vivo cartilage contact strain was measured by aligning 3D shoulder models with the motion tracking data. Articular cartilage T2* relaxation times were measured by quantitative MRI scans. Articular cartilage contact strain and T2* relaxation time were compared in the shoulders before and 3 months after the supraspinatus tendon resections. Results Excellent accuracy and reproducibility were found in our in vivo contact strain measurements with less than 1% errors. Changes in articular cartilage contact strain exhibited similar patterns with the changes in the T2* relaxation time after resection surgeries. Regional changes in the articular cartilage T2* relaxation time exhibited positive correlations with regional contact strain variations 3 months after the supraspinatus resection surgeries. Conclusion This is the first study to measure in vivo articular cartilage contact strains with high accuracy and reproducibility. Positive correlations between contact strain and T2* relaxation time suggest that the articular cartilage extracellular matrix may responds to mechanical changes in local areas.
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Affiliation(s)
- Dokwan Lee
- Department of Mechanical Engineering, Korea University Engineering Campus, Innovation Hall, Room 306, Anam-dong, Seongbuk-gu, Seoul, 02841, South Korea
| | - Ki-Taek Hong
- Department of Mechanical Engineering, Korea University Engineering Campus, Innovation Hall, Room 306, Anam-dong, Seongbuk-gu, Seoul, 02841, South Korea
| | - Tae Seong Lim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, South Korea
| | - Eugene Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ye Hyun Lee
- Department of Orthopedic Surgery, National Police Hospital, Seoul, South Korea
| | - Ji Soon Park
- Department of Orthopedic Surgery, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, United Arab Emirates
| | - Woo Kim
- Seoul Kiwoonchan Orthopedics Clinic, Seoul, South Korea
| | - Joo Han Oh
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jung-Ah Choi
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, South Korea
| | - Yongnam Song
- Department of Mechanical Engineering, Korea University Engineering Campus, Innovation Hall, Room 306, Anam-dong, Seongbuk-gu, Seoul, 02841, South Korea.
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23
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Koller U, Springer B, Rentenberger C, Szomolanyi P, Waldstein W, Windhager R, Trattnig S, Apprich S. Radiofrequency Chondroplasty May Not Have A Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans. J Clin Med 2020; 9:jcm9041202. [PMID: 32331338 PMCID: PMC7230966 DOI: 10.3390/jcm9041202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 01/10/2023] Open
Abstract
The effect of radiofrequency chondroplasty on cartilage tissue is not well studied. This prospective pilot study investigates the effect of radiofrequency chondroplasty on International Cartilage Repair Society (ICRS) grade II patellar cartilage defects using high-resolution magnetic resonance imaging (MRI) with T2 mapping. Six consecutive patients were treated for ICRS grade II patellar cartilage defects using radiofrequency chondroplasty. Before surgery and at defined follow-ups (2 weeks, 4 and 12 months) a high-resolution morphological 3 Tesla MRI with quantitative T2 mapping was performed. At baseline MRI, global T2 values of cartilage defects were increased (46.8 ms ± 9.7) compared to healthy cartilage (35.2 ms ± 4.5) in the same knee which served as reference. Two weeks after treatment, global T2 values (39.2 ms ± 7.7) of the defect areas decreased. However, global T2 values of the defect areas increased beyond the preoperative levels at 4 months (47.4 ms ± 3.1) and 12 months (51.5 ms ± 5.9), respectively. Zonal T2 mapping revealed that the predominant changes in T2 values occurred at the superficial cartilage layer. T2 mapping appears to be an ideal method to monitor cartilage degeneration after chondroplasty. Based on the small sample size of this pilot study, radiofrequency chondroplasty may cause cartilage damage and may not have a long-lasting effect in the treatment of grade II patellar cartilage defects. In five out of six patients, postoperative cartilage damage was observed on quantitative MRI. This study was therefore terminated before completion. We recommend only addressing the pathology which indicated arthroscopy and leaving concomitant cartilage lesions untreated.
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Affiliation(s)
- Ulrich Koller
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (U.K.); (B.S.); (C.R.); (R.W.); (S.A.)
| | - Bernhard Springer
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (U.K.); (B.S.); (C.R.); (R.W.); (S.A.)
| | - Colleen Rentenberger
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (U.K.); (B.S.); (C.R.); (R.W.); (S.A.)
| | - Pavol Szomolanyi
- High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Gürtel 18–20, 1090 Vienna, Austria; (P.S.); (S.T.)
- Institute of Measurement Science, Slovak Academy of Sciences, Dúbravská cesta 5801/9, 84104 Karlova Ves, Bratislava, Slovakia
| | - Wenzel Waldstein
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (U.K.); (B.S.); (C.R.); (R.W.); (S.A.)
- Correspondence: ; Tel.: +43-140-4004-0820; Fax: +43-140-4004-0290
| | - Reinhard Windhager
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (U.K.); (B.S.); (C.R.); (R.W.); (S.A.)
| | - Siegfried Trattnig
- High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Gürtel 18–20, 1090 Vienna, Austria; (P.S.); (S.T.)
- CD Laboratory for Clinical Molecular MR Imaging, Medical University of Vienna, Waehringer Gürtel 18-20, 1090 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Donaueschingenstr 13, 1200 Vienna, Austria
| | - Sebastian Apprich
- Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (U.K.); (B.S.); (C.R.); (R.W.); (S.A.)
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24
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Wang L, Gaddam S, Wang N, Xie Y, Deng Z, Zhou Z, Fan Z, Jiang T, Christodoulou AG, Han F, Lo SK, Wachsman AM, Hendifar AE, Pandol SJ, Li D. Multiparametric Mapping Magnetic Resonance Imaging of Pancreatic Disease. Front Physiol 2020; 11:8. [PMID: 32153416 PMCID: PMC7047169 DOI: 10.3389/fphys.2020.00008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022] Open
Abstract
Background Current magnetic resonance imaging (MRI) of pancreatic disease is qualitative in nature. Quantitative imaging offers several advantages, including increased reproducibility and sensitivity to detect mild or diffuse disease. The role of multiparametric mapping MRI in characterizing various tissue types in pancreatic disease such as chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) has rarely been evaluated. Purpose To evaluate the feasibility of multiparametric mapping [T1, T2, and apparent diffusion coefficient (ADC)] in defining tissue characteristics that occur in CP and PDAC to improve disease diagnosis. Materials and Methods: Pancreatic MRI was performed in 17 patients with PDAC undergoing therapy, 7 patients with CP, and 29 healthy volunteers with no pancreatic disease. T1 modified Look-Locker Inversion Recovery (T1 MOLLI), T2-prepared gradient-echo, and multi-slice single-shot echo-planar diffusion weighted imaging (SS-EPI DWI) sequences were used for data acquisition. Regions of interest (ROIs) of pancreas in PDAC, CP, and control subjects were outlined by an experienced radiologist. One-way analysis of variance (ANOVA) was used to compare the difference between groups and regions of the pancreas, and Tukey tests were used for multiple comparison testing within groups. Receiver operator characteristic (ROC) curves were analyzed, and the areas under the curves (AUCs) were calculated using single parameter and combined parameters, respectively. Results T1, T2, and ADC values of the entire pancreas among PDAC, CP, and control subjects; and between upstream and downstream portions of the pancreas in PDAC patients were all significantly different (p < 0.05). The AUC values were 0.90 for T1, 0.55 for T2, and 0.71 for ADC for independent prediction of PDAC. By combining T1, T2, and ADC, the AUC value was 0.94 (sensitivity 91.54%, specificity 85.81%, 95% CI: 0.92–0.96), which yielded higher accuracy than any one parameter only (p < 0.001). Conclusion Multiparametric mapping MRI is feasible for the evaluation of the differences between PDAC, CP, and normal pancreas tissues. The combination of multiple parameters of T1, T2, and ADC provides a higher accuracy than any single parameter alone in tissue characterization of the pancreas.
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Affiliation(s)
- Lixia Wang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Srinivas Gaddam
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Nan Wang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States.,Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Yibin Xie
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Zixin Deng
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Zhengwei Zhou
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Zhaoyang Fan
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Tao Jiang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | | | - Fei Han
- Department of Nuclear Science and Engineering, Siemens Healthineers, Princeton, NJ, United States
| | - Simon K Lo
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Ashley M Wachsman
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
| | - Andrew Eugene Hendifar
- Department of Gastrointestinal Malignancies, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Stephen J Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Debiao Li
- Cedars-Sinai Biomedical Imaging Research Institute, Los Angeles, CA, United States
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25
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Apprich SR, Schreiner MM, Szomolanyi P, Welsch GH, Koller UK, Weber M, Windhager R, Trattnig S. Potential predictive value of axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage defects over a mean follow-up of four years. Osteoarthritis Cartilage 2020; 28:215-222. [PMID: 31678665 DOI: 10.1016/j.joca.2019.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/20/2019] [Accepted: 10/16/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective was to demonstrate the potential of axial T2 mapping for quantification of untreated early-stage patellar cartilage lesions over time and to assess its capability as a potential predictive marker for future progression. STUDY DESIGN & METHODS Thirty patients (mean age, 36.7 ± 11.1 years; 16 males), with early-stage patellar cartilage defects (≤ICRS grade 2) at baseline and no treatment during follow up (4.0 ± 1.6 years) were enrolled. Morphological cartilage changes over time were subdivided into a Progression, Non-Progression Group and Regression Group. Quantitative analysis of cartilage defects and healthy reference was performed by means of global and zonal T2 mapping (deep and superficial cartilage T2 values) at both time points. Statistical evaluation included analysis of variance (ANOVA), paired t Test's and ROC analysis. RESULTS The Progression Group (N = 11) had significantly higher global T2 values at baseline (57.4 ± 7.8 ms) than patients without (N = 17) (40.6 ± 6.9 ms) (P < 0.01). Furthermore the Non-Progression Group showed only a minor increase in global T2 relaxation times to 43.1 ± 7.9 ms (P = 0.07) at follow up, whereas in the progression group global (68,7 ± 19 ms: P = 0.02) and superficial T2 values (65,8 ± 8.2-79.8 ± 24.4 ms; P = 0.03) increased significantly. T2 values for healthy reference cartilage remained stable. In 2 patients an improvement in ICRS grading was observed (Regression Group) with decreasing T2 values. The ROC analysis showed an area under the curve of 0.92 (95%CI 0.82-1.0). At a cut-off value of 47.15 ms, we found a sensitivity of 92% (false-positive rate of 18%) for future progression of cartilage defects. CONCLUSIONS This study provides evidence regarding the possible potential of axial T2 mapping as a tool for quantification and prediction of patellar cartilage defect progression in untreated defects.
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Affiliation(s)
- S R Apprich
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - M M Schreiner
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - P Szomolanyi
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia.
| | - G H Welsch
- UKE Athleticum, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
| | - U K Koller
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - M Weber
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria.
| | - R Windhager
- Department of Orthopedic and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
| | - S Trattnig
- High-Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Austria; CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Austria.
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Yang J, Shao H, Ma Y, Wan L, Zhang Y, Jiang J, Du J, Tang G. Quantitative ultrashort echo time magnetization transfer (UTE-MT) for diagnosis of early cartilage degeneration: comparison with UTE-T2* and T2 mapping. Quant Imaging Med Surg 2020; 10:171-183. [PMID: 31956540 DOI: 10.21037/qims.2019.12.04] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background To investigate the feasibility of using quantitative ultrashort echo time magnetization transfer (UTE-MT) technique in diagnosing early cartilage degeneration and to compare the technique's diagnostic efficacy with UTE-T2* mapping and T2 mapping. Methods Twenty human anterolateral condyle specimens with degeneration were obtained from volunteers undergoing total knee arthroplasty (TKA); they then underwent magnetic resonance (MR) scan on a clinical 3.0T scanner (GE, MR750). Seventy-two regions of interest (ROI) were manually drawn on specimens for UTE-MT, UTE-T2*, and T2 measurement, and the corresponding cartilage-bone regions were further divided into degeneration classifications of normal (n=11, Mankin scores 0-1), mild (n=28, Mankin scores 2-5), moderate (n=21, Mankin scores 6-9), and severe (n=12, Mankin scores 10-14) based on histological measures of degeneration (i.e., Mankin scores) as a reference standard. Differences among groups and correlations between quantitative MR parameters and Mankin scores were assessed using analysis of variance (ANOVA), Tamhane-T2, LSD, Kruskal-Wallis tests, and Spearman's correlation coefficient. The receiver-operating characteristic (ROC) curve was used to compare the diagnostic efficacy of different quantitative MR parameters for the detection of mild cartilage degeneration. Results The UTE magnetization transfer ratio (UTE-MTR) in the normal group was significantly different from the mild group (P=0.021), moderate group (P<0.001), and severe group (P<0.001). Significant differences were observed in the T2* values between both the normal group and the moderate group (P<0.032), and between the normal group and the severe group (P<0.001). For T2 values, the only significant difference was observed between the severe group and the normal group (P=0.011). The UTE-MTR, UTE-T2*, and T2 values were all significantly correlated with Mankin scores: UTE-MTR values were strongly (r=-0.678, P<0.001) correlated, UTE-T2* values were markedly correlated (r=-0.501, P<0.001), and T2 values were weakly correlated (r=0.337, P=0.004) correlated with Mankin scores. The diagnostic efficacy of UTE-MTR (AUC =0.828, P=0.002) was better than UTE T2* mapping and T2 mapping (AUC =0.604, P=0.318; AUC =0.644, P=0.165, respectively) for the diagnosis of early cartilage degeneration. Conclusions UTE-MTR values were strongly correlated with histological grades of cartilage degeneration, and its diagnostic efficacy was better than both UTE T2* mapping and T2 mapping in detecting early cartilage degeneration. Once the clinical potential of the technique has been confirmed, UTE-MT may provide a promising imaging biomarker with potential application in a more comprehensive diagnosis and monitoring of cartilage degeneration.
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Affiliation(s)
- Jiawei Yang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Hongda Shao
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, CA, USA
| | - Lidi Wan
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Yixuan Zhang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Junjie Jiang
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA
| | - Guangyu Tang
- Department of Radiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
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Waldenmeier L, Evers C, Uder M, Janka R, Hennig FF, Pachowsky ML, Welsch GH. Using Cartilage MRI T2-Mapping to Analyze Early Cartilage Degeneration in the Knee Joint of Young Professional Soccer Players. Cartilage 2019; 10:288-298. [PMID: 29448816 PMCID: PMC6585295 DOI: 10.1177/1947603518756986] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate and characterize the appearance of articular cartilage in the tibiofemoral joint of young professional soccer players using T2-relaxation time evaluation on magnetic resonance imaging (MRI). DESIGN In this study, we included 57 male adolescents from the youth academy of a professional soccer team. The MRI scans were acquired of the knee joint of the supporting leg. An "early unloading" (minute 0) and "late unloading" (minute 28) T2-sequence was included in the set of images. Quantitative T2-analysis was performed in the femorotibial joint cartilage in 4 slices with each 10 regions of interest (ROIs). Statistical evaluation, using Wilcoxon signed-rank tests, was primarily performed to compare the T2 values of the "early unloading" and "late unloading." RESULTS When comparing "early unloading" with "late unloading," our findings showed a significant increase of T2-relaxation times in the weightbearing femoral cartilage of the medial (P < 0.001) and lateral (P < 0.001) compartment of the knee and in the tibial cartilage of the medial compartment (P < 0.001). CONCLUSION In this study, alterations of the cartilage were found with a maximum in the medial condyle where the biomechanical load of the knee joint is highest, as well as where most of the chronic cartilage lesions occur. To avoid chronic damage, special focus should be laid on this region.
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Affiliation(s)
- Leonie Waldenmeier
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christoph Evers
- Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Uder
- Department of Radiology, University Hospital of Erlangen, Erlangen, Germany
| | - Rolf Janka
- Department of Radiology, University Hospital of Erlangen, Erlangen, Germany
| | | | - Milena L. Pachowsky
- Department of Trauma Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - Götz Hannes Welsch
- UKE Athleticum, University Hospital Hamburg-Eppendorf, Hamburg, Germany,Götz Hannes Welsch, UKE Athleticum, University Hospital Hamburg-Eppendorf, Building East 48, Martinistraße 52, Hamburg, 20246, Germany.
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28
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Bristela M, Skolka A, Eder J, Szomolanyi P, Weber M, Piehslinger E, Schmid-Schwap M, Trattnig S. T2 mapping with 3.0 T MRI of the temporomandibular joint disc of patients with disc dislocation. Magn Reson Imaging 2019; 58:125-134. [DOI: 10.1016/j.mri.2019.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/11/2018] [Accepted: 02/05/2019] [Indexed: 11/28/2022]
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29
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Atkinson HF, Birmingham TB, Moyer RF, Yacoub D, Kanko LE, Bryant DM, Thiessen JD, Thompson RT. MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:182. [PMID: 31039785 PMCID: PMC6492327 DOI: 10.1186/s12891-019-2547-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls. Methods We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments. Results 55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p < 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p < 0.001). Conclusions T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation. Electronic supplementary material The online version of this article (10.1186/s12891-019-2547-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hayden F Atkinson
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada. .,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada. .,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada. .,Musculoskeletal Rehabilitation, Elborn College, University of Western Ontario, London, Ontario, N6G 1H1, Canada.
| | - Rebecca F Moyer
- Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.,School of Physiotherapy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Yacoub
- Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada
| | - Lauren E Kanko
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Dianne M Bryant
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada.,Wolf Orthopaedic Biomechanics Laboratory, Fowler Kennedy Sport Medicine Clinic, University of Western Ontario, London, Ontario, Canada.,Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada
| | - Jonathan D Thiessen
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
| | - R Terry Thompson
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.,Imaging Program, Lawson Health Research Institute, London, Ontario, Canada
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Lange T, Taghizadeh E, Knowles BR, Südkamp NP, Zaitsev M, Meine H, Izadpanah K. Quantification of patellofemoral cartilage deformation and contact area changes in response to static loading via high-resolution MRI with prospective motion correction. J Magn Reson Imaging 2019; 50:1561-1570. [PMID: 30903682 DOI: 10.1002/jmri.26724] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/26/2019] [Accepted: 02/26/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Higher-resolution MRI of the patellofemoral cartilage under loading is hampered by subject motion since knee flexion is required during the scan. PURPOSE To demonstrate robust quantification of cartilage compression and contact area changes in response to in situ loading by means of MRI with prospective motion correction and regularized image postprocessing. STUDY TYPE Cohort study. SUBJECTS Fifteen healthy male subjects. FIELD STRENGTH 3 T. SEQUENCE Spoiled 3D gradient-echo sequence augmented with prospective motion correction based on optical tracking. Measurements were performed with three different loads (0/200/400 N). ASSESSMENT Bone and cartilage segmentation was performed manually and regularized with a deep-learning approach. Average patellar and femoral cartilage thickness and contact area were calculated for the three loading situations. Reproducibility was assessed via repeated measurements in one subject. STATISTICAL TESTS Comparison of the three loading situations was performed by Wilcoxon signed-rank tests. RESULTS Regularization using a deep convolutional neural network reduced the variance of the quantified relative load-induced changes of cartilage thickness and contact area compared to purely manual segmentation (average reduction of standard deviation by ∼50%) and repeated measurements performed on the same subject demonstrated high reproducibility of the method. For the three loading situations (0/200/400 N), the patellofemoral cartilage contact area as well as the mean patellar and femoral cartilage thickness were significantly different from each other (P < 0.05). While the patellofemoral cartilage contact area increased under loading (by 14.5/19.0% for loads of 200/400 N), patellar and femoral cartilage thickness exhibited a load-dependent thickness decrease (patella: -4.4/-7.4%, femur: -3.4/-7.1% for loads of 200/400 N). DATA CONCLUSION MRI with prospective motion correction enables quantitative evaluation of patellofemoral cartilage deformation and contact area changes in response to in situ loading. Regularizing the manual segmentations using a neural network enables robust quantification of the load-induced changes. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;50:1561-1570.
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Affiliation(s)
- Thomas Lange
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Elham Taghizadeh
- Medical Image Computing Group, Department of Informatics, University of Bremen, Germany.,Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Benjamin R Knowles
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Norbert P Südkamp
- Department of Orthopedic and Trauma Surgery, Medical Center - Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
| | - Maxim Zaitsev
- Department of Radiology, Medical Physics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Hans Meine
- Medical Image Computing Group, Department of Informatics, University of Bremen, Germany.,Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Kaywan Izadpanah
- Department of Orthopedic and Trauma Surgery, Medical Center - Albert-Ludwigs-University of Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg im Breisgau, Germany
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Vietti Violi N, Hilbert T, Bastiaansen JAM, Knebel JF, Ledoux JB, Stemmer A, Meuli R, Kober T, Schmidt S. Patient respiratory-triggered quantitative T 2 mapping in the pancreas. J Magn Reson Imaging 2019; 50:410-416. [PMID: 30637852 PMCID: PMC6766866 DOI: 10.1002/jmri.26612] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 02/06/2023] Open
Abstract
Background Long acquisition times and motion sensitivity limit T2 mapping in the abdomen. Accelerated mapping at 3 T may allow for quantitative assessment of diffuse pancreatic disease in patients during free‐breathing. Purpose To test the feasibility of respiratory‐triggered quantitative T2 analysis in the pancreas and correlate T2‐values with age, body mass index, pancreatic location, main pancreatic duct dilatation, and underlying pathology. Study Type Retrospective single‐center pilot study. Population Eighty‐eight adults. Field Strength/Sequence Ten‐fold accelerated multiecho‐spin‐echo 3 T MRI sequence to quantify T2 at 3 T. Assessment Two radiologists independently delineated three regions of interest inside the pancreatic head, body, and tail for each acquisition. Means and standard deviations for T2 values in these regions were determined. T2‐value variation with demographic data, intraparenchymal location, pancreatic duct dilation, and underlying pancreatic disease was assessed. Statistical Tests Interreader reliability was determined by calculating the interclass coefficient (ICCs). T2 values were compared for different pancreatic locations by analysis of variance (ANOVA). Interpatient associations between T2 values and demographical, clinical, and radiological data were calculated (ANOVA). Results The accelerated T2 mapping sequence was successfully performed in all participants (mean acquisition time, 2:48 ± 0:43 min). Low T2 value variability was observed across all patients (intersubject) (head: 60.2 ± 8.3 msec, body: 63.9 ± 11.5 msec, tail: 66.8 ± 16.4 msec). Interreader agreement was good (ICC, 0.82, 95% confidence interval: 0.77–0.86). T2‐values differed significantly depending on age (P < 0.001), location (P < 0.001), main pancreatic duct dilatation (P < 0.001), and diffuse pancreatic disease (P < 0.03). Data Conclusion The feasibility of accelerated T2 mapping at 3 T in moving abdominal organs was demonstrated in the pancreas, since T2 values were stable and reproducible. In the pancreatic parenchyma, T2‐values were significantly dependent on demographic and clinical parameters. Level of Evidence: 4 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;50:410–416.
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Affiliation(s)
- Naïk Vietti Violi
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Tom Hilbert
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare, Switzerland.,LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Jessica A M Bastiaansen
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Jean-Francois Knebel
- Center for Biomedical Imaging (CIBM), Lausanne, Switzerland.,Laboratory for investigative neurophysiology (The LINE), Department of Radiology and Department of Clinical Neurosciences, University hospital center and University of Lausanne, Lausanne, Switzerland
| | - Jean-Baptiste Ledoux
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Center for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | | | - Reto Meuli
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Tobias Kober
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Advanced Clinical Imaging Technology, Siemens Healthcare, Switzerland.,LTS5, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Sabine Schmidt
- Department of Radiology, University hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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32
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Han X, Hong G, Chen L, Zhao M, Guo Y, Xu L, Wu M, Leng X, Sun P. T1
ρ and T2
mapping for the determination of articular cartilage denaturalization with osteonecrosis of the femoral head: A prospective controlled trial. J Magn Reson Imaging 2018; 49:760-767. [PMID: 30461119 DOI: 10.1002/jmri.26267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 01/14/2023] Open
Affiliation(s)
- Xiaorui Han
- Department of Radiography; Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology; Guangzhou P.R. China
| | - Guoju Hong
- Department of Surgery; University of Alberta; Edmonton AB Canada
| | - Leilei Chen
- Orthopedic Department; First Affiliated Hospital of Guangzhou University of Chinese Medicine; Guangzhou P.R. China
| | - Man Zhao
- Department of Radiography; First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University; Guangzhou P.R. China
| | - Yuan Guo
- Department of Radiography; Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology; Guangzhou P.R. China
| | - Ling Xu
- Department of Ultrasound; Guangdong Women and Children Hospital; Guangzhou P.R. China
| | - Mei Wu
- Department of Radiography; Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology; Guangzhou P.R. China
| | - Xiaoming Leng
- Universal Medical Imaging Diagnostic Center; Guangzhou P.R. China
| | - Ping Sun
- Orthopedic Department; First Affiliated Hospital of Clinical Medicine of Guangdong Pharmaceutical University; Guangzhou P.R. China
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Colotti R, Omoumi P, van Heeswijk RB, Bastiaansen JAM. Simultaneous fat-free isotropic 3D anatomical imaging and T 2 mapping of knee cartilage with lipid-insensitive binomial off-resonant RF excitation (LIBRE) pulses. J Magn Reson Imaging 2018; 49:1275-1284. [PMID: 30318667 DOI: 10.1002/jmri.26322] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 08/13/2018] [Accepted: 08/13/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Improved knee cartilage morphological delineation and T2 mapping precision necessitates isotropic 3D high-resolution and efficient fat suppression. PURPOSE To develop and assess an isotropic 3D lipid-insensitive T2 mapping technique of the knee for improved cartilage delineation and precise measurement of T2 relaxation times. STUDY TYPE Prospective. PHANTOM/SUBJECTS Phantoms (n = 6) used in this study were designed to mimic the T1 and T2 relaxation times of cartilage and fat. The study cohort comprised healthy volunteers (n = 7) for morphometry and T2 relaxation time measurements. FIELD STRENGTH/SEQUENCE A high-resolution isotropic 3D T2 mapping technique that uses sequential T2 -prepared segmented gradient-recalled echo (Iso3DGRE) images and lipid-insensitive binomial off-resonant radiofrequency (RF) excitation (LIBRE) at 3T. ASSESSMENT Numerical simulations and phantom experiments were performed to optimize the LIBRE pulse. Phantom studies were carried out to test the accuracy of the technique against reference standard spin-echo (SE) T2 mapping. Subsequently, T2 maps with and without LIBRE pulses were acquired in knees of healthy volunteers and the T2 relaxation time values in different cartilage compartments were compared. STATISTICAL TESTS A two-tailed paired Student's t-test was used to compare the average T2 values and the relative standard deviations (inverse measurement of the precision) obtained with and without LIBRE pulses. RESULTS A LIBRE pulse of 1 msec suppressed fat with an RF excitation frequency offset of 1560 Hz and optimal RF excitation angle of 35°. These results were corroborated by phantom and knee experiments. Robust and homogeneous fat suppression was obtained (a fat signal-to-noise ratio (SNR) decrease of 86.4 ± 2.4%). In phantoms, T2 values were found in good agreement when comparing LIBRE-Iso3DGRE with SE (slope 0.93 ± 0.04, intercept 0.11 ± 1.6 msec, R2 >0.99). In vivo, LIBRE excitation resulted in more precise T2 estimation (23.7 ± 7.4%) than normal excitation (30.5 ± 9.9%, P < 0.0001). DATA CONCLUSION Homogeneous LIBRE fat signal suppression was achieved with a total RF pulse duration of 1 msec, allowing for the removal of chemical shift artifacts and resulting in improved cartilage delineation and precise T2 values. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1275-1284.
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Affiliation(s)
- Roberto Colotti
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Ruud B van Heeswijk
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Centre for Biomedical Imaging (CIBM), Lausanne, Switzerland
| | - Jessica A M Bastiaansen
- Department of Radiology, University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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Maturation-Related Changes in T2 Relaxation Times of Cartilage and Meniscus of the Pediatric Knee Joint at 3 T. AJR Am J Roentgenol 2018; 211:1369-1375. [PMID: 30299996 DOI: 10.2214/ajr.18.20026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to use a T2 mapping sequence performed at 3 T to investigate changes in the composition and microstructure of the cartilage and menisci of the pediatric knee joint during maturation. MATERIALS AND METHODS This retrospective study was performed of MRI examinations of 76 pediatric knees without internal derangement in 72 subjects (29 boys [mean age, 12.5 years] and 43 girls [mean age, 13.0 years]) who were evaluated with a sagittal T2 mapping sequence. T2 relaxation time values were quantitatively measured in eight cartilage subregions and in the medial and lateral menisci. Wilcoxon rank sum and Kruskal-Wallis tests were used to analyze the relationship between cartilage and meniscus T2 relaxation time values and sex and skeletal maturation, respectively. A multivariate linear regression model was used to investigate the independent association between cartilage T2 relaxation time values and age, weight, and body mass index (BMI [weight in kilograms divided by the square of height in meters]). RESULTS There were no significant sex differences (p = 0.26-0.91) in T2 relaxation time values for cartilage or meniscus. T2 relaxation time values in each individual cartilage subregion significantly decreased (p < 0.001) with progressive maturation. T2 relaxation time values in the lateral meniscus significantly increased (p = 0.001) with maturation, whereas T2 relaxation time values in the medial meniscus did not significantly change (p = 0.82). There was a significant association (p < 0.001) between cartilage T2 relaxation time values and age independent of weight and BMI, but no significant association between cartilage T2 relaxation time values and weight (p = 0.06) and BMI (p = 0.20) independent of age. CONCLUSION Cartilage T2 relaxation time values significantly decreased in all cartilage subregions and meniscus T2 relaxation time values significantly increased in the lateral meniscus during maturation. These changes in T2 relaxation time values reflect age-related changes in tissue composition and microstructure.
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Lockard CA, Wilson KJ, Ho CP, Shin RC, Katthagen JC, Millett PJ. Quantitative mapping of glenohumeral cartilage in asymptomatic subjects using 3 T magnetic resonance imaging. Skeletal Radiol 2018; 47:671-682. [PMID: 29196823 DOI: 10.1007/s00256-017-2829-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/17/2017] [Accepted: 11/14/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to develop quantitative T2 mapping methodology in asymptomatic shoulders for the entire mappable region of the glenohumeral cartilage in the coronal and sagittal planes, to assess the feasibility and limitations of the development of a diagnostic tool for future application in symptomatic patients. MATERIALS AND METHODS Twenty-one asymptomatic volunteers underwent sagittal and coronal glenohumeral T2 mapping, as the spherical geometry of the humeral head obviates the need to evaluate the entire glenohumeral cartilage in a single plane. The humeral head cartilage orthogonal to the mapping plane was manually segmented in the sagittal and coronal planes, whereas the glenoid cartilage was segmented in the coronal plane. Cartilage T2 summary statistics were calculated and coverage in each mapping plane was qualitatively assessed. RESULTS The mean ± standard deviation of the glenoid cartilage T2 was 38 ± 2 ms. The coronal and sagittal mapping planes captured different regions of the humeral head with some overlap: inferior-medial to superior-lateral versus superior/superior-lateral to anterior-lateral and posterior-lateral respectively. The mean humeral head cartilage T2 in the coronal plane was 41 ± 3 ms, which was significantly different (p < 0.05) from the sagittal plane mean of 34 ± 2 ms. CONCLUSION This study measured characteristic glenoid and humeral head cartilage T2 values over the area mappable with two planes. Importantly, this study demonstrated that two-dimensional mapping in a single plane or two combined planes cannot capture the entirety of the semi-spherical humeral head cartilage. This highlights the need for three-dimensional T2 mapping techniques in the shoulder.
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Affiliation(s)
- Carly A Lockard
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - Katharine J Wilson
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - Charles P Ho
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
| | - Richard C Shin
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - J Christoph Katthagen
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA
| | - Peter J Millett
- Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA.,The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA
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36
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Hesper T, Schleich C, Buchwald A, Hosalkar HS, Antoch G, Krauspe R, Zilkens C, Bittersohl B. T2* Mapping of the Hip in Asymptomatic Volunteers with Normal Cartilage Morphology: An Analysis of Regional and Age-Dependent Distribution. Cartilage 2018; 9:30-37. [PMID: 28466651 PMCID: PMC5724674 DOI: 10.1177/1947603516684591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To assess age-dependent and regional differences in T2* relaxation measurements in hip joint cartilage of asymptomatic volunteers at 3 T. Design Three age cohorts (cohort 1: age 20-30 years, 15 individuals; cohort 2: age 30-40 years, 17 individuals; cohort 3: age 40-50 years, 15 individuals) were enrolled. T2* values were obtained in the central and peripheral cartilage of the acetabulum and the femoral head in 7 regions (anterior to superior and posterior). Results T2* did not differ among age cohorts in acetabular cartilage (cohort 1: 24.65 ± 6.56 ms, cohort 2: 24.70 ± 4.83 ms, cohort 3: 25.81 ± 5.10 ms, P = 0.10) and femoral head cartilage (cohort 1: 27.08 ± 8.24 ms, cohort 2: 25.90 ± 7.82 ms, cohort 3: 26.50 ± 5.61 ms, P = 0.34). Analysis of the regional T2* distribution pattern indicates increased T2* values in the anterior, anterior-superior, superior-anterior, and the posterior-superior aspects of acetabular and femoral head cartilage. For acetabular cartilage, higher values were observed in the central region (25.90 ± 4.80 ms vs. 24.21 ± 4.05 ms, P < 0.0001) whereas femoral head cartilage did not reveal such differences (26.62 ± 5.74 ms vs. 26.37 ± 5.89 ms, P = 0.44). Conclusions The T2* analysis of presumably healthy hip joint cartilage does not seem to be stratified according to age in this population. Regional T2* variation throughout hip joint cartilage is apparent in this modality.
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Affiliation(s)
- Tobias Hesper
- Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Alexander Buchwald
- Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Harish S. Hosalkar
- Paradise Valley Hospital, National City, CA, USA,Tri-city Medical Center, San Diego, CA, USA
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Rüdiger Krauspe
- Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Christoph Zilkens
- Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Bernd Bittersohl
- Department of Orthopedics, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany,Bernd Bittersohl, Department of Orthopedics, Heinrich-Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
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37
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Xu R, Wei B, Li J, Huang C, Lin R, Tang C, Xu Y, Yao Q, Wang L. Investigations of Cartilage Matrix Degeneration in Patients with Early-Stage Femoral Head Necrosis. Med Sci Monit 2017; 23:5783-5792. [PMID: 29208853 PMCID: PMC5727749 DOI: 10.12659/msm.907522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The purpose of this study was to explore changes in cartilage matrix in early-stage femoral head necrosis (FHN). Material/Methods Femoral head samples of patients with early FHN were collected during total hip arthroplasty (THA), high-field 7.0T MRI scans were performed in vitro, and the average T2 values were calculated. Cartilage samples were obtained from the weight-bearing area (FHN group) and non-weight-bearing area (Control group), divided into 3 equal parts and used for biochemical analysis, histopathological staining, and gene expression analysis. Results T2 mapping of the femoral head specimens showed that the density distribution of cartilage surface was not uniform, and the average T2 value increased unevenly. Histological staining demonstrated that the number of chondrocytes was significantly decreased and they were irregularly arranged, SO staining was lost, and collagen fiber arrangement was slightly more irregular on the cartilage surface in the FHN group. The biochemical results in the FHN group showed that the water content increased significantly and the DNA content decreased significantly, while no significant changes in GAG and total collagen contents were detected. Gene expression analysis in the FHN group showed that SOX9 expression was significantly down-regulated, while COL10A1 and RUNX2 expressions were significantly up-regulated. The expression of ACAN and COL2A1 were decreased and COL1A1 was increased, but there was no significant difference compared with the Control group. Conclusions Taken together, the results of this study suggest that patients with early-stage FHN tend to have cartilage matrix degeneration, which provides new ideas for studying the pathogenesis of FHN and selecting treatment strategies.
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Affiliation(s)
- Ronghua Xu
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Department of Orthopedics, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, Jiangsu, China (mainland)
| | - Bo Wei
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Jiayi Li
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Chenyu Huang
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Rongcai Lin
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Cheng Tang
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Yan Xu
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Qingqiang Yao
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
| | - Liming Wang
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Cartilage Regeneration Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (mainland).,Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, China (mainland)
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Moström EB, Lammentausta E, Finnbogason T, Weidenhielm L, Janarv PM, Tiderius CJ. T2 mapping and post-contrast T1 (dGEMRIC) of the patellar cartilage: 12-year follow-up after patellar stabilizing surgery in childhood. Acta Radiol Open 2017; 6:2058460117738808. [PMID: 29123919 PMCID: PMC5661686 DOI: 10.1177/2058460117738808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 09/18/2017] [Indexed: 12/29/2022] Open
Abstract
Background Cartilage degeneration has been reported after recurrent patellar dislocation. However, effects of surgical stabilization in childhood have not yet been described. Purpose To examine the cartilage quality in very young adults operated with a patellar stabilizing procedure due to recurrent patellar dislocation in childhood, and evaluate if cartilage quality correlates with clinical parameters and patient-reported outcomes. Material and Methods Seventeen patients were investigated ≥ 5 years (mean = 11.6 years) after patellar stabilizing surgery in childhood. Pre-contrast T2 relaxation times were analyzed in four superficial and four deep patellar cartilage regions of both knees. Two hours after 0.2 mM/kg Gd-DTPA2 i.v., post-contrast T1 (T1(Gd)) was analyzed in the same regions. Patient-reported outcomes (KOOS, Kujala, and Tegner scores) and recurrence rates were evaluated. Results Comparing operated to healthy side, neither T2 nor dGEMRIC differed between the operated and the reference knee regarding the superficial half of the cartilage. In the deep half of the cartilage, T1(Gd) was shorter in the central part of the cartilage, whereas T2 was longer medially (P < 0.05). A low score in the KOOS subscales Symptom and Sports & Recreation, was correlated to the degenerative changes detected by T1(Gd) (r = 0.5, P = 0.041). Conclusion In general, our findings demonstrate good cartilage quality 12 years after patellar stabilizing surgery during childhood. The subtle changes in T2 and T1(Gd) in the deep cartilage layer may be a result of altered biomechanics, although very early degenerative changes cannot be excluded. The short T1(Gd) centrally may reflect lower glycosaminoglycan content, whereas the increase in T2 medially indicates increased cartilage hydration.
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Affiliation(s)
- Eva Bengtsson Moström
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Eveliina Lammentausta
- Department of Diagnostic Radiology, Oulu University Hospital, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Finland
| | | | - Lars Weidenhielm
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Per-Mats Janarv
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Carl Johan Tiderius
- Department of Orthopaedics, Skane University Hospital, Lund University, Sweden
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Soellner ST, Goldmann A, Muelheims D, Welsch GH, Pachowsky ML. Intraoperative validation of quantitative T2 mapping in patients with articular cartilage lesions of the knee. Osteoarthritis Cartilage 2017; 25:1841-1849. [PMID: 28801212 DOI: 10.1016/j.joca.2017.07.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 07/06/2017] [Accepted: 07/27/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to compare T2 relaxation times of knee cartilage with intraoperative results for the assessment of early osteoarthritis (OA) and to define T2 values for the differentiation between healthy and degenerated cartilage. DESIGN Twenty-one patients with cartilage lesions or moderate OA were examined using 3T magnetic resonance imaging (MRI). In this prospective study, a total of 882 regions of interest (ROIs) were examined by a sagittal, multi-echo, spin-echo T2 sequence and a morphological high-resolution three-dimensional, fat-saturated proton-density space sequence. Cartilage lesions were identified arthroscopically, graded by the International Cartilage Repair Society (ICRS) score in 42 defined ROIs per patient and consecutively compared with mean T2 values using analysis of variance and Spearman's rank correlation test. Receiver operating characteristics (ROC) curves were developed to identify threshold T2 values to differentiate between the ICRS grades. RESULTS A total of 882 ROIs were examined and graduated in ICRS score 0 (67.3%), 1 (25.2%), 2 (6.2%) and the merged ICRS 3 and 4 (1.0%). T2 values increased with increasing grade of cartilage damage with a statistically significant positive correlation between T2 values and ICRS scores. A T2 value threshold of 47.6 ms was identified to differentiate between ICRS score 0 (normal) and all other grades (ROC curve analysis). CONCLUSION T2 mapping might provide a diagnostic tool for the detection of early knee-joint cartilage damage and for the non-invasive differentiation between ICRS grades by MRI in clinical practice.
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Affiliation(s)
- S T Soellner
- Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany
| | - A Goldmann
- OCE Orthopaedie Centrum Erlangen, Germany
| | | | - G H Welsch
- UKE Athleticum, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - M L Pachowsky
- Department of Orthopedic and Trauma Surgery, University Hospital Erlangen, Germany
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40
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Peuna A, Hekkala J, Haapea M, Podlipská J, Guermazi A, Saarakkala S, Nieminen MT, Lammentausta E. Variable angle gray level co-occurrence matrix analysis of T2
relaxation time maps reveals degenerative changes of cartilage in knee osteoarthritis: Oulu knee osteoarthritis study. J Magn Reson Imaging 2017; 47:1316-1327. [DOI: 10.1002/jmri.25881] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/10/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Arttu Peuna
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Joonas Hekkala
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
| | - Marianne Haapea
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Jana Podlipská
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology; Boston University School of Medicine; Boston Massachusetts USA
| | - Simo Saarakkala
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Miika T. Nieminen
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Eveliina Lammentausta
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
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41
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Intra-articular Injection of Mesenchymal Stem Cells and Platelet-Rich Plasma to Treat Patellofemoral Osteoarthritis: Preliminary Results of a Long-Term Pilot Study. J Vasc Interv Radiol 2017; 28:1708-1713. [PMID: 29031987 DOI: 10.1016/j.jvir.2017.08.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 08/08/2017] [Accepted: 08/09/2017] [Indexed: 12/27/2022] Open
Abstract
PURPOSE To assess the feasibility and safety of concomitant intra-articular (IA) knee injection of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) under fluoroscopic guidance to treat patellofemoral osteoarthritis (OA). MATERIALS AND METHODS This prospective study included 19 consecutive patients referred for fluoroscopically guided IA MSC and PRP injection for symptomatic patellofemoral chondropathy in which conservative treatment had failed. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and magnetic resonance (MR) data, including T2 mapping sequence, were prospectively collected before and 6 months after treatment. Clinical data without MR imaging were collected until 12 months after the procedure. RESULTS WOMAC scores were significantly lower after IA injection of MSCs and PRP at 6 months and during 12-months follow-up compared with baseline (mean score decreased from 34.3 to 14.2; P < .0018). Patients reported no complications. Concerning MR imaging follow-up, there were no significant differences in grade, surface, or T2 value of the chondral lesions (P > .375). CONCLUSIONS IA injection of MSCs and PRP in early patellofemoral OA appears to allow functional improvement.
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42
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Hesper T, Hosalkar HS, Schleich C, Antoch G, Welsch GH, Krauspe R, Zilkens C, Bittersohl B. T2* Mapping for Hip Joint Cartilage Assessment: Pre-MRI Exercise and Time of Imaging Do Not Bias the T2* Measurement in Asymptomatic Volunteers. Cartilage 2017; 8:400-405. [PMID: 28466650 PMCID: PMC5613890 DOI: 10.1177/1947603516665446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To identify if the time of day and pre-imaging exercise matter while performing T2* mapping of hip joint cartilage at 3 T. Design Nine asymptomatic healthy volunteers (mean age 27.4 ± 4.0 years) with no obvious morphological evidence of cartilage damage were enrolled. The MRI protocol included a double-echo steady state (DESS) sequence for morphological cartilage assessment and a multi-echo data image combination sequence for the T2* measurement. T2* values were obtained between 8 and 11 a.m., between 3 and 6 p.m., and after 50 knee-bends at several time points of each measurement (0, 15, 30, 45, 60 minutes). Results We observed no differences ( P = 0.47) between the T2* values obtained in the morning (T2* = 22.9 ± 3.0 ms) and those measured in the afternoon (T2* = 23.2 ± 3.2 ms). We also observed no statistically significant differences between the T2* values at different time points ( P = 0.67) or after 50 knee-bends ( P = 0.43). Conclusions Timing of the scan and pre-imaging exercise clearly did not matter in this modality. This study consolidates the value of T2* imaging in hip joint cartilage that seems to be independent of diurnal effects and physical activity prior to MRI.
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Affiliation(s)
- Tobias Hesper
- Department of Orthopedics, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany,Tobias Hesper, Department of Orthopedics, Medical Faculty, Heinrich-Heine University, Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany.
| | - Harish S. Hosalkar
- Center for Hip Preservation and Children’s Orthopedics, San Diego, CA, USA
| | - Christoph Schleich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Götz H. Welsch
- Medical Faculty, University of Hamburg, UKE-Athleticum, Hamburg, Germany
| | - Rüdiger Krauspe
- Department of Orthopedics, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Christoph Zilkens
- Department of Orthopedics, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
| | - Bernd Bittersohl
- Department of Orthopedics, Medical Faculty, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany
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43
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Lange T, Knowles BR, Herbst M, Izadpanah K, Zaitsev M. Comparative T
2
and T
1ρ
mapping of patellofemoral cartilage under in situ mechanical loading with prospective motion correction. J Magn Reson Imaging 2017; 46:452-460. [DOI: 10.1002/jmri.25574] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 11/17/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Thomas Lange
- Department of Radiology, Medical Physics; Medical Center - University of Freiburg, Faculty of Medicine; Freiburg Germany
| | - Benjamin R. Knowles
- Department of Radiology, Medical Physics; Medical Center - University of Freiburg, Faculty of Medicine; Freiburg Germany
| | - Michael Herbst
- Department of Radiology, Medical Physics; Medical Center - University of Freiburg, Faculty of Medicine; Freiburg Germany
- John A. Burns School of Medicine; University of Hawaii; Honolulu Hawaii USA
| | - Kaywan Izadpanah
- Department of Orthopedic and Trauma Surgery; Medical Center - University of Freiburg, Faculty of Medicine; Freiburg Germany
| | - Maxim Zaitsev
- Department of Radiology, Medical Physics; Medical Center - University of Freiburg, Faculty of Medicine; Freiburg Germany
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44
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Van Ginckel A, De Mits S, Bennell KL, Bryant AL, Witvrouw EE. T2* mapping of subtalar cartilage: Precision and association between anatomical variants and cartilage composition. J Orthop Res 2016; 34:1969-1976. [PMID: 26919305 DOI: 10.1002/jor.23214] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 02/19/2016] [Indexed: 02/04/2023]
Abstract
Hindfoot arthritis is an important contributor to foot pain and physical disability. While the subtalar joint (STJ) is most frequently affected, anatomical variants such as facet configuration were suggested to further STJ cartilage deterioration. T2* mapping enables detection of ultra-structural cartilage change, particularly in thin cartilage layers, but its feasibility in the STJ has not yet been evaluated. The purpose of this study was to evaluate segmentation consistency and inter-scan short-term precision error of T2* mapping of talocalcaneal cartilage and to investigate the relationship between facet configuration and STJ T2* values. Using 3Tesla morphological magnetic resonance imaging, STJ configuration was categorized according to the degree of fusion between anterior, medial, or posterior facets. Subsequently, two repeats of multi-echo gradient recalled echo sequences were performed to obtain T2* maps with repositioning. Segmentation consistency of T2* values attained an ICC of 0.90 (95%CI 0.69-0.99). Precision errors comprised a coefficient of variation (CV) ranging 0.01-0.05, corresponding to a root mean square CV of 0.03-0.04. A 2-joint configuration type (i.e., fused anterior-medial facets) was significantly associated with a decrease in posterior facet T2* values (β = -0.6, p = 0.046). STJ T2* mapping is a reliable method requiring at least a 4% difference within people to enable detection of significant change. Anatomical variants in STJ configuration were associated with T2* values with the more stable 3-joint types exhibiting more favorable cartilage outcomes. Longer-term larger-scaled studies focusing on arthritis pathology are needed to further support the use of T2* mapping in hindfoot disease monitoring. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1969-1976, 2016.
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Affiliation(s)
- Ans Van Ginckel
- Faculty of Medicine, Dentistry and Health Sciences, Centre for Health, Exercise and Sports Medicine (CHESM), The University of Melbourne, 161 Barry Street, Carlton VIC 3053, Melbourne, Australia
| | - Sophie De Mits
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.,Department of Podiatry, Artevelde University College, Ghent, Belgium.,Department of Rheumatology, Ghent University Hospital, Ghent, Belgium
| | - Kim L Bennell
- Faculty of Medicine, Dentistry and Health Sciences, Centre for Health, Exercise and Sports Medicine (CHESM), The University of Melbourne, 161 Barry Street, Carlton VIC 3053, Melbourne, Australia
| | - Adam L Bryant
- Faculty of Medicine, Dentistry and Health Sciences, Centre for Health, Exercise and Sports Medicine (CHESM), The University of Melbourne, 161 Barry Street, Carlton VIC 3053, Melbourne, Australia
| | - Erik E Witvrouw
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.,Department of Physiotherapy, Aspetar, Doha, Qatar
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45
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Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, Adam G, Regier M. Comparison of T2* relaxation times of articular cartilage of the knee in elite professional football players and age-and BMI-matched amateur athletes. Eur J Radiol 2016; 86:105-111. [PMID: 28027735 DOI: 10.1016/j.ejrad.2016.10.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/26/2016] [Accepted: 10/26/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Recent investigation has underlined the potential of quantitative MR imaging to be used as a complementary tool for the diagnosis of cartilage degeneration at an early state. The presented study analyses T2* relaxation times of articular cartilage of the knee in professional athletes and compares the results to age- and BMI (Body Mass Index)-matched healthy amateur athletes. MATERIALS AND METHODS 22 professional football players and 22 age- and BMI-matched individuals were underwent knee Magnetic Resonance Imaging (MRI) at 3T including qualitative and quantitative analysis. Qualitative analysis included e.g. meniscal tears, joint effusion and bone edema. For quantitative analysis T2* (22 ET: 4.6-53.6ms) measurements in 3D data acquisition were performed. Deep and superficial layers of 22 predefined cartilage segments were analysed. All data sets were postprocessed using a dedicated software tool. Statistical analysis included Student t-test, confidence intervals and a random effects model. RESULTS In both groups, T2* relaxation times were significantly higher in the superficial compared to the deep layers (p<0.001). Professional athletes had significantly higher relaxation times in eight superficial and three deep cartilage layers in the predefined cartilage segments (p<0.05). Highly significant differences were found in the weight-bearing segments of the lateral superficial femoral condyle (p<0.001). CONCLUSION Elevated T2* values in cartilage layers of professional football players compared to amateur athletes were noted. The effects seem to predominate in superficial cartilage layers.
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Affiliation(s)
- C Behzadi
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany.
| | - G H Welsch
- Department of Sports Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - A Laqmani
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - F O Henes
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - M G Kaul
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - G Schoen
- Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - G Adam
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
| | - M Regier
- Department of Diagnostic and Interventional Radiology and Nuclearmedicine, University Medical Center Hamburg-Eppendorf, Hamburg, 20246, Germany
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46
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Zhang Y, Bao F, Wang Y, Wu Z. Influence of acupuncture in treatment of knee osteoarthritis and cartilage repairing. Am J Transl Res 2016; 8:3995-4002. [PMID: 27725880 PMCID: PMC5040698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/15/2016] [Indexed: 06/06/2023]
Abstract
As two major non-operative methods, physiotherapy and acupuncture have been proved to be safe and effective in osteoarthritis (OA) treatment. However, only a little study focused on functions of both methods on cartilage repairing. The main goal of this research is to prove and compare effectiveness of acupuncture and physiotherapy on OA, and to explore their possible efficacy on cartilage repairing. One hundred knees of 50 participants with knee osteoarthritis (KOA) were randomly divided into acupuncture group and physiotherapy group. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate the motor function of knee joints, followed by MRI scanning to measure T2 values in ten cartilage sub-regions in tibiofemoral joints. Significant lower scores of total WOMAC and three subscales on the 4th weekend were observed in both groups than those of the baseline (P < 0.01). For acupuncture group, scores of total WOMAC and three subscales for pain, stiffness and physical function on 4th weekend were significantly lower than those of the physiotherapy group (P < 0.01 and P < 0.05). T2 values in anterior medial tibial sub-region (MTa) and anterior lateral tibial sub-region (LTa) were significantly lower in acupuncture group on 4th weekend than those of the baseline (P < 0.05). No significant difference in T2 values was detected in physiotherapy group. These results indicate that acupuncture represents certain clinical effect on KOA which is superior compared with physiotherapy, and hint the possible roles of acupuncture in promoting cartilage repairing.
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Affiliation(s)
- Yan Zhang
- Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical SciencesBeijing, China
| | - Fei Bao
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical SciencesBeijing, China
| | - Yan Wang
- Department of Physiotherapy, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical SciencesBeijing, China
| | - Zhihong Wu
- Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical SciencesBeijing, China
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T2 mapping of articular cartilage of the glenohumeral joint at 3.0 T in healthy volunteers: a feasibility study. Skeletal Radiol 2016; 45:915-20. [PMID: 27115885 DOI: 10.1007/s00256-016-2398-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 03/29/2016] [Accepted: 04/17/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the T2 values of the glenohumeral joint cartilage in healthy asymptomatic individuals at 3.0 T and to analyze the T2 profile of the humeral cartilage. MATERIALS AND METHODS This prospective study was approved by our institutional review board and written informed consent was obtained. Thirteen subjects (mean age, 28.6 years; age range, 24-33 years) were included and underwent multiecho spin-echo T2-weighted MR imaging and T2 mapping was acquired. Regions of interest were placed on the humeral cartilage and glenoid cartilage on oblique coronal images. T2 profiles of humeral cartilage were measured from the bone-cartilage interface to the articular surface. Intra-observer agreement was analyzed using intraclass correlation coefficient (ICC). RESULTS All 13 joints showed normal appearance on conventional T2-weighted images. The mean T2 values of humeral and glenoid cartilage were 50.5 ± 12.1 and 49.0 ± 9.9 ms, respectively. Intra-observer agreement was good, as determined by ICC (0.736). Longer T2 values were observed at the articular surface with a tendency to decrease toward the bone-cartilage interface. The mean cartilage T2 value was 69.03 ± 21.2 ms at the articular surface and 46.99 ± 19.6 ms at the bone-cartilage interface. CONCLUSION T2 values of the glenohumeral joint cartilage were similar to reported values of cartilage in the knee. The T2 profile of normal humeral cartilage showed a spatial variation with an increase in T2 values from the subchondral bone to the articular surface.
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Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, Adam G, Regier M. The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging. Br J Radiol 2016; 89:20151075. [PMID: 27336705 DOI: 10.1259/bjr.20151075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To quantitatively assess the immediate effect of long-distance running on T2 and T2* relaxation times of the articular cartilage of the knee at 3.0 T in young healthy adults. METHODS 30 healthy male adults (18-31 years) who perform sports at an amateur level underwent an initial MRI at 3.0 T with T2 weighted [16 echo times (TEs): 9.7-154.6 ms] and T2* weighted (24 TEs: 4.6-53.6 ms) relaxation measurements. Thereafter, all participants performed a 45-min run. After the run, all individuals were immediately re-examined. Data sets were post-processed using dedicated software (ImageJ; National Institute of Health, Bethesda, MD). 22 regions of interest were manually drawn in segmented areas of the femoral, tibial and patellar cartilage. For statistical evaluation, Pearson product-moment correlation coefficients and confidence intervals were computed. RESULTS Mean initial values were 35.7 ms for T2 and 25.1 ms for T2*. After the run, a significant decrease in the mean T2 and T2* relaxation times was observed for all segments in all participants. A mean decrease of relaxation time was observed for T2 with 4.6 ms (±3.6 ms) and for T2* with 3.6 ms (±5.1 ms) after running. CONCLUSION A significant decrease could be observed in all cartilage segments for both biomarkers. Both quantitative techniques, T2 and T2*, seem to be valuable parameters in the evaluation of immediate changes in the cartilage ultrastructure after running. ADVANCES IN KNOWLEDGE This is the first direct comparison of immediate changes in T2 and T2* relaxation times after running in healthy adults.
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Affiliation(s)
- Cyrus Behzadi
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Goetz H Welsch
- 2 Department of Sports Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Azien Laqmani
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Frank O Henes
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Michael G Kaul
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Schoen
- 3 Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Regier
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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Juras V, Bohndorf K, Heule R, Kronnerwetter C, Szomolanyi P, Hager B, Bieri O, Zbyn S, Trattnig S. A comparison of multi-echo spin-echo and triple-echo steady-state T2 mapping for in vivo evaluation of articular cartilage. Eur Radiol 2016; 26:1905-12. [PMID: 26334512 PMCID: PMC4863907 DOI: 10.1007/s00330-015-3979-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/06/2015] [Accepted: 08/10/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To assess the clinical relevance of T2 relaxation times, measured by 3D triple-echo steady-state (3D-TESS), in knee articular cartilage compared to conventional multi-echo spin-echo T2-mapping. METHODS Thirteen volunteers and ten patients with focal cartilage lesions were included in this prospective study. All subjects underwent 3-Tesla MRI consisting of a multi-echo multi-slice spin-echo sequence (CPMG) as a reference method for T2 mapping, and 3D TESS with the same geometry settings, but variable acquisition times: standard (TESSs 4:35min) and quick (TESSq 2:05min). T2 values were compared in six different regions in the femoral and tibial cartilage using a Wilcoxon signed ranks test and the Pearson correlation coefficient (r). The local ethics committee approved this study, and all participants gave written informed consent. RESULTS The mean quantitative T2 values measured by CPMG (mean: 46±9ms) in volunteers were significantly higher compared to those measured with TESS (mean: 31±5ms) in all regions. Both methods performed similarly in patients, but CPMG provided a slightly higher difference between lesions and native cartilage (CPMG: 90ms→61ms [31%],p=0.0125;TESS 32ms→24ms [24%],p=0.0839). CONCLUSIONS 3D-TESS provides results similar to those of a conventional multi-echo spin-echo sequence with many benefits, such as shortening of total acquisition time and insensitivity to B1 and B0 changes. KEY POINTS • 3D-TESS T 2 mapping provides clinically comparable results to CPMG in shorter scan-time. • Clinical and investigational studies may benefit from high temporal resolution of 3D-TESS. • 3D-TESS T 2 values are able to differentiate between healthy and damaged cartilage.
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Affiliation(s)
- Vladimir Juras
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria.
- Department of Imaging Methods, Institute of Measurement Science, Bratislava, Slovakia.
| | - Klaus Bohndorf
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Rahel Heule
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland
| | - Claudia Kronnerwetter
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Pavol Szomolanyi
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Bratislava, Slovakia
| | - Benedikt Hager
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Oliver Bieri
- Division of Radiological Physics, Department of Radiology, University of Basel Hospital, Basel, Switzerland
| | - Stefan Zbyn
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Siegfried Trattnig
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria
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Juras V, Zbýň Š, Mlynarik V, Szomolanyi P, Hager B, Baer P, Frollo I, Trattnig S. The compositional difference between ankle and knee cartilage demonstrated by T2 mapping at 7 Tesla MR. Eur J Radiol 2016; 85:771-7. [DOI: 10.1016/j.ejrad.2016.01.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/23/2016] [Accepted: 01/30/2016] [Indexed: 11/17/2022]
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