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Radke KL, Grotheer V, Kamp B, Müller-Lutz A, Kertscher J, Strunk R, Martirosian P, Valentin B, Wittsack HJ, Sager M, Windolf J, Antoch G, Schiffner E, Jungbluth P, Frenken M. Comparison of compositional MRI techniques to quantify the regenerative potential of articular cartilage: a preclinical minipig model after osteochondral defect treatments with autologous mesenchymal stromal cells and unseeded scaffolds. Quant Imaging Med Surg 2023; 13:7467-7483. [PMID: 37969627 PMCID: PMC10644139 DOI: 10.21037/qims-23-570] [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: 04/28/2023] [Accepted: 08/28/2023] [Indexed: 11/17/2023]
Abstract
Background The field of orthopedics seeks effective, safer methods for evaluating articular cartilage regeneration. Despite various treatment innovations, non-invasive, contrast-free full quantitative assessments of hyaline articular cartilage's regenerative potential using compositional magnetic resonance (MR) sequences remain challenging. In this context, our aim was to investigate the effectiveness of different MR sequences for quantitative assessment of cartilage and to compare them with the current gold standard delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) measurements. Methods We employed ex vivo imaging in a preclinical minipig model to assess knee cartilage regeneration. Standardized osteochondral defects were drilled in the proximal femur of the specimens (n=14), which were divided into four groups. Porcine collagen scaffolds seeded with autologous adipose-derived stromal cells (ASC), autologous bone marrow stromal cells (BMSC), and unseeded scaffolds (US) were implanted in femoral defects. Furthermore, there was a defect group which received no treatment. After 6 months, the specimens were examined using different compositional MR methods, including the gold standard dGEMRIC as well as T1, T2, T2*, and T1ρ techniques. The statistical evaluation involved comparing the defect region with the uninjured tibia and femur cartilage layers and all measurements were performed on a clinical 3T MR Scanner. Results In the untreated defect group, we observed significant differences in the defect region, with dGEMRIC values significantly lower (404.86±64.2 ms, P=0.018) and T2 times significantly higher (44.24±2.75 ms, P<0.001). Contrastingly, in all three treatment groups (ASC, BMSC, US), there were no significant differences among the three regions in the dGEMRIC sequence, suggesting successful cartilage regeneration. However, T1, T2*, and T1ρ sequences failed to detect such differences, highlighting their lower sensitivity for cartilage regeneration. Conclusions As expected, dGEMRIC is well suited for monitoring cartilage regeneration. Interestingly, T2 imaging also proved to be a reliable cartilage imaging technique and thus offers a contrast agent-free alternative to the former gold standard for subsequent in vivo studies investigating the cartilage regeneration potential of different treatment modalities.
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Affiliation(s)
- Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Vera Grotheer
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Justus Kertscher
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Rosanna Strunk
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Petros Martirosian
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Tübingen, Tübingen, Germany
| | - Birte Valentin
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Martin Sager
- Central Unit for Animal Research and Animal Welfare Affairs, University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Joachim Windolf
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Erik Schiffner
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Pascal Jungbluth
- Department of Orthopedics and Trauma Surgery, Heinrich Heine University Hospital Düsseldorf, Düsseldorf, Germany
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Düsseldorf, Düsseldorf, Germany
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Radke KL, Kamp B, Adriaenssens V, Stabinska J, Gallinnis P, Wittsack HJ, Antoch G, Müller-Lutz A. Deep Learning-Based Denoising of CEST MR Data: A Feasibility Study on Applying Synthetic Phantoms in Medical Imaging. Diagnostics (Basel) 2023; 13:3326. [PMID: 37958222 PMCID: PMC10650582 DOI: 10.3390/diagnostics13213326] [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: 09/29/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Chemical Exchange Saturation Transfer (CEST) magnetic resonance imaging (MRI) provides a novel method for analyzing biomolecule concentrations in tissues without exogenous contrast agents. Despite its potential, achieving a high signal-to-noise ratio (SNR) is imperative for detecting small CEST effects. Traditional metrics such as Magnetization Transfer Ratio Asymmetry (MTRasym) and Lorentzian analyses are vulnerable to image noise, hampering their precision in quantitative concentration estimations. Recent noise-reduction algorithms like principal component analysis (PCA), nonlocal mean filtering (NLM), and block matching combined with 3D filtering (BM3D) have shown promise, as there is a burgeoning interest in the utilization of neural networks (NNs), particularly autoencoders, for imaging denoising. This study uses the Bloch-McConnell equations, which allow for the synthetic generation of CEST images and explores NNs efficacy in denoising these images. Using synthetically generated phantoms, autoencoders were created, and their performance was compared with traditional denoising methods using various datasets. The results underscored the superior performance of NNs, notably the ResUNet architectures, in noise identification and abatement compared to analytical approaches across a wide noise gamut. This superiority was particularly pronounced at elevated noise intensities in the in vitro data. Notably, the neural architectures significantly improved the PSNR values, achieving up to 35.0, while some traditional methods struggled, especially in low-noise reduction scenarios. However, the application to the in vivo data presented challenges due to varying noise profiles. This study accentuates the potential of NNs as robust denoising tools, but their translation to clinical settings warrants further investigation.
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Affiliation(s)
- Karl Ludger Radke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
| | - Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
| | - Vibhu Adriaenssens
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
| | - Julia Stabinska
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205, USA
- Division of MR Research, The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Patrik Gallinnis
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, 40225 Dusseldorf, Germany (G.A.); (A.M.-L.)
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Adaptive IoU Thresholding for Improving Small Object Detection: A Proof-of-Concept Study of Hand Erosions Classification of Patients with Rheumatic Arthritis on X-ray Images. Diagnostics (Basel) 2022; 13:diagnostics13010104. [PMID: 36611395 PMCID: PMC9818241 DOI: 10.3390/diagnostics13010104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/08/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
In recent years, much research evaluating the radiographic destruction of finger joints in patients with rheumatoid arthritis (RA) using deep learning models was conducted. Unfortunately, most previous models were not clinically applicable due to the small object regions as well as the close spatial relationship. In recent years, a new network structure called RetinaNets, in combination with the focal loss function, proved reliable for detecting even small objects. Therefore, the study aimed to increase the recognition performance to a clinically valuable level by proposing an innovative approach with adaptive changes in intersection over union (IoU) values during training of Retina Networks using the focal loss error function. To this end, the erosion score was determined using the Sharp van der Heijde (SvH) metric on 300 conventional radiographs from 119 patients with RA. Subsequently, a standard RetinaNet with different IoU values as well as adaptively modified IoU values were trained and compared in terms of accuracy, mean average accuracy (mAP), and IoU. With the proposed approach of adaptive IoU values during training, erosion detection accuracy could be improved to 94% and an mAP of 0.81 ± 0.18. In contrast Retina networks with static IoU values achieved only an accuracy of 80% and an mAP of 0.43 ± 0.24. Thus, adaptive adjustment of IoU values during training is a simple and effective method to increase the recognition accuracy of small objects such as finger and wrist joints.
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Evaluation of Sodium Relaxation Times and Concentrations in the Achilles Tendon Using MRI. Int J Mol Sci 2022; 23:ijms231810890. [PMID: 36142810 PMCID: PMC9501448 DOI: 10.3390/ijms231810890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022] Open
Abstract
Sodium magnetic resonance imaging (MRI) can be used to evaluate the change in the proteoglycan content in Achilles tendons (ATs) of patients with different AT pathologies by measuring the 23Na signal-to-noise ratio (SNR). As 23Na SNR alone is difficult to compare between different studies, because of the high influence of hardware configurations and sequence settings on the SNR, we further set out to measure the apparent tissue sodium content (aTSC) in the AT as a better comparable parameter. Ten healthy controls and one patient with tendinopathy in the AT were examined using a clinical 3 Tesla (T) MRI scanner in conjunction with a dual tuned 1H/23Na surface coil to measure 23Na SNR and aTSC in their ATs. 23Na T1 and T2* of the AT were also measured for three controls to correct for different relaxation behavior. The results were as follows: 23Na SNR = 11.7 ± 2.2, aTSC = 82.2 ± 13.9 mM, 23Na T1 = 20.4 ± 2.4 ms, 23Na T2s* = 1.4 ± 0.4 ms, and 23Na T2l* = 13.9 ± 0.8 ms for the whole AT of healthy controls with significant regional differences. These are the first reported aTSCs and 23Na relaxation times for the AT using sodium MRI and may serve for future comparability in different studies regarding examinations of diseased ATs with sodium MRI.
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