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Peng X, Xie AM, Fan HG, Zhu HL, Yang D, Wan DE, He F, Luo C, Li H, Shuang F. The clinical application value of 3.0T magnetic resonance T2 mapping imaging in evaluating the degree of acetabular cartilage degeneration in joint replacement surgery running title: MRI and acetabular cartilage degeneration. J Orthop Surg Res 2024; 19:414. [PMID: 39030606 PMCID: PMC11264721 DOI: 10.1186/s13018-024-04898-3] [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: 06/05/2024] [Accepted: 07/03/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND To explore and compare the values of 3.0T magnetic resonance imaging (MRI) T2 mapping in evaluating the degree of acetabular cartilage degeneration in hip replacement surgery. METHODS A total of 26 elderly patients with femoral neck fractures who were scanned in 3.0T MRI T2 mapping quantification technique were included. Basing on MRI images, the degree of acetabular cartilage degeneration was classified into Grade 0, 1, 2, 3 and 4, according to the International Cartilage Repair Society (ICRS) scores. In addition, 8 healthy volunteers were included for control group. RESULTS By comparison with health population, T2 relaxation values in the anterior, superior, and posterior regions of acetabular cartilage in patients with femoral neck fracture were obviously increased (P < 0.001). Among the patients with femoral neck fractures, there were 16 hip joint with Grade 1-2 (mild degeneration subgroup) and 10 hip joints with Grade 3-4 (severe degeneration subgroup), accounting for 61.54% and 38.46%, respectively. Additionally, T2 relaxation values in the anterior and superior bands of articular cartilage were positively related to the MRI-based grading (P < 0.05); while there was no significant difference of T2 relaxation values in the posterior areas of articular cartilage between severe degeneration subgroup and mild degeneration subgroup (P > 0.05). Importantly, acetabular cartilage degeneration can be detected through signal changes of T2 mapping pseudo-color images. CONCLUSION 3.0T MRI T2 mapping technology can be used to determine the degree of acetabular cartilage degeneration, which can effectively monitor the disease course.
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Affiliation(s)
- Xiang Peng
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - An-Min Xie
- Department of Diagnostic Radiology, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, Nanchang, 330002, Jiangxi Province, China
| | - Hua-Gang Fan
- Department of Diagnostic Radiology, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, Nanchang, 330002, Jiangxi Province, China
| | - Hong-Liang Zhu
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - Di Yang
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - De-En Wan
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - Fei He
- Department of Quality Management, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, Nanchang, 330002, Jiangxi Province, China
| | - Chong Luo
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China
| | - Hao Li
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China.
| | - Feng Shuang
- Department of Orthopedics, The 908th Hospital of Chinese People's Liberation Army Joint Logistics Support Force, No.1028 Jinggangshan Street, Qingyunpu District, Nanchang, 330002, Jiangxi Province, China.
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Eckstein F, Brisson NM, Maschek S, Wisser A, Berenbaum F, Duda GN, Wirth W. Clinical validation of fully automated laminar knee cartilage transverse relaxation time (T2) analysis in anterior cruciate ligament (ACL)-injured knees- on behalf of the osteoarthritis (OA)-Bio consortium. Quant Imaging Med Surg 2024; 14:4319-4332. [PMID: 39022226 PMCID: PMC11250285 DOI: 10.21037/qims-24-194] [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: 01/29/2024] [Accepted: 05/06/2024] [Indexed: 07/20/2024]
Abstract
Background Magnetic resonance imaging (MRI) cartilage transverse relaxation time (T2) reflects cartilage composition, mechanical properties, and early osteoarthritis (OA). T2 analysis requires cartilage segmentation. In this study, we clinically validate fully automated T2 analysis at 1.5 Tesla (T) in anterior cruciate ligament (ACL)-injured and healthy knees. Methods We studied 71 participants: 20 ACL-injured patients with, and 22 without dynamic knee instability, 13 with surgical reconstruction, and 16 healthy controls. Sagittal multi-echo-spin-echo (MESE) MRIs were acquired at baseline and 1-year follow-up. Femorotibial cartilage was segmented manually; a convolutional neural network (CNN) algorithm was trained on MRI data from the same scanner. Results Dice similarity coefficients (DSCs) of automated versus manual segmentation in the 71 participants were 0.83 (femora) and 0.89 (tibiae). Deep femorotibial T2 was similar between automated (45.7±2.6 ms) and manual (45.7±2.7 ms) segmentation (P=0.828), whereas superficial layer T2 was slightly overestimated by automated analysis (53.2±2.2 vs. 52.1±2.1 ms for manual; P<0.001). T2 correlations were r=0.91-0.99 for deep and r=0.86-0.97 for superficial layers across regions. The only statistically significant T2 increase over 1 year was observed in the deep layer of the lateral femur [standardized response mean (SRM) =0.58 for automated vs. 0.52 for manual analysis; P<0.001]. There was no relevant difference in baseline/longitudinal T2 values/changes between the ACL-injured groups and healthy participants, with either segmentation method. Conclusions This clinical validation study suggests that automated cartilage T2 analysis from MESE at 1.5T is technically feasible and accurate. More efficient 3D sequences and longer observation intervals may be required to detect the impact of ACL injury induced joint instability on cartilage composition (T2).
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Affiliation(s)
- Felix Eckstein
- Chondrometrics GmbH, Freilassing, Germany
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology & Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
| | - Nicholas M. Brisson
- Julius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin Movement Diagnostics (BeMoveD), Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | | | - Anna Wisser
- Chondrometrics GmbH, Freilassing, Germany
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology & Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
| | - Francis Berenbaum
- Moving Biotech, Lille, France
- Department of Rheumatology, Sorbonne University, INSERM, AP-HP, Saint-Antoine Hospital, Paris, France
| | - Georg N. Duda
- Julius Wolff Institute, Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin Movement Diagnostics (BeMoveD), Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfgang Wirth
- Chondrometrics GmbH, Freilassing, Germany
- Research Program for Musculoskeletal Imaging, Center for Anatomy and Cell Biology & Ludwig Boltzmann Institute for Arthritis and Rehabilitation (LBIAR), Paracelsus Medical University, Salzburg, Austria
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Akatsuka Y, Teramoto A, Murahashi Y, Takahashi K, Imamura R, Takashima H, Watanabe K, Yamashita T. Quantitative assessment of anterior talofibular ligament quality in chronic lateral ankle instability using magnetic resonance imaging T2* value. Skeletal Radiol 2024; 53:733-739. [PMID: 37857750 DOI: 10.1007/s00256-023-04480-8] [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: 08/13/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To determine T2* normal reference values for anterior talofibular ligament (ATFL) and to investigate the feasibility of the quantitative ATFL quality evaluation in chronic lateral ankle instability (CLAI) using T2* values. MATERIALS AND METHODS This study enrolled 15 patients with CLAI and 30 healthy volunteers. The entire ATFL T2* values from the MRI T2* mapping were measured. The prediction equation (variables: age, height, and weight) in a multiple linear regression model was used to calculate the T2* normal reference value in the healthy group. T2* ratio was defined as the ratio of the actual T2* value of the patient's ATFL to the normal reference value for each patient. A Telos device was used to measure the talar tilt angle (TTA) from the stress radiograph. RESULTS T2* values of ATFL in the healthy and CLAI groups were 10.82 ± 1.84 ms and 14.36 ± 4.30 ms, respectively, which are significantly higher in the CLAI group (P < 0.05). The prediction equation of the normal reference T2* value was [14.9 + 0.14 × age (years) - 4.7 × height (m) - 0.03 × weight (kg)] (R2 = 0.65, P < 0.0001). A significant positive correlation was found between the T2* ratio and TTA (r = 0.66, P = 0.007). CONCLUSION MRI T2* values in patients with CLAI were higher than those in healthy participants, and the T2* ratio correlated with TTA, suggesting that T2* values are promising for quantitative assessment of ATFL quality preoperatively.
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Affiliation(s)
- Yoshihiro Akatsuka
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Atsushi Teramoto
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Yasutaka Murahashi
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Katsunori Takahashi
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Rui Imamura
- Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Hiroyuki Takashima
- Faculty of Health Sciences, Hokkaido University, North-12, West-15, Kita-ku, Sapporo, 060-0812, Japan
| | - Kota Watanabe
- Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Toshihiko Yamashita
- Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan
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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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Okada S, Taniguchi M, Yagi M, Motomura Y, Okada S, Fukumoto Y, Kobayashi M, Kanemitsu K, Ichihashi N. Ultrasonographic echo intensity in the medial femoral cartilage is enhanced prior to cartilage thinning in women with early mild knee osteoarthritis. Knee Surg Sports Traumatol Arthrosc 2023; 31:3964-3970. [PMID: 37140655 DOI: 10.1007/s00167-023-07440-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/23/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE We aimed to determine whether altered cartilage echo intensity is associated with knee osteoarthritis (OA) severity and whether the alteration occurs before thinning of the femoral cartilage in knee OA. METHODS The medial femoral cartilage thickness and echo intensity of 118 women aged ≥ 50 years were assessed using an ultrasound imaging device. Based on the Kellgren-Lawrence (KL) grade and knee symptoms, participants were classified into five groups: control (asymptomatic grades 0-1), early OA (symptomatic grade 1), grade 2, grade 3, and grade 4. Analysis of covariance, with adjusted age and height, and the Sidak post hoc test were used to assess the differences in cartilage thickness and echo intensity in knees with varying OA severity. RESULTS The echo intensity on longitudinal images, equivalent to the tibiofemoral weight-bearing surface, was significantly higher in the grade 2 group than that in the control group (p = 0.049). However, no significant difference was noted in cartilage thickness (n.s.). In the grades 3 and 4 groups, cartilage thickness became thinner as OA progressed (p < 0.001 and p < 0.001, respectively). However, the cartilage echo intensity was not significantly enhanced compared with that of the grade 2 group (n.s.). There were no significant differences in the cartilage thickness and echo intensity between the early OA and control groups on the longitudinal images (n.s.). CONCLUSIONS The echo intensity of the medial femoral cartilage was high in patients with KL grade 2, without decreased thickness. Our findings suggested that higher echo intensity is a feature of early cartilage degeneration in mild knee OA. Further studies are needed to establish this feature as a useful screening parameter of early cartilage degeneration in knee OA. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Shogo Okada
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Masashi Taniguchi
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan.
| | - Masahide Yagi
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Yoshiki Motomura
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Kobayashi Hospital, 50-35 Kuzetakada-Cho, Minami-Ku, Kyoto, 601-8211, Japan
| | - Sayaka Okada
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
| | - Yoshihiro Fukumoto
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
- Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyamahigashicho, Hirakata, Osaka, 573-1136, Japan
| | - Masashi Kobayashi
- Kobayashi Hospital, 50-35 Kuzetakada-Cho, Minami-Ku, Kyoto, 601-8211, Japan
| | - Kyoseki Kanemitsu
- Kanemitsu Clinic, 33-2 Enmamae-Cho, Kamigyo-Ku, Kyoto, 602-8307, Japan
| | - Noriaki Ichihashi
- A Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-Cho, Shogoin, Sakyo-Ku, Kyoto, 606-8507, Japan
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Duvančić T, Škokić S, Erjavec I, Plečko M, Bohaček I, Gajović S, Delimar D. Novel micro-MRI approach for subchondral trabecular bone analysis in patients with hip osteoarthritis is comparable to micro-CT approach. Croat Med J 2022; 63:515-524. [PMID: 36597563 PMCID: PMC9837720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
AIM To test the agreement between a newly developed micro-magnetic resonance imaging (MRI) analysis of the subchondral bone and the micro-computed tomography (CT) approach. METHODS Samples obtained from 10 patients with osteoarthritis undergoing total hip arthroplasty were scanned with a 7.0 T micro-MRI. Proton density-weighted images and proton density-weighted images with fat suppression were obtained. The results were validated with a micro-CT device. Micro-MRI and micro-CT scans of the same sample were aligned, and regions of interest were delineated on equal areas of the sample. Bone volume fraction was calculated by using in-house plugins. The agreement between the methods was tested with Bland-Altman analysis. RESULTS The agreement between the methods was good, with average difference of 2.167%. The differences between the methods were not significant (P=0.272, t test). CONCLUSION The novel micro-MRI approach could be used for subchondral bone analysis. With further optimization for clinical MRI machines, the approach can be also used in the diagnostics of hip osteoarthritis.
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Affiliation(s)
- Tea Duvančić
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Siniša Škokić
- Laboratory for Regenerative Neuroscience – GlowLab, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Igor Erjavec
- University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ivan Bohaček
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Srećko Gajović
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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Duvančić T, Škokić S, Erjavec I, Plečko M, Bohaček I, Gajović S, Delimar D. Novel micro-MRI approach for subchondral trabecular bone analysis in patients with hip osteoarthritis is comparable to micro-CT approach. Croat Med J 2022. [PMID: 36597563 PMCID: PMC9837720 DOI: 10.3325/cmj.2022.63.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
AIM To test the agreement between a newly developed micro-magnetic resonance imaging (MRI) analysis of the subchondral bone and the micro-computed tomography (CT) approach. METHODS Samples obtained from 10 patients with osteoarthritis undergoing total hip arthroplasty were scanned with a 7.0 T micro-MRI. Proton density-weighted images and proton density-weighted images with fat suppression were obtained. The results were validated with a micro-CT device. Micro-MRI and micro-CT scans of the same sample were aligned, and regions of interest were delineated on equal areas of the sample. Bone volume fraction was calculated by using in-house plugins. The agreement between the methods was tested with Bland-Altman analysis. RESULTS The agreement between the methods was good, with average difference of 2.167%. The differences between the methods were not significant (P=0.272, t test). CONCLUSION The novel micro-MRI approach could be used for subchondral bone analysis. With further optimization for clinical MRI machines, the approach can be also used in the diagnostics of hip osteoarthritis.
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Affiliation(s)
- Tea Duvančić
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Siniša Škokić
- Laboratory for Regenerative Neuroscience – GlowLab, Croatian Institute for Brain Research, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Igor Erjavec
- University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Ivan Bohaček
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
| | - Srećko Gajović
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Domagoj Delimar
- Department of Orthopedic Surgery, University of Zagreb School of Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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A Comprehensive Framework to Evaluate the Effects of Anterior Cruciate Ligament Injury and Reconstruction on Graft and Cartilage Status through the Analysis of MRI T2 Relaxation Time and Knee Laxity: A Pilot Study. Life (Basel) 2021; 11:life11121383. [PMID: 34947914 PMCID: PMC8706566 DOI: 10.3390/life11121383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) tear represents a common orthopedic traumatic issue that often leads to an early development of osteoarthritis. To improve the diagnostic and prognostic techniques involved in the assessment of the joint after the trauma and during the healing process, the present work proposes a multi-parametric approach that aims to investigate the relationship between joint function and soft tissue status before and after ACL reconstruction. METHODS Thirteen consecutive patients who underwent ACL reconstruction were preliminarily enrolled in this study. Joint laxity assessment as well as magnetic resonance imaging with T2 mapping were performed in the pre-operative stage, at four and 18 months after surgery to acquire objective information to correlate knee function and soft tissue condition. RESULTS Correlations were found between graft and cartilage T2 signal, suggesting an interplay between these tissues within the knee joint. Moreover, graft maturation resulted in being connected to joint laxity, as underlined by the correlation between the graft T2 signal and the temporal evolution of knee function. CONCLUSIONS This preliminary study represents a step forward in assessing the effects of ACL graft maturation on knee biomechanics, and vice versa. The presented integrated framework underlines the possibility to quantitatively assess the impact of ACL reconstruction on trauma recovery and cartilage homeostasis. Moreover, the reported findings-despite the preliminary nature of the clinical impacts-evidence the possibility of monitoring the surgery outcomes using a multi-parametric prognostic investigation tool.
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Kamp B, Frenken M, Henke JM, Abrar DB, Nagel AM, Gast LV, Oeltzschner G, Wilms LM, Nebelung S, Antoch G, Wittsack HJ, Müller-Lutz A. Quantification of Sodium Relaxation Times and Concentrations as Surrogates of Proteoglycan Content of Patellar CARTILAGE at 3T MRI. Diagnostics (Basel) 2021; 11:diagnostics11122301. [PMID: 34943538 PMCID: PMC8700247 DOI: 10.3390/diagnostics11122301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022] Open
Abstract
Sodium MRI has the potential to depict cartilage health accurately, but synovial fluid can influence the estimation of sodium parameters of cartilage. Therefore, this study aimed to reduce the impact of synovial fluid to render the quantitative compositional analyses of cartilage tissue technically more robust. Two dedicated protocols were applied for determining sodium T1 and T2* relaxation times. For each protocol, data were acquired from 10 healthy volunteers and one patient with patellar cartilage damage. Data recorded with multiple repetition times for T1 measurement and multi-echo data acquired with an additional inversion recovery pulse for T2* measurement were analysed using biexponential models to differentiate longitudinal relaxation components of cartilage (T1,car) and synovial fluid (T1,syn), and short (T2s*) from long (T2l*) transversal relaxation components. Sodium relaxation times and concentration estimates in patellar cartilage were successfully determined: T1,car = 14.5 ± 0.7 ms; T1,syn = 37.9 ± 2.9 ms; c(T1-protocol) = 200 ± 48 mmol/L; T2s* = 0.4 ± 0.1 ms; T2l* = 12.6 ± 0.7 ms; c(T2*-protocol) = 215 ± 44 mmol/L for healthy volunteers. In conclusion, a robust determination of sodium relaxation times is possible at a clinical field strength of 3T to quantify sodium concentrations, which might be a valuable tool to determine cartilage health.
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Affiliation(s)
- Benedikt Kamp
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Miriam Frenken
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
- Correspondence:
| | - Jan M. Henke
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
- Clinic of Nuclear Medicine, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany
| | - Daniel B. Abrar
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Armin M. Nagel
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91054 Erlangen, Germany; (A.M.N.); (L.V.G.)
- German Cancer Research Center (DKFZ), Division of Medical Physics in Radiology, D-69120 Heidelberg, Germany
| | - Lena V. Gast
- Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), D-91054 Erlangen, Germany; (A.M.N.); (L.V.G.)
| | - Georg Oeltzschner
- Russell H. Morgan Department for Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD 21205-2196, USA;
- F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD 21205-2196, USA
| | - Lena M. Wilms
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Sven Nebelung
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Hans-Jörg Wittsack
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
| | - Anja Müller-Lutz
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, D-40225 Dusseldorf, Germany; (B.K.); (J.M.H.); (D.B.A.); (L.M.W.); (S.N.); (G.A.); (H.-J.W.); (A.M.-L.)
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10
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Kasar S, Ozturk M, Polat AV. Quantitative T2 mapping of the sacroiliac joint cartilage at 3T in patients with axial spondyloarthropathies. Eur Radiol 2021; 32:1395-1403. [PMID: 34797385 DOI: 10.1007/s00330-021-08357-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of T2 mapping of sacroiliac joint cartilage in patients with axial spondyloarthropathies (SpA). METHODS Thirty-seven SpA patients and 43 controls (mean age: 36.5 ± 8.2; 20 men) prospectively underwent conventional MRI and T2 mapping of the sacroiliac joints at 3 T. SpA patients and their sacroiliac joints were categorized into active and inactive based on the presence of bone marrow edema on the conventional MRI. T2-relaxation times were measured by drawing six manual ROIs on the cartilaginous part of the joints. T2 values of the bilateral iliac and sacral joint cartilages for each patient (T2subject), iliac and sacral cartilages for each sacroiliac joint (T2joint), iliac cartilage (T2iliac), and sacral cartilage (T2sacral) were calculated and compared between SpA patients and controls, and active and inactive joints. RESULTS The T2subject of SpA patients (50.48 ± 5.32 ms) was significantly higher than the T2subject of the controls (46.33 ± 3.30 ms, p < 0.001). Selecting an optimal T2subject cut-off value of 48.77 to differentiate SpA patients from controls revealed a sensitivity and a specificity of 62.2% and 81.4% respectively (AUC = 0.739). In SpA patients, T2joint, T2iliac, and T2sacral values of the inactive joints were not significantly different from those of the active joints (p = 0.088, p = 0.179, and p = 0.069). T2joint, T2iliac, and T2sacral values of the inactive joints of SpA patients were significantly higher than those of the controls (p = 0.012, p = 0.029, and p = 0.016). CONCLUSIONS T2 values of both active and inactive sacroiliac joint cartilages of SpA patients were increased. Thus, T2 mapping may be used in the diagnosis of SpA. KEY POINTS • Sacroiliac cartilage T2 values of SpA patients increase compared to those of the non-SpA controls. • Sacroiliac cartilage T2 values of active and inactive joints of SpA patients increase compared to those of the non-SpA controls. • Sacroiliac cartilage T2 values of active and inactive joints of SpA patients do not show statistically significant difference.
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Affiliation(s)
- Suleyman Kasar
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Mesut Ozturk
- Radiology Clinic, Samsun Gazi State Hospital, Samsun, Turkey.
| | - Ahmet Veysel Polat
- Department of Radiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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11
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Ranmuthu CDS, MacKay JW, Crowe VA, Kaggie JD, Kessler DA, McDonnell SM. Quantitative analysis of the ACL and PCL using T1rho and T2 relaxation time mapping: an exploratory, cross-sectional comparison between OA and healthy control knees. BMC Musculoskelet Disord 2021; 22:916. [PMID: 34717593 PMCID: PMC8556921 DOI: 10.1186/s12891-021-04755-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/28/2021] [Indexed: 12/18/2022] Open
Abstract
Background Quantitative magnetic resonance imaging (MRI) methods such as T1rho and T2 mapping are sensitive to changes in tissue composition, however their use in cruciate ligament assessment has been limited to studies of asymptomatic populations or patients with posterior cruciate ligament tears only. The aim of this preliminary study was to compare T1rho and T2 relaxation times of the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) between subjects with mild-to-moderate knee osteoarthritis (OA) and healthy controls. Methods A single knee of 15 patients with mild-to-moderate knee OA (Kellgren-Lawrence grades 2–3) and of 6 age-matched controls was imaged using a 3.0 T MRI. Three-dimensional (3D) fat-saturated spoiled gradient recalled-echo images were acquired for morphological assessment and T1ρ- and T2-prepared pseudo-steady-state 3D fast spin echo images for compositional assessment of the cruciate ligaments. Manual segmentation of whole ACL and PCL, as well as proximal / middle / distal thirds of both ligaments was carried out by two readers using ITK-SNAP and mean relaxation times were recorded. Variation between thirds of the ligament were assessed using repeated measures ANOVAs and differences in these variations between groups using a Kruskal-Wallis test. Inter- and intra-rater reliability were assessed using intraclass correlation coefficients (ICCs). Results In OA knees, both T1rho and T2 values were significantly higher in the distal ACL when compared to the rest of the ligament with the greatest differences in T1rho (e.g. distal mean = 54.5 ms, proximal = 47.0 ms, p < 0.001). The variation of T2 values within the PCL was lower in OA knees (OA: distal vs middle vs proximal mean = 28.5 ms vs 29.1 ms vs 28.7 ms, p = 0.748; Control: distal vs middle vs proximal mean = 26.4 ms vs 32.7 ms vs 33.3 ms, p = 0.009). ICCs were excellent for the majority of variables. Conclusion T1rho and T2 mapping of the cruciate ligaments is feasible and reliable. Changes within ligaments associated with OA may not be homogeneous. This study is an important step forward in developing a non-invasive, radiological biomarker to assess the ligaments in diseased human populations in-vivo. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04755-y.
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Affiliation(s)
- Chanuka D S Ranmuthu
- School of Clinical Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0SP, UK. .,, London, UK.
| | - James W MacKay
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK.,Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7UY, UK
| | - Victoria A Crowe
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - Joshua D Kaggie
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Dimitri A Kessler
- Department of Radiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Stephen M McDonnell
- Division of Trauma & Orthopaedic Surgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK
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12
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Liu Y, Ying L, Chen W, Cui ZX, Zhu Q, Liu X, Zheng H, Liang D, Zhu Y. Accelerating the 3D T 1ρ mapping of cartilage using a signal-compensated robust tensor principal component analysis model. Quant Imaging Med Surg 2021; 11:3376-3391. [PMID: 34341716 DOI: 10.21037/qims-20-790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 04/19/2021] [Indexed: 11/06/2022]
Abstract
Background Magnetic resonance (MR) quantitative T1ρ imaging has been increasingly used to detect the early stages of osteoarthritis. The small volume and curved surface of articular cartilage necessitate imaging with high in-plane resolution and thin slices for accurate T1ρ measurement. Compared with 2D T1ρ mapping, 3D T1ρ mapping is free from artifacts caused by slice cross-talk and has a thinner slice thickness and full volume coverage. However, this technique needs to acquire multiple T1ρ-weighted images with different spin-lock times, which results in a very long scan duration. It is highly expected that the scan time can be reduced in 3D T1ρ mapping without compromising the T1ρ quantification accuracy and precision. Methods To accelerate the acquisition of 3D T1ρ mapping without compromising the T1ρ quantification accuracy and precision, a signal-compensated robust tensor principal component analysis method was proposed in this paper. The 3D T1ρ-weighted images compensated at different spin-lock times were decomposed as a low-rank high-order tensor plus a sparse component. Poisson-disk random undersampling patterns were applied to k-space data in the phase- and partition-encoding directions in both retrospective and prospective experiments. Five volunteers were involved in this study. The fully sampled k-space data acquired from 3 volunteers were retrospectively undersampled at R=5.2, 7.7, and 9.7, respectively. Reference values were obtained from the fully sampled data. Prospectively undersampled data for R=5 and R=7 were acquired from 2 volunteers. Bland-Altman analyses were used to assess the agreement between the accelerated and reference T1ρ measurements. The reconstruction performance was evaluated using the normalized root mean square error and the median of the normalized absolute deviation (MNAD) of the reconstructed T1ρ-weighted images and the corresponding T1ρ maps. Results T1ρ parameter maps were successfully estimated from T1ρ-weighted images reconstructed using the proposed method for all accelerations. The accelerated T1ρ measurements and reference values were in good agreement for R=5.2 (T1ρ: 40.4±1.4 ms), R=7.7 (T1ρ: 40.4±2.1 ms), and R=9.7 (T1ρ: 40.9±2.2 ms) in the Bland-Altman analyses. The T1ρ parameter maps reconstructed from the prospectively undersampled data also showed promising image quality using the proposed method. Conclusions The proposed method achieves the 3D T1ρ mapping of in vivo knee cartilage in eight minutes using a signal-compensated robust tensor principal component analysis method in image reconstruction.
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Affiliation(s)
- Yuanyuan Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,National Innovation Center for Advanced Medical Devices, Shenzhen, China.,Shenzhen College of Advanced Technology, University of Chinese Academy of Sciences, Shenzhen, China.,Research Center for Medical AI, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Leslie Ying
- Department of Biomedical Engineering and Department of Electrical Engineering, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Weitian Chen
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Zhuo-Xu Cui
- Research Center for Medical AI, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Qingyong Zhu
- Research Center for Medical AI, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Xin Liu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Hairong Zheng
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Dong Liang
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Research Center for Medical AI, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yanjie Zhu
- Paul C. Lauterbur Research Center for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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13
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Verschueren J, Van Langeveld SJ, Dragoo JL, Bierma-Zeinstra SMA, Reijman M, Gold GE, Oei EHG. T2 relaxation times of knee cartilage in 109 patients with knee pain and its association with disease characteristics. Acta Orthop 2021; 92:335-340. [PMID: 33538221 PMCID: PMC8231385 DOI: 10.1080/17453674.2021.1882131] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Quantitative T2 mapping MRI of cartilage has proven value for the assessment of early osteoarthritis changes in research. We evaluated knee cartilage T2 relaxation times in a clinical population with knee complaints and its association with patients and disease characteristics and clinical symptoms.Patients and methods - In this cross-sectional study, T2 mapping knee scans of 109 patients with knee pain who were referred for an MRI by an orthopedic surgeon were collected. T2 relaxation times were calculated in 6 femoral and tibial regions of interest of full-thickness tibiofemoral cartilage. Its associations with age, sex, BMI, duration of complaints, disease onset (acute/chronic), and clinical symptoms were assessed with multivariate regression analysis. Subgroups were created of patients with abnormalities expected to cause predominantly medial or lateral tibiofemoral cartilage changes.Results - T2 relaxation times increased statistically significantly with higher age and BMI. In patients with expected medial cartilage damage, the medial femoral T2 values were significantly higher than the lateral; in patients with expected lateral cartilage damage the lateral tibial T2 values were significantly higher. A traumatic onset of knee complaints was associated with an acute elevation. No significant association was found with clinical symptoms.Interpretation - Our study demonstrates age, BMI, and type of injury-dependent T2 relaxation times and emphasizes the importance of acknowledging these variations when performing T2 mapping in a clinical population.
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Affiliation(s)
- Joost Verschueren
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Stephan J Van Langeveld
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Jason L Dragoo
- Department of Orthopedic Surgery, University of Colorado, Denver, CO, USA
| | - Sita M A Bierma-Zeinstra
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
- Department of General Practice, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopedic Surgery, Erasmus MC University Medical Center Rotterdam, The Netherlands
| | - Garry E Gold
- Department of Radiology, Stanford University Medical Center, CA, USA
- Department of Bioengineering, Stanford University Medical Center, CA, USA
- Department of Orthopedic Surgery, Stanford University Medical Center, CA, USA
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, The Netherlands
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14
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Baer K, Kieser S, Schon B, Rajendran K, Ten Harkel T, Ramyar M, Löbker C, Bateman C, Butler A, Raja A, Hooper G, Anderson N, Woodfield T. Spectral CT imaging of human osteoarthritic cartilage via quantitative assessment of glycosaminoglycan content using multiple contrast agents. APL Bioeng 2021; 5:026101. [PMID: 33834156 PMCID: PMC8018795 DOI: 10.1063/5.0035312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/22/2021] [Indexed: 01/06/2023] Open
Abstract
Detection of early osteoarthritis to stabilize or reverse the damage to articular cartilage would improve patient function, reduce disability, and limit the need for joint replacement. In this study, we investigated nondestructive photon-processing spectral computed tomography (CT) for the quantitative measurement of the glycosaminoglycan (GAG) content compared to destructive histological and biochemical assay techniques in normal and osteoarthritic tissues. Cartilage-bone cores from healthy bovine stifles were incubated in 50% ioxaglate (Hexabrix®) or 100% gadobenate dimeglumine (MultiHance®). A photon-processing spectral CT (MARS) scanner with a CdTe-Medipix3RX detector imaged samples. Calibration phantoms of ioxaglate and gadobenate dimeglumine were used to determine iodine and gadolinium concentrations from photon-processing spectral CT images to correlate with the GAG content measured using a dimethylmethylene blue assay. The zonal distribution of GAG was compared between photon-processing spectral CT images and histological sections. Furthermore, discrimination and quantification of GAG in osteoarthritic human tibial plateau tissue using the same contrast agents were demonstrated. Contrast agent concentrations were inversely related to the GAG content. The GAG concentration increased from 25 μg/ml (85 mg/ml iodine or 43 mg/ml gadolinium) in the superficial layer to 75 μg/ml (65 mg/ml iodine or 37 mg/ml gadolinium) in the deep layer of healthy bovine cartilage. Deep zone articular cartilage could be distinguished from subchondral bone by utilizing the material decomposition technique. Photon-processing spectral CT images correlated with histological sections in healthy and osteoarthritic tissues. Post-imaging material decomposition was able to quantify the GAG content and distribution throughout healthy and osteoarthritic cartilage using Hexabrix® and MultiHance® while differentiating the underlying subchondral bone.
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Affiliation(s)
| | - Sandra Kieser
- Christchurch Regenerative Medicine and Tissue Engineering (CReaTE), Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
| | | | | | | | - Mohsen Ramyar
- Department of Radiology, University of Otago Christchurch, Christchurch 8011, New Zealand
| | | | - Christopher Bateman
- Department of Radiology, University of Otago Christchurch, Christchurch 8011, New Zealand
| | | | | | | | - Nigel Anderson
- Department of Radiology, University of Otago Christchurch, Christchurch 8011, New Zealand
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15
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Wang HM, Shultz SJ, Ross SE, Henson RA, Perrin DH, Schmitz RJ. Relationship of Anterior Cruciate Ligament Volume and T2* Relaxation Time to Anterior Knee Laxity. Orthop J Sports Med 2021; 9:2325967120979986. [PMID: 33718498 PMCID: PMC7925955 DOI: 10.1177/2325967120979986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 08/04/2020] [Indexed: 12/15/2022] Open
Abstract
Background: High anterior knee laxity (AKL) has been prospectively identified as a risk factor for anterior cruciate ligament (ACL) injuries. Given that ACL morphometry and structural composition have the potential to influence ligamentous strength, understanding how these factors are associated with greater AKL is warranted. Hypothesis: Smaller ACL volumes combined with longer T2* relaxation times would collectively predict greater AKL. Study Design: Cross-sectional study; Level of evidence, 3. Methods: College-aged active male (n = 20) and female (n = 30) participants underwent magnetic resonance imaging (MRI) and AKL testing. T2-weighted MRI scans were used to assess ACL volumes, and T2* relaxation times were used to assess ACL structural composition. AKL was measured via a commercial knee arthrometer. Forward stepwise linear regression with sex and weight (first step; suppressor variables) as well as ACL volume and T2* relaxation time (second step; independent variables) was used to predict AKL (dependent variable). Results: After initially adjusting for sex and weight (R2 = 0.19; P = .006), smaller ACL volumes combined with longer T2* relaxation times collectively predicted greater AKL (R2 = 0.52; P < .001; R2Δ = 0.32; PΔ < .001). A smaller ACL volume was the primary predictor of greater AKL (R2Δ = 0.28; P < .001), with a longer T2* relaxation time trending toward a significant contribution to greater AKL (R2Δ = 0.04; P = .062). After adjusting for ACL volume and T2* relaxation time, sex (partial r = 0.05; P = .735) and weight (partial r = 0.05; P = .725) were no longer significant predictors. Conclusion: AKL was largely predicted by ACL volume and to a lesser extent by T2* relaxation time (and not a person’s sex and weight). These findings enhance our understanding of how AKL may be associated with a structurally weaker ACL. The current study presents initial evidence that AKL is a cost-effective and clinically accessible measure that shows us something about the structural composition of the ACL. As AKL has been consistently shown to be a risk factor for ACL injuries, work should be done to continue to investigate what AKL may tell a clinician about the structure and composition of the ACL.
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Affiliation(s)
- Hsin-Min Wang
- Department of Sports, National Changhua University of Education, Changhua City, Taiwan
| | - Sandra J Shultz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Scott E Ross
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Robert A Henson
- Department of Educational Research Methodology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - David H Perrin
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, USA
| | - Randy J Schmitz
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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16
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Galbusera F, Cina A, Panico M, Albano D, Messina C. Image-based biomechanical models of the musculoskeletal system. Eur Radiol Exp 2020; 4:49. [PMID: 32789547 PMCID: PMC7423821 DOI: 10.1186/s41747-020-00172-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/30/2020] [Indexed: 12/31/2022] Open
Abstract
Finite element modeling is a precious tool for the investigation of the biomechanics of the musculoskeletal system. A key element for the development of anatomically accurate, state-of-the art finite element models is medical imaging. Indeed, the workflow for the generation of a finite element model includes steps which require the availability of medical images of the subject of interest: segmentation, which is the assignment of each voxel of the images to a specific material such as bone and cartilage, allowing for a three-dimensional reconstruction of the anatomy; meshing, which is the creation of the computational mesh necessary for the approximation of the equations describing the physics of the problem; assignment of the material properties to the various parts of the model, which can be estimated for example from quantitative computed tomography for the bone tissue and with other techniques (elastography, T1rho, and T2 mapping from magnetic resonance imaging) for soft tissues. This paper presents a brief overview of the techniques used for image segmentation, meshing, and assessing the mechanical properties of biological tissues, with focus on finite element models of the musculoskeletal system. Both consolidated methods and recent advances such as those based on artificial intelligence are described.
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Affiliation(s)
| | - Andrea Cina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Matteo Panico
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, Milan, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedicine, Neuroscience and Advanced Diagnostics, Università degli Studi di Palermo, Palermo, Italy
| | - Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
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17
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Detection of early cartilage degeneration in the tibiotalar joint using 3 T gagCEST imaging: a feasibility study. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2020; 34:249-260. [PMID: 32725359 PMCID: PMC8018923 DOI: 10.1007/s10334-020-00868-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To establish and optimize a stable 3 Tesla (T) glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging protocol for assessing the articular cartilage of the tibiotalar joint in healthy volunteers and patients after a sustained injury to the ankle. METHODS Using Bloch-McConnell simulations, we optimized the sequence protocol for a 3 T MRI scanner for maximum gagCEST effect size within a clinically feasible time frame of less than 07:30 min. This protocol was then used to analyze the gagCEST effect of the articular cartilage of the tibiotalar joint of 17 healthy volunteers and five patients with osteochondral lesions of the talus following ankle trauma. Reproducibility was tested with the intraclass correlation coefficient. RESULTS The mean magnetization transfer ratio asymmetry (MTRasym), i.e., the gagCEST effect size, was significantly lower in patients than in healthy volunteers (0.34 ± 1.9% vs. 1.49 ± 0.11%; p < 0.001 [linear mixed model]). Intra- and inter-rater reproducibility was excellent with an average measure intraclass correlation coefficient (ICC) of 0.97 and a single measure ICC of 0.91 (p < 0.01). DISCUSSION In this feasibility study, pre-morphological tibiotalar joint cartilage damage was quantitatively assessable on the basis of the optimized 3 T gagCEST imaging protocol that allowed stable quantification gagCEST effect sizes across a wide range of health and disease in clinically feasible acquisition times.
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18
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Yilmaz EN, Zeugolis DI. Electrospun Polymers in Cartilage Engineering-State of Play. Front Bioeng Biotechnol 2020; 8:77. [PMID: 32133352 PMCID: PMC7039817 DOI: 10.3389/fbioe.2020.00077] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/29/2020] [Indexed: 12/17/2022] Open
Abstract
Articular cartilage defects remain a clinical challenge. Articular cartilage defects progress to osteoarthritis, which negatively (e.g., remarkable pain, decreased mobility, distress) affects millions of people worldwide and is associated with excessive healthcare costs. Surgical procedures and cell-based therapies have failed to deliver a functional therapy. To this end, tissue engineering therapies provide a promise to deliver a functional cartilage substitute. Among the various scaffold fabrication technologies available, electrospinning is continuously gaining pace, as it can produce nano- to micro- fibrous scaffolds that imitate architectural features of native extracellular matrix supramolecular assemblies and can deliver variable cell populations and bioactive molecules. Herein, we comprehensively review advancements and shortfalls of various electrospun scaffolds in cartilage engineering.
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Affiliation(s)
- Elif Nur Yilmaz
- Regenerative, Modular & Developmental Engineering Laboratory, National University of Ireland Galway, Galway, Ireland.,Science Foundation Ireland, Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - Dimitrios I Zeugolis
- Regenerative, Modular & Developmental Engineering Laboratory, National University of Ireland Galway, Galway, Ireland.,Science Foundation Ireland, Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
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19
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Wu PJ, Masouleh MI, Dini D, Paterson C, Török P, Overby DR, Kabakova IV. Detection of proteoglycan loss from articular cartilage using Brillouin microscopy, with applications to osteoarthritis. BIOMEDICAL OPTICS EXPRESS 2019; 10:2457-2466. [PMID: 31143498 PMCID: PMC6524605 DOI: 10.1364/boe.10.002457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 05/05/2023]
Abstract
The degeneration of articular cartilage (AC) occurs in osteoarthritis (OA), which is a leading cause of pain and disability in middle-aged and older people. The early disease-related changes in cartilage extra-cellular matrix (ECM) start with depletion of proteoglycan (PG), leading to an increase in tissue hydration and permeability. These early compositional changes are small (<10%) and hence difficult to register with conventional non-invasive imaging technologies (magnetic resonance and ultrasound imaging). Here we apply Brillouin microscopy for detecting changes in the mechanical properties and composition of porcine AC. OA-like degradation is mimicked by enzymatic tissue digestion, and we compare Brillouin microscopy measurements against histological staining of PG depletion over varying digestion times and enzyme concentrations. The non-destructive nature of Brillouin imaging technology opens new avenues for creating minimally invasive arthroscopic devices for OA diagnostics and therapeutic monitoring.
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Affiliation(s)
- Pei-Jung Wu
- Department of Bioengineering, Imperial College London, London,
UK
- Department of Physics, Imperial College London, London,
UK
| | | | - Daniele Dini
- Department of Mechanical Engineering, Imperial College London, London,
UK
| | - Carl Paterson
- Department of Physics, Imperial College London, London,
UK
| | - Peter Török
- Department of Physics, Imperial College London, London,
UK
- Division of Physics & Applied Physics, Nanyang Technological University, Singapore,
Singapore
| | - Darryl R. Overby
- Department of Bioengineering, Imperial College London, London,
UK
| | - Irina V. Kabakova
- Department of Physics, Imperial College London, London,
UK
- School of Mathematical and Physical Sciences, University of Technology Sydney, Sydney, NSW,
Australia
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20
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Van Rossom S, Wesseling M, Van Assche D, Jonkers I. Topographical Variation of Human Femoral Articular Cartilage Thickness, T1rho and T2 Relaxation Times Is Related to Local Loading during Walking. Cartilage 2019; 10:229-237. [PMID: 29322877 PMCID: PMC6425544 DOI: 10.1177/1947603517752057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Early detection of degenerative changes in the cartilage matrix composition is essential for evaluating early interventions that slow down osteoarthritis (OA) initiation. T1rho and T2 relaxation times were found to be effective for detecting early changes in proteoglycan and collagen content. To use these magnetic resonance imaging (MRI) methods, it is important to document the topographical variation in cartilage thickness, T1rho and T2 relaxation times in a healthy population. As OA is partially mechanically driven, the relation between these MRI-based parameters and localized mechanical loading during walking was investigated. DESIGN MR images were acquired in 14 healthy adults and cartilage thickness and T1rho and T2 relaxation times were determined. Experimental gait data was collected and processed using musculoskeletal modeling to identify weight-bearing zones and estimate the contact force impulse during gait. Variation of the cartilage properties (i.e., thickness, T1rho, and T2) over the femoral cartilage was analyzed and compared between the weight-bearing and non-weight-bearing zone of the medial and lateral condyle as well as the trochlea. RESULTS Medial condyle cartilage thickness was correlated to the contact force impulse ( r = 0.78). Lower T1rho, indicating increased proteoglycan content, was found in the medial weight-bearing zone. T2 was higher in all weight-bearing zones compared with the non-weight-bearing zones, indicating lower relative collagen content. CONCLUSIONS The current results suggest that medial condyle cartilage is adapted as a long-term protective response to localized loading during a frequently performed task and that the weight-bearing zone of the medial condyle has superior weight bearing capacities compared with the non-weight-bearing zones.
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Affiliation(s)
- Sam Van Rossom
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, Leuven, Belgium,Sam Van Rossom, Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, Box 1501, 3001 Leuven, Belgium.
| | - Mariska Wesseling
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal Rehabilitation Research Group, Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ilse Jonkers
- Human Movement Biomechanics Research Group, Department of Movement Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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21
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Bruno F, Arrigoni F, Palumbo P, Natella R, Maggialetti N, Reginelli A, Splendiani A, Di Cesare E, Brunese L, Guglielmi G, Giovagnoni A, Masciocchi C, Barile A. New advances in MRI diagnosis of degenerative osteoarthropathy of the peripheral joints. Radiol Med 2019; 124:1121-1127. [PMID: 30771216 DOI: 10.1007/s11547-019-01003-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 02/04/2019] [Indexed: 12/31/2022]
Abstract
Degenerative osteoarthropathy is one of the leading causes of the pain and disability from musculoskeletal disease in the adult population. Magnetic resonance imaging (MRI) allows optimal visualization of all tissues involved in degenerative osteoarthritis disease process, mainly the articular cartilage. In addition to qualitative and semiquantitative morphologic assessment, several MRI-based advanced techniques have been developed to allow characterization and quantification of the biochemical cartilage composition. These include quantitative analysis and several compositional techniques (T1 and T2 relaxometry measurements and mapping, sodium imaging, delayed gadolinium-enhanced MRI of cartilage dGEMRIC, glycosaminoglycan-specific chemical exchange saturation transfer gagCEST, diffusion-weighted imaging DWI and diffusion tensor imaging DTI). These compositional MRI techniques may have the potential to serve as quantitative, reproducible, noninvasive and objective endpoints for OA assessment, particularly in diagnosis of early and pre-radiographic stages of the disease and in monitoring disease progression and treatment effects over time.
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Affiliation(s)
- Federico Bruno
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Francesco Arrigoni
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Pierpaolo Palumbo
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Raffaele Natella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Nicola Maggialetti
- Department Life and Health "V. Tiberio", University of Molise, Campobasso, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Luca Brunese
- Department Life and Health "V. Tiberio", University of Molise, Campobasso, Italy
| | - Giuseppe Guglielmi
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, University of Foggia, Foggia, Italy
| | - Andrea Giovagnoni
- Department of Radiology, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio 1, 67100, L'Aquila, Italy.
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22
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Zibetti MVW, Baboli R, Chang G, Otazo R, Regatte RR. Rapid compositional mapping of knee cartilage with compressed sensing MRI. J Magn Reson Imaging 2018; 48:1185-1198. [PMID: 30295344 PMCID: PMC6231228 DOI: 10.1002/jmri.26274] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 07/12/2018] [Indexed: 12/15/2022] Open
Abstract
More than a decade after the introduction of compressed sensing (CS) in MRI, researchers are still working on ways to translate it into different research and clinical applications. The greatest advantage of CS in MRI is the reduced amount of k-space data needed to reconstruct images, which can be exploited to reduce scan time or to improve spatial resolution and volumetric coverage. Efficient data acquisition using CS is extremely important for compositional mapping of the musculoskeletal system in general and knee cartilage mapping techniques in particular. High-resolution quantitative information about tissue biochemical composition could be obtained in just a few minutes using CS MRI. However, in order to make this goal a reality, some issues still need to be addressed. In this article we review the current state of the art of CS methods for rapid compositional mapping of knee cartilage. Specifically, data acquisition strategies, image reconstruction algorithms, and data fitting models are discussed. Different CS studies for T2 and T1ρ mapping of knee cartilage are reviewed, with illustrative results. Future directions, opportunities, and challenges of rapid compositional mapping techniques are also discussed. Level of Evidence: 4 Technical Efficacy: Stage 6 J. Magn. Reson. Imaging 2018;47:1185-1198.
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Affiliation(s)
- Marcelo V W Zibetti
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Rahman Baboli
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Gregory Chang
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Ricardo Otazo
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Ravinder R Regatte
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
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23
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Fujisaki A, Aoki T, Narimatsu H, Kuwahara C, Nozaki A, Menuki K, Sakai A, Korogi Y. Ultrashort time-to-echo quantitative magnetic resonance imaging of the triangular fibrocartilage: differences in position. Eur Radiol 2018; 29:3219-3223. [PMID: 30178144 DOI: 10.1007/s00330-018-5693-7] [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: 05/30/2018] [Revised: 07/18/2018] [Accepted: 07/31/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To compare T2* values of the triangular fibrocartilage (TFC) obtained by ultrashort time-to-echo (UTE) techniques at the neutral position, ulnar flexion of the wrist, and pronation of the forearm. MATERIALS AND METHODS MR imaging was performed in ten healthy volunteers with a 3-T MR system by using an eight-channel knee coil. Coronal wrist T2* maps from three-dimensional cone UTE pulse sequences were obtained at the neutral, ulnar flexion, and pronation positions (TR: 19 ms, TE: 0.032 ms/4 ms/8 ms/12 ms, FOV: 18 cm, matrix: 430 × 430, section thickness: 1.5 mm, scan time: 8 min 31 s). UTE-T2* maps were calculated on a pixel-by-pixel basis for all structures of the wrist visualized in the coronal planes. The entire region of interest (ROI) for TFC was manually delineated, and the average T2* value was calculated for each ROI by three radiologists. The Kruskal-Wallis test, Wilcoxon signed-rank test, or intraclass correlation coefficients (ICC) were used for statistics. RESULTS The difference in the average T2* value among the three groups according to the forearm/wrist position was significant (p < 0.001). The T2* value of the TFC at pronation (mean ± 2 SD: 7.92 ± 1.37 ms) was significantly lower than those at the neutral (10.08 ± 1.90 ms) and ulnar flexion positions (9.15 ± 1.03 ms) (p < 0.017). The ICC showed a substantial interobserver agreement in the T2* value measurements of the TFC (ICC = 0.986). CONCLUSION T2* relaxation time measurement of the TFC using UTE may be useful for assessing the loading effect by the forearm/wrist position. KEY POINTS • The T2* value of the TFC may reflect the biomechanics of the wrist joint. • Acute loading at pronation results in a decrease in the T2* value of the TFC. • Quantitative wrist UTE MRI was successfully performed in vivo.
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Affiliation(s)
- Akitaka Fujisaki
- Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
| | - Hidekuni Narimatsu
- Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Chie Kuwahara
- Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
| | - Atsushi Nozaki
- MR Applications and Workflow, Asia Pacific, GE Healthcare, Tokyo, Japan
| | - Kunitaka Menuki
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Akinori Sakai
- Department of Orthopaedic Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Yukunori Korogi
- Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan
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24
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Tang S, Fernandez-Granda C, Lannuzel S, Bernstein B, Lattanzi R, Cloos M, Knoll F, Assländer J. Multicompartment Magnetic Resonance Fingerprinting. INVERSE PROBLEMS 2018; 34:094005. [PMID: 30880863 PMCID: PMC6415771 DOI: 10.1088/1361-6420/aad1c3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Magnetic resonance fingerprinting (MRF) is a technique for quantitative estimation of spin- relaxation parameters from magnetic-resonance data. Most current MRF approaches assume that only one tissue is present in each voxel, which neglects intravoxel structure, and may lead to artifacts in the recovered parameter maps at boundaries between tissues. In this work, we propose a multicompartment MRF model that accounts for the presence of multiple tissues per voxel. The model is fit to the data by iteratively solving a sparse linear inverse problem at each voxel, in order to express the measured magnetization signal as a linear combination of a few elements in a precomputed fingerprint dictionary. Thresholding-based methods commonly used for sparse recovery and compressed sensing do not perform well in this setting due to the high local coherence of the dictionary. Instead, we solve this challenging sparse-recovery problem by applying reweighted-𝓁1-norm regularization, implemented using an efficient interior-point method. The proposed approach is validated with simulated data at different noise levels and undersampling factors, as well as with a controlled phantom-imaging experiment on a clinical magnetic-resonance system.
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Affiliation(s)
- Sunli Tang
- Courant Institute of Mathematical Sciences, New York University
| | - Carlos Fernandez-Granda
- Courant Institute of Mathematical Sciences, New York University
- Center for Data Science, New York University
| | - Sylvain Lannuzel
- Center for Data Science, New York University
- École CentraleSup´elec
| | - Brett Bernstein
- Courant Institute of Mathematical Sciences, New York University
| | - Riccardo Lattanzi
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine
- Center for Advanced Imaging and Innovation Research (CAIR) Department of Radiology, New York University School of Medicine
| | - Martijn Cloos
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine
- Center for Advanced Imaging and Innovation Research (CAIR) Department of Radiology, New York University School of Medicine
| | - Florian Knoll
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine
- Center for Advanced Imaging and Innovation Research (CAIR) Department of Radiology, New York University School of Medicine
| | - Jakob Assländer
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine
- Center for Advanced Imaging and Innovation Research (CAIR) Department of Radiology, New York University School of Medicine
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25
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Ostrowska M, Maśliński W, Prochorec-Sobieszek M, Nieciecki M, Sudoł-Szopińska I. Cartilage and bone damage in rheumatoid arthritis. Reumatologia 2018; 56:111-120. [PMID: 29853727 PMCID: PMC5974634 DOI: 10.5114/reum.2018.75523] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 04/13/2018] [Indexed: 01/19/2023] Open
Abstract
Rheumatoid arthritis (RA), which is a chronic inflammatory disease with a multifactorial aetiology, leads to partial or permanent disability in the majority of patients. It is characterised by persistent synovitis and formation of pannus, i.e. invasive synovial tissue, which ultimately leads to destruction of the cartilage, subchondral bone, and soft tissues of the affected joint. Moreover, inflammatory infiltrates in the subchondral bone, which can lead to inflammatory cysts and later erosions, play an important role in the pathogenesis of RA. These inflammatory infiltrates can be seen in magnetic resonance imaging (MRI) as bone marrow oedema (BME). BME is observed in 68-75% of patients in early stages of RA and is considered a precursor of rapid disease progression. The clinical significance of synovitis and bone marrow oedema as precursors of erosions is well established in daily practice, and synovitis, BME, cysts, hyaline cartilage defects and bone erosions can be detected by ultrasonography (US) and MRI. A less explored subject is the inflammatory and destructive potential of intra- and extra-articular fat tissue, which can also be evaluated in US and MRI. Finally, according to certain hypotheses, hyaline cartilage damage may trigger synovitis and lead to irreversible joint damage, and MRI may be used for preclinical detection of cartilage biochemical abnormalities. This review discusses the pathomechanisms that lead to articular cartilage and bone damage in RA, including erosion precursors such as synovitis and osteitis and panniculitis, as well as the role of imaging techniques employed to detect early cartilage damage and bone erosions.
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Affiliation(s)
- Monika Ostrowska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Włodzimierz Maśliński
- Department of Pathophysiology and Immunology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Monika Prochorec-Sobieszek
- Diagnostic Haematology Department, Institute of Haematology and Transfusion Medicine, Warsaw, Poland
- Department of Pathomorphology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Michał Nieciecki
- Department of Diagnostic Imaging, Medical University of Warsaw, Poland
- Department of Nuclear Medicine, Medical University of Warsaw, Poland
| | - Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Diagnostic Imaging, Medical University of Warsaw, Poland
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26
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Effect of intra-articular injection of intermediate-weight hyaluronic acid on hip and knee cartilage: in-vivo evaluation using T2 mapping. Eur Radiol 2018; 28:2345-2355. [PMID: 29318429 DOI: 10.1007/s00330-017-5186-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/16/2017] [Accepted: 11/07/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We used T2 mapping to quantify the effect of intra-articular hyaluronic acid administration (IAHAA) on cartilage with correlation to clinical symptoms. METHODS One hundred two patients with clinical and MRI diagnosis of hip or knee grade I-III chondropathy were prospectively included. All patients received a standard MRI examination of the affected hip/knee (one joint/patient) and T2-mapping multiecho sequence for cartilage evaluation. T2 values of all slices were averaged and used for analysis. One month after MR evaluation 72 patients (38 males; mean age 51±10 years) underwent IAHAA. As a control group, 30 subjects (15 males; 51 ± 9 years) were not treated. MR and WOMAC evaluation was performed at baseline and after 3, 9, and 15 months in all patients. RESULTS T2 mapping in hyaluronic acid (HA) patients showed a significant increase in T2 relaxation times from baseline to the first time point after therapy in knees (40.7 ± 9.8 ms vs. 45.8 ± 8.6 ms) and hips (40.9 ± 9.7 ms; 45.9 ± 9.5 ms) (p < 0.001). At the 9- and 15-month evaluations, T2 relaxation dropped to values similar to the baseline ones (p < 0.001 vs. 3 month). The correlation between T2 increase and pain reduction after IAHAA was statistically significant (r = 0.54, p < 0.01) in patients with grade III chondropathy. CONCLUSIONS T2 mapping can be used to evaluate the effect over time of IAHAA in patients with hip and knee chondropathy. KEY POINTS • T2 relaxation times change over time after hyaluronic acid intra-articular administration • T2 relaxation times of the medial femoral condyle correlate with WOMAC variation • T2 relaxation times are different between Outerbridge I and II-III.
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27
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Ashinsky BG, Bouhrara M, Coletta CE, Lehallier B, Urish KL, Lin PC, Goldberg IG, Spencer RG. Predicting early symptomatic osteoarthritis in the human knee using machine learning classification of magnetic resonance images from the osteoarthritis initiative. J Orthop Res 2017; 35:2243-2250. [PMID: 28084653 PMCID: PMC5969573 DOI: 10.1002/jor.23519] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/06/2017] [Indexed: 02/06/2023]
Abstract
The purpose of this study is to evaluate the ability of a machine learning algorithm to classify in vivo magnetic resonance images (MRI) of human articular cartilage for development of osteoarthritis (OA). Sixty-eight subjects were selected from the osteoarthritis initiative (OAI) control and incidence cohorts. Progression to clinical OA was defined by the development of symptoms as quantified by the Western Ontario and McMaster Universities Arthritis (WOMAC) questionnaire 3 years after baseline evaluation. Multi-slice T2 -weighted knee images, obtained through the OAI, of these subjects were registered using a nonlinear image registration algorithm. T2 maps of cartilage from the central weight bearing slices of the medial femoral condyle were derived from the registered images using the multiple available echo times and were classified for "progression to symptomatic OA" using the machine learning tool, weighted neighbor distance using compound hierarchy of algorithms representing morphology (WND-CHRM). WND-CHRM classified the isolated T2 maps for the progression to symptomatic OA with 75% accuracy. CLINICAL SIGNIFICANCE Machine learning algorithms applied to T2 maps have the potential to provide important prognostic information for the development of OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2243-2250, 2017.
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Affiliation(s)
- Beth G Ashinsky
- Laboratory of Clinical Investigation, Magnetic Resonance Imaging and Spectroscopy Section, National Institute on Aging, NIH, 251 Bayview Boulevard, Baltimore 21224, Maryland
| | - Mustapha Bouhrara
- Laboratory of Clinical Investigation, Magnetic Resonance Imaging and Spectroscopy Section, National Institute on Aging, NIH, 251 Bayview Boulevard, Baltimore 21224, Maryland
| | - Christopher E Coletta
- Image Informatics and Computational Biology Unit, National Institute on Aging, NIH, Baltimore, Maryland
| | - Benoit Lehallier
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Kenneth L Urish
- Bone and Joint Center, Magee Women's Hospital, Department of Orthopaedic Surgery, Pittsburgh, Pennsylvania
| | - Ping-Chang Lin
- Department of Radiology, College of Medicine, Howard University, Washington, DC, Washington
| | - Ilya G Goldberg
- Image Informatics and Computational Biology Unit, National Institute on Aging, NIH, Baltimore, Maryland
| | - Richard G Spencer
- Laboratory of Clinical Investigation, Magnetic Resonance Imaging and Spectroscopy Section, National Institute on Aging, NIH, 251 Bayview Boulevard, Baltimore 21224, Maryland
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28
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Jungmann PM, Welsch GH, Brittberg M, Trattnig S, Braun S, Imhoff AB, Salzmann GM. Magnetic Resonance Imaging Score and Classification System (AMADEUS) for Assessment of Preoperative Cartilage Defect Severity. Cartilage 2017; 8:272-282. [PMID: 28618873 PMCID: PMC5625863 DOI: 10.1177/1947603516665444] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To design a simple magnetic resonance (MR)-based assessment system for quantification of osteochondral defect severity prior to cartilage repair surgery at the knee. Design The new scoring tool was supposed to include 3 different parameters: (1) cartilage defect size, (2) depth/morphology of the cartilage defect, and (3) subchondral bone quality, resulting in a specific 3-digit code. A clearly defined numeric score was developed, resulting in a final score of 0 to 100. Defect severity grades I through IV were defined. For intra- and interobserver agreement, defects were assessed by 2 independent readers on preoperative knee MR images of n = 44 subjects who subsequently received cartilage repair surgery. For statistical analyses, mean values ± standard deviation (SD), interclass correlation coefficients (ICC), and linear weighted kappa values were calculated. Results The mean total Area Measurement And DEpth & Underlying Structures (AMADEUS) score was 48 ± 24, (range, 0-85). The mean defect size was 2.8 ± 2.6 cm2. There were 36 of 44 full-thickness defects. The subchondral bone showed defects in 21 of 44 cases. Kappa values for intraobserver reliability ranged between 0.82 and 0.94. Kappa values for interobserver reliability ranged between 0.38 and 0.85. Kappa values for AMADEUS grade were 0.75 and 0.67 for intra- and interobserver agreement, respectively. ICC scores for the AMADEUS total score were 0.97 and 0.96 for intra- and interobserver agreement, respectively. Conclusions The AMADEUS score and classification system allows reliable severity encoding, scoring and grading of osteochondral defects on knee MR images, which is easily clinically applicable in daily practice.
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Affiliation(s)
- Pia M. Jungmann
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany,Department of Radiology, Orthopedic University Hospital Balgrist, Zurich, Switzerland,Pia M. Jungmann, Department of Radiology, Technische Universitaet Muenchen, Ismaninger Strasse 22, Munich 81675, Germany.
| | - Götz H. Welsch
- Athleticum, University Hospital of Hamburg-Eppendorf, Hamburg, Germany
| | - Mats Brittberg
- Region Halland Orthopaedics, Kungsbacka Hospital, University of Gothenburg, Kungsbacka, Sweden
| | - Siegfried Trattnig
- MR Center, Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - Sepp Braun
- Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
| | - Andreas B. Imhoff
- Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany
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Kester BS, Carpenter PM, Yu HJ, Nozaki T, Kaneko Y, Yoshioka H, Schwarzkopf R. T1ρ/T2 mapping and histopathology of degenerative cartilage in advanced knee osteoarthritis. World J Orthop 2017; 8:350-356. [PMID: 28473964 PMCID: PMC5396021 DOI: 10.5312/wjo.v8.i4.350] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 12/11/2016] [Accepted: 01/03/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate whether normal thickness cartilage in osteoarthritic knees demonstrate depletion of proteoglycan or collagen content compared to healthy knees.
METHODS Magnetic resonance (MR) images were acquired from 5 subjects scheduled for total knee arthroplasty (TKA) (mean age 70 years) and 20 young healthy control subjects without knee pain (mean age 28.9 years). MR images of T1ρ mapping, T2 mapping, and fat suppressed proton-density weighted sequences were obtained. Following TKA each condyle was divided into 4 parts (distal medial, posterior medial, distal lateral, posterior lateral) for cartilage analysis. Twenty specimens (bone and cartilage blocks) were examined. For each joint, the degree and extent of cartilage destruction was determined using the Osteoarthritis Research Society International cartilage histopathology assessment system. In magnetic resonance imaging (MRI) analysis, 2 readers performed cartilage segmentation for T1ρ/T2 values and cartilage thickness measurement.
RESULTS Eleven areas in MRI including normal or near normal cartilage thickness were selected. The corresponding histopathological sections demonstrated mild to moderate osteoarthritis (OA). There was no significant difference in cartilage thickness in MRI between control and advanced OA samples [medial distal condyle, P = 0.461; medial posterior condyle (MPC), P = 0.352; lateral distal condyle, P = 0.654; lateral posterior condyle, P = 0.550], suggesting arthritic specimens were morphologically similar to normal or early staged degenerative cartilage. Cartilage T2 and T1ρ values from the MPC were significantly higher among the patients with advanced OA (P = 0.043). For remaining condylar samples there was no statistical difference in T2 and T1ρ values between cases and controls but there was a trend towards higher values in advanced OA patients.
CONCLUSION Though cartilage is morphologically normal or near normal, degenerative changes exist in advanced OA patients. These changes can be detected with T2 and T1ρ MRI techniques.
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Badar F, Xia Y. Image interpolation improves the zonal analysis of cartilage T2 relaxation in MRI. Quant Imaging Med Surg 2017; 7:227-237. [PMID: 28516048 DOI: 10.21037/qims.2017.03.04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND This project aimed to investigate the improvement in the detection of osteoarthritis (OA) in cartilage by the interpolation of T2 images, in the situation when the native MRI resolution is insufficient to resolve the depth-dependent T2 characteristics in articular cartilage (AC). METHODS Eighteen intact canine knee joints that were healthy or had mild (contralateral) or severe OA were T2-imaged in a 7T/20 cm MRI system at 200 µm/pixel resolution (macro-MRI). Two image analysis methods were used to interpolate the images to 100 µm/pixel, i.e., by Fourier-transforming the time-domain FID (Free Induction Decay) signal using the Varian NMR software and by interpolating the 2D T2 image using the ImageJ software. RESULTS The T2 profiles from 30 individual ROI of each healthy [6], mild [6] and OA [6] cartilage at 200 µm and the interpolated 100 µm resolutions were subdivided into two equal-thickness regions and three-equal thickness regions based on clinical MRI protocols. A new method divided the T2 profiles into three-unequal thickness zones according to the T2 profiles at 17.6 µm/pixel from the same cartilage imaged in a 7 Tesla/9 cm µMRI system. Both interpolation methods improved the depth-dependent T2 images/profiles in macro-MRI. The unequal zone division in T2 had better OA sensitivity than the equal zone division. The three-equal zone division of T2 profiles had better OA sensitivity than the two-equal zone division. The statistical significant difference between the healthy and mild OA cartilage is detected (P=0.0018) only by the unequal zone division method at 100 µm resolution. CONCLUSIONS Data interpolation improves the T2 sensitivity in MRI of cartilage OA. Unequal division of tissue thickness enables better early stage of OA detection than the equal division.
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Affiliation(s)
- Farid Badar
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
| | - Yang Xia
- Department of Physics and Center for Biomedical Research, Oakland University, Rochester, MI, USA
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T1ρ Hip Cartilage Mapping in Assessing Patients With Cam Morphology: How Can We Optimize the Regions of Interest? Clin Orthop Relat Res 2017; 475:1066-1075. [PMID: 27506970 PMCID: PMC5339114 DOI: 10.1007/s11999-016-5011-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND T1ρ MRI has been shown feasible to detect the biochemical status of hip cartilage, but various region-of-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies. QUESTIONS/PURPOSES The purposes of this study were (1) to determine representative regions of interest (ROIs) for cartilage T1ρ mapping in hips with a cam deformity; and (2) to assess intra- and interobserver reliability for cartilage T1ρ mapping in hips with a cam deformity. METHODS The local ethics committee approved this prospective study with written informed consent obtained. Between 2010 and 2013, in 54 hips (54 patients), T1ρ 1.5-T MRI was performed. Thirty-eight hips (38 patients; 89% male) with an average age of 35 ± 7.5 years (range, 23-51 tears) were diagnosed with a cam deformity; 16 hips (16 patients; 87% male) with an average age of 34 ± 7 years (range, 23-47 years) were included in the control group. Of the 38 patients with a cam deformity, 20 were pain-free and 18 symptomatic patients underwent surgery after 6 months of failed nonsurgical management of antiinflammatories and physical therapy. Exclusion criteria were radiologic sings of osteoarthritis with Tönnis Grade 2 or higher as well as previous hip surgery. Three region-of-interest (ROI) selections were analyzed: Method 1: as a whole; Method 2: as 36 to 54 small ROIs (sections of 30° in the sagittal plane and 3 mm in the transverse plane); Method 3a: as six ROIs (sections of 90° in the sagittal plane and one-third of the acetabular depth in the transverse plane: the anterosuperior and posterosuperior quadrants, divided into lateral, intermediate, and medial thirds); and Method 3b: as the ratio (anterosuperior over posterosuperior quadrant). ROIs in Method 3 represent the region of macroscopic cartilage damage, described in intraoperative findings. To asses interobserver reliability, 10 patients were analyzed by two observers (HA, GM). For intraobserver reliability, 20 hip MRIs were analyzed twice by one observer (HA). To assess interscan reliability, three patients underwent two scans within a time period of 2 weeks and were analyzed twice by one observer (HA). T1ρ values were compared using Student's t test. Interclass correlation coefficient (ICC) and root mean square coefficient of variation (RMS-CV) were used to analyze intraobserver, interobserver, and interscan reliability. RESULTS Patients with a cam deformity showed increased T1ρ values in the whole hip cartilage (mean: 34.0 ± 3.8 ms versus 31.4 ± 3.0 ms; mean difference: 2.5; 95% confidence interval [CI], 4.7-0.4; p = 0.019; Method 1), mainly anterolateral (2), in the lateral and medial thirds of the anterosuperior quadrant (mean: 32.3 ± 4.9 ms versus 29.4 ± 4.1 ms; mean difference: 3.0; 95% CI, 5.8-0.2; p = 0.039 and mean 36.5 ± 5.6 ms versus 32.6 ± 3.8 ms; mean difference: 3.8; 95% CI, 6.9-0.8; p = 0.014), and in the medial third of the posterosuperior quadrant (mean: 34.4 ± 5.5 ms versus 31.1 ± 3.9 ms; mean difference: 3.1; 95% CI, 6.2-0.1; p = 0.039) (3a). The ratio was increased in the lateral third (mean: 1.00 ± 0.12 versus 0.90 ± 0.15; mean difference: 0.10; 95% CI, 0.18-0.2; p = 0.018) (3b). ICC and RMS-CV were 0.965 and 4% (intraobserver), 0.953 and 4% (interobserver), and 0.988 (all p < 0.001) and 9% (inter-MR scan), respectively. CONCLUSIONS Cartilage T1ρ MRI mapping in hips is feasible at 1.5 T with strong inter-, intraobserver, and inter-MR scan reliability. The six ROIs (Method 3) showed a difference of T1ρ values anterolateral quadrant, consistent with the dominant area of cartilage injury in cam femoroacetabular impingement, and antero- and posteromedial, indicating involvement of the entire hip cartilage health. The six ROIs (Method 3) have been shown feasible to assess cartilage damage in hips with a cam deformity using T1ρ MRI. We suggest applying this ROI selection for further studies using quantitative MRI for assessment of cartilage damage in hips with a cam deformity to achieve better comparability and reproducibility between different studies. The application of this ROI selection on hips with other deformities (eg, pincer deformity, developmental dysplasia of the hip, and acetabular retroversion) has to be analyzed and potentially adapted. LEVEL OF EVIDENCE Level III, diagnostic study.
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Nataraj G, Nielsen JF, Fessler JA. Optimizing MR Scan Design for Model-Based ${T}_{1}$ , ${T}_{2}$ Estimation From Steady-State Sequences. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:467-477. [PMID: 27893386 PMCID: PMC5378699 DOI: 10.1109/tmi.2016.2614967] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Rapid, reliable quantification of MR relaxation parameters T1 and T2 is desirable for many clinical applications. Steady-state sequences such as Spoiled Gradient-Recalled Echo (SPGR) and Dual-Echo Steady-State (DESS) are fast and well-suited for relaxometry because the signals they produce are quite sensitive to T1 and T2 variation. However, T1, T2 estimation with these sequences typically requires multiple scans with varied sets of acquisition parameters. This paper describes a systematic framework for selecting scan types (e.g., combinations of SPGR and DESS scans) and optimizing their respective parameters (e.g., flip angles and repetition times). The method is based on a Cramér-Rao Bound (CRB)-inspired min-max optimization that finds scan parameter combinations that robustly enable precise object parameter estimation. We apply this technique to optimize combinations of SPGR and DESS scans for T1, T2 relaxometry in white matter (WM) and grey matter (GM) regions of the human brain at 3T field strength. Phantom accuracy experiments show that SPGR/DESS scan combinations are in excellent agreement with reference measurements. Phantom precision experiments show that trends in T1,T2 pooled sample standard deviations reflect CRB-based predictions. In vivo experiments show that in WM and GM, T1 and T2 estimates from a pair of optimized DESS scans exhibit precision (but not necessarily accuracy) comparable to that of optimized combinations of SPGR and DESS scans. To our knowledge, T1 maps from DESS acquisitions alone are new. This example application illustrates that scan optimization may help reveal new parameter mapping techniques from combinations of established pulse sequences.
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Van Rossom S, Smith CR, Zevenbergen L, Thelen DG, Vanwanseele B, Van Assche D, Jonkers I. Knee Cartilage Thickness, T1ρ and T2 Relaxation Time Are Related to Articular Cartilage Loading in Healthy Adults. PLoS One 2017; 12:e0170002. [PMID: 28076431 PMCID: PMC5226797 DOI: 10.1371/journal.pone.0170002] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 12/27/2016] [Indexed: 11/19/2022] Open
Abstract
Cartilage is responsive to the loading imposed during cyclic routine activities. However, the local relation between cartilage in terms of thickness distribution and biochemical composition and the local contact pressure during walking has not been established. The objective of this study was to evaluate the relation between cartilage thickness, proteoglycan and collagen concentration in the knee joint and knee loading in terms of contact forces and pressure during walking. 3D gait analysis and MRI (3D-FSE, T1ρ relaxation time and T2 relaxation time sequence) of fifteen healthy subjects were acquired. Experimental gait data was processed using musculoskeletal modeling to calculate the contact forces, impulses and pressure distribution in the tibiofemoral joint. Correlates to local cartilage thickness and mean T1ρ and T2 relaxation times of the weight-bearing area of the femoral condyles were examined. Local thickness was significantly correlated with local pressure: medial thickness was correlated with medial condyle contact pressure and contact force, and lateral condyle thickness was correlated with lateral condyle contact pressure and contact force during stance. Furthermore, average T1ρ and T2 relaxation time correlated significantly with the peak contact forces and impulses. Increased T1ρ relaxation time correlated with increased shear loading, decreased T1ρ and T2 relaxation time correlated with increased compressive forces and pressures. Thicker cartilage was correlated with higher condylar loading during walking, suggesting that cartilage thickness is increased in those areas experiencing higher loading during a cyclic activity such as gait. Furthermore, the proteoglycan and collagen concentration and orientation derived from T1ρ and T2 relaxation measures were related to loading.
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Affiliation(s)
- Sam Van Rossom
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Colin Robert Smith
- Department of mechanical engineering, University of Wisconsin-Madison, Madison, United States of America
| | - Lianne Zevenbergen
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Darryl Gerard Thelen
- Department of mechanical engineering, University of Wisconsin-Madison, Madison, United States of America
- Department of biomedical engineering, University of Wisconsin-Madison, Madison, United States of America
- Department of orthopedics and rehabilitation, University of Wisconsin-Madison, Madison, United States of America
| | - Benedicte Vanwanseele
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Dieter Van Assche
- Musculoskeletal rehabilitation research group, Department of rehabilitation sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ilse Jonkers
- Human movement biomechanics research group, Department of kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium
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Bangerter NK, Taylor MD, Tarbox GJ, Palmer AJ, Park DJ. Quantitative techniques for musculoskeletal MRI at 7 Tesla. Quant Imaging Med Surg 2016; 6:715-730. [PMID: 28090448 DOI: 10.21037/qims.2016.12.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Whole-body 7 Tesla MRI scanners have been approved solely for research since they appeared on the market over 10 years ago, but may soon be approved for selected clinical neurological and musculoskeletal applications in both the EU and the United States. There has been considerable research work on musculoskeletal applications at 7 Tesla over the past decade, including techniques for ultra-high resolution morphological imaging, 3D T2 and T2* mapping, ultra-short TE applications, diffusion tensor imaging of cartilage, and several techniques for assessing proteoglycan content in cartilage. Most of this work has been done in the knee or other extremities, due to technical difficulties associated with scanning areas such as the hip and torso at 7 Tesla. In this manuscript, we first provide some technical context for 7 Tesla imaging, including challenges and potential advantages. We then review the major quantitative MRI techniques being applied to musculoskeletal applications on 7 Tesla whole-body systems.
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Affiliation(s)
- Neal K Bangerter
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA;; Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Meredith D Taylor
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Grayson J Tarbox
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Antony J Palmer
- Department of Orthopaedics, University of Oxford, Oxford, UK
| | - Daniel J Park
- Department of Orthopaedics, University of Oxford, Oxford, UK
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Bangerter NK, Tarbox GJ, Taylor MD, Kaggie JD. Quantitative sodium magnetic resonance imaging of cartilage, muscle, and tendon. Quant Imaging Med Surg 2016; 6:699-714. [PMID: 28090447 DOI: 10.21037/qims.2016.12.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sodium magnetic resonance imaging (MRI), or imaging of the 23Na nucleus, has been under exploration for several decades, and holds promise for potentially revealing additional biochemical information about the health of tissues that cannot currently be obtained from conventional hydrogen (or proton) MRI. This additional information could serve as an important complement to conventional MRI for many applications. However, despite these exciting possibilities, sodium MRI is not yet used routinely in clinical practice, and will likely remain strictly in the domain of exploratory research for the coming decade. This paper begins with a technical overview of sodium MRI, including the nuclear magnetic resonance (NMR) signal characteristics of the sodium nucleus, the challenges associated with sodium MRI, and the specialized pulse sequences, hardware, and reconstruction techniques required. Various applications of sodium MRI for quantitative analysis of the musculoskeletal system are then reviewed, including the non-invasive assessment of cartilage degeneration in vivo, imaging of tendinopathy, applications in the assessment of various muscular pathologies, and assessment of muscle response to exercise.
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Affiliation(s)
- Neal K Bangerter
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA;; Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Grayson J Tarbox
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Meredith D Taylor
- Department of Electrical & Computer Engineering, Brigham Young University, Provo, UT, USA
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
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Gong J, Pedoia V, Facchetti L, Link TM, Ma CB, Li X. Bone marrow edema-like lesions (BMELs) are associated with higher T 1ρ and T 2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study. Quant Imaging Med Surg 2016; 6:661-670. [PMID: 28090444 DOI: 10.21037/qims.2016.12.11] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND To evaluate the longitudinal changes of bone marrow edema-like lesions (BMELs) in patients after anterior cruciate ligament (ACL) reconstruction and to investigate the effect of BMELs on cartilage matrix composition changes measured using MR T1ρ and T2 mapping. METHODS Patients with acute ACL tear were enrolled in a prospective study. MR imaging was performed at baseline (before surgeries) and at 6-month, 1-year and 2-year after ACL reconstruction. MR imaging included sagittal high-resolution, 3D fast spin-echo (CUBE) sequences for BMEL evaluation, and 3D T1ρ mapping and T2 mapping for cartilage assessment. BMELs were assessed using whole-organ magnetic resonance imaging score (WORMS), and the volume of BMELs was measured by a semi-automatic method. Generalized estimating equation (GEE) was used to explore association between BMELs at baseline and cartilage changes during follow-up. RESULTS Fifty four patients were included in the present study and 39 patients had completed 2-year follow-up. BMELs were noted in 42 injured knees (77.8%) with 105 lesions and in 7 contralateral knees (13.0%) with 9 lesions (χ2=45.763, P<0.001) at the baseline. The WORMS and volume of BMELs of the injured knees were 2.36±0.65 and 386.98±382.54 mm3 (r=0.681, P<0.001), respectively. 87 BMELs were found at baseline in 34 patients (87.2%) of the 39 patients who had completed 2 years follow-up. During the follow-up, 18 (20.7%), 12 (13.8%), and 5 (5.7%) baseline lesions were still seen at 6-month, 1-year and 2-year, respectively. The changes of BMELs prevalence regarding bone compartments over time points were statistically significant (χ2=163.660, P<0.001). Except T2 value at 6 months, T1ρ and T2 values of cartilage overlying baseline BMELs in the injured knees were higher than that of anatomically matched cartilage in the contralateral knees at baseline and each follow-up time-point. In the injured knees, GEE analysis showed that baseline BMELs were significantly associated with higher T1ρ and T2 values of cartilage after adjustment of age, gender, body mass index (BMI), effusion and meniscus tear. The association between BMELs and Knee Injury and Osteoarthritis Outcome Scores (KOOS) scores was not statistically significant. CONCLUSIONS BMEL is a common finding in patients with acute ACL injury and resolves rapidly over time after ACL reconstruction. It is often associated with increased T1ρ and T2 values of cartilage. BMEL at baseline is an independent predictor for faster cartilage degeneration during follow-up.
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Affiliation(s)
- Jingshan Gong
- Department of Radiology, Shenzhen People's Hospital, the Second Clinical Medical College, Jinan University, Shenzhen 518020, China;; Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA
| | - Valentina Pedoia
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA
| | - Luca Facchetti
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA
| | - C Benjamin Ma
- Department of Orthopaedic Surgery, University of California, San Francisco, CA 94107, USA
| | - Xiaojuan Li
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94107, USA
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Behzadi C, Welsch GH, Laqmani A, Henes FO, Kaul MG, Schoen G, Adam G, Regier M. The immediate effect of long-distance running on T2 and T2* relaxation times of articular cartilage of the knee in young healthy adults at 3.0 T MR imaging. Br J Radiol 2016; 89:20151075. [PMID: 27336705 DOI: 10.1259/bjr.20151075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To quantitatively assess the immediate effect of long-distance running on T2 and T2* relaxation times of the articular cartilage of the knee at 3.0 T in young healthy adults. METHODS 30 healthy male adults (18-31 years) who perform sports at an amateur level underwent an initial MRI at 3.0 T with T2 weighted [16 echo times (TEs): 9.7-154.6 ms] and T2* weighted (24 TEs: 4.6-53.6 ms) relaxation measurements. Thereafter, all participants performed a 45-min run. After the run, all individuals were immediately re-examined. Data sets were post-processed using dedicated software (ImageJ; National Institute of Health, Bethesda, MD). 22 regions of interest were manually drawn in segmented areas of the femoral, tibial and patellar cartilage. For statistical evaluation, Pearson product-moment correlation coefficients and confidence intervals were computed. RESULTS Mean initial values were 35.7 ms for T2 and 25.1 ms for T2*. After the run, a significant decrease in the mean T2 and T2* relaxation times was observed for all segments in all participants. A mean decrease of relaxation time was observed for T2 with 4.6 ms (±3.6 ms) and for T2* with 3.6 ms (±5.1 ms) after running. CONCLUSION A significant decrease could be observed in all cartilage segments for both biomarkers. Both quantitative techniques, T2 and T2*, seem to be valuable parameters in the evaluation of immediate changes in the cartilage ultrastructure after running. ADVANCES IN KNOWLEDGE This is the first direct comparison of immediate changes in T2 and T2* relaxation times after running in healthy adults.
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Affiliation(s)
- Cyrus Behzadi
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Goetz H Welsch
- 2 Department of Sports Medicine, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Azien Laqmani
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Frank O Henes
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Michael G Kaul
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Schoen
- 3 Department of Medical Biometry and Epidemiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Gerhard Adam
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Regier
- 1 Department of Diagnostic and Interventional Radiology, University Medical Center, Hamburg-Eppendorf, Hamburg, Germany
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Gheno R, Yoon YC, Wang JH, Kim K, Baek SY. Changes in the T2 relaxation value of the tibiofemoral articular cartilage about 6 months after anterior cruciate ligament reconstruction using the double-bundle technique. Br J Radiol 2016; 89:20151002. [PMID: 26838956 DOI: 10.1259/bjr.20151002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate T2 relaxation values (T2RVs) of knee joint cartilage after double-bundle anterior cruciate ligament reconstruction (DB-ACLR) in a 6-month follow-up and to correlate changes between T2RVs with meniscal status and clinical findings. METHODS 27 patients who underwent DB-ACLR and MRI before and 6 months after surgery, and 27 control subjects were enrolled. We compared T2RVs of the control vs pre-operative MR and pre-operative vs post-operative MR using 28 subcompartments, including superficial and deep layers. Correlations between T2RV changes with meniscal status and clinical data were examined. RESULTS The pre-operative T2RV was significantly higher than that of the control group in the medial tibia (posterior-superficial), posterior medial femur (superficial) and posterior lateral femur (superficial and deep). The post-operative T2RV was significantly higher than that of pre-operative T2RV in the posterior medial femur (superficial), medial tibia (anterior-deep and central-deep), lateral femur (anterior-deep, anterior-superficial and central-superficial) and posterior medial femur (deep). Moderate positive correlations between pre-operative and post-operative T2RV changes were found at the posterior medial femur (interval between injury and MR examination, and instability) and posterior lateral femur (Lysholm score). CONCLUSION Patients with anterior cruciate ligament injury followed by DB-ACLR presented short-term subcompartment T2RV changes at the medial femur, lateral femur and medial tibia. Meniscal status did not affect T2RV; however, clinical findings influenced T2RV at the posterior grooves of the medial and lateral femoral condyles. ADVANCES IN KNOWLEDGE Patients submitted to DB-ACLR presented T2RV changes in both femoral and medial tibial condyles 6 months after the surgery, affecting not just the weight-bearing areas, but also the less-weight-bearing areas.
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Affiliation(s)
- Ramon Gheno
- 1 Instituto de Radiodiagnóstico Rio Preto (Ultra-X), São José do Rio Preto, Brazil
| | - Young Cheol Yoon
- 2 Department of Radiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Joon H Wang
- 3 Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
| | - Kyunga Kim
- 4 Department of Biostatistics and Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Sun-Y Baek
- 4 Department of Biostatistics and Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
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Ayeni OR, Sansone M, de Sa D, Simunovic N, Bedi A, Kelly BT, Farrokhyar F, Karlsson J. Femoro-acetabular impingement clinical research: is a composite outcome the answer? Knee Surg Sports Traumatol Arthrosc 2016; 24:295-301. [PMID: 25618276 DOI: 10.1007/s00167-014-3500-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/23/2014] [Indexed: 11/25/2022]
Abstract
Femoro-acetabular impingement (FAI) is increasingly recognized as an important cause of hip pain in the young adult. However, the methods of evaluating the efficacy of surgical intervention are often not validated and/or inconsistently reported. Important clinical, gait, radiographic and biomarker outcomes are discussed. This article (1) presents the rationale for considering a composite outcome for FAI patients; (2) examines a variety of important end points currently used to evaluate FAI surgery; (3) discusses a strategy to generate a composite outcome by combining these end points; and (4) highlights the challenges and current areas of controversy that such an approach to evaluating symptomatic FAI patients may present.
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Affiliation(s)
- Olufemi R Ayeni
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada.
| | - Mikael Sansone
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden
| | - Darren de Sa
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University Medical Centre, 1200 Main Street West, 4E15, Hamilton, ON, L8N 3Z5, Canada
| | - Nicole Simunovic
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington St N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Asheesh Bedi
- MedSport, Department of Orthopaedic Surgery, University of Michigan, 24 Frank Lloyd Wright Drive, Lobby A, Ann Arbor, MI, 48106, USA
| | - Bryan T Kelly
- Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, 10021, USA
| | - Forough Farrokhyar
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington St N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Jon Karlsson
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Sahlgrenska University Hospital/Mölndal, Mölndal, Sweden
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Meijer DT, de Muinck Keizer RJO, Doornberg JN, Sierevelt IN, Stufkens SA, Kerkhoffs GMMJ, van Dijk CN. Diagnostic Accuracy of 2-Dimensional Computed Tomography for Articular Involvement and Fracture Pattern of Posterior Malleolar Fractures. Foot Ankle Int 2016; 37:75-82. [PMID: 26420736 DOI: 10.1177/1071100715603999] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Up to 44% of ankle fractures have involvement of the posterior tibial margin. Fracture size and morphology are important factors to guide treatment of these fragments, but reliability of plain radiography in estimating size is low. The aim of the current study was to evaluate the accuracy of 2-dimensional computed tomography (2DCT) in the assessment of posterior malleolar fractures. Additionally, the diagnostic accuracy of 2DCT and its value in preoperative planning was evaluated. METHODS Thirty-one patients with 31 ankle fractures including a posterior malleolar fragment were selected. Preoperative CT scans were analyzed by 50 observers from 23 countries. Quantitative 3-dimensional CT (Q3DCT) reconstructions were used as a reference standard. RESULTS Articular involvement of the posterior fragment was overestimated on 2DCT by factors 1.6, 1.4, and 2.2 for Haraguchi types I, II, and III, respectively. Interobserver agreement on operative management ("to fix, or not to fix?") was substantial (κ = 0.69) for Haraguchi type I fractures, fair (κ = 0.23) for type II fractures, and poor (κ = 0.09) for type III fractures. 2DCT images led to a change in treatment of the posterior malleolus in 23% of all fractures. Surgeons would operatively treat type I fractures in 63%, type II fractures in 67%, and type III fractures in 22%. CONCLUSION Surgeons overestimated true articular involvement of posterior malleolar fractures on 2DCT scans. 2DCT showed some additional value in estimating the involved articular surface when compared to plain radiographs; however, this seemed not yet sufficient to accurately read the fractures. Analysis of the CT images showed a significant influence on choice of treatment in 23% with a shift toward operative treatment in 12% of cases compared to evaluating plain lateral radiographs alone. LEVEL OF EVIDENCE Level III, comparative study.
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Affiliation(s)
- Diederik T Meijer
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Job N Doornberg
- University of Amsterdam Orthopaedic Residency Program (PGY5) and Postdoc Research Fellow, Orthotrauma Research Center Amsterdam, the Netherlands
| | - Inger N Sierevelt
- Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands
| | - Sjoerd A Stufkens
- University of Amsterdam Orthopaedic Residency Program (PGY5) and Postdoc Research Fellow, Orthotrauma Research Center Amsterdam, the Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, Academic Center for Evidence based Sports medicine (ACES), Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, the Netherlands
| | - C Niek van Dijk
- Academic Medical Center, Amsterdam, Amsterdam, the Netherlands
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Novakofski KD, Pownder SL, Koff MF, Williams RM, Potter HG, Fortier LA. High-Resolution Methods for Diagnosing Cartilage Damage In Vivo. Cartilage 2016; 7:39-51. [PMID: 26958316 PMCID: PMC4749750 DOI: 10.1177/1947603515602307] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Advances in current clinical modalities, including magnetic resonance imaging and computed tomography, allow for earlier diagnoses of cartilage damage that could mitigate progression to osteoarthritis. However, current imaging modalities do not detect submicrometer damage. Developments in in vivo or arthroscopic techniques, including optical coherence tomography, ultrasonography, bioelectricity including streaming potential measurement, noninvasive electroarthrography, and multiphoton microscopy can detect damage at an earlier time point, but they are limited by a lack of penetration and the ability to assess an entire joint. This article reviews current advancements in clinical and developing modalities that can aid in the early diagnosis of cartilage injury and facilitate studies of interventional therapeutics.
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Affiliation(s)
| | | | - Matthew F. Koff
- MRI Laboratory, Hospital for Special Surgery, New York, NY, USA
| | | | | | - Lisa A. Fortier
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA,Lisa A. Fortier, Department of Clinical Sciences, Cornell University, VMC C3-181, Ithaca, NY 14853, USA. Email
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Li X, Pedoia V, Kumar D, Rivoire J, Wyatt C, Lansdown D, Amano K, Okazaki N, Savic D, Koff MF, Felmlee J, Williams SL, Majumdar S. Cartilage T1ρ and T2 relaxation times: longitudinal reproducibility and variations using different coils, MR systems and sites. Osteoarthritis Cartilage 2015; 23:2214-2223. [PMID: 26187574 PMCID: PMC4663102 DOI: 10.1016/j.joca.2015.07.006] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 06/15/2015] [Accepted: 07/06/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the longitudinal reproducibility and variations of cartilage T1ρ and T2 measurements using different coils, MR systems and sites. METHODS Single-Site study: Phantom data were collected monthly for up to 29 months on four GE 3T MR systems. Data from phantoms and human subjects were collected on two MR systems using the same model of coil; and were collected on one MR system using two models of coils. Multi-site study: Three participating sites used the same model of MR systems and coils, and identical imaging protocols. Phantom data were collected monthly. Human subjects were scanned and rescanned on the same day at each site. Two traveling human subjects were scanned at all three sites. RESULTS Single-Site Study: The phantom longitudinal RMS-CVs ranged from 1.8% to 2.7% for T1ρ and 1.8-2.8% for T2. Significant differences were found in T1ρ and T2 values using different MR systems and coils. Multi-Site Study: The phantom longitudinal RMS-CVs ranged from 1.3% to 2.6% for T1ρ and 1.2-2.7% for T2. Across three sites (n = 16), the in vivo scan-rescan RMS-CV was 3.1% and 4.0% for T1ρ and T2, respectively. Phantom T1ρ and T2 values were significantly different between three sites but highly correlated (R > 0.99). No significant difference was found in T1ρ and T2 values of traveling controls, with cross-site RMS-CV as 4.9% and 4.4% for T1ρ and T2, respectively. CONCLUSION With careful quality control and cross-calibration, quantitative MRI can be readily applied in multi-site studies and clinical trials for evaluating cartilage degeneration.
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Affiliation(s)
- Xiaojuan Li
- University of California, San Francisco, CA, USA
| | | | - Deepak Kumar
- University of California, San Francisco, CA, USA
| | | | - Cory Wyatt
- University of California, San Francisco, CA, USA
| | | | - Keiko Amano
- University of California, San Francisco, CA, USA
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Wáng YXJ, Zhang Q, Li X, Chen W, Ahuja A, Yuan J. T1ρ magnetic resonance: basic physics principles and applications in knee and intervertebral disc imaging. Quant Imaging Med Surg 2015; 5:858-85. [PMID: 26807369 PMCID: PMC4700236 DOI: 10.3978/j.issn.2223-4292.2015.12.06] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 12/06/2015] [Indexed: 12/15/2022]
Abstract
T1ρ relaxation time provides a new contrast mechanism that differs from T1- and T2-weighted contrast, and is useful to study low-frequency motional processes and chemical exchange in biological tissues. T1ρ imaging can be performed in the forms of T1ρ-weighted image, T1ρ mapping and T1ρ dispersion. T1ρ imaging, particularly at low spin-lock frequency, is sensitive to B0 and B1 inhomogeneity. Various composite spin-lock pulses have been proposed to alleviate the influence of field inhomogeneity so as to reduce the banding-like spin-lock artifacts. T1ρ imaging could be specific absorption rate (SAR) intensive and time consuming. Efforts to address these issues and speed-up data acquisition are being explored to facilitate wider clinical applications. This paper reviews the T1ρ imaging's basic physic principles, as well as its application for cartilage imaging and intervertebral disc imaging. Compared to more established T2 relaxation time, it has been shown that T1ρ provides more sensitive detection of proteoglycan (PG) loss at early stages of cartilage degeneration. T1ρ has also been shown to provide more sensitive evaluation of annulus fibrosis (AF) degeneration of the discs.
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YU A, Heilmeier U, Kretzschmar M, Joseph G, Liu F, Liebl H, McCulloch C, Nevitt M, Lane NE, Link T. Racial differences in biochemical knee cartilage composition between African-American and Caucasian-American women with 3 T MR-based T2 relaxation time measurements--data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2015; 23:1595-604. [PMID: 25937026 PMCID: PMC4646660 DOI: 10.1016/j.joca.2015.04.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 03/09/2015] [Accepted: 04/21/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine whether knee cartilage composition differs between African-American and Caucasian-American women at risk for Osteoarthritis (OA) using in vivo 3 T MRI T2 relaxation time measurements. METHODS Right knee MRI studies of 200 subjects (100 African-American women, and 100 closely matched Caucasian-American women) were selected from the Osteoarthritis Initiative (OAI). Knee cartilage was segmented in the patellar (PAT), medial and lateral femoral (MF/LF), and medial and lateral tibial compartments (MT/LT)). Mean T2 relaxation time values per compartment and per whole joint cartilage were generated and analyzed spatially via laminar and grey-level co-occurrence matrix (GLCM) texture methods. Presence and severity of cartilage lesions per compartment were graded using a modified WORMS grading. Statistical analysis employed paired t- and McNemar testing. RESULTS While African-American women and Caucasian-Americans had similar WORMS cartilage lesion scores (P = 0.970), African-Americans showed significantly lower mean T2 values (∼1 ms difference; ∼0.5SD) than Caucasian-Americans in the whole knee cartilage (P < 0.001), and in the subcompartments (LF: P = 0.001, MF: P < 0.001, LT: P = 0.019, MT: P = 0.001) and particularly in the superficial cartilage layer (whole cartilage: P < 0.001, LF: P < 0.001, MF: P < 0.001, LT: P = 0.003, MT: P < 0.001). T2 texture parameters were also significantly lower in the whole joint cartilage of African-Americans than in Caucasian-Americans (variance: P = 0.001; contrast: P = 0.018). In analyses limited to matched pairs with no cartilage lesions in a given compartment, T2 values remained significantly lower in African-Americans. CONCLUSION Using T2 relaxation time as a biomarker for the cartilage collagen network, our findings suggest racial differences in the biochemical knee cartilage composition between African-American and Caucasian-American women.
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Affiliation(s)
- A. YU
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA,Department of Radiology, Beijing Jishuitan Hospital, 4th Medical College of Peking University, Beijing China
| | - U. Heilmeier
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - M. Kretzschmar
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - G.B. Joseph
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
| | - F. Liu
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - H. Liebl
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA,Institut für diagnostische und interventionelle Radiologie, Technische Universitaet Muenchen, Munich, Germany
| | - C.E. McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - M.C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA USA
| | - Nancy E. Lane
- Center for Healthy Aging, University of California Davis, Davis, CA USA
| | - T.M. Link
- Musculoskeletal and Quantitative Imaging Research Group, Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, CA USA
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Bittersohl B, Hosalkar HS, Hesper T, Tiderius CJ, Zilkens C, Krauspe R. Advanced Imaging in Femoroacetabular Impingement: Current State and Future Prospects. Front Surg 2015; 2:34. [PMID: 26258129 PMCID: PMC4513289 DOI: 10.3389/fsurg.2015.00034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 07/10/2015] [Indexed: 11/13/2022] Open
Abstract
Symptomatic femoroacetabular impingement (FAI) is now a known precursor of early osteoarthritis (OA) of the hip. In terms of clinical intervention, the decision between joint preservation and joint replacement hinges on the severity of articular cartilage degeneration. The exact threshold during the course of disease progression when the cartilage damage is irreparable remains elusive. The intention behind radiographic imaging is to accurately identify the morphology of osseous structural abnormalities and to accurately characterize the chondrolabral damage as much as possible. However, both plain radiographs and computed tomography (CT) are insensitive for articular cartilage anatomy and pathology. Advanced magnetic resonance imaging (MRI) techniques include magnetic resonance arthrography and biochemically sensitive techniques of delayed gadolinium-enhanced MRI of cartilage (dGEMRIC), T1rho (T1ρ), T2/T2* mapping, and several others. The diagnostic performance of these techniques to evaluate cartilage degeneration could improve the ability to predict an individual patient-specific outcome with non-surgical and surgical care. This review discusses the facts and current applications of biochemical MRI for hip joint cartilage assessment covering the roles of dGEMRIC, T2/T2*, and T1ρ mapping. The basics of each technique and their specific role in FAI assessment are outlined. Current limitations and potential pitfalls as well as future directions of biochemical imaging are also outlined.
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Affiliation(s)
- Bernd Bittersohl
- Department of Orthopedics, Medical Faculty, University Düsseldorf , Düsseldorf , Germany
| | - Harish S Hosalkar
- Center for Hip Preservation and Children's Orthopedics , San Diego, CA , USA
| | - Tobias Hesper
- Department of Orthopedics, Medical Faculty, University Düsseldorf , Düsseldorf , Germany
| | | | - Christoph Zilkens
- Department of Orthopedics, Medical Faculty, University Düsseldorf , Düsseldorf , Germany
| | - Rüdiger Krauspe
- Department of Orthopedics, Medical Faculty, University Düsseldorf , Düsseldorf , Germany
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Abstract
Excellent morphological imaging of cartilage is now possible and allows the detection of subtle cartilage pathologies. Besides the standard 2D sequences, a multitude of 3D sequences are available for high-resolution cartilage imaging. The first part therefore deals with modern possibilities of morphological imaging. The second part deals with functional cartilage imaging with which it is possible to detect changes in cartilage composition and thus early osteoarthritis as well as to monitor biochemical changes after therapeutic interventions. Validated techniques such as delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T2 mapping as well the latest techniques, such as the glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) technique will be discussed.
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47
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Siversson C, Akhondi-Asl A, Bixby S, Kim YJ, Warfield SK. Three-dimensional hip cartilage quality assessment of morphology and dGEMRIC by planar maps and automated segmentation. Osteoarthritis Cartilage 2014; 22:1511-5. [PMID: 25278060 PMCID: PMC4404159 DOI: 10.1016/j.joca.2014.08.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 08/11/2014] [Accepted: 08/24/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The quantitative interpretation of hip cartilage magnetic resonance imaging (MRI) has been limited by the difficulty of identifying and delineating the cartilage in a three-dimensional (3D) dataset, thereby reducing its routine usage. In this paper a solution is suggested by unfolding the cartilage to planar two-dimensional (2D) maps on which both morphology and biochemical degeneration patterns can be investigated across the entire hip joint. DESIGN Morphological TrueFISP and biochemical delayed gadolinium enhanced MRI of cartilage (dGEMRIC) hip images were acquired isotropically for 15 symptomatic subjects with mild or no radiographic osteoarthritis (OA). A multi-template based label fusion technique was used to automatically segment the cartilage tissue, followed by a geometric projection algorithm to generate the planar maps. The segmentation performance was investigated through a leave-one-out study, for two different fusion methods and as a function of the number of utilized templates. RESULTS For each of the generated planar maps, various patterns could be seen, indicating areas of healthy and degenerated cartilage. Dice coefficients for cartilage segmentation varied from 0.76 with four templates to 0.82 with 14 templates. Regional analysis suggests even higher segmentation performance in the superior half of the cartilage. CONCLUSIONS The proposed technique is the first of its kind to provide planar maps that enable straightforward quantitative assessment of hip cartilage morphology and dGEMRIC values. This technique may have important clinical applications for patient selection for hip preservation surgery, as well as for epidemiological studies of cartilage degeneration patterns. It is also shown that 10-15 templates are sufficient for accurate segmentation in this application.
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Affiliation(s)
- Carl Siversson
- Computational Radiology Laboratory, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States,Department of Medical Radiation Physics, Lund University, Malmö, Sweden
| | - Alireza Akhondi-Asl
- Computational Radiology Laboratory, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Sarah Bixby
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Young-Jo Kim
- Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Simon K. Warfield
- Computational Radiology Laboratory, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
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Riley GM, McWalter EJ, Stevens KJ, Safran MR, Lattanzi R, Gold GE. MRI of the hip for the evaluation of femoroacetabular impingement; past, present, and future. J Magn Reson Imaging 2014; 41:558-72. [PMID: 25155435 DOI: 10.1002/jmri.24725] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 07/21/2014] [Indexed: 11/07/2022] Open
Abstract
The concept of femoroacetabular impingement (FAI) has, in a relatively short time, come to the forefront of orthopedic imaging. In just a few short years MRI findings that were in the past ascribed to degenerative change, normal variation, or other pathologies must now be described and included in radiology reports, as they have been shown, or are suspected to be related to, FAI. Crucial questions have come up in this time, including: what is the relationship of bony morphology to subsequent cartilage and labral damage, and most importantly, how is this morphology related to the development of osteoarthritis? In this review, we attempt to place a historical perspective on the controversy, provide guidelines for interpretation of MRI examinations of patients with suspected FAI, and offer a glimpse into the future of MRI of this complex condition.
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Affiliation(s)
- Geoffrey M Riley
- Department of Radiology, Stanford University, Stanford, California, USA
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Csapo R, Malis V, Sinha U, Du J, Sinha S. Age-associated differences in triceps surae muscle composition and strength - an MRI-based cross-sectional comparison of contractile, adipose and connective tissue. BMC Musculoskelet Disord 2014; 15:209. [PMID: 24939372 PMCID: PMC4072482 DOI: 10.1186/1471-2474-15-209] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 06/12/2014] [Indexed: 11/25/2022] Open
Abstract
Background In human skeletal muscles, the aging process causes a decrease of contractile and a concomitant increase of intramuscular adipose (IMAT) and connective (IMCT) tissues. The accumulation of non-contractile tissues may contribute to the significant loss of intrinsic muscle strength typically observed at older age but their in vivo quantification is challenging. The purpose of this study was to establish MR imaging-based methods to quantify the relative amounts of IMCT, IMAT and contractile tissues in young and older human cohorts, and investigate their roles in determining age-associated changes in skeletal muscle strength. Methods Five young (31.6 ± 7.0 yrs) and five older (83.4 ± 3.2 yrs) Japanese women were subject to a detailed MR imaging protocol, including Fast Gradient Echo, Quantitative Fat/Water (IDEAL) and Ultra-short Echo Time (UTE) sequences, to determine contractile muscle tissue and IMAT within the entire Triceps Surae complex, and IMCT within both heads of the Gastrocnemius muscle. Specific force was calculated as the ratio of isometric plantarflexor force and the physiological cross-sectional area of the Triceps Surae complex. Results In the older cohort, total Triceps Surae volume was smaller by 17.5%, while the relative amounts of Triceps Surae IMAT and Gastrocnemius IMCT were larger by 55.1% and 48.9%, respectively. Differences of 38.6% and 42.1% in plantarflexor force and specific force were observed. After subtraction of IMAT and IMCT from total muscle volume, differences in intrinsic strength decreased to 29.6%. Conclusions Our data establishes that aging causes significant changes in skeletal muscle composition, with marked increases in non-contractile tissues. Such quantification of the remodeling process is likely to be of functional and clinical importance in elucidating the causes of the disproportionate age-associated decrease of force compared to that of muscle volume.
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Affiliation(s)
| | | | | | | | - Shantanu Sinha
- Department of Radiology, University of California, San Diego, CA, USA.
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50
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Schmid-Schwap M, Bristela M, Pittschieler E, Skolka A, Szomolanyi P, Weber M, Piehslinger E, Trattnig S. Biochemical analysis of the articular disc of the temporomandibular joint with magnetic resonance T2 mapping: a feasibility study. Clin Oral Investig 2013; 18:1865-71. [PMID: 24306680 DOI: 10.1007/s00784-013-1154-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Symptoms of temporomandibular joint (TMJ) dysfunction can seriously compromise patients' quality of life. The aim of our study was to use magnetic resonance imaging (MRI) T2 mapping of the articular disc to determine whether T2 mapping of the TMJ disc is feasible in routine clinical imaging and to assess the normal T2 relaxation time distribution within the TMJ. METHODS Included were ten asymptomatic volunteers without pain, any mouth-opening limitations, or any clicking phenomena. MR imaging was performed on a 3-T MR scanner using a flexible, dedicated, eight-channel multielement coil. T2 mapping was performed in the oblique sagittal plane. The regions of interest (ROIs) for the T2 relaxation time maps of the disc were selected manually. RESULTS The mean values for ROIs ranged between 22.4 and 28.8 ms, and the mean for all ROIs was 26.0 ± 5.0 ms. Intraclass correlation (ICC) for interobserver variability was 0.698, and ICC for intraobserver variability was 0.861. There was no statistically significant difference between raters (p = 0.091) or sides (p = 0.810). CONCLUSION The T2 mapping technique enables ultrastructural analysis of the composition of TMJ disc. This biochemical technique is feasible in vivo, as shown in our study, when a high-field (3 T) MR and a dedicated TMJ coil are used. CLINICAL RELEVANCE T2 mapping as a biochemical technique, together with morphological MRI, may help to gain more insights into the physiology and into the pathophysiology of the articular disc in the TMJ noninvasively and in vivo.
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Affiliation(s)
- Martina Schmid-Schwap
- Department of Prosthodontics, Bernhard Gottlieb University of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria,
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