1
|
Zhao X, Ruan J, Li J, Dai C, Pei M, Zhou Y. Three-dimensional texture analyses of multi-quantitative relaxation time maps for evaluating cartilage repair with the treatment of allogeneic human adipose-derived mesenchymal progenitor cells. Magn Reson Imaging 2024; 110:7-16. [PMID: 38547934 DOI: 10.1016/j.mri.2024.03.039] [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: 02/08/2024] [Revised: 03/18/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND To explore the ability of three-dimensional texture analyses based on gray-level run-length matrix (GLRLM) for examining the spatial distribution of pixel values on magnetic resonance imaging (MRI) relaxation time maps and detecting the compositional variation of cartilage repair following treatment with allogeneic human adipose-derived mesenchymal progenitor cells (haMPCs). METHODS Participants with knee osteoarthritis were randomly divided into three groups with intra-articular haMPCs injections: low-, medium-, and high-dose groups. We analyzed five GLRLM parameters in the T1rho, T2 and T2star maps, including run length non-uniformity (RLNonUni), gray-level non-uniformity (GLevNonU), long run emphasis (LngREmph), short run emphasis (ShrtREmp), and fraction of images in runs. We used the relative D values (the ratio of difference values to baseline) as the objective to avoid errors caused by individual differences. We calculated the two-tailed Pearson's linear correlation coefficient (r) to investigate the correlations of the texture parameters with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. RESULTS Compared with the base time, significant reduction of WOMAC score was observed in both high and medium doses groups at terminal time, indicating relief of pain symptoms in high and medium groups with the treatment of allogeneic haMPCs. Significant differences were observed in the GLRLM parameters of cartilage MR relaxation time maps in different doses groups. In both T1rho and T2 relaxation time maps, the high-dose group showed significant increases in relative D values of RLNonUni, GLevNonU, LngREmph and ShrtREmp, which indicated significant changes in the uniformity of relaxation time maps. For T2star map, GLRLM parameters such as GLevNonU and ShrtREmp, especially LngREmph, showed significant increases in relative D values in high-dose group. Among all GLRLM features, LngREmph of three relaxation time maps had performed excellent linear correlations with WOMAC scores. CONCLUSIONS Texture analysis of the cartilage may allow the detection of compositional variation in cartilage repair with the treatment of allogeneic haMPCs. This technique displays potential applications in understanding the mechanism of stem cell repair of the cartilage and assessing the treatment response.
Collapse
Affiliation(s)
- Xinxin Zhao
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai 200127, China.
| | - Jingjing Ruan
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai 200127, China
| | - Jia Li
- Department of Rheumatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai 200127, China
| | - Chengxiang Dai
- Cellular Biomedicine Group, Inc., No. 85 Faladi Road, Building 3, Zhangjiang, Pudong New Area, Shanghai 201210, China
| | - Mengchao Pei
- Institute of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, No.320, Yueyang Road, Shanghai 200031, China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai 200127, China.
| |
Collapse
|
2
|
Herger S, Wirth W, Eckstein F, Nüesch C, Egloff C, Mündermann A. Anterior cruciate ligament injury and age affect knee cartilage T2 but not thickness. Osteoarthritis Cartilage 2024:S1063-4584(24)01269-X. [PMID: 38950877 DOI: 10.1016/j.joca.2024.06.014] [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] [Received: 06/23/2023] [Revised: 06/21/2024] [Accepted: 06/26/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE To investigate the effect of unilateral anterior cruciate ligament (ACL) injury on cartilage thickness and composition, specifically laminar transverse relaxation time (T2) by magnetic resonance imaging (MRI), in younger and older participants and to compare within-person side differences in these parameters between ACL-injured and healthy controls. DESIGN Quantitative double-echo steady-state 3 Tesla MRI-sequences were acquired in both knees of 85 participants in four groups: 20-30 years: healthy, HEA20-30, n = 24; ACL-injured, ACL20-30, n = 23; 40-60 years: healthy, HEA40-60, n = 24; ACL-injured, ACL40-60, n = 14 (ACL injury 2-10 years prior to study inclusion). Weight-bearing femorotibial cartilages were manually segmented; cartilage T2 and thickness were computed using custom software. Mean and side differences in subregional cartilage thickness, superficial and deep cartilage T2 were compared within and between groups using non-parametric statistics. RESULTS Cartilage thickness did not differ within or between groups. Only the side difference in medial femorotibial cartilage thickness was greater in ACL20-30 than in HEA20-30. Deep zone T2 was longer in the ACL-injured than in the contralateral uninjured knees and than in healthy controls, especially in the lateral compartment. Most ACL-injured participants had side differences in femorotibial deep zone T2 above the threshold derived from controls. CONCLUSION In the ACL-injured knee, early compositional differences in femorotibial cartilage (T2) appear to occur in the deep zone and precede cartilage thickness loss. These results suggest that monitoring laminar T2 after ACL injury may be useful in diagnosing and monitoring early articular cartilage changes.
Collapse
Affiliation(s)
- Simon Herger
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
| | - Wolfgang Wirth
- Research Program for Musculoskeletal Imaging, Center of Anatomy and Cell Biology, and Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany.
| | - Felix Eckstein
- Research Program for Musculoskeletal Imaging, Center of Anatomy and Cell Biology, and Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Freilassing, Germany.
| | - Corina Nüesch
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
| | - Christian Egloff
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel Switzerland.
| | - Annegret Mündermann
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel Switzerland; Department of Spine Surgery, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland.
| |
Collapse
|
3
|
Casula V, Kajabi AW. Quantitative MRI methods for the assessment of structure, composition, and function of musculoskeletal tissues in basic research and preclinical applications. MAGMA (NEW YORK, N.Y.) 2024:10.1007/s10334-024-01174-7. [PMID: 38904746 DOI: 10.1007/s10334-024-01174-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 05/04/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024]
Abstract
Osteoarthritis (OA) is a disabling chronic disease involving the gradual degradation of joint structures causing pain and dysfunction. Magnetic resonance imaging (MRI) has been widely used as a non-invasive tool for assessing OA-related changes. While anatomical MRI is limited to the morphological assessment of the joint structures, quantitative MRI (qMRI) allows for the measurement of biophysical properties of the tissues at the molecular level. Quantitative MRI techniques have been employed to characterize tissues' structural integrity, biochemical content, and mechanical properties. Their applications extend to studying degenerative alterations, early OA detection, and evaluating therapeutic intervention. This article is a review of qMRI techniques for musculoskeletal tissue evaluation, with a particular emphasis on articular cartilage. The goal is to describe the underlying mechanism and primary limitations of the qMRI parameters, their association with the tissue physiological properties and their potential in detecting tissue degeneration leading to the development of OA with a primary focus on basic and preclinical research studies. Additionally, the review highlights some clinical applications of qMRI, discussing the role of texture-based radiomics and machine learning in advancing OA research.
Collapse
Affiliation(s)
- Victor Casula
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Abdul Wahed Kajabi
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
4
|
Brenneman Wilson EC, Quenneville CE, Maly MR. Integrating MR imaging with full-surface indentation mapping of femoral cartilage in an ex vivo porcine stifle. J Mech Behav Biomed Mater 2023; 139:105651. [PMID: 36640543 DOI: 10.1016/j.jmbbm.2023.105651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 11/22/2022] [Accepted: 01/01/2023] [Indexed: 01/08/2023]
Abstract
The potential of MRI to predict cartilage mechanical properties across an entire cartilage surface in an ex vivo model would enable novel perspectives in modeling cartilage tolerance and predicting disease progression. The purpose of this study was to integrate MR imaging with full-surface indentation mapping to determine the relationship between femoral cartilage thickness and T2 relaxation change following loading, and cartilage mechanical properties in an ex vivo porcine stifle model. Matched-pairs of stifle joints from the same pig were randomized into either 1) an imaging protocol where stifles were imaged at baseline and after 35 min of static axial loading; and 2) full surface mapping of the instantaneous modulus (IM) and an electromechanical property named quantitative parameter (QP). The femur and femoral cartilage were segmented from baseline and post-intervention scans, then meshes were generated. Coordinate locations of the indentation mapping points were rigidly registered to the femur. Multiple linear regressions were performed at each voxel testing the relationship between cartilage outcomes (thickness change, T2 change) and mechanical properties (IM, QP) after accounting for covariates. Statistical Parametric Mapping was used to determine significance of clusters. No significant clusters were identified; however, this integrative method shows promise for future work in ex vivo modeling by identifying spatial relationships among variables.
Collapse
Affiliation(s)
| | - Cheryl E Quenneville
- Department of Mechanical Engineering, McMaster University, Hamilton, ON, Canada; School of Biomedical Engineering, Hamilton, ON, Canada
| | - Monica R Maly
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada; Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada.
| |
Collapse
|
5
|
Väärälä A, Casula V, Peuna A, Panfilov E, Mobasheri A, Haapea M, Lammentausta E, Nieminen MT. Predicting osteoarthritis onset and progression with 3D texture analysis of cartilage MRI DESS: 6-Year data from osteoarthritis initiative. J Orthop Res 2022; 40:2597-2608. [PMID: 35152476 PMCID: PMC9790756 DOI: 10.1002/jor.25293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/13/2021] [Accepted: 02/02/2022] [Indexed: 02/04/2023]
Abstract
In this study, we developed a gray level co-occurrence matrix-based 3D texture analysis method for dual-echo steady-state (DESS) magnetic resonance (MR) images to be used for knee cartilage analysis in osteoarthritis (OA) studies and use it to study changes in articular cartilage between different subpopulations based on their rate of progression into radiographically confirmed OA. In total, 642 series of right knee DESS MR images at 3T were obtained from baseline, 36- and 72-month follow-ups from the OA Initiative database. At baseline, all 214 subjects included in the study had Kellgren-Lawrence (KL) grade <2. Three groups were defined, based on time of progression into radiographic OA (ROA) (KL grades ≥2): control (no progression), fast progressor (ROA at 36 months), and slow progressor (ROA at 72 months) groups. 3D texture analysis was used to extract textural features for femoral and tibial cartilages. All textural features, in both femur and tibia, showed significant longitudinal changes across all groups and tissue layers. Most of the longitudinal changes were observed in progressors, but significant changes were observed also in controls. Differences between groups were mostly seen at baseline and 72 months. The method is sensitive to cartilage changes before and after ROA. It was able to detect longitudinal changes in controls and progressors and to distinguish cartilage alterations due to OA and aging. Moreover, it was able to distinguish controls and different progressor groups before any radiographic signs of OA and during OA. Thus, texture analysis could be used as a marker for the onset and progression of OA.
Collapse
Affiliation(s)
- Ari Väärälä
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
| | - Victor Casula
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland,Medical Research CenterUniversity of Oulu and Oulu University HospitalOuluFinland
| | - Arttu Peuna
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland,Medical Research CenterUniversity of Oulu and Oulu University HospitalOuluFinland,Department of Medical ImagingCentral Finland Central HospitalJyväskyläFinland
| | - Egor Panfilov
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland,Department of Regenerative MedicineState Research Institute Centre for Innovative MedicineVilniusLithuania,Departments of Orthopedics, Rheumatology and Clinical ImmunologyUniversity Medical Center UtrechtUtrechtThe Netherlands,Department of Joint SurgeryThe First Affiliated Hospital, Sun Yat‐sen UniversityGuangzhouGuangdongChina
| | - Marianne Haapea
- Medical Research CenterUniversity of Oulu and Oulu University HospitalOuluFinland,Department of Diagnostic RadiologyOulu University HospitalOuluFinland
| | - Eveliina Lammentausta
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland,Department of Diagnostic RadiologyOulu University HospitalOuluFinland
| | - Miika T. Nieminen
- Research Unit of Medical Imaging, Physics and TechnologyUniversity of OuluOuluFinland,Medical Research CenterUniversity of Oulu and Oulu University HospitalOuluFinland,Department of Diagnostic RadiologyOulu University HospitalOuluFinland
| |
Collapse
|
6
|
Janacova V, Szomolanyi P, Kirner A, Trattnig S, Juras V. Adjacent cartilage tissue structure after successful transplantation: a quantitative MRI study using T 2 mapping and texture analysis. Eur Radiol 2022; 32:8364-8375. [PMID: 35737095 DOI: 10.1007/s00330-022-08897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/03/2022] [Accepted: 05/19/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to assess the texture of repair tissue and tissue adjacent to the repair site after matrix-associated chondrocyte transplantation (MACT) of the knee using gray-level co-occurrence matrix (GLCM) texture analysis of T2 quantitative maps. METHODS Twenty patients derived from the MRI sub-study of multicenter, single-arm phase III study underwent examination on a 3 T MR scanner, including a T2 mapping sequence 12 and 24 months after MACT. Changes between the time points in mean T2 values and 20 GLCM features were assessed for repair tissue, adjacent tissue, and reference cartilage. Differences in T2 values and selected GLCM features between the three cartilage sites at two time points were analyzed using linear mixed-effect models. RESULTS A significant decrease in T2 values after MACT, between time points, was observed only in repair cartilage (p < 0.001). Models showed significant differences in GLCM features between repair tissue and reference cartilage, namely, autocorrelation (p < 0.001), correlation (p = 0.015), homogeneity (p = 0.002), contrast (p < 0.001), and difference entropy (p = 0.047). The effect of time was significant in a majority of models with regard to GLCM features (except autocorrelation) (p ≤ 0.001). Values in repair and adjacent tissue became similar to reference tissue over time. CONCLUSIONS GLCM is a useful add-on to T2 mapping in the evaluation of knee cartilage after MACT by increasing the sensitivity to changes in cartilage structure. The results suggest that cartilage tissue adjacent to the repair site heals along with the cartilage implant. KEY POINTS • GLCM is a useful add-on to T2 mapping in the evaluation of knee cartilage after MACT by increasing the sensitivity to changes in cartilage structure. • Repair and adjacent tissue became similar to reference tissue over time. • The results suggest that cartilage tissue adjacent to the repair site heals along with the cartilage implant.
Collapse
Affiliation(s)
- Veronika Janacova
- High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
| | - Pavol Szomolanyi
- High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria.,Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Alexandra Kirner
- TETEC Tissue Engineering Technologies AG, Aspenhaustraße 18, 72770, Reutlingen, Germany
| | - Siegfried Trattnig
- High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria. .,CD Laboratory for Clinical Molecular MR Imaging, Vienna, Austria. .,Austrian Cluster for Tissue Regeneration, Vienna, Austria. .,Institute for Clinical Molecular MRI in the Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria.
| | - Vladimir Juras
- High-Field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, BT32, Lazarettgasse 14, 1090, Vienna, Austria
| |
Collapse
|
7
|
Calivà F, Namiri NK, Dubreuil M, Pedoia V, Ozhinsky E, Majumdar S. Studying osteoarthritis with artificial intelligence applied to magnetic resonance imaging. Nat Rev Rheumatol 2022; 18:112-121. [PMID: 34848883 DOI: 10.1038/s41584-021-00719-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 02/08/2023]
Abstract
The 3D nature and soft-tissue contrast of MRI makes it an invaluable tool for osteoarthritis research, by facilitating the elucidation of disease pathogenesis and progression. The recent increasing employment of MRI has certainly been stimulated by major advances that are due to considerable investment in research, particularly related to artificial intelligence (AI). These AI-related advances are revolutionizing the use of MRI in clinical research by augmenting activities ranging from image acquisition to post-processing. Automation is key to reducing the long acquisition times of MRI, conducting large-scale longitudinal studies and quantitatively defining morphometric and other important clinical features of both soft and hard tissues in various anatomical joints. Deep learning methods have been used recently for multiple applications in the musculoskeletal field to improve understanding of osteoarthritis. Compared with labour-intensive human efforts, AI-based methods have advantages and potential in all stages of imaging, as well as post-processing steps, including aiding diagnosis and prognosis. However, AI-based methods also have limitations, including the arguably limited interpretability of AI models. Given that the AI community is highly invested in uncovering uncertainties associated with model predictions and improving their interpretability, we envision future clinical translation and progressive increase in the use of AI algorithms to support clinicians in optimizing patient care.
Collapse
Affiliation(s)
- Francesco Calivà
- Department of Radiology and Biomedical Imaging and Center for Intelligent Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Nikan K Namiri
- Department of Radiology and Biomedical Imaging and Center for Intelligent Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Maureen Dubreuil
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging and Center for Intelligent Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Eugene Ozhinsky
- Department of Radiology and Biomedical Imaging and Center for Intelligent Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging and Center for Intelligent Imaging, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
8
|
Babel H, Omoumi P, Cosendey K, Stanovici J, Cadas H, Jolles BM, Favre J. An Expert-Supervised Registration Method for Multiparameter Description of the Knee Joint Using Serial Imaging. J Clin Med 2022; 11:jcm11030548. [PMID: 35160002 PMCID: PMC8837137 DOI: 10.3390/jcm11030548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/11/2022] [Accepted: 01/21/2022] [Indexed: 01/25/2023] Open
Abstract
As knee osteoarthritis is a disease of the entire joint, our pathophysiological understanding could be improved by the characterization of the relationships among the knee components. Diverse quantitative parameters can be characterized using magnetic resonance imaging (MRI) and computed tomography (CT). However, a lack of methods for the coordinated measurement of multiple parameters hinders global analyses. This study aimed to design an expert-supervised registration method to facilitate multiparameter description using complementary image sets obtained by serial imaging. The method is based on three-dimensional tissue models positioned in the image sets of interest using manually placed attraction points. Two datasets, with 10 knees CT-scanned twice and 10 knees imaged by CT and MRI were used to assess the method when registering the distal femur and proximal tibia. The median interoperator registration errors, quantified using the mean absolute distance and Dice index, were ≤0.45 mm and ≥0.96 unit, respectively. These values differed by less than 0.1 mm and 0.005 units compared to the errors obtained with gold standard methods. In conclusion, an expert-supervised registration method was introduced. Its capacity to register the distal femur and proximal tibia supports further developments for multiparameter description of healthy and osteoarthritic knee joints, among other applications.
Collapse
Affiliation(s)
- Hugo Babel
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
| | - Patrick Omoumi
- Service of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland;
- Department of Radiology, Cliniques Universitaires St Luc-UC Louvain, BE-1200 Brussels, Belgium
| | - Killian Cosendey
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
| | - Julien Stanovici
- Service of Orthopedics and Traumatology, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland;
| | - Hugues Cadas
- Unité Facultaire d’Anatomie et de Morphologie, University of Lausanne (UNIL), CH-1005 Lausanne, Switzerland;
| | - Brigitte M. Jolles
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
- Institute of Microengineering, Ecole Polytechnique Fédérale Lausanne (EPFL), CH-1015 Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland; (H.B.); (K.C.); (B.M.J.)
- Correspondence:
| |
Collapse
|
9
|
Yang Z, Xie C, Ou S, Zhao M, Lin Z. Cutoff points of T1 rho/T2 mapping relaxation times distinguishing early-stage and advanced osteoarthritis. Arch Med Sci 2022; 18:1004-1015. [PMID: 35832709 PMCID: PMC9266714 DOI: 10.5114/aoms/140714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/01/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The histopathology grading system is the gold standard post-operative method to evaluate cartilage degeneration in knee osteoarthritis (OA). Magnetic resonance imaging (MRI) T1 rho/T2 mapping imaging can be used for preoperative detection. An association between histopathology and T1 rho/T2 mapping relaxation times was suggested in previous research. However, the cutoff point was not determined among different histopathology grades. Our study aimed to determine the cutoff point of T1 rho/T2 mapping. MATERIAL AND METHODS T1 rho/T2 mapping images were acquired from 80 samples before total knee replacements. Then the histopathology grading system was applied. RESULTS The mean T1 rho/T2 mapping relaxation times of 80 samples were 39.17 ms and 37.98 ms respectively. Significant differences were found in T1 rho/T2 mapping values between early-stage and advanced OA (p < 0.001). The cutoff point for T1 rho was 33 ms with a sensitivity of 94.12 (95% CI: 80-99.3) and a specificity of 91.30 (95% CI: 79.2-97.6). The cutoff point for T2 mapping was suggested as 35.04 ms with a sensitivity of 88.24 (95% CI: 72.5-96.7) and specificity of 97.83 (95% CI: 88.5-99.9). After bootstrap simulation, the 95% CI of the T1 rho/T2 mapping cutoff point was estimated as 29.36 to 36.32 ms and 34.8 to 35.04 ms respectively. The area under the PR curve of T1 rho/T2 mapping was 0.972 (95% CI: 0.925-0.992) and 0.949 (95% CI: 0.877-0.989) respectively. CONCLUSIONS The cutoff point of T1 rho relaxation times, which was suggested as 33 ms, could be used to distinguish early-stage and advanced OA.
Collapse
Affiliation(s)
- Zhijian Yang
- Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chao Xie
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Songwen Ou
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Minning Zhao
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaowei Lin
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
10
|
Peuna A, Thevenot J, Saarakkala S, Nieminen MT, Lammentausta E. Machine learning classification on texture analyzed T2 maps of osteoarthritic cartilage: oulu knee osteoarthritis study. Osteoarthritis Cartilage 2021; 29:859-869. [PMID: 33631317 DOI: 10.1016/j.joca.2021.02.561] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 01/04/2021] [Accepted: 02/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To introduce local binary pattern (LBP) texture analysis to cartilage osteoarthritis (OA) research and compare the performance of different classification systems in discrimination of OA subjects from healthy controls using gray-level co-occurrence matrix (GLCM) and LBP texture data. Classification algorithms were used to reduce the dimensionality of texture data into a likelihood of subject belonging to the reference class. METHOD T2 relaxation time mapping with multi-slice multi-echo spin echo sequence was performed for eighty symptomatic OA patients and 63 asymptomatic controls on a 3T clinical MRI scanner. Relaxation time maps were subjected to GLCM and LBP texture analysis, and classification algorithms were deployed with an in-house developed software. Implemented algorithms were K nearest neighbors, support vector machine, and neural network classifier. RESULTS LBP and GLCM discerned OA patients from controls with a significant difference in all studied regions. Classification models comprising GLCM and LBP showed high accuracy in classing OA patients and controls. The best performance was obtained with a multilayer perceptron type classifier with an overall accuracy of 90.2 %. CONCLUSION LBP texture analysis complements prior results with GLCM, and together LBP and GLCM serve as significant input data for classification algorithms trained for OA assessment. Presented algorithms are adaptable to versatile OA evaluations also for future gradational or predictive approaches.
Collapse
Affiliation(s)
- A Peuna
- Department of Medical Imaging, Central Finland Central Hospital, Jyväskylä, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
| | - J Thevenot
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - S Saarakkala
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - E Lammentausta
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| |
Collapse
|
11
|
Razmjoo A, Caliva F, Lee J, Liu F, Joseph GB, Link TM, Majumdar S, Pedoia V. T 2 analysis of the entire osteoarthritis initiative dataset. J Orthop Res 2021; 39:74-85. [PMID: 32691905 DOI: 10.1002/jor.24811] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 02/04/2023]
Abstract
While substantial work has been done to understand the relationships between cartilage T2 relaxation times and osteoarthritis (OA), diagnostic and prognostic abilities of T2 on a large population yet need to be established. Using 3921 manually annotated 2D multi-slice multi-echo spin-echo magnetic resonance imaging volume, a segmentation model for automatic knee cartilage segmentation was built and evaluated. The optimized model was then used to calculate T2 values on the entire osteoarthritis initiative (OAI) dataset composed of longitudinal acquisitions of 4796 unique patients, 25 729 magnetic resonance imaging studies in total. Cross-sectional relationships between T2 values, OA risk factors, radiographic OA, and pain were analyzed in the entire OAI dataset. The performance of T2 values in predicting the future incidence of radiographic OA as well as total knee replacement (TKR) were also explored. Automatic T2 values were comparable with manual ones. Significant associations between T2 relaxation times and demographic and clinical variables were found. Subjects in the highest 25% quartile of tibio-femoral T2 values had a five times higher risk of radiographic OA incidence 2 years later. Elevation of medial femur T2 values was significantly associated with TKR after 5 years (coeff = 0.10; P = .036; CI = [0.01,0.20]). Our investigation reinforces the predictive value of T2 for future incidence OA and TKR. The inclusion of T2 averages from the automatic segmentation model improved several evaluation metrics when compared to only using demographic and clinical variables.
Collapse
Affiliation(s)
- Alaleh Razmjoo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Francesco Caliva
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Jinhee Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Felix Liu
- Department of Epidemiology and Biostatistics, University of California, San Franscisco, California
| | - Gabby B Joseph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California
| |
Collapse
|
12
|
Burge AJ, Jawetz ST. Advanced Magnetic Resonance Imaging in Osteoarthritis. Semin Musculoskelet Radiol 2020; 24:355-366. [PMID: 32992364 DOI: 10.1055/s-0040-1708822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Osteoarthritis (OA) is one of the most common causes of disability throughout the world. Current therapeutic strategies are aimed at preventing the development and delaying the progression of OA, as well as repairing or replacing worn articular surfaces, because the regeneration of lost hyaline articular cartilage is not currently a clinically feasible option. Imaging is useful in formulating treatment strategies in patients at risk for OA, allowing assessment of risk factors, the degree of preexisting tissue damage, and posttreatment monitoring. Magnetic resonance imaging (MRI), in particular, provides in-depth evaluation of these patients, with optimal clinical sequencing allowing sensitive assessment of chondral signal and morphology, and the addition of advanced MRI techniques facilitating comprehensive evaluation of joint health, with increased sensitivity for changes in articular cartilage and surrounding joint tissues.
Collapse
Affiliation(s)
- Alissa J Burge
- Department of Radiology and Imaging (MRI), MRI Laboratory, Hospital for Special Surgery, New York
| | - Shari T Jawetz
- Department of Radiology and Imaging, Hospital for Special Surgery, New York
| |
Collapse
|
13
|
Ashmeik W, Joseph GB, Nevitt MC, Lane NE, McCulloch CE, Link TM. Association of blood pressure with knee cartilage composition and structural knee abnormalities: data from the osteoarthritis initiative. Skeletal Radiol 2020; 49:1359-1368. [PMID: 32146485 PMCID: PMC7365750 DOI: 10.1007/s00256-020-03409-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/24/2020] [Accepted: 03/01/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the associations of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with changes in knee cartilage composition and joint structure over 48 months, using magnetic resonance imaging (MRI) data from the Osteoarthritis Initiative (OAI). MATERIALS AND METHODS A total of 1126 participants with right knee Kellgren-Lawrence (KL) score 0-2 at baseline, no history of rheumatoid arthritis, blood pressure measurements at baseline, and cartilage T2 measurements at baseline and 48 months were selected from the OAI. Cartilage composition was assessed using MRI T2 measurements, including laminar and gray-level co-occurrence matrix texture analyses. Structural knee abnormalities were graded using the whole-organ magnetic resonance imaging score (WORMS). We performed linear regression, adjusting for age, sex, body mass index, physical activity, smoking status, alcohol use, KL score, number of anti-hypertensive medications, and number of nonsteroidal anti-inflammatory drugs. RESULTS Higher baseline DBP was associated with greater increases in global T2 (coefficient 0.22 (95% CI 0.09, 0.34), P = 0.004), global superficial layer T2 (coefficient 0.39 (95% CI 0.20, 0.58), P = 0.001), global contrast (coefficient 15.67 (95% CI 8.81, 22.53), P < 0.001), global entropy (coefficient 0.02 (95% CI 0.01, 0.03) P = 0.011), and global variance (coefficient 9.14 (95% CI 5.18, 13.09), P < 0.001). Compared with DBP, the associations of SBP with change in cartilage T2 parameters and WORMS subscores showed estimates of smaller magnitude. CONCLUSION Higher baseline DBP was associated with higher and more heterogenous cartilage T2 values over 48 months, indicating increased cartilage matrix degenerative changes.
Collapse
Affiliation(s)
- Walid Ashmeik
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Gabby B. Joseph
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Nancy E. Lane
- Department of Medicine and Center for Musculoskeletal Health, University of California Davis, Sacramento, California, USA
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| |
Collapse
|
14
|
Lin Z, Yang Z, Wang H, Zhao M, Liang W, Lin L. Histological Grade and Magnetic Resonance Imaging Quantitative T1rho/T2 Mapping in Osteoarthritis of the Knee: A Study in 20 Patients. Med Sci Monit 2019; 25:10057-10066. [PMID: 31881548 PMCID: PMC6946051 DOI: 10.12659/msm.918274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Magnetic resonance imaging (MRI) of osteoarthritis (OA) of the knee is a preoperative method of joint assessment. Histology of the joint is invasive and performed after surgery. T1rho/T2 MRI mapping is a new preoperative method of quantifying joint changes. This study aimed to analyze and compare the histological changes in the joint cartilage with the use of quantitative T1rho/T2 MRI mapping in patients with OA of the knee. Material/Methods Twenty patients with OA of the knee (20 knees) underwent preoperative MRI with T1rho mapping, T2 mapping, T1-weighted, and T2-weighted fat-suppressed MRI sequences. The degree of OA of the knee on MRI was graded according to the Osteoarthritis Research Society International (OARSI) criteria and the Kellgren-Lawrence grading system. Histological grading of OA used the OARSI criteria. Four tibiofemoral condyles were assessed histologically, and the degree of cartilage destruction was determined using the OARSI criteria. Two investigators performed cartilage segmentation for T1rho/T2 values. Results Histology of the four knee joint condyles confirmed mild to severe OA. The histology of the cartilage thickness (P<0.001) and the MRI findings of the distal medial condyle (P<0.00) were significantly different from the other three knee joint condyles. The T2 and T1rho values of each condyle were significantly correlated with the histological grade (II–IV) of the joint condyles, including the cartilage volume, cartilage defects, thickness, and bone lesions (P<0.05). Conclusions In 20 patients with OA of the knee, preoperative T2/T1rho MRI identified Grade II–IV OA changes in the joint.
Collapse
Affiliation(s)
- Zhaowei Lin
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Zhijian Yang
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland).,Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China (mainland)
| | - Huashou Wang
- Department of Pathology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Minning Zhao
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Wen Liang
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| | - Lijun Lin
- Department of Orthopaedics, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (mainland)
| |
Collapse
|
15
|
Lehtovirta S, Mäkitie RE, Casula V, Haapea M, Niinimäki J, Niinimäki T, Peuna A, Lammentausta E, Mäkitie O, Nieminen MT. Defective WNT signaling may protect from articular cartilage deterioration - a quantitative MRI study on subjects with a heterozygous WNT1 mutation. Osteoarthritis Cartilage 2019; 27:1636-1646. [PMID: 31299386 DOI: 10.1016/j.joca.2019.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/01/2019] [Accepted: 07/03/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE WNT signaling is of key importance in chondrogenesis and defective WNT signaling may contribute to the pathogenesis of osteoarthritis and other cartilage diseases. Biochemical composition of articular cartilage in patients with aberrant WNT signaling has not been studied. Our objective was to assess the knee articular cartilage in WNT1 mutation-positive individuals using a 3.0T MRI unit to measure cartilage thickness, relaxation times, and texture features. DESIGN Cohort comprised mutation-positive (N = 13; age 17-76 years) and mutation-negative (N = 13; 16-77 years) subjects from two Finnish families with autosomal dominant WNT1 osteoporosis due to a heterozygous missense mutation c.652T>G (p.C218G) in WNT1. All subjects were imaged with a 3.0T MRI unit and assessed for cartilage thickness, T2 and T1ρ relaxation times, and T2 texture features contrast, dissimilarity and homogeneity of T2 relaxation time maps in six regions of interest (ROIs) in the tibiofemoral cartilage. RESULTS All three texture features showed opposing trends with age between the groups in the medial tibiofemoral cartilage (P = 0.020-0.085 for the difference of the regression coefficients), the mutation-positive individuals showing signs of cartilage preservation. No significant differences were observed in the lateral tibiofemoral cartilage. Cartilage thickness and means of T2 relaxation time did not differ between groups. Means of T1ρ relaxation time were significantly different in one ROI but the regression analysis displayed no differences. CONCLUSIONS Our results show less age-related cartilage deterioration in the WNT1 mutation-positive than the mutation-negative subjects. This suggests, that the WNT1 mutation may alter cartilage turnover and even have a potential cartilage-preserving effect.
Collapse
Affiliation(s)
- S Lehtovirta
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland
| | - R E Mäkitie
- Folkhälsan Institute of Genetics and Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, FI-00290, Finland.
| | - V Casula
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland
| | - M Haapea
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FI-90220, Finland
| | - J Niinimäki
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FI-90220, Finland
| | - T Niinimäki
- Department of Orthopedics, Oulu University Hospital, Oulu, FI-90220, Finland
| | - A Peuna
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FI-90220, Finland
| | - E Lammentausta
- Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FI-90220, Finland
| | - O Mäkitie
- Folkhälsan Institute of Genetics and Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, FI-00290, Finland; Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, FI-00290, Finland; Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, SE-171 76, Stockholm, Sweden
| | - M T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, FI-90014, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Oulu, FI-90220, Finland
| |
Collapse
|
16
|
Pedoia V, Lee J, Norman B, Link TM, Majumdar S. Diagnosing osteoarthritis from T 2 maps using deep learning: an analysis of the entire Osteoarthritis Initiative baseline cohort. Osteoarthritis Cartilage 2019; 27:1002-1010. [PMID: 30905742 PMCID: PMC6579664 DOI: 10.1016/j.joca.2019.02.800] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 01/23/2019] [Accepted: 02/21/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We aim to study to what extent conventional and deep-learning-based T2 relaxometry patterns are able to distinguish between knees with and without radiographic osteoarthritis (OA). METHODS T2 relaxation time maps were analyzed for 4,384 subjects from the baseline Osteoarthritis Initiative (OAI) Dataset. Voxel Based Relaxometry (VBR) was used for automatic quantification and voxel-based analysis of the differences in T2 between subjects with and without radiographic OA. A Densely Connected Convolutional Neural Network (DenseNet) was trained to diagnose OA from T2 data. For comparison, more classical feature extraction techniques and shallow classifiers were used to benchmark the performance of our algorithm's results. Deep and shallow models were evaluated with and without the inclusion of risk factors. Sensitivity and Specificity values and McNemar test were used to compare the performance of the different classifiers. RESULTS The best shallow model was obtained when the first ten Principal Components, demographics and pain score were included as features (AUC = 77.77%, Sensitivity = 67.01%, Specificity = 71.79%). In comparison, DenseNet trained on raw T2 data obtained AUC = 83.44%, Sensitivity = 76.99%, Specificity = 77.94%. McNemar test on two misclassified proportions form the shallow and deep model showed that the boost in performance was statistically significant (McNemar's chi-squared = 10.33, degree of freedom (DF) = 1, P-value = 0.0013). CONCLUSION In this study, we presented a Magnetic Resonance Imaging (MRI)-based data-driven platform using T2 measurements to characterize radiographic OA. Our results showed that feature learning from T2 maps has potential in uncovering information that can potentially better diagnose OA than simple averages or linear patterns decomposition.
Collapse
Affiliation(s)
- V Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA; Center of Digital Health Innovation (CDHI), USA.
| | - J Lee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
| | - B Norman
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
| | - T M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA.
| | - S Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, USA; Center of Digital Health Innovation (CDHI), USA.
| |
Collapse
|
17
|
Edd SN, Babel H, Kerkour N, Jolles BM, Omoumi P, Favre J. Comprehensive description of T2 value spatial variations in non-osteoarthritic femoral cartilage using three-dimensional registration of morphological and relaxometry data. Knee 2019; 26:555-563. [PMID: 31078393 DOI: 10.1016/j.knee.2019.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/31/2019] [Accepted: 03/17/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE The aim of this study was to develop and assess a method of quantifying cartilage T2 relaxation times in a series of volumes of interest (VOIs) covering the entire cartilage of the femoral condyles. Subsequently, the method was used to test for T2 spatial variations in non-osteoarthritic (OA) knees. METHODS Ten non-OA subjects (five female, average 30 years) were enrolled after informed consent. Three-dimensional bone and cartilage models were created by double echo steady state (DESS) morphological magnetic resonance image (MRI) segmentation, and the models were semi-manually registered with multi-slice, multi-echo (MSME) T2 MRI. Mean T2 values were calculated for 12 VOIs derived from cartilage thickness literature and their respective superficial and deep layers. RESULTS Analyses showed that intra- and inter-rater reliabilities of the presented method were "good" to "excellent" in more than 90% of the VOIs. Additionally, several spatial differences in T2 values were observed, including, for the medial condyle, higher T2 values in the anterior and central VOIs versus in the posterior VOI (p < .05). T2 values were also generally higher in the superficial versus deep layers (p < .05). CONCLUSIONS The presented MRI T2 analysis method is reliable and provides a comprehensive quantification of spatial heterogeneity of healthy cartilage compositional properties. This method can be further applied to better understand knee OA pathophysiology and potentially define clinically relevant diagnostic features of the disease.
Collapse
Affiliation(s)
- Shannon N Edd
- Department of Musculoskeletal Medicine (DAL), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
| | - Hugo Babel
- Department of Musculoskeletal Medicine (DAL), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Nadia Kerkour
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Brigitte M Jolles
- Department of Musculoskeletal Medicine (DAL), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Julien Favre
- Department of Musculoskeletal Medicine (DAL), Lausanne University Hospital (CHUV), Lausanne, Switzerland
| |
Collapse
|
18
|
The Possibilities of Magnetic Resonance Imaging in the Diagnosis of Microstructural Changes of the Subchondral Bone in Osteoarthritis. ACTA BIOMEDICA SCIENTIFICA 2019. [DOI: 10.29413/abs.2018-3.6.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background. Magnetic resonance imaging not only has powerful capabilities for visualization, but is also of interest in terms of obtaining ideas about microstructural and biochemical changes in the tissues of the joints in osteoarthritis. Aims. To assess the possibility of T2-images of magnetic resonance imaging in the diagnosis of microstructural changes in the subchondral bone in osteoarthritis. Materials and methods. 62 patients with osteoarthritis and 8 volunteers without osteoarthritis were examined. All patients underwent magnetic resonance imaging of knee. To assess the variability of transverse relaxation time, the T2-images segmentation of the subchondral segmentation in the frontal projection was performed by hand. The proton density was estimated from a 3D histogram on a scale of 0 to 255. Results. At the first stage of osteoarthritis, the intensity of the magnetic resonance signal decreases over the entire surface of the tibial plateau, with minimal values in the region of the medial part of the knee joint. At stage 2 osteoarthritis, there was an even greater decrease in the number of protons that made the phase transition with the lowest value in the medial region. The subchondral bone texture in stage 3 was characterized by a significant decrease in signal intensity in the region of the medial plateau of the tibia. In the terminal stage of osteoarthritis. Conclusion. The revealed regularity of the change in the relaxation time spectrum of T2-images reflects the degenerative process in subchondral bone with osteoarthritis.
Collapse
|
19
|
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.
Collapse
Affiliation(s)
| | | | | | | | | | - Xiaobing Xi
- Orthopedics and Traumatology Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | | |
Collapse
|
20
|
Pedoia V, Majumdar S. Translation of morphological and functional musculoskeletal imaging. J Orthop Res 2019; 37:23-34. [PMID: 30273968 DOI: 10.1002/jor.24151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/24/2018] [Indexed: 02/04/2023]
Abstract
In an effort to develop quantitative biomarkers for degenerative joint disease and fill the void that exists for diagnosing, monitoring, and assessing the extent of whole joint degeneration, the past decade has been marked by a greatly increased role of noninvasive imaging. This coupled with recent advances in image processing and deep learning opens new possibilities for promising quantitative techniques. The clinical translation of quantitative imaging was previously hampered by tedious non-scalable and subjective image analysis. Osteoarthritis (OA) diagnosis using X-rays can be automated by the use of deep learning models and pilot studies showed feasibility of using similar techniques to reliably segment multiple musculoskeletal tissues and detect and stage the severity of morphological abnormalities in magnetic resonance imaging (MRI). Automation and more advanced feature extraction techniques have applications on larger more heterogeneous samples. Analyses based on voxel based relaxometry have shown local patterns in relaxation time elevations and local correlations with outcome variables. Bone cartilage interactions are also enhanced by the analysis of three-dimensional bone morphology and the potential for the assessment of metabolic activity with simultaneous Positron Emission Tomography (PET)/MR systems. Novel techniques in image processing and deep learning are augmenting imaging to be a source of quantitative and reliable data and new multidimensional analytics allow us to exploit the interactions of data from various sources. In this review, we aim to summarize recent advances in quantitative imaging, the application of image processing and deep learning techniques to study knee and hip OA. ©2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res XX:XX-XX, 2018.
Collapse
Grants
- GE Healthcare
- P50 AR060752 National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, (NIH-NIAMS)
- R01AR046905 National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, (NIH-NIAMS)
- K99AR070902 National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, (NIH-NIAMS)
- R00AR070902 National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, (NIH-NIAMS)
- R61AR073552 National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, (NIH-NIAMS)
Collapse
Affiliation(s)
- Valentina Pedoia
- Department of Radiology and Biomedical Imaging, QB3 Building, 2nd Floor, Suite 203, 1700 - 4th Street, University of California, San Francisco, California, 94158
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, QB3 Building, 2nd Floor, Suite 203, 1700 - 4th Street, University of California, San Francisco, California, 94158
| |
Collapse
|
21
|
Samaan MA, Pedoia V, Zhang AL, Gallo MC, Link TM, Souza RB, Majumdar S. A novel mr-based method for detection of cartilage delamination in femoroacetabular impingement patients. J Orthop Res 2018; 36:971-978. [PMID: 28762536 PMCID: PMC5794666 DOI: 10.1002/jor.23667] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/29/2017] [Indexed: 02/04/2023]
Abstract
In this study, quantitative magnetic resonance based measurements were used to evaluate T1ρ and T2 mapping and heterogeneity in femoroacetabular impingement (FAI) patients with acetabular cartilage delamination and to determine the ability of these quantitative MR-based measurements in detecting delamination. Unilateral hip joint MR-scans of 36 FAI patients with arthroscopically-confirmed acetabular cartilage delamination and 36 age, gender, and BMI matched controls were obtained. T1ρ and T2 mapping and heterogeneity of the hip joint articular cartilage were assessed in both groups using voxel-based relaxometry (VBR). Quantitative MR-based measurements were compared using statistical parametric mapping (SPM). Receiver operating characteristic (ROC) analysis was used to assess the ability of these quantitative measurements in detecting delamination by calculating the area under the curve (AUC). Pearson partial correlations (r) were used to assess for associations between T1ρ and T2 radial heterogeneity with the alpha angle in FAI patients. T1ρ and T2 global acetabular values were significantly higher in FAI patients with a focal increase within the posterior acetabular cartilage. FAI patients exhibited increased anterior superior acetabular T1ρ and T2 heterogeneity and both of these measures demonstrated a strong ability to detect acetabular cartilage delamination (T1ρ AUC: 0.96, p < 0.001; T2 AUC: 0.93, p < 0.001). FAI patients with a larger alpha angle exhibited increased anterior superior acetabular T1ρ (r = 0.48, p = 0.02) and T2 (r = 0.42, p = 0.03) heterogeneity. T1ρ and T2 heterogeneity within the anterior superior acetabular cartilage was shown to be a sensitive measure in detecting delamination and may prove beneficial to clinicians in determining optimal interventions for FAI patients. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:971-978, 2018.
Collapse
Affiliation(s)
- Michael A. Samaan
- Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA
| | - Alan L. Zhang
- Department of Orthopaedic Surgery, University of California-San Francisco, San Francisco, CA
| | - Matthew C. Gallo
- Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA
| | - Richard B. Souza
- Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA
- Department of Physical Therapy and Rehabilitation Science, University of California-San Francisco, San Francisco, CA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California – San Francisco, San Francisco, CA
| |
Collapse
|
22
|
Savic D, Pedoia V, Seo Y, Yang J, Bucknor M, Franc BL, Majumdar S. Imaging Bone-Cartilage Interactions in Osteoarthritis Using [ 18F]-NaF PET-MRI. Mol Imaging 2018; 15:1-12. [PMID: 28654417 PMCID: PMC5470142 DOI: 10.1177/1536012116683597] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: Simultaneous positron emission tomography–magnetic resonance imaging (PET-MRI) is an emerging technology providing both anatomical and functional images without increasing the scan time. Compared to the traditional PET/computed tomography imaging, it also exposes the patient to significantly less radiation and provides better anatomical images as MRI provides superior soft tissue characterization. Using PET-MRI, we aim to study interactions between cartilage composition and bone function simultaneously, in knee osteoarthritis (OA). Procedures: In this article, bone turnover and remodeling was studied using [18F]-sodium fluoride (NaF) PET data. Quantitative MR-derived T1ρ relaxation times characterized the biochemical cartilage degeneration. Sixteen participants with early signs of OA of the knee received intravenous injections of [18F]-NaF at the onset of PET-MR image acquisition. Regions of interest were identified, and kinetic analysis of dynamic PET data provided the rate of uptake (Ki) and the normalized uptake (standardized uptake value) of [18F]-NaF in the bone. Morphological MR images and quantitative voxel-based T1ρ maps of cartilage were obtained using an atlas-based registration technique to segment cartilage automatically. Voxel-by-voxel statistical parameter mapping was used to investigate the relationship between bone and cartilage. Results: Increases in cartilage T1ρ, indicating degenerative changes, were associated with increased turnover in the adjoining bone but reduced turnover in the nonadjoining compartments. Associations between pain and increased bone uptake were seen in the absence of morphological lesions in cartilage, but the relationship was reversed in the presence of incident cartilage lesions. Conclusion: This study shows significant cartilage and bone interactions in OA of the knee joint using simultaneous [18F]-NaF PET-MR, the first in human study. These observations highlight the complex biomechanical and biochemical interactions in the whole knee joint in OA, which potentially could help assess therapeutic targets in treating OA.
Collapse
Affiliation(s)
- Dragana Savic
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA.,2 Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Valentina Pedoia
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Youngho Seo
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Jaewon Yang
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Matt Bucknor
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Benjamin L Franc
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| |
Collapse
|
23
|
Hofmann FC, Neumann J, Heilmeier U, Joseph GB, Nevitt MC, McCulloch CE, Link TM. Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skeletal Radiol 2018; 47:93-106. [PMID: 28852821 PMCID: PMC5699952 DOI: 10.1007/s00256-017-2759-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 06/29/2017] [Accepted: 08/09/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the association of cartilage degeneration with previous knee injuries not undergoing surgery, determined by morphologic and quantitative 3-T magnetic resonance imaging (MRI). MATERIALS AND METHODS We performed a nested cross-sectional study of right knee MRIs from participants in the Osteoarthritis Initiative (OAI) aged 45-79 with baseline Kellgren-Lawrence score of 0-2. Cases were 142 right knees of patients with self-reported history of injury limiting the ability to walk for at least 2 days. Controls were 426 right knees without history of injury, frequency-matched to cases on age, BMI, gender, KL scores and race (1:3 ratio). Cases and controls were compared using covariate-adjusted linear regression analysis, with the outcomes of region-specific T2 mean, laminar analysis and heterogeneity measured by texture analysis to investigate early cartilage matrix abnormalities and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) to investigate morphologic knee lesions. RESULTS Compared to control subjects, we found significantly higher mean T2 values in the injury [lateral tibia (28.10 ms vs. 29.11 ms, p = 0.001), medial tibia (29.70 ms vs. 30.40 ms, p = 0.014) and global knee cartilage (32.73 ms vs. 33.29 ms, p = 0.005)]. Injury subjects also had more heterogeneous cartilage as measured by GLCM texture contrast, variance and entropy (p < 0.05 in 14 out of 18 texture parameters). WORMS gradings were not significantly different between the two groups (p > 0.05). CONCLUSION A history of knee injury not treated surgically is associated with higher and more heterogeneous T2 values, but not with morphologic knee abnormalities. Our findings suggest that significant, conservatively treated knee injuries are associated with permanent cartilage matrix abnormalities.
Collapse
Affiliation(s)
- Felix C. Hofmann
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA,Department of Radiology, Technical University of Munich, Munich, Germany
| | - Jan Neumann
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Ursula Heilmeier
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Gabby B. Joseph
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Thomas M. Link
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| |
Collapse
|
24
|
Peuna A, Hekkala J, Haapea M, Podlipská J, Guermazi A, Saarakkala S, Nieminen MT, Lammentausta E. Variable angle gray level co-occurrence matrix analysis of T2
relaxation time maps reveals degenerative changes of cartilage in knee osteoarthritis: Oulu knee osteoarthritis study. J Magn Reson Imaging 2017; 47:1316-1327. [DOI: 10.1002/jmri.25881] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/10/2017] [Indexed: 12/25/2022] Open
Affiliation(s)
- Arttu Peuna
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Joonas Hekkala
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
| | - Marianne Haapea
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Jana Podlipská
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology; Boston University School of Medicine; Boston Massachusetts USA
| | - Simo Saarakkala
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Miika T. Nieminen
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu and Oulu University Hospital; Oulu Finland
| | - Eveliina Lammentausta
- Research Unit of Medical Imaging; Physics and Technology, University of Oulu; Oulu Finland
- Department of Diagnostic Radiology; Oulu University Hospital; Oulu Finland
| |
Collapse
|
25
|
Cluster analysis of quantitative MRI T 2 and T 1ρ relaxation times of cartilage identifies differences between healthy and ACL-injured individuals at 3T. Osteoarthritis Cartilage 2017; 25:513-520. [PMID: 27720806 PMCID: PMC5359021 DOI: 10.1016/j.joca.2016.09.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 08/07/2016] [Accepted: 09/22/2016] [Indexed: 02/02/2023]
Abstract
PURPOSE To identify focal lesions of elevated MRI T2 and T1ρ relaxation times in articular cartilage of an ACL-injured group using a novel cluster analysis technique. MATERIALS AND METHODS Eighteen ACL-injured patients underwent 3T MRI T2 and T1ρ relaxometry at baseline, 6 months and 1 year and six healthy volunteers at baseline, 1 day and 1 year. Clusters of contiguous pixels above or below T2 and T1ρ intensity and area thresholds were identified on a projection map of the 3D femoral cartilage surface. The total area of femoral cartilage plate covered by clusters (%CA) was split into areas above (%CA+) and below (%CA-) the thresholds and the differences in %CA(+ or -) over time in the ACL-injured group were determined using the Wilcoxon signed rank test. RESULTS %CA+ was greater in the ACL-injured patients than the healthy volunteers at 6 months and 1 year with average %CA+ of 5.2 ± 4.0% (p = 0.0054) and 6.6 ± 3.7% (p = 0.0041) for T2 and 6.2 ± 7.1% (p = 0.063) and 8.2 ± 6.9% (p = 0.042) for T1ρ, respectively. %CA- at 6 months and 1 year was 3.0 ± 1.8% (p > 0.1) and 5.9 ± 5.0% (p > 0.1) for T2 and 4.4 ± 4.9% (p > 0.1) and 4.5 ± 4.6% (p > 0.1) for T1ρ, respectively. CONCLUSION With the proposed cluster analysis technique, we have quantified cartilage lesion coverage and demonstrated that the ACL-injured group had greater areas of elevated T2 and T1ρ relaxation times as compared to healthy volunteers.
Collapse
|
26
|
Williams A, Winalski CS, Chu CR. Early articular cartilage MRI T2 changes after anterior cruciate ligament reconstruction correlate with later changes in T2 and cartilage thickness. J Orthop Res 2017; 35:699-706. [PMID: 27381512 PMCID: PMC5823014 DOI: 10.1002/jor.23358] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/02/2016] [Indexed: 02/04/2023]
Abstract
UNLABELLED Anterior cruciate ligament (ACL) injury is a known risk factor for future development of osteoarthritis (OA). This human clinical study seeks to determine if early changes to cartilage MRI T2 maps between baseline and 6 months following ACL reconstruction (ACLR) are associated with changes to cartilage T2 and cartilage thickness between baseline and 2 years after ACLR. Changes to T2 texture metrics and T2 mean values in medial knee cartilage of 17 human subjects 6 months after ACLR were compared to 2-year changes in T2 and in cartilage thickness of the same areas. T2 texture and mean assessments were also compared to that of 11 uninjured controls. In ACLR subjects, six-month changes in mean T2 correlated to 2-year changes in mean T2 (R = 0.80, p = 0.0001), and 6-month changes to T2 texture metrics, but not T2 mean, correlated with 2-year changes in medial femoral cartilage thickness in 9 of the 20 texture features assessed (R = 0.48-0.72, p ≤ 0.05). Both mean T2 and texture differed (p < 0.05) between ALCR subjects and uninjured controls. CLINICAL SIGNIFICANCE These results show that short-term longitudinal evaluation of T2 map and textural changes may provide early warning of cartilage at risk for progressive degeneration after ACL injury and reconstruction. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:699-706, 2017.
Collapse
Affiliation(s)
- Ashley Williams
- Department of Orthopaedic Surgery, Stanford University, Stanford, California
| | - Carl S. Winalski
- Department of Biomedical Engineering and Imaging Institute, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Constance R. Chu
- Department of Orthopaedic Surgery, Stanford University, Stanford, California,Veterans Administration Palo Alto Health Care System, Palo Alto, California
| |
Collapse
|
27
|
Maher SA, Wang H, Koff MF, Belkin N, Potter HG, Rodeo SA. Clinical platform for understanding the relationship between joint contact mechanics and articular cartilage changes after meniscal surgery. J Orthop Res 2017; 35:600-611. [PMID: 27410773 DOI: 10.1002/jor.23365] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 07/02/2016] [Indexed: 02/04/2023]
Abstract
Injury to the meniscus of the knee has been implicated as a significant risk factor for the subsequent development of osteoarthritis, but the mechanisms of joint degeneration are unclear. Our objective was to develop a clinically applicable methodology to evaluate the relationship of joint contact mechanics at the time of surgery to biological changes of articular cartilage as a function of time following surgery. A series of pre-, intra-, and post-operative protocols were developed which utilized electronic sensors for the direct measurement of contact mechanics, and advanced imaging to assess cartilage health. The tests were applied to a pilot cohort of young active patients undergoing meniscus allograft transplantation. Our study demonstrated significant variability across patients in terms of contact area and peak contact stress, both before and after transplantation. Nonetheless, the majority of patients exhibited decreased peak contact stress and increased contact area after graft implantation. MR scans at 3-6 months showed decreased T1ρ values in tibial articular cartilage, suggesting an increase in proteoglycan content or concomitant decrease in water content. Prolongation of T2 values was found primarily within the central, cartilage-cartilage contact region of the tibial plateau suggested disruption of the collagen network. Minimal differences were found in cartilage thickness over the short time frame of this preliminary study. With longer clinical follow-up, our platform of clinical tests can be used to better understand the patient-specific mechanical factors that are related to increased risk of OA after meniscus injury and surgery. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:600-611, 2017.
Collapse
Affiliation(s)
- Suzanne A Maher
- Tissue Engineering Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Hongsheng Wang
- Tissue Engineering Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Matthew F Koff
- Magnetic Resonance Imaging Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Nicole Belkin
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Hollis G Potter
- Magnetic Resonance Imaging Laboratory, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| | - Scott A Rodeo
- Tissue Engineering Regeneration and Repair Program, Hospital for Special Surgery, 535 East 70th Street, New York, 10021.,Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, 10021
| |
Collapse
|
28
|
Eagle S, Potter HG, Koff MF. Morphologic and quantitative magnetic resonance imaging of knee articular cartilage for the assessment of post-traumatic osteoarthritis. J Orthop Res 2017; 35:412-423. [PMID: 27325163 DOI: 10.1002/jor.23345] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 06/14/2016] [Indexed: 02/04/2023]
Abstract
Orthopedic trauma, such as anterior cruciate ligament (ACL) disruption, is a common source of osteoarthritis in the knee. Magnetic resonance imaging (MRI) is a non-invasive multi-planar imaging modality commonly used to evaluate hard and soft tissues of diarthrodial joints following traumatic injury. The contrast provided by generated images enables the evaluation of bone marrow lesions as well as delamination and degeneration of articular cartilage. We will provide background information about MRI signal generation and decay (T1 and T2 values), the utility of morphologic MRI, and the quantitative MRI techniques of T1ρ , T2 , and T2 * mapping, to evaluate subjects with traumatic knee injuries, such as ACL rupture. Additionally, we will provide information regarding the dGEMRIC, sodium, and gagCEST imaging techniques. Finally, the description and utility of newer post hoc analysis techniques, such as texture analysis, will be given. Continued development and refinement of these advanced MRI techniques will facilitate their clinical translation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:412-423, 2017.
Collapse
Affiliation(s)
- Sonja Eagle
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Hollis G Potter
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| | - Matthew F Koff
- MRI Laboratory, Department of Radiology and Imaging-MRI, Hospital for Special Surgery, 535 East 70th Street, Room: BW-08G, New York, New York, 10021
| |
Collapse
|
29
|
Russell C, Pedoia V, Amano K, Potter H, Majumdar S. Baseline cartilage quality is associated with voxel-based T 1ρ and T 2 following ACL reconstruction: A multicenter pilot study. J Orthop Res 2017; 35:688-698. [PMID: 27138363 PMCID: PMC6860012 DOI: 10.1002/jor.23277] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/25/2016] [Indexed: 02/04/2023]
Abstract
In this multi-center study, voxel-based relaxometry (VBR), a novel technique to automatically quantify localized cartilage change, was used to investigate T1ρ and T2 relaxation times of patients with anterior cruciate ligament (ACL) tears at the time of injury and 6 months after reconstructive surgery. Sixty-four ACL-injured patients from three sites underwent bilateral 3T MR T1ρ and T2 mapping; 56 patients returned 6 months after surgery. Cross-sectional and longitudinal VBR comparisons of relaxation times were calculated. Noyes Score (NS) clinical grades of cartilage lesions were noted at both times and correlated with relaxation times. Lastly, patients were divided into two groups based on baseline NS grades in the injured knee. T1ρ times of each group were assessed with VBR and compared. Results illustrate the feasibility of VBR for efficiently analyzing data from patients at different sites. Significant relaxation time elevations at baseline were observed in the injured knee compared to the uninjured, particularly in the posterolateral tibia (pLT). Longitudinally, a decrease was observed in the pLT and patella, while an increase was noted in the trochlea. Stratifying patients by baseline lesion presence revealed T1ρ increased more 6 months after surgery in patients with lesions. Such findings propose that the presence of cartilage lesions at baseline are associated with the longitudinal progression of T1ρ and T2 after ACL injury, and may contribute to early cartilage degeneration. Furthermore, the speed and localized specificity of automatic VBR analysis may translate well for clinical application, as seen in this multicenter study. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:688-698, 2017.
Collapse
Affiliation(s)
- Colin Russell
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California, California
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California, California
| | - Keiko Amano
- Deparment of Orthopaedic Surgery, University of California, San Francisco, California
| | - Hollis Potter
- Department of Radiology, Hospital for Special Surgery, New York City, New York
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, Musculoskeletal Quantitative Imaging Research, University of California, California
| | | |
Collapse
|
30
|
Wise BL, Niu J, Guermazi A, Liu F, Heilmeier U, Ku E, Lynch JA, Zhang Y, Felson DT, Kwoh CK, Lane NE. Magnetic resonance imaging lesions are more severe and cartilage T2 relaxation time measurements are higher in isolated lateral compartment radiographic knee osteoarthritis than in isolated medial compartment disease - data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2017; 25:85-93. [PMID: 27539891 PMCID: PMC5182174 DOI: 10.1016/j.joca.2016.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 07/02/2016] [Accepted: 08/09/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Isolated lateral compartment tibiofemoral radiographic osteoarthritis (IL-ROA) is an understudied form of knee osteoarthritis (OA). The objective of the present study was to characterize Magnetic Resonance Imaging (MRI) abnormalities and MR-T2 relaxation time measurements associated with IL-ROA and with isolated medial compartment ROA (IM-ROA) compared with knees without OA. METHOD 200 case subjects with IL-ROA (Kellgren/Lawrence (K/L) grade≥2 and joint space narrowing (JSN) > 0 in the lateral compartment but JSN = 0 in the medial compartment) were randomly selected from the Osteoarthritis Initiative baseline visit. 200 cases with IM-ROA and 200 controls were frequency matched to the IL-ROA cases. Cases and controls were analyzed for odds of having a subregion with >10% cartilage area affected, with ≥25% bone marrow lesions (BML), with meniscal tear or maceration, and for association with cartilage T2 values. RESULTS IL-ROA was more strongly associated with ipsilateral MRI knee pathologies than IM-ROA (IL-ROA: OR = 135.2 for size of cartilage lesion, 95% CI 42.7-427.4; OR = 145.4 for large size BML, 95% CI 41.5-509.5; OR = 176 for meniscal tears, 95% CI 59.8-517.7; IM-ROA: OR = 28.4 for size of cartilage lesion, 95% CI 14.7-54.7; OR = 38.1 for size of BML, 95% CI 12.7-114; OR = 37.0 for meniscal tears, 95% CI 12-113.6). Cartilage T2 values were higher in both tibial and medial femoral compartments in IL-ROA, but in IM-ROA were only significantly different from controls in the medial femur. CONCLUSION IL-ROA knees show a greater prevalence and severity of MRI lesions and higher cartilage T2 values than IM-ROA knees compared with controls.
Collapse
Affiliation(s)
- Barton L. Wise
- Center for Musculoskeletal Health, University of California, Davis School of
Medicine, 4625 2 Avenue, Suite 2002, Sacramento, CA 95817
| | - Jingbo Niu
- Boston University School of Medicine, Boston, MA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA
| | - Felix Liu
- University of California, San Francisco School of Medicine
| | | | - Eric Ku
- University of California, San Francisco School of Medicine
| | - John A. Lynch
- University of California, San Francisco School of Medicine
| | - Yuqing Zhang
- Boston University School of Medicine, Boston, MA
| | | | - C. Kent Kwoh
- University of Arizona College of Medicine, Tuscon, AZ
| | - Nancy E. Lane
- University of California, Davis School of Medicine, Sacramento, CA
| |
Collapse
|
31
|
Pedoia V, Russell C, Randolph A, Li X, Majumdar S. Principal component analysis-T 1ρ voxel based relaxometry of the articular cartilage: a comparison of biochemical patterns in osteoarthritis and anterior cruciate ligament subjects. Quant Imaging Med Surg 2016; 6:623-633. [PMID: 28090441 DOI: 10.21037/qims.2016.11.03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Quantitative MR, including T1ρ mapping, has been extensively used to probe early biochemical changes in knee articular cartilage of subjects with osteoarthritis (OA) and others at risk for cartilage degeneration, such as those with anterior cruciate ligament (ACL) injury and reconstruction. However, limited studies have been performed aimed to assess the spatial location and patterns of T1ρ. In this study we used a novel voxel-based relaxometry (VBR) technique coupled with principal component analysis (PCA) to extract relevant features so as to describe regional patterns and to investigate their similarities and differences in T1ρ maps in subjects with OA and subjects six months after ACL reconstruction (ACLR). METHODS T1ρ quantitative MRI images were collected for 180 subjects from two separate cohorts. The OA cohort included 93 osteoarthritic patients and 25 age-matched controls. The ACLR-6M cohort included 52 patients with unilateral ACL tears who were imaged 6 months after ACL reconstruction, and 10 age-matched controls. Non-rigid registration on a single template and local Z-score conversion were adopted for T1ρ spatial and intensity normalization of all the images in the dataset. PCA was used as a data dimensionality reduction to obtain a description of all subjects in a 10-dimensional feature space. Logistic linear regression was used to identify distinctive features of OA and ACL subjects. RESULTS Global prolongation of the Z-score was observed in both OA and ACL subjects compared to controls [higher values in 1st principal component (PC1); P=0.01]. In addition, relaxation time differences between superficial and deep cartilage layers of the lateral tibia and trochlea were observed to be significant distinctive features between OA and ACL subjects. OA subjects demonstrated similar values between the two cartilage layers [higher value in 2nd principal component (PC2); P=0.008], while ACL reconstructed subjects showed T1ρ prolongation specifically in the cartilage superficial layer (lower values in PC2; P<0.0001). T1ρ elevation located outside of the weight-bearing area, located in the posterior and anterior aspects of the lateral femoral compartment, was also observed to be a key feature in distinguishing OA subjects from controls [higher value in 6th principal component (PC6); P=0.007]. CONCLUSIONS This study is the first example of T1ρ local/regional pattern analysis and data-driven feature extraction in knees with cartilage degeneration. Our results revealed similarities and differences between OA and ACL relaxation patterns that could be potentially useful to better understand the pathogenesis of post-traumatic cartilage degeneration and the identification of imaging biomarkers for the early stratification of subjects at risk for developing post-traumatic OA.
Collapse
Affiliation(s)
- Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Colin Russell
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Allison Randolph
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | | |
Collapse
|
32
|
Layer-specific femorotibial cartilage T2 relaxation time in knees with and without early knee osteoarthritis: Data from the Osteoarthritis Initiative (OAI). Sci Rep 2016; 6:34202. [PMID: 27670272 PMCID: PMC5037443 DOI: 10.1038/srep34202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/09/2016] [Indexed: 11/08/2022] Open
Abstract
Magnetic resonance imaging (MRI)-based spin-spin relaxation time (T2) mapping has been shown to be associated with cartilage matrix composition (hydration, collagen content &orientation). To determine the impact of early radiographic knee osteoarthritis (ROA) and ROA risk factors on femorotibial cartilage composition, we studied baseline values and one-year change in superficial and deep cartilage T2 layers in 60 subjects (age 60.6 ± 9.6 y; BMI 27.8 ± 4.8) with definite osteophytes in one knee (earlyROA, n = 32) and with ROA risk factors in the contralateral knee (riskROA, n = 28), and 89 healthy subjects (age 55.0 ± 7.5 y; BMI 24.4 ± 3.1) without signs or risk factors of ROA. Baseline T2 did not differ significantly between earlyROA and riskROA knees in the superficial (48.0 ± 3.5 ms vs. 48.1 ± 3.1 ms) or the deep layer (37.3 ± 2.5 ms vs. 37.3 ± 1.8 ms). However, healthy knees showed significantly lower superficial layer T2 (45.4 ± 2.3 ms) than earlyROA or riskROA knees (p ≤ 0.001) and significantly lower deep layer T2 (35.8 ± 1.8 ms) than riskROA knees (p = 0.006). Significant longitudinal change in T2 (superficial: 0.5 ± 1.4 ms; deep: 0.8 ± 1.3 ms) was only detected in healthy knees. These results do not suggest an association of early ROA (osteophytes) with cartilage composition, as assessed by T2 mapping, whereas cartilage composition was observed to differ between knees with and without ROA risk factors.
Collapse
|
33
|
Pedoia V, Gallo MC, Souza RB, Majumdar S. Longitudinal study using voxel-based relaxometry: Association between cartilage T 1ρ and T 2 and patient reported outcome changes in hip osteoarthritis. J Magn Reson Imaging 2016; 45:1523-1533. [PMID: 27626787 DOI: 10.1002/jmri.25458] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/18/2016] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To study the local distribution of hip cartilage T1ρ and T2 relaxation times and their association with changes in patient reported outcome measures (PROMs) using a fully automatic, local, and unbiased method in subjects with and without hip osteoarthritis (OA). MATERIALS AND METHODS The 3 Tesla MRI studies of the hip were obtained for 37 healthy controls and 16 subjects with radiographic hip OA. The imaging protocol included a three-dimensional (3D) SPGR sequence and a combined 3D T1ρ and T2 sequence. Quantitative cartilage analysis was compared between a traditional region of interest (ROI)-based method and a fully automatic voxel-based relaxometry (VBR) method. Additionally, VBR was used to assess local T1ρ and T2 differences between subjects with and without OA, and to evaluate the association between T1ρ and T2 and 18-month changes PROMs. RESULTS Results for the two methods were consistent in the acetabular (R = 0.79; coefficients of variation [CV] = 2.9%) and femoral cartilage (R = 0.90; CV = 2.6%). VBR revealed local patterns of T1ρ and T2 elevation in OA subjects, particularly in the posterosuperior acetabular cartilage (T1ρ : P = 0.02; T2 : P = 0.038). Overall, higher T1ρ and T2 values at baseline, particularly in the anterosuperior acetabular cartilage (T1ρ : Rho = -0.42; P = 0.002; T2 : Rho = -0.44; P = 0.002), were associated with worsening PROMS at 18-month follow-up. CONCLUSION VBR is an accurate and robust method for quantitative MRI analysis in hip cartilage. VBR showed the capability to detect local variations in T1ρ and T2 values in subjects with and without osteoarthritis, and voxel based correlations demonstrated a regional dependence between baseline T1ρ and T2 values and changes in PROMs. LEVEL OF EVIDENCE 1 J. MAGN. RESON. IMAGING 2017;45:1523-1533.
Collapse
Affiliation(s)
- Valentina Pedoia
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Matthew C Gallo
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Richard B Souza
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA.,Department of Physical Therapy and Rehabilitation Science, University of California San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| |
Collapse
|
34
|
Teng HL, Calixto N, MacLeod T, Nardo L, Link T, Majumdar S, Souza R. Associations between patellofemoral joint cartilage T1ρ and T2 and knee flexion moment and impulse during gait in individuals with and without patellofemoral joint osteoarthritis. Osteoarthritis Cartilage 2016; 24:1554-64. [PMID: 27084352 PMCID: PMC6348063 DOI: 10.1016/j.joca.2016.04.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 03/10/2016] [Accepted: 04/04/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to investigate the associations between patellofemoral cartilage T1ρ and T2 relaxation times and knee flexion moment (KFM) and KFM impulse during gait. METHOD Knee magnetic resonance (MR) images were obtained from 99 subjects with and without patellofemoral joint (PFJ) osteoarthritis (OA), using fast spin-echo, T1ρ and T2 relaxation time sequences. Patellar and trochlear cartilage relaxation times were computed for the whole cartilage, and superficial and deep layers (laminar analysis). Subjects also underwent three-dimensional (3D) gait analysis. Peak KFM and KFM impulse were calculated during the stance phase. Linear regressions were used to examine whether cartilage relaxation times were associated with knee kinetics during walking while adjusting age, sex, body mass index (BMI) and walking speed. RESULTS Higher peak KFM and KFM impulse were significantly related to higher T1ρ and T2 relaxation times of the trochlear and patellar cartilage, with standardized regression coefficients ranging from 0.21 to 0.28. Laminar analysis showed that overall the superficial layer of patellofemoral cartilage showed stronger associations with knee kinetics. Subgroup analysis revealed that in subjects with PFJ OA, every standard deviation change in knee kinetics was related to greater increases in PFJ cartilage T1ρ and T2 (standardized coefficients: 0.29 to 0.41). Conversely, in subjects without OA, weaker relationships were observed between knee kinetics and PFJ cartilage T1ρ and T2. CONCLUSIONS Our findings suggest that increased peak KFM and KFM impulse were related to worse cartilage health at the PFJ. This association is more prominent in superficial layer cartilage and cartilage with morphological lesions.
Collapse
Affiliation(s)
- H.-L. Teng
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging,
University of California, San Francisco, San Francisco, CA, United States,Address correspondence and reprint requests to: H.-L. Teng, 185 Berry Street, Suite 350, Lobby 6,
San Francisco, CA, 94107, United States. Tel: 1 (415) 514 8266
| | - N.E. Calixto
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging,
University of California, San Francisco, San Francisco, CA, United States
| | - T.D. MacLeod
- Department of Physical Therapy, California State University, Sacramento, CA, USA
| | - L. Nardo
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging,
University of California, San Francisco, San Francisco, CA, United States
| | - T.M. Link
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging,
University of California, San Francisco, San Francisco, CA, United States
| | - S. Majumdar
- Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging,
University of California, San Francisco, San Francisco, CA, United States
| | - R.B. Souza
- Musculoskeletal Quantitative Imaging Research, 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
| |
Collapse
|
35
|
Abstract
Context: Osteoarthritis (OA) is a common, worldwide disorder. Magnetic resonance (MR) imaging can directly and noninvasively evaluate articular cartilage and has emerged as an essential tool in the study of OA. Evidence Acquisition: A PubMed search was performed using the keywords quantitative MRI and cartilage. No limits were set on the range of years searched. Articles were reviewed for relevance with an emphasis on in vivo studies performed at 3 tesla. Study Design: Clinical review. Level of Evidence: Level 4. Results: T2, T2*, T1 (particularly when measured after exogenous contrast administration, such as with the delayed gadolinium-enhanced MR imaging of cartilage [dGEMRIC] technique), and T1ρ are among the most widely utilized quantitative MR imaging techniques to evaluate cartilage and have been implemented in various patient cohorts. Existing challenges include reproducibility of results, insufficient consensus regarding optimal sequences and parameters, and interpretation of values. Conclusion: Quantitative assessment of cartilage using MR imaging techniques likely represents the best opportunity to identify early cartilage degeneration and to follow patients after treatment. Despite existing challenges, ongoing work and unique approaches have shown exciting and promising results.
Collapse
Affiliation(s)
- Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California Department of Radiology, University of California, San Diego Medical Center, San Diego, California
| | - Yajun Ma
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California
| |
Collapse
|
36
|
Pandit P, Talbott JF, Pedoia V, Dillon W, Majumdar S. T1ρ and T2 -based characterization of regional variations in intervertebral discs to detect early degenerative changes. J Orthop Res 2016; 34:1373-81. [PMID: 27227485 PMCID: PMC6860013 DOI: 10.1002/jor.23311] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 05/19/2016] [Indexed: 02/04/2023]
Abstract
Lower back pain is one of the main contributors to morbidity and chronic disability in the United States. Despite the significance of the problem, it is still not well understood. There is a clear need for objective, non-invasive biomarkers to localize specific pain generators and identify early stage changes to enable reliable diagnosis and treatment. In this study we focus on intervertebral disc degeneration as a source of lower back pain. Quantitative imaging markers T1ρ and T2 have been shown to be promising techniques for in vivo diagnosis of biochemical degeneration in discs due to their sensitivity to macromolecular changes in proteoglycan content and collagen integrity. We describe a semi-automated technique for quantifying T1ρ and T2 relaxation time maps in the nucleus pulposus (NP) and the annulus fibrosus (AF) of the lumbar intervertebral discs. Compositional changes within the NP and AF associated with degeneration occur much earlier than the visually observable structural changes. The proposed technique rigorously quantifies these biochemical changes taking into account subtle regional variations to allow interpretation of early degenerative changes that are difficult to interpret with traditional MRI techniques and clinical subjective grading scores. T1ρ and T2 relaxation times in the NP decrease with degenerative severity in the disc. Moreover, standard deviation and texture measurements of these values show sharper and more significant changes during early degeneration compared to later degenerative stages. Our results suggest that future prospective studies should include automated T1ρ and T2 metrics as early biomarkers for disc degeneration-induced lower back pain. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1373-1381, 2016.
Collapse
Affiliation(s)
- Prachi Pandit
- Department of Radiology and Biomedical Imaging; University of California; 1700 4th Street, Suite 203 San Francisco California 94158
| | - Jason F. Talbott
- Department of Radiology and Biomedical Imaging; University of California; 1700 4th Street, Suite 203 San Francisco California 94158
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging; University of California; 1700 4th Street, Suite 203 San Francisco California 94158
| | - William Dillon
- Department of Radiology and Biomedical Imaging; University of California; 1700 4th Street, Suite 203 San Francisco California 94158
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging; University of California; 1700 4th Street, Suite 203 San Francisco California 94158
| |
Collapse
|
37
|
Wilson KJ, Surowiec RK, Ho CP, Devitt BM, Fripp J, Smith WS, Spiegl UJ, Dornan GJ, LaPrade RF. Quantifiable Imaging Biomarkers for Evaluation of the Posterior Cruciate Ligament Using 3-T Magnetic Resonance Imaging: A Feasibility Study. Orthop J Sports Med 2016; 4:2325967116639044. [PMID: 27104206 PMCID: PMC4827116 DOI: 10.1177/2325967116639044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Quantitative magnetic resonance imaging (MRI) techniques, such as T2 and T2 star (T2*) mapping, have been used to evaluate ligamentous tissue in vitro and to identify significant changes in structural integrity of a healing ligament. These studies lay the foundation for a clinical study that uses quantitative mapping to evaluate ligaments in vivo, particularly the posterior cruciate ligament (PCL). To establish quantitative mapping as a clinical tool for identifying and evaluating chronic or acute PCL injuries, T2 and T2* values first must be determined for an asymptomatic population. Purpose: To quantify T2 and T2* mapping properties, including texture variables (entropy, variance, contrast, homogeneity), of the PCL in an asymptomatic population. It was hypothesized that biomarker values would be consistent throughout the ligament, as measured across 3 clinically relevant subregions (proximal, middle, and distal thirds) in the asymptomatic cohort. Study Design: Cross-sectional study; Level of evidence, 4. Methods: Unilateral knee MRI scans were acquired for 25 asymptomatic subjects with a 3.0-T MRI system using T2 and T2* mapping sequences in the sagittal plane. The PCL was manually segmented and divided into thirds (proximal, middle, and distal). Summary statistics for T2 and T2* values were calculated. Intra- and interrater reliability was assessed across 3 raters to 2 time points. Results: The asymptomatic PCL cohort had mean T2 values of 36.7, 29.2, and 29.6 ms in the distal, middle, and proximal regions, respectively. The distal PCL exhibited significantly higher mean, variance, and contrast and lower homogeneity of T2 values than the middle and proximal subregions (P < .05). T2* results exhibited substantial positive skew and were therefore presented as median and quartile (Q) values. Median T2* values were 7.3 ms (Q1-Q3, 6.8-8.9 ms), 7.3 ms (Q1-Q3, 7.0-8.5 ms), and 7.3 ms (Q1-Q3, 6.4-8.2 ms) in the distal, middle, and proximal subregions, respectively. Conclusion: This is the first study to identify T2 and T2* mapping values, and their texture variables, for the asymptomatic PCL. The distal third of the PCL had significantly greater T2 values than the proximal or middle thirds. Clinical Relevance: T2 and T2* values of the asymptomatic PCL can provide a baseline for comparison with acute and chronic PCL injuries in future studies.
Collapse
Affiliation(s)
| | | | - Charles P Ho
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Brian M Devitt
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Jurgen Fripp
- Commonwealth Scientific and Industrial Research Organization, Digital Productivity and Services Flagship, The Australian eHealth Research Centre, Queensland, Australia
| | - W Sean Smith
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | | | - Grant J Dornan
- Steadman Philippon Research Institute, Vail, Colorado, USA
| | - Robert F LaPrade
- Steadman Philippon Research Institute, Vail, Colorado, USA.; The Steadman Clinic, Vail, Colorado, USA
| |
Collapse
|
38
|
Evaluation of Water Retention in Lumbar Intervertebral Disks Before and After Exercise Stress With T2 Mapping. Spine (Phila Pa 1976) 2016; 41:E430-6. [PMID: 27018906 DOI: 10.1097/brs.0000000000001283] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN T2 mapping was used to quantify moisture content of the lumbar spinal disk nucleus pulposus (NP) and annulus fibrosus before and after exercise stress, and after rest, to evaluate the intervertebral disk function. OBJECTIVE To clarify water retention in intervertebral disks of the lumbar vertebrae by performing magnetic resonance imaging before and after exercise stress and quantitatively measuring changes in moisture content of intervertebral disks with T2 mapping. SUMMARY OF BACKGROUND DATA To date, a few case studies describe functional evaluation of articular cartilage with T2 mapping; however, T2 mapping to the functional evaluation of intervertebral disks has rarely been applied. Using T2 mapping might help detect changes in the moisture content of intervertebral disks, including articular cartilage, before and after exercise stress, thus enabling the evaluation of changes in water retention shock absorber function. METHODS Subjects, comprising 40 healthy individuals (males: 26, females: 14), underwent magnetic resonance imaging T2 mapping before and after exercise stress and after rest. Image J image analysis software was then used to set regions of interest in the obtained images of the anterior annulus fibrosus, posterior annulus fibrosus, and NP. T2 values were measured and compared according to upper vertebrae position and degeneration grade. RESULTS T2 values significantly decreased in the NP after exercise stress and significantly increased after rest. According to upper vertebrae position, in all of the upper vertebrae positions, T2 values for the NP significantly decreased after exercise stress and significantly increased after rest. According to the degeneration grade, in the NP of grade 1 and 2 cases, T2 values significantly decreased after exercise stress and significantly increased after rest. CONCLUSION T2 mapping could be used to not only diagnose the degree of degeneration but also evaluate intervertebral disk function. LEVEL OF EVIDENCE 3.
Collapse
|
39
|
Wáng YXJ, Zhang Q, Li X, Chen W, Ahuja A, Yuan J. T1ρ magnetic resonance: basic physics principles and applications in knee and intervertebral disc imaging. Quant Imaging Med Surg 2015; 5:858-85. [PMID: 26807369 PMCID: PMC4700236 DOI: 10.3978/j.issn.2223-4292.2015.12.06] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/06/2015] [Indexed: 12/15/2022]
Abstract
T1ρ relaxation time provides a new contrast mechanism that differs from T1- and T2-weighted contrast, and is useful to study low-frequency motional processes and chemical exchange in biological tissues. T1ρ imaging can be performed in the forms of T1ρ-weighted image, T1ρ mapping and T1ρ dispersion. T1ρ imaging, particularly at low spin-lock frequency, is sensitive to B0 and B1 inhomogeneity. Various composite spin-lock pulses have been proposed to alleviate the influence of field inhomogeneity so as to reduce the banding-like spin-lock artifacts. T1ρ imaging could be specific absorption rate (SAR) intensive and time consuming. Efforts to address these issues and speed-up data acquisition are being explored to facilitate wider clinical applications. This paper reviews the T1ρ imaging's basic physic principles, as well as its application for cartilage imaging and intervertebral disc imaging. Compared to more established T2 relaxation time, it has been shown that T1ρ provides more sensitive detection of proteoglycan (PG) loss at early stages of cartilage degeneration. T1ρ has also been shown to provide more sensitive evaluation of annulus fibrosis (AF) degeneration of the discs.
Collapse
|
40
|
Pedoia V, Li X, Su F, Calixto N, Majumdar S. Fully automatic analysis of the knee articular cartilage T1ρ relaxation time using voxel-based relaxometry. J Magn Reson Imaging 2015; 43:970-80. [PMID: 26443990 DOI: 10.1002/jmri.25065] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/07/2015] [Accepted: 09/17/2015] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To develop and compare with the classical region of interest (ROI)-based approach a fully automatic, local, and unbiased way of studying the knee T1ρ relaxation time by creating an atlas and using voxel-based relaxometry (VBR) in osteoarthritis (OA) and anterior cruciate ligament (ACL) subjects. MATERIALS AND METHODS In this study 110 subjects from two cohorts: 1) Mild OA 40 patients with mild-OA Kellgren-Lawrence (KL) ≤ 2 and 15 controls KL ≤ 1; 2) ACL cohort (a model for early OA): 40 ACL-injured patients imaged prior to ACL reconstruction and 1-year postsurgery and 15 controls are analyzed. All the subjects were acquired at 3T with a protocol that includes: 3D-FSE (CUBE) and 3D-T1ρ . A nonrigid registration technique was applied to align all the images on a single template. This allows for performing VBR to assess local statistical differences of T1ρ values using z-score analysis. VBR results were compared with those obtained with classical ROI-based technique. RESULTS ROI-based results from atlas-based segmentation were consistent with classical ROI-based method (coefficient of variation [CV] = 3.83%). Voxel-based group analysis revealed local patterns that were overlooked by the ROI-based approach; eg, VBR showed posterior lateral femur and posterior lateral tibia significant T1ρ elevations in ACL-injured patients (sample mean z-score=9.7 and 10.3). Those elevations were overlooked by the classical ROI-based approach (sample mean z-score=1.87 and -1.73) CONCLUSION: VBR is a feasible and accurate tool for the local evaluation of the biochemical composition of knee articular cartilage. VBR is capable of detecting specific local patterns on T1ρ maps in OA and ACL subjects.
Collapse
Affiliation(s)
- Valentina Pedoia
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, UC San Francisco, San Francisco, California, USA
| | - Xiaojuan Li
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, UC San Francisco, San Francisco, California, USA
| | - Favian Su
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, UC San Francisco, San Francisco, California, USA
| | - Nathaniel Calixto
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, UC San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Musculoskeletal Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, UC San Francisco, San Francisco, California, USA
| |
Collapse
|
41
|
Nozaki T, Kaneko Y, Yu HJ, Kaneshiro K, Schwarzkopf R, Hara T, Yoshioka H. T1rho mapping of entire femoral cartilage using depth- and angle-dependent analysis. Eur Radiol 2015; 26:1952-62. [PMID: 26396106 PMCID: PMC4803634 DOI: 10.1007/s00330-015-3988-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/22/2015] [Accepted: 08/31/2015] [Indexed: 12/11/2022]
Abstract
Objectives To create and evaluate normalized T1rho profiles of the entire femoral cartilage in healthy subjects with three-dimensional (3D) angle- and depth-dependent analysis. Methods T1rho images of the knee from 20 healthy volunteers were acquired on a 3.0-T unit. Cartilage segmentation of the entire femur was performed slice-by-slice by a board-certified radiologist. The T1rho depth/angle-dependent profile was investigated by partitioning cartilage into superficial and deep layers, and angular segmentation in increments of 4° over the length of segmented cartilage. Average T1rho values were calculated with normalized T1rho profiles. Surface maps and 3D graphs were created. Results T1rho profiles have regional and depth variations, with no significant magic angle effect. Average T1rho values in the superficial layer of the femoral cartilage were higher than those in the deep layer in most locations (p < 0.05). T1rho values in the deep layer of the weight-bearing portions of the medial and lateral condyles were lower than those of the corresponding non-weight-bearing portions (p < 0.05). Surface maps and 3D graphs demonstrated that cartilage T1rho values were not homogeneous over the entire femur. Conclusions Normalized T1rho profiles from the entire femoral cartilage will be useful for diagnosing local or early T1rho abnormalities and osteoarthritis in clinical applications. Key Points • T1rho profiles are not homogeneous over the entire femur. • There is angle- and depth-dependent variation in T1rho profiles. • There is no influence of magic angle effect on T1rho profiles. • Maps/graphs might be useful if several difficulties are solved.
Collapse
Affiliation(s)
- Taiki Nozaki
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Rt. 140, Bldg. 56, Orange, CA, 92868, USA
| | - Yasuhito Kaneko
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Rt. 140, Bldg. 56, Orange, CA, 92868, USA
| | - Hon J Yu
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Rt. 140, Bldg. 56, Orange, CA, 92868, USA
| | | | - Ran Schwarzkopf
- Department of Orthopedic Surgery, University of California Irvine, Irvine, CA, USA
| | - Takeshi Hara
- Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California Irvine, 101 The City Drive South, Rt. 140, Bldg. 56, Orange, CA, 92868, USA.
| |
Collapse
|
42
|
Guha A, Wyatt C, Karampinos DC, Nardo L, Link TM, Majumdar S. Spatial variations in magnetic resonance-based diffusion of articular cartilage in knee osteoarthritis. Magn Reson Imaging 2015; 33:1051-1058. [PMID: 26119421 DOI: 10.1016/j.mri.2015.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 05/15/2015] [Accepted: 06/10/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate a pulse sequence combining stimulated echo diffusion preparation with a 3D segmented spoiled gradient echo (SPGR) acquisition for diffusion tensor imaging (DTI) of knee cartilage in healthy and osteoarthritis (OA) populations for early diagnosis and characterization of OA. METHODS Diffusion-weighted images of 40 subjects (20 healthy, 20 OA) at baseline and 20 subjects (10 healthy, 10 OA) at one year were obtained. The subjects were classified according to Kellgren Lawrence (KL) and whole organ magnetic resonance imaging scoring (WORMS) method acquired at 3 T. Cartilage full thickness and laminar mean diffusivity (MD) and fractional anisotropy (FA) values were quantified. The reproducibility of MD and FA values was assessed in five healthy human subjects based on test-retest scans. RESULTS In general, the full thickness MD values were higher in subjects with knee OA compared to healthy controls in both the baseline and follow up cohort. Laminar analysis MD and FA results were significantly different (p<0.05) between the bone-articular and articular layer with the articular layer having higher MD and lower FA value compared to the bone layer. The global reproducibility error was 6.5% for MD and 11.6% for FA. CONCLUSION The diffusion-weighted stimulated echo-based sequence may be used as a valuable tool for early diagnosis and characterization of knee OA at 3 T in the future.
Collapse
Affiliation(s)
- Aditi Guha
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA.
| | - Cory Wyatt
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, Technische Universität München, Munich, Germany
| | - Lorenzo Nardo
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of San Francisco, San Francisco, CA, USA
| |
Collapse
|
43
|
Kaneko Y, Nozaki T, Yu H, Chang A, Kaneshiro K, Schwarzkopf R, Hara T, Yoshioka H. Normal T2 map profile of the entire femoral cartilage using an angle/layer-dependent approach. J Magn Reson Imaging 2015; 42:1507-16. [PMID: 25917977 DOI: 10.1002/jmri.24936] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 04/14/2015] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To create standard T2 map profiles from the entire femoral cartilage of healthy volunteers in order to assess regional variations using an angular and layer-dependent approach. MATERIALS AND METHODS Twenty healthy knees were evaluated using 3T sagittal images of a T2 mapping sequence. Manual segmentation of the entire femoral cartilage was performed slice-by-slice by two raters using MatLab. Inter- and intrarater reliabilities were calculated using intraclass correlation coefficient (ICC) and Bland-Altman analysis. T2 values were analyzed with respect to specific locations (medial condyle, trochlea, and lateral condyle), angles to B0 , and layers of cartilage (whole, deep, and superficial). RESULTS Inter- and intrarater reliability obtained from the entire femoral cartilage was excellent (ICC = 0.84, 0.86, respectively). The ICCs around the trochlea were lower than those of the medial and lateral condyle. Both the inter- and intrarater Bland-Altman plots indicated larger differences in pixel count are seen as the size of the angular segment becomes larger. T2 values were significantly higher in the superficial layer compared to the deep layer at each femoral compartment (P < 0.001). A magic angle effect was clearly observed, especially within the whole and deep layer over the medial and lateral femoral condyles, except for the superficial layer at the medial condyle. CONCLUSION The normal T2 map profiles of the entire femoral cartilage showed variations in ICCs by location and in T2 values by angles and layers. These profiles can be useful for diagnosis of early cartilage degeneration in a specific angle and layer of each condyle and trochlea.
Collapse
Affiliation(s)
- Yasuhito Kaneko
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Taiki Nozaki
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Hon Yu
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA.,John Tu and Thomas Yuen Center for Functional Onco-Imaging, University of California, Irvine, Orange, California, USA
| | - Andrew Chang
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Kayleigh Kaneshiro
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| | - Ran Schwarzkopf
- Department of Orthopaedic Surgery, University of California, Irvine, Orange, California, USA
| | - Takeshi Hara
- Department of Intelligent Image Information, Division of Regeneration and Advanced Medical Sciences, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine, Orange, California, USA
| |
Collapse
|
44
|
Physical activity and spatial differences in medial knee T1rho and t2 relaxation times in knee osteoarthritis. J Orthop Sports Phys Ther 2014; 44:964-72. [PMID: 25353261 PMCID: PMC4476033 DOI: 10.2519/jospt.2014.5523] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVES To investigate the association between knee loading- related osteoarthritis (OA) risk factors (obesity, malalignment, and physical activity) and medial knee laminar (superficial and deep) T1rho and T2 relaxation times. BACKGROUND The interaction of various modifiable loading-related knee risk factors and cartilage health in knee OA is currently not well known. METHODS Participants with and without knee OA (n = 151) underwent magnetic resonance imaging at 3 T for superficial and deep cartilage T1rho and T2 magnetic resonance relaxation times in the medial femur (MF) and medial tibia (MT). Other variables included radiographic Kellgren-Lawrence (KL) grade, alignment, pain and symptoms using the Knee injury and Osteoarthritis Outcome Score, and physical activity using the International Physical Activity Questionnaire (IPAQ). Individuals with a KL grade of 4 were excluded. Group differences were calculated using 1-way analysis of variance, adjusting for age and body mass index. Linear regression models were created with age, sex, body mass index, alignment, KL grade, and the IPAQ scores to predict the laminar T1rho and T2 times. RESULTS Total IPAQ scores were the only significant predictors among the loading-related variables for superficial MF T1rho (P = .005), deep MT T1rho (P = .026), and superficial MF T2 (P = .049). Additionally, the KL grade predicted the superficial MF T1rho (P = .023) and deep MT T1rho (P = .022). CONCLUSION Higher physical activity levels and worse radiographic severity of knee OA, but not obesity or alignment, were associated with worse cartilage composition.
Collapse
|
45
|
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.
Collapse
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
| |
Collapse
|
46
|
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.
Collapse
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
| |
Collapse
|
47
|
Lee JH, Badar F, Kahn D, Matyas J, Qu X, Chen CT, Xia Y. Topographical variations of the strain-dependent zonal properties of tibial articular cartilage by microscopic MRI. Connect Tissue Res 2014; 55:205-16. [PMID: 24559385 PMCID: PMC6423514 DOI: 10.3109/03008207.2014.894997] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The topographical variations of the zonal properties of canine articular cartilage over the medial tibia were evaluated as the function of external loading by microscopic magnetic resonance imaging (µMRI). T2 and T1 relaxation maps and GAG (glycosaminoglycan) images from a total of 70 specimens were obtained with and without the mechanical loading at 17.6 µm depth resolution. In addition, mechanical modulus and water content were measured from the tissue. For the bulk without loading, the means of T2 at magic angle (43.6 ± 8.1 ms), absolute thickness (907.6 ± 187.9 µm) and water content (63.3 ± 9.3%) on the meniscus-covered area were significantly lower than the means of T2 at magic angle (51.1 ± 8.5 ms), absolute thickness (1251.6 ± 218.4 µm) and water content (73.2 ± 5.6%) on the meniscus-uncovered area. However GAG (86.0 ± 15.3 mg/ml) on the covered area was significantly higher than GAG (70.0 ± 8.8 mg/ml) on the uncovered area. Complex relationships were found in the tissue properties as the function of external loading. The tissue parameters in the superficial zone changed more profoundly than the same properties in the radial zone. The tissue parameters in the meniscus-covered areas changed differently when comparing with the same parameters in the uncovered areas. This project confirms that the load-induced changes in the molecular distribution and structure of cartilage are both depth-dependent and topographically distributed. Such detailed knowledge of the tibial layer could improve the early detection of the subtle softening of the cartilage that will eventually lead to the clinical diseases such as osteoarthritis.
Collapse
Affiliation(s)
- Ji Hyun Lee
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - David Kahn
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - John Matyas
- Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Xianggui Qu
- Department of Mathematics and Statistics, Oakland University, Rochester, MI, USA
| | - Christopher T. Chen
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| |
Collapse
|
48
|
Surowiec RK, Lucas EP, Ho CP. Quantitative MRI in the evaluation of articular cartilage health: reproducibility and variability with a focus on T2 mapping. Knee Surg Sports Traumatol Arthrosc 2014; 22:1385-95. [PMID: 24170187 DOI: 10.1007/s00167-013-2714-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Accepted: 10/08/2013] [Indexed: 01/14/2023]
Abstract
PURPOSE Early diagnosis of cartilage degeneration and longitudinal tracking of cartilage health including repair following surgical intervention would benefit from the ability to detect and monitor changes of the articular cartilage non-invasively and before gross morphological alterations appear. METHODS Quantitative MR imaging has shown promising results with various imaging biomarkers such as T2 mapping, T1 rho and dGEMRIC demonstrating sensitivity in the detection of biochemical alterations within tissues of interest. However, acquiring accurate and clinically valuable quantitative data has proven challenging, and the reproducibility of the quantitative mapping technique and its values are essential. Although T2 mapping has been the focus in this discussion, all quantitative mapping techniques are subject to the same issues including variability in the imaging protocol, unloading and exercise, analysis, scanner and coil, calculation methods, and segmentation and registration concerns. RESULTS The causes for variability between time points longitudinally in a patient, among patients, and among centres need to be understood further and the issues addressed. CONCLUSIONS The potential clinical applications of quantitative mapping are vast, but, before the clinical community can take full advantage of this tool, it must be automated, standardized, validated, and have proven reproducibility prior to its implementation into the standard clinical care routine.
Collapse
Affiliation(s)
- Rachel K Surowiec
- Steadman Philippon Research Institute, 181 W Meadow Dr, Suite 1000, Vail, CO, 81657, USA,
| | | | | |
Collapse
|
49
|
T2 values of articular cartilage in clinically relevant subregions of the asymptomatic knee. Knee Surg Sports Traumatol Arthrosc 2014; 22:1404-14. [PMID: 24271329 DOI: 10.1007/s00167-013-2779-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 11/10/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE In order for T2 mapping to become more clinically applicable, reproducible subregions and standardized T2 parameters must be defined. This study sought to: (1) define clinically relevant subregions of knee cartilage using bone landmarks identifiable on both MR images and during arthroscopy and (2) determine healthy T2 values and T2 texture parameters within these subregions. METHODS Twenty-five asymptomatic volunteers (age 18-35) were evaluated with a sagittal T2 mapping sequence. Manual segmentation was performed by three raters, and cartilage was divided into twenty-one subregions modified from the International Cartilage Repair Society Articular Cartilage Mapping System. Mean T2 values and texture parameters (entropy, variance, contrast, homogeneity) were recorded for each subregion, and inter-rater and intra-rater reliability was assessed. RESULTS The central regions of the condyles had significantly higher T2 values than the posterior regions (P < 0.05) and higher variance than the posterior region on the medial side (P < 0.001). The central trochlea had significantly greater T2 values than the anterior and posterior condyles. The central lateral plateau had lower T2 values, lower variance, higher homogeneity, and lower contrast than nearly all subregions in the tibia. The central patellar regions had higher entropy than the superior and inferior regions (each P ≤ 0.001). Repeatability was good to excellent for all subregions. CONCLUSION Significant differences in mean T2 values and texture parameters were found between subregions in this carefully selected asymptomatic population, which suggest that there is normal variation of T2 values within the knee joint. The clinically relevant subregions were found to be robust as demonstrated by the overall high repeatability.
Collapse
|
50
|
Serebrakian AT, Poulos T, Liebl H, Joseph GB, Lai A, Nevitt MC, Lynch JA, McCulloch CE, Link TM. Weight loss over 48 months is associated with reduced progression of cartilage T2 relaxation time values: data from the osteoarthritis initiative. J Magn Reson Imaging 2014; 41:1272-1280. [PMID: 24700497 DOI: 10.1002/jmri.24630] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 02/20/2014] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To assess whether changes in knee cartilage MR-based T2 relaxation times are associated with weight loss in individuals with risk factors for knee osteoarthritis (OA) compared with controls with stable weight. MATERIALS AND METHODS One hundred twenty-seven individuals with risk factors for knee OA were studied: 62 subjects had a body mass index (BMI) decrease≥10% over 48 months and 65 controls had a BMI change <3%. Cartilage segmentation from five knee compartments at baseline and 48-month follow-up was performed, and T2 maps were generated. The association of change in T2 values over 48 months in the weight-loss group versus the control group was assessed using multiple linear regression models. RESULTS Weight loss was associated with significantly smaller increases in cartilage T2 in the medial femoral condyle (P = 0.035) and overall medial compartment (P = 0.006) compared with the controls. In a subgroup analysis comparing weight-loss subjects who were obese (BMI≥30 kg/m(2) ) and overweight (BMI 25-30 kg/m(2) ) at baseline, obesity was associated with smaller increases in cartilage T2 values in the medial femoral condyle (P = 0.022), lateral femoral condyle (P = 0.015), patella (P = 0.002), and globally across all compartments (P = 0.002). CONCLUSION A decrease in BMI of ≥ 10% was associated with a slower progression of T2 values in individuals with risk factors for OA, suggesting a beneficial impact of weight loss on cartilage matrix degeneration.
Collapse
Affiliation(s)
- Arman T Serebrakian
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Theresa Poulos
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Hans Liebl
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Gabby B Joseph
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Andrew Lai
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - John A Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Charles E McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Thomas M Link
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology and Biomedical Imaging, University of California San Francisco
| |
Collapse
|