1
|
Miyazaki M, Malis V, Yamamoto A, Kungsamutr J, McEvoy LK, McDonald MA, Bae WC. Physical Exercise Alters Egress Pathways for Intrinsic CSF Outflow: An Investigation Performed with Spin-labeling MR Imaging. Magn Reson Med Sci 2024; 23:171-183. [PMID: 36908171 PMCID: PMC11024710 DOI: 10.2463/mrms.mp.2023-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/03/2023] [Indexed: 03/13/2023] Open
Abstract
PURPOSE Cerebrospinal fluid (CSF) clearance is essential for maintaining a healthy brain and cognition by removal of metabolic waste from the central nervous system. Physical exercise has been shown to improve human health; however, the effect of physical exercise on intrinsic CSF outflow in humans remains unexplored. The purpose of this study was to investigate intrinsic CSF outflow pathways and quantitative metrics of healthy individuals with active and sedentary lifestyles. In addition, the effect of exercise was investigated among the sedentary subjects before and after 3 weeks of physical activity. METHODS This study was performed on 18 healthy adults with informed consent, using a clinical 3-Tesla MRI scanner. We classified participants into two groups based on reported time spent sitting per day (active group: < 7 hours sitting per day and sedentary group: ≥ 7 hours sitting per day). To elucidate the effect of exercise, sedentary individuals increased their activity to 3.5 hours for 3 weeks. RESULTS We show that there are two intrinsic CSF egress pathways of the dura mater and lower parasagittal dura (PSD). The adults with an active lifestyle had greater intrinsic CSF outflow metrics than adults with a more sedentary lifestyle. However, after increased physical activity, the sedentary group showed improved CSF outflow metrics. This improvement was particularly notable at the lower PSD, where outflow metrics were highest among the active group. CONCLUSION Our findings describe the relationship between physical activity and intrinsic CSF outflow and show a potential selective outflow pathway with increasing physical activity in the lower PSD pathway, potentially from the perivascular space or cortical venous subpial space.
Collapse
Affiliation(s)
- Mitsue Miyazaki
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Vadim Malis
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Asako Yamamoto
- Department of Radiology, Teikyo University, Tokyo, Japan
| | - Jirach Kungsamutr
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Linda K. McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Marin A. McDonald
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Won C Bae
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, Veterans Affairs Healthcare System, La Jolla, CA, USA
| |
Collapse
|
2
|
Malis V, Bae WC, Yamamoto A, Kassai Y, McDonald MA, Miyazaki M. Aliphatic and Olefinic Fat Suppression in the Orbit Using Polarity-altered Spectral and Spatial Selective Acquisition (PASTA) with Opposed Phase. Magn Reson Med Sci 2024; 23:193-203. [PMID: 36948628 PMCID: PMC11024719 DOI: 10.2463/mrms.mp.2022-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/12/2023] [Indexed: 03/24/2023] Open
Abstract
PURPOSE Fatty acid composition of the orbit makes it challenging to achieve complete fat suppression during orbit MR imaging. Implementation of a fat suppression technique capable of suppressing signals from saturated (aliphatic) and unsaturated (olefinic or protons at double-bonded carbon sites) fat would improve the visualization of an optical nerve. Furthermore, the ability to semi-quantify the fractions of aliphatic and olefinic fat may potentially provide valuable information in assessing orbit pathology. METHODS A phantom study was conducted on various oil samples on a clinical 3 Tesla scanner. The imaging protocol included three 2D fast spin echo (FSE) sequences: in-phase, polarity-altered spectral and spatial selective acquisition (PASTA), and a combination of PASTA with opposed phase in olefinic and aliphatic chemical shift. The results were validated against high-resolution 11.7T NMR and compared with images acquired with spectral attenuated inversion recovery (SPAIR) and chemical shift selective (CHESS) fat suppression techniques. In-vivo data were acquired on eight healthy subjects and were compared with the prior histological studies. RESULTS PASTA with opposed phase achieved complete suppression of fat signals in the orbits and provided images of well-delineated optical nerves and muscles in all subjects. The olefinic fat fraction in the olive, walnut, and fish oil phantoms at 3T was found to be 5.0%, 11.2%, and 12.8%, respectively, whereas 11.7T NMR provides the following olefinic fat fractions: 6.0% for olive, 11.5% for walnut, and 12.6% for fish oils. For the in-vivo study, on average, olefinic fat accounted for 9.9% ± 3.8% of total fat while the aliphatic fat fraction was 90.1% ± 3.8%, in the normal orbits. CONCLUSION We have introduced a new fat suppression technique using PASTA with opposed phase and applied it to human orbits. The purposed method achieves an excellent orbital fat suppression and the quantification of aliphatic and olefinic fat signals.
Collapse
Affiliation(s)
- Vadim Malis
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Won C. Bae
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
| | - Asako Yamamoto
- Department of Radiology, Teikyo University, Tokyo, Japan
| | - Yoshimori Kassai
- CT-MR Solution Planning Department, Canon Medical Systems Corp., Otawara, Tochigi, Japan
| | - Marin A McDonald
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Mitsue Miyazaki
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
3
|
Bae WC, Statum S, Masuda K, Chung CB. T1rho MR properties of human patellar cartilage: correlation with indentation stiffness and biochemical contents. Skeletal Radiol 2024; 53:649-656. [PMID: 37740079 DOI: 10.1007/s00256-023-04458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Cartilage degeneration involves structural, compositional, and biomechanical alterations that may be detected non-invasively using quantitative MRI. The goal of this study was to determine if topographical variation in T1rho values correlates with indentation stiffness and biochemical contents of human patellar cartilage. DESIGN Cadaveric patellae from unilateral knees of 5 donors with moderate degeneration were imaged at 3-Telsa with spiral chopped magnetization preparation T1rho sequence. Indentation testing was performed, followed by biochemical analyses to determine water and sulfated glycosaminoglycan contents. T1rho values were compared to indentation stiffness, using semi-circular regions of interest (ROIs) of varying sizes at each indentation site. ROIs matching the resected tissues were analyzed, and univariate and multivariate regression analyses were performed to compare T1rho values to biochemical contents. RESULTS Grossly, superficial degenerative change of the cartilage (i.e., roughened texture and erosion) corresponded with regions of high T1rho values. High T1rho values correlated with low indentation stiffness, and the strength of correlation varied slightly with the ROI size. Spatial variations in T1rho values correlated positively with that of the water content (R2 = 0.10, p < 0.05) and negatively with the variations in the GAG content (R2 = 0.13, p < 0.01). Multivariate correlation (R2 = 0.23, p < 0.01) was stronger than either of the univariate correlations. CONCLUSION These results demonstrate the sensitivity of T1rho values to spatially varying function and composition of cartilage and that the strength of correlation depends on the method of data analysis and consideration of multiple variables.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, University of California-San Diego, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA.
- VA San Diego Healthcare System, 3350 La Jolla Village Drive MC-114, San Diego, CA, 92161, USA.
| | - Sheronda Statum
- Department of Radiology, University of California-San Diego, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA
- VA San Diego Healthcare System, 3350 La Jolla Village Drive MC-114, San Diego, CA, 92161, USA
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr, La Jolla, CA, 92093-0863, USA
| | - Christine B Chung
- Department of Radiology, University of California-San Diego, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA
- VA San Diego Healthcare System, 3350 La Jolla Village Drive MC-114, San Diego, CA, 92161, USA
| |
Collapse
|
4
|
Mautner K, Gottschalk M, Boden SD, Akard A, Bae WC, Black L, Boggess B, Chatterjee P, Chung CB, Easley KA, Gibson G, Hackel J, Jensen K, Kippner L, Kurtenbach C, Kurtzberg J, Mason RA, Noonan B, Roy K, Valentine V, Yeago C, Drissi H. Author Correction: Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med 2024; 30:905. [PMID: 38135824 PMCID: PMC10957470 DOI: 10.1038/s41591-023-02776-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Affiliation(s)
- Ken Mautner
- Department of Orthopaedics, Emory University, Atlanta, GA, USA.
| | | | - Scott D Boden
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - Alison Akard
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - Won C Bae
- Department of Radiology, University of California, Davis, La Jolla, CA, USA
| | | | | | - Paramita Chatterjee
- Marcus Center for Therapeutic Cell Characterization and Manufacturing, Georgia Institute of Technology, Atlanta, GA, USA
| | - Christine B Chung
- Department of Radiology, University of California, Davis, La Jolla, CA, USA
| | - Kirk A Easley
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Greg Gibson
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA, USA
| | | | | | - Linda Kippner
- Marcus Center for Therapeutic Cell Characterization and Manufacturing, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Joanne Kurtzberg
- Marcus Center for Therapeutic Cures, Duke University, Durham, NC, USA
| | - R Amadeus Mason
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | | | - Krishnendu Roy
- Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | | | - Carolyn Yeago
- Marcus Center for Therapeutic Cell Characterization and Manufacturing, Georgia Institute of Technology, Atlanta, GA, USA
| | - Hicham Drissi
- Department of Orthopaedics, Emory University, Atlanta, GA, USA.
| |
Collapse
|
5
|
Malis V, Bae WC, Yamamoto A, McEvoy LK, McDonald MA, Miyazaki M. Age-related Decline of Intrinsic Cerebrospinal Fluid Outflow in Healthy Humans Detected with Non-contrast Spin-labeling MR Imaging. Magn Reson Med Sci 2024; 23:66-79. [PMID: 36529500 PMCID: PMC10838716 DOI: 10.2463/mrms.mp.2022-0117] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/24/2022] [Indexed: 01/05/2024] Open
Abstract
PURPOSE Clearance of cerebrospinal fluid (CSF) is important for the removal of toxins from the brain, with implications for neurodegenerative diseases. Imaging evaluation of CSF outflow in humans has been limited, relying on venous or invasive intrathecal injections of contrast agents. The objective of this study was to introduce a novel spin-labeling MRI technique to detect and quantify the movement of endogenously tagged CSF, and then apply it to evaluate CSF outflow in normal humans of varying ages. METHODS This study was performed on a clinical 3-Tesla MRI scanner in 16 healthy subjects with an age range of 19-71 years with informed consent. Our spin-labeling MRI technique applies a tag pulse on the brain hemisphere, and images the outflow of the tagged CSF into the superior sagittal sinus (SSS). We obtained 3D images in real time, which was analyzed to determine tagged-signal changes in different regions of the meninges involved in CSF outflow. Additionally, the signal changes over time were fit to a signal curve to determine quantitative flow metrics. These were correlated against subject age to determine aging effects. RESULTS We observed the signal of the tagged CSF moving from the dura mater and parasagittal dura, and finally draining into the SSS. In addition, we observed a possibility of another pathway which is seen in some young subjects. Furthermore, quantitative CSF outflow metrics were shown to decrease significantly with age. CONCLUSION We demonstrate a novel non-invasive MRI technique identifying two intrinsic CSF clearance pathways, and observe an age-related decline of CSF flow metrics in healthy subjects. Our work provides a new opportunity to better understand the relationships of these CSF clearance pathways during the aging process, which may ultimately provide insight into the age-related prevalence of neurodegenerative diseases.
Collapse
Affiliation(s)
- Vadim Malis
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Won C. Bae
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, Veterans Affairs Healthcare System, La Jolla, CA, USA
| | - Asako Yamamoto
- Department of Radiology, Teikyo University, Tokyo, Japan
| | - Linda K. McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Marin A. McDonald
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Mitsue Miyazaki
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
6
|
Mautner K, Gottschalk M, Boden SD, Akard A, Bae WC, Black L, Boggess B, Chatterjee P, Chung CB, Easley KA, Gibson G, Hackel J, Jensen K, Kippner L, Kurtenbach C, Kurtzberg J, Mason RA, Noonan B, Roy K, Valentine V, Yeago C, Drissi H. Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med 2023; 29:3120-3126. [PMID: 37919438 PMCID: PMC10719084 DOI: 10.1038/s41591-023-02632-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/05/2023] [Indexed: 11/04/2023]
Abstract
Various types of cellular injection have become a popular and costly treatment option for patients with knee osteoarthritis despite a paucity of literature establishing relative efficacy to each other or corticosteroid injections. Here we aimed to identify the safety and efficacy of cell injections from autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction and allogeneic human umbilical cord tissue-derived mesenchymal stromal cells, in comparison to corticosteroid injection (CSI). The study was a phase 2/3, four-arm parallel, multicenter, single-blind, randomized, controlled clinical trial with 480 patients with a diagnosis of knee osteoarthritis (Kellgren-Lawrence II-IV). Participants were randomized to the three different arms with a 3:1 distribution. Arm 1: autologous bone marrow aspirate concentrate (n = 120), CSI (n = 40); arm 2: umbilical cord tissue-derived mesenchymal stromal cells (n = 120), CSI (n = 40); arm 3: stromal vascular fraction (n = 120), CSI (n = 40). The co-primary endpoints were the visual analog scale pain score and Knee injury and Osteoarthritis Outcome Score pain score at 12 months versus baseline. Analyses of our primary endpoints, with 440 patients, revealed that at 1 year post injection, none of the three orthobiologic injections was superior to another, or to the CSI control. In addition, none of the four groups showed a significant change in magnetic resonance imaging osteoarthritis score compared to baseline. No procedure-related serious adverse events were reported during the study period. In summary, this study shows that at 1 year post injection, there was no superior orthobiologic as compared to CSI for knee osteoarthritis. ClinicalTrials.gov Identifier: NCT03818737.
Collapse
Affiliation(s)
- Ken Mautner
- Department of Orthopaedics, Emory University, Atlanta, GA, USA.
| | | | - Scott D Boden
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - Alison Akard
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - Won C Bae
- Department of Radiology, University of California, Davis, La Jolla, CA, USA
| | | | | | - Paramita Chatterjee
- Marcus Center for Therapeutic Cell Characterization and Manufacturing, Georgia Institute of Technology, Atlanta, GA, USA
| | - Christine B Chung
- Department of Radiology, University of California, Davis, La Jolla, CA, USA
| | - Kirk A Easley
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA
| | - Greg Gibson
- Center for Integrative Genomics, Georgia Institute of Technology, Atlanta, GA, USA
| | | | | | - Linda Kippner
- Marcus Center for Therapeutic Cell Characterization and Manufacturing, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Joanne Kurtzberg
- Marcus Center for Therapeutic Cures, Duke University, Durham, NC, USA
| | - R Amadeus Mason
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | | | - Krishnendu Roy
- Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | | | - Carolyn Yeago
- Marcus Center for Therapeutic Cell Characterization and Manufacturing, Georgia Institute of Technology, Atlanta, GA, USA
| | - Hicham Drissi
- Department of Orthopaedics, Emory University, Atlanta, GA, USA.
| |
Collapse
|
7
|
Malis V, Kassai Y, Vucevic D, Bae WC, Ohno Y, Yen A, Miyazaki M. Lung T 2 * mapping using 3D ultrashort TE with tight intervals δTE. Magn Reson Med 2023; 90:2001-2010. [PMID: 37288577 PMCID: PMC10545378 DOI: 10.1002/mrm.29756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
PURPOSE To develop 3D ultrashort-TE (UTE) sequences with tight TE intervals (δTE), allowing for accurateT 2 * $$ {\mathrm{T}}_2^{\ast } $$ mapping of lungs under free breathing. METHODS We have implemented a four-echo UTE sequence with δTE (< 0.5 ms). A Monte-Carlo simulation was performed to identify an optimal number of echoes that would result in a significant improvement in the accuracy of theT 2 * $$ {\mathrm{T}}_2^{\ast } $$ fit within an acceptable scan time. A validation study was conducted on a phantom with known shortT 2 * $$ {\mathrm{T}}_2^{\ast } $$ values (< 5 ms). The scanning protocol included a combination of a standard multi-echo UTE with six echoes (2.2-ms intervals) and a new four-echo UTE (TE < 2 ms) with tight TE intervals δTE. The human imaging was performed at 3 T on 6 adult volunteers.T 2 * $$ {\mathrm{T}}_2^{\ast } $$ mapping was performed with mono-exponential and bi-exponential models. RESULTS The simulation for the proposed 10-echo acquisition predicted over 2-fold improvement in the accuracy of estimating the shortT 2 * $$ {\mathrm{T}}_2^{\ast } $$ compared with the regular six-echo acquisition. In the phantom study, theT 2 * $$ {\mathrm{T}}_2^{\ast } $$ was measured up to three times more accurately compared with standard six-echo UTE. In human lungs,T 2 * $$ {\mathrm{T}}_2^{\ast } $$ maps were successfully obtained from 10 echoes, yielding average valuesT 2 * $$ {\mathrm{T}}_2^{\ast } $$ = 1.62 ± 0.48 ms for mono-exponential andT 2 s * $$ {\mathrm{T}}_{2s}^{\ast } $$ = 1.00 ± 0.53 ms for bi-exponential models. CONCLUSION A UTE sequence using δTE was implemented and validated on shortT 2 * $$ {\mathrm{T}}_2^{\ast } $$ phantoms. The sequence was successfully applied for lung imaging; the bi-exponential signal model fit for human lung imaging may provide valuable insights into the diseased human lungs.
Collapse
Affiliation(s)
- Vadim Malis
- Department of Radiology, University of California-San Diego, La Jolla, CA
| | | | - Diana Vucevic
- Department of Radiology, University of California-San Diego, La Jolla, CA
| | - Won C. Bae
- Department of Radiology, University of California-San Diego, La Jolla, CA
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA
| | - Yoshiharu Ohno
- Department of Radiology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
- Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Andrew Yen
- Department of Radiology, University of California-San Diego, La Jolla, CA
| | - Mitsue Miyazaki
- Department of Radiology, University of California-San Diego, La Jolla, CA
| |
Collapse
|
8
|
Bae WC, Malis V, Kassai Y, Miyazaki M. 3D T1rho sequences with FASE, UTE, and MAPSS acquisitions for knee evaluation. Jpn J Radiol 2023; 41:1308-1315. [PMID: 37247122 DOI: 10.1007/s11604-023-01453-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/16/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE For biochemical evaluation of soft tissues of the knee, T1rho magnetic resonance imaging (MRI) has been proposed. Purpose of this study was to compare three T1rho sequences based on fast advanced spin echo (FASE), ultrashort echo time (UTE), and magnetization-prepared angle-modulated partitioned k-space spoiled gradient echo snapshots (MAPSS) acquisitions for the knee evaluation. MATERIALS AND METHODS We developed two T1rho sequences using 3D FASE or 3D radial UTE acquisitions. 3D MAPSS T1rho was provided by the manufacturer. Agarose phantoms with varying concentrations were imaged. Additionally, bilateral knees of asymptomatic subjects were imaged sagittally. T1rho values of the phantoms and 4 regions of interest (ROI) of the knees (i.e., anterior and posterior meniscus, femoral and tibial cartilage) were determined. RESULTS In phantoms, all T1rho values monotonically decreased with increasing agarose concentration. 3D MAPSS T1rho values of 51, 34, and 38 ms were found for 2, 3, and 4% agarose, respectively, similar to published values on another platform. In the knee, the raw images were detailed with good contrast. Cartilage and meniscus T1rho values varied with the pulse sequence, being the lowest in the 3D UTE T1rho sequence. Comparing different ROIs, menisci generally had lower T1rho values compared to cartilage, as expected in healthy knees. CONCLUSION We have successfully developed and implemented the new T1rho sequences and validated them using agarose phantoms and volunteer knees. All sequences were optimized to be clinically feasible (~ 5 min or less) and yielded satisfactory image quality and T1rho values consistent with the literature.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, University of California-San Diego, 9427 Health Sciences Drive, La Jolla, CA, USA.
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA.
| | - Vadim Malis
- Department of Radiology, University of California-San Diego, 9427 Health Sciences Drive, La Jolla, CA, USA
| | | | - Mitsue Miyazaki
- Department of Radiology, University of California-San Diego, 9427 Health Sciences Drive, La Jolla, CA, USA
| |
Collapse
|
9
|
Achar S, Hwang D, Finkenstaedt T, Malis V, Bae WC. Deep-Learning-Aided Evaluation of Spondylolysis Imaged with Ultrashort Echo Time Magnetic Resonance Imaging. Sensors (Basel) 2023; 23:8001. [PMID: 37766055 PMCID: PMC10538057 DOI: 10.3390/s23188001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/31/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
Isthmic spondylolysis results in fracture of pars interarticularis of the lumbar spine, found in as many as half of adolescent athletes with persistent low back pain. While computed tomography (CT) is the gold standard for the diagnosis of spondylolysis, the use of ionizing radiation near reproductive organs in young subjects is undesirable. While magnetic resonance imaging (MRI) is preferable, it has lowered sensitivity for detecting the condition. Recently, it has been shown that ultrashort echo time (UTE) MRI can provide markedly improved bone contrast compared to conventional MRI. To take UTE MRI further, we developed supervised deep learning tools to generate (1) CT-like images and (2) saliency maps of fracture probability from UTE MRI, using ex vivo preparation of cadaveric spines. We further compared quantitative metrics of the contrast-to-noise ratio (CNR), mean squared error (MSE), peak signal-to-noise ratio (PSNR), and structural similarity index (SSIM) between UTE MRI (inverted to make the appearance similar to CT) and CT and between CT-like images and CT. Qualitative results demonstrated the feasibility of successfully generating CT-like images from UTE MRI to provide easier interpretability for bone fractures thanks to improved image contrast and CNR. Quantitatively, the mean CNR of bone against defect-filled tissue was 35, 97, and 146 for UTE MRI, CT-like, and CT images, respectively, being significantly higher for CT-like than UTE MRI images. For the image similarity metrics using the CT image as the reference, CT-like images provided a significantly lower mean MSE (0.038 vs. 0.0528), higher mean PSNR (28.6 vs. 16.5), and higher SSIM (0.73 vs. 0.68) compared to UTE MRI images. Additionally, the saliency maps enabled quick detection of the location with probable pars fracture by providing visual cues to the reader. This proof-of-concept study is limited to the data from ex vivo samples, and additional work in human subjects with spondylolysis would be necessary to refine the models for clinical use. Nonetheless, this study shows that the utilization of UTE MRI and deep learning tools could be highly useful for the evaluation of isthmic spondylolysis.
Collapse
Affiliation(s)
- Suraj Achar
- Department of Family Medicine, University of California-San Diego, La Jolla, CA 92093, USA
| | - Dosik Hwang
- Department of Electrical and Electronic Engineering, Yonsei University, Seoul 03722, Republic of Korea
- Center for Healthcare Robotics, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea
| | - Tim Finkenstaedt
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University Zurich, 8091 Zurich, Switzerland
| | - Vadim Malis
- Department of Radiology, University of California-San Diego, La Jolla, CA 92093, USA
| | - Won C. Bae
- Department of Radiology, University of California-San Diego, La Jolla, CA 92093, USA
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA 92161, USA
| |
Collapse
|
10
|
Finkenstaedt T, Siriwananrangsun P, Masuda K, Bydder GM, Chen KC, Bae WC. Ultrashort time-to-echo MR morphology of cartilaginous endplate correlates with disc degeneration in the lumbar spine. Eur Spine J 2023; 32:2358-2367. [PMID: 37195362 DOI: 10.1007/s00586-023-07739-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/15/2023] [Accepted: 04/22/2023] [Indexed: 05/18/2023]
Abstract
PURPOSE Using ultrashort echo time (UTE) MRI, we determined prevalence of abnormal cartilaginous endplate (CEP), and the relationship between CEP and disc degeneration in human lumbar spines. MATERIALS AND METHODS Lumbar spines from 71 cadavers (age 14-74 years) were imaged at 3 T using sagittal UTE and spin echo T2 map sequences. On UTE images, CEP morphology was defined as "normal" with linear high signal intensity or "abnormal" with focal signal loss and/or irregularity. On spin echo images, disc grade and T2 values of the nucleus pulposus (NP) and annulus fibrosus (AF) were determined. 547 CEPs and 284 discs were analysed. Effects of age, sex, and level on CEP morphology, disc grade, and T2 values were determined. Effects of CEP abnormality on disc grade, T2 of NP, and T2 of AF were also determined. RESULTS Overall prevalence of CEP abnormality was 33% and it tended to increase with older ages (p = 0.08) and at lower spinal levels of L5 than L2 or L3 (p = 0.001). Disc grades were higher and T2 values of the NP were lower in older spines (p < 0.001) and at lower disc level of L4-5 (p < 0.05). We found significant association between CEP and disc degeneration; discs adjacent to abnormal CEPs had high grades (p < 0.01) and lower T2 values of the NP (p < 0.05). CONCLUSION These results suggest that abnormal CEPs are frequently found, and it associates significantly with disc degeneration, suggesting an insight into pathoetiology of disc degeneration.
Collapse
Affiliation(s)
- Tim Finkenstaedt
- Department of Radiology, University of California, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Palanan Siriwananrangsun
- Department of Radiology, University of California, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA
- Department of Radiology, Siriraj Hospital, Bangkok, Thailand
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Graeme M Bydder
- Department of Radiology, University of California, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA
| | - Karen C Chen
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
| | - Won C Bae
- Department of Radiology, University of California, 9427 Health Sciences Drive, La Jolla, CA, 92093-0997, USA.
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA.
| |
Collapse
|
11
|
Bae WC. Advances and Shortfalls in MRI Evaluation of Osteoporosis. Radiology 2023; 307:e223144. [PMID: 36692406 PMCID: PMC10102620 DOI: 10.1148/radiol.223144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Won C. Bae
- From the Department of Radiology, University of California San Diego, 9427 Health Sciences Dr, La Jolla, CA 92093
| |
Collapse
|
12
|
Miyazaki M, Yamamoto A, Malis V, Statum S, Chung CB, Sozanski J, Bae WC. Time-Resolved Noncontrast Magnetic Resonance Perfusion Imaging of Paraspinal Muscles. J Magn Reson Imaging 2022; 56:1591-1599. [PMID: 35191562 PMCID: PMC9393201 DOI: 10.1002/jmri.28123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND While evaluation of blood perfusion in lumbar paraspinal muscles is of interest in low back pain, it has not been performed using noncontrast magnetic resonance (MR) techniques. PURPOSE To introduce a novel application of a time-resolved, noncontrast MR perfusion technique for paraspinal muscles and demonstrate effect of exercise on perfusion parameters. STUDY TYPE Longitudinal. SUBJECTS Six healthy subjects (27-48 years old, two females) and two subjects with acute low back pain (46 and 65 years old females, one with diabetes/obesity). FIELD STRENGTH/SEQUENCE 3-T, MR perfusion sequence. ASSESSMENT Lumbar spines of healthy subjects were imaged axially at L3 level with a tag-on and tag-off alternating inversion recovery arterial spin labeling technique that suppresses background signal and acquires signal increase ratio (SIR) from the in-flow blood at varying inversion times (TI) from 0.12 seconds to 3.5 seconds. SIR vs. TI data were fit to determine the perfusion metrics of peak height (PH), time to peak (TTP), mean transit time, apparent muscle blood volume (MBV), and apparent muscle blood flow (MBF) in iliocostal, longissimus, and multifidus. Imaging was repeated immediately after healthy subjects performed a 20-minute walk, to determine the effect of exercise. STATISTICAL TESTS Repeated measures analysis of variance. RESULTS SIR vs. TI data showed well-defined leading and trailing edges, with sharply increasing SIR to TI of approximately 500 msec subsiding quickly to near zero around TI of 1500 msec. After exercise, the mean SIR at every TI increased markedly, resulting in significantly higher PH, MBV, and MBF (each P < 0.001 and F > 28.9), and a lower TTP (P < 0.05, F = 4.5), regardless of the muscle. MBF increased 2- to 2.5-fold after exercise, similar to the expected increase in cardiac output, given the intensity of the exercise. DATA CONCLUSIONS Feasibility of an MR perfusion technique for muscle perfusion imaging was demonstrated, successfully detecting significantly increased perfusion after exercise. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.
Collapse
Affiliation(s)
- Mitsue Miyazaki
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
| | - Asako Yamamoto
- Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Vadim Malis
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
- Department of Radiology, VA San Diego Healthcare System, San Diego, California, USA
| | - Christine B. Chung
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
- Department of Radiology, VA San Diego Healthcare System, San Diego, California, USA
| | - Jesse Sozanski
- Department of Family Medicine, University of California, San Diego, La Jolla, California, USA
| | - Won C. Bae
- Department of Radiology, University of California, San Diego, La Jolla, California, USA
- Department of Radiology, VA San Diego Healthcare System, San Diego, California, USA
| |
Collapse
|
13
|
Forsythe B, Chahla J, Korrapati A, Lavoie-Gagne O, Forlenza E, Diaz CC, Chung CB, Bae WC, Bach BR, Cole B, Yanke AB, Verma NN. Bone Marrow Aspirate Concentrate Augmentation May Accelerate Allograft Ligamentization in Anterior Cruciate Ligament Reconstruction: A Double-Blinded Randomized Controlled Trial. Arthroscopy 2022; 38:2255-2264. [PMID: 35042007 DOI: 10.1016/j.arthro.2022.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the effect of bone marrow aspiration concentrate (BMAC) augmentation on clinical outcomes and magnetic resonance imaging (MRI) findings in anterior cruciate ligament (ACL) reconstruction (ACLR) with bone-patellar tendon-bone (BTB) allografts. METHODS A double-blinded, randomized controlled trial was conducted on 80 patients undergoing ACL reconstruction using BTB allografts. Patients were randomized to 2 groups: (1) bone marrow aspirate was collected from the iliac crest, concentrated, and approximately 2.5 mL was injected into the BTB allograft, or (2) a small sham incision was made at the iliac crest (control). MRI was performed at 3 months and 9 months postoperatively to determine the signal intensity ratio of the ACL graft. RESULTS Seventy-three patients were available for follow-up at 1-year postoperatively (36 BMAC, 37 control). International Knee Documentation Committee (IKDC) scores were significantly greater in the BMAC group versus the control at the 9-month postoperative period (81.6 ± 10.5 vs 74.6 ± 14.2, P = .048). There was no significant difference in the proportion of patients who met the minimal clinically important difference for IKDC between the BMAC and control groups at 9 months (89% vs 85%; P = .7). Three months postoperatively, signal intensity ratio of the inferior third of the ACL graft was significantly greater in the BMAC group versus the control group (3.2 ± 2.2 vs 2.1 ± 1.5; P = .02). CONCLUSIONS Patients who received BMAC augmentation of the BTB allograft during ACL reconstruction demonstrated greater signal intensity scores on MRI at 3 months, suggesting increased metabolic activity and remodeling, and potentially accelerated ligamentization. Additionally, patients in the BMAC group had greater patient-reported outcomes (IKDC) at 9 months postoperatively when compared with those who underwent a standard surgical procedure. There was no significant difference in the proportion of patients who met the minimal clinically important difference for IKDC between the BMAC and control groups at 9 months, suggesting limited clinical significance at this time point. LEVEL OF EVIDENCE I, randomized control trial.
Collapse
Affiliation(s)
- Brian Forsythe
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A..
| | - Jorge Chahla
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Avinaash Korrapati
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Ophelie Lavoie-Gagne
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, U.S.A
| | - Enrico Forlenza
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Connor C Diaz
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, California, U.S.A
| | - Won C Bae
- Department of Radiology, University of California, San Diego, California, U.S.A
| | - Bernard R Bach
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Brian Cole
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Adam B Yanke
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| | - Nikhil N Verma
- Department of Sports Medicine, Midwest Orthopaedics at Rush, Chicago, Illinois, U.S.A
| |
Collapse
|
14
|
Kim S, Jang H, Hong S, Hong YS, Bae WC, Kim S, Hwang D. Fat-saturated image generation from multi-contrast MRIs using generative adversarial networks with Bloch equation-based autoencoder regularization. Med Image Anal 2021; 73:102198. [PMID: 34403931 DOI: 10.1016/j.media.2021.102198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 07/18/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
Obtaining multiple series of magnetic resonance (MR) images with different contrasts is useful for accurate diagnosis of human spinal conditions. However, this can be time consuming and a burden on both the patient and the hospital. We propose a Bloch equation-based autoencoder regularization generative adversarial network (BlochGAN) to generate a fat saturation T2-weighted (T2 FS) image from T1-weighted (T1-w) and T2-weighted (T2-w) images of human spine. To achieve this, our approach was to utilize the relationship between the contrasts using Bloch equation since it is a fundamental principle of MR physics and serves as a physical basis of each contrasts. BlochGAN properly generated the target-contrast images using the autoencoder regularization based on the Bloch equation to identify the physical basis of the contrasts. BlochGAN consists of four sub-networks: an encoder, a decoder, a generator, and a discriminator. The encoder extracts features from the multi-contrast input images, and the generator creates target T2 FS images using the features extracted from the encoder. The discriminator assists network learning by providing adversarial loss, and the decoder reconstructs the input multi-contrast images and regularizes the learning process by providing reconstruction loss. The discriminator and the decoder are only used in the training process. Our results demonstrate that BlochGAN achieved quantitatively and qualitatively superior performance compared to conventional medical image synthesis methods in generating spine T2 FS images from T1-w, and T2-w images.
Collapse
Affiliation(s)
- Sewon Kim
- School of Electrical and Electronic Engineering, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hanbyol Jang
- School of Electrical and Electronic Engineering, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Seokjun Hong
- School of Electrical and Electronic Engineering, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Yeong Sang Hong
- Center for Clinical Imaging Data Science Center, Research Institute of Radiological Science, Department of Radiology, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; Department of Radiology, Gangnam Severance Hospital, 211, Eonju-ro, Gangnam-gu, Seoul 06273, Republic of Korea
| | - Won C Bae
- Department of Radiology, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161-0114, USA; Department of Radiology, University of California-San Diego, La Jolla, CA 92093-0997, USA
| | - Sungjun Kim
- Center for Clinical Imaging Data Science Center, Research Institute of Radiological Science, Department of Radiology, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; Department of Radiology, Gangnam Severance Hospital, 211, Eonju-ro, Gangnam-gu, Seoul 06273, Republic of Korea.
| | - Dosik Hwang
- School of Electrical and Electronic Engineering, Yonsei University, 50, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea; Center for Clinical Imaging Data Science Center, Research Institute of Radiological Science, Department of Radiology, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| |
Collapse
|
15
|
Bae WC, Tadros AS, Finkenstaedt T, Du J, Statum S, Chung CB. Quantitative magnetic resonance imaging of meniscal pathology ex vivo. Skeletal Radiol 2021; 50:2405-2414. [PMID: 33983499 PMCID: PMC8536602 DOI: 10.1007/s00256-021-03808-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/25/2021] [Accepted: 05/02/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the ability of conventional spin echo (SE) T2 and ultrashort echo time (UTE) T2* relaxation times to characterize pathology in cadaveric meniscus samples. MATERIALS AND METHODS From 10 human donors, 54 triangular (radially cut) meniscus samples were harvested. Meniscal pathology was classified as normal (n = 17), intrasubstance degenerated (n = 33), or torn (n = 4) using a modified arthroscopic grading system. Using a 3-T MR system, SE T2 and UTE T2* values of the menisci were determined, followed by histopathology. Effect of meniscal pathology on relaxation times and histology scores were determined, along with correlation between relaxation times and histology scores. RESULTS Mean ± standard deviation UTE T2* values for normal, degenerated, and torn menisci were 3.6 ± 1.3 ms, 7.4 ± 2.5 ms, and 9.8 ± 5.7 ms, respectively, being significantly higher in degenerated (p < 0.0001) and torn (p = 0.0002) menisci compared to that in normal. In contrast, the respective mean SE T2 values were 27.7 ± 9.5 ms, 25.9 ± 7.0 ms, and 35.7 ± 10.4 ms, without significant differences between groups (all p > 0.14). In terms of histology, we found significant group-wise differences (each p < 0.05) in fiber organization and inner-tip surface integrity sub-scores, as well as the total score. Finally, we found a significant weak correlation between UTE T2* and histology total score (p = 0.007, Rs2 = 0.19), unlike the correlation between SE T2 and histology (p = 0.09, Rs2 = 0.05). CONCLUSION UTE T2* values were found to distinguish normal from both degenerated and torn menisci and correlated significantly with histopathology.
Collapse
Affiliation(s)
- Won C. Bae
- Radiology Service, Veterans Affairs San Diego Healthcare System, MC-114, 3350 La Jolla Village Drive, San Diego, CA 92161 USA ,Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997 USA
| | - Anthony S. Tadros
- Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997 USA
| | - Tim Finkenstaedt
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jiang Du
- Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997 USA
| | - Sheronda Statum
- Radiology Service, Veterans Affairs San Diego Healthcare System, MC-114, 3350 La Jolla Village Drive, San Diego, CA 92161 USA ,Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997 USA
| | - Christine B. Chung
- Radiology Service, Veterans Affairs San Diego Healthcare System, MC-114, 3350 La Jolla Village Drive, San Diego, CA 92161 USA ,Department of Radiology, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997 USA
| |
Collapse
|
16
|
Bae WC. Editorial for "In Vivo Assessment of Age- and Loading Configuration-Related Changes in Multiscale Mechanical Behavior of the Human Proximal Femur Using MRI-Based Finite Element Analysis". J Magn Reson Imaging 2020; 53:913-914. [PMID: 33155743 DOI: 10.1002/jmri.27427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Won C Bae
- Department of Radiology, VA San Diego Healthcare System, San Diego, California, USA.,Department of Radiology, University of California-San Diego, La Jolla, California, USA
| |
Collapse
|
17
|
Finkenstaedt T, Siriwanarangsun P, Achar S, Carl M, Finkenstaedt S, Abeydeera N, Chung CB, Bae WC. Ultrashort Time-to-Echo Magnetic Resonance Imaging at 3 T for the Detection of Spondylolysis in Cadaveric Spines: Comparison With CT. Invest Radiol 2019; 54:32-38. [PMID: 30157099 DOI: 10.1097/rli.0000000000000506] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The objective of this study was to compare the diagnostic performance and confidence of conventional, optimized, and ultrashort time to echo (UTE) magnetic resonance (MR) protocols for detection of simulated lumbar spondylolysis in human cadavers. In addition, we sought to demonstrate the feasibility of the UTE technique in subjects with and without spondylolysis. MATERIALS AND METHODS Four human lumbar spine specimens with 46 individual pars interarticularis were randomly left intact (n = 26) or received experimental osteotomy (n = 20) using a microsurgical saw to simulate spondylolysis. The specimens were imaged using a computed tomography (CT) scan along with 3 "Tiers" of MR protocols at 3 T: Tier 1, conventional lumbar MR protocol; Tier 2, optimized conventional protocol consisting of a sagittal oblique spoiled gradient recall echo and axial oblique T1 and short tau inversion recovery sequences; and Tier 3, a sagittal UTE MR sequence. Two blinded readers evaluated the images using a 4-point scale (1 = spondylolysis certainly absent, 2 = probably absent, 3 = probably present, 4 = certainly present) at each individual pars. For each imaging protocol, diagnostic performance (sensitivity, specificity, and area under the receiver operating characteristic curve, using the surgical osteotomy as the reference) and confidence were assessed and compared using the McNemar test. Furthermore, 2 human subjects were imaged with the conventional and UTE MR protocols to demonstrate feasibility in vivo. RESULTS Diagnostic performance was moderate for Tiers 1 and 2, with a moderate sensitivity (0.70 to 0.75) and high (1.00) specificity. In contrast, CT and Tier 3 UTE MR imaging had both high sensitivity (1.00) and specificity (1.00). The sensitivities of CT or Tier 3 were statistically greater than Tier 1 sensitivity (P = 0.041) and neared statistical significance when compared with Tier 2 sensitivity (P = 0.074). Area under the receiver operating characteristic curve was also significantly greater for CT and Tier 3 (each area = 1.00), compared with the areas for Tier 1 (0.89, P = 0.037) or Tier 2 (0.873, P = 0.024). Diagnostic confidences of CT or Tier 3 were much greater than other Tiers: Both Tiers 1 and 2 had a large percentage of uncertain (>60%, P < 0.001) or wrong interpretations (>10%, P < 0.001), unlike CT or Tier 3 (0% uncertain or wrong interpretations). Preliminary in vivo UTE images clearly depicted intact and fractured pars. CONCLUSIONS Our study demonstrated that the detection of pars fractures using a single sagittal UTE MR sequence is superior in performance and confidence to conventional and optimized MR protocols at 3 T, whereas matching those from CT evaluation. Furthermore, we demonstrated the feasibility of in vivo application of the UTE sequence in subjects with and without spondylolysis.
Collapse
Affiliation(s)
- Tim Finkenstaedt
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | | | - Suraj Achar
- Department of Family Medicine, University of California, San Diego, La Jolla
| | | | - Sina Finkenstaedt
- Department of Neurosurgery, University Hospital Zurich, University of Zurich, Switzerland
| | - Nirusha Abeydeera
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA
| | - Won C Bae
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA
| |
Collapse
|
18
|
Siriwanarangsun P, Chen KC, Finkenstaedt T, Bae WC, Statum S, Gentili A, Chung CB. Patterns of cartilage degeneration in knees with medial tibiofemoral offset. Skeletal Radiol 2019; 48:931-937. [PMID: 30357459 DOI: 10.1007/s00256-018-3093-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 09/20/2018] [Accepted: 10/04/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine if radiographic medial tibiofemoral offset (MTFO) is associated with: (1) magnetic resonance imaging (MRI) pathology of cartilage, meniscus, and ligament; and (2) a distinct pattern of lateral cartilage degeneration on MRI. MATERIALS AND METHODS Three hundred consecutive adult knee MRIs with anteroposterior (AP) radiographs were retrospectively reviewed, and 145 studies were included. MTFO was defined as a medial extension of the medial femoral condyle beyond the articular surface of the medial tibial plateau on weight-bearing AP radiographs. The patients were then divided into the MTFO (n = 61) or no-offset (n = 84) groups. On MRI data obtained on a 1.5-Tesla system, articular cartilage of the femoral condyle and tibial plateau were graded using a modified Outerbridge classification (36 sub-regions similar to whole-organ MRI Score (WORMS) system). In addition, MR pathology of the ACL, MCL, LCL, medial and lateral menisci, were determined. RESULTS Significantly increased (ANOVA p < 0.007) MR grade of the ligaments, menisci, and cartilage in the MTFO group (ranging from 0.3 to 2.5) compared to the control group (0.2 to 1.1). Color maps of the cartilage grades suggested a marked difference in both severity of degeneration and regional variations between the groups. MTFO group exhibited focally increased cartilage grades in the central, non-weight regions of lateral compartment (region p = 0.07 to 0.12, interaction p = 0.05 to 0.1). CONCLUSIONS MTFO is associated with overall degeneration of the knee and features a distinct lateral cartilage degeneration pattern, which may reflect non-physiologic contact of the cartilage between the lateral tibial eminence and lateral central femoral condyle.
Collapse
Affiliation(s)
- Palanan Siriwanarangsun
- Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Karen C Chen
- Department of Radiology, VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC-114, San Diego, CA, 92161, USA
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Tim Finkenstaedt
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Won C Bae
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Sheronda Statum
- Department of Radiology, VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC-114, San Diego, CA, 92161, USA
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Amilcare Gentili
- Department of Radiology, VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC-114, San Diego, CA, 92161, USA
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, 3350 La Jolla Village Dr., MC-114, San Diego, CA, 92161, USA.
- Department of Radiology, University of California, San Diego, School of Medicine, San Diego, CA, USA.
| |
Collapse
|
19
|
Miyazaki S, Diwan AD, Kato K, Cheng K, Bae WC, Sun Y, Yamada J, Muehleman C, Lenz ME, Inoue N, Sah RL, Kawakami M, Masuda K. Correction to: ISSLS PRIZE IN BASIC SCIENCE 2018: Growth differentiation factor-6 attenuated pro-inflammatory molecular changes in the rabbit anular-puncture model and degenerated disc-induced pain generation in the rat xenograft radiculopathy model. Eur Spine J 2019; 28:889. [PMID: 30661198 DOI: 10.1007/s00586-019-05878-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The author "Ashish D. Diwan" receives educational consultant fees from Nuvasive Inc.
Collapse
Affiliation(s)
- Shingo Miyazaki
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho Chuo-Ku, Kobe, 650-0017, Hyogo, Japan
| | - Ashish D Diwan
- Orthopaedic Research Institute and Department of Orthopaedic Surgery, St George Hospital, University of New South Wales, Suite 16, Lvl 5, 1 South Street, Kogarah, Sydney NSW, 2217, Australia
| | - Kenji Kato
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medicine, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Aichi, Japan
| | - Kevin Cheng
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA
| | - Won C Bae
- Department of Radiology, University of California-San Diego, 9500 Gilman Dr., MC0997, La Jolla, CA, 92093-0997, USA
| | - Yang Sun
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Dr., MC0412, La Jolla, CA, 92093-0412, USA.,Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Junichi Yamada
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Mie, Japan
| | - Carol Muehleman
- Department of Biochemistry, Rush University Medical Center, 1645 W Harrison St, 5th floor, Chicago, 60612, IL, USA
| | - Mary E Lenz
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA
| | - Nozomu Inoue
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite 204 J, Chicago, 60612, IL, USA
| | - Robert L Sah
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Bioengineering, University of California-San Diego, 9500 Gilman Dr., MC0412, La Jolla, CA, 92093-0412, USA
| | - Mamoru Kawakami
- Spine Care Center, Wakayama Medical University Kihoku Hospital, 219, Myouji, Katsuragicho, Ito Gun, 649-7113, Wakayama, Japan
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.
| |
Collapse
|
20
|
Kim S, Bae WC, Masuda K, Chung CB, Hwang D. Fine-Grain Segmentation of the Intervertebral Discs from MR Spine Images Using Deep Convolutional Neural Networks: BSU-Net. Appl Sci (Basel) 2018; 8:1656. [PMID: 30637135 PMCID: PMC6326186 DOI: 10.3390/app8091656] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We propose a new deep learning network capable of successfully segmenting intervertebral discs and their complex boundaries from magnetic resonance (MR) spine images. The existing U-network (U-net) is known to perform well in various segmentation tasks in medical images; however, its performance with respect to details of segmentation such as boundaries is limited by the structural limitations of a max-pooling layer that plays a key role in feature extraction process in the U-net. We designed a modified convolutional and pooling layer scheme and applied a cascaded learning method to overcome these structural limitations of the max-pooling layer of a conventional U-net. The proposed network achieved 3% higher Dice similarity coefficient (DSC) than conventional U-net for intervertebral disc segmentation (89.44% vs. 86.44%, respectively; p < 0.001). For intervertebral disc boundary segmentation, the proposed network achieved 10.46% higher DSC than conventional U-net (54.62% vs. 44.16%, respectively; p < 0.001).
Collapse
Affiliation(s)
- Sewon Kim
- School of Electrical Engineering, Yonsei University, Seoul 03722, Korea;
| | - Won C Bae
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA 92161-0114, USA; (W.C.B.); (C.B.C.)
- Department of Radiology, University of California-San Diego, La Jolla, CA 92093-0997, USA
| | - Koichi Masuda
- Department of Orthopedic Surgery, University of California-San Diego, La Jolla, CA 92037, USA;
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA 92161-0114, USA; (W.C.B.); (C.B.C.)
- Department of Radiology, University of California-San Diego, La Jolla, CA 92093-0997, USA
| | - Dosik Hwang
- School of Electrical Engineering, Yonsei University, Seoul 03722, Korea;
| |
Collapse
|
21
|
Miyazaki S, Diwan AD, Kato K, Cheng K, Bae WC, Sun Y, Yamada J, Muehleman C, Lenz ME, Inoue N, Sah RL, Kawakami M, Masuda K. ISSLS PRIZE IN BASIC SCIENCE 2018: Growth differentiation factor-6 attenuated pro-inflammatory molecular changes in the rabbit anular-puncture model and degenerated disc-induced pain generation in the rat xenograft radiculopathy model. Eur Spine J 2018; 27:739-751. [PMID: 29460012 DOI: 10.1007/s00586-018-5488-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 01/14/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To elucidate the effects of growth differentiation factor-6 (GDF6) on: (i) gene expression of inflammatory/pain-related molecules and structural integrity in the rabbit intervertebral disc (IVD) degeneration model, and (ii) sensory dysfunction and changes in pain-marker expression in dorsal nerve ganglia (DRGs) in the rat xenograft radiculopathy model. METHODS Forty-six adolescent rabbits received anular-puncture in two non-consecutive lumbar IVDs. Four weeks later, phosphate-buffered saline (PBS) or GDF6 (1, 10 or 100 µg) was injected into the nucleus pulposus (NP) of punctured discs and followed for 4 weeks for gene expression analysis and 12 weeks for structural analyses. For pain assessment, eight rabbits were sacrificed at 4 weeks post-injection and NP tissues of injected discs were transplanted onto L5 DRGs of 16 nude rats to examine mechanical allodynia. The rat DRGs were analyzed immunohistochemically. RESULTS In GDF6-treated rabbit NPs, gene expressions of interleukin-6, tumor necrosis factor-α, vascular endothelial growth factor, prostaglandin-endoperoxide synthase 2, and nerve growth factor were significantly lower than those in the PBS group. GDF6 injections resulted in partial restoration of disc height and improvement of MRI disc degeneration grades with statistical significance in rabbit structural analyses. Allodynia induced by xenograft transplantation of rabbit degenerated NPs onto rat DRGs was significantly reduced by GDF6 injection. Staining intensities for ionized calcium-binding adaptor molecule-1 and calcitonin gene-related peptide in rat DRGs of the GDF6 group were significantly lower than those of the PBS group. CONCLUSION GDF6 injection may change the pathological status of degenerative discs and attenuate degenerated IVD-induced pain.
Collapse
Affiliation(s)
- Shingo Miyazaki
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho Chuo-Ku, Kobe, 650-0017, Hyogo, Japan
| | - Ashish D Diwan
- Orthopaedic Research Institute and Department of Orthopaedic Surgery, St George Hospital, University of New South Wales, Suite 16, Lvl 5, 1 South Street, Kogarah, Sydney, NSW 2217, Australia
| | - Kenji Kato
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Orthopaedic Surgery, Nagoya City University Graduate School of Medicine, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Aichi, Japan
| | - Kevin Cheng
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA
| | - Won C Bae
- Department of Radiology, University of California-San Diego, 9500 Gilman Dr., MC0997, La Jolla, CA, 92093-0997, USA
| | - Yang Sun
- Department of Bioengineering, University of California-San Diego, 9500 Gilman Dr., MC0412, La Jolla, CA, 92093-0412, USA.,Orthopaedic Medical Center, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Junichi Yamada
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Mie, Japan
| | - Carol Muehleman
- Department of Biochemistry, Rush University Medical Center, 1645 W Harrison St, 5th floor, Chicago, 60612, IL, USA
| | - Mary E Lenz
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA
| | - Nozomu Inoue
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W. Harrison St. Suite 204J, Chicago, 60612, IL, USA
| | - Robert L Sah
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.,Department of Bioengineering, University of California-San Diego, 9500 Gilman Dr., MC0412, La Jolla, CA, 92093-0412, USA
| | - Mamoru Kawakami
- Spine Care Center, Wakayama Medical University Kihoku Hospital, 219, Myouji, Katsuragicho, Ito Gun, 649-7113, Wakayama, Japan
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California-San Diego, 9500 Gilman Dr., MC0863, La Jolla, CA, 92093-0863, USA.
| |
Collapse
|
22
|
Abstract
Foot and ankle disorders are common in everyday clinical practice. MR imaging is frequently required for diagnosis given the variety and complexity of foot and ankle anatomy. Although conventional MR imaging plays a significant role in diagnosis, contemporary management increasingly relies on advanced imaging for monitoring therapeutic response. There is an expanding need for identification of biomarkers for musculoskeletal tissues. Advanced imaging techniques capable of imaging these tissue substrates will be increasingly used in routine clinical practice. Radiologists should therefore become familiar with these innovative MR techniques. Many such techniques are already widely used in other organ systems.
Collapse
Affiliation(s)
- Won C Bae
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA
| | - Thumanoon Ruangchaijatuporn
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok 10400, Thailand
| | - Christine B Chung
- Radiology Service, Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA 92161, USA; Department of Radiology, UCSD MSK Imaging Research Lab, University of California, San Diego, 9427 Health Sciences Drive, La Jolla, CA 92093-0997, USA.
| |
Collapse
|
23
|
Ariyachaipanich A, Bae WC, Statum S, Chung CB. Update on MRI Pulse Sequences for the Knee: Imaging of Cartilage, Meniscus, Tendon, and Hardware. Semin Musculoskelet Radiol 2017; 21:45-62. [PMID: 28355670 DOI: 10.1055/s-0037-1599209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Magnetic resonance imaging (MRI) is widely used in the clinical setting as well as for research applications. Since its inception, technical development has broadly progressed as a response to challenges in both the clinical and research settings. Higher magnetic field strength and advances in hardware and software have revolutionized the diagnostic potential of MRI and moved well beyond diagnosis to characterization of tissue metabolism, biochemistry, disease pathogenesis, and material property, to name a few. This article focuses on state-of-the-art clinical and cutting-edge novel pulse sequences applied to knee MRI.
Collapse
Affiliation(s)
| | - Won C Bae
- Department of Radiology, University of California-San Diego, La Jolla, California
| | - Sheronda Statum
- Department of Radiology, University of California-San Diego, La Jolla, California
| | - Christine B Chung
- Department of Radiology, University of California-San Diego, La Jolla, California
| |
Collapse
|
24
|
Hwang D, Kim S, Abeydeera NA, Statum S, Masuda K, Chung CB, Siriwanarangsun P, Bae WC. Quantitative magnetic resonance imaging of the lumbar intervertebral discs. Quant Imaging Med Surg 2016; 6:744-755. [PMID: 28090450 DOI: 10.21037/qims.2016.12.09] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Human lumbar spine is composed of multiple tissue components that serve to provide structural stability and proper nutrition. Conventional magnetic resonance (MR) imaging techniques have been useful for evaluation of IVD, but inadequate at imaging the discovertebral junction and ligamentous tissues due primarily to their short T2 nature. Ultrashort time to echo (UTE) MR techniques acquire sufficient MR signal from these short T2 tissues, thereby allowing direct and quantitative evaluation. This article discusses the anatomy of the lumbar spine, MR techniques available for morphologic and quantitative MR evaluation of long and short T2 tissues of the lumbar spine, considerations for T2 relaxation modeling and fitting, and existing and new techniques for spine image post-processing, focusing on segmentation. This article will be of interest to radiologic and orthopaedic researchers performing lumbar spine imaging.
Collapse
Affiliation(s)
- Dosik Hwang
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA; ; School of Electrical and Electronic Engineering, Yonsei University, Seoul, Korea
| | - Sewon Kim
- School of Electrical and Electronic Engineering, Yonsei University, Seoul, Korea
| | - Nirusha A Abeydeera
- Department of Radiology, University of California-San Diego, La Jolla, CA, USA
| | - Sheronda Statum
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA; ; Department of Radiology, University of California-San Diego, La Jolla, CA, USA
| | - Koichi Masuda
- Department of Orthopaedic Surgery, University of California-San Diego, La Jolla, CA, USA
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA; ; Department of Radiology, University of California-San Diego, La Jolla, CA, USA
| | - Palanan Siriwanarangsun
- Department of Radiology, University of California-San Diego, La Jolla, CA, USA;; Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Won C Bae
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA; ; Department of Radiology, University of California-San Diego, La Jolla, CA, USA
| |
Collapse
|
25
|
Siriwanarangsun P, Statum S, Biswas R, Bae WC, Chung CB. Ultrashort time to echo magnetic resonance techniques for the musculoskeletal system. Quant Imaging Med Surg 2016; 6:731-743. [PMID: 28090449 DOI: 10.21037/qims.2016.12.06] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Magnetic resonance (MR) imaging has been widely implemented as a non-invasive modality to investigate musculoskeletal (MSK) tissue disease, injury, and pathology. Advancements in MR sequences provide not only enhanced morphologic contrast for soft tissues, but also quantitative biochemical evaluation. Ultrashort time to echo (UTE) sequence, in particular, enables novel morphologic and quantitative evaluation of previously unseen MSK tissues. By using short minimum echo times (TE) below 1 msec, the UTE sequence can unveil short T2 properties of tissues including the deepest layers of the articular cartilage, cartilaginous endplate at the discovertebral junction, the meniscus, and the cortical bone. This article will discuss the application of UTE to evaluate these MSK tissues, starting with tissue structure, MR imaging appearance on standard versus short and ultrashort TE sequences, and provide the range of quantitative MR values found in literature.
Collapse
Affiliation(s)
- Palanan Siriwanarangsun
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA;; Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA;; Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
| | - Reni Biswas
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA;; Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
| | - Won C Bae
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA;; Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA;; Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA
| |
Collapse
|
26
|
Bae WC, Ruangchaijatuporn T, Chang EY, Biswas R, Du J, Statum S, Chung CB. MR morphology of triangular fibrocartilage complex: correlation with quantitative MR and biomechanical properties. Skeletal Radiol 2016; 45:447-54. [PMID: 26691643 PMCID: PMC4755783 DOI: 10.1007/s00256-015-2309-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 11/12/2015] [Accepted: 11/30/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate pathology of the triangular fibrocartilage complex (TFCC) using high-resolution morphologic magnetic resonance (MR) imaging, and compare with quantitative MR and biomechanical properties. MATERIALS AND METHODS Five cadaveric wrists (22-70 years) were imaged at 3 T using morphologic (proton density weighted spin echo, PD FS, and 3D spoiled gradient echo, 3D SPGR) and quantitative MR sequences to determine T2 and T1rho properties. In eight geographic regions, morphology of TFC disc and laminae were evaluated for pathology and quantitative MR values. Samples were disarticulated and biomechanical indentation testing was performed on the distal surface of the TFC disc. RESULTS On morphologic PD SE images, TFC disc pathology included degeneration and tears, while that of the laminae included degeneration, degeneration with superimposed tear, mucinous transformation, and globular calcification. Punctate calcifications were highly visible on 3D SPGR images and found only in pathologic regions. Disc pathology occurred more frequently in proximal regions of the disc than distal regions. Quantitative MR values were lowest in normal samples, and generally higher in pathologic regions. Biomechanical testing demonstrated an inverse relationship, with indentation modulus being high in normal regions with low MR values. The laminae studied were mostly pathologic, and additional normal samples are needed to discern quantitative changes. CONCLUSION These results show technical feasibility of morphologic MR, quantitative MR, and biomechanical techniques to characterize pathology of the TFCC. Quantitative MRI may be a suitable surrogate marker of soft tissue mechanical properties, and a useful adjunct to conventional morphologic MR techniques.
Collapse
Affiliation(s)
- Won C Bae
- Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.
- Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA.
| | - Thumanoon Ruangchaijatuporn
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Rachathewi, Bangkok, Thailand, 10400.
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.
- Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA.
| | - Reni Biswas
- Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA.
| | - Jiang Du
- Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA.
| | - Sheronda Statum
- Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA.
| | - Christine B Chung
- Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, MC 114, San Diego, CA, 92161, USA.
- Department of Radiology, University of California-San Diego, 408 Dickinson St., San Diego, CA, 92103-8226, USA.
| |
Collapse
|
27
|
Bae WC, Tafur M, Chang EY, Du J, Biswas R, Kwack KS, Healey R, Statum S, Chung CB. High-resolution morphologic and ultrashort time-to-echo quantitative magnetic resonance imaging of the temporomandibular joint. Skeletal Radiol 2016; 45:383-91. [PMID: 26685898 PMCID: PMC4720153 DOI: 10.1007/s00256-015-2305-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/15/2015] [Accepted: 11/18/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To implement high-resolution morphologic and quantitative magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) using ultrashort time-to-echo (UTE) techniques in cadavers and volunteers. METHODS This study was approved by the institutional review board. TMJs of cadavers and volunteers were imaged on a 3-T MR system. High-resolution morphologic and quantitative sequences using conventional and UTE techniques were performed in cadaveric TMJs. Morphologic and UTE quantitative sequences were performed in asymptomatic and symptomatic volunteers. RESULTS Morphologic evaluation demonstrated the TMJ structures in open- and closed-mouth position. UTE techniques facilitated the visualization of the disc and fibrocartilage. Quantitative UTE MRI was successfully performed ex vivo and in vivo, reflecting the degree of degeneration. There was a difference in the mean UTE T2* values between asymptomatic and symptomatic volunteers. CONCLUSIONS MRI evaluation of the TMJ using UTE techniques allows characterization of the internal structure and quantification of the MR properties of the disc. Quantitative UTE MRI can be performed in vivo with short scan times.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, Veterans Administration (VA) San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.,Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Monica Tafur
- Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Eric Y Chang
- Department of Radiology, Veterans Administration (VA) San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.,Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Reni Biswas
- Department of Radiology, Veterans Administration (VA) San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.,Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Kyu-Sung Kwack
- Department of Radiology, Ajou University Medical Center, San 5, Wonchon-dong, Yeongtong-gu, Gyeonggi-do, Suwon, 443-721, Republic of Korea
| | - Robert Healey
- Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Sheronda Statum
- Department of Radiology, Veterans Administration (VA) San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.,Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA
| | - Christine B Chung
- Department of Radiology, Veterans Administration (VA) San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA. .,Department of Radiology, University of California, San Diego, School of Medicine, 408 Dickinson Street, San Diego, CA, 92103-8226, USA.
| |
Collapse
|
28
|
Choi JY, Biswas R, Bae WC, Healey R, Im M, Statum S, Chang EY, Du J, Bydder GM, D'Lima D, Chung CB. Thickness of the Meniscal Lamellar Layer: Correlation with Indentation Stiffness and Comparison of Normal and Abnormally Thick Layers by Using Multiparametric Ultrashort Echo Time MR Imaging. Radiology 2016; 280:161-8. [PMID: 26829523 DOI: 10.1148/radiol.2016150633] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine the relationship between lamellar layer thickness on ultrashort echo time (UTE) magnetic resonance (MR) images and indentation stiffness of human menisci and to compare quantitative MR imaging values between two groups with normal and abnormally thick lamellar layers. Materials and Methods This was a HIPAA-compliant, institutional review board-approved study. Nine meniscal pieces were obtained from seven donors without gross meniscal pathologic results (mean age, 57.4 years ± 14.5 [standard deviation]). UTE MR imaging and T2, UTE T2*, and UTE T1ρ mapping were performed. The presence of abnormal lamellar layer thickening was determined and thicknesses were measured. Indentation testing was performed. Correlation between the thickness and indentation stiffness was assessed, and mean quantitative MR imaging values were compared between the groups. Results Thirteen normal lamellar layers had mean thickness of 232 μm ± 85 and indentation peak force of 1.37 g ± 0.87. Four abnormally thick lamellar layers showed mean thickness of 353.14 μm ± 98.36 and peak force 0.72 g ± 0.31. In most cases, normal thicknesses showed highly positive correlation with the indentation peak force (r = 0.493-0.912; P < .001 to .05). However, the thickness in two abnormal lamellar layers showed highly negative correlation (r = -0.90, P < .001; and r = -0.23, P = .042) and no significant correlation in the others. T2, UTE T2*, and UTE T1ρ values in abnormally thick lamellar layers were increased compared with values in normal lamellar layers, although only the UTE T2* value showed significant difference (P = .010). Conclusion Variation of lamellar layer thickness in normal human menisci was evident on two-dimensional UTE images. In normal lamellar layers, thickness is highly and positively correlated with surface indentation stiffness. UTE T2* values may be used to differentiate between normal and abnormally thickened lamellar layers. (©) RSNA, 2016.
Collapse
Affiliation(s)
- Ja-Young Choi
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Reni Biswas
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Won C Bae
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Robert Healey
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Michael Im
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Sheronda Statum
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Eric Y Chang
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Jiang Du
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Graeme M Bydder
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Darryl D'Lima
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| | - Christine B Chung
- From the Department of Radiology, Seoul National University Hospital, Seoul, Korea (J.Y.C.); Department of Radiology, University of California-San Diego Medical Center, 3350 La Jolla Village Dr, Mail Code 8226, San Diego, CA 92103 (R.B., W.C.B., M.I., S.S., E.Y.C., J.D., G.M.B., C.B.C.); Department of Orthopedic Surgery, University of California, La Jolla, Calif (R.H.); Radiology Service, Veterans Administration San Diego Healthcare System, La Jolla, Calif (E.Y.C., C.B.C.); and Molecular and Experimental Medicine, Scripps Translational Science Institute, La Jolla, Calif (D.D.)
| |
Collapse
|
29
|
Abstract
Ultrashort echo time (UTE) sequences represent a group of clinically compatible techniques that are capable of using echo times < 1 ms. With these techniques, direct imaging of short T2/T2* tissues or tissue components can now be performed. Continuing modifications to the UTE techniques have allowed for faster and more robust sequences now comparable with conventional clinical sequences. UTE also allows for morphological imaging and quantitative evaluation in a manner not previously possible with conventional imaging sequences utilizing much longer echo times. Numerous potential clinical applications have emerged that are discussed in this review article.
Collapse
Affiliation(s)
- Eric Y Chang
- Department of Radiology, VA San Diego Healthcare System, San Diego, California
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California
| | - Won C Bae
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, San Diego, California
| |
Collapse
|
30
|
Li S, Chang EY, Bae WC, Chung CB, Gao S, Bao S, Bydder GM, Hua Y, Du J. Ultrashort echo time bi-component analysis of cortical bone--a field dependence study. Magn Reson Med 2015; 71:1075-81. [PMID: 23630048 DOI: 10.1002/mrm.24769] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
PURPOSE The purpose of this study is to investigate the effect of differing field strength on the T2* of cortical bone at 1.5 T and 3 T. METHODS Ultrashort echo time pulse sequences were used to study six bovine and nine human bone samples at 1.5 T and 3 T using single- and bi-component T2* analysis. RESULTS On average, the bound water T2* of bovine bone decreased by 16% (from 0.32 ms at 1.5 T to 0.27 ms at 3 T, P < 0.01) and the bound water T2* of human bone decreased by 21% (from 0.42 ms at 1.5 T to 0.33 ms at 3 T, P < 0.01) at the higher field strength. The free water T2* of bovine bone decreased by 50% (from 4.23 ms at 1.5 T to 2.12 ms at 3 T, P < 0.001) and the free water T2* of human bone decreased by 68% (from 7.65 ms at 1.5 T to 2.46 ms at 3 T, P < 0.001) at the higher field strength. Bound and free water fractions showed only minor change with field strength in bovine (< 2%, P > 0.05) and human bone (< 4%, P > 0.05). CONCLUSION Ultrashort echo time bi-component analysis provides consistent bound and free water fractions at 1.5 T and 3 T, thereby allowing field-independent comparisons.
Collapse
Affiliation(s)
- Shihong Li
- Department of Radiology, University of California, San Diego, California, USA; Department of Radiology, Hua Dong Hospital, Fudan University, Shanghai, People's Republic of China; Yancheng Medical College, Jiangsu, People's Republic of China
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Iwasaki K, Tafur M, Chang EY, Statum S, Biswas R, Tran B, Bae WC, Du J, Bydder GM, Chung CB. High-Resolution Qualitative and Quantitative Magnetic Resonance Evaluation of the Glenoid Labrum. J Comput Assist Tomogr 2015; 39:936-44. [PMID: 26359581 DOI: 10.1097/rct.0000000000000307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study aimed to implement qualitative and quantitative magnetic resonance sequences for the evaluation of labral pathology. METHODS Six glenoid labra were dissected, and the anterior and posterior portions were divided into normal, mildly degenerated, or severely degenerated groups using gross and magnetic resonance findings. Qualitative evaluation was performed using T1-weighted, proton density-weighted, spoiled gradient echo and ultrashort echo time (UTE) sequences. Quantitative evaluation included T2 and T1rho measurements as well as T1, T2*, and T1rho measurements acquired with UTE techniques. RESULTS Spoiled gradient echo and UTE sequences best demonstrated labral fiber structure. Degenerated labra had a tendency toward decreased T1 values, increased T2/T2* values, and increased T1rho values. T2* values obtained with the UTE sequence allowed for delineation among normal, mildly degenerated, and severely degenerated groups (P < 0.001). CONCLUSIONS Quantitative T2* measurements acquired with the UTE technique are useful for distinguishing among normal, mildly degenerated, and severely degenerated labra.
Collapse
Affiliation(s)
- Kenyu Iwasaki
- From the *Department of Radiology, University of California, San Diego; and †Radiology Service, VA San Diego Healthcare System, San Diego, CA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Abstract
OBJECTIVE The aim of the study was to determine whether quantitative ultrashort echo time (UTE) -T1ρ magnetic resonance (MR) measurements are sensitive to proteoglycan degradation in human menisci by trypsin digestion. METHODS Conventional and quantitative UTE-T1ρ MR sequences were performed on 4 meniscal samples using a 3T scanner. Magnetic resonance imaging was performed before and after 4, 8, and 12 hours of trypsin solution immersion, inducing proteoglycan loss. One sample was used as a control. Digest solutions were analyzed for glycosaminoglycan (GAG) content. The UTE-T1ρ studies were analyzed for quantitative changes. RESULTS Images showed progressive tissue swelling, fiber disorganization, and increase in signal intensity after GAG depletion. The UTE-T1ρ values tended to increase with time after trypsin treatment (P = 0.06). Cumulative GAG loss into the bath showed a trend of increased values for trypsin-treated samples (P = 0.1). CONCLUSIONS Ultrashort echo time T1ρ measurements can noninvasively detect and quantify severity of meniscal degeneration, which has been correlated with progression of osteoarthritis.
Collapse
Affiliation(s)
- Eric Y. Chang
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA 92161
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| | - Juliana C. Campos
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| | - Won C. Bae
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| | - Richard Znamirowski
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| | - Christine B. Chung
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA 92161
- Department of Radiology, University of California, San Diego Medical Center, San Diego, CA 92103
| |
Collapse
|
33
|
Chang EY, Bae WC, Shao H, Biswas R, Li S, Chen J, Patil S, Healey R, D’Lima DD, Chung CB, Du J. Ultrashort echo time magnetization transfer (UTE-MT) imaging of cortical bone. NMR Biomed 2015; 28:873-80. [PMID: 25981914 PMCID: PMC4652942 DOI: 10.1002/nbm.3316] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/20/2015] [Accepted: 04/06/2015] [Indexed: 05/24/2023]
Abstract
Magnetization transfer (MT) imaging is one way to indirectly assess pools of protons with fast transverse relaxation. However, conventional MT imaging sequences are not applicable to short T2 tissues such as cortical bone. Ultrashort echo time (UTE) sequences with TE values as low as 8 µs can detect signals from different water components in cortical bone. In this study we aim to evaluate two-dimensional UTE-MT imaging of cortical bone and its application in assessing cortical bone porosity as measured by micro-computed tomography (μCT) and biomechanical properties. In total, 38 human cadaveric distal femur and proximal tibia bones were sectioned to produce 122 rectangular pieces of cortical bone for quantitative UTE-MT MR imaging, μCT, and biomechanical testing. Off-resonance saturation ratios (OSRs) with a series of MT pulse frequency offsets (Δf) were calculated and compared with porosity assessed with μCT, as well as elastic (modulus, yield stress, and strain) and failure (ultimate stress, failure strain, and energy) properties, using Pearson correlation and linear regression. A moderately strong negative correlation was observed between OSR and μCT porosity (R(2) = 0.46-0.51), while a moderate positive correlation was observed between OSR and yield stress (R(2) = 0.25-0.30) and failure stress (R(2) = 0.31-0.35), and a weak positive correlation (R(2) = 0.09-0.12) between OSR and Young's modulus at all off-resonance saturation frequencies. OSR determined with the UTE-MT sequence provides quantitative information on cortical bone and is sensitive to μCT porosity and biomechanical function.
Collapse
Affiliation(s)
- Eric Y Chang
- Department of Radiology, VA San Diego Healthcare System, La Jolla, CA
- Department of Radiology, University of California, San Diego, CA
| | - Won C Bae
- Department of Radiology, VA San Diego Healthcare System, La Jolla, CA
| | - Hongda Shao
- Department of Radiology, University of California, San Diego, CA
| | - Reni Biswas
- Department of Radiology, University of California, San Diego, CA
| | - Shihong Li
- Department of Radiology, University of California, San Diego, CA
| | - Jun Chen
- Department of Radiology, University of California, San Diego, CA
| | - Shantanu Patil
- Shiley Center for Orthopaedic Research & Education, Scripps Clinic, La Jolla, CA
| | - Robert Healey
- Department of Radiology, University of California, San Diego, CA
| | - Darryl D D’Lima
- Shiley Center for Orthopaedic Research & Education, Scripps Clinic, La Jolla, CA
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, La Jolla, CA
- Department of Radiology, University of California, San Diego, CA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA
| |
Collapse
|
34
|
Chang EY, Du J, Biswas R, Statum S, Pauli C, Bae WC, Chung CB. Off-resonance saturation ratio obtained with ultrashort echo time-magnetization transfer techniques is sensitive to changes in static tensile loading of tendons and degeneration. J Magn Reson Imaging 2015; 42:1064-71. [PMID: 25808266 DOI: 10.1002/jmri.24881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/18/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To determine if off-saturation ratio (OSR) measured with the ultrashort echo time magnetization transfer (UTE-MT) sequence could differentiate between tendons under different states of tensile load and to compare these changes between normal versus degenerated tendons. METHODS Fourteen tendons were imaged at 3 Tesla before and during the application of 0.5-1 kg tension. A two-dimensional (2D) -UTE-MT sequence with 1.5, 3, and 5 kHz frequency offsets was used on nine tendons and a 3D-UTE-MT sequence with 1.5 kHz frequency offset was used on five tendons. OSR was calculated and compared for each condition. Histologic correlation was performed using light microscopy. RESULTS In general, OSR increased after the application of tension. Mean increase of 2D OSR was 0.035 (95% confidence interval [CI], 0.013-0.056) at 1.5 kHz offset (P < 0.01), 0.031 (95% CI, 0.023-0.040) at 3 kHz offset (P < 0.01), and 0.013 (95% CI, -0.013-0.027) at 5 kHz offset (P = 0.07) from pre- to posttension states. Mean increase of 3D OSR was 0.026 (95% CI, 0.008-0.044) at a 1.5 kHz offset (P = 0.02) from pre- to posttension states. Mean decrease of 2D OSR at 1.5 kHz offset was 0.074-0.087 when comparing normal versus degenerated tendons (P < 0.01). CONCLUSION OSR as measured with 2D or 3D UTE-MT sequences can detect the changes in hydration seen when tendons are placed under two different states of tensile load, but these changes are smaller than those encountered when comparing between normal versus pathologic tendons. Lower off-resonance saturation frequencies (3 kHz or less) are more sensitive to these changes than higher off-resonance saturation frequencies.
Collapse
Affiliation(s)
- Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA.,Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Reni Biswas
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Chantal Pauli
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Won C Bae
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Christine B Chung
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA.,Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| |
Collapse
|
35
|
Yamaguchi T, Goto S, Nishigaki Y, Espinoza Orías AA, Bae WC, Masuda K, Inoue N. Microstructural analysis of three-dimensional canal network in the rabbit lumbar vertebral endplate. J Orthop Res 2015; 33:270-6. [PMID: 25367593 DOI: 10.1002/jor.22759] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 09/29/2014] [Indexed: 02/04/2023]
Abstract
Insufficient nutrient supply through vertebral canal structures to the intervertebral disc (IVD) has been considered as an important contributor for disc degeneration. Despite previous canal structure characterization studies using histology, scanning electron microscopy, and angiography, among others, their three-dimensional (3D) topology inside the vertebral endplate remains poorly understood. This study aims to characterize the 3D canal structure in the rabbit lumbar vertebral endplate using micro computed tomography (μCT). Vertebral endplates were imaged using high-resolution μCT with 1.4 × 1.4 × 1.8 μm voxel size. Diameter, length, orientation, and depth starting from the vertebral endplate surface were analyzed for each canal using individual 3D canal models from the vertebral endplate scans. In the layer underneath the vertebral endplate, at a mean depth of 76.2 μm, longitudinally-oriented relatively short-length (57.6 μm) and small diameter (45.7 μm) canals were dominant. Large-scale canals with a mean diameter of 152.1 μm running parallel to the endplate surface were isolated at the depth of 224.1 μm. These canals were connected to both IVD and bone marrow spaces through vertically oriented canals.
Collapse
Affiliation(s)
- Tomonori Yamaguchi
- Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyoto, Japan
| | | | | | | | | | | | | |
Collapse
|
36
|
Li S, Chang EY, Bae WC, Chung CB, Hua Y, Zhou Y, Du J. The effect of excitation and preparation pulses on nonslice selective 2D UTE bicomponent analysis of bound and free water in cortical bone at 3T. Med Phys 2014; 41:022306. [PMID: 24506644 DOI: 10.1118/1.4862838] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the effect of excitation, fat saturation, long T2 saturation, and adiabatic inversion pulses on ultrashort echo time (UTE) imaging with bicomponent analysis of bound and free water in cortical bone for potential applications in osteoporosis. METHODS Six bovine cortical bones and six human tibial midshaft samples were harvested for this study. Each bone sample was imaged with eight sequences using 2D UTE imaging at 3T with half and hard excitation pulses, without and with fat saturation, long T2 saturation, and adiabatic inversion recovery (IR) preparation pulses. Single- and bicomponent signal models were utilized to calculate the T2(*)s and/or relative fractions of short and long T2(*)s. RESULTS For all bone samples UTE T2(*) signal decay showed bicomponent behavior. A higher short T2(*) fraction was observed on UTE images with hard pulse excitation compared with half pulse excitation (75.6% vs 68.8% in bovine bone, 79.9% vs 73.2% in human bone). Fat saturation pulses slightly reduced the short T2(*) fraction relative to regular UTE sequences (5.0% and 2.0% reduction, respectively, with half and hard excitation pulses for bovine bone, 6.3% and 8.2% reduction, respectively, with half and hard excitation pulses for human bone). Long T2 saturation pulses significantly reduced the long T2(*) fraction relative to regular UTE sequence (18.9% and 17.2% reduction, respectively, with half and hard excitation pulses for bovine bone, 26.4% and 27.7% reduction, respectively, with half and hard excitation pulses for human bone). With IR-UTE preparation the long T2(*) components were significantly reduced relative to regular UTE sequence (75.3% and 66.4% reduction, respectively, with half and hard excitation pulses for bovine bone, 87.7% and 90.3% reduction, respectively, with half and hard excitation pulses for human bone). CONCLUSIONS Bound and free water T2(*)s and relative fractions can be assessed using UTE bicomponent analysis. Long T2(*) components are affected more by long T2 saturation and IR pulses, and short T2(*) components are affected more by fat saturation pulses.
Collapse
Affiliation(s)
- Shihong Li
- Department of Radiology, University of California, San Diego, California 92103-8226; Department of Radiology, Hua Dong Hospital, Fudan University, Shanghai 200040, China; Yancheng Medical College, Jiangsu, China; and The First People's Hospital of Yancheng City, Jiangsu 224005, China
| | - Eric Y Chang
- VA San Diego Healthcare System, San Diego, California 92161 and Department of Radiology, University of California, San Diego, California 92103-8226
| | - Won C Bae
- Department of Radiology, University of California, San Diego, California 92103-8226
| | - Christine B Chung
- VA San Diego Healthcare System, San Diego, California 92161 and Department of Radiology, University of California, San Diego, California 92103-8226
| | - Yanqing Hua
- Department of Radiology, Hua Dong Hospital, Fudan University, Shanghai 200040, China
| | - Yi Zhou
- The First People's Hospital of Yancheng City, Jiangsu 224005, China
| | - Jiang Du
- Department of Radiology, University of California, San Diego, California 92103-8226
| |
Collapse
|
37
|
Chang EY, Du J, Iwasaki K, Biswas R, Statum S, He Q, Bae WC, Chung CB. Single- and Bi-component T2* analysis of tendon before and during tensile loading, using UTE sequences. J Magn Reson Imaging 2014; 42:114-20. [PMID: 25223714 DOI: 10.1002/jmri.24758] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 08/28/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND To determine if the application of tensile force alters the single- or bi-component T2* values of human tendons as measured on a clinical MRI scanner with ultrashort echo time (UTE sequences and if single- or bi-component T2* values differ when measured with 2D-UTE, 3D-UTE, or 3D-UTE-Cones sequences. METHODS Ten tendons were imaged before and during the application of tension using various UTE sequences at 3 Tesla. Single and bi-component T2* analysis was performed pre- and posttension and compared with Bonferroni-corrected paired Wilcoxon tests. RESULTS Range of mean pre- and posttension T2* analysis values were: short T2* fraction (78.6-79.7% and 77.3-79.7%, respectively; P = 1.0 for all sequences), long T2* fraction (20.3-21.4% and 20.3-22.7%, respectively; P = 1.0 for all sequences), short T2* (0.9-1.0 ms and 0.9 ms, respectively; P = 1.0 for all sequences), long T2* (19.9-20.4 ms and 21.9-24.0 ms, respectively; P = 0.9 for 2D-UTE and P = 1.0 for 3D-UTE and 3D-UTE-Cones), and single-component T2* (2.3-2.5 ms and 2.5-3.2 ms, respectively; P = 1.0 for all sequences). CONCLUSION No significant difference in single- or bi-component results was found after the application of tension to tendons. Results are similar regardless of UTE sequence used for acquisition.
Collapse
Affiliation(s)
- Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA.,Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Kenyu Iwasaki
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Reni Biswas
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Qun He
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Won C Bae
- Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| | - Christine B Chung
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA.,Department of Radiology, University of California, San Diego Medical Center, San Diego, California, USA
| |
Collapse
|
38
|
Bae WC, Patil S, Biswas R, Li S, Chang EY, Statum S, D'Lima DD, Chung CB, Du J. Magnetic resonance imaging assessed cortical porosity is highly correlated with μCT porosity. Bone 2014; 66:56-61. [PMID: 24928498 PMCID: PMC4125420 DOI: 10.1016/j.bone.2014.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 05/29/2014] [Accepted: 06/02/2014] [Indexed: 12/29/2022]
Abstract
Cortical bone is typically regarded as "MR invisible" with conventional clinical magnetic resonance imaging (MRI) pulse sequences. However, recent studies have demonstrated that free water in the microscopic pores of cortical bone has a short T2* but a relatively long T2, and may be detectable with conventional clinical spin echo (SE) or fast spin echo (FSE) sequences. In this study we describe the use of a conventional two-dimensional (2D) FSE sequence to assess cortical bone microstructure and measure cortical porosity using a clinical 3T scanner. Twelve cadaveric human cortical bone samples were studied with MRI and microcomputed tomography (μCT) (downsampled to the same spatial resolution). Preliminary results show that FSE-determined porosity is highly correlated (R(2)=0.83; P<0.0001) with μCT porosity. Bland-Altman analysis suggested a good agreement between FSE and μCT with tight limit of agreement at around 3%. There is also a small bias of -2% for the FSE data, which suggested that the FSE approach slightly underestimated μCT porosity. The results demonstrate that cortical porosity can be directly assessed using conventional clinical FSE sequences. The clinical feasibility of this approach was also demonstrated on six healthy volunteers using 2D FSE sequences as well as 2D ultrashort echo time (UTE) sequences with a minimal echo time (TE) of 8μs, which provide high contrast imaging of cortical bone in vivo.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, University of California, San Diego, CA, USA; Department of Radiology, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Shantanu Patil
- Shiley Center for Orthopaedic Research & Education, Scripps Clinic, La Jolla, CA, USA
| | - Reni Biswas
- Department of Radiology, University of California, San Diego, CA, USA
| | - Shihong Li
- Department of Radiology, University of California, San Diego, CA, USA; Department of Radiology, Hua Dong Hospital, Fudan University, Shanghai, PR China
| | - Eric Y Chang
- Department of Radiology, VA San Diego Healthcare System, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, CA, USA
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego, CA, USA; Department of Radiology, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Darryl D D'Lima
- Shiley Center for Orthopaedic Research & Education, Scripps Clinic, La Jolla, CA, USA
| | - Christine B Chung
- Department of Radiology, VA San Diego Healthcare System, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, CA, USA; Department of Radiology, VA San Diego Healthcare System, La Jolla, CA, USA.
| |
Collapse
|
39
|
Gregory DE, Bae WC, Sah RL, Masuda K. Disc degeneration reduces the delamination strength of the annulus fibrosus in the rabbit annular disc puncture model. Spine J 2014; 14:1265-71. [PMID: 24594442 PMCID: PMC4063999 DOI: 10.1016/j.spinee.2013.07.489] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 06/01/2013] [Accepted: 07/25/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Degenerative disc disease is a common pathologic disorder accompanied by both structural and biochemical changes. Changes in stress distribution across the disc can lead to annulus fibrosus (AF) damage that can affect the strength and integrity of the disc. Given that some present degeneration therapies incorporate biological regrowth of the nucleus pulposus (NP), it is crucial that the AF remains capable of containing this newly grown material. PURPOSE To examine the resistance of AF to delamination using an adhesive peel test in experimentally degenerated rabbit discs. STUDY DESIGN Experimentally induced disc degeneration; excised AF tissue study. METHODS Disc degeneration was induced in eight New Zealand white rabbits by annular puncture; four additional rabbits served as controls. In experimental rabbits, an 18-gauge needle was inserted into the anterolateral AF region of levels L2-L3 and L4-L5, and disc height was monitored by X-ray. Animals were sacrificed at 4 and 12 weeks postsurgery and magnetic resonance images and X-rays were taken. Four discs were excised from the experimental animals; two punctured (L2-L3 and L4-L5) and two controls (L3-L4 and L6-L7). The same four discs were also excised from the age-matched control animals and served as nonpunctured control discs. To determine resistance to delamination, AF samples were dissected from each disc and subjected to a mechanical peel test at 0.5 mm/s. RESULTS Magnetic resonance imaging and X-ray images confirmed dehydration of the NP and reduced disc height, similar to that found in clinical degeneration. Resistance to delamination was significantly lower in punctured/degenerated discs compared with both the nonpunctured discs from the same animal (27% lower) and the nonpunctured control discs (30% lower) (p=.024). CONCLUSIONS The findings of this study suggest that degeneration increases the potential for delamination between AF layers. Given this substantial change to the integrity of the AF after degeneration, clinical treatments should not only target rehydration or regrowth of the NP, but should also target repair and strengthening of the AF to confine the NP.
Collapse
Affiliation(s)
- Diane E. Gregory
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, Canada
| | - Won C. Bae
- Department of Radiology, University of California San Diego, USA
| | - Robert L. Sah
- Department of Bioengineering, University of California San Diego, USA
,Department of Orthopaedic Surgery, University of California San Diego, USA
| | - Koichi Masuda
- Department of Radiology, University of California San Diego, 200 West Arbor Drive, San Diego, CA, 92103, USA.
| |
Collapse
|
40
|
Yamaguchi T, Inoue N, Sah RL, Lee YP, Taborek AP, Williams GM, Moseley TA, Bae WC, Masuda K. Micro-computed tomography-based three-dimensional kinematic analysis during lateral bending for spinal fusion assessment in a rat posterolateral lumbar fusion model. Tissue Eng Part C Methods 2014; 20:578-87. [PMID: 24199634 DOI: 10.1089/ten.tec.2013.0439] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Rat posterolateral lumbar fusion (PLF) models have been used to assess the safety and effectiveness of new bone substitutes and osteoinductive growth factors using palpation, radiography, micro-computed tomography (μCT), and histology as standard methods to evaluate spinal fusion. Despite increased numbers of PLF studies involving alternative bone substitutes and growth factors, the quantitative assessment of treatment efficacy during spinal motion has been limited. The purpose of this study was to evaluate the effect of spinal fusion on lumbar spine segment stability during lateral bending using a μCT-based three-dimensional (3D) kinematic analysis in the rat PLF model. Fourteen athymic male rats underwent PLF surgery at L4/5 and received bone grafts harvested from the ilium and femurs of syngeneic rats (Isograft, n=7) or no graft (Sham, n=7). At 8 weeks after the PLF surgery, spinal fusion was assessed by manual palpation, plain radiography, μCT, and histology. To determine lumbar segmental motions at the operated level during lateral bending, 3D kinematic analysis was performed. The Isograft group, but not the Sham group, showed spinal fusion on manual palpation (6/7), solid fusion mass in radiographs (6/7), as well as bone bridging in μCT and histological images (5/7). Compared to the Sham group, the Isograft group revealed limited 3D lateral bending angular range of motion and lateral translation during lateral bending at the fused segment where disc height narrowing was observed. This μCT-based 3D kinematic analysis can provide a quantitative assessment of spinal fusion in a rat PLF model to complement current gold standard methods used for efficacy assessment of new therapeutic approaches.
Collapse
Affiliation(s)
- Tomonori Yamaguchi
- 1 Department of Orthopaedic Surgery, School of Medicine, University of California , San Diego, La Jolla, California
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Patil S, Steklov N, Song L, Bae WC, D'Lima DD. Comparative biomechanical analysis of human and caprine knee articular cartilage. Knee 2014; 21:119-25. [PMID: 23583005 DOI: 10.1016/j.knee.2013.03.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 10/19/2012] [Accepted: 03/14/2013] [Indexed: 02/02/2023]
Abstract
BACKGROUND The goat is one of the most commonly used preclinical models for focal defect repair and regeneration. While the biomechanics of the human knee has been studied extensively, less is known about the biomechanics of the caprine knee. Differences between human and caprine knees have not been quantified and their significance is largely unknown. METHODS We conducted a biomechanical analysis of the differences in goat and human knees to assess the validity of these preclinical in vivo models. RESULTS CT and MRI scans revealed several differences in articular geometry: the caprine tibial plateaux were more convex and the menisci were significantly thicker and covered a larger proportion of the tibial articular surface. Caprine cartilage thickness was consistently thinner, while elastic modulus on indentation testing was consistently stiffer than human cartilage measured at eight different articular locations. Contact area and pressure were measured with electronic pressure sensors under loads normalized by multiples of body weight and at knee flexion angles reported for walking. The highest peaks in contact pressure were measured in the patellofemoral joint in goat and human knees. Peak contact pressure measured at 2 times body weight at the goat tibiofemoral joint at 70° flexion was significantly higher than for any other condition at the human tibiofemoral joint. CONCLUSION These differences in contact conditions might explain the lower quality of local repair reported for caprine femoral condylar defects relative to trochlear defects. Further comparative analysis, including biologic response, is necessary to determine the extent to which the goat knee reproduces clinical conditions.
Collapse
Affiliation(s)
- Shantanu Patil
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, United States
| | - Nikolai Steklov
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, United States
| | - Lin Song
- Stryker Orthopaedics, Mahwah, NJ, United States
| | - Won C Bae
- University of California, San Diego, La Jolla, CA, United States
| | - Darryl D D'Lima
- Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, CA, United States.
| |
Collapse
|
42
|
Geiger D, Bae WC, Statum S, Du J, Chung CB. Quantitative 3D ultrashort time-to-echo (UTE) MRI and micro-CT (μCT) evaluation of the temporomandibular joint (TMJ) condylar morphology. Skeletal Radiol 2014; 43:19-25. [PMID: 24092237 PMCID: PMC4000774 DOI: 10.1007/s00256-013-1738-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/28/2013] [Accepted: 09/04/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Temporomandibular dysfunction involves osteoarthritis of the TMJ, including degeneration and morphologic changes of the mandibular condyle. The purpose of this study was to determine the accuracy of novel 3D-UTE MRI versus micro-CT (μCT) for quantitative evaluation of mandibular condyle morphology. MATERIALS AND METHODS Nine TMJ condyle specimens were harvested from cadavers (2 M, 3 F; age 85 ± 10 years, mean ± SD). 3D-UTE MRI (TR = 50 ms, TE = 0.05 ms, 104-μm isotropic-voxel) was performed using a 3-T MR scanner and μCT (18-μm isotropic-voxel) was also performed. MR datasets were spatially registered with a μCT dataset. Two observers segmented bony contours of the condyles. Fibrocartilage was segmented on the MR dataset. Using a custom program, bone and fibrocartilage surface coordinates, Gaussian curvature, volume of segmented regions, and fibrocartilage thickness were determined for quantitative evaluation of joint morphology. Agreement between techniques (MRI vs. μCT) and observers (MRI vs. MRI) for Gaussian curvature, mean curvature, and segmented volume of the bone were determined using intraclass correlation coefficient (ICC) analysis. RESULTS Between MRI and μCT, the average deviation of surface coordinates was 0.19 ± 0.15 mm, slightly higher than the spatial resolution of MRI. Average deviation of the Gaussian curvature and volume of segmented regions, from MRI to μCT, was 5.7 ± 6.5% and 6.6 ± 6.2%, respectively. ICC coefficients (MRI vs. μCT) for Gaussian curvature, mean curvature, and segmented volumes were 0.892, 0.893, and 0.972, respectively. Between observers (MRI vs. MRI), the ICC coefficients were 0.998, 0.999, and 0.997, respectively. Fibrocartilage thickness was 0.55 ± 0.11 mm, as previously described in the literature for grossly normal TMJ samples. CONCLUSIONS 3D-UTE MR quantitative evaluation of TMJ condyle morphology ex-vivo, including surface, curvature, and segmented volume, shows high correlation against μCT and between observers. In addition, UTE MRI allows quantitative evaluation of the fibrocartilaginous condylar component.
Collapse
Affiliation(s)
- Daniel Geiger
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, V.le Regina Elena 324, Rome, Italy, 00161,
| | | | | | | | | |
Collapse
|
43
|
Chang EY, Pallante-Kichura AL, Bae WC, Du J, Statum S, Wolfson T, Gamst AC, Cory E, Amiel D, Bugbee WD, Sah RL, Chung CB. Development of a Comprehensive Osteochondral Allograft MRI Scoring System (OCAMRISS) with Histopathologic, Micro-Computed Tomography, and Biomechanical Validation. Cartilage 2014; 5:16-27. [PMID: 24489999 PMCID: PMC3904392 DOI: 10.1177/1947603513514436] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To describe and apply a semi-quantitative MRI scoring system for multi-feature analysis of cartilage defect repair in the knee by osteochondral allografts, and to correlate this scoring system with histopathologic, micro-computed tomography (μCT), and biomechanical reference standards using a goat repair model. DESIGN Fourteen adult goats had two osteochondral allografts implanted into each knee: one in the medial femoral condyle (MFC) and one in the lateral trochlea (LT). At 12 months, goats were euthanized and MRI was performed. Two blinded radiologists independently rated nine primary features for each graft, including cartilage signal, fill, edge integration, surface congruity, calcified cartilage integrity, subchondral bone plate congruity, subchondral bone marrow signal, osseous integration, and presence of cystic changes. Four ancillary features of the joint were also evaluated, including opposing cartilage, meniscal tears, synovitis, and fat-pad scarring. Comparison was made with histological and μCT reference standards as well as biomechanical measures. Interobserver agreement and agreement with reference standards was assessed. Cohen's kappa, Spearman's correlation, and Kruskal-Wallis tests were used as appropriate. RESULTS There was substantial agreement (κ>0.6, p<0.001) for each MRI feature and with comparison against reference standards, except for cartilage edge integration (κ=0.6). There was a strong positive correlation between MRI and reference standard scores (ρ=0.86, p<0.01). OCAMRISS was sensitive to differences in outcomes between the types of allografts. CONCLUSIONS We have described a comprehensive MRI scoring system for osteochondral allografts and have validated this scoring system with histopathologic and μCT reference standards as well as biomechanical indentation testing.
Collapse
Affiliation(s)
- Eric Y. Chang
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA,Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| | | | - Won C. Bae
- Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| | - Sheronda Statum
- Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| | - Tanya Wolfson
- Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| | - Anthony C. Gamst
- Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| | - Esther Cory
- Department of Bioengineering, University of California, San Diego, CA, USA
| | - David Amiel
- Department of Orthopaedic Surgery, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - William D. Bugbee
- Department of Orthopaedic Surgery, University of California, San Diego School of Medicine, La Jolla, CA, USA,Department of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA, USA
| | - Robert L. Sah
- Department of Bioengineering, University of California, San Diego, CA, USA,Department of Orthopaedic Surgery, University of California, San Diego School of Medicine, La Jolla, CA, USA
| | - Christine B. Chung
- Department of Radiology, VA San Diego Healthcare System, San Diego, CA, USA,Department of Radiology, University of California, San Diego Medical Center, La Jolla, CA, USA
| |
Collapse
|
44
|
Abstract
The osteochondral junction is composed of numerous tissue components and serves important functions relating to structural stability and proper nutrition in joints such as the knee and spine. Conventional MR techniques have been inadequate at imaging the tissues of the osteochondral junction primarily because of the intrinsically short T2 nature of these tissues, rendering them "invisible" with the standard acquisitions. Ultrashort time to echo (UTE) MR techniques acquire sufficient MR signal of osteochondral tissues, thereby allowing direct evaluation. This article reviews the anatomy of the osteochondral junction of the knee and the spine, technical aspects of UTE MRI, and the application of UTE MRI for evaluation of the osteochondral junction.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, University of California, San Diego, 408 Dickinson St., San Diego, CA 92103-8226, USA
| | - Reni Biswas
- Department of Radiology, University of California, San Diego, 408 Dickinson St., San Diego, CA 92103-8226, USA
| | - Karen Chen
- Department of Radiology, University of California, San Diego, 408 Dickinson St., San Diego, CA 92103-8226, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, 408 Dickinson St., San Diego, CA 92103-8226, USA
| | - Christine B Chung
- Department of Radiology, University of California, San Diego, 408 Dickinson St., San Diego, CA 92103-8226, USA
| |
Collapse
|
45
|
Chang EY, Lim WY, Wolfson T, Gamst AC, Chung CB, Bae WC, Resnick DL. Frequency of atlantoaxial calcium pyrophosphate dihydrate deposition at CT. Radiology 2013; 269:519-24. [PMID: 23737539 DOI: 10.1148/radiol.13130125] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE To determine (a) the prevalence of atlantoaxial calcium pyrophosphate dihydrate (CPPD) crystal deposition in a population of patients undergoing computed tomography (CT) for acute trauma and (b) the association between atlantoaxial CPPD crystal deposition and retro-odontoid soft-tissue thickness. MATERIALS AND METHODS This HIPAA-compliant study was approved by the institutional review board, and the requirement to obtain informed consent was waived. In 513 consecutive patients, CT scans of the cervical spine obtained for acute trauma were retrospectively reviewed for the presence of atlantoaxial CPPD crystal deposition, and the maximal thickness of the retro-odontoid soft tissues was measured. The relationships among imaging findings, age, and sex were assessed with the t test, the χ(2) test, Spearman correlation, and logistic and linear regression models as appropriate. RESULTS The overall prevalence of atlantoaxial CPPD crystal deposition was 12.5% (64 of 513 patients), and prevalence increased with age (P < .0001, logistic regression coefficient). In patients aged 60 years and older, the prevalence of CPPD crystal deposition was 34% (58 of 170 patients). In patients aged 80 years and older, the prevalence of CPPD crystal deposition was 49% (37 of 75 patients). There was a positive correlation between age and retro-odontoid soft-tissue thickness (Spearman ρ = 0.48, P < .0001). The mean retro-odontoid soft-tissue thickness in patients with CPPD crystal deposition was greater than that in patients without CPPD crystal deposition (3.4 mm vs 2.2 mm, respectively; P < .0001, t test). CONCLUSION CPPD crystal deposition in the cervical spine is seen with a higher prevalence than previously reported. CPPD crystal deposition shows a positive correlation with age and retro-odontoid soft-tissue thickening.
Collapse
Affiliation(s)
- Eric Y Chang
- Department of Radiology, VA San Diego Healthcare System, 3350 La Jolla Village Dr, MC 114, San Diego, CA 92161
| | | | | | | | | | | | | |
Collapse
|
46
|
Du J, Carl M, Bae WC, Statum S, Chang EY, Bydder GM, Chung CB. Dual inversion recovery ultrashort echo time (DIR-UTE) imaging and quantification of the zone of calcified cartilage (ZCC). Osteoarthritis Cartilage 2013; 21:77-85. [PMID: 23025927 PMCID: PMC4051156 DOI: 10.1016/j.joca.2012.09.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 09/08/2012] [Accepted: 09/19/2012] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To develop ultrashort echo time (UTE) magnetic resonance imaging (MRI) techniques to image the zone of calcified cartilage (ZCC), and quantify its T2*, T1 and T1ρ. DESIGN In this feasibility study a dual inversion recovery UTE (DIR-UTE) sequence was developed for high contrast imaging of the ZCC. T2* of the ZCC was measured with DIR-UTE acquisitions at progressively increasing TEs. T1 of the ZCC was measured with saturation recovery UTE acquisitions at progressively increasing saturation recovery times. T1ρ of the ZCC was measured with spin-locking prepared DIR-UTE acquisitions at progressively increasing spin-locking times. RESULTS The feasibility of the qualitative and quantitative DIR-UTE techniques was demonstrated on phantoms and in six cadaveric patellae using a clinical 3 T scanner. On average the ZCC has a short T2* ranging from 1.0 to 3.3 ms (mean ± standard deviation = 2.0 ± 1.2 ms), a short T1 ranging from 256 to 389 ms (mean ± standard deviation = 305 ± 45 ms), and a short T1ρ ranging from 2.2 to 4.6 ms (mean ± standard deviation = 3.6 ± 1.2 ms). CONCLUSION UTE MR based techniques have been developed for high resolution imaging of the ZCC and quantitative evaluation of its T2*, T1 and T1ρ relaxation times, providing non-invasive assessment of collagen orientation and proteoglycan content at the ZCC and the bone cartilage interface. These measurements may be useful for non-invasive assessment of the ZCC, including understanding the involvement of this tissue component in osteoarthritis.
Collapse
Affiliation(s)
- J Du
- Department of Radiology, University of California, San Diego, CA 92103-8756, United States.
| | | | | | | | | | | | | |
Collapse
|
47
|
Bae WC, Statum S, Zhang Z, Yamaguchi T, Wolfson T, Gamst AC, Du J, Bydder GM, Masuda K, Chung CB. Morphology of the cartilaginous endplates in human intervertebral disks with ultrashort echo time MR imaging. Radiology 2012. [PMID: 23192776 DOI: 10.1148/radiol.12121181] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To image human disk-bone specimens by using conventional spin-echo (SE) and ultrashort echo time (TE) techniques, to describe the morphology at magnetic resonance (MR) imaging, and to identify tissue components contributing to high signal intensity near the cartilaginous endplates (CEPs). MATERIALS AND METHODS This study was exempt from institutional review board approval, and informed consent was not required. Five cadaveric lumbar spines (mean age, 61 years ± 11) were prepared into six sample types containing different combinations of disk, uncalcified CEP, calcified CEP, and subchondral bone components and were imaged with proton density-weighted SE (repetition time msec/TE msec, 2000/15) and ultrashort TE (300/0.008, 6.6, echo-subtraction) sequences. Images were evaluated to determine the presence of intermediate-to-high signal intensity in regions excluding the bone marrow. Logistic regression was used to determine which tissue components were significant predictors of the presence of signal intensity for each MR technique. RESULTS On ultrashort TE MR images, intact disk/uncalcified CEP/calcified CEP/bone samples exhibited bilaminar intermediate-to-high signal intensity in the region near the CEP, consistent with the histologic appearance of uncalcified and calcified CEPs. Conversely, proton density-weighted SE images exhibited low signal intensity in this region. Results of logistic regression suggested that the presence of uncalcified CEP (P = .023) and calcified CEP (P = .007) in the sample were strong predictors of the presence of signal intensity on ultrashort TE images, whereas the disk was the only predictor (P < .001) of signal intensity on proton density-weighted SE images. CONCLUSION Ultrashort TE imaging, unlike proton density-weighted SE imaging, enabled direct visualization of the uncalcified and calcified CEP. Evaluation of the morphology and identification of sources of signal intensity at ultrashort TE MR imaging provides opportunities to potentially aid in the understanding of degenerative disk disease.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, University of California-San Diego, 408 Dickinson St, San Diego, CA 92103-8226, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Omoumi P, Bae WC, Du J, Diaz E, Statum S, Bydder GM, Chung CB. Meniscal calcifications: morphologic and quantitative evaluation by using 2D inversion-recovery ultrashort echo time and 3D ultrashort echo time 3.0-T MR imaging techniques--feasibility study. Radiology 2012; 264:260-8. [PMID: 22723564 DOI: 10.1148/radiol.12111439] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To assess the ability of ultrashort echo time (UTE) magnetic resonance (MR) imaging techniques to enable morphologic assessment of different types of meniscal calcifications, to compare these sequences with standard clinical sequences, and to perform T2* measurements of meniscal calcifications. MATERIALS AND METHODS This study was exempted by the institutional review board, and informed consent was not required. Ten human cadaveric menisci were imaged with high-spatial-resolution radiography and 3.0-T MR imaging by using morphologic (T1-weighted fast spin-echo [FSE], T2-weighted FSE, proton density [PD]-weighted FSE, two-dimensional [2D] fast spoiled gradient-echo [FSPGR], three-dimensional [3D] FSPGR, and 3D UTE) and quantitative (2D inversion-recovery [IR] UTE and 3D UTE) sequences. The menisci were divided into thirds for regional analysis. Morphologic assessment was performed with MR imaging; MR imaging findings were correlated with radiographs. Calcifications were classified as punctate, linear, or globular. T2* measurements were performed by manual placement of regions of interest (ROIs) in calcifications and by automatically creating ROIs in the surrounding tissues. Mixed-effects linear regression was used to determine variations in T2* as a function of region, morphology, and tissue type. RESULTS The two globular calcifications were visualized with all sequences. For punctate (n=21) and linear (n=21) calcifications, respectively, visibility rates were as follows: 9.5% for both with the T1-weighted FSE sequence, 0% for both with the T2-weighted FSE sequence, 19.0% and 23.8% with the PD-weighted FSE sequence, 0% for both with the 2D IR UTE sequence, 100% for both with the 3D UTE sequence, and 100% for both with the 3D FSPGR sequence. T2* values were significantly lower for calcifications than for the surrounding meniscal tissue (P<.001). There was a trend of globular calcifications having lower T2* values than other morphologies (P=.08). With the 2D IR UTE technique, the T2* of the globular calcifications tended to be lower than with the 3D UTE technique (0.13-0.16 vs 1.32-3.03 msec) (P=.14, analysis of variance). CONCLUSION UTE MR imaging sequences may allow morphologic as well as quantitative evaluation of meniscal calcifications.
Collapse
Affiliation(s)
- Patrick Omoumi
- Department of Radiology, University of Califonia-San Diego, 408 Dickinson St, San Diego, CA 92103, USA
| | | | | | | | | | | | | |
Collapse
|
49
|
Pauli C, Bae WC, Lee M, Lotz M, Bydder GM, D'Lima DL, Chung CB, Du J. Ultrashort-echo time MR imaging of the patella with bicomponent analysis: correlation with histopathologic and polarized light microscopic findings. Radiology 2012; 264:484-93. [PMID: 22653187 DOI: 10.1148/radiol.12111883] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To correlate short and long T2* water fractions, derived from ultrashort-echo time (TE) magnetic resonance (MR) imaging, with semiquantitative histopathologic and polarized light microscopic (PLM) assessment of human cadaveric patellae cartilage. MATERIALS AND METHODS Twenty human cadaveric patellae were evaluated by using ultrashort-TE imaging, spin-echo imaging, histopathologic analysis, and PLM, with institutional review board approval. Short and long T2* water components were evaluated for each patella by using bicomponent fitting of ultrashort-TE signal decay. Four to six regions of interest (ROIs) within each patella were chosen for correlation between ultrashort-TE bicomponent analysis, histopathologic grading (Mankin score), and PLM grading (Vaudey score). RESULTS Ultrashort-TE imaging with bicomponent analysis showed two distinct water components with a short T2* and a longer T2* in all patellae. ROI analysis showed that the short T2* fraction was correlated significantly with the Mankin (ρ = 0.66, P < .001) and Vaudey (ρ = 0.68, P < .001) scores. The Mankin scores were weakly positively correlated with T2 (ρ = 0.28, P = .13) and short T2* (ρ = 0.24, P = .14) but were negatively correlated with long T2* (ρ = -0.55, P < .01). The Vaudey scores were weakly positively correlated with T2 (ρ = 0.18, P = .16) and short T2* (ρ = 0.22, P = .14) but were negatively correlated with long T2* (ρ = -0.55, P < .01). CONCLUSION Short T2* water fraction derived from ultrashort-TE imaging with bicomponent analysis correlates significantly with both the Mankin and Vaudey scores and may serve as a biomarker of cartilage degeneration.
Collapse
Affiliation(s)
- Chantal Pauli
- Department of Molecular and Experimental Medicine, the Scripps Research Institute, La Jolla, CA, USA
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Bae WC, Chen PC, Chung CB, Masuda K, D'Lima D, Du J. Quantitative ultrashort echo time (UTE) MRI of human cortical bone: correlation with porosity and biomechanical properties. J Bone Miner Res 2012; 27:848-57. [PMID: 22190232 PMCID: PMC3463505 DOI: 10.1002/jbmr.1535] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this study we describe the use of ultrashort echo time (UTE) magnetic resonance imaging (MRI) to evaluate short and long T2* components as well as the water content of cortical bone. Fourteen human cadaveric distal femur and proximal tibia were sectioned to produce 44 rectangular slabs of cortical bone for quantitative UTE MR imaging, microcomputed tomography (µCT), and biomechanical testing. A two-dimensional (2D) UTE pulse sequence with a minimal nominal TE of 8 µseconds was used together with bicomponent analysis to quantify the bound and free water in cortical bone using a clinical 3T scanner. Total water concentration was measured using a 3D UTE sequence together with a reference water phantom. UTE MR measures of water content (total, free, and bound), T2* (short and long), and short and long T2* fractions were compared with porosity assessed with µCT, as well as elastic (modulus, yield stress, and strain) and failure (ultimate stress, failure strain, and energy) properties, using Pearson correlation. Porosity significantly correlated positively with total (R(2) = 0.23; p < 0.01) and free (R(2) = 0.31; p < 0.001) water content as well as long T2* fraction (R(2) = 0.25; p < 0.001), and negatively with short T2* fraction and short T2* (R(2) = 0.24; p < 0.01). Failure strain significantly correlated positively with short T2* (R(2) = 0.29; p < 0.001), ultimate stress significantly correlated negatively with total (R(2) = 0.25; p < 0.001) and bound (R(2) = 0.22; p < 0.01) water content, and failure energy significantly correlated positively with both short (R(2) = 0 30; p < 0.001) and long (R(2) = 0.17; p < 0.01) T2* values. These results suggest that UTE MR measures are sensitive to the structure and failure properties of human cortical bone, and may provide a novel way of evaluating cortical bone quality.
Collapse
Affiliation(s)
- Won C Bae
- Department of Radiology, University of California, San Diego, San Diego, CA 92103-8226, USA
| | | | | | | | | | | |
Collapse
|