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Luo P, Lu L, Xu R, Jiang L, Li G. Gaining Insight into Updated MR Imaging for Quantitative Assessment of Cartilage Injury in Knee Osteoarthritis. Curr Rheumatol Rep 2024:10.1007/s11926-024-01152-x. [PMID: 38809506 DOI: 10.1007/s11926-024-01152-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE OF THE REVIEW Knee Osteoarthritis (KOA) entails progressive cartilage degradation, reviewed via MRI for morphology, biochemical composition, and microtissue alterations, discussing clinical advantages, limitations, and research applicability. RECENT FINDINGS Compositional MRI, like T2/T2* mapping, T1rho mapping, gagCEST, dGEMRIC, sodium imaging, diffusion-weighted imaging, and diffusion-tensor imaging, provide insights into cartilage injury in KOA. These methods quantitatively measure collagen, glycosaminoglycans, and water content, revealing important information about biochemical compositional and microstructural alterations. Innovative techniques like hybrid multi-dimensional MRI and diffusion-relaxation correlation spectrum imaging show potential in depicting initial cartilage changes at a sub-voxel level. Integration of automated image analysis tools addressed limitations in manual cartilage segmentation, ensuring robust and reproducible assessments of KOA cartilage. Compositional MRI techniques reveal microstructural changes in cartilage. Multi-dimensional MR imaging assesses biochemical alterations in KOA-afflicted cartilage, aiding early degeneration identification. Integrating artificial intelligence enhances cartilage analysis, optimal diagnostic accuracy for early KOA detection and monitoring.
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Affiliation(s)
- Peng Luo
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Shanghai, 200437, China
| | - Li Lu
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Shanghai, 200437, China
| | - Run Xu
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Shanghai, 200437, China
| | - Lei Jiang
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Shanghai, 200437, China
| | - Guanwu Li
- Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Rd, Shanghai, 200437, China.
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Zhang Y, Zu T, Liu R, Zhou J. Acquisition sequences and reconstruction methods for fast chemical exchange saturation transfer imaging. NMR IN BIOMEDICINE 2023; 36:e4699. [PMID: 35067987 DOI: 10.1002/nbm.4699] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/02/2022] [Accepted: 01/17/2022] [Indexed: 05/23/2023]
Abstract
Chemical exchange saturation transfer (CEST) imaging is an emerging molecular magnetic resonance imaging (MRI) technique that has been developed and employed in numerous diseases. Based on the unique saturation transfer principle, a family of CEST-detectable biomolecules in vivo have been found capable of providing valuable diagnostic information. However, CEST MRI needs a relatively long scan time due to the common long saturation labeling module and typical acquisition of multiple frequency offsets and signal averages, limiting its widespread clinical applications. So far, a plethora of imaging schemes and techniques has been developed to accelerate CEST MRI. In this review, the key acquisition and reconstruction methods for fast CEST imaging are summarized from a practical and systematic point of view. The first acquisition sequence section describes the major development of saturation schemes, readout patterns, ultrafast z-spectroscopy, and saturation-editing techniques for rapid CEST imaging. The second reconstruction method section lists the important advances of parallel imaging, compressed sensing, sparsity in the z-spectrum, and algorithms beyond the Fourier transform for speeding up CEST MRI.
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Affiliation(s)
- Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
- Cancer Center, Zhejiang University, Hangzhou, Zhejiang, China
| | - Tao Zu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ruibin Liu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, Baltimore, Maryland, USA
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Nischal N, Iyengar KP, Herlekar D, Botchu R. Imaging of Cartilage and Chondral Defects: An Overview. Life (Basel) 2023; 13:life13020363. [PMID: 36836719 PMCID: PMC9960762 DOI: 10.3390/life13020363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/15/2023] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
A healthy articular cartilage is paramount to joint function. Cartilage defects, whether acute or chronic, are a significant source of morbidity. This review summarizes various imaging modalities used for cartilage assessment. While radiographs are insensitive, they are still widely used to indirectly assess cartilage. Ultrasound has shown promise in the detection of cartilage defects, but its efficacy is limited in many joints due to inadequate visualization. CT arthrography has the potential to assess internal derangements of joints along with cartilage, especially in patients with contraindications to MRI. MRI remains the favored imaging modality to assess cartilage. The conventional imaging techniques are able to assess cartilage abnormalities when cartilage is already damaged. The newer imaging techniques are thus targeted at detecting biochemical and structural changes in cartilage before an actual visible irreversible loss. These include, but are not limited to, T2 and T2* mapping, dGEMRI, T1ρ imaging, gagCEST imaging, sodium MRI and integrated PET with MRI. A brief discussion of the advances in the surgical management of cartilage defects and post-operative imaging assessment is also included.
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Affiliation(s)
- Neha Nischal
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham B31 2AP, UK
- Department of Radiology, Holy Family Hospital, New Delhi 110025, India
| | | | - Deepak Herlekar
- Department of Orthopaedics, University Hospitals of Morecambe Bay NHS Foundation Trust, Kendal LA9 7RG, UK
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham B31 2AP, UK
- Correspondence:
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Abstract
PURPOSE OF REVIEW Imaging plays a pivotal role for diagnosis, follow-up and stratification of osteoarthritis patients in clinical trials and research. We aim to present an overview of currently available and emerging imaging techniques for osteoarthritis assessment and provide insight into relevant benefits and pitfalls of the different modalities. RECENT FINDINGS Although radiography is considered sufficient for a structural diagnosis of osteoarthritis and is commonly used to define eligibility of patients for participation in clinical trials, it has inherent limitations based on the projectional nature of the technique and inherent challenges regarding reproducibility in longitudinal assessment. MRI has changed our understanding of the disease from 'wear and tear' of cartilage to a whole organ disorder. MRI assessment of structural changes of osteoarthritis includes semi-quantitative, quantitative and compositional evaluation. Ultrasound is helpful in evaluating the degree of synovitis and has value in the assessment particularly of the patella-femoral joint. Recent development of computed tomography technology including weight-bearing systems has led to broader application of this technology in a research context. SUMMARY Advances in MRI technology have resulted in a significant improvement in understanding osteoarthritis as a multitissue disease.
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Affiliation(s)
- Majid Chalian
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Frank W Roemer
- Department of Radiology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine
| | - Ali Guermazi
- Quantitative Imaging Center, Department of Radiology, Boston University School of Medicine
- Department of Radiology, VA Boston Healthcare System, Boston, Massachusetts, USA
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Lopez Kolkovsky AL, Carlier PG, Marty B, Meyerspeer M. Interleaved and simultaneous multi-nuclear magnetic resonance in vivo. Review of principles, applications and potential. NMR IN BIOMEDICINE 2022; 35:e4735. [PMID: 35352440 PMCID: PMC9542607 DOI: 10.1002/nbm.4735] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/03/2022] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
Magnetic resonance signals from different nuclei can be excited or received at the same time,rendering simultaneous or rapidly interleaved multi-nuclear acquisitions feasible. The advan-tages are a reduction of total scan time compared to sequential multi-nuclear acquisitions or that additional information from heteronuclear data is obtained at thesame time and anatomical position. Information content can be qualitatively increased by delivering a more comprehensive MR-based picture of a transient state (such as an exercise bout). Also, combiningnon-proton MR acquisitions with 1 Hinformation (e.g., dynamic shim updates and motion correction) can be used to improve data quality during long scans and benefits image coregistration. This work reviews the literature on interleaved and simultaneous multi-nuclear MRI and MRS in vivo. Prominent use cases for this methodology in clinical and research applications are brain and muscle, but studies have also been carried out in other targets, including the lung, knee, breast and heart. Simultaneous multi-nuclear measurements in the liver and kidney have also been performed, but exclusively in rodents. In this review, a consistent nomenclature is proposed, to help clarify the terminology used for this principle throughout the literature on in-vivo MR. An overview covers the basic principles, the technical requirements on the MR scanner and the implementations realised either by MR system vendors or research groups, from the early days until today. Considerations regarding the multi-tuned RF coils required and heteronuclear polarisation interactions are briefly discussed, and fields for future in-vivo applications for interleaved multi-nuclear MR pulse sequences are identified.
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Affiliation(s)
- Alfredo L. Lopez Kolkovsky
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
- NMR laboratoryCEA, DRF, IBFJParisFrance
| | - Pierre G. Carlier
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
- NMR laboratoryCEA, DRF, IBFJParisFrance
| | - Benjamin Marty
- NMR Laboratory, Neuromuscular Investigation CenterInstitute of MyologyParisFrance
- NMR laboratoryCEA, DRF, IBFJParisFrance
| | - Martin Meyerspeer
- High‐Field MR Center, Center for Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
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6
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Three-dimensional chemical exchange saturation transfer imaging using compressed SENSE for full z-spectrum acquisition. Magn Reson Imaging 2022; 92:58-66. [DOI: 10.1016/j.mri.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 05/19/2022] [Accepted: 05/21/2022] [Indexed: 11/20/2022]
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Emanuel KS, Kellner LJ, Peters MJM, Haartmans MJJ, Hooijmans MT, Emans PJ. The relation between the biochemical composition of knee articular cartilage and quantitative MRI: a systematic review and meta-analysis. Osteoarthritis Cartilage 2022; 30:650-662. [PMID: 34826570 DOI: 10.1016/j.joca.2021.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Early and non-invasive detection of osteoarthritis (OA) is required to enable early treatment and monitoring of interventions. Some of the earliest signs of OA are the change in proteoglycan and collagen composition. The aim of this study is to establish the relations between quantitative magnetic resonance imaging (MRI) and biochemical concentration and organization in knee articular cartilage. METHODS A preregistered systematic literature review was performed using the databases PubMed and Embase. Papers were included if quantitative MRI and a biochemical assay or polarized light microscopy (PLM) was performed on knee articular cartilage, and a quantified correlation was described. The extracted correlations were pooled using a random effects model. RESULTS 21 papers were identified. The strongest pooled correlation was found for delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) vs proteoglycan concentration (r = 0.59). T1ρ relaxation times are inversely correlated to proteoglycan concentration (r = -0.54). A weak correlation between T2 relaxation times and proteoglycans was found (r = -0.38). No correlation between T2 relaxation time and collagen concentration was found (r = -0.02). A heterogeneous set of correlations between T2 relaxation times and PLM were identified, including strong correlations to anisotropy. CONCLUSION DGEMRIC measures are significantly correlated to proteoglycan concentration. The needed contrast agent is however a disadvantage; the T1ρ sequence was found as a non-invasive alternative. Remarkably, no correlation was found between T2 relaxation times and collagen concentration. T2 relaxation times is related to organization, rather than concentration of collagen fibers. PROSPERO ID CRD42020168337.
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Affiliation(s)
- K S Emanuel
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands; Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - L J Kellner
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - M J M Peters
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - M J J Haartmans
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - M T Hooijmans
- Amsterdam UMC, University of Amsterdam, Department of Biomedical Engineering and Physics, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
| | - P J Emans
- Department of Orthopedic Surgery, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Center+, Maastricht, the Netherlands.
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8
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Lombardi AF, Ma Y, Jang H, Jerban S, Tang Q, Searleman AC, Meyer RS, Du J, Chang EY. AcidoCEST-UTE MRI Reveals an Acidic Microenvironment in Knee Osteoarthritis. Int J Mol Sci 2022; 23:4466. [PMID: 35457284 PMCID: PMC9027981 DOI: 10.3390/ijms23084466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 02/01/2023] Open
Abstract
A relationship between an acidic pH in the joints, osteoarthritis (OA), and pain has been previously demonstrated. Acidosis Chemical Exchange Saturation Transfer (acidoCEST) indirectly measures the extracellular pH through the assessment of the exchange of protons between amide groups on iodinated contrast agents and bulk water. It is possible to estimate the extracellular pH in the osteoarthritic joint using acidoCEST MRI. However, conventional MR sequences cannot image deep layers of cartilage, meniscus, ligaments, and other musculoskeletal tissues that present with short echo time and fast signal decay. Ultrashort echo time (UTE) MRI, on the other hand, has been used successfully to image those joint tissues. Here, our goal is to compare the pH measured in the knee joints of volunteers without OA and patients with severe OA using acidoCEST-UTE MRI. Patients without knee OA and patients with severe OA were examined using acidoCEST-UTE MRI and the mean pH of cartilage, meniscus, and fluid was calculated. Additionally, the relationship between the pH measurements and the Knee Injury and Osteoarthritis Outcome Score (KOOS) was investigated. AcidoCEST-UTE MRI can detect significant differences in the pH of knee cartilage, meniscus, and fluid between joints without and with OA, with OA showing lower pH values. In addition, symptoms and knee-joint function become worse at lower pH measurements.
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Affiliation(s)
- Alecio F. Lombardi
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; (Q.T.); (E.Y.C.)
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Yajun Ma
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Hyungseok Jang
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Qingbo Tang
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; (Q.T.); (E.Y.C.)
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Adam C. Searleman
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Robert Scott Meyer
- Orthopaedic Surgery Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA;
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
| | - Eric Y. Chang
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA; (Q.T.); (E.Y.C.)
- Department of Radiology, University of California San Diego, San Diego, CA 92161, USA; (Y.M.); (H.J.); (S.J.); (A.C.S.); (J.D.)
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9
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Chalian M, Li X, Guermazi A, Obuchowski NA, Carrino JA, Oei EH, Link TM. The QIBA Profile for MRI-based Compositional Imaging of Knee Cartilage. Radiology 2021; 301:423-432. [PMID: 34491127 PMCID: PMC8574057 DOI: 10.1148/radiol.2021204587] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/18/2021] [Accepted: 07/07/2021] [Indexed: 12/16/2022]
Abstract
MRI-based cartilage compositional analysis shows biochemical and microstructural changes at early stages of osteoarthritis before changes become visible with structural MRI sequences and arthroscopy. This could help with early diagnosis, risk assessment, and treatment monitoring of osteoarthritis. Spin-lattice relaxation time constant in rotating frame (T1ρ) and T2 mapping are the MRI techniques best established for assessing cartilage composition. Only T2 mapping is currently commercially available, which is sensitive to water, collagen content, and orientation of collagen fibers, whereas T1ρ is more sensitive to proteoglycan content. Clinical application of cartilage compositional imaging is limited by high variability and suboptimal reproducibility of the biomarkers, which was the motivation for creating the Quantitative Imaging Biomarkers Alliance (QIBA) Profile for cartilage compositional imaging by the Musculoskeletal Biomarkers Committee of the QIBA. The profile aims at providing recommendations to improve reproducibility and to standardize cartilage compositional imaging. The QIBA Profile provides two complementary claims (summary statements of the technical performance of the quantitative imaging biomarkers that are being profiled) regarding the reproducibility of biomarkers. First, cartilage T1ρ and T2 values are measurable at 3.0-T MRI with a within-subject coefficient of variation of 4%-5%. Second, a measured increase or decrease in T1ρ and T2 of 14% or more indicates a minimum detectable change with 95% confidence. If only an increase in T1ρ and T2 values is expected (progressive cartilage degeneration), then an increase of 12% represents a minimum detectable change over time. The QIBA Profile provides recommendations for clinical researchers, clinicians, and industry scientists pertaining to image data acquisition, analysis, and interpretation and assessment procedures for T1ρ and T2 cartilage imaging and test-retest conformance. This special report aims to provide the rationale for the proposed claims, explain the content of the QIBA Profile, and highlight the future needs and developments for MRI-based cartilage compositional imaging for risk prediction, early diagnosis, and treatment monitoring of osteoarthritis.
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Affiliation(s)
- Majid Chalian
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Xiaojuan Li
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Ali Guermazi
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Nancy A. Obuchowski
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - John A. Carrino
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Edwin H. Oei
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - Thomas M. Link
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
| | - for the RSNA QIBA MSK Biomarker Committee
- From the Department of Radiology, Division of Musculoskeletal Imaging
and Intervention, University of Washington, UW Radiology–Roosevelt
Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department
of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI)
(X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland,
Ohio; Department of Radiology, Boston University School of Medicine, Boston,
Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery,
New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine,
Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.);
European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and
Biomedical Imaging, University of California, San Francisco, Calif
(T.M.L.)
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10
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Banjar M, Horiuchi S, Gedeon DN, Yoshioka H. Review of Quantitative Knee Articular Cartilage MR Imaging. Magn Reson Med Sci 2021; 21:29-40. [PMID: 34471014 PMCID: PMC9199985 DOI: 10.2463/mrms.rev.2021-0052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Osteoarthritis (OA) is one of the most prevalent disorders in today’s society, resulting in significant socio-economic costs and morbidity. MRI is widely used as a non-invasive imaging tool for OA of the knee. However, conventional knee MRI has limitations to detect subtle early cartilage degeneration before morphological changes are visually apparent. Novel MRI pulse sequences for cartilage assessment have recently received increased attention due to newly developed compositional MRI techniques, including: T2 mapping, T1rho mapping, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), sodium MRI, diffusion-weighted imaging (DWI)/ diffusion tensor imaging (DTI), ultrashort TE (uTE), and glycosaminoglycan specific chemical exchange saturation transfer (gagCEST) imaging. In this article, we will first review these quantitative assessments. Then, we will discuss the variations of quantitative values of knee articular cartilage with cartilage layer (depth)- and angle (regional)-dependent approaches. Multiple MRI sequence techniques can discern qualitative differences in knee cartilage. Normal articular hyaline cartilage has a zonal variation in T2 relaxation times with increasing T2 values from the subchondral bone to the articular surface. T1rho values were also higher in the superficial layer than in the deep layer in most locations in the medial and lateral femoral condyles, including the weight-bearing portion. Magic angle effect on T2 mapping is clearly observed in the both medial and lateral femoral condyles, especially within the deep layers. One of the limitations for clinical use of these compositional assessments is a long scan time. Recent new approaches with compressed sensing (CS) and MR fingerprinting (MRF) have potential to provide accurate and fast quantitative cartilage assessments.
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Affiliation(s)
- Mai Banjar
- Medical Imaging Department, King Abdullah Medical Complex Jeddah
| | - Saya Horiuchi
- Department of Radiology, St Luke's International Hospital
| | - David N Gedeon
- Department of Radiological Sciences, University of California, Irvine
| | - Hiroshi Yoshioka
- Department of Radiological Sciences, University of California, Irvine
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11
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Soellner ST, Welsch GH, Gelse K, Goldmann A, Kleyer A, Schett G, Pachowsky ML. gagCEST imaging at 3 T MRI in patients with articular cartilage lesions of the knee and intraoperative validation. Osteoarthritis Cartilage 2021; 29:1163-1172. [PMID: 33933584 DOI: 10.1016/j.joca.2021.04.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 03/22/2021] [Accepted: 04/05/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to compare glycosaminoglycan chemical exchange saturation transfer (gagCEST) of knee cartilage with intraoperative results for the assessment of early osteoarthritis (OA) and to define gagCEST values for the differentiation between healthy and degenerated cartilage. DESIGN Twenty-one patients with cartilage lesions or moderate OA were examined using 3 T Magnetic Resonance Imaging (MRI). In this prospective study, regions of interest (ROIs) were examined by a sagittal gagCEST analysis and a morphological high-resolution three-dimensional, fat-saturated proton-density space sequence. Cartilage lesions were identified arthroscopically, graded by the International Cartilage Repair Society (ICRS) score in 42 defined ROIs per patient and consecutively compared with mean gagCEST values using analysis of variance and Spearman's rank correlation test. Receiver operating characteristics (ROC) curves were applied to identify gagCEST threshold values to differentiate between the ICRS grades. RESULTS A total of 882 ROIs were examined and graduated in ICRS score 0 (67.3%), 1 (25.2%), 2 (6.2%) and the merged ICRS 3 and 4 (1.0%). gagCEST values decreased with increasing grade of cartilage damage with a negative correlation between gagCEST values and ICRS scores. A gagCEST value threshold of 3.55% was identified to differentiate between ICRS score 0 (normal) and all other grades. CONCLUSIONS gagCEST reflects the content of glycosaminoglycan and might provide a diagnostic tool for the detection of early knee-joint cartilage damage and for the non-invasive subtle differentiation between ICRS grades by MRI even at early stages in clinical practice.
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Affiliation(s)
- S T Soellner
- Department of Trauma and Orthopaedic Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
| | - G H Welsch
- UKE Athleticum, and Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - K Gelse
- Klinikum Traunstein, Traunstein, Germany; Department of Trauma and Orthopaedic Surgery, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany; University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
| | - A Goldmann
- OCE Orthopaedie Centrum Erlangen, Erlangen, Germany.
| | - A Kleyer
- Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
| | - G Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
| | - M L Pachowsky
- Department of Trauma and Orthopaedic Surgery and Department of Internal Medicine 3 - Rheumatology and Immunology, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany.
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12
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Assessment of Low-Grade Focal Cartilage Lesions in the Knee With Sodium MRI at 7 T: Reproducibility and Short-Term, 6-Month Follow-up Data. Invest Radiol 2021; 55:430-437. [PMID: 32011573 DOI: 10.1097/rli.0000000000000652] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Several articles have investigated potential of sodium (Na) magnetic resonance imaging (MRI) for the in vivo evaluation of cartilage health, but so far no study tested its feasibility for the evaluation of focal cartilage lesions of grade 1 or 2 as defined by the International Cartilage Repair Society. The aims of this study were to evaluate the ability of Na-MRI to differentiate between early focal lesions and normal-appearing cartilage, to evaluate within-subject reproducibility of Na-MRI, and to monitor longitudinal changes in participants with low-grade, focal chondral lesions. MATERIALS AND METHODS Thirteen participants (mean age, 50.1 ± 10.9 years; 7 women, 6 men) with low-grade, focal cartilage lesions in the weight-bearing region of femoral cartilage were included in this prospective cohort study. Participants were assessed at baseline, 1 week, 3 months, and 6 months using morphological MRI at 3 T and 7 T, compositional Na-MRI at 7 T, and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Na signal intensities corrected for coil sensitivity and partial volume effect (Na-cSI) were calculated in the lesion, and in weight-bearing and non-weight-bearing regions of healthy femoral cartilage. Coefficients of variation, repeated measures analysis of covariance models, and Pearson correlation coefficients were calculated to evaluate within-subject reproducibility as well as cross-sectional and longitudinal changes in Na-cSI values. RESULTS The mean coefficients of variation of Na-cSI values between the baseline and 1-week follow-up were 5.1% or less in all cartilage regions. Significantly lower Na-cSI values were observed in lesion than in weight-bearing and non-weight-bearing regions at all time points (all P values ≤ 0.002). Although a significant decrease from baseline Na-cSI values in lesion was found at 3-month visit (P = 0.015), no substantial change was observed at 6 months. KOOS scores have improved in all subscales at 3 months and 6 months visit, with a significant increase observed only in the quality of life subscale (P = 0.004). CONCLUSIONS In vivo Na-MRI is a robust and reproducible method that allows to differentiate between low-grade, focal cartilage lesions and normal-appearing articular cartilage, which supports the concept that compositional cartilage changes can be found early, before the development of advanced morphological changes visible at clinical 3-T MRI.
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13
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Brinkhof S, Nizak R, Sim S, Khlebnikov V, Quenneville E, Garon M, Klomp DW, Saris D. In vivo biochemical assessment of cartilage with gagCEST MRI: Correlation with cartilage properties. NMR IN BIOMEDICINE 2021; 34:e4463. [PMID: 33352622 PMCID: PMC7900973 DOI: 10.1002/nbm.4463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/22/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
To assess articular cartilage in vivo, a noninvasive measurement is proposed to evaluate damage of the cartilage. It is hypothesized that glycosaminoglycan chemical exchange saturation transfer (gagCEST) can be applied as a noninvasive imaging technique as it would relate to electromechanical indentation and GAG content as measured with biochemical assays. This pilot study applies gagCEST MRI in total knee arthroplasty (TKA) patients to assess substantially damaged articular cartilage. The outcome was verified against electromechanical indentation and biochemical assays to assess the potential of gagCEST MRI. Five TKA patients were scanned on a 7.0 T MRI with a gagCEST sequence. Articular resurfacing cuts after TKA were obtained for electromechanical and biochemical analyses. The gagCEST MRI measurements on the medial condyle showed a moderate correlation with the GAG content, although sensitivity on the lateral condyle was lacking. Additionally, a strong negative correlation of gagCEST MRI with the electromechanical measurements was observed in the regression analysis. Correlation of gagCEST MRI with electromechanical measurements was shown, but the correlation of gagCEST MRI with GAG content was not convincing. In conclusion, gagCEST could be a useful tool to assess the GAG content in articular cartilage noninvasively, although the mismatch in heterogeneity requires further investigation.
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Affiliation(s)
- Sander Brinkhof
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Razmara Nizak
- Department of OrthopaedicsUniversity Medical Center UtrechtUtrechtthe Netherlands
| | | | - Vitaliy Khlebnikov
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | | | | | - Dennis W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtthe Netherlands
| | - Daniel Saris
- Department of OrthopaedicsUniversity Medical Center UtrechtUtrechtthe Netherlands
- MIRA Institute for Biomedical Technology and Technical MedicineUniversity of TwenteEnschedethe Netherlands
- Department of Orthopaedics, Mayo ClinicRochesterMassachusettsUnited States
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14
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MRSI vs CEST MRI to understand tomato metabolism in ripening fruit: is there a better contrast? Anal Bioanal Chem 2021; 413:1251-1257. [PMID: 33404743 DOI: 10.1007/s00216-020-03101-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/03/2020] [Accepted: 11/26/2020] [Indexed: 12/18/2022]
Abstract
Besides structural information, magnetic resonance imaging (MRI) is crucial to reveal the presence and gradients of metabolites in organs constituted of several tissues. In plant science, such knowledge is key to better understand fruit development and metabolism. Routine methods based on fixation for cytological studies or dissection for metabolite measurements induce biases and plant sample destruction. Magnetic resonance spectroscopy imaging (MSRI) leads to one NMR spectrum per pixel while chemical exchange saturation transfer (CEST) MRI allows mapping metabolites having exchangeable protons. As both methods present different advantages and drawbacks, we compared them to map metabolites in ripe tomato fruits. We demonstrated that MRSI was difficult to interpret due to large spatial chemical shift variations while CEST MRI produced promising image mapping of the main carbohydrates and amino acids. It showed that glucose/fructose was mostly located in the locular tissue, whereas glutamate/glutamine/GABA was found inside the columella.Graphical abstract.
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15
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Abstract
Regulatory approval of ultrahigh field (UHF) MR imaging scanners for clinical use has opened new opportunities for musculoskeletal imaging applications. UHF MR imaging has unique advantages in terms of signal-to-noise ratio, contrast-to-noise ratio, spectral resolution, and multinuclear applications, thus providing unique information not available at lower field strengths. But UHF also comes with a set of technical challenges that are yet to be resolved and may not be suitable for all imaging applications. This review focuses on the latest research in musculoskeletal MR imaging applications at UHF including morphologic imaging, T2, T2∗, and T1ρ mapping, chemical exchange saturation transfer, sodium imaging, and phosphorus spectroscopy imaging applications.
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16
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Chaudhari AS, Kogan F, Pedoia V, Majumdar S, Gold GE, Hargreaves BA. Rapid Knee MRI Acquisition and Analysis Techniques for Imaging Osteoarthritis. J Magn Reson Imaging 2020; 52:1321-1339. [PMID: 31755191 PMCID: PMC7925938 DOI: 10.1002/jmri.26991] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 12/16/2022] Open
Abstract
Osteoarthritis (OA) of the knee is a major source of disability that has no known treatment or cure. Morphological and compositional MRI is commonly used for assessing the bone and soft tissues in the knee to enhance the understanding of OA pathophysiology. However, it is challenging to extend these imaging methods and their subsequent analysis techniques to study large population cohorts due to slow and inefficient imaging acquisition and postprocessing tools. This can create a bottleneck in assessing early OA changes and evaluating the responses of novel therapeutics. The purpose of this review article is to highlight recent developments in tools for enhancing the efficiency of knee MRI methods useful to study OA. Advances in efficient MRI data acquisition and reconstruction tools for morphological and compositional imaging, efficient automated image analysis tools, and hardware improvements to further drive efficient imaging are discussed in this review. For each topic, we discuss the current challenges as well as potential future opportunities to alleviate these challenges. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY STAGE: 3.
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Affiliation(s)
| | - Feliks Kogan
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Center of Digital Health Innovation (CDHI), University of California San Francisco, San Francisco, California, USA
| | - Sharmila Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
- Center of Digital Health Innovation (CDHI), University of California San Francisco, San Francisco, California, USA
| | - Garry E. Gold
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Brian A. Hargreaves
- Department of Radiology, Stanford University, Stanford, California, USA
- Department of Bioengineering, Stanford University, Stanford, California, USA
- Department of Electrical Engineering, Stanford University, Stanford, California, USA
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17
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Villano D, Romdhane F, Irrera P, Consolino L, Anemone A, Zaiss M, Dastrù W, Longo DL. A fast multislice sequence for 3D MRI-CEST pH imaging. Magn Reson Med 2020; 85:1335-1349. [PMID: 33031591 PMCID: PMC7756816 DOI: 10.1002/mrm.28516] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/30/2020] [Accepted: 08/22/2020] [Indexed: 12/13/2022]
Abstract
Purpose Chemical exchange saturation transfer MRI can provide accurate pH images, but the slow scan time (due to long saturation periods and multiple offsets sampling) reduce both the volume coverage and spatial resolution capability, hence the possibility to interrogate the heterogeneity in tumors and organs. To overcome these limitations, we propose a fast multislice CEST‐MRI sequence with high pH accuracy and spatial resolution. Methods The sequence first uses a long saturation pulse to induce the steady‐state CEST contrast and a second short saturation pulse repeated after each image acquisition to compensate for signal losses based on an uneven irradiation scheme combined with a single‐shot rapid acquisition with refocusing echoes readout. Sequence sensitivity and accuracy in measuring pH was optimized by simulation and assessed by in vitro studies in pH‐varying phantoms. In vivo validation was performed in two applications by acquiring multislice pH images covering the whole tumors and kidneys after iopamidol injection. Results Simulated and in vivo data showed comparable contrast efficiency and pH responsiveness by reducing saturation time. The experimental data from a homogeneous, pH‐varying, iopamidol‐containing phantom show that the sequence produced a uniform CEST contrast across slices and accurate values across slices in less than 10 minutes. In vivo measurements allowed us to quantify the 3D pH gradients of tumors and kidneys, with pH ranges comparable with the literature. Conclusion The proposed fast multislice CEST‐MRI sequence allows volumetric acquisitions with good pH sensitivity, accuracy, and spatial resolution for several in vivo pH imaging applications.
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Affiliation(s)
- Daisy Villano
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Feriel Romdhane
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.,National Engineering School of Tunis (ENIT), University al Manar, Tunis, Tunisia
| | - Pietro Irrera
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy.,Institute of Biostructures and Bioimaging, University of Campania "Luigi Vanvitelli," Italian National Research Council, Napoli, Italy
| | - Lorena Consolino
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Annasofia Anemone
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Moritz Zaiss
- Department of Neuroradiology, Friedrich-Alexander Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Walter Dastrù
- Molecular Imaging Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino, Italy
| | - Dario Livio Longo
- Institute of Biostructures and Bioimaging, Italian National Research Council, Torino, Italy
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18
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Zaric O, Juras V, Szomolanyi P, Schreiner M, Raudner M, Giraudo C, Trattnig S. Frontiers of Sodium MRI Revisited: From Cartilage to Brain Imaging. J Magn Reson Imaging 2020; 54:58-75. [PMID: 32851736 PMCID: PMC8246730 DOI: 10.1002/jmri.27326] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 12/19/2022] Open
Abstract
Sodium magnetic resonance imaging (23 Na-MRI) is a highly promising imaging modality that offers the possibility to noninvasively quantify sodium content in the tissue, one of the most relevant parameters for biochemical investigations. Despite its great potential, due to the intrinsically low signal-to-noise ratio (SNR) of sodium imaging generated by low in vivo sodium concentrations, low gyromagnetic ratio, and substantially shorter relaxation times than for proton (1 H) imaging, 23 Na-MRI is extremely challenging. In this article, we aim to provide a comprehensive overview of the literature that has been published in the last 10-15 years and which has demonstrated different technical designs for a range of 23 Na-MRI methods applicable for disease diagnoses and treatment efficacy evaluations. Currently, a wider use of 3.0T and 7.0T systems provide imaging with the expected increase in SNR and, consequently, an increased image resolution and a reduced scanning time. A great interest in translational research has enlarged the field of sodium MRI applications to almost all parts of the body: articular cartilage tendons, spine, heart, breast, muscle, kidney, and brain, etc., and several pathological conditions, such as tumors, neurological and degenerative diseases, and others. The quantitative parameter, tissue sodium concentration, which reflects changes in intracellular sodium concentration, extracellular sodium concentration, and intra-/extracellular volume fractions is becoming acknowledged as a reliable biomarker. Although the great potential of this technique is evident, there must be steady technical development for 23 Na-MRI to become a standard imaging tool. The future role of sodium imaging is not to be considered as an alternative to 1 H MRI, but to provide early, diagnostically valuable information about altered metabolism or tissue function associated with disease genesis and progression. LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 1.
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Affiliation(s)
- Olgica Zaric
- Institute for Clinical Molecular MRI in the Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria
| | - Vladimir Juras
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Pavol Szomolanyi
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Markus Schreiner
- Deartment of Orthopaedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria
| | - Marcus Raudner
- High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Chiara Giraudo
- Radiology Institute, Department of Medicine, DIMED Padova University Via Giustiniani 2, Padova, Italy
| | - Siegfried Trattnig
- Institute for Clinical Molecular MRI in the Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria.,High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MRI, Christian Doppler Forschungsgesellschaft, Vienna, Austria
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19
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Aringhieri G, Zampa V, Tosetti M. Musculoskeletal MRI at 7 T: do we need more or is it more than enough? Eur Radiol Exp 2020; 4:48. [PMID: 32761480 PMCID: PMC7410909 DOI: 10.1186/s41747-020-00174-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/01/2020] [Indexed: 12/18/2022] Open
Abstract
Ultra-high field magnetic resonance imaging (UHF-MRI) provides important diagnostic improvements in musculoskeletal imaging. The higher signal-to-noise ratio leads to higher spatial and temporal resolution which results in improved anatomic detail and higher diagnostic confidence. Several methods, such as T2, T2*, T1rho mapping, delayed gadolinium-enhanced, diffusion, chemical exchange saturation transfer, and magnetisation transfer techniques, permit a better tissue characterisation. Furthermore, UHF-MRI enables in vivo measurements by low-γ nuclei (23Na, 31P, 13C, and 39K) and the evaluation of different tissue metabolic pathways. European Union and Food and Drug Administration approvals for clinical imaging at UHF have been the first step towards a more routinely use of this technology, but some drawbacks are still present limiting its widespread clinical application. This review aims to provide a clinically oriented overview about the application of UHF-MRI in the different anatomical districts and tissues of musculoskeletal system and its pros and cons. Further studies are needed to consolidate the added value of the use of UHF-MRI in the routine clinical practice and promising efforts in technology development are already in progress.
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Affiliation(s)
- Giacomo Aringhieri
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Risorgimento, 36, Pisa, Italy.
| | - Virna Zampa
- Diagnostic and Interventional Radiology, University Hospital of Pisa, Via paradisa, 2, Pisa, Italy
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20
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Watkins LE, Rubin EB, Mazzoli V, Uhlrich SD, Desai AD, Black M, Ho GK, Delp SL, Levenston ME, Beaupré GS, Gold GE, Kogan F. Rapid volumetric gagCEST imaging of knee articular cartilage at 3 T: evaluation of improved dynamic range and an osteoarthritic population. NMR IN BIOMEDICINE 2020; 33:e4310. [PMID: 32445515 PMCID: PMC7347437 DOI: 10.1002/nbm.4310] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/03/2020] [Accepted: 03/20/2020] [Indexed: 05/22/2023]
Abstract
Chemical exchange saturation transfer of glycosaminoglycans, gagCEST, is a quantitative MR technique that has potential for assessing cartilage proteoglycan content at field strengths of 7 T and higher. However, its utility at 3 T remains unclear. The objective of this work was to implement a rapid volumetric gagCEST sequence with higher gagCEST asymmetry at 3 T to evaluate its sensitivity to osteoarthritic changes in knee articular cartilage and in comparison with T2 and T1ρ measures. We hypothesize that gagCEST asymmetry at 3 T decreases with increasing severity of osteoarthritis (OA). Forty-two human volunteers, including 10 healthy subjects and 32 subjects with medial OA, were included in the study. Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed for all subjects, and Kellgren-Lawrence grading was performed for OA volunteers. Healthy subjects were scanned consecutively at 3 T to assess the repeatability of the volumetric gagCEST sequence at 3 T. For healthy and OA subjects, gagCEST asymmetry and T2 and T1ρ relaxation times were calculated for the femoral articular cartilage to assess sensitivity to OA severity. Volumetric gagCEST imaging had higher gagCEST asymmetry than single-slice acquisitions (p = 0.015). The average scan-rescan coefficient of variation was 6.8%. There were no significant differences in average gagCEST asymmetry between younger and older healthy controls (p = 0.655) or between healthy controls and OA subjects (p = 0.310). T2 and T1ρ relaxation times were elevated in OA subjects (p < 0.001 for both) compared with healthy controls and both were moderately correlated with total KOOS scores (rho = -0.181 and rho = -0.332 respectively). The gagCEST technique developed here, with volumetric scan times under 10 min and high gagCEST asymmetry at 3 T, did not vary significantly between healthy subjects and those with mild-moderate OA. This further supports a limited utility for gagCEST imaging at 3 T for assessment of early changes in cartilage composition in OA.
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Affiliation(s)
| | - Elka B Rubin
- Radiology, Stanford University, Stanford, California, USA
| | | | - Scott D Uhlrich
- Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Arjun D Desai
- Electrical Engineering, Stanford University, Stanford, California, USA
| | - Marianne Black
- Radiology, Stanford University, Stanford, California, USA
- Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Gabe K Ho
- Bioengineering, Stanford University, Stanford, California, USA
| | - Scott L Delp
- Bioengineering, Stanford University, Stanford, California, USA
- Mechanical Engineering, Stanford University, Stanford, California, USA
- Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Marc E Levenston
- Bioengineering, Stanford University, Stanford, California, USA
- Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Gary S Beaupré
- Bioengineering, Stanford University, Stanford, California, USA
- Veteran Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Garry E Gold
- Bioengineering, Stanford University, Stanford, California, USA
- Radiology, Stanford University, Stanford, California, USA
- Orthopaedic Surgery, Stanford University, Stanford, California, USA
| | - Feliks Kogan
- Radiology, Stanford University, Stanford, California, USA
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21
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Roemer FW, Demehri S, Omoumi P, Link TM, Kijowski R, Saarakkala S, Crema MD, Guermazi A. State of the Art: Imaging of Osteoarthritis—Revisited 2020. Radiology 2020; 296:5-21. [DOI: 10.1148/radiol.2020192498] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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22
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Einarsson E, Peterson P, Önnerfjord P, Gottschalk M, Xu X, Knutsson L, Dahlberg LE, Struglics A, Svensson J. The role of cartilage glycosaminoglycan structure in gagCEST. NMR IN BIOMEDICINE 2020; 33:e4259. [PMID: 31999387 DOI: 10.1002/nbm.4259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/20/2019] [Accepted: 12/23/2019] [Indexed: 06/10/2023]
Abstract
Glycosaminoglycan (GAG) chemical exchange saturation transfer (gagCEST) is a potential method for cartilage quality assessment. The aim of this study was to investigate how the gagCEST effect depends on the types and molecular organization of GAG typically found in articular cartilage. gagCEST was performed on different concentrations of GAG in various forms: free chains of chondroitin sulfate (CS) of different types (-A and -C) and GAG bound to protein in aggregated and nonaggregated aggrecan extracted from calf articular cartilage. The measured magnetization transfer ratio asymmetry (MTRasym ) was compared with known GAG concentrations or GAG concentrations determined through biochemical analysis. The gagCEST effect was assessed through the linear regression coefficient with 95% confidence interval of MTRasym per GAG concentration. We observed a lower gagCEST effect in phantoms containing a mixture of CS-A and CS-C compared with phantoms containing mainly CS-A. The difference in response corresponds well to the difference in CS-A concentration. GAG bound in aggrecan from calf articular cartilage, where CS-A is assumed to be the major type of GAG, produed a similar gagCEST effect as that observed for free CS-A. The effect was also similar for aggregated (ie, bound to hyaluronic acid) and nonaggregated aggrecan. In conclusion, our results indicate that the aggrecan structure in itself does not impact the gagCEST effect, but that the effect is strongly dependent on GAG type. In phantoms, the current implementation of gagCEST is sensitive to CS-A while for CS-C, the main GAG component in mature human articular cartilage, the sensitivity is limited. This difference in gagCEST sensitivity between GAG types detected in phantoms is a strong motivation to also explore the possibility of a similar effect in vivo.
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Affiliation(s)
- Emma Einarsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Pernilla Peterson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Radiation Physics, Department of Oncology and Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Patrik Önnerfjord
- Rheumatology and Molecular Skeletal Biology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | | | - Xiang Xu
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Research Institute, Baltimore, Maryland, USA
| | - Linda Knutsson
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Medical Radiation Physics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Leif E Dahlberg
- Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - André Struglics
- Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Jonas Svensson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Malmö, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
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Molecular imaging of inflammation - Current and emerging technologies for diagnosis and treatment. Pharmacol Ther 2020; 211:107550. [PMID: 32325067 DOI: 10.1016/j.pharmthera.2020.107550] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/07/2019] [Indexed: 12/12/2022]
Abstract
Inflammation is a key factor in multiple diseases including primary immune-mediated inflammatory diseases e.g. rheumatoid arthritis but also, less obviously, in many other common conditions, e.g. cardiovascular disease and diabetes. Together, chronic inflammatory diseases contribute to the majority of global morbidity and mortality. However, our understanding of the underlying processes by which the immune response is activated and sustained is limited by a lack of cellular and molecular information obtained in situ. Molecular imaging is the visualization, detection and quantification of molecules in the body. The ability to reveal information on inflammatory biomarkers, pathways and cells can improve disease diagnosis, guide and monitor therapeutic intervention and identify new targets for research. The optimum molecular imaging modality will possess high sensitivity and high resolution and be capable of non-invasive quantitative imaging of multiple disease biomarkers while maintaining an acceptable safety profile. The mainstays of current clinical imaging are computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US) and nuclear imaging such as positron emission tomography (PET). However, none of these have yet progressed to routine clinical use in the molecular imaging of inflammation, therefore new approaches are required to meet this goal. This review sets out the respective merits and limitations of both established and emerging imaging modalities as clinically useful molecular imaging tools in addition to potential theranostic applications.
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24
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Maloney E, Wang YN, Vohra R, Son H, Whang S, Khokhlova T, Park J, Gravelle K, Totten S, Hwang JH, Lee D. Magnetic resonance imaging biomarkers for pulsed focused ultrasound treatment of pancreatic ductal adenocarcinoma. World J Gastroenterol 2020; 26:904-917. [PMID: 32206002 PMCID: PMC7081013 DOI: 10.3748/wjg.v26.i9.904] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 01/12/2020] [Accepted: 02/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The robust fibroinflammatory stroma characteristic of pancreatic ductal adenocarcinoma (PDA) impedes effective drug delivery. Pulsed focused ultrasound (pFUS) can disrupt this stroma and has improved survival in an early clinical trial. Non-invasive methods to characterize pFUS treatment effects are desirable for advancement of this promising treatment modality in larger clinical trials.
AIM To identify promising, non-invasive pre-clinical imaging methods to characterize acute pFUS treatment effects for in vivo models of PDA.
METHODS We utilized quantitative magnetic resonance imaging methods at 14 tesla in three mouse models of PDA (subcutaneous, orthotopic and transgenic - KrasLSL-G12D/+, Trp53LSL-R172H/+, Cre or “KPC”) to assess immediate tumor response to pFUS treatment (VIFU 2000 Alpinion Medical Systems; 475 W peak electric power, 1 ms pulse duration, 1 Hz, duty cycle 0.1%) vs sham therapy, and correlated our results with histochemical data. These pFUS treatment parameters were previously shown to enhance tumor permeability to chemotherapeutics. T1 and T2 relaxation maps, high (126, 180, 234, 340, 549) vs low (7, 47, 81) b-value apparent diffusion coefficient (ADC) maps, magnetization transfer ratio (MTR) maps, and chemical exchange saturation transfer (CEST) maps for the amide proton spectrum (3.5 parts per million or “ppm”) and the glycosaminoglycan spectrum (0.5-1.5 ppm) were generated and analyzed pre-treatment, and immediately post-treatment, using ImageJ. Animals were sacrificed immediately following post-treatment imaging. The whole-tumor was selected as the region of interest for data analysis and subsequent statistical analysis. T-tests and Pearson correlation were used for statistical inference.
RESULTS Mean high-b value ADC measurements increased significantly with pFUS treatment for all models. Mean glycosaminoglycan CEST and T2 measurements decreased significantly post-treatment for the KPC group. Mean MTR and amide CEST values increased significantly for the KPC group. Hyaluronic acid focal intensities in the treated regions were significantly lower following pFUS treatment for all animal models. The magnetic resonance imaging changes observed acutely following pFUS therapy likely reflect: (1) Sequelae of variable degrees of microcapillary hemorrhage (T1, MTR and amide CEST); (2) Lower PDA glycosaminoglycan content and associated water content (glycosaminoglycan CEST, T2 and hyaluronic acid focal intensity); and (3) Improved tumor diffusivity (ADC) post pFUS treatment.
CONCLUSION T2, glycosaminoglycan CEST, and ADC maps may provide reliable quantitation of acute pFUS treatment effects for patients with PDA.
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Affiliation(s)
- Ezekiel Maloney
- Department of Radiology, University of Washington, Seattle, WA 98195, United States
| | - Yak-Nam Wang
- Applied Physics Laboratory, University of Washington, Seattle, WA 98195, United States
| | - Ravneet Vohra
- Department of Radiology, University of Washington, Seattle, WA 98195, United States
| | - Helena Son
- Division of Gastroenterology, University of Washington, Seattle 98195, WA, United States
| | - Stella Whang
- Division of Gastroenterology, University of Washington, Seattle 98195, WA, United States
| | - Tatiana Khokhlova
- Division of Gastroenterology, University of Washington, Seattle 98195, WA, United States
| | - Joshua Park
- Department of Radiology, University of Washington, Seattle, WA 98195, United States
| | - Kayla Gravelle
- Division of Gastroenterology, University of Washington, Seattle 98195, WA, United States
| | - Stephanie Totten
- Division of Gastroenterology, University of Washington, Seattle 98195, WA, United States
| | - Joo Ha Hwang
- Division of Gastroenterology & Hepatology, Stanford University School of Medicine, Redwood City, CA 94063, United States
| | - Donghoon Lee
- Department of Radiology, University of Washington, Seattle, WA 98195, United States
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25
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Lansdown DA, Ma CB. Clinical Utility of Advanced Imaging of the Knee. J Orthop Res 2020; 38:473-482. [PMID: 31498473 DOI: 10.1002/jor.24462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 07/17/2019] [Indexed: 02/04/2023]
Abstract
Advanced imaging modalities, including computed tomography, magnetic resonance imaging (MRI), and dynamic fluoroscopic imaging, allow for a comprehensive evaluation of the knee joint. Compositional sequences for MRI can allow for an evaluation of the biochemical properties of cartilage, meniscus, and ligament that offer further insight into pathology that may not be apparent on conventional clinical imaging. Advances in image processing, shape modeling, and dynamic studies also offer a novel way to evaluate common conditions and to monitor patients after treatment. The purpose of this article is to review advanced imaging modalities of the knee and their current and anticipated future applications to clinical practice. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:473-482, 2020.
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Affiliation(s)
- Drew A Lansdown
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California
| | - C Benjamin Ma
- Department of Orthopedic Surgery, Sports Medicine & Shoulder Surgery, University of California, San Francisco, San Francisco, California
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26
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Brinkhof S, Ali Haghnejad A, Ito K, Markenroth Bloch K, Klomp D. Uncompromised MRI of knee cartilage while incorporating sensitive sodium MRI. NMR IN BIOMEDICINE 2019; 32:e4173. [PMID: 31502337 PMCID: PMC6900061 DOI: 10.1002/nbm.4173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
Sodium imaging is able to assess changes in ion content, linked to glycosaminoglycan content, which is important to guide orthopeadic procedures such as articular cartilage repair. Sodium imaging is ideally performed using double tuned RF coils, to combine high resolution morphological imaging with biochemical information from sodium imaging to assess ion content. The proton image quality of such coils is often harshly degraded, with up to 50% of SNR or severe acceleration loss as compared to single tuned coils. Reasons are that the number of proton receive channels often severely reduced and double tuning will degrade the intrinsic sensitivity of the RF coil on at least one of the nuclei. However, the aim of this work was to implement a double-tuned sodium/proton knee coil setup without deterioration of the proton signal whilst being able to achieve acquisition of high SNR sodium images. A double-tuned knee coil was constructed as a shielded birdcage optimized for sodium and compromised for proton. To exclude any compromise, the proton part of the birdcage is used for transmit only and interfaced to RF amplifiers that can fully mitigate the reduced efficiency. In addition, a 15 channel single tuned proton receiver coil was embedded within the double-resonant birdcage to maintain optimal SNR and acceleration for proton imaging. To validate the efficiency of our coil, the designed coil was compared with the state-of-the-art single-tuned alternative at 7 T. B1+ corrected SNR maps were used to compare both coils on proton performance and g-factor maps were used to compare both coils on acceleration possibilities. The newly constructed double-tuned coil was shown to have comparable proton quality and acceleration possibilities to the single-tuned alternative while also being able to acquire high SNR sodium images.
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Affiliation(s)
- S. Brinkhof
- Department of RadiologyUniversity Medical Center UtrechtUtrechtNetherlands
| | | | - K. Ito
- Department of Orthopaedics, University Medical Center Utrecht, Utrecht, Netherlands
- Orthopaedic Biomechanics, Department of Biomedical EngineeringEindhoven University of TechnologyEindhovenNetherlands
| | | | - D.W.J. Klomp
- Department of RadiologyUniversity Medical Center UtrechtUtrechtNetherlands
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27
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Juras V, Mlynarik V, Szomolanyi P, Valkovič L, Trattnig S. Magnetic Resonance Imaging of the Musculoskeletal System at 7T: Morphological Imaging and Beyond. Top Magn Reson Imaging 2019; 28:125-135. [PMID: 30951006 PMCID: PMC6565434 DOI: 10.1097/rmr.0000000000000205] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In 2017, a whole-body 7T magnetic resonance imaging (MRI) device was given regulatory approval for clinical use in both the EU and United States for neuro and musculoskeletal applications. As 7 Tesla allows for higher signal-to-noise , which results in higher resolution images than those obtained on lower-field-strength scanners, it has attracted considerable attention from the musculoskeletal field, as evidenced by the increasing number of publications in the last decade. Besides morphological imaging, the quantitative MR methods, such as T2, T2∗, T1ρ mapping, sodium imaging, chemical-exchange saturation transfer, and spectroscopy, substantially benefit from ultrahigh field scanning. In this review, we provide technical considerations for the individual techniques and an overview of (mostly) clinical applications for the assessment of cartilage, tendon, meniscus, and muscle. The first part of the review is dedicated to morphological applications at 7T, and the second part describes the most recent developments in quantitative MRI at 7T.
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Affiliation(s)
- Vladimir Juras
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Vladimir Mlynarik
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Karl Landsteiner Society, St. Pölten, Austria
| | - Pavol Szomolanyi
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Ladislav Valkovič
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Oxford Centre for Clinical Magnetic Resonance Research, BHF Centre of Research Excellence, University of Oxford, Oxford, UK.,Department of Imaging Methods, Institute of Measurements Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Siegfried Trattnig
- High-field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.,Austrian Cluster for Tissue Regeneration, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
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28
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Dou W, Lin CYE, Ding H, Shen Y, Dou C, Qian L, Wen B, Wu B. Chemical exchange saturation transfer magnetic resonance imaging and its main and potential applications in pre-clinical and clinical studies. Quant Imaging Med Surg 2019; 9:1747-1766. [PMID: 31728316 PMCID: PMC6828581 DOI: 10.21037/qims.2019.10.03] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 09/29/2019] [Indexed: 12/26/2022]
Abstract
Chemical exchange saturation transfer (CEST) imaging is a novel contrast mechanism, relying on the exchange between mobile protons in amide (-NH), amine (-NH2) and hydroxyl (-OH) groups and bulk water. Due to the targeted protons present in endogenous molecules or exogenous compounds applied externally, CEST imaging can respectively, generate endogenous or exogenous contrast. Nowadays, CEST imaging for endogenous contrast has been explored in pre-clinical and clinical studies. Amide CEST, also called amide proton transfer weighted (APT) imaging, generates CEST effect at 3.5 ppm away from the water signal and has been widely investigated. Given the sensitivity to amide proton concentration and pH level, APT imaging has shown robust performance in the assessment of ischemia, brain tumors, breast and prostate cancer as well as neurodegenerative diseases. With advanced methods proposed, pure APT and Nuclear Overhauser Effect (NOE) mediated CEST effects were separately fitted from original APT signal. Using both effects, early but promising results were obtained for glioma patients in the evaluation of tumor response to therapy and patient survival. Compared to amide CEST, amine CEST is also mobile proton concentration and pH dependent, but has a faster exchange rate between amine protons and water. The resultant CEST effect is usually introduced at 1.8-3 ppm. Glutamate and creatine, as two main metabolites with amine groups for CEST imaging, have been applied to quantitatively assess diseases in the central nervous system and muscle system, respectively. Glycosaminoglycan (Gag) as a representative metabolite with hydroxyl groups has also been measured to evaluate the cartilage of knee or intervertebral discs in CEST MRI. Due to limited frequency difference between hydroxyl protons and water, 7T for better spectral separation is preferred over 3T for GagCEST measurement. The applications of CEST MRI with exogenous contrast agents are still quite limited in clinic. While certain diamagnetic CEST agents, such as dynamic-glucose, have been tried in human for brain tumor or neck cancer assessment, most exogenous agents, i.e., paramagnetic CEST agents, are still tested in the pre-clinical stage, mainly due to potential toxicity. Engineered tissues for tissue regeneration and drug delivery have also shown a great potential in CEST imaging, as many of them, such as hydrogel and polyamide materials, contain mobile protons or can be incorporated with CEST specific chemical compounds. These engineered tissues can thus generate CEST effect in vivo, allowing a possibility to understand the fate of them in vivo longitudinally. Although the CEST MRI with engineered tissues has only been established in early stage, the obtained first evidence is crucial for further optimizing these biomaterials and finally accomplishing the translation into clinical use.
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Affiliation(s)
- Weiqiang Dou
- MR Research, GE Healthcare, Beijing 100076, China
| | | | - Hongyuan Ding
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yong Shen
- MR Enhanced Application, GE Healthcare, Beijing 100076, China
| | - Carol Dou
- Faculty of Medicine, University of British Columbia, British Columbia, Canada
| | - Long Qian
- MR Research, GE Healthcare, Beijing 100076, China
| | - Baohong Wen
- Department of MRI, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Bing Wu
- MR Research, GE Healthcare, Beijing 100076, China
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29
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Sewerin P, Ostendorf B, Schleich C. [MRI diagnostics in inflammatory joint and spinal diseases: protocols and special sequences: when and for what?]. Z Rheumatol 2019; 77:538-548. [PMID: 29916005 DOI: 10.1007/s00393-018-0497-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Magnetic resonance imaging (MRI) is an important component in rheumatology for imaging diagnostics and therapy monitoring of inflammatory and non-inflammatory diseases of the spine and peripheral joints. The correct selection of suitable and practical MRI protocols and sequences represents a great challenge for physicians with respect to requesting and interpreting the indications for MRI investigations. This review article provides recommendations and suggestions for MRI investigation protocols for clinical utilization and practice. New sequences are evaluated and assessed in order to generate the best possible standardized and comparable examinations for rheumatology in the future and therefore optimize the quality of radiological interventions.
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Affiliation(s)
- P Sewerin
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
| | - B Ostendorf
- Poliklinik, Funktionsbereich & Hiller Forschungszentrum für Rheumatologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland
| | - C Schleich
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinikum, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland
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30
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Jin T, Kim SG. Approximated analytical characterization of the steady-state chemical exchange saturation transfer (CEST) signals. Magn Reson Med 2019; 82:1876-1889. [PMID: 31237027 DOI: 10.1002/mrm.27864] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/01/2019] [Accepted: 05/26/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE CEST MRI can indirectly detect low-concentrated molecules via their proton exchange with the bulk water and is widely measured by a sensitivity index, the asymmetry of magnetization transfer ratio (MTRasym ). Because CEST applications are often limited by their low sensitivity or specificity, it is important to characterize MTRasym analytically to optimize its sensitivity or specifity. METHODS Approximated analytical solutions of the MTRasym spectrum were derived based on a 2-pool chemical exchange model for slow-to-intermediate exchanges. The optimal saturation pulse power for maximizing the MTRasym or tuning MTRasym to a specific exchange rate and the peak position and linewidth of a MTRasym spectrum were also derived. These approximated analytical solutions were compared with the solutions from the Bloch-McConnell equations using computer simulations. RESULTS The approximated analytical solutions of the MTRasym spectra, the optimizing parameters, and the peak and linewidth of MTRasym matched well with the solutions of Bloch-McConnell equations in the slow or slow-to-intermediate exchange regimes. CONCLUSION These approximate analytical solutions can provide insights to the understanding of CEST signal property and help the optimization of saturation parameters and the interpretation of CEST data.
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Affiliation(s)
- Tao Jin
- Neuroimaging Laboratory, Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, Republic of Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
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31
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Trattnig S, Raudner M, Schreiner M, Roemer F, Bohndorf K. [Biochemical cartilage imaging-update 2019]. Radiologe 2019; 59:742-749. [PMID: 31187160 DOI: 10.1007/s00117-019-0558-x] [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] [Indexed: 10/26/2022]
Abstract
BACKGROUND Cartilage imaging using magnetic resonance imaging (MRI) is increasingly used for early detection of cartilage damage. Biochemical MR methods to assess cartilage damage are essential for optimal treatment planning. PURPOSE The aim of this review is to provide an update on advanced cartilage imaging based on biochemical MR techniques. The clinical applications and additional benefits compared to conventional MRI are presented. MATERIALS AND METHODS A literature search of PubMed regarding the clinical applications of various biochemical MR methods and morphological MR imaging was performed. RESULTS While T2 mapping can be easily implemented on clinical routine MR scanners, the T1rho method is technically more demanding and is not available on all MR scanners. dGEMRIC, which can be performed with all field strengths, is now severely restricted due to the recent decision of the European Medical Agency (EMA) to withdraw linear gadolinium contrast agents from the market because of proven gadolinium deposition in the brain. Sodium imaging is the most sensitive MRI method for glycosaminoglycan (GAG), but is limited to 7 T. In addition to early diagnosis of cartilage degeneration before morphological changes are visible, biochemical MRI offers predictive markers, e.g., effect of lifestyle changes or assessing results of cartilage repair surgery. CONCLUSION Cartilage imaging based on biochemical MRI allows a shift from qualitative to quantitative MRI. Biochemical MRI plays an increasingly important role in the early diagnosis of cartilage degeneration for monitoring of disease-modifying drugs and as predictive imaging biomarker in clinical diagnostics. In cartilage repair, monitoring of the efficacy of different cartilage repair surgery techniques to develop hyaline-like cartilage can be performed with biochemical MRI.
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Affiliation(s)
- S Trattnig
- Exzellenzzentrum für Hochfeld MR, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Lazarettgasse 14, 1090, Wien, Österreich.
| | - M Raudner
- Exzellenzzentrum für Hochfeld MR, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Lazarettgasse 14, 1090, Wien, Österreich
| | - M Schreiner
- Universitätsklinik für Orthopädie und Unfallchirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich
| | - F Roemer
- Radiologisches Institut, Universitätsklinikum Erlangen, Maximiliansplatz 3, 91054, Erlangen, Deutschland
| | - K Bohndorf
- Exzellenzzentrum für Hochfeld MR, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Lazarettgasse 14, 1090, Wien, Österreich
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Non-Invasive Monitoring of Stromal Biophysics with Targeted Depletion of Hyaluronan in Pancreatic Ductal Adenocarcinoma. Cancers (Basel) 2019; 11:cancers11060772. [PMID: 31167451 PMCID: PMC6627077 DOI: 10.3390/cancers11060772] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 12/12/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDA) is characterized by a pronounced fibroinflammatory stromal reaction consisting of inordinate levels of hyaluronan (HA), collagen, immune cells, and activated fibroblasts that work in concert to generate a robust physical barrier to the perfusion and diffusion of small molecule therapeutics. The targeted depletion of hyaluronan with a PEGylated recombinant human hyaluronidase (PEGPH20) lowers interstitial gel–fluid pressures and re-expands collapsed intratumoral vasculature, improving the delivery of concurrently administered agents. Here we report a non-invasive means of assessing biophysical responses to stromal intervention with quantitative multiparametric magnetic resonance imaging (MRI) at 14 Tesla (T). We found that spin-spin relaxation time T2 values and glycosaminoglycan chemical exchange saturation transfer (GagCEST) values decreased at 24 h, reflecting depletion of intratumoral HA content, and that these parameters recovered at 7 days concurrent with replenishment of intratumoral HA. This was also reflected in an increase in low-b apparent diffusion coefficient (ADC) at 24 h, consistent with improved tumor perfusion that again normalized at 7 days after treatment. Phantom imaging suggests that the GagCEST signal is driven by changes in HA versus other glycosaminoglycans. Thus, multiparametric magnetic resonance imaging (MRI) can be used as a non-invasive tool to assess therapeutic responses to targeted stromal therapy in PDA and likely other stroma-rich solid tumors that have high levels of hyaluronan and collagen.
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Elite Rowers Demonstrate Consistent Patterns of Hip Cartilage Damage Compared With Matched Controls: A T2* Mapping Study. Clin Orthop Relat Res 2019; 477:1007-1018. [PMID: 30516651 PMCID: PMC6494313 DOI: 10.1097/corr.0000000000000576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Rowing exposes the femoral head and acetabulum to high levels of repetitive abutment motion and axial loading that may put elite athletes at an increased risk for developing early hip osteoarthritis. QUESTIONS/PURPOSES Do elite rowers demonstrate characteristic hip cartilage lesions on T2 MRI sequences compared with asymptomatic individuals who do not row? METHODS This study included 20 asymptomatic rowers (mean age, 23 ± 3 years; nine females, 11 males) who had a minimum of 5 years of intensive (≥ 12 hours/week) training. The recruiting of the rowers took place from the central German federal rowing base, which has inherent intense training and selection requirements to declare these athletes as "elite rowers." We investigated one hip per study participant. MRI was performed on a 3-T scanner. The protocol included standard sequences, a double-echo steady-state sequence, and a multiecho data image combination sequence with inline T2 calculation (= the decay of transverse magnetization arising from molecular interactions [T2] and inhomogeneities in the magnetic field resulting from tissue susceptibility-induced field distortions and variations in the magnet itself), which detects changes in water content and the disruption of collagen structure. Although extrinsic and intrinsic influences on the T2 values including diurnal effects, MR technic-derived variations, and anatomic-related regional disparities need to be taken into account, low T2 values well below 20 ms indicate cartilage degeneration. Cartilage was morphologically analyzed in the anterior, anterosuperior, superoanterior, superior, superoposterior, posterosuperior, and posterior regions of the hip and graded as follows: Grade 0 = normal; Grade 1 = signal changes; Grade 2 = cartilage abrasion; Grade 3 = cartilage loss. Labrum was classified as follows: Grade 0 = normal; Grade 1 = partial tear; Grade 2 = full-thickness tear; Grade 3 = labrum degeneration. The T2 measurement was done through a region of interest analysis. For reliability assessment, morphologic evaluation and T2 measurement were performed by two observers while one observer repeated his analysis with a time interval > 2 weeks. Intra- and interobserver reliability was determined using κ analysis and intraclass correlation coefficients. Control T2 data were derived from a previous study on 15 hips in 15 asymptomatic volunteers of similar ages (seven males and eight females) who were not competitive rowers with similar MR hardware and imaging sequences. RESULTS Compared with the control group of asymptomatic volunteers who were not competitive rowers, we noted a high level of labrum and cartilage degeneration in the cohort of elite rowers. In the group of elite rowers, cartilage degeneration was noted in all hips. Regarding the acetabular cartilage, 271 zones could be evaluated. Of those, 44% (120 of 271) were graded normal, 6% (15 of 271) revealed signal alteration, 45% (122 of 271) demonstrated cartilage abrasion, and 5% (14 of 271) were noted to have full-thickness cartilage loss. Morphologic cartilage degeneration in the femoral head was less frequent. T2 values were lower than the control hips in all zones except for the posterior central acetabular zone (global T2 acetabular: 20 ± 6 ms, range, 9-36 ms, 95% confidence interval [CI], 19-21 ms versus 25 ± 5 ms, range, 14-44 ms, 95% CI, 24-25 ms, p < 0.001; global T2 femoral: 23 ± 7 ms, range, 9-38 ms, 95% CI, 22-24 ms versus 27 ± 5 ms, range, 17-45 ms, 95% CI, 26-28 ms, p < 0.001). The difference in T2 between the two study groups was superior in the peripheral zone of the anterosuperior region (16 ± 3 ms; range, 10-22 ms, 95% CI, 15-18 ms versus 26 ms ± 5 ms, range, 18-38 ms, 95% CI, 24-29 ms, p < 0.001). CONCLUSIONS We found signs of hip cartilage degeneration to a much greater degree in elite rowers than in asymptomatic controls. Although causation cannot be inferred, this is concerning, and future investigations including controlled longitudinal studies both on elite and nonelite athletes with sufficient cohort size are warranted to clarify our findings. LEVEL OF EVIDENCE Level III, therapeutic study.
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Alizai H, Chang G, Regatte RR. MR Imaging of the Musculoskeletal System Using Ultrahigh Field (7T) MR Imaging. PET Clin 2019; 13:551-565. [PMID: 30219187 DOI: 10.1016/j.cpet.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
MR imaging is an indispensable instrument for the diagnosis of musculoskeletal diseases. In vivo MR imaging at 7T offers many advantages, including increased signal-to-noise ratio, higher spatial resolution, improved spectral resolution for spectroscopy, improved sensitivity for X-nucleus imaging, and decreased image acquisition times. There are also however technical challenges of imaging at a higher field strength compared with 1.5 and 3T MR imaging systems. We discuss the many potential opportunities as well as the challenges presented by 7T MR imaging systems and highlight recent developments in in vivo research imaging of musculoskeletal applications in general and cartilage, skeletal muscle, and bone in particular.
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Affiliation(s)
- Hamza Alizai
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA.
| | - Gregory Chang
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
| | - Ravinder R Regatte
- Department of Radiology, New York University Langone Medical Center, 660 First Avenue, New York, NY 10016, USA
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Windschuh J, Zaiss M, Ehses P, Lee JS, Jerschow A, Regatte RR. Assessment of frequency drift on CEST MRI and dynamic correction: application to gagCEST at 7 T. Magn Reson Med 2019; 81:573-582. [PMID: 29851141 PMCID: PMC6258338 DOI: 10.1002/mrm.27367] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the effect of a frequency drift of the static magnetic field on 3D CEST MRI based on glycosaminoglycans (GAGs) of articular cartilage at 7 T and to introduce a retrospective correction method that uses the phase images of the gradient-echo readout. METHODS Repeated gagCEST and B0 measurements were performed in a glucose model solution and in vivo in the knee joint of 3 healthy volunteers at 7 T. Phase images of the modified 3D rectangular spiral centric-reordered gradient-echo CEST sequence were used to quantify and compensate the apparent frequency drift in repeated gagCEST measurements. RESULTS The frequency drift of the MRI scanner strongly influences the gagCEST signal in the articular cartilage of the human knee joint. The gagCEST signal in the articular cartilage is changed by 0.18%/Hz while an average drift of 0.7 ± 0.2 Hz/minute was observed. The proposed correction method can be applied retrospectively without the need of additional measurements and provides improved comparability and reproducibility for gagCEST studies. This correction method may also be of interest for other applications of CEST MRI. CONCLUSION Prospective or retrospective correction of the frequency drift of the MRI scanner is essential for reproducible gagCEST measurements. The proposed retrospective correction method fulfills this requirement without the need of additional measurements.
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Affiliation(s)
- Johannes Windschuh
- New York University Langone Medical Center, Department of Radiology, Center for Biomedical Imaging, 660 First Avenue, New York, NY 10013, USA
| | - Moritz Zaiss
- Max Planck Institute for Biological Cybernetics, High-field Magnetic Resonance Center, Spemannstr. 41, 72076 Tübingen, Germany
| | - Philipp Ehses
- German Center for Neurodegenerative Diseases, Department of MR Physics, Sigmund-Freud-Str. 27, 53127 Bonn, Germany
| | - Jae-Seung Lee
- New York University Langone Medical Center, Department of Radiology, Center for Biomedical Imaging, 660 First Avenue, New York, NY 10013, USA
- New York University, Department of Chemistry, 100 Washington Square East, New York, NY 10003, USA
| | - Alexej Jerschow
- New York University, Department of Chemistry, 100 Washington Square East, New York, NY 10003, USA
| | - Ravinder R Regatte
- New York University Langone Medical Center, Department of Radiology, Center for Biomedical Imaging, 660 First Avenue, New York, NY 10013, USA
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Ladd ME, Bachert P, Meyerspeer M, Moser E, Nagel AM, Norris DG, Schmitter S, Speck O, Straub S, Zaiss M. Pros and cons of ultra-high-field MRI/MRS for human application. PROGRESS IN NUCLEAR MAGNETIC RESONANCE SPECTROSCOPY 2018; 109:1-50. [PMID: 30527132 DOI: 10.1016/j.pnmrs.2018.06.001] [Citation(s) in RCA: 264] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 05/08/2023]
Abstract
Magnetic resonance imaging and spectroscopic techniques are widely used in humans both for clinical diagnostic applications and in basic research areas such as cognitive neuroimaging. In recent years, new human MR systems have become available operating at static magnetic fields of 7 T or higher (≥300 MHz proton frequency). Imaging human-sized objects at such high frequencies presents several challenges including non-uniform radiofrequency fields, enhanced susceptibility artifacts, and higher radiofrequency energy deposition in the tissue. On the other side of the scale are gains in signal-to-noise or contrast-to-noise ratio that allow finer structures to be visualized and smaller physiological effects to be detected. This review presents an overview of some of the latest methodological developments in human ultra-high field MRI/MRS as well as associated clinical and scientific applications. Emphasis is given to techniques that particularly benefit from the changing physical characteristics at high magnetic fields, including susceptibility-weighted imaging and phase-contrast techniques, imaging with X-nuclei, MR spectroscopy, CEST imaging, as well as functional MRI. In addition, more general methodological developments such as parallel transmission and motion correction will be discussed that are required to leverage the full potential of higher magnetic fields, and an overview of relevant physiological considerations of human high magnetic field exposure is provided.
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Affiliation(s)
- Mark E Ladd
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine, University of Heidelberg, Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany; Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen, Germany.
| | - Peter Bachert
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Physics and Astronomy, University of Heidelberg, Heidelberg, Germany.
| | - Martin Meyerspeer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
| | - Ewald Moser
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
| | - Armin M Nagel
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - David G Norris
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, Netherlands; Erwin L. Hahn Institute for MRI, University of Duisburg-Essen, Essen, Germany.
| | - Sebastian Schmitter
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Physikalisch-Technische Bundesanstalt (PTB), Braunschweig and Berlin, Germany.
| | - Oliver Speck
- Department of Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany; German Center for Neurodegenerative Diseases, Magdeburg, Germany; Center for Behavioural Brain Sciences, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany.
| | - Sina Straub
- Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Moritz Zaiss
- High-Field Magnetic Resonance Center, Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany.
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Peterson P, Olsson E, Svensson J. T
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relaxation time bias in gagCEST at 3T and 7T: comparison of saturation schemes. Magn Reson Med 2018; 81:1044-1051. [DOI: 10.1002/mrm.27465] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/08/2018] [Accepted: 07/05/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Pernilla Peterson
- Medical Radiation Physics, Malmö, Department of Translational Medicine Lund University Sweden
- Radiation Physics Skåne University Hospital Malmö Sweden
| | - Emma Olsson
- Medical Radiation Physics, Malmö, Department of Translational Medicine Lund University Sweden
| | - Jonas Svensson
- Medical Radiation Physics, Malmö, Department of Translational Medicine Lund University Sweden
- Medical Imaging and Physiology Skåne University Hospital Lund Sweden
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Menon RG, Chang G, Regatte RR. The Emerging Role of 7 Tesla MRI in Musculoskeletal Imaging. CURRENT RADIOLOGY REPORTS 2018. [DOI: 10.1007/s40134-018-0286-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Shazeeb MS, Corazzini R, Konowicz PA, Fogle R, Bangari DS, Johnson J, Ying X, Dhal PK. Assessment of in vivo degradation profiles of hyaluronic acid hydrogels using temporal evolution of chemical exchange saturation transfer (CEST) MRI. Biomaterials 2018; 178:326-338. [PMID: 29861090 DOI: 10.1016/j.biomaterials.2018.05.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/19/2018] [Accepted: 05/22/2018] [Indexed: 12/22/2022]
Abstract
Hyaluronic acid (HA) hydrogels have found a wide range of applications in biomedicine: regenerative medicine to drug delivery applications. In vivo quantitative assessment of these hydrogels using magnetic resonance imaging (MRI) provides an effective, accurate, safe, and non-invasive translational approach to assess the biodegradability of HA hydrogels. Chemical exchange saturation transfer (CEST) is an MRI contrast enhancement technique that overcomes the concentration limitation of other techniques like magnetic resonance spectroscopy (MRS) by detecting metabolites at up to two orders of magnitude or higher. In this study, HA hydrogels were synthesized based on different crosslinking agents and assessed using CEST MRI to investigate the in vivo degradation profiles of these gels in a mouse subcutaneous injection model over a three-month period. Nature of crosslinking agents was found to influence their degradation profiles. Since CEST MRI provides a unique chemical signature to visualize HA hydrogels, our studies proved that this technique could be used as a guide in the hydrogel optimization process for drug delivery and regenerative medicine applications.
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Affiliation(s)
| | - Rubina Corazzini
- Diabetes Research, Sanofi Global R&D, 153 Second Avenue, Waltham, MA 02451, USA
| | - Paul A Konowicz
- Diabetes Research, Sanofi Global R&D, 153 Second Avenue, Waltham, MA 02451, USA
| | - Robert Fogle
- Bioimaging Research, Sanofi Global R&D, 49 New York Avenue, Framingham, MA 01701, USA
| | - Dinesh S Bangari
- Pathology Research, Sanofi Global R&D, 5 Mountain Road, Framingham, MA 01701, USA
| | - Jennifer Johnson
- Pathology Research, Sanofi Global R&D, 5 Mountain Road, Framingham, MA 01701, USA
| | - Xiaoyou Ying
- Bioimaging Research, Sanofi Global R&D, 49 New York Avenue, Framingham, MA 01701, USA.
| | - Pradeep K Dhal
- Diabetes Research, Sanofi Global R&D, 153 Second Avenue, Waltham, MA 02451, USA.
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Editorial comment: the future of compositional MRI for cartilage. Eur Radiol 2018; 28:2872-2873. [PMID: 29713777 DOI: 10.1007/s00330-018-5457-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/28/2018] [Indexed: 02/06/2023]
Abstract
This editorial comment refers to the article: "Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T" by Brinkhof et al, Eur Radiol 2018.
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Abidin AZ, Deng B, DSouza AM, Nagarajan MB, Coan P, Wismüller A. Deep transfer learning for characterizing chondrocyte patterns in phase contrast X-Ray computed tomography images of the human patellar cartilage. Comput Biol Med 2018; 95:24-33. [PMID: 29433038 PMCID: PMC5869140 DOI: 10.1016/j.compbiomed.2018.01.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 10/18/2022]
Abstract
Phase contrast X-ray computed tomography (PCI-CT) has been demonstrated to be effective for visualization of the human cartilage matrix at micrometer resolution, thereby capturing osteoarthritis induced changes to chondrocyte organization. This study aims to systematically assess the efficacy of deep transfer learning methods for classifying between healthy and diseased tissue patterns. We extracted features from two different convolutional neural network architectures, CaffeNet and Inception-v3 for characterizing such patterns. These features were quantitatively evaluated in a classification task measured by the area (AUC) under the Receiver Operating Characteristic (ROC) curve as well as qualitative visualization through a dimension reduction approach t-Distributed Stochastic Neighbor Embedding (t-SNE). The best classification performance, for CaffeNet, was observed when using features from the last convolutional layer and the last fully connected layer (AUCs >0.91). Meanwhile, off-the-shelf features from Inception-v3 produced similar classification performance (AUC >0.95). Visualization of features from these layers further confirmed adequate characterization of chondrocyte patterns for reliably distinguishing between healthy and osteoarthritic tissue classes. Such techniques, can be potentially used for detecting the presence of osteoarthritis related changes in the human patellar cartilage.
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Affiliation(s)
- Anas Z Abidin
- Department of Biomedical Engineering, University of Rochester Medical Center, Rochester, NY, USA.
| | - Botao Deng
- Department of Electrical Engineering, University of Rochester Medical Center, Rochester, NY, USA
| | - Adora M DSouza
- Department of Electrical Engineering, University of Rochester Medical Center, Rochester, NY, USA
| | - Mahesh B Nagarajan
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, USA
| | - Paola Coan
- European Synchrotron Radiation Facility, Grenoble, France; Faculty of Medicine and Institute of Clinical Radiology, Ludwig Maximilians University, Munich Germany
| | - Axel Wismüller
- Department of Biomedical Engineering, University of Rochester Medical Center, Rochester, NY, USA; Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Electrical Engineering, University of Rochester Medical Center, Rochester, NY, USA; Faculty of Medicine and Institute of Clinical Radiology, Ludwig Maximilians University, Munich Germany
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Nelson BB, Kawcak CE, Barrett MF, McIlwraith CW, Grinstaff MW, Goodrich LR. Recent advances in articular cartilage evaluation using computed tomography and magnetic resonance imaging. Equine Vet J 2018; 50:564-579. [DOI: 10.1111/evj.12808] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/09/2018] [Indexed: 12/18/2022]
Affiliation(s)
- B. B. Nelson
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - C. E. Kawcak
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. F. Barrett
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
- Department of Environmental and Radiological Health Sciences Colorado State University Fort Collins Colorado USA
| | - C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
| | - M. W. Grinstaff
- Departments of Biomedical Engineering, Chemistry and Medicine Boston University Boston Massachusetts USA
| | - L. R. Goodrich
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins Colorado USA
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Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T. Eur Radiol 2018; 28:2874-2881. [PMID: 29383528 PMCID: PMC5986839 DOI: 10.1007/s00330-017-5277-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 12/18/2017] [Accepted: 12/21/2017] [Indexed: 12/04/2022]
Abstract
Objectives The purpose was to implement a fast 3D glycosaminoglycan Chemical Exchange Saturation Transfer (gagCEST) sequence at 7 T, test stability and reproducibility in cartilage in the knee in healthy volunteers, and evaluate clinical applicability in cartilage repair patients. Methods Experiments were carried out on a 7-T scanner using a volume transmit coil and a 32-channel receiver wrap-around knee coil. The 3D gagCEST measurement had an acquisition time of 7 min. Signal stability and reproducibility of the GAG effect were assessed in eight healthy volunteers. Clinical applicability of the method was demonstrated in five patients before cartilage repair surgery. Results Coefficient of variation of the gagCEST signal was 1.9%. The reproducibility of the GAG effect measurements was good in the medial condyle (ICC = 0.87) and excellent in the lateral condyle (ICC = 0.97). GAG effect measurements in healthy cartilage ranged from 2.6%-12.4% compared with 1.3%-5.1% in damaged cartilage. Difference in GAG measurement between healthy cartilage and damaged cartilage was significant (p < 0.05). Conclusions A fast 3D gagCEST sequence was applied at 7 T for use in cartilage in the knee, acquired within a clinically feasible scan time of 7 min. We demonstrated that the method has high stability, reproducibility and clinical applicability. Key Points • gagCEST measurements are stable and reproducible • A non-invasive GAG measurement with gagCEST can be acquired in 7 min • gagCEST is able to discriminate between healthy and damaged cartilage Electronic supplementary material The online version of this article (10.1007/s00330-017-5277-y) contains supplementary material, which is available to authorized users.
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Jones KM, Pollard AC, Pagel MD. Clinical applications of chemical exchange saturation transfer (CEST) MRI. J Magn Reson Imaging 2017; 47:11-27. [PMID: 28792646 DOI: 10.1002/jmri.25838] [Citation(s) in RCA: 184] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/30/2017] [Indexed: 02/06/2023] Open
Abstract
Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) has been developed and employed in multiple clinical imaging research centers worldwide. Selective radiofrequency (RF) saturation pulses with standard 2D and 3D MRI acquisition schemes are now routinely performed, and CEST MRI can produce semiquantitative results using magnetization transfer ratio asymmetry (MTRasym ) analysis while accounting for B0 inhomogeneity. Faster clinical CEST MRI acquisition methods and more quantitative acquisition and analysis routines are under development. Endogenous biomolecules with amide, amine, and hydroxyl groups have been detected during clinical CEST MRI studies, and exogenous CEST agents have also been administered to patients. These CEST MRI tools show promise for contributing to assessments of cerebral ischemia, neurological disorders, lymphedema, osteoarthritis, muscle physiology, and solid tumors. This review summarizes the salient features of clinical CEST MRI protocols and critically evaluates the utility of CEST MRI for these clinical imaging applications. LEVEL OF EVIDENCE 5 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:11-27.
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Affiliation(s)
- Kyle M Jones
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA
| | | | - Mark D Pagel
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona, USA.,Department of Chemistry, Rice University, Houston, Texas, USA.,Department of Cancer Systems Imaging, MD Anderson Cancer Center, Houston, Texas, USA
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Schleich C, Miese F, Müller-Lutz A, Boos J, Aissa J, Nasca A, Zaucke F, Bostelmann T, Schimmöller L, Bittersohl B, Steiger HJ, Antoch G, Bostelmann R. Value of delayed gadolinium-enhanced magnetic resonance imaging of cartilage for the pre-operative assessment of cervical intervertebral discs. J Orthop Res 2017; 35:1824-1830. [PMID: 27699832 DOI: 10.1002/jor.23454] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 09/29/2016] [Indexed: 02/04/2023]
Abstract
The study was performed to preoperatively assess the cartilage integrity of cervical intervertebral discs (IVDs) using Delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC). Therefore, 53 cervical intervertebral discs of nine preoperative patients with neck and shoulder/arm pain scheduled for discectomy (five females, four males; mean age: 47.1 ± 8.4 years; range: 36-58 years) were included for biochemical analysis in this retrospective study. The patients underwent 3T magnetic resonance imaging (MRI) including biochemical imaging with dGEMRIC and morphological, sagittal T2 weighted (T2w) imaging. Cervical IVDs were rated using an MRI based grading system for cervical IVDs on T2w images. Region-of-interest measurements were performed in the nucleus pulposus (NP) and annulus fibrosus (AF) and a dGEMRIC index was calculated. Our results demonstrated that IVDs scheduled for discectomy showed significantly lower dGEMRIC index compared to IVDs that did not require surgical intervention in NP and AF (NP: 898.4 ± 191.9 ms vs. 1,150.3 ± 320.7 ms, p = 0.008; AF: 738.7 ± 183.8 ms vs. 984.6 ± 178.9 ms, p = 0.008). For Miyazaki score 3, the dGEMRIC indices were significantly lower in IVDs scheduled for surgery compared to non-operated discs for NP (p = 0.043) and AF (p = 0.018). In conclusion we could demonstrate that biochemical imaging with dGEMRIC is feasible in cervical IVDs. Significantly lower dGEMRIC index suggested GAG depletion in degenerated cervical IVD, scheduled for discectomy. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1824-1830, 2017.
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Affiliation(s)
- Christoph Schleich
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Falk Miese
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Anja Müller-Lutz
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Johannes Boos
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Joel Aissa
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Adrian Nasca
- Neurosurgical Department, University Hospital, Dusseldorf, Germany
| | - Frank Zaucke
- Medical Faculty, Department of Orthopedics, University of Frankfurt/Main, Germany
| | | | - Lars Schimmöller
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
| | - Bernd Bittersohl
- Medical Faculty, Department of Orthopedics, University Duesseldorf, Germany
| | | | - Gerald Antoch
- Medical Faculty, Department of Diagnostic and Interventional Radiology, University Dusseldorf, D-40225, Dusseldorf, Germany
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Evaluating the cartilage adjacent to the site of repair surgery with glycosaminoglycan-specific magnetic resonance imaging. INTERNATIONAL ORTHOPAEDICS 2017; 41:969-974. [DOI: 10.1007/s00264-017-3434-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 02/28/2017] [Indexed: 01/17/2023]
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Wei W, Lambach B, Jia G, Kaeding C, Flanigan D, Knopp MV. A Phase I clinical trial of the knee to assess the correlation of gagCEST MRI, delayed gadolinium-enhanced MRI of cartilage and T2 mapping. Eur J Radiol 2017; 90:220-224. [PMID: 28583638 DOI: 10.1016/j.ejrad.2017.02.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 02/14/2017] [Accepted: 02/18/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE Osteoarthritis (OA) is associated with the loss of glycosaminoglycan (GAG) during disease progression, which can be detected by glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) MRI. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is considered one of the standard methods for GAG quantification in vivo. This Phase I study assessed the correlation between gagCEST MRI and dGEMRIC in determining cartilage GAG concentration. Standard T2 mapping was used as a comparator with the two other methods. MATERIALS AND METHODS Eight athletic volunteers with no known knee diseases were recruited in this study. The sagittal images of both knees in each volunteer were obtained by a 3T MRI system. GAG concentration was calculated based on fixed charge density (FCD) within articular cartilage as calculated by T1 values obtained from dGEMRIC sequences. Magnetization transfer ratio asymmetry (MTRasym) of the CEST spectrum at 1ppm was determined with gagCEST MRI. T2 values were calculated using a multi-echo turbo spin echo (TSE) sequence. The Pearson correlations among MTRasym were calculated from gagCEST analysis. RESULTS There was moderate correlation (correlation coefficient r=0.55) between dGEMRIC and gagCEST MRI results. T2 had a low correlation (r=-0.30) with gagCEST and no correlation with dGEMRIC (r=0.003). Both gagCEST and dGEMRIC were able to distinguish between high GAG concentration cartilage compartments (higher than 210mM) and low GAG cartilage compartments (lower than 210mM). CONCLUSION dGEMRIC was shown to be a more accurate and sensitive clinical imaging tool in evaluating cartilage GAG levels in vivo. While GagCEST showed less sensitivity to GAG concentration variations than dGEMRIC, further improvements may yet enable gagCEST to be a clinically robust methodology.
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Affiliation(s)
- Wenbo Wei
- Wright Center of Innovation in Biomedical Imaging and Department of Radiology, The Ohio State University, Columbus, OH, United States
| | - Becky Lambach
- Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, United States
| | - Guang Jia
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA, United States
| | - Christopher Kaeding
- Department of Orthopedics, The Ohio State University, Columbus, OH, United States
| | - David Flanigan
- Department of Orthopedics, The Ohio State University, Columbus, OH, United States
| | - Michael V Knopp
- Wright Center of Innovation in Biomedical Imaging and Department of Radiology, The Ohio State University, Columbus, OH, United States.
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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.
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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
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Zhang S, Liu Z, Grant A, Keupp J, Lenkinski RE, Vinogradov E. Balanced Steady-State Free Precession (bSSFP) from an effective field perspective: Application to the detection of chemical exchange (bSSFPX). JOURNAL OF MAGNETIC RESONANCE (SAN DIEGO, CALIF. : 1997) 2017; 275:55-67. [PMID: 28012297 PMCID: PMC5810596 DOI: 10.1016/j.jmr.2016.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 12/02/2016] [Accepted: 12/03/2016] [Indexed: 05/08/2023]
Abstract
Chemical exchange saturation transfer (CEST) is a novel contrast mechanism and it is gaining increasing popularity as many promising applications have been proposed and investigated. Fast and quantitative CEST imaging techniques are further needed in order to increase the applicability of CEST for clinical use as well as to derive quantitative physiological and biological information. Steady-state methods for fast CEST imaging have been reported recently. Here, we observe that an extreme case of these methods is a balanced steady-state free precession (bSSFP) sequence. The bSSFP in itself is sensitive to the exchange processes; hence, no additional saturation or preparation is needed for CEST-like data acquisition. The bSSFP experiment can be regarded as observation during saturation, without separate saturation and acquisition modules as used in standard CEST and similar experiments. One of the differences from standard CEST methods is that the bSSFP spectrum is an XY-spectrum not a Z-spectrum. As the first proof-of-principle step, we have implemented the steady-state bSSFP sequence for chemical exchange detection (bSSFPX) and verified its feasibility in phantom studies. These studies have shown that bSSFPX can achieve exchange-mediated contrast comparable to the standard CEST experiment. Therefore, the bSSFPX method has a potential for fast and quantitative CEST data acquisition.
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Affiliation(s)
- Shu Zhang
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Zheng Liu
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Aaron Grant
- Division of MR Research, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | | | - Robert E Lenkinski
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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