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Zibetti MVW, Menon RG, de Moura HL, Zhang X, Kijowski R, Regatte RR. Updates on Compositional MRI Mapping of the Cartilage: Emerging Techniques and Applications. J Magn Reson Imaging 2023; 58:44-60. [PMID: 37010113 PMCID: PMC10323700 DOI: 10.1002/jmri.28689] [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: 01/18/2023] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 04/04/2023] Open
Abstract
Osteoarthritis (OA) is a widely occurring degenerative joint disease that is severely debilitating and causes significant socioeconomic burdens to society. Magnetic resonance imaging (MRI) is the preferred imaging modality for the morphological evaluation of cartilage due to its excellent soft tissue contrast and high spatial resolution. However, its utilization typically involves subjective qualitative assessment of cartilage. Compositional MRI, which refers to the quantitative characterization of cartilage using a variety of MRI methods, can provide important information regarding underlying compositional and ultrastructural changes that occur during early OA. Cartilage compositional MRI could serve as early imaging biomarkers for the objective evaluation of cartilage and help drive diagnostics, disease characterization, and response to novel therapies. This review will summarize current and ongoing state-of-the-art cartilage compositional MRI techniques and highlight emerging methods for cartilage compositional MRI including MR fingerprinting, compressed sensing, multiexponential relaxometry, improved and robust radio-frequency pulse sequences, and deep learning-based acquisition, reconstruction, and segmentation. The review will also briefly discuss the current challenges and future directions for adopting these emerging cartilage compositional MRI techniques for use in clinical practice and translational OA research studies. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Marcelo V. W. Zibetti
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Rajiv G. Menon
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Hector L. de Moura
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Xiaoxia Zhang
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Richard Kijowski
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Ravinder R. Regatte
- Center of Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
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2
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Banjar M, Horiuchi S, Gedeon DN, Yoshioka H. Review of Quantitative Knee Articular Cartilage MR Imaging. Magn Reson Med Sci 2021; 21:29-40. [PMID: 34471014 PMCID: PMC9199985 DOI: 10.2463/mrms.rev.2021-0052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Osteoarthritis (OA) is one of the most prevalent disorders in today’s society, resulting in significant socio-economic costs and morbidity. MRI is widely used as a non-invasive imaging tool for OA of the knee. However, conventional knee MRI has limitations to detect subtle early cartilage degeneration before morphological changes are visually apparent. Novel MRI pulse sequences for cartilage assessment have recently received increased attention due to newly developed compositional MRI techniques, including: T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), sodium MRI, diffusion-weighted imaging (DWI)/ diffusion tensor imaging (DTI), ultrashort TE (uTE), and glycosaminoglycan specific chemical exchange saturation transfer (gagCEST) imaging. In this article, we will first review these quantitative assessments. Then, we will discuss the variations of quantitative values of knee articular cartilage with cartilage layer (depth)- and angle (regional)-dependent approaches. Multiple MRI sequence techniques can discern qualitative differences in knee cartilage. Normal articular hyaline cartilage has a zonal variation in T2 relaxation times with increasing T2 values from the subchondral bone to the articular surface. T1rho values were also higher in the superficial layer than in the deep layer in most locations in the medial and lateral femoral condyles, including the weight-bearing portion. Magic angle effect on T2 mapping is clearly observed in the both medial and lateral femoral condyles, especially within the deep layers. One of the limitations for clinical use of these compositional assessments is a long scan time. Recent new approaches with compressed sensing (CS) and MR fingerprinting (MRF) have potential to provide accurate and fast quantitative cartilage assessments.
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Affiliation(s)
- Mai Banjar
- Medical Imaging Department, King Abdullah Medical Complex Jeddah
| | - Saya Horiuchi
- Department of Radiology, St Luke's International Hospital
| | - David N Gedeon
- Department of Radiological Sciences, University of California, Irvine
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine
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3
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Tornifoglio B, Stone AJ, Johnston RD, Shahid SS, Kerskens C, Lally C. Diffusion tensor imaging and arterial tissue: establishing the influence of arterial tissue microstructure on fractional anisotropy, mean diffusivity and tractography. Sci Rep 2020; 10:20718. [PMID: 33244026 PMCID: PMC7693170 DOI: 10.1038/s41598-020-77675-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022] Open
Abstract
This study investigates diffusion tensor imaging (DTI) for providing microstructural insight into changes in arterial tissue by exploring how cell, collagen and elastin content effect fractional anisotropy (FA), mean diffusivity (MD) and tractography. Five ex vivo porcine carotid artery models (n = 6 each) were compared-native, fixed native, collagen degraded, elastin degraded and decellularised. Vessels were imaged at 7 T using a DTI protocol with b = 0 and 800 s/mm2 and 10 isotopically distributed directions. FA and MD were evaluated in the vessel media and compared across models. FA values measured in native (p < 0.0001), fixed native (p < 0.0001) and collagen degraded (p = 0.0018, p = 0.0016, respectively) were significantly higher than those in elastin degraded and decellularised arteries. Native and fixed native had significantly lower MD values than elastin degraded (p < 0.0001) and decellularised tissue (p = 0.0032, p = 0.0003, respectively). Significantly lower MD was measured in collagen degraded compared with the elastin degraded model (p = 0.0001). Tractography yielded helically arranged tracts for native and collagen degraded vessels only. FA, MD and tractography were found to be highly sensitive to changes in the microstructural composition of arterial tissue, specifically pointing to cell, not collagen, content as the dominant source of the measured anisotropy in the vessel wall.
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Affiliation(s)
- B Tornifoglio
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - A J Stone
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - R D Johnston
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
| | - S S Shahid
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - C Kerskens
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - C Lally
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.
- Department of Mechanical, Manufacturing and Biomedical Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland.
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland.
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4
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Lansdown DA, Ma CB. Clinical Utility of Advanced Imaging of the Knee. J Orthop Res 2020; 38:473-482. [PMID: 31498473 DOI: 10.1002/jor.24462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/17/2019] [Indexed: 02/04/2023]
Abstract
Advanced imaging modalities, including computed tomography, magnetic resonance imaging (MRI), and dynamic fluoroscopic imaging, allow for a comprehensive evaluation of the knee joint. Compositional sequences for MRI can allow for an evaluation of the biochemical properties of cartilage, meniscus, and ligament that offer further insight into pathology that may not be apparent on conventional clinical imaging. Advances in image processing, shape modeling, and dynamic studies also offer a novel way to evaluate common conditions and to monitor patients after treatment. The purpose of this article is to review advanced imaging modalities of the knee and their current and anticipated future applications to clinical practice. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:473-482, 2020.
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Affiliation(s)
- Drew A Lansdown
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California
| | - C Benjamin Ma
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California
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3D grating-based X-ray phase-contrast computed tomography for high-resolution quantitative assessment of cartilage: An experimental feasibility study with 3T MRI, 7T MRI and biomechanical correlation. PLoS One 2019; 14:e0212106. [PMID: 30763375 PMCID: PMC6375589 DOI: 10.1371/journal.pone.0212106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 01/28/2019] [Indexed: 01/21/2023] Open
Abstract
Objective Aim of this study was, to demonstrate the feasibility of high-resolution grating-based X-ray phase-contrast computed tomography (PCCT) for quantitative assessment of cartilage. Materials and methods In an experimental setup, 12 osteochondral samples were harvested from n = 6 bovine knees (n = 2 each). From each knee, one cartilage sample was degraded using 2.5% Trypsin. In addition to PCCT and biomechanical cartilage stiffness measurements, 3T and 7T MRI was performed including MSME SE T2 and ME GE T2* mapping sequences for relaxationtime measurements. Paired t-tests and receiver operating characteristics (ROC) curves were used for statistical analyses. Results PCCT provided high-resolution images for improved morphological cartilage evaluation as compared to 3T and 7T MRI. Quantitative analyses revealed significant differences between the superficial and the deep cartilage layer for T2 mapping as well as for PCCT (P<0.05). No significant difference was detected for PCCT between healthy and degraded samples (P>0.05). MRI and stiffness measurements showed significant differences between healthy and degraded osteochondral samples. Accuracy in the prediction of cartilage degradation was excellent for MRI and biomechanical analyses. Conclusion In conclusion, high-resolution grating-based X-ray PCCT cartilage imaging is feasible. In addition to MRI and biomechanical analyses it provides complementary, water content independent, information for improved morphological and quantitative characterization of articular cartilage ultrastructure.
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Duarte A, Ruiz A, Ferizi U, Bencardino J, Abramson SB, Samuels J, Krasnokutsky-Samuels S, Raya JG. Diffusion tensor imaging of articular cartilage using a navigated radial imaging spin-echo diffusion (RAISED) sequence. Eur Radiol 2018; 29:2598-2607. [PMID: 30382348 DOI: 10.1007/s00330-018-5780-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/27/2018] [Accepted: 09/19/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To validate a radial imaging spin-echo diffusion tensor (RAISED) sequence for high-resolution diffusion tensor imaging (DTI) of articular cartilage at 3 T. METHODS The RAISED sequence implementation is described, including the used non-linear motion correction algorithm. The robustness to eddy currents was tested on phantoms, and accuracy of measurement was assessed with measurements of temperature-dependent diffusion of free water. Motion correction was validated by comparing RAISED with single-shot diffusion-weighted echo-planar imaging (EPI) measures. DTI was acquired in asymptomatic subjects (n = 6) and subjects with doubtful (Kellgren-Lawrence [KL] grade 1, n = 9) and mild (KL = 2, n = 9) symptomatic knee osteoarthritis (OA). MD and FA values without correction, and after all corrections, were calculated. A test-retest evaluation of the DTI acquisition on three asymptomatic and three OA subjects was also performed. RESULTS The root mean squared coefficient of variation of the global test-restest reproducibility was 3.54% for MD and 5.34% for FA. MD was significantly increased in both femoral condyles (7-9%) of KL 1 and in the medial (11-17%) and lateral (10-12%) compartments of KL 2 subjects. Averaged FA presented a trend of lower values with increasing KL grade, which was significant for the medial femoral condyle (-11%) of KL 1 and all three compartments in KL 2 subjects (-18 to -11%). Group differences in MD and FA were only significant after motion correction. CONCLUSION The RAISED sequence with the proposed reconstruction framework provides reproducible assessment of DTI parameters in vivo at 3 T and potentially the early stages of the disease in large regions of interest. KEY POINTS • DTI of articular cartilage is feasible at 3T with a multi-shot RAISED sequence with non-linear motion correction. • RAISED sequence allows estimation of the diffusion indices MD and FA with test-retest errors below 4% (MD) and 6% (FA). • RAISED-based measurement of DTI of articular cartilage with non-linear motion correction holds potential to differentiate healthy from OA subjects.
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Affiliation(s)
- Alejandra Duarte
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Amparo Ruiz
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Uran Ferizi
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Jenny Bencardino
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Steven B Abramson
- Division of Rheumatology, Department of Medicine, New York University Langone Health, New York, NY, USA
| | - Jonathan Samuels
- Division of Rheumatology, Department of Medicine, New York University Langone Health, New York, NY, USA
| | | | - José G Raya
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA.
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7
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Georgi J, Metere R, Jäger C, Morawski M, Möller HE. Influence of the extracellular matrix on water mobility in subcortical gray matter. Magn Reson Med 2018; 81:1265-1279. [PMID: 30276849 DOI: 10.1002/mrm.27459] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/12/2018] [Accepted: 06/29/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE Water mobility in tissues is related to the microstructure that modulates diffusion and spin relaxation. Previous work has shown that the extracellular matrix (ECM) impacts water diffusion in cartilage. To investigate if similar contributions to image contrast exist for brain, which is characterized by a substantially lower ECM content, diffusion and relaxation were studied in fixed samples from goat and human thalamus before and after enzymatic digestion of ECM compounds. Selected experiments in human corpus callosum were included for comparing subcortical gray matter and white matter. METHODS Digestion of matrix components was achieved by treatment with hyaluronidase. Nonlocalized pulsed field gradient measurements were performed with <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>b</mml:mi></mml:math> values between 0.6 and 18,000 s/mm2 at 3T and temperatures between 0°C and 20°C, in addition to T1 and T2 relaxation measurements. The data were fitted to multiexponential models to account for different water compartments. After the measurements, the samples were sliced and stained for ECM-sensitive markers to verify efficient digestion. RESULTS Microstructural alterations associated with hyaluronan digestion did not lead to measurable effects on water diffusion or <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:msub><mml:mi>T</mml:mi> <mml:mn>2</mml:mn></mml:msub> </mml:math> . However, T1 of the main relaxographic component, attributed to intra-/extracellular water, decreased by 7%. CONCLUSION Investigations with very strong gradients did not reveal a detectable effect on water diffusion or <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:msub><mml:mi>T</mml:mi> <mml:mn>2</mml:mn></mml:msub> </mml:math> after hyaluronan removal, indicating that the brain ECM content is too low to produce a detectable effect. The subtle alteration of T1 upon hyaluronidase treatment might reflect a modulation of intercompartmental water exchange properties.
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Affiliation(s)
- Jakob Georgi
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Riccardo Metere
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carsten Jäger
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Paul Flechsig Institute of Brain Research, University of Leipzig, Germany
| | - Markus Morawski
- Paul Flechsig Institute of Brain Research, University of Leipzig, Germany
| | - Harald E Möller
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Felix Bloch Institute for Solid State Physics, University of Leipzig, Germany
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8
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Tadimalla S, Tourell MC, Knott R, Momot KI. Assessment of collagen fiber orientation dispersion in articular cartilage by small-angle X-ray scattering and diffusion tensor imaging: Preliminary results. Magn Reson Imaging 2018; 48:115-121. [DOI: 10.1016/j.mri.2017.12.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 12/29/2017] [Indexed: 12/23/2022]
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9
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Mailhiot SE, Codd SL, Brown JR, Seymour JD, June RK. Pulsed gradient stimulated echo (PGStE) NMR shows spatial dependence of fluid diffusion in human stage IV osteoarthritic cartilage. Magn Reson Med 2018; 80:1170-1177. [PMID: 29393539 DOI: 10.1002/mrm.27093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/01/2017] [Accepted: 12/27/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Sarah E Mailhiot
- Molecular Biosciences Program, Montana State University, Bozeman, Montana, USA.,Mechanical & Industrial Engineering, Montana State University, Bozeman, Montana, USA
| | - Sarah L Codd
- Mechanical & Industrial Engineering, Montana State University, Bozeman, Montana, USA
| | - Jennifer R Brown
- Chemical and Biological Engineering, Montana State University, Bozeman, Montana, USA
| | - Joseph D Seymour
- Chemical and Biological Engineering, Montana State University, Bozeman, Montana, USA
| | - Ronald K June
- Molecular Biosciences Program, Montana State University, Bozeman, Montana, USA.,Cell Biology and Neurosciences, Montana State University, Bozeman, Montana, USA.,Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington, USA
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10
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Shahid SS, Gaul RT, Kerskens C, Flamini V, Lally C. Quantifying the ultrastructure of carotid arteries using high-resolution micro-diffusion tensor imaging—comparison of intact versus open cut tissue. ACTA ACUST UNITED AC 2017; 62:8850-8868. [DOI: 10.1088/1361-6560/aa9159] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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11
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Rössler E, Mattea C, Saarakkala S, Lehenkari P, Finnilä M, Rieppo L, Karhula S, Nieminen MT, Stapf S. Correlations of low-field NMR and variable-field NMR parameters with osteoarthritis in human articular cartilage under load. NMR IN BIOMEDICINE 2017; 30:e3738. [PMID: 28543921 DOI: 10.1002/nbm.3738] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 03/28/2017] [Accepted: 03/30/2017] [Indexed: 06/07/2023]
Abstract
NMR experiments carried out at magnetic fields below 1 T provide new relaxation parameters unavailable with conventional clinical scanners. Contrast of T1 generally becomes larger towards low fields, as slow molecular reorientation processes dominate relaxation at the corresponding Larmor frequencies. This advantage has to be considered in the context of lower sensitivity and frequently reduced spatial resolution. The layered structure of cartilage is one example where a particularly strong variation of T1 across the tissue occurs, being affected by degenerative diseases such as osteoarthritis (OA). Furthermore, the presence of 1 H-14 N cross-relaxation, leading to so-called quadrupolar dips in the 1 H relaxation time dispersion, provide insight into the concentration and mobility of proteoglycans and collagen in cartilage, both being affected by OA. In this study, low-field imaging and variable-field NMR relaxometry were combined for the first time for tissue samples, employing unidirectional load to probe the mechanical properties. 20 human knee cartilage samples were placed in a compression cell, and studied by determining relaxation profiles without and with applied pressure (0.6 MPa) at 50 μm in-plane resolution, and comparing with volume-averaged T1 dispersion. Samples were subsequently stored in formalin, prepared for histology and graded according to the Mankin score system. Quadrupolar dips and thickness change under load showed the strongest correlation with Mankin grade. Average T1 and change of maximum T1 under load, as well as its position, correlate with thickness and thickness change. Furthermore, T1 (ω) above 25 mT was found to correlate with thickness change. While volume-averaged T1 is not a suitable indicator for OA, its change due to mechanical load and its extreme values are suggested as biomarkers available in low-field MRI systems. The shape of the dispersion T1 (ω) represents a promising access to understanding and quantifying molecular dynamics in tissue, pointing toward future in vivo tissue studies.
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Affiliation(s)
- Erik Rössler
- Department of Technical Physics II, TU Ilmenau, Ilmenau, Germany
| | - Carlos Mattea
- Department of Technical Physics II, TU Ilmenau, Ilmenau, Germany
| | - Simo Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 50, Oulu, Finland
| | - Petri Lehenkari
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, Oulu, Finland
| | - Mikko Finnilä
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 50, Oulu, Finland
| | - Lassi Rieppo
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 50, Oulu, Finland
| | - Sakari Karhula
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 50, Oulu, Finland
| | - Miika T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, P.O. Box 5000, Oulu, Finland
- Medical Research Center, University of Oulu and Oulu University Hospital, P.O. Box 50, Oulu, Finland
- Department of Diagnostic Radiology, Oulu University Hospital, P.O. Box 50, Oulu, Finland
| | - Siegfried Stapf
- Department of Technical Physics II, TU Ilmenau, Ilmenau, Germany
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Ferizi U, Rossi I, Lee Y, Lendhey M, Teplensky J, Kennedy OD, Kirsch T, Bencardino J, Raya JG. Diffusion tensor imaging of articular cartilage at 3T correlates with histology and biomechanics in a mechanical injury model. Magn Reson Med 2017; 78:69-78. [PMID: 27455389 PMCID: PMC9175493 DOI: 10.1002/mrm.26336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/01/2016] [Accepted: 06/20/2016] [Indexed: 01/23/2024]
Abstract
PURPOSE We establish a mechanical injury model for articular cartilage to assess the sensitivity of diffusion tensor imaging (DTI) in detecting cartilage damage early in time. Mechanical injury provides a more realistic model of cartilage degradation compared with commonly used enzymatic degradation. METHODS Nine cartilage-on-bone samples were obtained from patients undergoing knee replacement. The 3 Tesla DTI (0.18 × 0.18 × 1 mm3 ) was performed before, 1 week, and 2 weeks after (zero, mild, and severe) injury, with a clinical radial spin-echo DTI (RAISED) sequence used in our hospital. We performed stress-relaxation tests and used a quasilinear-viscoelastic (QLV) model to characterize cartilage mechanical properties. Serial histology sections were dyed with Safranin-O and given an OARSI grade. We then correlated the changes in DTI parameters with the changes in QLV-parameters and OARSI grades. RESULTS After severe injury the mean diffusivity increased after 1 and 2 weeks, whereas the fractional anisotropy decreased after 2 weeks (P < 0.05). The QLV-parameters and OARSI grades of the severe injury group differed from the baseline with statistical significance. The changes in mean diffusivity across all the samples correlated with the changes in the OARSI grade (r = 0.72) and QLV-parameters (r = -0.75). CONCLUSION DTI is sensitive in tracking early changes after mechanical injury, and its changes correlate with changes in biomechanics and histology. Magn Reson Med 78:69-78, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Uran Ferizi
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ignacio Rossi
- Department of Radiology, New York University School of Medicine, New York, New York, USA
- Centro de Diagnostico Dr. Enrique Rossi, Buenos Aires, Argentina
| | - Youjin Lee
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - Matin Lendhey
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - Jason Teplensky
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Oran D Kennedy
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - Thorsten Kirsch
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - Jenny Bencardino
- Department of Radiology, New York University School of Medicine, New York, New York, USA
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - José G Raya
- Department of Radiology, New York University School of Medicine, New York, New York, USA
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13
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Ferizi U, Ruiz A, Rossi I, Bencardino J, Raya JG. A robust diffusion tensor model for clinical applications of MRI to cartilage. Magn Reson Med 2017; 79:1157-1164. [PMID: 28556394 DOI: 10.1002/mrm.26702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 01/06/2023]
Abstract
PURPOSE Diffusion tensor imaging (DTI) of articular cartilage is a promising technique for the early diagnosis of osteoarthritis (OA). However, in vivo diffusion tensor (DT) measurements suffer from low signal-to-noise ratio (SNR) that can result in bias when estimating the six parameters of the full DT, thus reducing sensitivity. This study seeks to validate a simplified four-parameter DT model (zeppelin) for obtaining more robust and sensitive in vivo DTI biomarkers of cartilage. METHODS We use simulations in a substrate to mimic changes during OA; and analytic simulations of the DT drawn from a range of fractional anisotropies (FA) measured with high-quality DT data from ex vivo human cartilage. We also use in vivo data from the knees of a healthy subject and two OA patients with Kellgren-Lawrence (KL) grades 1 and 2. RESULTS For simulated in vivo cartilage SNR (∼25) and anisotropy levels, the estimated mean values of MD from the DT and zeppelin models were identical to the ground truth values. However, zeppelin's FA is more accurate in measuring water restriction. More specifically, the FA estimations of the DT model were additionally biased by between +2% and +48% with respect to zeppelin values. Additionally, both mean diffusivity (MD) and FA of the zeppelin had lower parameter variance compared to the full DT (F-test, P < 0.05). We observe the same trends from in vivo values of patient data. CONCLUSION The zeppelin is more robust than the full DT for cartilage diffusion anisotropy and SNR at levels typically encountered in clinical applications of articular cartilage. Magn Reson Med 79:1157-1164, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Uran Ferizi
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Amparo Ruiz
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - Ignacio Rossi
- Centro de Diagnostico Dr. Enrique Rossi, Buenos Aires, Argentina
| | - Jenny Bencardino
- Department of Radiology, New York University School of Medicine, New York, New York, USA
| | - José G Raya
- Department of Radiology, New York University School of Medicine, New York, New York, USA
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Bangerter NK, Taylor MD, Tarbox GJ, Palmer AJ, Park DJ. Quantitative techniques for musculoskeletal MRI at 7 Tesla. Quant Imaging Med Surg 2016; 6:715-730. [PMID: 28090448 DOI: 10.21037/qims.2016.12.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Whole-body 7 Tesla MRI scanners have been approved solely for research since they appeared on the market over 10 years ago, but may soon be approved for selected clinical neurological and musculoskeletal applications in both the EU and the United States. There has been considerable research work on musculoskeletal applications at 7 Tesla over the past decade, including techniques for ultra-high resolution morphological imaging, 3D T2 and T2* mapping, ultra-short TE applications, diffusion tensor imaging of cartilage, and several techniques for assessing proteoglycan content in cartilage. Most of this work has been done in the knee or other extremities, due to technical difficulties associated with scanning areas such as the hip and torso at 7 Tesla. In this manuscript, we first provide some technical context for 7 Tesla imaging, including challenges and potential advantages. We then review the major quantitative MRI techniques being applied to musculoskeletal applications on 7 Tesla whole-body systems.
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Affiliation(s)
- Neal K Bangerter
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA;; Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Meredith D Taylor
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Grayson J Tarbox
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Antony J Palmer
- Department of Orthopaedics, University of Oxford, Oxford, UK
| | - Daniel J Park
- Department of Orthopaedics, University of Oxford, Oxford, UK
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15
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Kakkad S, Zhang J, Akhbardeh A, Jacob D, Krishnamachary B, Solaiyappan M, Jacobs MA, Raman V, Leibfritz D, Glunde K, Bhujwalla ZM. Collagen fibers mediate MRI-detected water diffusion and anisotropy in breast cancers. Neoplasia 2016; 18:585-593. [PMID: 27742013 PMCID: PMC5035345 DOI: 10.1016/j.neo.2016.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/15/2016] [Accepted: 08/19/2016] [Indexed: 12/19/2022] Open
Abstract
Collagen 1 (Col1) fibers play an important role in tumor interstitial macromolecular transport and cancer cell dissemination. Our goal was to understand the influence of Col1 fibers on water diffusion, and to examine the potential of using noninvasive diffusion tensor imaging (DTI) to indirectly detect Col1 fibers in breast lesions. We previously observed, in human MDA-MB-231 breast cancer xenografts engineered to fluoresce under hypoxia, relatively low amounts of Col1 fibers in fluorescent hypoxic regions. These xenograft tumors together with human breast cancer samples were used here to investigate the relationship between Col1 fibers, water diffusion and anisotropy, and hypoxia. Hypoxic low Col1 fiber containing regions showed decreased apparent diffusion coefficient (ADC) and fractional anisotropy (FA) compared to normoxic high Col1 fiber containing regions. Necrotic high Col1 fiber containing regions showed increased ADC with decreased FA values compared to normoxic viable high Col1 fiber regions that had increased ADC with increased FA values. A good agreement of ADC and FA patterns was observed between in vivo and ex vivo images. In human breast cancer specimens, ADC and FA decreased in low Col1 containing regions. Our data suggest that a decrease in ADC and FA values observed within a lesion could predict hypoxia, and a pattern of high ADC with low FA values could predict necrosis. Collectively the data identify the role of Col1 fibers in directed water movement and support expanding the evaluation of DTI parameters as surrogates for Col1 fiber patterns associated with specific tumor microenvironments as companion diagnostics and for staging.
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Affiliation(s)
- Samata Kakkad
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; Department of Chemistry and Biology, University of Bremen, Bremen, Germany
| | - Jiangyang Zhang
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science
| | - Alireza Akhbardeh
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science
| | - Desmond Jacob
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science
| | - Balaji Krishnamachary
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science
| | - Meiyappan Solaiyappan
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science
| | - Michael A Jacobs
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Venu Raman
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Dieter Leibfritz
- Department of Chemistry and Biology, University of Bremen, Bremen, Germany
| | - Kristine Glunde
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zaver M Bhujwalla
- JHU ICMIC Program, Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Bajd F, Mattea C, Stapf S, Sersa I. Diffusion tensor MR microscopy of tissues with low diffusional anisotropy. Radiol Oncol 2016; 50:175-87. [PMID: 27247550 PMCID: PMC4852972 DOI: 10.1515/raon-2016-0018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 02/08/2016] [Indexed: 11/22/2022] Open
Abstract
Background Diffusion tensor imaging exploits preferential diffusional motion of water molecules residing within tissue compartments for assessment of tissue structural anisotropy. However, instrumentation and post-processing errors play an important role in determination of diffusion tensor elements. In the study, several experimental factors affecting accuracy of diffusion tensor determination were analyzed. Materials and methods Effects of signal-to-noise ratio and configuration of the applied diffusion-sensitizing gradients on fractional anisotropy bias were analyzed by means of numerical simulations. In addition, diffusion tensor magnetic resonance microscopy experiments were performed on a tap water phantom and bovine articular cartilage-on-bone samples to verify the simulation results. Results In both, the simulations and the experiments, the multivariate linear regression of the diffusion-tensor analysis yielded overestimated fractional anisotropy with low SNRs and with low numbers of applied diffusion-sensitizing gradients. Conclusions An increase of the apparent fractional anisotropy due to unfavorable experimental conditions can be overcome by applying a larger number of diffusion sensitizing gradients with small values of the condition number of the transformation matrix. This is in particular relevant in magnetic resonance microscopy, where imaging gradients are high and the signal-to-noise ratio is low.
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Affiliation(s)
| | - Carlos Mattea
- TU Ilmenau, Institute of Physics, Fachgebiet Technische Physik II, Ilmenau, Germany
| | - Siegfried Stapf
- TU Ilmenau, Institute of Physics, Fachgebiet Technische Physik II, Ilmenau, Germany
| | - Igor Sersa
- Jožef Stefan Institute, Ljubljana, Slovenia
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Manzano S, Doblaré M, Doweidar MH. Parameter-dependent behavior of articular cartilage: 3D mechano-electrochemical computational model. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2015; 122:491-502. [PMID: 26506530 DOI: 10.1016/j.cmpb.2015.09.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 09/02/2015] [Accepted: 09/23/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND AND OBJECTIVE Changes in mechano-electrochemical properties of articular cartilage play an essential role in the majority of cartilage diseases. Despite of this importance, the specific effect of each parameter into tissue behavior remains still obscure. Parametric computational modeling of cartilage can provide some insights into this matter, specifically the study of mechano-electrochemical properties variation and their correlation with tissue swelling, water and ion fluxes. Thus, the aim of this study is to evaluate the influence of the main mechanical and electrochemical parameters on the determination of articular cartilage behavior by a parametric analysis through a 3D finite element model. METHODS For this purpose, a previous 3D mechano-electrochemical model, developed by the same authors, of articular cartilage behavior has been used. Young's modulus, Poisson coefficient, ion diffusivities and ion activity coefficients variations have been analyzed and quantified through monitoring tissue simulated response. RESULTS Simulation results show how Young's modulus and Poisson coefficient control tissue behavior rather than electrochemical properties. Meanwhile, ion diffusivity and ion activity coefficients appear to be vital in controlling velocity of incoming and outgoing fluxes. CONCLUSIONS This parametric study establishes a basic guide when defining the main properties that are essential to be included into computational modeling of articular cartilage providing a helpful tool in tissue simulations.
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Affiliation(s)
- Sara Manzano
- Group of Structural Mechanics and Materials Modelling (GEMM), Aragón Institute of Engineering Research (I3A), University of Zaragoza, Spain; Mechanical Engineering Department, School of Engineering and Architecture (EINA), University of Zaragoza, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
| | - Manuel Doblaré
- Group of Structural Mechanics and Materials Modelling (GEMM), Aragón Institute of Engineering Research (I3A), University of Zaragoza, Spain; Mechanical Engineering Department, School of Engineering and Architecture (EINA), University of Zaragoza, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
| | - Mohamed Hamdy Doweidar
- Group of Structural Mechanics and Materials Modelling (GEMM), Aragón Institute of Engineering Research (I3A), University of Zaragoza, Spain; Mechanical Engineering Department, School of Engineering and Architecture (EINA), University of Zaragoza, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain.
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Mittelstaedt D, Xia Y. Depth-Dependent Glycosaminoglycan Concentration in Articular Cartilage by Quantitative Contrast-Enhanced Micro-Computed Tomography. Cartilage 2015; 6:216-25. [PMID: 26425259 PMCID: PMC4568736 DOI: 10.1177/1947603515596418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE A quantitative contrast-enhanced micro-computed tomography (qCECT) method was developed to investigate the depth dependency and heterogeneity of the glycosaminoglycan (GAG) concentration of ex vivo cartilage equilibrated with an anionic radiographic contrast agent, Hexabrix. DESIGN Full-thickness fresh native (n = 19 in 3 subgroups) and trypsin-degraded (n = 6) articular cartilage blocks were imaged using micro-computed tomography (μCT) at high resolution (13.4 μm(3)) before and after equilibration with various Hexabrix bathing concentrations. The GAG concentration was calculated depth-dependently based on Gibbs-Donnan equilibrium theory. Analysis of variance with Tukey's post hoc was used to test for statistical significance (P < 0.05) for effect of Hexabrix bathing concentration, and for differences in bulk and zonal GAG concentrations individually and compared between native and trypsin-degraded cartilage. RESULTS The bulk GAG concentration was calculated to be 74.44 ± 6.09 and 11.99 ± 4.24 mg/mL for native and degraded cartilage, respectively. A statistical difference was demonstrated for bulk and zonal GAG between native and degraded cartilage (P < 0.032). A statistical difference was not demonstrated for bulk GAG when comparing Hexabrix bathing concentrations (P > 0.3214) for neither native nor degraded cartilage. Depth-dependent GAG analysis of native cartilage revealed a statistical difference only in the radial zone between 30% and 50% Hexabrix bathing concentrations. CONCLUSIONS This nondestructive qCECT methodology calculated the depth-dependent GAG concentration for both native and trypsin-degraded cartilage at high spatial resolution. qCECT allows for more detailed understanding of the topography and depth dependency, which could help diagnose health, degradation, and repair of native and contrived cartilage.
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Affiliation(s)
- Daniel Mittelstaedt
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
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19
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Raya JG. Techniques and applications of in vivo diffusion imaging of articular cartilage. J Magn Reson Imaging 2015; 41:1487-504. [PMID: 25865215 DOI: 10.1002/jmri.24767] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/11/2014] [Indexed: 01/07/2023] Open
Abstract
Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity and to the collagen architecture through the fractional anisotropy. However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (∼40 ms at 3 Tesla) and the high resolution needed (0.5-0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications.
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Affiliation(s)
- José G Raya
- Department Radiology, New York University Langone Medical Center, New York, New York, USA
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Ukai T, Sato M, Yamashita T, Imai Y, Mitani G, Takagaki T, Serigano K, Mochida J. Diffusion tensor imaging can detect the early stages of cartilage damage: a comparison study. BMC Musculoskelet Disord 2015; 16:35. [PMID: 25886863 PMCID: PMC4342082 DOI: 10.1186/s12891-015-0499-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 02/12/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND In the present study, we measured damaged areas of cartilage with diffusion tensor (DT) imaging and T2 mapping, and investigated the extent to which cartilage damage could be determined using these techniques. METHODS Forty-one patients underwent arthroscopic knee surgery for osteoarthritis of the knee, a meniscus injury, or an anterior cruciate ligament injury. Preoperative magnetic resonance imaging of the knee was performed, including T2 mapping and diffusion tensor imaging. The presence of cartilage injury involving the medial and lateral femoral condyles and tibia plateau was assessed during surgery using the Outerbridge scale. The ADC, T2 values and fractional anisotropy of areas of cartilage injury were then retrospectively analysed. RESULTS The ADC results identified significant differences between Outerbridge grades 0 and 2 (P = 0.041); 0 and 3 (P < 0.001); 1 and 2 (P = 0.045); 1 and 3 (P < 0.001); and 2 and 3 (P = 0.028). The FA results identified significant differences between grades 0 and 1 (P < 0.001); 0 and 2 (P < 0.001); and 0 and 3 (P < 0.001). T2 mapping identified significant differences between Outerbridge grades 0 and 2 (P = 0.032); 0 and 3 (P < 0.001); 1 and 3 (P < 0.001); and 2 and 3 (P < 0.001). Both the T2 mapping (R(2) = 0.7883) and the ADC (R(2) = 0.9184) correlated significantly with the Outerbridge grade. The FA (R(2) = 0.6616) correlated slightly with the Outerbridge grade. CONCLUSIONS T2 mapping can be useful for detecting moderate or severe cartilage damage, and the ADC can be used to detect early stage cartilage damage. The FA can also distinguish normal from damaged cartilage.
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Affiliation(s)
- Taku Ukai
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Masato Sato
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Tomohiro Yamashita
- Department of Radiology, Specialized Clinical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Yutaka Imai
- Department of Radiology, Specialized Clinical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Genya Mitani
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Tomonori Takagaki
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Kenji Serigano
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Joji Mochida
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
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Kijowski R, Chaudhary R. Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am 2014; 22:649-69. [PMID: 25442027 DOI: 10.1016/j.mric.2014.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Osteoarthritis is characterized by a decrease in the proteoglycan content and disruption of the highly organized collagen fiber network of articular cartilage. Various quantitative magnetic resonance imaging techniques have been developed for noninvasive assessment of the proteoglycan and collagen components of cartilage. These techniques have been extensively used in clinical practice to detect early cartilage degeneration and in osteoarthritis research studies to monitor disease-related and treatment-related changes in cartilage over time. This article reviews the role of quantitative magnetic resonance imaging in evaluating the composition and ultrastructure of the articular cartilage of the knee joint.
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Affiliation(s)
- Richard Kijowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA.
| | - Rajeev Chaudhary
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792-3252, USA
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Jaimes C, Berman JI, Delgado J, Ho-Fung V, Jaramillo D. Diffusion-tensor imaging of the growing ends of long bones: pilot demonstration of columnar structure in the physes and metaphyses of the knee. Radiology 2014; 273:491-501. [PMID: 25102295 DOI: 10.1148/radiol.14132136] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the feasibility of using in vivo diffusion-tensor imaging and tractography of the physis to examine changes related to rate of growth, location, and age. MATERIALS AND METHODS This retrospective study was institutional review board approved and HIPAA compliant and the requirement for informed consent was waived. Diffusion-tensor imaging of the knee was performed at 3.0 T in 31 subjects (nine boys and 22 girls) with a median age of 13.6 years. The mean ages of boys and girls were 14.7 years (range, 12.0-18.3 years) and 13.2 years (range, 7.0-18.6 years), respectively. Regions of interest were placed in the physis of the tibia and femur, and in the epiphyseal and articular cartilage of these bones. Tractography was performed by using a fractional anisotropic threshold of 0.15 and an angle threshold of 40°. The tractographic patterns were qualitatively evaluated and changes related to age were described. The tract-based apparent diffusion coefficient, fractional anistropy, tensor eigenvalues, and tract length were measured. Diffusion parameters were compared between the center and periphery of the physis, and between the distal femur and proximal tibia. RESULTS Tractography resulted in parallel tracts in the physis and the adjacent metaphysis. Tractographic pattern changed with age, with individuals approaching physeal closure having shorter tracts in a random arrangement. Patterns of tractography varied with age in the femur (P < .001) and tibia (P < .001). Femoral tracts (median length, 6.5 mm) were longer than tibial tracts (median length, 4.3 mm) (P < .001). Tracts in the periphery of the physes were longer than those in the center (femur, P = .005; tibia, P = .004). In the physis of the femur and tibia, a significant age-related decrease was observed in apparent diffusion coefficient (P < .001 for both), axial diffusion (femur, P = .001; tibia, P < .001), and transverse diffusion [P < .001 for both]), and an age-related increase was seen in fractional anistropy (P < .001, for both). CONCLUSION Diffusion-tensor imaging shows the columnar microstructure of the physis and adjacent metaphysis, and provides further insight into normal growth.
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Affiliation(s)
- Camilo Jaimes
- From the Department of Radiology, The Children's Hospital of Philadelphia, 34th & Civic Center Blvd, Room 3NW, Philadelphia, PA 19104 (C.J., J.I.B., J.D., V.H.F., D.J.); and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa (J.I.B., V.H.F., D.J.)
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Cartilage repair surgery: outcome evaluation by using noninvasive cartilage biomarkers based on quantitative MRI techniques? BIOMED RESEARCH INTERNATIONAL 2014; 2014:840170. [PMID: 24877139 PMCID: PMC4024422 DOI: 10.1155/2014/840170] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 03/25/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND New quantitative magnetic resonance imaging (MRI) techniques are increasingly applied as outcome measures after cartilage repair. OBJECTIVE To review the current literature on the use of quantitative MRI biomarkers for evaluation of cartilage repair at the knee and ankle. METHODS Using PubMed literature research, studies on biochemical, quantitative MR imaging of cartilage repair were identified and reviewed. RESULTS Quantitative MR biomarkers detect early degeneration of articular cartilage, mainly represented by an increasing water content, collagen disruption, and proteoglycan loss. Recently, feasibility of biochemical MR imaging of cartilage repair tissue and surrounding cartilage was demonstrated. Ultrastructural properties of the tissue after different repair procedures resulted in differences in imaging characteristics. T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), and diffusion weighted imaging (DWI) are applicable on most clinical 1.5 T and 3 T MR scanners. Currently, a standard of reference is difficult to define and knowledge is limited concerning correlation of clinical and MR findings. The lack of histological correlations complicates the identification of the exact tissue composition. CONCLUSIONS A multimodal approach combining several quantitative MRI techniques in addition to morphological and clinical evaluation might be promising. Further investigations are required to demonstrate the potential for outcome evaluation after cartilage repair.
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Li X, Majumdar S. Quantitative MRI of articular cartilage and its clinical applications. J Magn Reson Imaging 2013; 38:991-1008. [PMID: 24115571 DOI: 10.1002/jmri.24313] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 06/21/2013] [Indexed: 12/27/2022] Open
Abstract
Cartilage is one of the most essential tissues for healthy joint function and is compromised in degenerative and traumatic joint diseases. There have been tremendous advances during the past decade using quantitative MRI techniques as a noninvasive tool for evaluating cartilage, with a focus on assessing cartilage degeneration during osteoarthritis (OA). In this review, after a brief overview of cartilage composition and degeneration, we discuss techniques that grade and quantify morphologic changes as well as the techniques that quantify changes in the extracellular matrix. The basic principles, in vivo applications, advantages, and challenges for each technique are discussed. Recent studies using the OA Initiative (OAI) data are also summarized. Quantitative MRI provides noninvasive measures of cartilage degeneration at the earliest stages of joint degeneration, which is essential for efforts toward prevention and early intervention in OA.
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Affiliation(s)
- Xiaojuan Li
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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Nieminen MT, Nissi MJ, Mattila L, Kiviranta I. Evaluation of chondral repair using quantitative MRI. J Magn Reson Imaging 2013; 36:1287-99. [PMID: 23165732 DOI: 10.1002/jmri.23644] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 02/17/2012] [Indexed: 01/30/2023] Open
Abstract
Various quantitative magnetic resonance imaging (qMRI) biomarkers, including but not limited to parametric MRI mapping, semiquantitative evaluation, and morphological assessment, have been successfully applied to assess cartilage repair in both animal and human studies. Through the interaction between interstitial water and constituent macromolecules the compositional and structural properties of cartilage can be evaluated. In this review a comprehensive view of a variety of quantitative techniques, particularly those involving parametric mapping, and their relationship to the properties of cartilage repair is presented. Some techniques, such as T2 relaxation time mapping and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), are well established, while the full potential of more recently introduced techniques remain to be demonstrated. A combination of several MRI techniques is necessary for a comprehensive characterization of chondral repair.
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Affiliation(s)
- Miika T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
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Shapiro L, Harish M, Hargreaves B, Staroswiecki E, Gold G. Advances in musculoskeletal MRI: technical considerations. J Magn Reson Imaging 2013; 36:775-87. [PMID: 22987756 DOI: 10.1002/jmri.23629] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The technology of musculoskeletal magnetic resonance imaging (MRI) is advancing at a dramatic rate. MRI is now done at medium and higher field strengths with more specialized surface coils and with more variable pulse sequences and postprocessing techniques than ever before. These innumerable technical advances are advantageous as they lead to an increased signal-to-noise ratio and increased variety of soft-tissue contrast options. However, at the same time they potentially produce more imaging artifacts when compared with past techniques. Substantial technical advances have considerable clinical challenges in musculoskeletal radiology such as postoperative patient imaging, cartilage mapping, and molecular imaging. In this review we consider technical advances in hardware and software of musculoskeletal MRI along with their clinical applications.
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Affiliation(s)
- Lauren Shapiro
- Department of Radiology, Stanford University, Stanford, California, USA
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Abstract
This review briefly summarises some of the definitive studies of articular cartilage by microscopic MRI (µMRI) that were conducted with the highest spatial resolutions. The article has four major sections. The first section introduces the cartilage tissue, MRI and µMRI, and the concept of image contrast in MRI. The second section describes the characteristic profiles of three relaxation times (T1, T2 and T1ρ) and self-diffusion in healthy articular cartilage. The third section discusses several factors that can influence the visualisation of articular cartilage and the detection of cartilage lesion by MRI and µMRI. These factors include image resolution, image analysis strategies, visualisation of the total tissue, topographical variations of the tissue properties, surface fibril ambiguity, deformation of the articular cartilage, and cartilage lesion. The final section justifies the values of multidisciplinary imaging that correlates MRI with other technical modalities, such as optical imaging. Rather than an exhaustive review to capture all activities in the literature, the studies cited in this review are merely illustrative.
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Affiliation(s)
- Y Xia
- Oakland University, 276 Hannah Hall, Department of Physics, Rochester, Michigan 48309, USA
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Raya JG, Melkus G, Adam-Neumair S, Dietrich O, Mützel E, Reiser MF, Putz R, Kirsch T, Jakob PM, Glaser C. Diffusion-tensor imaging of human articular cartilage specimens with early signs of cartilage damage. Radiology 2012; 266:831-41. [PMID: 23238155 DOI: 10.1148/radiol.12120954] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To assess the use of diffusion-tensor (DT) imaging of articular cartilage to detect and grade early cartilage damage in human specimens with early signs of cartilage damage. MATERIALS AND METHODS This study was approved by the institutional review board. Forty-three cartilage-on-bone samples drilled from 21 human patellae were examined with 17.6-T magnetic resonance (MR) imaging and a diffusion-weighted spin-echo sequence (spatial resolution, 50 × 100 × 800 μm). Subsequently, samples underwent histologic analysis with safranin O staining. Cartilage damage on safranin O histologic slides was quantified with Osteoarthritis Research Society International (OARSI) grades; grades ranged from 0 (healthy) to 6 (bone remodeling). Maps of longitudinal diffusivity (λ(l)), transverse diffusivity (λ(t)), mean diffusivity (MD), and fractional anisotropy (FA) were calculated. Cartilage was segmented, and region of interest (ROI) analysis was performed and compared with histologic findings. Significant differences in MR parameters between the OARSI groups were assessed with the Tukey test. The value of DT imaging in the diagnosis and grading of cartilage damage was assessed with logistic regression analysis. RESULTS Samples had OARSI grades of 0 (n = 14), 1 (n = 11), 2 (n = 12), 3 (n = 4), and 4 (n = 2). Samples with an OARSI grade greater than 0 had significantly increased λ(l), λ(t), and MD (7%-25% increase) in the superficial cartilage growing deeper into cartilage with increasing OARSI grade. Samples with an OARSI grade greater than 0 showed significantly decreased FA in the deep cartilage (-25% to -35% decrease), suggesting that changes in the collagen architecture may occur early in cartilage degradation. DTI showed excellent performance in the detection of cartilage damage (accuracy, 0.95; 41 of 43 samples) and good performance in the grading of cartilage damage (accuracy, 0.74; 32 of 43 samples). CONCLUSION DT imaging of articular cartilage can enable physicians to detect and grade early cartilage damage.
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Affiliation(s)
- José G Raya
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, 4th Floor, New York, NY 10016, USA.
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Powell SK, Momot KI. Langevin dynamics modeling of the water diffusion tensor in partially aligned collagen networks. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2012; 86:031917. [PMID: 23030954 DOI: 10.1103/physreve.86.031917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 04/12/2012] [Indexed: 06/01/2023]
Abstract
In this work, a Langevin dynamics model of the diffusion of water in articular cartilage was developed. Numerical simulations of the translational dynamics of water molecules and their interaction with collagen fibers were used to study the quantitative relationship between the organization of the collagen fiber network and the diffusion tensor of water in model cartilage. Langevin dynamics was used to simulate water diffusion in both ordered and partially disordered cartilage models. In addition, an analytical approach was developed to estimate the diffusion tensor for a network comprising a given distribution of fiber orientations. The key findings are that (1) an approximately linear relationship was observed between collagen volume fraction and the fractional anisotropy of the diffusion tensor in fiber networks of a given degree of alignment, (2) for any given fiber volume fraction, fractional anisotropy follows a fiber alignment dependency similar to the square of the second Legendre polynomial of cos(θ), with the minimum anisotropy occurring at approximately the magic angle (θ(MA)), and (3) a decrease in the principal eigenvalue and an increase in the transverse eigenvalues is observed as the fiber orientation angle θ progresses from 0° to 90°. The corresponding diffusion ellipsoids are prolate for θ<θ(MA), spherical for θ≈θ(MA), and oblate for θ>θ(MA). Expansion of the model to include discrimination between the combined effects of alignment disorder and collagen fiber volume fraction on the diffusion tensor is discussed.
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Affiliation(s)
- Sean K Powell
- School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, GPO Box 2434, Brisbane, Queensland 4001, Australia
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31
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Zhu SC, Shi DP, Xuan A. Human patellar cartilage: echo planar diffusion-weighted MR imaging findings at 3.0 T. Clin Imaging 2012; 36:199-202. [DOI: 10.1016/j.clinimag.2011.08.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 08/26/2011] [Indexed: 10/28/2022]
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Fischer KJ, Johnson JE, Waller AJ, McIff TE, Toby EB, Bilgen M. MRI-based modeling for radiocarpal joint mechanics: validation criteria and results for four specimen-specific models. J Biomech Eng 2012; 133:101004. [PMID: 22070329 DOI: 10.1115/1.4005171] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The objective of this study was to validate the MRI-based joint contact modeling methodology in the radiocarpal joints by comparison of model results with invasive specimen-specific radiocarpal contact measurements from four cadaver experiments. We used a single validation criterion for multiple outcome measures to characterize the utility and overall validity of the modeling approach. For each experiment, a Pressurex film and a Tekscan sensor were sequentially placed into the radiocarpal joints during simulated grasp. Computer models were constructed based on MRI visualization of the cadaver specimens without load. Images were also acquired during the loaded configuration used with the direct experimental measurements. Geometric surface models of the radius, scaphoid and lunate (including cartilage) were constructed from the images acquired without the load. The carpal bone motions from the unloaded state to the loaded state were determined using a series of 3D image registrations. Cartilage thickness was assumed uniform at 1.0 mm with an effective compressive modulus of 4 MPa. Validation was based on experimental versus model contact area, contact force, average contact pressure and peak contact pressure for the radioscaphoid and radiolunate articulations. Contact area was also measured directly from images acquired under load and compared to the experimental and model data. Qualitatively, there was good correspondence between the MRI-based model data and experimental data, with consistent relative size, shape and location of radioscaphoid and radiolunate contact regions. Quantitative data from the model generally compared well with the experimental data for all specimens. Contact area from the MRI-based model was very similar to the contact area measured directly from the images. For all outcome measures except average and peak pressures, at least two specimen models met the validation criteria with respect to experimental measurements for both articulations. Only the model for one specimen met the validation criteria for average and peak pressure of both articulations; however the experimental measures for peak pressure also exhibited high variability. MRI-based modeling can reliably be used for evaluating the contact area and contact force with similar confidence as in currently available experimental techniques. Average contact pressure, and peak contact pressure were more variable from all measurement techniques, and these measures from MRI-based modeling should be used with some caution.
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Affiliation(s)
- Kenneth J Fischer
- Department of Mechanical Engineering, University of Kansas, Lawrence, KS 66045-7609, USA.
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33
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Bieri O, Ganter C, Scheffler K. Quantitative in vivo diffusion imaging of cartilage using double echo steady-state free precession. Magn Reson Med 2011; 68:720-9. [DOI: 10.1002/mrm.23275] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 09/29/2011] [Accepted: 10/09/2011] [Indexed: 11/09/2022]
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Raya JG, Horng A, Dietrich O, Krasnokutsky S, Beltran LS, Storey P, Reiser MF, Recht MP, Sodickson DK, Glaser C. Articular cartilage: in vivo diffusion-tensor imaging. Radiology 2011; 262:550-9. [PMID: 22106350 DOI: 10.1148/radiol.11110821] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To investigate technical feasibility, test-retest reproducibility, and the ability to differentiate healthy subjects from subjects with osteoarthritis (OA) with diffusion-tensor (DT) imaging parameters and T2 relaxation time. MATERIALS AND METHODS This study was approved by the institutional review board and was HIPAA compliant. All subjects provided written informed consent. DT imaging parameters and T2 (resolution=0.6×0.6×2 mm) of patellar cartilage were measured at 7.0 T in 16 healthy volunteers and 10 patients with OA with subtle inhomogeneous signal intensity but no signs of cartilage erosion at clinical magnetic resonance (MR) imaging. Ten volunteers were imaged twice to determine test-retest reproducibility. After cartilage segmentation, maps of mean apparent diffusion coefficient (ADC), fractional anisotropy (FA), and T2 relaxation time were calculated. Differences for ADC, FA, and T2 between the healthy and OA populations were assessed with nonparametric tests. The ability of each MR imaging parameter to help discriminate healthy subjects from subjects with OA was assessed by using receiver operating characteristic curve analysis. RESULTS Test-retest reproducibility was better than 10% for mean ADC (8.1%), FA (9.7%), and T2 (5.9%). Mean ADC and FA differed significantly (P<.01) between the OA and healthy populations, but T2 did not. For ADC, the optimal threshold to differentiate both populations was 1.2×10(-3) mm2/sec, achieving specificity of 1.0 (16 of 16) and sensitivity of 0.80 (eight of 10). For FA, the optimal threshold was 0.25, yielding specificity of 0.88 (14 of 16) and sensitivity of 0.80 (eight of 10). T2 showed poor differentiation between groups (optimal threshold=22.9 msec, specificity=0.69 [11 of 16], sensitivity=0.60 [six of 10]). CONCLUSION In vivo DT imaging of patellar cartilage is feasible, has good test-retest reproducibility, and may be accurate in discriminating healthy subjects from subjects with OA. ADC and FA are two promising biomarkers for early OA.
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Affiliation(s)
- José G Raya
- Department of Radiology, New York University Langone Medical Center, 660 First Ave, 4th Floor, New York, NY 10016, USA.
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Winalski CS, Rajiah P. The evolution of articular cartilage imaging and its impact on clinical practice. Skeletal Radiol 2011; 40:1197-222. [PMID: 21847750 DOI: 10.1007/s00256-011-1226-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 06/27/2011] [Indexed: 02/02/2023]
Abstract
Over the past four decades, articular cartilage imaging has developed rapidly. Imaging now plays a critical role not only in clinical practice and therapeutic decisions but also in the basic research probing our understanding of cartilage physiology and biomechanics.
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Affiliation(s)
- Carl S Winalski
- Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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36
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Bieri O, Ganter C, Welsch GH, Trattnig S, Mamisch TC, Scheffler K. Fast diffusion-weighted steady state free precession imaging of in vivo knee cartilage. Magn Reson Med 2011; 67:691-700. [PMID: 21858861 DOI: 10.1002/mrm.23061] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 05/26/2011] [Accepted: 05/27/2011] [Indexed: 02/02/2023]
Abstract
Quantification of molecular diffusion with steady state free precession (SSFP) is complicated by the fact that diffusion effects accumulate over several repetition times (TR) leading to complex signal dependencies on transverse and longitudinal magnetization paths. This issue is commonly addressed by setting TR > T(2), yielding strong attenuation of all higher modes, except of the shortest ones. As a result, signal attenuation from diffusion becomes T(2) independent but signal-to-noise ratio (SNR) and sequence efficiency are remarkably poor. In this work, we present a new approach for fast in vivo steady state free precession diffusion-weighted imaging of cartilage with TR << T(2) offering a considerable increase in signal-to-noise ratio and sequence efficiency. At a first glance, prominent coupling between magnetization paths seems to complicate quantification issues in this limit, however, it is observed that diffusion effects become rather T(2) (ΔD ≈ 1/10 ΔT(2)) but not T(1) independent (ΔD ≈ 1/2 ΔT(1)) for low flip angles α ≈ 10 - 15°. As a result, fast high-resolution (0.35 × 0.35 - 0.50 × 0.50 mm(2) in-plane resolution) quantitative diffusion-weighted imaging of human articular cartilage is demonstrated at 3.0 T in a clinical setup using estimated T(1) and T(2) or a combination of measured T(1) and estimated T(2) values.
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Affiliation(s)
- O Bieri
- Division of Radiological Physics, Department of Medical Radiology, University of Basel Hospital, Basel, Switzerland.
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Change of Diffusion Tensor Imaging Parameters in Articular Cartilage With Progressive Proteoglycan Extraction. Invest Radiol 2011; 46:401-9. [DOI: 10.1097/rli.0b013e3182145aa8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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38
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Ultra-high field diffusion tensor imaging of articular cartilage correlated with histology and scanning electron microscopy. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2011; 24:247-58. [DOI: 10.1007/s10334-011-0259-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 04/26/2011] [Accepted: 05/05/2011] [Indexed: 12/26/2022]
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Zheng YP, Wang Q, Butt YKC. Real-time electro-mechano-acoustic imaging for monitoring interactions between trypsin and different inhibitors in articular cartilage. ULTRASOUND IN MEDICINE & BIOLOGY 2011; 37:465-473. [PMID: 21256664 DOI: 10.1016/j.ultrasmedbio.2010.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 11/25/2010] [Accepted: 12/06/2010] [Indexed: 05/30/2023]
Abstract
The purpose of this study was to observe the real-time interactions between trypsin and various inhibitors in articular cartilage in vitro using a novel electro-mechano-acoustic imaging method. Monitored in real-time, articular cartilage specimens from bovine patellae were first treated with trypsin to reach half proteoglycan depletion (Phase I), then the trypsin solution was replaced with (i) physiological saline buffer (PS), (ii) fetal bovine serum (FBS), (iii) protease inhibitor cocktail (PI) and (iv) 10% formalin (F), respectively, to observe their effects on residual digestion (Phase II). Ultrasound radio frequency signals from the articular cartilage were used to form a M-mode image, where the interface between trypsin digested and intact cartilage tissues could be observed with an additional echo generated. The inhibition time, the digestion depth and digestion fraction were measured for each specimen. The results showed that the dilution of trypsin using saline solution was not sufficient to stop the enzyme action instantly. Although groups FBS and PI had a similar inhibition time of approximately 1.5 h, their digestion depth was obviously different (0.25±0.03 and 0.06±0.06 mm, respectively). In contrast, formalin only took <30 min to stop the trypsin digestion with almost no further digestion. The results demonstrated that the current system was capable of monitoring the trypsin digestion and inhibition process in real time. Also, different chemicals affected the residual trypsin digestion to different degrees.
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Affiliation(s)
- Yong-Ping Zheng
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China.
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40
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Trattnig S, Winalski CS, Marlovits S, Jurvelin JS, Welsch GH, Potter HG. Magnetic Resonance Imaging of Cartilage Repair: A Review. Cartilage 2011; 2:5-26. [PMID: 26069565 PMCID: PMC4300792 DOI: 10.1177/1947603509360209] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Articular cartilage lesions are a common pathology of the knee joint, and many patients may benefit from cartilage repair surgeries that offer the chance to avoid the development of osteoarthritis or delay its progression. Cartilage repair surgery, no matter the technique, requires a noninvasive, standardized, and high-quality longitudinal method to assess the structure of the repair tissue. This goal is best fulfilled by magnetic resonance imaging (MRI). The present article provides an overview of the current state of the art of MRI of cartilage repair. In the first 2 sections, preclinical and clinical MRI of cartilage repair tissue are described with a focus on morphological depiction of cartilage and the use of functional (biochemical) MR methodologies for the visualization of the ultrastructure of cartilage repair. In the third section, a short overview is provided on the regulatory issues of the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) regarding MR follow-up studies of patients after cartilage repair surgeries.
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Affiliation(s)
- Siegfried Trattnig
- MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria,Siegfried Trattnig, MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Lazarettgasse 14, A-1090 Vienna, Austria
| | | | - Stephan Marlovits
- Trauma Surgery Department, Medical University of Vienna, Vienna, Austria
| | - Jukka S. Jurvelin
- Department of Physics and Mathematics, University of Eastern Finland, Kuopio, Finland
| | - Goetz H. Welsch
- MR Centre - High Field MR, Department of Radiology, Medical University of Vienna, Vienna, Austria,Department of Trauma Surgery, University Hospital of Erlangen, Erlangen, Germany
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41
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Momot KI. Diffusion tensor of water in model articular cartilage. EUROPEAN BIOPHYSICS JOURNAL: EBJ 2010; 40:81-91. [DOI: 10.1007/s00249-010-0629-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2010] [Revised: 08/08/2010] [Accepted: 09/09/2010] [Indexed: 11/29/2022]
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42
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Bittersohl B, Hosalkar HS, Kim YJ, Werlen S, Trattnig S, Siebenrock KA, Mamisch TC. T1 assessment of hip joint cartilage following intra-articular gadolinium injection: A pilot study. Magn Reson Med 2010; 64:1200-7. [DOI: 10.1002/mrm.22472] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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43
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Momot KI, Pope JM, Wellard RM. Anisotropy of spin relaxation of water protons in cartilage and tendon. NMR IN BIOMEDICINE 2010; 23:313-324. [PMID: 20013798 DOI: 10.1002/nbm.1466] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Transverse spin relaxation rates of water protons in articular cartilage and tendon depend on the orientation of the tissue relative to the applied static magnetic field. This complicates the interpretation of magnetic resonance images of these tissues. At the same time, relaxation data can provide information about their organisation and microstructure. We present a theoretical analysis of the anisotropy of spin relaxation of water protons observed in fully hydrated cartilage. We demonstrate that the anisotropy of transverse relaxation is due almost entirely to intramolecular dipolar coupling modulated by a specific mode of slow molecular motion: the diffusion of water molecules in the hydration shell of a collagen fibre around the fibre, such that the molecular director remains perpendicular to the fibre. The theoretical anisotropy arising from this mechanism follows the 'magic-angle' dependence observed in magnetic-resonance measurements of cartilage and tendon and is in good agreement with the available experimental results. We discuss the implications of the theoretical findings for MRI of ordered collagenous tissues.
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Affiliation(s)
- Konstantin I Momot
- School of Physical and Chemical Sciences, Queensland University of Technology, Brisbane, Australia.
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Welsch GH, Trattnig S, Domayer S, Marlovits S, White LM, Mamisch TC. Multimodal approach in the use of clinical scoring, morphological MRI and biochemical T2-mapping and diffusion-weighted imaging in their ability to assess differences between cartilage repair tissue after microfracture therapy and matrix-associated autologous chondrocyte transplantation: a pilot study. Osteoarthritis Cartilage 2009; 17:1219-27. [PMID: 19409295 DOI: 10.1016/j.joca.2009.03.018] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Revised: 03/23/2009] [Accepted: 03/25/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of the present pilot study is to show initial results of a multimodal approach using clinical scoring, morphological magnetic resonance imaging (MRI) and biochemical T2-relaxation and diffusion-weighted imaging (DWI) in their ability to assess differences between cartilage repair tissue after microfracture therapy (MFX) and matrix-associated autologous chondrocyte transplantation (MACT). METHOD Twenty patients were cross-sectionally evaluated at different post-operative intervals from 12 to 63 months after MFX and 12-59 months after MACT. The two groups were matched by age (MFX: 36.0+/-10.4 years; MACT: 35.1+/-7.7 years) and post-operative interval (MFX: 32.6+/-16.7 months; MACT: 31.7+/-18.3 months). After clinical evaluation using the Lysholm score, 3T-MRI was performed obtaining the MR observation of cartilage repair tissue (MOCART) score as well as T2-mapping and DWI for multi-parametric MRI. Quantitative T2-relaxation was achieved using a multi-echo spin-echo sequence; semi-quantitative diffusion-quotient (signal intensity without diffusion-weighting divided by signal intensity with diffusion weighting) was prepared by a partially balanced, steady-state gradient-echo pulse sequence. RESULTS No differences in Lysholm (P=0.420) or MOCART (P=0.209) score were observed between MFX and MACT. T2-mapping showed lower T2 values after MFX compared to MACT (P=0.039). DWI distinguished between healthy cartilage and cartilage repair tissue in both procedures (MFX: P=0.001; MACT: P=0.007). Correlations were found between the Lysholm and the MOCART score (Pearson: 0.484; P=0.031), between the Lysholm score and DWI (Pearson:-0.557; P=0.011) and a trend between the Lysholm score and T2 (Person: 0.304; P=0.193). CONCLUSION Using T2-mapping and DWI, additional information could be gained compared to clinical scoring or morphological MRI. In combination clinical, MR-morphological and MR-biochemical parameters can be seen as a promising multimodal tool in the follow-up of cartilage repair.
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Affiliation(s)
- G H Welsch
- MR Center, Department of Radiology, Medical University of Vienna, Vienna, Austria
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45
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Wang Q, Zheng YP. Ultrasound biomicroscopy imaging for monitoring progressive trypsin digestion and inhibition in articular cartilage. ULTRASOUND IN MEDICINE & BIOLOGY 2009; 35:1535-1545. [PMID: 19616365 DOI: 10.1016/j.ultrasmedbio.2009.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Revised: 04/17/2009] [Accepted: 04/21/2009] [Indexed: 05/28/2023]
Abstract
This study reports an ultrasound biomicroscopy (UBM) imaging approach to monitor the progressive trypsin-induced depletion of proteoglycan (PG) and its inhibition in articular cartilage. Three fresh, normal bovine patellae were obtained and four full-thickness cartilage-bone specimens were prepared from the lower medial side of each patella. One sample was used as a control and the other three were divided into three groups: Groups A, B and C (n=3 for each group). After a 40min 0.25% trypsin digestion, samples from group A were continuously digested in trypsin solution, while those in groups B and C were immersed in physiologic saline and fetal bovine serum (FBS), respectively, for another 280min. The trypsin penetration front was observed by UBM and M-mode images were acquired using 50MHz focused ultrasound and custom-developed software. The results show that the 40min trypsin digestion degraded nearly the whole surface layer of the cartilage tissue. Further digestion in trypsin or residual digestion in saline for 280min depleted most of the PG content, as observed in groups A and B. The replacement of trypsin with a physiologic saline solution only slightly slowed the digestion process (group B), while trypsin inhibitors in FBS stopped the digestion in approximately 1.5h (group C). The normalized digestion fractions of the digested tissues were calculated from ultrasound data and histology sections, and then compared between the groups. Without the use of FBS, 80% to 100% of the full thickness was digested, while this number was only approximately 50% when using FBS. Our findings indicate that the UBM imaging system could provide two-dimensional (2-D) visual information for monitoring progressive trypsin-induced PG depletion in articular cartilage. The system also potentially offers a useful tool for preparing cartilage degeneration models with precisely controlled PG depletion.
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Affiliation(s)
- Qing Wang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, China
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46
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Azuma T, Nakai R, Takizawa O, Tsutsumi S. In vivo structural analysis of articular cartilage using diffusion tensor magnetic resonance imaging. Magn Reson Imaging 2009; 27:1242-8. [PMID: 19553054 DOI: 10.1016/j.mri.2009.05.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Revised: 04/01/2009] [Accepted: 05/07/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE The articular cartilage is a small tissue with a matrix structure of three layers between which the orientation of collagen fiber differs. A diffusion-weighted twice-refocused spin-echo echo-planar imaging (SE-EPI) sequence was optimized for the articular cartilage, and the structure of the three layers of human articular cartilage was imaged in vivo from diffusion tensor images. MATERIALS AND METHODS The subjects imaged were five specimens of swine femur head after removal of the flesh around the knee joint, five specimens of swine articular cartilage with flesh present and the knee cartilage of five adult male volunteers. Based on diffusion-weighted images in six directions, the mean diffusivity (MD) and the fractional anisotropy (FA) values were calculated. RESULTS Diffusion tensor images of the articular cartilage were obtained by sequence optimization. The MD and FA value of the specimens (each of five examples) under different conditions were estimated. Although the articular cartilage is a small tissue, the matrix structure of each layer in the articular cartilage was obtained by SE-EPI sequence with GRAPPA. The MD and FA values of swine articular cartilage are different between the synovial fluid and saline. In human articular cartilage, the load of the body weight on the knee had an effect on the FA value of the surface layer of the articular cartilage. CONCLUSION This method can be used to create images of the articular cartilage structure, not only in vitro but also in vivo. Therefore, it is suggested that this method should support the elucidation of the in vivo structure and function of the knee joint and might be applied to clinical practice.
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Affiliation(s)
- Takashi Azuma
- Institute for Frontier Medical Sciences, Kyoto University, Kyoto, Japan.
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Abstract
Standardized magnetic resonance imaging (MRI) pulse sequences provide an accurate, reproducible assessment of cartilage morphology. Three-dimensional (3D) modeling techniques enable semiautomated models of the joint surface and thickness measurements, which may eventually prove essential in templating before partial or total joint resurfacing as well as focal cartilage repair. Quantitative MRI techniques, such as T2 mapping, T1 rho, and delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), provide noninvasive information about cartilage and repair tissue biochemistry. Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) demonstrate information regarding the regional anisotropic variation of cartilage ultrastructure. Further research strengthening the association between quantitative MRI and cartilage material properties may predict the functional capacity of native and repaired tissue. MRI provides an essential objective assessment of cartilage regenerative procedures.
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Guermazi A, Eckstein F, Hellio Le Graverand-Gastineau MP, Conaghan PG, Burstein D, Keen H, Roemer FW. Osteoarthritis: current role of imaging. Med Clin North Am 2009; 93:101-26, xi. [PMID: 19059024 DOI: 10.1016/j.mcna.2008.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Osteoarthritis (OA) is the most prevalent joint disease; it is increasingly common in the aging population of Western society and has a major health economic impact. Despite surgery and symptom-oriented approaches there is no efficient treatment. Conventional radiography has played a role in the past in confirming diagnosis and demonstrating late bony changes and joint space narrowing. MRI has become the method of choice in large research endeavors and may become important for individualized treatment planning. This article focuses on radiography and MRI, with insight into other modalities, such as ultrasound, scintigraphy, and CT. Their role in OA diagnosis, follow-up, and research is discussed.
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Affiliation(s)
- Ali Guermazi
- Department of Radiology, Boston University School of Medicine, 820 Harrison Avenue, FGH Building, Third Floor, Boston, MA 02118, USA.
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Regatte RR, Schweitzer ME. Novel contrast mechanisms at 3 Tesla and 7 Tesla. Semin Musculoskelet Radiol 2008; 12:266-80. [PMID: 18850506 DOI: 10.1055/s-0028-1083109] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Osteoarthritis (OA) is the most common musculoskeletal degenerative disease, affecting millions of people. Although OA has been considered primarily a cartilage disorder associated with focal cartilage degeneration, it is accompanied by well-known changes in subchondral and trabecular bone, including sclerosis and osteophyte formation. The exact cause of OA initiation and progression remains under debate, but OA typically first affects weightbearing joints such as the knee. Magnetic resonance imaging (MRI) has been recognized as a potential tool for quantitative assessment of cartilage abnormalities due to its excellent soft tissue contrast. Over the last two decades, several new MR biochemical imaging methods have been developed to characterize the disease process and possibly predict the progression of knee OA. These new MR biochemical methods play an important role not only for diagnosis of disease at an early stage, but also for their potential use in monitoring outcome of various drug therapies (success or failure). Recent advances in multicoil radiofrequency technology and high field systems (3 T and above) significantly improve the sensitivity and specificity of imaging studies for the diagnosis of musculoskeletal disorders. The current state-of-the-art MR imaging methods are briefly reviewed for the quantitative biochemical and functional imaging assessment of musculoskeletal systems.
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Affiliation(s)
- Ravinder R Regatte
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, New York 10003, USA.
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Guermazi A, Burstein D, Conaghan P, Eckstein F, Hellio Le Graverand-Gastineau MP, Keen H, Roemer FW. Imaging in Osteoarthritis. Rheum Dis Clin North Am 2008; 34:645-87. [DOI: 10.1016/j.rdc.2008.04.006] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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