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Toguchi K, Watanabe A, Horii M, Watanabe S, Itoh R, Sakamoto T, Murata Y, Ohtori S, Sasho T. Longitudinal Analysis of Knee Articular Cartilage Degeneration After Anterior Cruciate Ligament Reconstruction: Comparison of T1rho and T2 Mapping. Cartilage 2024:19476035241264013. [PMID: 39058092 DOI: 10.1177/19476035241264013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
OBJECTIVE To assess articular cartilage degeneration in anterior cruciate ligament (ACL) reconstructed knees as detected by MR T1rho and T2 mapping relative to controls and longitudinally at 3 months and 1 year after ACL reconstruction (ACLR). DESIGN Twenty-five patients with acute ACL injury were enrolled (13 women and 12 men; mean age 30.8), and 14 healthy controls were selected by sex and age matching. The affected knees of the ACLR participants were imaged using a 3.0T magnetic resonance (MR) scanner 3 months and 1 year after ACLR. Cartilage T1rho and T2 values were quantified for subcompartments in the full-thickness, superficial, and deep layers and were compared with the matched subcompartments of control knees. The influence of concomitant meniscal tears identified using proton density-weighted imaging (PDWI) was also investigated. RESULTS In the posterior lateral tibia, T1rho and T2 values were significantly higher in ACLR participants at 3 months and slightly decreased at 1-year compared to the control group. T1rho values in the medial compartment exhibited a significant increase at 1-year compared with those of control knees, while T2 showed no significance. In cartilage with medial meniscal tears, the T1rho values in multiple medial subcompartments were significantly higher than those in cartilage without medial meniscal tears, and this alteration was relatively detectable by T1rho. CONCLUSIONS T1rho and T2 mapping is effective in evaluating cartilage degeneration following ACLR. T1rho may exhibit greater sensitivity for assessing the progression of early degeneration in the medial compartment after ACLR.
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Affiliation(s)
- Kaoru Toguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Atsuya Watanabe
- Osteoarthritis Center, Medical Corporation Jyunhokai, Chiba, Japan
| | - Manato Horii
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shotaro Watanabe
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ryu Itoh
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takuya Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasuaki Murata
- Department of Orthopaedic Surgery, Teikyo University Chiba Medical Center, Chiba, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Takahisa Sasho
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
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Coletti C, Naaktgeboren R, Tourais J, Van De Steeg-Henzen C, Weingärtner S. Generalized inhomogeneity-resilient relaxation along a fictitious field (girRAFF) for improved robustness in rotating frame relaxometry at 3T. Magn Reson Med 2024. [PMID: 39046914 DOI: 10.1002/mrm.30219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 06/07/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE To optimize Relaxation along a Fictitious Field (RAFF) pulses for rotating frame relaxometry with improved robustness in the presence ofB 0 $$ {\mathrm{B}}_0 $$ andB 1 + $$ {\mathrm{B}}_1^{+} $$ field inhomogeneities. METHODS The resilience of RAFF pulses againstB 0 $$ {\mathrm{B}}_0 $$ andB 1 + $$ {\mathrm{B}}_1^{+} $$ inhomogeneities was studied using Bloch simulations. A parameterized extension of the RAFF formulation was introduced and used to derive a generalized inhomogeneity-resilient RAFF (girRAFF) pulse. RAFF and girRAFF preparation efficiency, defined as the ratio of the longitudinal magnetization before and after the preparation (M z ( T p ) / M 0 $$ {M}_z\left({T}_p\right)/{M}_0 $$ ), were simulated and validated in phantom experiments.T RAFF $$ {T}_{\mathrm{RAFF}} $$ andT girRAFF $$ {T}_{\mathrm{girRAFF}} $$ parametric maps were acquired at 3T in phantom, the calf muscle, and the knee cartilage of healthy subjects. The relaxation time maps were analyzed for resilience against artificially induced field inhomogeneities and assessed in terms of in vivo reproducibility. RESULTS Optimized girRAFF preparations yielded improved preparation efficiency (0.95/0.91 simulations/phantom) with respect to RAFF (0.36/0.67 simulations/phantom).T girRAFF $$ {T}_{\mathrm{girRAFF}} $$ preparations showed in phantom/calf 6.0/4.8 times higher resilience toB 0 $$ {\mathrm{B}}_0 $$ inhomogeneities than RAFF, and a 4.7/5.3 improved resilience toB 1 + $$ {\mathrm{B}}_1^{+} $$ inhomogeneities. In the knee cartilage,T girRAFF $$ {T}_{\mathrm{girRAFF}} $$ (53± $$ \pm $$ 14 ms) was higher thanT RAFF $$ {T}_{\mathrm{RAFF}} $$ (42± $$ \pm $$ 11 ms). Moreover, girRAFF preparations yielded 7.6/4.9 times improved reproducibility acrossB 0 $$ {\mathrm{B}}_0 $$ /B 1 + $$ {\mathrm{B}}_1^{+} $$ inhomogeneity conditions, 1.9 times better reproducibility across subjects and 1.2 times across slices compared with RAFF. Dixon-based fat suppression led to a further 15-fold improvement in the robustness of girRAFF to inhomogeneities. CONCLUSIONS RAFF pulses display residual sensitivity to off-resonance and pronounced sensitivity toB 1 + $$ {\mathrm{B}}_1^{+} $$ inhomogeneities. Optimized girRAFF pulses provide increased robustness and may be an appealing alternative for applications where resilience against field inhomogeneities is required.
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Affiliation(s)
- Chiara Coletti
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Roeland Naaktgeboren
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - Joao Tourais
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | | | - Sebastian Weingärtner
- Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
- HollandPTC, Delft, The Netherlands
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Mahendrakar P, Kumar D, Patil U. Comprehensive Study on Scoring and Grading Systems for Predicting the Severity of Knee Osteoarthritis. Curr Rheumatol Rev 2024; 20:133-156. [PMID: 37828677 DOI: 10.2174/0115733971253574231002074759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 10/14/2023]
Abstract
Knee Osteoarthritis (KOA) is a degenerative joint ailment characterized by cartilage loss, which can be seen using imaging modalities and converted into imaging features. The older population is the most affected by knee OA, which affects 16% of people worldwide who are 15 years of age and older. Due to cartilage tissue degradation, primary knee OA develops in older people. In contrast, joint overuse or trauma in younger people can cause secondary knee OA. Early identification of knee OA, according to research, may be a successful management tactic for the condition. Scoring scales and grading systems are important tools for the management of knee osteoarthritis as they allow clinicians to measure the progression of the disease's severity and provide suggestions on suitable treatment at identified stages. The comprehensive study reviews various subjective and objective knee evaluation scoring systems that effectively score and grade the KOA based on where defects or changes in articular cartilage occur. Recent studies reveal that AI-based approaches, such as that of DenseNet, integrating the concept of deep learning for scoring and grading the KOA, outperform various state-of-the-art methods in order to predict the KOA at an early stage.
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Affiliation(s)
- Pavan Mahendrakar
- Department of Computer Science and Engineering, B.L.D.E.A's V.P.Dr.P.G. Halakatti College of Engineering and Technology, Vijayapur, Karnataka, India
| | - Dileep Kumar
- Department of Computer Science and Engineering, Scientific Collaborations for Developing Markets United Imaging Healthcare, Shanghai, China
| | - Uttam Patil
- Jain College of Engineering, T.S Nagar, Hunchanhatti Road, Machhe, Belagavi, Karnataka, India
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Piccolo CL, Mallio CA, Vaccarino F, Grasso RF, Zobel BB. Imaging of knee osteoarthritis: a review of multimodal diagnostic approach. Quant Imaging Med Surg 2023; 13:7582-7595. [PMID: 37969633 PMCID: PMC10644136 DOI: 10.21037/qims-22-1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/22/2023] [Indexed: 11/17/2023]
Abstract
Knee osteoarthritis (KOA) is a common chronic condition among the elderly population that significantly affects the quality of life. Imaging is crucial in the diagnosis, evaluation, and management of KOA. This manuscript reviews the various imaging modalities available until now, with a little focus on the recent developments with Artificial Intelligence. Currently, radiography is the first-line imaging modality recommended for the diagnosis of KOA, owing to its wide availability, affordability, and ability to provide a clear view of bony components of the knee. Although radiography is useful in assessing joint space narrowing (JSN), osteophytes and subchondral sclerosis, it has limited effectiveness in detecting early cartilage damage, soft tissue abnormalities and synovial inflammation. Ultrasound is a safe and affordable imaging technique that can provide information on cartilage thickness, synovial fluid, JSN and osteophytes, though its ability to evaluate deep structures such as subchondral bone is limited. Magnetic resonance imaging (MRI) represents the optimal imaging modality to assess soft tissue structures. New MRI techniques are able to detect early cartilage damage measuring the T1ρ and T2 relaxation time of knee cartilage. Delayed gadolinium-enhanced MRI of cartilage, by injecting a contrast agent to enhance the visibility of the cartilage on MRI scans, can provide information about its integrity. Despite these techniques can provide valuable information about the biochemical composition of knee cartilage and can help detect early signs of osteoarthritis (OA), they may not be widely available. Computed tomography (CT) has restricted utility in evaluating OA; nonetheless, weight-bearing CT imaging, using the joint space mapping technique, exhibits potential in quantifying knee joint space width and detecting structural joint ailments. PET-MRI is a hybrid imaging technique able to combine morphological information on bone and soft tissue alterations with the biochemical changes, but more research is needed to justify its high cost and time involved. The new tools of artificial intelligence, including machine learning models, can assist in detecting patterns and correlations in KOA that may be useful in the diagnosis, grading, predicting the need for arthroplasty, and improving surgical accuracy.
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Affiliation(s)
- Claudia Lucia Piccolo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Roma, Italy
| | - Carlo Augusto Mallio
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Roma, Italy
- Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
| | - Federica Vaccarino
- Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
| | - Rosario Francesco Grasso
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Roma, Italy
- Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
| | - Bruno Beomonte Zobel
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, Roma, Italy
- Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma, Italy
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Abstract
PURPOSE OF REVIEW Imaging plays a pivotal role for diagnosis, follow-up and stratification of osteoarthritis patients in clinical trials and research. We aim to present an overview of currently available and emerging imaging techniques for osteoarthritis assessment and provide insight into relevant benefits and pitfalls of the different modalities. RECENT FINDINGS Although radiography is considered sufficient for a structural diagnosis of osteoarthritis and is commonly used to define eligibility of patients for participation in clinical trials, it has inherent limitations based on the projectional nature of the technique and inherent challenges regarding reproducibility in longitudinal assessment. MRI has changed our understanding of the disease from 'wear and tear' of cartilage to a whole organ disorder. MRI assessment of structural changes of osteoarthritis includes semi-quantitative, quantitative and compositional evaluation. Ultrasound is helpful in evaluating the degree of synovitis and has value in the assessment particularly of the patella-femoral joint. Recent development of computed tomography technology including weight-bearing systems has led to broader application of this technology in a research context. SUMMARY Advances in MRI technology have resulted in a significant improvement in understanding osteoarthritis as a multitissue disease.
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Affiliation(s)
- Majid Chalian
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Frank W Roemer
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine
- Department of Radiology, VA Boston Healthcare System, Boston, Massachusetts, USA
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Advanced MR Imaging for Knee Osteoarthritis: A Review on Local and Brain Effects. Diagnostics (Basel) 2022; 13:diagnostics13010054. [PMID: 36611346 PMCID: PMC9818324 DOI: 10.3390/diagnostics13010054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/13/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Knee osteoarthritis is one of the leading causes of chronic disability worldwide and is a significant social and economic burden on healthcare systems; hence it has become essential to develop methods to identify patients at risk for developing knee osteoarthritis at an early stage. Standard morphological MRI sequences are focused mostly on alterations seen in advanced stages of osteoarthritis. However, they possess low sensitivity for early, subtle, and potentially reversible changes of the degenerative process. In this review, we have summarized the state of the art with regard to innovative quantitative MRI techniques that exploit objective and quantifiable biomarkers to identify subtle alterations that occur in early stages of osteoarthritis in knee cartilage before any morphological alteration occurs and to capture potential effects on the brain. These novel MRI imaging tools are believed to have great potential for improving the current standard of care, but further research is needed to address limitations before these compositional techniques can be robustly applied in research and clinical settings.
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Bolcos PO, Mononen ME, Roach KE, Tanaka MS, Suomalainen JS, Mikkonen S, Nissi MJ, Töyräs J, Link TM, Souza R, Majumdar S, Ma B, Li X, Korhonen RK. Subject-specific biomechanical analysis to estimate locations susceptible to osteoarthritis-Finite element modeling and MRI follow-up of ACL reconstructed patients. J Orthop Res 2022; 40:1744-1755. [PMID: 34820897 PMCID: PMC9127000 DOI: 10.1002/jor.25218] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/16/2021] [Accepted: 11/09/2021] [Indexed: 02/04/2023]
Abstract
The aims of this case-control study were to: (1) Identify cartilage locations and volumes at risk of osteoarthritis (OA) using subject-specific finite element (FE) models; (2) Quantify the relationships between the simulated biomechanical parameters and T2 and T1ρ relaxation times of magnetic resonance imaging (MRI). We created subject-specific FE models for seven patients with anterior cruciate ligament (ACL) reconstruction and six controls based on a previous proof-of-concept study. We identified locations and cartilage volumes susceptible to OA, based on maximum principal stresses and absolute maximum shear strains in cartilage exceeding thresholds of 7 MPa and 32%, respectively. The locations and volumes susceptible to OA were compared qualitatively and quantitatively against 2-year longitudinal changes in T2 and T1ρ relaxation times. The degeneration volumes predicted by the FE models, based on excessive maximum principal stresses, were significantly correlated (r = 0.711, p < 0.001) with the degeneration volumes determined from T2 relaxation times. There was also a significant correlation between the predicted stress values and changes in T2 relaxation time (r = 0.649, p < 0.001). Absolute maximum shear strains and changes in T1ρ relaxation time were not significantly correlated. Five out of seven patients with ACL reconstruction showed excessive maximum principal stresses in either one or both tibial cartilage compartments, in agreement with follow-up information from MRI. Expectedly, for controls, the FE models and follow-up information showed no degenerative signs. Our results suggest that the presented modelling methodology could be applied to prospectively identify ACL reconstructed patients at risk of biomechanically driven OA, particularly by the analysis of maximum principal stresses of cartilage.
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Affiliation(s)
- Paul O. Bolcos
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Corresponding author: Paul Octavian Bolcos, Department of Applied Physics, University of Eastern Finland, POB 1627, FI-70211 Kuopio, Finland, Tel. +358 45 2290653,
| | - Mika E. Mononen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Koren E. Roach
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Matthew S. Tanaka
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | | | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Mikko J. Nissi
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Juha Töyräs
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia,Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio Finland
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Richard Souza
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Benjamin Ma
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, Unites States of America
| | - Xiaojuan Li
- Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Unites States of America
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
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8
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Emanuel KS, Kellner LJ, Peters MJM, Haartmans MJJ, Hooijmans MT, Emans PJ. The relation between the biochemical composition of knee articular cartilage and quantitative MRI: a systematic review and meta-analysis. Osteoarthritis Cartilage 2022; 30:650-662. [PMID: 34826570 DOI: 10.1016/j.joca.2021.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Early and non-invasive detection of osteoarthritis (OA) is required to enable early treatment and monitoring of interventions. Some of the earliest signs of OA are the change in proteoglycan and collagen composition. The aim of this study is to establish the relations between quantitative magnetic resonance imaging (MRI) and biochemical concentration and organization in knee articular cartilage. METHODS A preregistered systematic literature review was performed using the databases PubMed and Embase. Papers were included if quantitative MRI and a biochemical assay or polarized light microscopy (PLM) was performed on knee articular cartilage, and a quantified correlation was described. The extracted correlations were pooled using a random effects model. RESULTS 21 papers were identified. The strongest pooled correlation was found for delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) vs proteoglycan concentration (r = 0.59). T1ρ relaxation times are inversely correlated to proteoglycan concentration (r = -0.54). A weak correlation between T2 relaxation times and proteoglycans was found (r = -0.38). No correlation between T2 relaxation time and collagen concentration was found (r = -0.02). A heterogeneous set of correlations between T2 relaxation times and PLM were identified, including strong correlations to anisotropy. CONCLUSION DGEMRIC measures are significantly correlated to proteoglycan concentration. The needed contrast agent is however a disadvantage; the T1ρ sequence was found as a non-invasive alternative. Remarkably, no correlation was found between T2 relaxation times and collagen concentration. T2 relaxation times is related to organization, rather than concentration of collagen fibers. PROSPERO ID CRD42020168337.
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Affiliation(s)
- K S Emanuel
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - L J Kellner
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - M J M Peters
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - M J J Haartmans
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - M T Hooijmans
- Amsterdam UMC, University of Amsterdam, Department of Biomedical Engineering and Physics, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - P J Emans
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
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9
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Chalian M, Li X, Guermazi A, Obuchowski NA, Carrino JA, Oei EH, Link TM. The QIBA Profile for MRI-based Compositional Imaging of Knee Cartilage. Radiology 2021; 301:423-432. [PMID: 34491127 PMCID: PMC8574057 DOI: 10.1148/radiol.2021204587] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
MRI-based cartilage compositional analysis shows biochemical and microstructural changes at early stages of osteoarthritis before changes become visible with structural MRI sequences and arthroscopy. This could help with early diagnosis, risk assessment, and treatment monitoring of osteoarthritis. Spin-lattice relaxation time constant in rotating frame (T1ρ) and T2 mapping are the MRI techniques best established for assessing cartilage composition. Only T2 mapping is currently commercially available, which is sensitive to water, collagen content, and orientation of collagen fibers, whereas T1ρ is more sensitive to proteoglycan content. Clinical application of cartilage compositional imaging is limited by high variability and suboptimal reproducibility of the biomarkers, which was the motivation for creating the Quantitative Imaging Biomarkers Alliance (QIBA) Profile for cartilage compositional imaging by the Musculoskeletal Biomarkers Committee of the QIBA. The profile aims at providing recommendations to improve reproducibility and to standardize cartilage compositional imaging. The QIBA Profile provides two complementary claims (summary statements of the technical performance of the quantitative imaging biomarkers that are being profiled) regarding the reproducibility of biomarkers. First, cartilage T1ρ and T2 values are measurable at 3.0-T MRI with a within-subject coefficient of variation of 4%-5%. Second, a measured increase or decrease in T1ρ and T2 of 14% or more indicates a minimum detectable change with 95% confidence. If only an increase in T1ρ and T2 values is expected (progressive cartilage degeneration), then an increase of 12% represents a minimum detectable change over time. The QIBA Profile provides recommendations for clinical researchers, clinicians, and industry scientists pertaining to image data acquisition, analysis, and interpretation and assessment procedures for T1ρ and T2 cartilage imaging and test-retest conformance. This special report aims to provide the rationale for the proposed claims, explain the content of the QIBA Profile, and highlight the future needs and developments for MRI-based cartilage compositional imaging for risk prediction, early diagnosis, and treatment monitoring of osteoarthritis.
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Affiliation(s)
- Majid Chalian
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Xiaojuan Li
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Ali Guermazi
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Nancy A. Obuchowski
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - John A. Carrino
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Edwin H. Oei
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Thomas M. Link
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - for the RSNA QIBA MSK Biomarker Committee
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
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10
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Hafner T, Post M, Said O, Schad P, Schock J, Abrar DB, Knobe M, Kuhl C, Truhn D, Nebelung S. Identifying the imaging correlates of cartilage functionality based on quantitative MRI mapping - The collagenase exposure model. Acta Biomater 2020; 117:310-321. [PMID: 32980541 DOI: 10.1016/j.actbio.2020.09.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 01/05/2023]
Abstract
Cartilage functionality is determined by tissue structure and composition. If altered, cartilage is predisposed to premature degeneration. This pathomimetical study of early osteoarthritis evaluated the dose-dependant effects of collagenase-induced collagen disintegration and proteoglycan depletion on cartilage functionality as assessed by serial T1, T1ρ, T2, and T2* mapping under loading. 30 human femoral osteochondral samples underwent imaging on a clinical 3.0 T MRI scanner (Achieva, Philips) in the unloaded reference configuration (δ0) and under pressure-controlled quasi-static indentation loading to 15.1 N (δ1) and to 28.6 N (δ2). Imaging was performed before and after exposure to low (LC, 0.5 mg/mL; n = 10) or high concentration (HC, 1.5 mg/mL; n = 10) of collagenase. Untreated samples served as controls (n = 10). Loading responses were determined for the entire sample and the directly loaded (i.e. sub-pistonal) and bilaterally adjacent (i.e. peri‑pistonal) regions, referenced histologically, quantified as relative changes, and analysed using adequate parametric and non-parametric statistical tests. Dose-dependant surface disintegration and tissue loss were reflected by distinctly different pre- and post-exposure response-to-loading patterns. While T1 generally decreased with loading, regardless of collagenase exposure, T1ρ increased significantly after HC exposure (p = 0.008). Loading-induced decreases in T2 were significant after LC exposure (p = 0.006), while changes in T2* were ambiguous. In conclusion, aberrant loading-induced changes in T2 and T1ρ reflect moderate and severe matrix changes, respectively, and indicate the close interrelatedness of matrix changes and functionality in cartilage.
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Affiliation(s)
- Tobias Hafner
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology,D-52074 Aachen, Germany
| | - Manuel Post
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology,D-52074 Aachen, Germany
| | - Oliver Said
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology,D-52074 Aachen, Germany
| | - Philipp Schad
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology,D-52074 Aachen, Germany
| | - Justus Schock
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany; Institute of Computer Vision and Imaging, RWTH University Aachen, D-52074 Aachen, Germany
| | - Daniel Benjamin Abrar
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany
| | - Matthias Knobe
- Clinic for Orthopaedic and Trauma Surgery, Cantonal Hospital Luzern, CH-6004 Luzern, Switzerland
| | - Christiane Kuhl
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology,D-52074 Aachen, Germany
| | - Daniel Truhn
- Aachen University Hospital, Department of Diagnostic and Interventional Radiology,D-52074 Aachen, Germany
| | - Sven Nebelung
- University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany.
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11
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Franklin SP, Stoker AM, Lin ASP, Pownder SL, Burke EE, Bozynski CC, Kuroki K, Guldberg RE, Cook JL, Holmes SP. T1ρ, T2 mapping, and EPIC-µCT Imaging in a Canine Model of Knee Osteochondral Injury. J Orthop Res 2020; 38:368-377. [PMID: 31429976 DOI: 10.1002/jor.24450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 08/02/2019] [Indexed: 02/04/2023]
Abstract
The dog is the most commonly used large animal model for the study of osteoarthritis. Optimizing methods for assessing cartilage health would prove useful in reducing the number of dogs needed for a valid study of osteoarthritis and cartilage repair. Twelve beagles had critical-sized osteochondral defects created in the medial femoral condyle of both knees. Eight dogs had T1ρ and T2 magnetic resonance imaging (MRI) performed approximately 6 months after defect creation. Following MRI evaluations, all 12 dogs were humanely euthanatized and cartilage samples were obtained from the medial and lateral femoral condyles, medial and lateral tibial plateaus, trochlear groove, and patella for proteoglycan and collagen quantification. Equilibrium partitioning of an ionic contrast (EPIC)-µCT was then performed followed by the histologic assessment of the knees. Correlations between T1ρ, T2, EPIC-µCT and proteoglycan, collagen, and histology scores were assessed using a multivariate analysis accounting for correlations from samples within the same knee and in the same dog. Pearson's correlation coefficients were calculated to assess the strength of significant relationships. Correlations between µCT values and biochemical or histologic assessment were weak to moderately strong (0.09-0.41; p < 0.0001-0.66). There was a weak correlation between the T2 values and cartilage proteoglycan (-0.32; p = 0.04). The correlation between T1ρ values and cartilage proteoglycan were moderately strong (-0.38; p < 0.05) while the strongest correlation was between the T1ρ values and histological assessment of cartilage with a correlation coefficient of 0.58 (p < 0.0001). These data suggest that T1ρ shows promise for possible utility in the translational study of cartilage health and warrants further development in this species. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:368-377, 2020.
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Affiliation(s)
- Samuel P Franklin
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia.,Regenerative Bioscience Center, University of Georgia, Athens, Georgia
| | - Aaron M Stoker
- Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
| | - Angela S P Lin
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, Oregon
| | - Sarah L Pownder
- MRI Laboratory, Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Emily E Burke
- Veterinary Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Chantelle C Bozynski
- Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
| | - Kei Kuroki
- Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
| | - Robert E Guldberg
- Knight Campus for Accelerating Scientific Impact, University of Oregon, Eugene, Oregon
| | - James L Cook
- Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri
| | - Shannon P Holmes
- Veterinary Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, Athens, Georgia
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12
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Sherman SL, Raines BT, Burch MB, Ray T, Shubin Stein BE. Patellofemoral Imaging and Analysis. OPER TECHN SPORT MED 2019. [DOI: 10.1016/j.otsm.2019.150684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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13
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Martín Noguerol T, Raya JG, Wessell DE, Vilanova JC, Rossi I, Luna A. Functional MRI for evaluation of hyaline cartilage extracelullar matrix, a physiopathological-based approach. Br J Radiol 2019; 92:20190443. [PMID: 31433668 DOI: 10.1259/bjr.20190443] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
MRI of articular cartilage (AC) integrity has potential to become a biomarker for osteoarthritis progression. Traditional MRI sequences evaluate AC morphology, allowing for the measurement of thickness and its change over time. In the last two decades, more advanced, dedicated MRI cartilage sequences have been developed aiming to assess AC matrix composition non-invasively and detect early changes in cartilage not captured on morphological sequences. T2-mapping and T1ρ sequences can be used to estimate the relaxation times of water inside the AC. These sequences have been introduced into clinical protocols and show promising results for cartilage assessment. Extracelullar matrix can also be assessed using diffusion-weighted imaging and diffusion tensor imaging as the movement of water is limited by the presence of extracellular matrix in AC. Specific techniques for glycosaminoglycans (GAG) evaluation, such as delayed gadolinium enhanced MRI of cartilage or Chemical Exchange Saturation Transfer imaging of GAG, as well as sodium imaging have also shown utility in the detection of AC damage. This manuscript provides an educational update on the physical principles behind advanced AC MRI techniques as well as a comprehensive review of the strengths and weaknesses of each approach. Current clinical applications and potential future applications of these techniques are also discussed.
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Affiliation(s)
| | - Jose G Raya
- Department of Radiology, NYU School of Medicine, NY, USA
| | | | - Joan C Vilanova
- Department of Radiology, Clínica Girona. Institute Diagnostic Imaging (IDI), University of Girona, Girona, Spain
| | | | - Antonio Luna
- MRI unit, Radiology department, Health Time, Jaén, Spain
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14
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Kondo S, Nakagawa Y, Mizuno M, Katagiri K, Tsuji K, Kiuchi S, Ono H, Muneta T, Koga H, Sekiya I. Transplantation of Aggregates of Autologous Synovial Mesenchymal Stem Cells for Treatment of Cartilage Defects in the Femoral Condyle and the Femoral Groove in Microminipigs. Am J Sports Med 2019; 47:2338-2347. [PMID: 31306591 DOI: 10.1177/0363546519859855] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. PURPOSE To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. STUDY DESIGN Controlled laboratory study. METHODS Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. RESULTS Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. CONCLUSION Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. CLINICAL RELEVANCE Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.
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Affiliation(s)
- Shimpei Kondo
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.,Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mitsuru Mizuno
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenta Katagiri
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | | | | | - Takeshi Muneta
- National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
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15
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Li Z, Wang H, Lu Y, Jiang M, Chen Z, Xi X, Ding X, Yan F. Diagnostic value of T1ρ and T2 mapping sequences of 3D fat-suppressed spoiled gradient (FS SPGR-3D) 3.0-T magnetic resonance imaging for osteoarthritis. Medicine (Baltimore) 2019; 98:e13834. [PMID: 30608398 PMCID: PMC6344148 DOI: 10.1097/md.0000000000013834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Three-dimensional fat-suppressed spoiled gradient magnetic resonance imaging can be used to observe cartilages with high resolution.To quantify and compare the T1ρ and T2 relaxation times of the knee articular cartilage between healthy asymptomatic adults and patients with osteoarthritis (OA).This was a retrospective study of 53 patients with symptomatic OA (6 males and 47 females; aged 57.6 ± 10.0 years) and 26 healthy adults (11 males and 15 females; aged 31.7 ± 12.2 years) from the Ruijin Hospital. T1ρ and T2 relaxation times of knee cartilage were quantified using sagittal multi-echo T1ρ and T2 mapping sequences (3.0-T scanner) and analyzed by receiver operating characteristic (ROC) curve.T1ρ and T2 relaxation times in the OA group were higher than in controls (both P < .01). The sensitivity, specificity, and critical value for differentiating normal from OA cartilage were respectively 92%, 85.6%, and 45.90 ms for T1ρ, and 93.6%, 93.3%, and 50.42 ms for T2. T2 mapping sequence showed a higher area under the ROC curve (AUC) than T1ρ (0.965 vs 0.927, P = .02). The AUC for differentiating normal from Noyes IIA cartilage was 0.922 for T1ρ (cut-off: 46.0; sensitivity: 87.7%; specificity: 89.7%) and 0.954 for T2 (cut-off: 49.5; sensitivity: 91.2%; specificity: 92.3%), with no significant difference between them (P = .08).Both T1ρ and T2 mapping sequences could be used to assess OA cartilage lesions, with T2 mapping sequence demonstrating significant sensitivity for cartilage degeneration. These 2 sequences could also identify early-stage OA cartilage.
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Affiliation(s)
| | | | | | | | | | - Xiaobing Xi
- Orthopedics and Traumatology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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16
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Collins AT, Kulvaranon ML, Cutcliffe HC, Utturkar GM, Smith WAR, Spritzer CE, Guilak F, DeFrate LE. Obesity alters the in vivo mechanical response and biochemical properties of cartilage as measured by MRI. Arthritis Res Ther 2018; 20:232. [PMID: 30333058 PMCID: PMC6235204 DOI: 10.1186/s13075-018-1727-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/19/2018] [Indexed: 01/17/2023] Open
Abstract
Background Obesity is a primary risk factor for the development of knee osteoarthritis (OA). However, there remains a lack of in vivo data on the influence of obesity on knee cartilage mechanics and composition. The purpose of this study was to determine the relationship between obesity and tibiofemoral cartilage properties. Methods Magnetic resonance images (3T) of cartilage geometry (double-echo steady-state) and T1rho relaxation of the knee were obtained in healthy subjects with a normal (n = 8) or high (n = 7) body mass index (BMI) before and immediately after treadmill walking. Subjects had no history of lower limb injury or surgery. Bone and cartilage surfaces were segmented and three-dimensional models were created to measure cartilage thickness and strain. T1rho relaxation times were measured before exercise in both the tibial and femoral cartilage in order to characterize biochemical composition. Body fat composition was also measured. Results Subjects with a high BMI exhibited significantly increased tibiofemoral cartilage strain and T1rho relaxation times (P <0.05). Tibial pre-exercise cartilage thickness was also affected by BMI (P <0.05). Correlational analyses revealed that pre-exercise tibial cartilage thickness decreased with increasing BMI (R2 = 0.43, P <0.01) and body fat percentage (R2 = 0.58, P <0.01). Tibial and femoral cartilage strain increased with increasing BMI (R2 = 0.45, P <0.01; R2 = 0.51, P <0.01, respectively) and increasing body fat percentage (R2 = 0.40, P <0.05; R2 = 0.38, P <0.05, respectively). Additionally, tibial T1rho was positively correlated with BMI (R2 = 0.39, P <0.05) and body fat percentage (R2 = 0.47, P <0.01). Conclusions Strains and T1rho relaxation times in the tibiofemoral cartilage were increased in high BMI subjects compared with normal BMI subjects. Additionally, pre-exercise tibial cartilage thickness decreased with obesity. Reduced proteoglycan content may be indicative of pre-symptomatic osteoarthritic degeneration, resulting in reduced cartilage thickness and increased deformation of cartilage in response to loading.
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Affiliation(s)
- Amber T Collins
- Department of Orthopaedic Surgery, Duke University, Box 3093, Duke University Medical Center, Durham, NC, 27710, USA
| | - Micaela L Kulvaranon
- Department of Orthopaedic Surgery, Duke University, Box 3093, Duke University Medical Center, Durham, NC, 27710, USA
| | - Hattie C Cutcliffe
- Department of Orthopaedic Surgery, Duke University, Box 3093, Duke University Medical Center, Durham, NC, 27710, USA.,Department of Biomedical Engineering, Duke University, Campus Box 90281, 101 Science Drive, Durham, 27708, NC, USA
| | - Gangadhar M Utturkar
- Department of Orthopaedic Surgery, Duke University, Box 3093, Duke University Medical Center, Durham, NC, 27710, USA
| | - Wyatt A R Smith
- Department of Orthopaedic Surgery, Duke University, Box 3093, Duke University Medical Center, Durham, NC, 27710, USA
| | - Charles E Spritzer
- Department of Radiology, Duke University, Box 3808, Duke University Medical Center, Durham, 27710, NC, USA
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Washington University and Shriners Hospitals for Children, Campus Box 8233, Couch Research Building, Room 3121, St. Louis, 63110, MO, USA
| | - Louis E DeFrate
- Department of Orthopaedic Surgery, Duke University, Box 3093, Duke University Medical Center, Durham, NC, 27710, USA. .,Department of Biomedical Engineering, Duke University, Campus Box 90281, 101 Science Drive, Durham, 27708, NC, USA. .,Department of Mechanical Engineering and Materials Science, Duke University, Campus Box 90300, Hudson Hall, Durham, 27708, NC, USA.
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17
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Selective Enzymatic Digestion of Proteoglycans and Collagens Alters Cartilage T1rho and T2 Relaxation Times. Ann Biomed Eng 2018; 47:190-201. [PMID: 30288634 DOI: 10.1007/s10439-018-02143-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 09/26/2018] [Indexed: 12/21/2022]
Abstract
Our objective was to determine the relationship of T1rho and T2 relaxation mapping to the biochemical and biomechanical properties of articular cartilage through selective digestion of proteoglycans and collagens. Femoral condyles were harvested from porcine knee joints and treated with either chondroitinase ABC (cABC) followed by collagenase, or collagenase followed by cABC. Magnetic resonance images were acquired and cartilage explants were harvested for biochemical, biomechanical, and histological analyses before and after each digestion. Targeted enzymatic digestion of proteoglycans with cABC resulted in elevated T1rho relaxation times and decreased sulfated glycosaminoglycan content without affecting T2 relaxation times. In contrast, extractable collagen and T2 relaxation times were increased by collagenase digestion; however, neither was altered by cABC digestion. Aggregate modulus decreased with digestion of both components. Overall, we found that targeted digestion of proteoglycans and collagens had varying effects on biochemical, biomechanical, and imaging properties. T2 relaxation times were altered with changes in extractable collagen, but not changes in proteoglycan. However, T1rho relaxation times were altered with proteoglycan loss, which may also coincide with collagen disruption. Since it is unclear which matrix components are disrupted first in osteoarthritis, both markers may be important for tracking disease progression.
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18
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D'Este M, Eglin D, Alini M. Lessons to be learned and future directions for intervertebral disc biomaterials. Acta Biomater 2018; 78:13-22. [PMID: 30092378 DOI: 10.1016/j.actbio.2018.08.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/16/2018] [Accepted: 08/04/2018] [Indexed: 02/07/2023]
Abstract
Biomaterials science has achieved significant advancements for the replacement, repair and regeneration of intervertebral disc tissues. However, the translation of this research to the clinic presents hurdles. The goal of this paper is to identify strategies to recapitulate the intrinsic complexities of the intervertebral disc, to highlight the unresolved issues in basic knowledge hindering the clinical translation, and finally to report on the emerging technologies in the biomaterials field. On this basis, we identify promising research directions, with the hope of stimulating further debate and advances for resolving clinical problems such as cervical and low back pain using biomaterial-based approaches. STATEMENT OF SIGNIFICANCE Although not life-threatening, intervertebral disc disorders have enormous impact on life quality and disability. Disc function within the human body is mainly mechanical, and therefore the use of biomaterials to rescue disc function and alleviate pain is logical. Despite intensive research, the clinical translation of biomaterial-based therapies is hampered by the intrinsic complexity of this organ. After decades of development, artificial discs or tissue replacements are still niche applications given their issues of integration and displacement with detrimental consequences. The struggles of biological therapies and tissue engineering are therefore understandable. However, recent advances in biomaterial science give new hope. In this paper we identify the most promising new directions for intervertebral disc biomaterials.
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19
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Multiparametric MRI and Computational Modelling in the Assessment of Human Articular Cartilage Properties: A Comprehensive Approach. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9460456. [PMID: 29862300 PMCID: PMC5976938 DOI: 10.1155/2018/9460456] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 04/08/2018] [Indexed: 12/26/2022]
Abstract
Quantitative magnetic resonance imaging (qMRI) is a promising approach to detect early cartilage degeneration. However, there is no consensus on which cartilage component contributes to the tissue's qMRI signal properties. T1, T1ρ, and T2⁎ maps of cartilage samples (n = 8) were generated on a clinical 3.0-T MRI system. All samples underwent histological assessment to ensure structural integrity. For cross-referencing, a discretized numerical model capturing distinct compositional and structural tissue properties, that is, fluid fraction (FF), proteoglycan (PG) and collagen (CO) content and collagen fiber orientation (CFO), was implemented. In a pixel-wise and region-specific manner (central versus peripheral region), qMRI parameter values and modelled tissue parameters were correlated and quantified in terms of Spearman's correlation coefficient ρs. Significant correlations were found between modelled compositional parameters and T1 and T2⁎, in particular in the central region (T1: ρs ≥ 0.7 [FF, CFO], ρs ≤ −0.8 [CO, PG]; T2⁎: ρs ≥ 0.67 [FF, CFO], ρs ≤ −0.71 [CO, PG]). For T1ρ, correlations were considerably weaker and fewer (0.16 ≤ ρs ≤ −0.15). QMRI parameters are characterized in their biophysical properties and their sensitivity and specificity profiles in a basic scientific context. Although none of these is specific towards any particular cartilage constituent, T1 and T2⁎ reflect actual tissue compositional features more closely than T1ρ.
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20
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Nebelung S, Sondern B, Jahr H, Tingart M, Knobe M, Thüring J, Kuhl C, Truhn D. Non-invasive T1ρ mapping of the human cartilage response to loading and unloading. Osteoarthritis Cartilage 2018; 26:236-244. [PMID: 29175373 DOI: 10.1016/j.joca.2017.11.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 09/21/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To define the physiological response to sequential loading and unloading in histologically intact human articular cartilage using serial T1ρ mapping, as T1ρ is considered to indicate the tissue's macromolecular content. METHOD 18 macroscopically intact cartilage-bone samples were obtained from the central lateral femoral condyles of 18 patients undergoing total knee replacement. Serial T1ρ mapping was performed on a clinical 3.0-T MRI system using a modified prostate coil. Spin-lock multiple gradient-echo sequences prior to, during and after standardized indentation loading (displacement controlled, strain 20%) were used to obtain seven serial T1ρ maps: unloaded (δ0), quasi-statically loaded (indentation1-indentation3) and under subsequent relaxation (relaxation1-relaxation3). After manual segmentation, zonal and regional regions-of-interest were defined. ROI-specific relative changes were calculated and statistically assessed using paired t-tests. Histological (Mankin classification) and biomechanical (unconfined compression) evaluations served as references. RESULTS All samples were histologically and biomechanically grossly intact (Mankin sum: 1.8 ± 1.2; Young's Modulus: 0.7 ± 0.4 MPa). Upon loading, T1ρ consistently increased throughout the entire sample thickness, primarily subpistonally (indentation1 [M ± SD]: 9.5 ± 7.8% [sub-pistonal area, SPA] vs 4.2 ± 5.8% [peri-pistonal area, PPA]; P < 0.001). T1ρ further increased with ongoing loading (indentation3: 14.1 ± 8.1 [SPA] vs 7.7 ± 5.9% [PPA]; P < 0.001). Even upon unloading (i.e., relaxation), T1ρ persistently increased in time. CONCLUSION Serial T1ρ-mapping reveals distinct and complex zonal and regional changes in articular cartilage as a function of loading and unloading. Thereby, longitudinal adaptive processes in hyaline cartilage become evident, which may be used for the tissue's non-invasive functional characterization by T1ρ.
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Affiliation(s)
- S Nebelung
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany.
| | - B Sondern
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany.
| | - H Jahr
- Department of Orthopaedics, Aachen University Hospital, Aachen, Germany.
| | - M Tingart
- Department of Orthopaedics, Aachen University Hospital, Aachen, Germany.
| | - M Knobe
- Department of Orthopaedic Trauma, Aachen University Hospital, Aachen, Germany.
| | - J Thüring
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany.
| | - C Kuhl
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany.
| | - D Truhn
- Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany.
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Pathria MN, Chung CB, Resnick DL. Acute and Stress-related Injuries of Bone and Cartilage: Pertinent Anatomy, Basic Biomechanics, and Imaging Perspective. Radiology 2017; 280:21-38. [PMID: 27322971 DOI: 10.1148/radiol.16142305] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Bone or cartilage, or both, are frequently injured related to either a single episode of trauma or repetitive overuse. The resulting structural damage is varied, governed by the complex macroscopic and microscopic composition of these tissues. Furthermore, the biomechanical properties of both cartilage and bone are not uniform, influenced by the precise age and activity level of the person and the specific anatomic location within the skeleton. Of the various histologic components that are found in cartilage and bone, the collagen fibers and bundles are most influential in transmitting the forces that are applied to them, explaining in large part the location and direction of the resulting internal stresses that develop within these tissues. Therefore, thorough knowledge of the anatomy, physiology, and biomechanics of normal bone and cartilage serves as a prerequisite to a full understanding of both the manner in which these tissues adapt to physiologic stresses and the patterns of tissue failure that develop under abnormal conditions. Such knowledge forms the basis for more accurate assessment of the diverse imaging features that are encountered following acute traumatic and stress-related injuries to the skeleton. (©) RSNA, 2016.
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Affiliation(s)
- Mini N Pathria
- From the Department of Radiology (M.N.P.) and Radiology Service, VA San Diego Healthcare System (C.B.C.), UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103; and Department of Radiology, UCSD Teleradiology and Education Center, La Jolla, Calif (D.L.R.)
| | - Christine B Chung
- From the Department of Radiology (M.N.P.) and Radiology Service, VA San Diego Healthcare System (C.B.C.), UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103; and Department of Radiology, UCSD Teleradiology and Education Center, La Jolla, Calif (D.L.R.)
| | - Donald L Resnick
- From the Department of Radiology (M.N.P.) and Radiology Service, VA San Diego Healthcare System (C.B.C.), UC San Diego Medical Center, 200 W Arbor Dr, San Diego, CA 92103; and Department of Radiology, UCSD Teleradiology and Education Center, La Jolla, Calif (D.L.R.)
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22
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Lakin BA, Snyder BD, Grinstaff MW. Assessing Cartilage Biomechanical Properties: Techniques for Evaluating the Functional Performance of Cartilage in Health and Disease. Annu Rev Biomed Eng 2017; 19:27-55. [DOI: 10.1146/annurev-bioeng-071516-044525] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Benjamin A. Lakin
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
| | - Brian D. Snyder
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215
- Orthopedic Center, Children's Hospital, Boston, Massachusetts 02115
| | - Mark W. Grinstaff
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts 02215
- Department of Chemistry, Boston University, Boston, Massachusetts 02215
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23
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Hu J, Zhang Y, Duan C, Peng X, Hu P, Lu H. Feasibility study for evaluating early lumbar facet joint degeneration using axial T 1 ρ, T 2 , and T2* mapping in cartilage. J Magn Reson Imaging 2017; 46:468-475. [PMID: 28152249 DOI: 10.1002/jmri.25596] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 11/22/2016] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To assess the feasibility of axial T2 , T2*, and T1 ρ mapping of lumbar facet joint (LFJ) cartilage for evaluation of early degeneration. MATERIALS AND METHODS We examined a total of 176 LFJs from 21 volunteers using axial T2 , T2*, and T1 ρ mapping with a 3.0T magnetic resonance imaging (MRI) scanner. All LFJs were measured and grouped according to the presence of low back pain (LBP), the Weishaupt grading system, and the Pfirrmann grade of the adjacent intervertebral disk (IVD). T2 , T2*, and T1 ρ values were analyzed and compared among the different groups. RESULTS Low interobserver agreement was found in the Weishaupt grading of LFJs (κ = 0.161). The T1 ρ values of LFJs were significantly different between adjacent two Pfirrmann grade of disks (grade I 50.15 ± 3.63 msec / grade II 53.27 ± 3.80 msec, P = 0.002; grade II 53.27 ± 3.80 msec / grade III 58.40 ± 4.17 msec, P < 0.01), and in different Weishaupt grades of LFJs (P = 0.000). T2* values were only found significantly different between Pfirrmann grade I and III of disks (P = 0.048). There was no significant difference in T2 values of LFJs whatever in Pfirrmann (P = 0.556) or Weishaupt grades (P = 0.694). No significant difference was found in T2 , T2*, and T1 ρ values between volunteers with LBP and without LBP (PT2 = 0.783, PT2*=0.311, PT1 ρ = 0.259). CONCLUSION Axial T1 ρ could be an effective and sensitive method to assess for early degenerative changes in LFJ cartilage. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:468-475.
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Affiliation(s)
- Jianzhong Hu
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Yi Zhang
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Chunyue Duan
- Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Xianjing Peng
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Ping Hu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
| | - Hongbin Lu
- Department of Sports Medicine and Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, PR China
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Link TM, Neumann J, Li X. Prestructural cartilage assessment using MRI. J Magn Reson Imaging 2016; 45:949-965. [PMID: 28019053 DOI: 10.1002/jmri.25554] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 10/25/2016] [Indexed: 12/20/2022] Open
Abstract
Cartilage loss is irreversible, and to date, no effective pharmacotherapies are available to protect or regenerate cartilage. Quantitative prestructural/compositional MR imaging techniques have been developed to characterize the cartilage matrix quality at a stage where abnormal findings are early and potentially reversible, allowing intervention to halt disease progression. The goal of this article is to critically review currently available technologies, present the basic concept behind these techniques, but also to investigate their suitability as imaging biomarkers including their validity, reproducibility, risk prediction and monitoring of therapy. Moreover, we highlighted important clinical applications. This review article focuses on the currently most relevant and clinically applicable technologies, such as T2 mapping, T2*, T1ρ, delayed gadolinium enhanced MRI of cartilage (dGEMRIC), sodium imaging and glycosaminoglycan chemical exchange saturation transfer (gagCEST). To date, most information is available for T2 and T1ρ mapping. dGEMRIC has also been used in multiple clinical studies, although it requires Gd contrast administration. Sodium imaging and gagCEST are promising technologies but are dependent on high field strength and sophisticated software and hardware. LEVEL OF EVIDENCE 5 J. Magn. Reson. Imaging 2017;45:949-965.
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Affiliation(s)
- Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Jan Neumann
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, California, USA
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25
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Palukuru UP, Hanifi A, McGoverin CM, Devlin S, Lelkes PI, Pleshko N. Near infrared spectroscopic imaging assessment of cartilage composition: Validation with mid infrared imaging spectroscopy. Anal Chim Acta 2016; 926:79-87. [PMID: 27216396 DOI: 10.1016/j.aca.2016.04.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 04/16/2016] [Indexed: 11/18/2022]
Abstract
Disease or injury to articular cartilage results in loss of extracellular matrix components which can lead to the development of osteoarthritis (OA). To better understand the process of disease development, there is a need for evaluation of changes in cartilage composition without the requirement of extensive sample preparation. Near infrared (NIR) spectroscopy is a chemical investigative technique based on molecular vibrations that is increasingly used as an assessment tool for studying cartilage composition. However, the assignment of specific molecular vibrations to absorbance bands in the NIR spectrum of cartilage, which arise from overtones and combinations of primary absorbances in the mid infrared (MIR) spectral region, has been challenging. In contrast, MIR spectroscopic assessment of cartilage is well-established, with many studies validating the assignment of specific bands present in MIR spectra to specific molecular vibrations. In the current study, NIR imaging spectroscopic data were obtained for compositional analysis of tissues that served as an in vitro model of OA. MIR spectroscopic data obtained from the identical tissue regions were used as the gold-standard for collagen and proteoglycan (PG) content. MIR spectroscopy in transmittance mode typically requires a much shorter pathlength through the sample (≤10 microns thick) compared to NIR spectroscopy (millimeters). Thus, this study first addressed the linearity of small absorbance bands in the MIR region with increasing tissue thickness, suitable for obtaining a signal in both the MIR and NIR regions. It was found that the linearity of specific, small MIR absorbance bands attributable to the collagen and PG components of cartilage (at 1336 and 856 cm(-1), respectively) are maintained through a thickness of 60 μm, which was also suitable for NIR data collection. MIR and NIR spectral data were then collected from 60 μm thick samples of cartilage degraded with chondroitinase ABC as a model of OA. Partial least squares (PLS) regression using NIR spectra as input predicted the MIR-determined compositional parameters of PG/collagen within 6% of actual values. These results indicate that NIR spectral data can be used to assess molecular changes that occur with cartilage degradation, and further, the data provide a foundation for future clinical studies where NIR fiber optic probes can be used to assess the progression of cartilage degradation.
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Affiliation(s)
- Uday P Palukuru
- Department of Bioengineering, Temple University, 1947 N. 12th St, Philadelphia, PA, USA
| | - Arash Hanifi
- Department of Bioengineering, Temple University, 1947 N. 12th St, Philadelphia, PA, USA
| | - Cushla M McGoverin
- Department of Bioengineering, Temple University, 1947 N. 12th St, Philadelphia, PA, USA
| | - Sean Devlin
- Department of Bioengineering, Temple University, 1947 N. 12th St, Philadelphia, PA, USA
| | - Peter I Lelkes
- Department of Bioengineering, Temple University, 1947 N. 12th St, Philadelphia, PA, USA
| | - Nancy Pleshko
- Department of Bioengineering, Temple University, 1947 N. 12th St, Philadelphia, PA, USA.
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26
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Shen S, Wang H, Zhang J, Wang F, Chen M. T1ρ magnetic resonance imaging quantification of early articular cartilage degeneration in a rabbit model. BMC Musculoskelet Disord 2015; 16:361. [PMID: 26585246 PMCID: PMC4653945 DOI: 10.1186/s12891-015-0810-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 11/10/2015] [Indexed: 11/10/2022] Open
Abstract
Background Osteoarthritis (OA) is a serious problem in the recent aging society, and early diagnosis and intervention of articular cartilage degeneration are very important for the onset of OA. Therefore, development of newer MRI techniques is necessary and expected for detection of early articular cartilage degeneration. Methods 24 rabbits were randomly divided into four equal experimental groups (Group A, B, C, D) to establish articular cartilage models in different grades of early degeneration by injecting papain into the left knee joint cavity. Another 8 rabbits were considered as blank control (Group E), and then randomized into four subgroups (EA, EB, EC, ED). T1ρ and T2-weighted images of the bilateral knee joints were obtained for rabbits by using 3.0 T MRI. Group A, B, C, and D were imaged respectively at 1, 2, 3, and 4 weeks post-operation, and EA, EB, EC, ED underwent the same period imaging. Rabbits were sacrificed after scanning and the femoral condyle cartilage (FCC) was histological examined. T1ρ values of the femoral condyle cartilage were measured and statistically analyzed, and contrasted with the histologic results. Results T1ρ values of the left side in experimental groups were significantly higher than the right side (P < 0.05), and which increased gradually with the passage of post-operation time (P < 0.05). Histological examination demonstrated the proteoglycan content of the left side decreased, and indicated the occurrence of early degeneration. Conclusions T1ρ MRI can sensitively and quantitatively reflect the change in proteoglycans prior to the morphologic alterations of articular cartilage, and T1ρ value is gradually increased with a decrease in proteoglycan content, therefore that T1ρ could potentially act as a reliable tool to identify early cartilage degeneration.
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Affiliation(s)
- Si Shen
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Hao Wang
- Pain Clinic, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Jing Zhang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Fei Wang
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
| | - Meng Chen
- Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
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27
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Che X, Chi L, Park CY, Cho GH, Park N, Kim SG, Lee BH, Choi JY. A novel method to detect articular chondrocyte death during early stages of osteoarthritis using a non-invasive ApoPep-1 probe. Arthritis Res Ther 2015; 17:309. [PMID: 26530111 PMCID: PMC4632461 DOI: 10.1186/s13075-015-0832-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 10/21/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction Current methods for early diagnosis of osteoarthritis (OA) are limited. We assessed whether in vivo detection of chondrocyte death by ApoPep-1 (CQRPPR), a peptide that binds to histone H1 of apoptotic and necrotic cells, could be used to detect the initiation of OA. Methods Apoptosis-induced ATDC5 cells were labeled with Annexin V and ApoPep-1. Surgical destabilization of the medial meniscus (DMM) was performed on both knees of 12-week-old male mice and severity of OA was determined by histological analysis according to the Osteoarthritis Research Society International (OARSI) guidelines. At 1, 2, 4, and 8 weeks post-surgery, mice were intravenously injected with fluorescence-labeled ApoPep-1 or control peptide and in vivo imaging was performed within 30 minutes of injection by near-infrared fluorescence (NIRF). Binding of ApoPep-1 to OA joints was demonstrated by ex vivo imaging and immunofluorescent staining using TUNEL and histone H1 and type II collagen antibodies. Results Strong signals of ApoPep-1 were observed on the apoptotic ATDC5 cells. Knees corresponded to grade II, III, and V OA at 2, 4, and 8 weeks after DMM, respectively. Between 2 and 8 weeks after surgery, the in vivo NIRF signal at OA-ApoPep1-injected joints was consistently stronger than sham-operated or OA-control peptide-injected joints. ApoPep-1, TUNEL, and histone H1 signals were stronger in grade II OA cartilage than sham-operated cartilage when detected by immunofluorescent staining. Type II collagen expression was similar between grade II OA and sham group. Conclusion ApoPep-1 can be used to detect OA in vivo by binding to apoptotic chondrocytes. This is a novel, sensitive, and rapid method which can detect apoptotic cells in OA rodent models soon after its onset.
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Affiliation(s)
- Xiangguo Che
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
| | - Lianhua Chi
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
| | - Clara Yongjoo Park
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
| | - Gyoung-Ho Cho
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
| | - Narae Park
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 210-702, Republic of Korea.
| | - Byung-Heon Lee
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
| | - Je-Yong Choi
- Department of Biochemistry and Cell Biology, Kyungpook National University School of Medicine, Daegu, 700-422, Republic of Korea.
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Nakagawa Y, Sekiya I, Kondo S, Tabuchi T, Ichinose S, Koga H, Tsuji K, Muneta T. Relationship between MRIT1rho value and histological findings of intact and radially incised menisci in microminipigs. J Magn Reson Imaging 2015; 43:434-45. [DOI: 10.1002/jmri.24988] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 06/12/2015] [Indexed: 01/10/2023] Open
Affiliation(s)
- Yusuke Nakagawa
- Department of Joint Surgery and Sports Medicine; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | - Ichiro Sekiya
- Center for Stem Cell and Regenerative Medicine; Tokyo Medical and Dental University; Tokyo Japan
| | - Shimpei Kondo
- Department of Joint Surgery and Sports Medicine; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | | | - Shizuko Ichinose
- Research Center for Medical and Dental Sciences, Tokyo Medical and Dental University; Tokyo Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | - Kunikazu Tsuji
- Department of Cartilage Regeneration; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
| | - Takeshi Muneta
- Department of Joint Surgery and Sports Medicine; Graduate School, Tokyo Medical and Dental University; Tokyo Japan
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Zaid M, Lansdown D, Su F, Pedoia V, Tufts L, Rizzo S, Souza RB, Li X, Ma CB. Abnormal tibial position is correlated to early degenerative changes one year following ACL reconstruction. J Orthop Res 2015; 33:1079-86. [PMID: 25721417 PMCID: PMC7238841 DOI: 10.1002/jor.22867] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 02/08/2015] [Indexed: 02/04/2023]
Abstract
Altered knee kinematics following ACL reconstruction may predispose patients to the development of early onset post-traumatic osteoarthritis. The goal of our study was to examine the longitudinal interrelationship between altered tibial position relative to the femur and cartilage health measured by quantitative T1ρ MRI. Twenty-five patients with isolated unilateral ACL injury underwent kinematic and cartilage T1ρ MRI at baseline prior to ACL reconstruction and then at 1-year post-reconstruction. Tibial position relative to the femur in the anterior-posterior plane was calculated as well as cartilage T1ρ relaxation values in the injured and uninjured knee. At baseline prior to ACL reconstruction, the tibia was in a significantly more anterior position relative to the femur in the ACL deficient knee compared to the healthy contralateral knee. This difference was no longer present at 1-year follow-up. Additionally, the side-side difference in tibial position correlated to increased cartilage T1ρ relaxation values in the medial compartment of the knee 1-year post-reconstruction. Altered tibial position following ACL reconstruction is correlated with detectable cartilage degeneration as soon as 1 year following ACL reconstruction.
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Affiliation(s)
- Musa Zaid
- University of California San Francisco School of Medicine, San Francisco
| | - Drew Lansdown
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco
| | - Favian Su
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco
| | - Lauren Tufts
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco
| | - Sarah Rizzo
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco
| | - Richard B. Souza
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco
| | - C. Benjamin Ma
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco
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OARSI Clinical Trials Recommendations: Hip imaging in clinical trials in osteoarthritis. Osteoarthritis Cartilage 2015; 23:716-31. [PMID: 25952344 PMCID: PMC4430132 DOI: 10.1016/j.joca.2015.03.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 03/01/2015] [Accepted: 03/09/2015] [Indexed: 02/02/2023]
Abstract
Imaging of hip in osteoarthritis (OA) has seen considerable progress in the past decade, with the introduction of new techniques that may be more sensitive to structural disease changes. The purpose of this expert opinion, consensus driven recommendation is to provide detail on how to apply hip imaging in disease modifying clinical trials. It includes information on acquisition methods/techniques (including guidance on positioning for radiography, sequence/protocol recommendations/hardware for magnetic resonance imaging (MRI)); commonly encountered problems (including positioning, hardware and coil failures, artifacts associated with various MRI sequences); quality assurance/control procedures; measurement methods; measurement performance (reliability, responsiveness, and validity); recommendations for trials; and research recommendations.
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Surgical induction, histological evaluation, and MRI identification of cartilage necrosis in the distal femur in goats to model early lesions of osteochondrosis. Osteoarthritis Cartilage 2015; 23:300-7. [PMID: 25463443 PMCID: PMC4305013 DOI: 10.1016/j.joca.2014.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 09/25/2014] [Accepted: 11/06/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Identify and interrupt the vascular supply to portions of the distal femoral articular-epiphyseal cartilage complex (AECC) in goat kids to induce cartilage necrosis, characteristic of early lesions of osteochondrosis (OC); then utilize magnetic resonance imaging (MRI) to identify necrotic areas of cartilage. DESIGN Distal femora were perfused and cleared in goat kids of various ages to visualize the vascular supply to the distal femoral AECC. Vessels located on the axial aspect of the medial femoral condyle (MFC) and on the abaxial side of the lateral trochlear ridge were transected in eight 4- to 5-day-old goats to induce cartilage necrosis. Goats were euthanized 1, 2, 3, 4, 5, 6, 9, and 10 weeks post operatively and operated stifles were harvested. Adiabatic T1ρ relaxation time maps of the harvested distal femora were generated using a 9.4 T MR scanner, after which samples were evaluated histologically. RESULTS Interruption of the vascular supply to the MFC caused lesions of cartilage necrosis in 6/8 goat kids that were demonstrated histologically. Adiabatic T1ρ relaxation time mapping identified these areas of cartilage necrosis in 5/6 cases. No significant findings were detected after transection of perichondrial vessels supplying the lateral trochlear ridge. CONCLUSIONS Cartilage necrosis, characteristic of early OC, can be induced by interrupting the vascular supply to the distal femoral AECC in goat kids. The ability of high field MRI to identify these areas of cartilage necrosis in the AECC using the adiabatic T1ρ sequence suggests that this technique may be useful in the future for the early diagnosis of OC.
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32
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Shapiro LM, Matzat SJ, Gold GE. Functional magnetic resonance imaging. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Souza RB, Wu SJ, Morse LJ, Subburaj K, Allen CR, Feeley BT. Cartilage MRI relaxation times after arthroscopic partial medial meniscectomy reveal localized degeneration. Knee Surg Sports Traumatol Arthrosc 2015; 23:188-97. [PMID: 24792070 DOI: 10.1007/s00167-014-2997-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 04/06/2014] [Indexed: 01/14/2023]
Abstract
PURPOSE Little is known about the early changes in cartilage composition and tibiofemoral kinematics following partial meniscectomy. The purpose of this study was to determine the effects of partial meniscectomy on cartilage compositional properties using T1ρ and T2 relaxation time mapping and to assess changes in tibiofemoral kinematics. It is hypothesize that abnormal tibiofemoral kinematics and relaxation time elevation (a reflection of changes in cartilage biochemical composition) in the weight-bearing regions of the knees following meniscectomy will be observed. METHODS Nine patients (7 males and 2 females; mean age, 48.6 ± 10.8 years; BMI = 27.3 ± 3.8 kg/m(2)) with tears of the posterior horn of the medial meniscus underwent arthroscopic partial meniscectomy. Pre-surgical and 6 months post-surgical MRIs were obtained in all subjects to evaluate cartilage relaxation times and tibiofemoral kinematics. Paired t tests were performed to determine significant changes in cartilage relaxation times from baseline. RESULTS T1ρ relaxation time in the region of the medial femoral condyle directly adjacent to the resection showed an increase of 7.4% at 6 months (p = 0.02). T2 relaxation times in both the medial and lateral tibial plateaus showed significant elevation at 6 months. Consistent kinematic trends were not found in post-meniscectomized knees. CONCLUSIONS These results suggest that arthroscopic partial meniscectomy affects the biochemical composition of articular cartilage in the knee in as early as 6 months. The largest responses were observed in the weight-bearing regions and the cartilage immediately adjacent to the resection. This suggests that the loading environment has been altered enough to result in cartilage compositional changes in a very brief period of time following meniscectomy. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA,
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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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Souza RB, Kumar D, Calixto N, Singh J, Schooler J, Subburaj K, Li X, Link TM, Majumdar S. Response of knee cartilage T1rho and T2 relaxation times to in vivo mechanical loading in individuals with and without knee osteoarthritis. Osteoarthritis Cartilage 2014; 22:1367-76. [PMID: 24792208 PMCID: PMC4184934 DOI: 10.1016/j.joca.2014.04.017] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/11/2014] [Accepted: 04/20/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the effects of mechanical loading on knee articular cartilage T1ρ and T2 relaxation times in patients with and without osteoarthritis (OA). DESIGN Magnetic resonance (MR) images were acquired from 137 subjects with and without knee OA under two conditions: unloaded and loaded at 50% body weight. Three sequences were acquired: a high-resolution 3D-CUBE, a T1ρ relaxation time, and a T2 relaxation time sequences. Cartilage regions of interest included: medial and lateral femur (MF, LF); medial and lateral tibia (MT, LT), laminar analysis (superficial and deep layers), and subcompartments. Changes in relaxation times in response to loading were evaluated. RESULTS In response to loading, we observed significant reductions in T1ρ relaxation times in the MT and LT. In both the MF and LF, loading resulted in significant decreases in the superficial layer and significant increases in the deep layer of the cartilage for T1ρ and T2. All subcompartments of the MT and LT showed significant reduction in T1ρ relaxation times. Reductions were larger for subjects with OA (range: 13-19% change) when compared to healthy controls (range: 3-13% change). CONCLUSIONS Loading of the cartilage resulted in significant changes in relaxation times in the femur and tibia, with novel findings regarding laminar and subcompartmental variations. In general, changes in relaxation times with loading were larger in the OA group suggesting that the collagen-proteoglycan matrix of subjects with OA is less capable of retaining water, and may reflect a reduced ability to dissipate loads.
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Affiliation(s)
- R B Souza
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States; Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States.
| | - D Kumar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - N Calixto
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - J Singh
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - J Schooler
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - K Subburaj
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - X Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - T M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - S Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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Kijowski R, Roemer F, Englund M, Tiderius CJ, Swärd P, Frobell RB. Imaging following acute knee trauma. Osteoarthritis Cartilage 2014; 22:1429-43. [PMID: 25278054 DOI: 10.1016/j.joca.2014.06.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/21/2014] [Accepted: 06/03/2014] [Indexed: 02/02/2023]
Abstract
Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma.
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Affiliation(s)
- R Kijowski
- Department of Radiology, University of Wisconsin, Madison, WI, USA.
| | - F Roemer
- Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany; Department of Radiology, Boston University, Boston, MA, USA
| | - M Englund
- Department of Orthopedics, Clinical Sciences Lund, Lund, Sweden; Clinical Epidemiology Research and Training Unit, Boston University, Boston, MA, USA
| | - C J Tiderius
- Department of Orthopedics, Clinical Sciences Lund, Lund, Sweden
| | - P Swärd
- Department of Orthopedics, Clinical Sciences Lund, Lund, Sweden
| | - R B Frobell
- Department of Orthopedics, Clinical Sciences Lund, Lund, Sweden
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Ellingson AM, Nagel TM, Polly DW, Ellermann J, Nuckley DJ. Quantitative T2* (T2 star) relaxation times predict site specific proteoglycan content and residual mechanics of the intervertebral disc throughout degeneration. J Orthop Res 2014; 32:1083-9. [PMID: 24788830 PMCID: PMC4136382 DOI: 10.1002/jor.22633] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 03/28/2014] [Indexed: 02/04/2023]
Abstract
Degeneration alters the biochemical composition of the disc, affecting the mechanical integrity leading to spinal instability. Quantitative T2* MRI probes water mobility within the macromolecular network, a potentially more sensitive assessment of disc health. We determined the relationship between T2* relaxation time and proteoglycan content, collagen content, and compressive mechanics throughout the degenerative spectrum. Eighteen human cadaveric lumbar (L4-L5) discs were imaged using T2* MRI. The T2* relaxation time at five locations (nucleous pulposus or NP, anterior annulus fibrosis or AF, posterior AF, inner AF, and outer AF) was correlated with sulfated-glycosaminoglycan (s-GAG) content, hydroxyproline content, and residual stress and strain at each location. T2* relaxation times were significantly correlated with s-GAG contents in all test locations and were particularly strong in the NP (r = 0.944; p < 0.001) and inner AF (r = 0.782; p < 0.001). T2* relaxation times were also significantly correlated with both residual stresses and excised strains in the NP (r = 0.857; p < 0.001: r = 0.816; p < 0.001), inner AF (r = 0.535; p = 0.022: r = 0.516; p = 0.028), and outer AF (r = 0.668; p = 0.002: r = 0.458; p = 0.041). These strong correlations highlight T2* MRI's ability to predict the biochemical and mechanical health of the disc. T2* MRI assessment of disc health is a clinically viable tool showing promise as a biomarker for distinguishing degenerative changes.
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Affiliation(s)
- Arin M. Ellingson
- Department of Biomedical Engineering, University of Minnesota, Nils Hasselmo Hall, Room 7-105, 312 Church Street S.E., Minneapolis, Minnesota
| | - Tina M. Nagel
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, Minnesota
| | - David W. Polly
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Jutta Ellermann
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota
| | - David J. Nuckley
- Department of Biomedical Engineering, University of Minnesota, Nils Hasselmo Hall, Room 7-105, 312 Church Street S.E., Minneapolis, Minnesota,Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, Minnesota,Orthopaedic Biomechanics Laboratory, University of Minnesota, Minneapolis, Minnesota
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Non-invasive and in vivo assessment of osteoarthritic articular cartilage: a review on MRI investigations. Rheumatol Int 2014; 35:1-16. [PMID: 24879325 DOI: 10.1007/s00296-014-3052-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 05/16/2014] [Indexed: 10/25/2022]
Abstract
Early detection of knee osteoarthritis (OA) is of great interest to orthopaedic surgeons, rheumatologists, radiologists, and researchers because it would allow physicians to provide patients with treatments and advice to slow the onset or progression of the disease. Early detection can be achieved by identifying early changes in selected features of degenerative articular cartilage (AC) using non-invasive imaging modalities. Magnetic resonance imaging (MRI) is becoming the standard for assessment of OA. The aim of this paper was to review the influence of MRI on the selection, detection, and measurement of AC features associated with early OA. Our review of the literature indicates that the changes associated with early OA are in cartilage thickness, cartilage volume, cartilage water content, and proteoglycan content that can be accurately, consistently, and non-invasively measured using MRI. Choosing an MR pulse sequence that provides the capability to assess cartilage physiology and morphology in a single acquisition and advanced multi-nuclei MRI is desirable. The results of the review indicate that using an ultra-high magnetic strength, MR imager does not affect early OA detection. In conclusion, MRI is currently the most suitable modality for early detection of knee OA, and future research should focus on the quantitative evaluation of early OA features using advances in MR hardware, software, and data processing with sophisticated image/pattern recognition techniques.
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T1ρ magnetic resonance imaging for detection of early cartilage changes in knees of asymptomatic collegiate female impact and nonimpact athletes. Clin J Sport Med 2014; 24:218-25. [PMID: 24172654 PMCID: PMC6425943 DOI: 10.1097/jsm.0000000000000013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if T1ρ magnetic resonance imaging (T1ρ MRI) could assess early articular cartilage changes in knees of asymptomatic female collegiate athletes. It was hypothesized that impact cohort would demonstrate greater changes than nonimpact cohort. DESIGN An institutional review board-approved prospective cohort study. Blinded MRI analyses. SETTING Participants from collegiate athletic program. Imaging at university hospital, February 2008 to July 2009. PARTICIPANTS Inclusion criteria were female collegiate athletes in athletic season and asymptomatic. Exclusion criteria were previous/current knee injuries/surgeries. Twenty-one female NCAA Division I athletes, 11 impact (basketball players) and 10 nonimpact (swimmers) participants were consented and imaged with 3.0-T MRI (Siemens) and T1ρ sequence (University of Pennsylvania). One patient was removed (injury diagnosis). Final roster was 10 impact and 10 nonimpact participants. No difference in cohort body mass index, height, or weight. MAIN OUTCOME MEASURES Average T1ρ relaxation times (ART) for patellar and femoral cartilage to analyze defined regions and depth and modified International Cartilage Repair Society classification. RESULTS Statistical analyses showed that ART of radial zone of central third weight-bearing region of cartilage in basketball players was significantly greater (P = 0.041) than swimmers and ART of the superficial zone in basketball players was significantly less (P = 0.003) than that of swimmers. For both groups, the ART of superficial zones were significantly greater than that of radial zones (P < 0.001). Four impact athletes showed macroscopic changes (none in nonimpact cohort). CONCLUSIONS T1ρ MRI detected early changes in articular cartilage of asymptomatic collegiate female impact athletes, with significant differences between cohorts in radial zone of central third weight-bearing region and superficial zones ART. Both cohorts showed increased ART in superficial zone. Four impact athletes showed macroscopic changes. CLINICAL RELEVANCE This study demonstrates a quantitative MRI sequence able to detect signal differences in articular cartilage in asymptomatic athletes.
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Wang L, Regatte RR. Quantitative mapping of human cartilage at 3.0T: parallel changes in T₂, T₁ρ, and dGEMRIC. Acad Radiol 2014; 21:463-71. [PMID: 24594416 DOI: 10.1016/j.acra.2013.12.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Revised: 12/14/2013] [Accepted: 12/15/2013] [Indexed: 10/25/2022]
Abstract
RATIONALE AND OBJECTIVES The objectives of this study were to measure the parallel changes of transverse relaxation times (T₂), spin-lattice relaxation time in the rotating frame (T₁ρ), and the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC)-T1 mapping of human knee cartilage in detecting cartilage degeneration at 3.0T. MATERIALS AND METHODS Healthy volunteers (n = 10, mean age 35.6 years) and patients (n = 10, mean age 65 years) with early knee osteoarthritis (OA) were scanned at 3.0T MR using an 8-channel phased array knee coil (transmit-receive). Quantitative assessment of T₂, T₁ρ, and dGEMRIC-T₁ values (global and regional) were correlated between asymptomatic subjects and patients with OA. RESULTS The average T₂ (39 ± 2 milliseconds [mean ± standard deviation] vs. 47 ± 6 milliseconds, P < .0007) and T₁ρ (48 ± 3 vs. 62 ± 8 milliseconds, P < .0002) values were all markedly increased in all patients with OA when compared to healthy volunteers. The average dGEMRIC-T₁ (1244 ± 134 vs. 643 ± 227 milliseconds, P < .000002) value was sharply decreased after intravenous administration of gadolinium contrast agent in all patients with OA. CONCLUSIONS The research results showed that all the T₂, T₁ρ, and dGEMRIC-T₁ relaxation times varied with the cartilage degeneration. The dGEMRIC-T₁ and T₁ρ relaxation times seem to be more sensitive than T₂ in detecting early cartilage degeneration. The preliminary study demonstrated that the early biochemical changes in knee osteoarthritic patients could be detected noninvasively in in vivo using T₁ρ and dGEMRIC-T₁ mapping.
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Hayter CL, Linklater JM, Man KH. State of the Art MR Imaging Techniques for the Foot and Ankle. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0042-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Feldman RE, Stobbe R, Watts A, Beaulieu C. Sodium imaging of the human knee using soft inversion recovery fluid attenuation. JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2013; 234:197-206. [PMID: 23896067 DOI: 10.1016/j.jmr.2013.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/27/2013] [Accepted: 06/30/2013] [Indexed: 06/02/2023]
Abstract
Sodium signal strength in MRI is low when compared with (1)H. Thus, image voxel volumes must be relatively large in order to produce a sufficient signal-to-noise ratio (SNR). The measurement of sodium in cartilage is hindered by conflation with signal from the adjacent fluid spaces. Inversion recovery can be used to null signal from fluid, but reduces SNR. The purpose of this work was to optimize inversion recovery sodium MRI to enhance cartilage SNR while nulling fluid. Sodium relaxation was first measured for knee cartilage (T1=21±1 ms, T(2 fast)(∗)=0.8±0.2 ms, T(2 slow)(∗)=19.7±0.5 ms) and fluid (T1=48±3 ms, T2(∗)=47±4 ms) in nine healthy subjects at 4.7 T. The rapid relaxation of cartilage in relation to fluid permits the use of a lengthened inversion pulse to preferentially invert the fluid components. Simulations of inversion pulse length were performed to yield a cartilage SNR enhancing combination of parameters that nulled fluid. The simulations were validated in a phantom and then in vivo. B0 inhomogeneity was measured and the effect of off-resonance during the soft inversion pulse was assessed with simulation. Soft inversion recovery yielded twice the SNR and much improved sodium images of cartilage in human knee with little confounding signal from fluid.
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Palmer AJR, Brown CP, McNally EG, Price AJ, Tracey I, Jezzard P, Carr AJ, Glyn-Jones S. Non-invasive imaging of cartilage in early osteoarthritis. Bone Joint J 2013; 95-B:738-46. [PMID: 23723266 DOI: 10.1302/0301-620x.95b6.31414] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Treatment for osteoarthritis (OA) has traditionally focused on joint replacement for end-stage disease. An increasing number of surgical and pharmaceutical strategies for disease prevention have now been proposed. However, these require the ability to identify OA at a stage when it is potentially reversible, and detect small changes in cartilage structure and function to enable treatment efficacy to be evaluated within an acceptable timeframe. This has not been possible using conventional imaging techniques but recent advances in musculoskeletal imaging have been significant. In this review we discuss the role of different imaging modalities in the diagnosis of the earliest changes of OA. The increasing number of MRI sequences that are able to non-invasively detect biochemical changes in cartilage that precede structural damage may offer a great advance in the diagnosis and treatment of this debilitating condition.
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Affiliation(s)
- A J R Palmer
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Headington OX3 7LD, UK
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Son M, Goodman SB, Chen W, Hargreaves B, Gold G, Levenston M. Regional variation in T1ρ and T2 times in osteoarthritic human menisci: correlation with mechanical properties and matrix composition. Osteoarthritis Cartilage 2013; 21:796-805. [PMID: 23499673 PMCID: PMC3909565 DOI: 10.1016/j.joca.2013.03.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 02/04/2013] [Accepted: 03/01/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Changes in T1ρ and T2 magnetic resonance relaxation times have been associated with articular cartilage degeneration, but similar relationships for meniscal tissue have not been extensively investigated. This work examined relationships between T1ρ and T2 measurements and biochemical and mechanical properties across regions of degenerate human menisci. DESIGN Average T1ρ and T2 relaxation times were determined for nine regions each of seven medial and 13 lateral menisci from 14 total knee replacement patients. Sulfated glycosaminoglycan (sGAG), collagen and water contents were measured for each region. Biomechanical measurements of equilibrium compressive, dynamic compressive and dynamic shear moduli were made for anterior, central and posterior regions. RESULTS T1ρ and T2 times showed similar regional patterns, with longer relaxation times in the (radially) middle region compared to the inner and outer regions. Pooled over all regions, T1ρ and T2 times showed strong correlations both with one another and with water content. Correlations with biochemical content varied depending on normalization to wet or dry mass, and both imaging parameters showed stronger correlations with collagen compared to sGAG content. Mechanical properties displayed moderate inverse correlations with increasing T1ρ and T2 times and water content. CONCLUSION Both T1ρ and T2 relaxation times correlated strongly with water content and moderately with mechanical properties in osteoarthritic menisci, but not as strongly with sGAG or collagen contents alone. While the ability of magnetic resonance imaging (MRI) to detect early osteoarthritic changes remains the subject of investigation, these results suggest that T1ρ and T2 relaxation times have limited ability to detect compositional variations in degenerate menisci.
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Affiliation(s)
- M. Son
- Department of Bioengineering, Stanford University, Stanford, CA
| | - S. B. Goodman
- Department of Bioengineering, Stanford University, Stanford, CA
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA
| | - W. Chen
- GE Healthcare, Menlo Park, CA
| | | | - G.E. Gold
- Department of Bioengineering, Stanford University, Stanford, CA
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA
- Department of Radiology, Stanford University, Stanford, CA
| | - M.E. Levenston
- Department of Bioengineering, Stanford University, Stanford, CA
- Department of Mechanical Engineering, Stanford University, Stanford, CA
- To whom correspondence should be addressed 233 Durand Building Stanford, CA 94305-4038 Ph: 650-723-9464 Fax: 650-725-1587
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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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Chan DD, Neu CP. Probing articular cartilage damage and disease by quantitative magnetic resonance imaging. J R Soc Interface 2013; 10:20120608. [PMID: 23135247 DOI: 10.1098/rsif.2012.0608] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Osteoarthritis (OA) is a debilitating disease that reflects a complex interplay of biochemical, biomechanical, metabolic and genetic factors, which are often triggered by injury, and mediated by inflammation, catabolic cytokines and enzymes. An unmet clinical need is the lack of reliable methods that are able to probe the pathogenesis of early OA when disease-rectifying therapies may be most effective. Non-invasive quantitative magnetic resonance imaging (qMRI) techniques have shown potential for characterizing the structural, biochemical and mechanical changes that occur with cartilage degeneration. In this paper, we review the background in articular cartilage and OA as it pertains to conventional MRI and qMRI techniques. We then discuss how conventional MRI and qMRI techniques are used in clinical and research environments to evaluate biochemical and mechanical changes associated with degeneration. Some qMRI techniques allow for the use of relaxometry values as indirect biomarkers for cartilage components. Direct characterization of mechanical behaviour of cartilage is possible via other specialized qMRI techniques. The combination of these qMRI techniques has the potential to fully characterize the biochemical and biomechanical states that represent the initial changes associated with cartilage degeneration. Additionally, knowledge of in vivo cartilage biochemistry and mechanical behaviour in healthy subjects and across a spectrum of osteoarthritic patients could lead to improvements in the detection, management and treatment of OA.
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Affiliation(s)
- Deva D Chan
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN 47907, USA
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47
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Souza RB, Fang C, Luke A, Wu S, Li X, Majumdar S. Relationship between knee kinetics during jumping tasks and knee articular cartilage MRI T1rho and T2 relaxation times. Clin Biomech (Bristol, Avon) 2012; 27:403-8. [PMID: 22115848 PMCID: PMC3327363 DOI: 10.1016/j.clinbiomech.2011.10.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 10/26/2011] [Accepted: 10/27/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Articular cartilage of young healthy individuals is dynamic and responsive to loading behaviors. The purpose of this study was to evaluate the relationship of cartilage T(1ρ) and T(2) relaxation times with loading kinetics during jumping tasks in healthy young individuals. METHODS Fourteen healthy subjects underwent: 1) motion analysis while performing a unilateral hopping task and bilateral drop jumping task; and 2) quantitative imaging using a 3 Tesla MRI for T(1ρ) and T(2) relaxation time analysis. Three dimensional net joint moments and angular impulse was calculated using standard inverse dynamics equations. Average T(1ρ) and T(2) relaxation times and medial-lateral ratios for each were calculated. Multiple regression was used to identify predictors of cartilage relaxation times. FINDINGS Average knee flexion moment during hopping was observed to best predict overall T(1ρ) (R(2)=.185) and T(2) (R(2)=.154) values. Peak knee adduction moment during a drop jump was the best predictor of the T(1ρ) medial-lateral ratio (R(2)=.220). The T(2) medial-lateral ratio was best predicted by average internal rotation moment during the drop jump (R(2)=.174). INTERPRETATION These data suggest that loads across the knee may affect the biochemistry of the cartilage. In young healthy individuals, higher flexion moments were associated with decreased T(1ρ) and T(2) values, suggesting a potentially beneficial effect. The medial-to-lateral ratio of T(1ρ) and T(2) times appears to be related to the frontal and transverse plane joint mechanics. These data offer promising findings of potentially modifiable parameters associated with cartilage composition.
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Affiliation(s)
- Richard B Souza
- Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco, San Francisco, CA 94107, USA.
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Abstract
Osteoarthritis (OA) is a common disease that results in cartilage degeneration in the joints and is a disabling condition for millions of individuals. Poor sensitivity and specificity of standard diagnostic methods have relegated treatment options to mitigating pain or surgical replacement. The advent of disease-modifying drugs holds the potential for reversing the normal course of OA and rebuilding cartilage. To aid these therapies, novel magnetic resonance imaging-based tools are required for detecting subtle early changes in cartilage physiology due to OA that may provide improved diagnoses and clinical management of patients. Some of the techniques reviewed here such as T1ρ and T2 relaxometry, magnetization transfer, chemical exchange saturation transfer, and Na magnetic resonance imaging are all biomarkers of cartilage pathological diseases that are sensitive to early biochemical changes in the extracellular matrix of cartilage. These techniques have the potential to noninvasively detect early pathological changes with the goal of aiding clinical decision making as well as contributing to the development and evaluation of potential disease-modifying therapies.
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Potter HG, Koff MF. MR Imaging Tools to Assess Cartilage and Joint Structures. HSS J 2012; 8:29-32. [PMID: 23372524 PMCID: PMC3295949 DOI: 10.1007/s11420-011-9241-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 11/02/2011] [Indexed: 02/07/2023]
Affiliation(s)
- Hollis G. Potter
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th St., New York, NY 10021 USA
| | - Matthew F. Koff
- Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th St., New York, NY 10021 USA
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50
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Fenty MC, Dodge GR, Kassey VB, Witschey WRT, Borthakur A, Reddy R. Quantitative cartilage degeneration associated with spontaneous osteoarthritis in a guinea pig model. J Magn Reson Imaging 2011; 35:891-8. [PMID: 22128105 DOI: 10.1002/jmri.22867] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 09/30/2011] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine (i) the feasibility and intra- and inter-scan reproducibility of T(1ρ) MRI in assessing cartilage degeneration in a guinea pig model with naturally occurring joint disease that closely mimics human osteoarthritis (OA), (ii) demonstrate the sensitivity of T(1ρ) MRI in assessing the age dependent cartilage degeneration in OA progression as compared to histopathological changes. MATERIALS AND METHODS Duncan-Hartley guinea pigs were obtained at various ages and maintained under an IACUC approved protocol. The left hind stifle joint was imaged using T(1ρ) MRI on a 9.4 Tesla Varian horizontal 20 cm bore scanner using a custom surface coil. Reproducibility of T(1ρ) MRI was assessed using 4-month-old guinea pigs (N = 3). Three age cohorts; 3 month (N = 8), 5 month (N = 6), and 9 month (N = 5), were used to determine the age-dependent osteoarthritic changes as measured by T(1ρ) MRI. Validation of age-dependent cartilage degeneration was confirmed by histology and Safranin-O staining. RESULTS T(1ρ) values obtained in the cartilage of the stifle joint in guinea pigs were highly reproducible with an inter-scan mean coefficient of variation (CV) of 6.57% and a maximum intra-scan CV of 9.29%. Mean cartilage T(1ρ) values in animals with late stage cartilage degeneration were 56.3-56.9 ms (5-9 month cohorts) were both significantly (P < 0.01) higher than that obtained from 3-month-old cohort (44 ms) demonstrating an age-dependent variation. T(1ρ) was shown to be significantly greater than T(2) . T(1ρ) dispersion was observed in this animal model for the first time showing an increase of 45% between 500 Hz and 1500 Hz spin-locking frequency. Cartilage thickness measurements were calculated from single mid-coronal histology sections from same animals used for T(1ρ) MRI. Thickness calculations showed insignificant differences between 3- and 5-month cohorts and was significantly decreased by 9 months of age (P < 0.01). A moderate correlation (R(2) = 0.45) existed between T(1ρ) values and signal intensity of Safranin-O stain. CONCLUSION The data presented demonstrate that T(1ρ) MRI is highly reproducible in this spontaneous model of OA and may serve as a noninvasive tool to characterize joint cartilage degeneration during OA. Age-dependent changes, verified with histological measurements of proteoglycan loss, correlated with T(1ρ) across different age groups. T(1ρ) has adequate dynamic range and is sensitive to detect and track the progression of cartilage degeneration in the guinea pig model before gross anatomical changes such as cartilage thinning has occurred. This study presents a technological advancement that would permit longitudinal studies of evaluating disease-modifying therapies useful for treating human OA.
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Affiliation(s)
- Matthew C Fenty
- CMROI, Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
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