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Chianca V, Lanckoroński M, Curti M, Chalian M, Sudoł-Szopińska I, Giraudo C, Del Grande F. Whole-Body Magnetic Resonance Imaging in Rheumatology. Radiol Clin North Am 2024; 62:865-876. [PMID: 39059977 DOI: 10.1016/j.rcl.2024.02.008] [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: 07/28/2024]
Abstract
This review focuses on the most frequent whole-body MRI applications in patients with rheumatological pathologies, for which this tool can be helpful to both radiologists and clinicians. It reports technical aspects of the acquisition of both 1.5 and 3.0 T scanners. The article lists the main findings that help radiologists during the evaluation of a specific pathology, both in the diagnostic phase and during follow-up.
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Affiliation(s)
- Vito Chianca
- Istituto di Imaging Della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, Lugano 6900 Switzerland.
| | - Michał Lanckoroński
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1 Street, Warsaw 02-637, Poland
| | - Marco Curti
- Istituto di Imaging Della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, Lugano 6900 Switzerland
| | - Majid Chalian
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1 Street, Warsaw 02-637, Poland
| | - Chiara Giraudo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health - DCTV, University of Padova, Padova, Italy
| | - Filippo Del Grande
- Istituto di Imaging Della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, Lugano 6900 Switzerland; Facoltà di Scienze Biomediche, Università Della Svizzera Italiana, Via Buffi 13, Lugano 6900, Switzerland
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Li X, Kim J, Yang M, Ok AH, Zbýň Š, Link TM, Majumdar S, Ma CB, Spindler KP, Winalski CS. Cartilage compositional MRI-a narrative review of technical development and clinical applications over the past three decades. Skeletal Radiol 2024:10.1007/s00256-024-04734-z. [PMID: 38980364 DOI: 10.1007/s00256-024-04734-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 07/10/2024]
Abstract
Articular cartilage damage and degeneration are among hallmark manifestations of joint injuries and arthritis, classically osteoarthritis. Cartilage compositional MRI (Cart-C MRI), a quantitative technique, which aims to detect early-stage cartilage matrix changes that precede macroscopic alterations, began development in the 1990s. However, despite the significant advancements over the past three decades, Cart-C MRI remains predominantly a research tool, hindered by various technical and clinical hurdles. This paper will review the technical evolution of Cart-C MRI, delve into its clinical applications, and conclude by identifying the existing gaps and challenges that need to be addressed to enable even broader clinical application of Cart-C MRI.
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Affiliation(s)
- Xiaojuan Li
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA.
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA.
| | - Jeehun Kim
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Mingrui Yang
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmet H Ok
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Štefan Zbýň
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Sharmilar Majumdar
- Department of Radiology and Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - C Benjamin Ma
- Department of Orthopaedic Surgery, UCSF, San Francisco, CA, USA
| | - Kurt P Spindler
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Carl S Winalski
- Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, 9500 Euclid Avenue, ND20, Cleveland, OH, 44195, USA
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Department of Diagnostic Radiology, Cleveland Clinic, Cleveland, OH, USA
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Wille CM, Hurley SA, Schmida E, Lee K, Kijowski R, Heiderscheit BC. Diffusion tensor imaging of hamstring muscles after acute strain injury and throughout recovery in collegiate athletes. Skeletal Radiol 2024; 53:1369-1379. [PMID: 38267763 DOI: 10.1007/s00256-024-04587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 01/26/2024]
Abstract
OBJECTIVE To identify the region of interest (ROI) to represent injury and observe between-limb diffusion tensor imaging (DTI) microstructural differences in muscle following hamstring strain injury. MATERIALS AND METHODS Participants who sustained a hamstring strain injury prospectively underwent 3T-MRI of bilateral thighs using T1, T2, and diffusion-weighted imaging at time of injury (TOI), return to sport (RTS), and 12 weeks after RTS (12wks). ROIs were using the hyperintense region on a T2-weighted sequence: edema, focused edema, and primary muscle injured excluding edema (no edema). Linear mixed-effects models were used to compare diffusion parameters between ROIs and timepoints and limbs and timepoints. RESULTS Twenty-four participants (29 injuries) were included. A significant ROI-by-timepoint interaction was detected for all diffusivity measures. The edema and focused edema ROIs demonstrated increased diffusion at TOI compared to RTS for all diffusivity measures (p-values < 0.006), except λ1 (p-values = 0.058-0.12), and compared to 12wks (p-values < 0.02). In the no edema ROI, differences in diffusivity measures were not observed (p-values > 0.82). At TOI, no edema ROI diffusivity measures were lower than the edema ROI (p-values < 0.001) but not at RTS or 12wks (p-values > 0.69). A significant limb-by-timepoint interaction was detected for all diffusivity measures with increased diffusion in the involved limb at TOI (p-values < 0.001) but not at RTS or 12wks (p-values > 0.42). Significant differences in fractional anisotropy over time or between limbs were not detected. CONCLUSION Hyperintensity on T2-weighted imaging used to define the injured region holds promise in describing muscle microstructure following hamstring strain injury by demonstrating between-limb differences at TOI but not at follow-up timepoints.
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Affiliation(s)
- Christa M Wille
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 6136 UW Medical Foundation Centennial Bldg, 1685 Highland Ave, Madison, WI, 53705, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Samuel A Hurley
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth Schmida
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 6136 UW Medical Foundation Centennial Bldg, 1685 Highland Ave, Madison, WI, 53705, USA
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA
- Department of Mechanical Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Kenneth Lee
- Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
| | - Richard Kijowski
- Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - Bryan C Heiderscheit
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, 6136 UW Medical Foundation Centennial Bldg, 1685 Highland Ave, Madison, WI, 53705, USA.
- Badger Athletic Performance Program, University of Wisconsin-Madison, Madison, WI, USA.
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Ren C, Zhu Q, Li Q, Sommer S, Zhang X, Yuan H. Assessment of the sacroiliac joint in patients with axial spondyloarthritis via three-dimensional ultrashort echo time magnetic resonance imaging. Quant Imaging Med Surg 2024; 14:4141-4154. [PMID: 38846278 PMCID: PMC11151252 DOI: 10.21037/qims-23-1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 01/02/2024] [Indexed: 06/09/2024]
Abstract
Background Bone erosion in the sacroiliac joint (SIJ) is highly specific for the diagnosis of axial spondyloarthritis (axSpA) and may indicate early disease progression. The 3D ultrashort echo time (3D-UTE) technique excels in providing clear contrast between the articular cartilage and the bone cortex interface. Additionally, it is emerging as a promising quantitative tool for detecting early cartilage changes. Therefore, this study aimed to evaluate the diagnostic performance of 3D-UTE sequences in identifying bone erosion in the SIJ of patients with axSpA and to clarify the potential of cartilage T2* values as a quantitative biomarker for axSpA. Methods This prospective study employed convenience and consecutive sampling methods to recruit patients diagnosed with axSpA in Peking University Third Hospital who met the Assessment of Spondyloarthritis International Society (ASAS) criteria and also an equal number of healthy volunteers. After providing informed consent, all participants underwent 3D-UTE sequences and conventional T2* mapping of the SIJs. Two radiologists separately interpreted the bone erosion of each SIJ on 3D-UTE sequences. Erosion detection of SIJs via computed tomography (CT) served as the standard of reference. The T2* values of the cartilage were measured and compared, and the diagnostic efficacy of the T2* value for axSpA diagnosis was evaluated. Results A total of 32 patients and 32 healthy volunteers were included. The 3D-UTE sequence, as separately assessed by two reviewers in terms of its ability to detect erosions, exhibited a notable level of accuracy. For the two reviewers, the respective diagnostic sensitivities were 94.7% and 92.9%, the specificities were 97.4% and 96.5%, positive predictive values were 96.7% and 95.4%, the negative predictive values were 95.9% and 94.5%, the accuracies were 96.2% and 94.9%, and the areas under the curve (AUCs) were 96.1% and 94.7%. For the detection of erosions, the interreader κ value was 0.949. The T2* values of the SIJ cartilage were significantly higher in patients with axSpA than in healthy volunteers. The intraobserver intraclass correlation coefficients (ICCs) for T2* measurements ranged between 80.5% and 82.2%. Meanwhile, the interobserver ICCs for UTE-T2* and gradient echo T2* measurements were 81.5% and 80.8%, respectively. The AUCs of the UTE-T2* values for discriminating patients with axSpA from the healthy volunteers of the two readers were 73.3% and 71.6%, respectively. Conclusions 3D-UTE sequences can be used as a reliable morphological imaging technique for detecting bone erosion in the SIJ. Additionally, UTE-T2* values of the cartilage may offer a quantitative method for identifying patients with axSpA.
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Affiliation(s)
- Cui Ren
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Qiao Zhu
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Qing Li
- MR Collaborations, Siemens Healthineers Ltd., Shanghai, China
| | - Stefan Sommer
- Siemens Healthcare, Zurich, Switzerland
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland
| | - Xianchang Zhang
- MR Collaborations, Siemens Healthineers Ltd., Beijing, China
| | - Huishu Yuan
- Department of Radiology, Peking University Third Hospital, Beijing, China
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Lemainque T, Pridöhl N, Huppertz M, Post M, Yüksel C, Siepmann R, Radke KL, Zhang S, Yoneyama M, Prescher A, Kuhl C, Truhn D, Nebelung S. Two for One-Combined Morphologic and Quantitative Knee Joint MRI Using a Versatile Turbo Spin-Echo Platform. Diagnostics (Basel) 2024; 14:978. [PMID: 38786276 PMCID: PMC11120432 DOI: 10.3390/diagnostics14100978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/25/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Quantitative MRI techniques such as T2 and T1ρ mapping are beneficial in evaluating knee joint pathologies; however, long acquisition times limit their clinical adoption. MIXTURE (Multi-Interleaved X-prepared Turbo Spin-Echo with IntUitive RElaxometry) provides a versatile turbo spin-echo (TSE) platform for simultaneous morphologic and quantitative joint imaging. Two MIXTURE sequences were designed along clinical requirements: "MIX1", combining proton density (PD)-weighted fat-saturated (FS) images and T2 mapping (acquisition time: 4:59 min), and "MIX2", combining T1-weighted images and T1ρ mapping (6:38 min). MIXTURE sequences and their reference 2D and 3D TSE counterparts were acquired from ten human cadaveric knee joints at 3.0 T. Contrast, contrast-to-noise ratios, and coefficients of variation were comparatively evaluated using parametric tests. Clinical radiologists (n = 3) assessed diagnostic quality as a function of sequence and anatomic structure using five-point Likert scales and ordinal regression, with a significance level of α = 0.01. MIX1 and MIX2 had at least equal diagnostic quality compared to reference sequences of the same image weighting. Contrast, contrast-to-noise ratios, and coefficients of variation were largely similar for the PD-weighted FS and T1-weighted images. In clinically feasible scan times, MIXTURE sequences yield morphologic, TSE-based images of diagnostic quality and quantitative parameter maps with additional insights on soft tissue composition and ultrastructure.
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Affiliation(s)
- Teresa Lemainque
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Nicola Pridöhl
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Marc Huppertz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Manuel Post
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Can Yüksel
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Robert Siepmann
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, University Dusseldorf, 40225 Düsseldorf, Germany
| | - Shuo Zhang
- Philips GmbH Market DACH, 22335 Hamburg, Germany
- Philips Healthcare, 5684 PZ Best, The Netherlands
| | | | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany
| | - Christiane Kuhl
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Daniel Truhn
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany (C.Y.); (R.S.); (S.N.)
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Feuerriegel GC, Marth AA, Goller SS, Hilbe M, Sommer S, Sutter R. Quantifying Tendon Degeneration Using Magic Angle Insensitive Ultra-Short Echo Time Magnetization Transfer: A Phantom Study in Bovine Tendons. Invest Radiol 2024:00004424-990000000-00207. [PMID: 38598670 DOI: 10.1097/rli.0000000000001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The aim of this study was to qualitatively and quantitatively assess changes in bovine flexor tendons before and after collagen degradation and at different angles in relation to the static B0 field using 3-dimensional ultra-short echo time (UTE) magnetization transfer (MT) imaging within a clinically feasible acquisition time. MATERIALS AND METHODS Eight bovine flexor tendons were examined at 3 T magnetic resonance imaging including 3-dimensional UTE MT and UTE T2* research application sequences (acquired within 4:04 and 6:38 minutes, respectively) before and after enzyme-induced degradation. The tendons were divided into 2 groups: group 1 (controls) treated with phosphate-buffered saline and group 2 treated with collagenase I to induce collagen degeneration. Magnetic resonance imaging was repeated at 0, 27, 55, and 90 degrees to the B0 field. To calculate quantitative tissue properties, all tendons were semiautomatically segmented, and changes in quantitative UTE T2* and UTE MT ratios (MTRs) were compared at different angles and between groups. In addition to descriptive statistics, the coefficient of variation was calculated to compare UTE MT and UTE T2* imaging. RESULTS Ultra-short echo time MTR showed a significantly lower coefficient of variation compared with UTE T2* values, indicating a more robust imaging method (UTE MTR 9.64%-11.25%, UTE T2* 18.81%-24.06%, P < 0.001). Both methods showed good performance in detecting degenerated tendons using histopathology as reference standard, with UTE MT imaging having a better area under the curve than UTE T2* mapping (0.918 vs 0.865). Falsely high UTE T2* values were detected at the 55 degrees acquisition angle, whereas UTE MTR values were robust, that is, insensitive to the MAE. CONCLUSIONS Ultra-short echo time MT imaging is a reliable method for quantifying tendon degeneration that is robust to the MAE and can be acquired in a clinically reasonable time.
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Affiliation(s)
- Georg C Feuerriegel
- From the Department of Radiology, Balgrist University Hospital, Faculty of Medicine, University of Zurich, Zurich, Switzerland (G.C.F., A.A.M., S.S.G., R.S.); Swiss Center for Musculoskeletal Imaging, Balgrist Campus, Zurich, Switzerland (A.A.M., S.S.); University of Zurich, Institute of Veterinary Pathology, Laboratory for Animal Pathology, Zurich, Switzerland (M.H.); and Advanced Clinical Imaging Technology, Siemens Healthineers International AG, Zurich, Switzerland (S.S.)
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Chang EY, Suprana A, Tang Q, Cheng X, Fu E, Orozco E, Jerban S, Shah SB, Du J, Ma Y. Rotator cuff muscle fibrosis can be assessed using ultrashort echo time magnetization transfer MRI with fat suppression. NMR IN BIOMEDICINE 2024; 37:e5058. [PMID: 37828713 PMCID: PMC10841248 DOI: 10.1002/nbm.5058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/30/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
Muscle degeneration following rotator cuff tendon tearing is characterized by fatty infiltration and fibrosis. While tools exist for the characterization of fat, the ability to noninvasively assess muscle fibrosis is limited. The purpose of this study was to evaluate the capability of quantitative ultrashort echo time T1 (UTE-T1) and UTE magnetization transfer (UTE-MT) mapping with and without fat suppression (FS) for the differentiation of injured and control rotator cuff muscles and for the detection of fibrosis. A rat model of chronic massive rotator cuff tearing (n = 12) was used with tenotomy of the right supraspinatus and infraspinatus tendons and silicone implants to prevent healing. Imaging was performed on a 3-T scanner, and UTE-T1 mapping with and without FS and UTE-MT with and without FS for macromolecular fraction (MMF) mapping was performed. At 20 weeks postinjury, T1 and MMF were measured in the supraspinatus and infraspinatus muscles of the injured and contralateral, internal control sides. Histology was performed and connective tissue fraction (CTF) was measured, defined as the area of collagen-rich extracellular matrix divided by the total muscle area. Paired t-tests and correlation analyses were performed. Significant differences between injured and control sides were found for CTF in the supraspinatus (mean ± SD, 14.5% ± 3.9% vs. 11.3% ± 3.7%, p = 0.01) and infraspinatus (17.0% ± 5.4% vs. 12.5% ± 4.6%, p < 0.01) muscles, as well as for MMF using UTE-MT FS in the supraspinatus (9.7% ± 0.3% vs. 9.5% ± 0.2%, p = 0.04) and infraspinatus (10.9% ± 0.8% vs. 10.1% ± 0.5%, p < 0.01) muscles. No significant differences between sides were evident for T1 without or with FS or for MMF using UTE-MT. Only MMF using UTE-MT FS was significantly correlated with CTF for both supraspinatus (r = 0.46, p = 0.03) and infraspinatus (r = 0.51, p = 0.01) muscles. Fibrosis occurs in rotator cuff muscle degeneration, and the UTE-MT FS technique may be helpful to evaluate the fibrosis component, independent from the fatty infiltration process.
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Affiliation(s)
- Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Radiology, University of California San Diego, San Diego, California, USA
| | - Arya Suprana
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Department of Bioengineering, University of California San Diego, San Diego, California, USA
| | - Qingbo Tang
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Xin Cheng
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Eddie Fu
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Elisabeth Orozco
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Orthopedic Surgery, University of California San Diego, San Diego, California, USA
| | - Saeed Jerban
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Orthopedic Surgery, University of California San Diego, San Diego, California, USA
| | - Sameer B Shah
- Department of Bioengineering, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
- Department of Orthopedic Surgery, University of California San Diego, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Department of Bioengineering, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Yajun Ma
- Department of Radiology, University of California San Diego, San Diego, California, USA
- Research Service, VA San Diego Healthcare System, San Diego, California, USA
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Wang S, Chen Y, Guo W, She D, Liao Y, Xing Z, Huang N, Huang H, Cao D. Gender differences in lateral pterygoid muscle in patients with anterior disk displacement. Oral Dis 2023; 29:3481-3492. [PMID: 36152024 DOI: 10.1111/odi.14391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To use quantitative MRI to assess gender differences in lateral pterygoid muscle (LPM) characteristics in patients with anterior disk displacement (ADD). METHODS Lateral pterygoid muscle of 51 patients diagnosed with temporomandibular joint disorders (TMD) who underwent T1-weighted Dixon and T1-mapping sequences were retrospectively analyzed. There were 34 female patients (10 with bilateral normal position disk [NP]; 24 with bilateral ADD) and 17 male patients (eight with bilateral NP; nine with bilateral ADD) among them. After controlling for age, differences in fat fraction, T1 value, volume and histogram features related to gender and disk status were tested with 2-way ANCOVA or Quade ANCOVA with Bonferroni correction. RESULTS Volume of LPM in NP was significantly smaller than that of ADD (p < 0.001). Fat fraction of LPM in females with NP was significantly higher than males with NP (p < 0.05). Females with ADD showed a significantly higher T1 value (p < 0.05), and higher intramuscular heterogeneity than males with ADD. CONCLUSIONS Lateral pterygoid muscle in female TMD patients presented more fatty infiltration in the NP stage and might present more fibrosis in the ADD stage compared with males. Together, this leads to more serious intramuscular heterogeneity during the pathogenesis of ADD in females.
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Affiliation(s)
- Shuo Wang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yu Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wei Guo
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dejun She
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yunyang Liao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhen Xing
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Nan Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hongjie Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dairong Cao
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Zellers JA, Edalati M, Eekhoff JD, McNish R, Tang SY, Lake SP, Mueller MJ, Hastings MK, Zheng J. Quantative MRI predicts tendon mechanical behavior, collagen composition, and organization. J Orthop Res 2023; 41:2329-2338. [PMID: 36324161 PMCID: PMC10151441 DOI: 10.1002/jor.25471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/06/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022]
Abstract
Quantitative magnetic resonance imaging (qMRI) measures have provided insights into the composition, quality, and structure-function of musculoskeletal tissues. Low signal-to-noise ratio has limited application to tendon. Advances in scanning sequences and sample positioning have improved signal from tendon allowing for evaluation of structure and function. The purpose of this study was to elucidate relationships between tendon qMRI metrics (T1, T2, T1ρ and diffusion tensor imaging [DTI] metrics) with tendon tissue mechanics, collagen concentration and organization. Sixteen human Achilles tendon specimens were collected, imaged with qMRI, and subjected to mechanical testing with quantitative polarized light imaging. T2 values were related to tendon mechanics [peak stress (rsp = 0.51, p = 0.044), equilibrium stress (rsp = 0.54, p = 0.033), percent relaxation (rsp = -0.55, p = 0.027), hysteresis (rsp = -0.64, p = 0.007), linear modulus (rsp = 0.67, p = 0.009)]. T1ρ had a statistically significant relationship with percent relaxation (r = 0.50, p = 0.048). Collagen content was significantly related to DTI measures (range of r = 0.56-0.62). T2 values from a single slice of the midportion of human Achilles tendons were strongest predictors of tendon tensile mechanical metrics. DTI diffusivity indices (mean diffusivity, axial diffusivity, radial diffusivity) were strongly correlated with collagen content. These findings build on a growing body of literature supporting the feasibility of qMRI to characterize tendon tissue and noninvasively measure tendon structure and function. Statement of Clinical Significance: Quantitative MRI can be applied to characterize tendon tissue and is a noninvasive measure that relates to tendon composition and mechanical behavior.
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Affiliation(s)
- Jennifer A. Zellers
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
| | - Masoud Edalati
- Mallinckrodt Institute of Radiology; Washington University School of Medicine in St. Louis
| | - Jeremy D. Eekhoff
- Department of Biomedical Engineering; Washington University in St. Louis
| | - Reika McNish
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
| | - Simon Y. Tang
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
| | - Spencer P. Lake
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
- Department of Mechanical Engineering & Materials Science; Washington University in St. Louis
| | - Michael J. Mueller
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
- Mallinckrodt Institute of Radiology; Washington University School of Medicine in St. Louis
| | - Mary K. Hastings
- Program in Physical Therapy; Washington University School of Medicine in St. Louis
- Department of Orthopaedic Surgery; Washington University School of Medicine in St. Louis
| | - Jie Zheng
- Mallinckrodt Institute of Radiology; Washington University School of Medicine in St. Louis
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10
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Russo F, Ambrosio L, Giannarelli E, Vorini F, Mallio CA, Quattrocchi CC, Vadalà G, Papalia R, Denaro V. Innovative quantitative magnetic resonance tools to detect early intervertebral disc degeneration changes: a systematic review. Spine J 2023; 23:1435-1450. [PMID: 37247638 DOI: 10.1016/j.spinee.2023.05.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND CONTEXT Low back pain (LBP) is the leading cause of disability worldwide, with a tremendous socioeconomic burden. It is mainly caused by intervertebral disc degeneration (IDD), a progressive and age-related process. Due to its ability to accurately characterize intervertebral disc morphology, magnetic resonance imaging (MRI) has been established as one of the most valuable tools in diagnosing IDD. Innovative quantitative MRI (qMRI) techniques able to detect the earliest signs of IDD have been increasingly reported. PURPOSE To systematically review available reports on the application of novel qMRI techniques to detect early IDD changes. STUDY DESIGN Systematic literature review. METHODS A systematic search of PubMed/MEDLINE, Scopus, CINAHL, EMBASE, CENTRAL and Cochrane databases was performed through January 21, 2023. Randomized and nonrandomized studies on innovative qMRI tools able to diagnose early biochemical and architectural IDD changes in patients with or without discogenic LBP were searched. Data on study population, follow-up time (when applicable) and MRI sequence used were recorded. The QUADAS-2 tool was utilized to assess the risk of bias of included studies. RESULTS A total of 39 articles published between 2005 and 2022 resulted from the search. All novel qMRI techniques showed an increased capacity to detect early IDD changes thanks to the ability to assess subtle alterations of water content, proteoglycan and glycosaminoglycan concentration, and increased levels of catabolic biomarkers compared to conventional MRI. CONCLUSIONS Innovative qMRI techniques have proven effective in identifying premature IDD changes. Further studies are needed to validate their application in wider populations and confirm their applicability in the clinical setting.
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Affiliation(s)
- Fabrizio Russo
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Luca Ambrosio
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
| | - Eugenio Giannarelli
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Ferruccio Vorini
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo A Mallio
- Department of Diagnostic Imaging and Interventional Radiology, Research Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo C Quattrocchi
- Department of Diagnostic Imaging and Interventional Radiology, Research Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Gianluca Vadalà
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Research Unit of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Rome, Italy; Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Vincenzo Denaro
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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11
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Sneag DB, Abel F, Potter HG, Fritz J, Koff MF, Chung CB, Pedoia V, Tan ET. MRI Advancements in Musculoskeletal Clinical and Research Practice. Radiology 2023; 308:e230531. [PMID: 37581501 PMCID: PMC10477516 DOI: 10.1148/radiol.230531] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 08/16/2023]
Abstract
Over the past decades, MRI has become increasingly important for diagnosing and longitudinally monitoring musculoskeletal disorders, with ongoing hardware and software improvements aiming to optimize image quality and speed. However, surging demand for musculoskeletal MRI and increased interest to provide more personalized care will necessitate a stronger emphasis on efficiency and specificity. Ongoing hardware developments include more powerful gradients, improvements in wide-bore magnet designs to maintain field homogeneity, and high-channel phased-array coils. There is also interest in low-field-strength magnets with inherently lower magnetic footprints and operational costs to accommodate global demand in middle- and low-income countries. Previous approaches to decrease acquisition times by means of conventional acceleration techniques (eg, parallel imaging or compressed sensing) are now largely overshadowed by deep learning reconstruction algorithms. It is expected that greater emphasis will be placed on improving synthetic MRI and MR fingerprinting approaches to shorten overall acquisition times while also addressing the demand of personalized care by simultaneously capturing microstructural information to provide greater detail of disease severity. Authors also anticipate increased research emphasis on metal artifact reduction techniques, bone imaging, and MR neurography to meet clinical needs.
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Affiliation(s)
- Darryl B. Sneag
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Frederik Abel
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Hollis G. Potter
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Jan Fritz
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Matthew F. Koff
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Christine B. Chung
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Valentina Pedoia
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
| | - Ek T. Tan
- From the Department of Radiology and Imaging, Hospital for Special
Surgery, 535 E 70th St, New York, NY 10021 (D.B.S., F.A., H.G.P., M.F.K.,
E.T.T.); Department of Radiology, New York University Grossman School of
Medicine, New York, NY (J.F.); Department of Radiology, University of California
San Diego, La Jolla, Calif (C.B.C.); Radiology Service, Veterans Affairs San
Diego Healthcare System, La Jolla, Calif (C.B.C.); and Department of Radiology
and Biomedical Imaging, University of California San Francisco, San Francisco,
Calif (V.P.)
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12
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Nasr AJ, Pierson CJ, Tzen YT, Khazzam M, Jain NB, Lin YS. Emerging Role of Quantitative Ultrasound-Based Imaging Techniques for Characterizing Rotator Cuff Tears: A Scoping Review. Diagnostics (Basel) 2023; 13:2011. [PMID: 37370906 DOI: 10.3390/diagnostics13122011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Rotator cuff myosteatosis following cuff tears is very common and one of the most important prognostic factors in clinical management. Quantitative ultrasound-based imaging techniques (QUBIT) are frequently used along with magnetic resonance imaging (MRI) to evaluate rotator cuff fatty degeneration. However, the examination of rotator cuff tissue integrity by QUBIT is lacking a standardized imaging protocol and procedural methodologies. In this scoping review, we synthesized the current state of QUBIT against the reference imaging modalities in patients with rotator cuff tears. The literature search was extracted from 963 studies, with 22 studies included in the final review in accordance with the preferred reporting items for systematic reviews and meta-analyses extensions for scoping reviews. The selected studies included human participants and focused on measuring at least one prognostic or diagnostic factor using ultrasonography-based imaging with reference to MRI. The findings suggest both conventional B-mode ultrasound and shear wave elastography imaging were comparable to MRI-based imaging techniques for the evaluation of fatty infiltration and rotator cuff tear characterization. This review establishes guidelines for reporting shoulder-specific QUBIT aimed at developing a standardized imaging protocol. The objective was to enhance the diagnostic and prognostic capabilities of QUBIT in the clinical setting.
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Affiliation(s)
- Andrew J Nasr
- Department of Applied Clinical Research, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Chris J Pierson
- Department of Applied Clinical Research, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Yi-Ting Tzen
- Department of Applied Clinical Research, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Michael Khazzam
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Nitin B Jain
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Yen-Sheng Lin
- Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX 75390, USA
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern, Dallas, TX 75390, USA
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13
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Sacher SE, Neri JP, Gao MA, Argentieri EC, Potter HG, Koch KM, Koff MF. MAVRIC based T2 mapping assessment of infrapatellar fat pad scarring in patients with total knee arthroplasty. J Orthop Res 2023; 41:1299-1309. [PMID: 36262013 PMCID: PMC10113607 DOI: 10.1002/jor.25472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/06/2022] [Accepted: 10/18/2022] [Indexed: 02/04/2023]
Abstract
The infrapatellar fat pad (IPFP) has been implicated as a source of postoperative knee pain. Imaging the IPFP is challenging in patients with total knee arthroplasty (TKA) due to metallic susceptibility artifact. Multi-Acquisition Variable-Resonance Image Combination (MAVRIC)-based T2 Mapping has been developed to mitigate this artifact and can generate quantitative T2 data. Objectives of this study were to (1) measure T2 values of the IPFP in patients with TKAs using a MAVRIC based T2 mapping technique and (2) determine if IPFP T2 values are related to the degree of fat pad scarring or clinical magnetic resonance imaging (MRI) findings. Twenty-eight subjects (10 males, 18 females, Age: 66 + 7.2 years [Mean ± standard deviations]) undergoing clinical MRIs were sequentially recruited. Morphological imaging and quantitative T2 mapping sequences were performed on a clinical 1.5 T scanner. The morphologic images were graded for the presence and severity of fat pad scarring and clinical outcomes. T2 values were calculated in the total fat pad volume, a normal regions of interest (ROI), and an abnormal ROI. T2 values were shortened in the total IPFP volume (p = 0.001) and within abnormal regions (p = 0.003) in subjects with more severe IPFP scarring. The difference between T2 values in normal-abnormal regions was greater in subjects with severe versus no scarring (+1426.1%, p = 0.008). T2 values were elevated in patients with MRI findings of osteolysis (+32.3%, p = 0.02). These findings indicate that MAVRIC-based T2 Mapping may be used as a quantitative biomarker of postoperative IPFP scarring in individuals following TKA.
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Affiliation(s)
- Sara E. Sacher
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | - John P. Neri
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | - Madeleine A. Gao
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | | | - Hollis G. Potter
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
| | | | - Matthew F. Koff
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021
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14
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Ma Y, Jang H, Jerban S, Chang EY, Chung CB, Bydder GM, Du J. Making the invisible visible-ultrashort echo time magnetic resonance imaging: Technical developments and applications. APPLIED PHYSICS REVIEWS 2022; 9:041303. [PMID: 36467869 PMCID: PMC9677812 DOI: 10.1063/5.0086459] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/12/2022] [Indexed: 05/25/2023]
Abstract
Magnetic resonance imaging (MRI) uses a large magnetic field and radio waves to generate images of tissues in the body. Conventional MRI techniques have been developed to image and quantify tissues and fluids with long transverse relaxation times (T2s), such as muscle, cartilage, liver, white matter, gray matter, spinal cord, and cerebrospinal fluid. However, the body also contains many tissues and tissue components such as the osteochondral junction, menisci, ligaments, tendons, bone, lung parenchyma, and myelin, which have short or ultrashort T2s. After radio frequency excitation, their transverse magnetizations typically decay to zero or near zero before the receiving mode is enabled for spatial encoding with conventional MR imaging. As a result, these tissues appear dark, and their MR properties are inaccessible. However, when ultrashort echo times (UTEs) are used, signals can be detected from these tissues before they decay to zero. This review summarizes recent technical developments in UTE MRI of tissues with short and ultrashort T2 relaxation times. A series of UTE MRI techniques for high-resolution morphological and quantitative imaging of these short-T2 tissues are discussed. Applications of UTE imaging in the musculoskeletal, nervous, respiratory, gastrointestinal, and cardiovascular systems of the body are included.
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Affiliation(s)
- Yajun Ma
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California 92037, USA
| | | | | | - Graeme M Bydder
- Department of Radiology, University of California, San Diego, California 92037, USA
| | - Jiang Du
- Author to whom correspondence should be addressed:. Tel.: (858) 246-2248, Fax: (858) 246-2221
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15
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Lin CH, Hsieh TJ, Chou YC, Chen CKH. Feasibility of Arterial Spin Labeling Magnetic Resonance Imaging for Musculoskeletal Tumors with Optimized Post-Labeling Delay. Diagnostics (Basel) 2022; 12:diagnostics12102450. [PMID: 36292139 PMCID: PMC9600497 DOI: 10.3390/diagnostics12102450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/08/2022] [Accepted: 10/08/2022] [Indexed: 11/16/2022] Open
Abstract
Arterial spin labeling (ASL) magnetic resonance imaging (MRI) is used to perform perfusion imaging without administration of contrast media. However, the reliability of ASL for musculoskeletal tumors and the influence of post-labeling delay (PLD) have not been fully clarified. This study aimed to evaluate the performance of ASL with different PLDs in the imaging of musculoskeletal tumors. Forty-five patients were enrolled and were divided into a malignant group, a hypervascular benign group, a hypovascular benign group and a control group. The tissue blood flow (TBF) of the lesions and normal muscles was measured and the lesion-to-muscle TBF ratio and differences were calculated. The results showed that both the TBF of lesions and muscles increased as the PLD increased, and the TBF of muscles correlated significantly and positively with the TBF of lesions (all p < 0.05). The TBF and lesion-to-muscle TBF differences of the malignant lesions were significantly higher than those of the hypovascular benign lesions and the control group in all PLD groups (all p < 0.0125) and only those of the hypervascular benign lesions in the longest PLD (3025 ms) group (p = 0.0120, 0.0116). In conclusion, ASL detects high TBF in malignant tumors and hypervascular benign lesions, and a longer PLD is recommended for ASL to differentiate musculoskeletal tumors.
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Affiliation(s)
- Chien-Hung Lin
- Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan
| | - Tsyh-Jyi Hsieh
- Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan
- Department of Radiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-6-2812811 (ext. 53130)
| | - Yi-Chen Chou
- Department of Medical Imaging, Chi Mei Medical Center, Yongkang, Tainan 71004, Taiwan
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16
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Sharafi A, Zibetti MVW, Chang G, Cloos MA, Regatte RR. Simultaneous bilateral T 1 , T 2 , and T 1ρ relaxation mapping of the hip joint with magnetic resonance fingerprinting. NMR IN BIOMEDICINE 2022; 35:e4651. [PMID: 34825750 PMCID: PMC9233946 DOI: 10.1002/nbm.4651] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
Quantitative MRI can detect early biochemical changes in cartilage, but its bilateral use in clinical routines is challenging. The aim of this prospective study was to demonstrate the feasibility of magnetic resonance fingerprinting for bilateral simultaneous T1 , T2 , and T1ρ mapping of the hip joint. The study population consisted of six healthy volunteers with no known trauma or pain in the hip. Monoexponential T1 , T2 , and T1ρ relaxation components were assessed in femoral lateral, superolateral, and superomedial, and inferior, as well as acetabular, superolateral, and superomedial subregions in left and right hip cartilage. Aligned ranked nonparametric factorial analysis was used to assess the side's impact on the subregions. Kruskal-Wallis and Wilcoxon tests were used to compare subregions, and coefficient of variation to assess repeatability. Global averages of T1 (676.0 ± 45.4 and 687.6 ± 44.5 ms), T2 (22.5 ± 2.6 and 22.1 ± 2.5 ms), and T1ρ (38.2 ± 5.5 and 38.2 ± 5.5 ms) were measured in the left and right hip, and articular cartilage, respectively. The Kruskal-Wallis test showed a significant difference between different subregions' relaxation times regardless of the hip side (p < 0.001 for T1 , p = 0.012 for T2 , and p < 0.001 for T1ρ ). The Wilcoxon test showed that T1 of femoral layers was significantly (p < 0.003) higher than that for acetabular cartilage. The experiments showed excellent repeatability with CVrms of 1%, 2%, and 4% for T1 , T2 , and T1ρ, respectively. It was concluded that bilateral T1 , T2 , and T1ρ relaxation times, as well as B1+ maps, can be acquired simultaneously from hip joints using the proposed MRF sequence.
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Affiliation(s)
- Azadeh Sharafi
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Marcelo V. W. Zibetti
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Gregory Chang
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Martijn A. Cloos
- Center of Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Ravinder R. Regatte
- Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
- Center for Advanced Imaging Innovation and Research (CAI2R), Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
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17
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Beirinckx Q, Jeurissen B, Nicastro M, Poot DH, Verhoye M, Dekker AJD, Sijbers J. Model-based super-resolution reconstruction with joint motion estimation for improved quantitative MRI parameter mapping. Comput Med Imaging Graph 2022; 100:102071. [DOI: 10.1016/j.compmedimag.2022.102071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 04/07/2022] [Accepted: 04/29/2022] [Indexed: 01/18/2023]
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18
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Feng L, Ma D, Liu F. Rapid MR relaxometry using deep learning: An overview of current techniques and emerging trends. NMR IN BIOMEDICINE 2022; 35:e4416. [PMID: 33063400 PMCID: PMC8046845 DOI: 10.1002/nbm.4416] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/25/2020] [Accepted: 09/09/2020] [Indexed: 05/08/2023]
Abstract
Quantitative mapping of MR tissue parameters such as the spin-lattice relaxation time (T1 ), the spin-spin relaxation time (T2 ), and the spin-lattice relaxation in the rotating frame (T1ρ ), referred to as MR relaxometry in general, has demonstrated improved assessment in a wide range of clinical applications. Compared with conventional contrast-weighted (eg T1 -, T2 -, or T1ρ -weighted) MRI, MR relaxometry provides increased sensitivity to pathologies and delivers important information that can be more specific to tissue composition and microenvironment. The rise of deep learning in the past several years has been revolutionizing many aspects of MRI research, including image reconstruction, image analysis, and disease diagnosis and prognosis. Although deep learning has also shown great potential for MR relaxometry and quantitative MRI in general, this research direction has been much less explored to date. The goal of this paper is to discuss the applications of deep learning for rapid MR relaxometry and to review emerging deep-learning-based techniques that can be applied to improve MR relaxometry in terms of imaging speed, image quality, and quantification robustness. The paper is comprised of an introduction and four more sections. Section 2 describes a summary of the imaging models of quantitative MR relaxometry. In Section 3, we review existing "classical" methods for accelerating MR relaxometry, including state-of-the-art spatiotemporal acceleration techniques, model-based reconstruction methods, and efficient parameter generation approaches. Section 4 then presents how deep learning can be used to improve MR relaxometry and how it is linked to conventional techniques. The final section concludes the review by discussing the promise and existing challenges of deep learning for rapid MR relaxometry and potential solutions to address these challenges.
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Affiliation(s)
- Li Feng
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Dan Ma
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Fang Liu
- Department of Radiology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts
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19
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Novel Magnetic Resonance Imaging Tools for the Diagnosis of Degenerative Disc Disease: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12020420. [PMID: 35204509 PMCID: PMC8870820 DOI: 10.3390/diagnostics12020420] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 01/27/2023] Open
Abstract
Low back pain (LBP) is one of the leading causes of disability worldwide, with a significant socioeconomic burden on healthcare systems. It is mainly caused by degenerative disc disease (DDD), a progressive, chronic, and age-related process. With its capacity to accurately characterize intervertebral disc (IVD) and spinal morphology, magnetic resonance imaging (MRI) has been established as one of the most valuable tools in diagnosing DDD. However, existing technology cannot detect subtle changes in IVD tissue composition and cell metabolism. In this review, we summarized the state of the art regarding innovative quantitative MRI modalities that have shown the capacity to discriminate and quantify changes in matrix composition and integrity, as well as biomechanical changes in the early stages of DDD. Validation and implementation of this new technology in the clinical setting will allow for an early diagnosis of DDD and ideally guide conservative and regenerative treatments that may prevent the progression of the degenerative process rather than intervene at the latest stages of the disease.
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20
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Repeatability of quantitative MRI in patients with rheumatoid arthritis. Radiography (Lond) 2022; 28:831-837. [DOI: 10.1016/j.radi.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/21/2022]
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21
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Chen Y, Li L, Le N, Chang EY, Huang W, Ma YJ. On the fat saturation effect in quantitative ultrashort TE MR imaging. Magn Reson Med 2022; 87:2388-2397. [PMID: 34985141 DOI: 10.1002/mrm.29149] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/01/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the effect of fat saturation (FatSat) on quantitative UTE imaging of variable knee tissues on a 3T scanner. METHODS Three quantitative UTE imaging techniques, including the UTE multi-echo sequence for T 2 ∗ measurement, the adiabatic T1ρ prepared UTE sequence for T1ρ measurement, and the magnetization transfer (MT)-prepared UTE sequence for MT ratio (MTR) and macromolecular proton fraction (MMF) measurements were used in this study. Twelve samples of cartilage and twelve samples of meniscus, as well as six whole knee cadaveric specimens, were imaged with the three above-mentioned UTE sequences with and without FatSat. The difference, correlation, and agreement between the UTE measurements with and without FatSat were calculated to investigate the effects of FatSat on quantification. RESULTS Fat was well-suppressed using all three UTE sequences when FatSat was deployed. For the small sample study, the quantification difference ratio (QDR) values of all the measured biomarkers ranged from 0.7% to 12.6%, whereas for the whole knee joint specimen study, the QDR values ranged from 0.2% to 12.0%. Except for T1ρ in muscle and MMF in meniscus (p > 0.05), most of the measurements showed statistical differences for T1ρ , MTR, and MMF (p < 0.05) between FatSat and non-FatSat scans. Most of the measurements for T 2 ∗ showed no significant differences (p > 0.05). Strong correlations were found for all the biomarkers between measurements with and without FatSat. CONCLUSION The UTE biomarkers showed good correlation and agreement with some slight differences between the scans with and without FatSat.
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Affiliation(s)
- Yanjun Chen
- Department of Medical Imaging, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China.,Department of Radiology, University of California, San Diego, California, USA
| | - Liang Li
- Department of Radiology, University of California, San Diego, California, USA.,Department of Radiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Nicole Le
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Wenhua Huang
- Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Ya-Jun Ma
- Department of Radiology, University of California, San Diego, California, USA
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22
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Afsahi AM, Ma Y, Jang H, Jerban S, Chung CB, Chang EY, Du J. Ultrashort Echo Time Magnetic Resonance Imaging Techniques: Met and Unmet Needs in Musculoskeletal Imaging. J Magn Reson Imaging 2021; 55:1597-1612. [PMID: 34962335 DOI: 10.1002/jmri.28032] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 12/14/2022] Open
Abstract
This review article summarizes recent technical developments in ultrashort echo time (UTE) magnetic resonance imaging of musculoskeletal (MSK) tissues with short-T2 relaxation times. A series of contrast mechanisms are discussed for high-contrast morphological imaging of short-T2 MSK tissues including the osteochondral junction, menisci, ligaments, tendons, and bone. Quantitative UTE mapping of T1, T2*, T1ρ, adiabatic T1ρ, magnetization transfer ratio, MT modeling of macromolecular proton fraction, quantitative susceptibility mapping, and water content is also introduced. Met and unmet needs in MSK imaging are discussed. EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Amir Masoud Afsahi
- Department of Radiology, University of California, San Diego, California, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, California, USA
| | - Hyungseok Jang
- Department of Radiology, University of California, San Diego, California, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, California, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California, USA.,Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California, USA
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23
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Altahawi F, Pierce J, Aslan M, Li X, Winalski CS, Subhas N. 3D MRI of the Knee. Semin Musculoskelet Radiol 2021; 25:455-467. [PMID: 34547811 DOI: 10.1055/s-0041-1730400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Three-dimensional (3D) magnetic resonance imaging (MRI) of the knee is widely used in musculoskeletal (MSK) imaging. Currently, 3D sequences are most commonly used for morphological imaging. Isotropic 3D MRI provides higher out-of-plane resolution than standard two-dimensional (2D) MRI, leading to reduced partial volume averaging artifacts and allowing for multiplanar reconstructions in any plane with any thickness from a single high-resolution isotropic acquisition. Specifically, isotropic 3D fast spin-echo imaging, with options for tissue weighting similar to those used in multiplanar 2D FSE imaging, is of particular interest to MSK radiologists. New applications for 3D spatially encoded sequences are also increasingly available for clinical use. These applications offer advantages over standard 2D techniques for metal artifact reduction, quantitative cartilage imaging, nerve imaging, and bone shape analysis. Emerging fast imaging techniques can be used to overcome the long acquisition times that have limited the adoption of 3D imaging in clinical protocols.
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Affiliation(s)
- Faysal Altahawi
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jason Pierce
- Diagnostic Radiology Residency, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Mercan Aslan
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
| | - Xiaojuan Li
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Carl S Winalski
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Naveen Subhas
- Section of Musculoskeletal Imaging, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
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24
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Sudoł-Szopińska I, Giraudo C, Oei EH, Jans L. Imaging update in inflammatory arthritis. J Clin Orthop Trauma 2021; 20:101491. [PMID: 34290958 PMCID: PMC8274298 DOI: 10.1016/j.jcot.2021.101491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022] Open
Abstract
Ultrasonography and magnetic resonance imaging have become important imaging modalities in rheumatological disorders next to standard radiography. Due to their ability to assess both morphological and functional changes they play a significant role in early diagnosis and treatment monitoring. This review presents the latest advancements in imaging of inflammatory arthritis with a focus on two main groups of rheumatic diseases: connective tissue diseases and spondyloarthritis. New developments related to peripheral and sacroiliac joints imaging are discussed, including Superb Micro Flow Imaging and Shear Wave Elastography in ultrasonography, as well as Whole Body MRI, quantitative MRI, and the recent advances in cartilage imaging in MRI, including T2-and T1p-mapping, and dGEMRIC. The role of emerging imaging techniques in the early diagnosis of inflammatory arthritis is discussed, including DECT, VIBE, BoneMRI, and pQCT.
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Affiliation(s)
- Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Chiara Giraudo
- Chiara Giraudo, Department of Medicine – DIMED, University of Padova, Padova, Italy
| | - Edwin H.G. Oei
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Lennart Jans
- Department of Radiology, Ghent University Hospital, Ghent, Belgium
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25
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Kumar R. Soft Tissue Sarcomas. Semin Ultrasound CT MR 2021; 42:194-200. [PMID: 33814105 DOI: 10.1053/j.sult.2020.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Imaging evaluation of soft tissue masses is essential for diagnosis, preoperative staging, and post-treatment follow-up. Magnetic resonance imaging plays the major role because of its superior resolution that helps in better tissue characterization, and its multiplanar imaging capability in evaluation of soft tissue masses. Additional imaging techniques, such as radiographs, computed tomography, positron-emission tomography-CT, radionuclide scintigraphy and ultrasonography, also play vital roles by providing additional information required in management of soft tissue masses. Knowledge of the usefulness and limitations of these imaging techniques is essential for their judicious selection. This article reviews the current role of various imaging techniques in diagnosis, presurgical planning, and post-treatment follow-up of soft tissue masses.
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Affiliation(s)
- Rajendra Kumar
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
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26
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Yang BW, Brusalis CM, Fabricant PD, Greditzer HG. Articular Cartilage Repair in the Knee: Postoperative Imaging. J Knee Surg 2021; 34:2-10. [PMID: 32898909 DOI: 10.1055/s-0040-1716357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diagnostic and therapeutic advancements have improved clinical outcomes for patients with focal chondral injuries of the knee. An increased number and complexity of surgical treatment options have, in turn, resulted in a commensurate proliferation of patients requiring postoperative evaluation and management. In addition to patient-reported clinical outcomes, magnetic resonance imaging (MRI) offers clinicians with noninvasive, objective data to assist with postoperative clinical decision making. However, successful MRI interpretation in this setting is clinically challenging; it relies upon an understanding of the evolving and procedure-specific nature of normal postoperative imaging. Moreover, further research is required to better elucidate the correlation between MRI findings and long-term clinical outcomes. This article focuses on how specific morphologic features identified on MRI can be utilized to evaluate patients following the most commonly performed cartilage repair surgeries of the knee.
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Affiliation(s)
- Brian W Yang
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
| | | | - Peter D Fabricant
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.,Department of Radiology and Imaging, Hospital for Special Surgery, New York, New York
| | - Harry G Greditzer
- Division of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, New York, New York
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27
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Secondulfo L, Ogier AC, Monte JR, Aengevaeren VL, Bendahan D, Nederveen AJ, Strijkers GJ, Hooijmans MT. Supervised segmentation framework for evaluation of diffusion tensor imaging indices in skeletal muscle. NMR IN BIOMEDICINE 2021; 34:e4406. [PMID: 33001508 PMCID: PMC7757256 DOI: 10.1002/nbm.4406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 05/05/2023]
Abstract
Diffusion tensor imaging (DTI) is becoming a relevant diagnostic tool to understand muscle disease and map muscle recovery processes following physical activity or after injury. Segmenting all the individual leg muscles, necessary for quantification, is still a time-consuming manual process. The purpose of this study was to evaluate the impact of a supervised semi-automatic segmentation pipeline on the quantification of DTI indices in individual upper leg muscles. Longitudinally acquired MRI datasets (baseline, post-marathon and follow-up) of the upper legs of 11 subjects were used in this study. MR datasets consisted of a DTI and Dixon acquisition. Semi-automatic segmentations for the upper leg muscles were performed using a transversal propagation approach developed by Ogier et al on the out-of-phase Dixon images at baseline. These segmentations were longitudinally propagated for the post-marathon and follow-up time points. Manual segmentations were performed on the water image of the Dixon for each of the time points. Dice similarity coefficients (DSCs) were calculated to compare the manual and semi-automatic segmentations. Bland-Altman and regression analyses were performed, to evaluate the impact of the two segmentation methods on mean diffusivity (MD), fractional anisotropy (FA) and the third eigenvalue (λ3 ). The average DSC for all analyzed muscles over all time points was 0.92 ± 0.01, ranging between 0.48 and 0.99. Bland-Altman analysis showed that the 95% limits of agreement for MD, FA and λ3 ranged between 0.5% and 3.0% for the transversal propagation and between 0.7% and 3.0% for the longitudinal propagations. Similarly, regression analysis showed good correlation for MD, FA and λ3 (r = 0.99, p < 60; 0.0001). In conclusion, the supervised semi-automatic segmentation framework successfully quantified DTI indices in the upper-leg muscles compared with manual segmentation while only requiring manual input of 30% of the slices, resulting in a threefold reduction in segmentation time.
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Affiliation(s)
- Laura Secondulfo
- Department of Biomedical Engineering and Physics, Amsterdam University Medical CentersUniversity of AmsterdamThe Netherlands
| | - Augustin C. Ogier
- Aix Marseille Universite, Universite de Toulon, CNRS, LISMarseilleFrance
- Aix Marseille Universite, CNRS, CRMBMMarseilleFrance
| | - Jithsa R. Monte
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of AmsterdamThe Netherlands
| | - Vincent L. Aengevaeren
- Radboud Institute for Health Sciences, Department of PhysiologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Aart J. Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical CentersUniversity of AmsterdamThe Netherlands
| | - Gustav J. Strijkers
- Department of Biomedical Engineering and Physics, Amsterdam University Medical CentersUniversity of AmsterdamThe Netherlands
| | - Melissa T. Hooijmans
- Department of Biomedical Engineering and Physics, Amsterdam University Medical CentersUniversity of AmsterdamThe Netherlands
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28
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Ding J, Cao P, Chang HC, Gao Y, Chan SHS, Vardhanabhuti V. Deep learning-based thigh muscle segmentation for reproducible fat fraction quantification using fat-water decomposition MRI. Insights Imaging 2020; 11:128. [PMID: 33252711 PMCID: PMC7704819 DOI: 10.1186/s13244-020-00946-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Time-efficient and accurate whole volume thigh muscle segmentation is a major challenge in moving from qualitative assessment of thigh muscle MRI to more quantitative methods. This study developed an automated whole thigh muscle segmentation method using deep learning for reproducible fat fraction quantification on fat-water decomposition MRI. RESULTS This study was performed using a public reference database (Dataset 1, 25 scans) and a local clinical dataset (Dataset 2, 21 scans). A U-net was trained using 23 scans (16 from Dataset 1, seven from Dataset 2) to automatically segment four functional muscle groups: quadriceps femoris, sartorius, gracilis and hamstring. The segmentation accuracy was evaluated on an independent testing set (3 × 3 repeated scans in Dataset 1 and four scans in Dataset 2). The average Dice coefficients between manual and automated segmentation were > 0.85. The average percent difference (absolute) in volume was 7.57%, and the average difference (absolute) in mean fat fraction (meanFF) was 0.17%. The reproducibility in meanFF was calculated using intraclass correlation coefficients (ICCs) for the repeated scans, and automated segmentation produced overall higher ICCs than manual segmentation (0.921 vs. 0.902). A preliminary quantitative analysis was performed using two-sample t test to detect possible differences in meanFF between 14 normal and 14 abnormal (with fat infiltration) thighs in Dataset 2 using automated segmentation, and significantly higher meanFF was detected in abnormal thighs. CONCLUSIONS This automated thigh muscle segmentation exhibits excellent accuracy and higher reproducibility in fat fraction estimation compared to manual segmentation, which can be further used for quantifying fat infiltration in thigh muscles.
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Affiliation(s)
- Jie Ding
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.,Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Peng Cao
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Hing-Chiu Chang
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Yuan Gao
- Division of Neurology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Sophelia Hoi Shan Chan
- Division of Paediatric Neurology, Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Varut Vardhanabhuti
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
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29
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Nolte T, Scholten H, Gross-Weege N, Amthor T, Koken P, Doneva M, Schulz V. Confounding factors in breast magnetic resonance fingerprinting: B 1 + , slice profile, and diffusion effects. Magn Reson Med 2020; 85:1865-1880. [PMID: 33118649 DOI: 10.1002/mrm.28545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/03/2020] [Accepted: 09/14/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE Magnetic resonance fingerprinting (MRF) offers rapid quantitative imaging but may be subject to confounding effects (CE) if these are not included in the model-based reconstruction. This study characterizes the influence of in-plane B 1 + , slice profile and diffusion effects on T1 and T2 estimation in the female breast at 1.5T. METHODS Simulations were used to predict the influence of each CE on the accuracy of MRF and to investigate the influence of electronic noise and spiral aliasing artefacts. The experimentally observed bias in regions of fibroglandular tissue (FGT) and fatty tissue (FT) was analyzed for undersampled spiral breast MRF data of 6 healthy volunteers by performing MRF reconstruction with and without a CE. RESULTS Theoretic analysis predicts T1 under-/T2 overestimation if the nominal flip angles are underestimated and inversely, T1 under-/T2 overestimation if omitting slice profile correction, and T1 under-/T2 underestimation if omitting diffusion in the signal model. Averaged over repeated signal simulations, including spiral aliasing artefacts affected precision more than accuracy. Strong in-plane B 1 + effects occurred in vivo, causing T2 left-right inhomogeneity between both breasts. Their correction decreased the T2 difference from 29 to 5 ms in FGT and from 29 to 9 ms in FT. Slice profile correction affected FGT T2 most strongly, resulting in -22% smaller values. For the employed spoiler gradient strengths, diffusion did not affect the parameter maps, corresponding well with theoretic predictions. CONCLUSION Understanding CEs and their relative significance for an MRF sequence is important when defining an MRF signal model for accurate parameter mapping.
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Affiliation(s)
- Teresa Nolte
- Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany
| | - Hannah Scholten
- Department of Diagnostic and Interventional Radiology, University of Würzburg, Würzburg, Germany
| | - Nicolas Gross-Weege
- Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany
| | - Thomas Amthor
- Tomographic Imaging Systems, Philips Research Europe, Hamburg, Germany
| | - Peter Koken
- Tomographic Imaging Systems, Philips Research Europe, Hamburg, Germany
| | - Mariya Doneva
- Tomographic Imaging Systems, Philips Research Europe, Hamburg, Germany
| | - Volkmar Schulz
- Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany.,Hyperion Hybrid Imaging Systems GmbH, Aachen, Germany.,Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany.,Physics Institute III B, RWTH Aachen University, Aachen, Germany
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30
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Giraudo C, Kainberger F, Boesen M, Trattnig S. Quantitative Imaging in Inflammatory Arthritis: Between Tradition and Innovation. Semin Musculoskelet Radiol 2020; 24:337-354. [PMID: 32992363 DOI: 10.1055/s-0040-1708823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Radiologic imaging is crucial for diagnosing and monitoring rheumatic inflammatory diseases. Particularly the emerging approach of precision medicine has increased the interest in quantitative imaging. Extensive research has shown that ultrasound allows a quantification of direct signs such as bone erosions and synovial thickness. Dual-energy X-ray absorptiometry and high-resolution peripheral quantitative computed tomography (CT) contribute to the quantitative assessment of secondary signs such as osteoporosis or lean mass loss. Magnetic resonance imaging (MRI), using different techniques and sequences, permits in-depth evaluations. For instance, the perfusion of the inflamed synovium can be quantified by dynamic contrast-enhanced imaging or diffusion-weighted imaging, and cartilage injury can be assessed by mapping (T1ρ, T2). Furthermore, the increased metabolic activity characterizing the inflammatory response can be reliably assessed by hybrid imaging (positron emission tomography [PET]/CT, PET/MRI). Finally, advances in intelligent systems are pushing forward quantitative imaging. Complex mathematical algorithms of lesions' segmentation and advanced pattern recognition are showing promising results.
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Affiliation(s)
- Chiara Giraudo
- Department of Medicine, DIMED, Radiology Institute, University of Padova, Padova, Italy
| | - Franz Kainberger
- Division of Neuro- and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Mikael Boesen
- Department of Radiology, Copenhagen University Hospital Bispebjerg-Frederiksberg, Frederiksberg, Denmark
| | - Siegfried Trattnig
- Department of Biomedical Imaging and Image-Guided Therapy, High-Field MR Centre, Medical University of Vienna, Vienna, Austria
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