ISMRM 21st Annual Meeting & Exhibition 20-26 April 2013 Salt Lake City, Utah, USA

Cartilage: Clinical & Translational
Thursday 25 April 2013
Room 355 BC  10:30 - 12:30 Moderators: Hollis G. Potter, Siegfried Trattnig

10:30 0632.   Cartilage T1? and T2 Quantification in ACL-Reconstructed Knees: A 2-Year Follow-Up
Favian Su1, Joan Hilton2, Lorenzo Nardo1, Samuel Wu1, Fei Liang1, Thomas M. Link1, C. Benjamin Ma3, and Xiaojuan Li1,3
1Musculoskeletal Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, United States, 2Department of Epidemiology and Biostatistics, University of California, San Francisco (UCSF), San Francisco, CA, United States, 3Department of Orthopaedic Surgery, University of California, San Francisco (UCSF), San Francisco, CA, United States

Previous studies suggested that subjects with ACL injuries have a high risk of developing post-traumatic osteoarthritis even after ACL reconstruction. Cartilage matrix and morphology changes were evaluated within the medial and lateral regions of the femur and tibia of ACL-injured knees using 3 T MRI T1ρ and T2 quantification two years following reconstruction. Elevated T1ρ values and thicker medial compartments in ACL-injured patients was observed over the two years. T1ρ values in posterolateral tibial cartilage were significantly higher in ACL-reconstructed knees and were not fully recovered at the 2-year follow-up. These results suggest quantitative MRI can be a powerful tool for stratifying injury, monitoring and potentially predicting post-traumatic OA development in ACL-injured joints.

10:42 0633.   Intra-Articular DGEMRIC: Contrast Concentration in Joint Cavity May Impact Cartilage T1 Measurements
Wei Li1, Martin Lazarus1, Jason Koh2, Ewa Gliwa1, and Pottumarthi Vara Prasad1
1Radiology, NorthShore University HealthSystem, Evanston, Illinois, United States, 2Orthopaedic Surgery, NorthShore University HealthSystem, Evanston, Illinois, United States

Based on the logistical advantage of the ia-dGEMRIC over the iv-dGEMRIC, we conducted a preliminary trial using ia-dGEMRIC to assess biochemical changes in cartilage in 39 patients with hip pain who underwent MR-arthrography at our institution. The T1 of articular cartilage was moderately correlated with T1 of joint fluid. This finding suggests that in ia-dGEMRIC, the cartilage T1 measurements may not be specifically related to the proteoglycan (PG) content in the cartilage, but may also reflect the contrast concentration in articular cavity. This will impact the interpretation of T1 values observed and inter-subject comparisons in articular cartilage

10:54 0634.   Detection and Staging of Acetabular Cartilage Damage in Femoroacetabular Impingement Using DGEMRIC and T2 Mapping
Daniele Ascani1, Catherine Petchprapa2, James S. Babb2, Michael P. Recht2, and Riccardo Lattanzi1,3
1Radiology/Center for Biomedical Imaging, NYU Langone Medical Center, New York, NY, United States, 2Radiology, NYU Langone Medical Center, New York, NY, United States, 3The Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, United States

Early detection of articular cartilage damage is critical to the success of joint preserving surgeries for patients with femoroacetabular impingement (FAI). Delayed Gadolinium-Enhanced MRI of Cartilage (dGEMRIC) and T2 mapping can detect early biochemical changes in cartilage. We investigated the relationship of dGEMRIC and T2 with morphologic cartilage assessment at 3T. dGEMRIC was very sensitive to cartilage damage (71% and 86% for minor and severe lesions, respectively), whereas T2 was very specific (87% for any type of lesion). This preliminary study suggests that the combination of morphologic MRI, dGEMRIC and T2 could be effective in detecting and staging cartilage damage.

11:06 0635.   Morphological and Biochemical Assessment of Repair Tissue After Chondrosphere-Based Autologous Chondrozyte Transplantation
Benjamin Schmitt1, Beser Ferzan Suezer2, Patrik Zamecnik3, Vladimir Jellus4, Marco Essig3, Siegfried Trattnig5, and Rainer Siebold6
1Department of Radiology, Medical University of Vienna, Vienna, Vienna, Austria, 2Atos Hospital Heidelberg, Heidelberg, BW, Germany, 3German Cancer Research Center, Heidelberg, BW, Germany,4Healthcare Sector, Siemens AG, Erlangen, BY, Germany, 5Medical University of Vienna, Vienna, Vienna, Austria, 6Center Hip-Knee-Foot Surgery, Atos Hospital Heidelberg, Heidelberg, BW, Germany

The study was performed to assess to compare the results from gagCEST imaging and T2 mapping in 30 patients after autologous cartilage transplantation with a novel chondrosphere-based approach. While T2 mapping showed no significant differences between transplants and reference values taken from the contralateral knee, gagCEST signal intensities were lower in the transplants. This hints towards a reduced GAG content in repair tissue compared to native cartilage, although a high morphologic integrity of the transplants was demonstrated via MOCART scoring. The employed transplantation technique yielded a superior biochemical and morphologic outcome compared to previous MR studies.

11:18 0636.   Multi-Component T2 Analysis of Articular Cartilage with Synovial Fluid Partial Volume Correction Using McDESPOT at 3.0T
Fang Liu1, Samuel A. Hurley1, Alexey Samosonov1, Andrew L. Alexander1, Sean C. L. Deoni2, Walter F. Block1,3, and Richard Kijowski4
1Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, United States, 2Division of Engineering, Brown University, Providence, RI, United States, 3Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States, 4Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, United States

Multi-component T2 mapping using mcDESPOT three pool model was performed for correcting synovial fluid partial volume contamination in human knee cartilage in-vivo scan at 3.0T. T2 relaxation time for the bulk water loosely bound to the proteoglycan matrix (Wb) were shown to be mostly affected at the superficial layer of the cartilage with increasing T2 values more than 100% compared to the deep layer. mcDESPOT three pool model shows significant advantage of correcting the T2 relaxation time estimation bias while has no influence on measurements within the remaining portions of the cartilage.

11:30 0637.   High-Resolution Knee MRI Using Prospective Motion Correction for Quantification of Cartilage Compression Under in Situ Mechanical Loading
Thomas Lange1, Michael Herbst1, Julian R. Maclaren2, Cris Lovell-Smith1, Kaywan Izadpanah3, and Maxim Zaitsev1
1Department of Radiology, University Medical Center Freiburg, Freiburg, Germany, 2Department of Radiology, Stanford University, Stanford, California, United States, 3Department of Orthopedic and Trauma Surgery, University Medical Center Freiburg, Freiburg, Germany

Knee MRI can be used to probe the mechanical properties of the articular cartilage by comparative volumetric measurements with and without mechanical loading. However, to date MRI studies with in situ loading have been hampered by excessive subject motion. In this work, it is demonstrated that almost artifact-free high-resolution cartilage MRI of loaded tibiofemoral as well as patellofemoral joints can be performed using prospective motion correction based on optical tracking with appropriate tracking marker placement. Load-induced compression of the patellar cartilage is quantified in six healthy subjects. The method might provide new insight into the altered biomechanics associated with chondromalacia.

11:42 0638.   Classification of Sodium MRI Data of Cartilage with Machine Learning and Logistic Regression
Guillaume Madelin1, James S. Babb1, and Ravinder R. Regatte1
1Radiology Department, New York University Langone Medical Center, New York, NY, United States

Statistical learning algorithms, such as support vector machine (SVM), k-nearest neighbor (KNN), naive Bayes (NB) and discriminant analysis (DA), and logistic regression (LR), are compared for classifying subjects with and without osteoarthritis (OA) from sodium MRI data of articular cartilage at 7T. The best accuracy results are obtained with SVM and LR. SVM can classify the data with an accuracy of 78-80% by combining MRI measurements acquired with and without fluid suppression. LR generates a slightly lower accuracy (74-79%), but use only a single MRI measurement acquired with fluid suppression.

11:54 0639.   Longitudinal Clinical Evaluation of Cartilage and Meniscus UTE-T2* Following ACL Reconstruction
Ashley A. Williams1, Yongxian Qian2, and Constance R. Chu1
1Cartilage Restoration Center, University of Pittsburgh, Pittsburgh, PA, United States, 2Radiology, University of Pittsburgh, Pittsburgh, PA, United States

This study examines UTE-T2* maps in 16 subjects acquired prior to and 12-months following ACL reconstruction surgery. UTE-T2* values decrease to asymptomatic levels in deep pMFC cartilage, suggesting healing of the deep articular cartilage matrix over 12 months following surgery. Meniscus UTE-T2* values in half of the subjects remain elevated or show further increases over the 12 months, demonstrating evidence of persistent subsurface degeneration a year after operative stabilization of the ACL-injured knee. Together these findings suggest that UTE-T2* provides a useful non-invasive tool to monitor cartilage and meniscal status in knees at risk of developing OA.

12:06 0640.   MRI Is Predictive of Adverse Tissue Reaction in Failed Metal-On-Metal Hip Arthroplasty
Alissa J. Burge1, Danyal H. Nawabi2, Stephanie Gold1, Stephen Lyman3, Douglas E. Padgett2, Matthew F. Koff1, and Hollis G. Potter1
1Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States, 2Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, United States, 3Division of Epidemiology and Biostatistics, Hospital for Special Surgery, New York, NY, United States

An MRI classification system was developed to predict adverse local tissue reactions (ALTRs) in patients with metal-on-metal hip arthroplasty. MR images from 70 patients were assessed for osteolysis, synovitis, synovial thickness, presence of edema, synovial decompression, low signal intensity deposits, pseudocapsule dehiscence, disrupted abductors and neurovascular compression. Synovial tissues were obtained intra-operatively and were graded to assess tissue reaction. The presence and volume of synovitis, and the synovial thickness were found to correlate with histologic scoring. In patients with failed metal-on-metal (MOM) hip arthroplasty, MRI can be used to identify an adverse tissue reaction and predict the presence of soft tissue damage, helping guide the need for revision.

12:18 0641.   In Vivo Comparison of Intravenous and Intra-Articular DGEMRIC and Delayed Quantitative CT Arthrography
Jukka Hirvasniemi1, Katariina A.M. Kulmala2, Eveliina Lammentausta3, Risto Ojala4, Petri Lehenkari5,6, Alaaeldin Kamel3, Jukka S. Jurvelin2, Juha Töyräs2,7, Miika T. Nieminen3,4, and Simo Saarakkala1,3
1Department of Medical Technology, University of Oulu, Oulu, Finland, 2Department of Applied Physics, University of Eastern Finland, Kuopio, Finland, 3Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland, 4Department of Diagnostic Radiology, University of Oulu, Oulu, Finland, 5Department of Anatomy and Cell Biology, University of Oulu, Oulu, Finland, 6Department of Surgery, Oulu University Hospital, Oulu, Finland, 7Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland

dGEMRIC with intravenous (dGEMRICIV) and intra-articular contrast agent injection (dGEMRICIA) and delayed quantitative CT arthrography (dQCTA) were compared in a patient study. dGEMRICIVand dGEMRICIA were performed at 90 minutes after gadopentetate injection. dQCTA was performed at 5 and 45 minutes after intra-articular injection of ioxaglate. Normalized dQCTA was in best agreement with dGEMRICIV at 45 minutes after ioxaglate injection (rs=0.72). dGEMRICIV and dGEMRICIA were not correlated without taking account of synovial fluid. The findings of the study indicate the importance of taking account of the contrast agent concentration in synovial fluid in dQCTA and dGEMRICIA.