Division scheme optimization for the molecular evaluation of the intervertebral disc by gadolinium‐enhanced MRI

Purpose

To evaluate the effects of reducing the number of segments in which the intervertebral disc (IVD) can be subdivided on the accuracy in estimating its sGAG content by computation of the parameter ΔT1 from delayed Gadolinium‐Enhanced MRI of Cartilage (dGEMRIC) protocol.

Materials and Methods

Twenty‐three herniectomy patients underwent dGEMRIC acquisitions for IVD. Thirty‐one tissue samples were obtained at herniectomy from the same patients and biochemically analysed for their sGAG content. Eleven different division schemes (DS) were applied by processing dGEMRIC images, and ΔT1 values of the segments related to the surgical sampling locations were computed and correlated to the corresponding biochemical data. For each DS, the linear regression and Pearson's coefficient were computed.

Results

Reducing the number of segments from 48 (4 annular rings and 12 angular sectors) to 12 (2 rings and 6 sectors), correlation with sGAG biochemical data did not decline (r > 0.7).

Conclusion

A 12‐segment DS provided the best compromise between preserving accuracy and reducing the number of segments. J. Magn. Reson. Imaging 2009;29:1443–1449. © 2009 Wiley‐Liss, Inc.     

Cartilage quality in rheumatoid arthritis: comparison of T2* mapping, native T1 mapping, dGEMRIC, ΔR1 and value of pre-contrast imaging

Purpose

To prospectively evaluate four non-invasive markers of cartilage quality—T2* mapping, native T1 mapping, dGEMRIC and ΔR1—in healthy volunteers and rheumatoid arthritis (RA) patients.

Materials and methods

Cartilage of metacarpophalangeal (MCP) joints II were imaged in 28 consecutive subjects: 12 healthy volunteers [9 women, mean (SD) age 52.67 (9.75) years, range 30–66] and 16 RA patients with MCP II involvement [12 women, mean (SD) age 58.06 (12.88) years, range 35–76]. Sagittal T2* mapping was performed with a multi-echo gradient-echo on a 3?T MRI scanner. For T1 mapping the dual flip angle method was applied prior to native T1 mapping and 40?min after gadolinium application (delayed gadolinium-enhanced MRI of cartilage, dGEMRIC, T1_Gd). The difference in the longitudinal relaxation rate induced by gadolinium (ΔR1) was calculated. The area under the receiver operating characteristic curve (AROC) was used to test for differentiation of RA patients from healthy volunteers.

Results

dGEMRIC (AUC 0.81) and ΔR1 (AUC 0.75) significantly differentiated RA patients from controls. T2* mapping (AUC 0.66) and native T1 mapping (AUC 0.66) were not significantly different in RA patients compared to controls.

Conclusions

The data support the use of dGEMRIC for the assessment of MCP joint cartilage quality in RA. T2* and native T1 mapping are of low diagnostic value. Pre-contrast T1 mapping for the calculation of ΔR1 does not increase the diagnostic value of dGEMRIC.     

A Phase I clinical trial of the knee to assess the correlation of gagCEST MRI,delayed gadolinium-enhanced MRI of cartilage and T2 mapping

PurposeOsteoarthritis (OA) is associated with the loss of glycosaminoglycan (GAG) during disease progression, which can be detected by glycosaminoglycan chemical exchange-dependent saturation transfer (gagCEST) MRI. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is considered one of the standard methods for GAG quantification in vivo. This Phase I study assessed the correlation between gagCEST MRI and dGEMRIC in determining cartilage GAG concentration. Standard T2 mapping was used as a comparator with the two other methods.Materials and methodsEight athletic volunteers with no known knee diseases were recruited in this study. The sagittal images of both knees in each volunteer were obtained by a 3 T MRI system. GAG concentration was calculated based on fixed charge density (FCD) within articular cartilage as calculated by T1 values obtained from dGEMRIC sequences. Magnetization transfer ratio asymmetry (MTR_asym) of the CEST spectrum at 1 ppm was determined with gagCEST MRI. T2 values were calculated using a multi-echo turbo spin echo (TSE) sequence. The Pearson correlations among MTR_asym were calculated from gagCEST analysis.ResultsThere was moderate correlation (correlation coefficient r = 0.55) between dGEMRIC and gagCEST MRI results. T2 had a low correlation (r = −0.30) with gagCEST and no correlation with dGEMRIC (r = 0.003). Both gagCEST and dGEMRIC were able to distinguish between high GAG concentration cartilage compartments (higher than 210 mM) and low GAG cartilage compartments (lower than 210 mM).ConclusiondGEMRIC was shown to be a more accurate and sensitive clinical imaging tool in evaluating cartilage GAG levels in vivo. While GagCEST showed less sensitivity to GAG concentration variations than dGEMRIC, further improvements may yet enable gagCEST to be a clinically robust methodology.     

Signal polarity restoration in a 3D inversion recovery sequence used with delayed gadolinium‐enhanced magnetic resonance imaging of cartilage (dGEMRIC)

Purpose:

To develop an image reconstruction algorithm that restores the signal polarity in a three‐dimensional inversion‐recovery (3D‐IR) sequence used in delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC). This approach effectively doubles the dynamic range of data used for T1 curve fitting.

Materials and Methods:

We applied this reconstruction algorithm to a 3D‐IR TFE sequence used for T1 mapping, validated the technique in a phantom study, and performed T1‐map calculations in postosteochondral allograft transplant (OAT) patients. In addition, we performed a signal simulation study to assess the algorithm's capability to reduce the number of inversion times used in the 3D‐IR TFE sequence.

Results:

In comparison to a standard T1‐mapping algorithm that uses the magnitude of the MRI signal, the proposed algorithm improves the reliability of T1 relaxation fits to the inversion‐recovery three‐parameter function. The signal simulation study shows that the number of TI inversion times can be reduced to as few as four, without compromising the accuracy of T1 calculations.

Conclusion:

This algorithm can be applied to any 2D‐ or 3D‐IR acquisition sequence used in conjunction with dGEMRIC. Application of the algorithm improves the reliability of T1 calculations and allows the number of TIs to be reduced, leading to shorter scan times in dGEMRIC. J. Magn. Reson. Imaging 2012;36:1248–1255. © 2012 Wiley Periodicals, Inc.     

Impact of motion on T1 mapping acquired with inversion recovery fast spin echo and rapid spoiled gradient recalled‐echo pulse sequences for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) in volunteers

Purpose:

To evaluate the impact of motion on T1 values acquired by using either inversion‐recovery fast spin echo (IR‐FSE) or three‐dimensional (3D) spoiled gradient recalled‐echo (SPGR) sequences for delayed gadolinium‐enhanced magnetic resonance imaging of cartilage (dGEMRIC) in volunteers.

Materials and Methods:

Single‐slice IR‐FSE and 3D SPGR sequences were applied to perform dGEMRIC in five healthy volunteers. A mutual information‐based approach was used to correct for image misregistration. Displacements were expressed as averaged Euclidean distances and angles. Averages of differences in goodness of fit (Δχ²) tests and averages of relative differences in T1 values (ΔT1) before and after motion correction were computed.

Results:

Maximum Euclidean distance was 3.5 mm and 1.2 mm for IR‐FSE and SPGR respectively. Mean ± SD of Δχ² were 10.18 ± 8.4 for IR‐FSE and ?1.37 ± 5.5 for SPGR. Mean ± SD of ΔT1 were 0.008 ± 0.0048 for IR‐FSE and ?0.002 ± 0.019 for FSPGR. Pairwise comparison of Δχ² values showed a significant difference for IR‐FSE, but not for 3D‐SPGR. Significantly greater variability in T1 values was also noted for IR‐FSE than for 3D‐SPGR.

Conclusion:

Involuntary motion has a significant influence on T1 values acquired with IR‐FSE, but not with 3D‐SPGR in healthy volunteers. J. Magn. Reson. Imaging 2010;32:394–398. © 2010 Wiley‐Liss, Inc.

     

Magnetic resonance imaging of relative glycosaminoglycan distribution in patients with autologous chondrocyte transplants.

RATIONALE AND OBJECTIVES: Autologous chondrocyte transplantation (ACT) is a potential treatment for full-thickness chondral lesions in the knee. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) has recently been developed as a sensitive and specific measure of cartilage glycosaminoglycans (GAGs). Under the conditions of dGEMRIC, T1 is directly related to the GAG concentration. Our aim for this study was to demonstrate the potential of dGEMRIC to evaluate ACT implants. METHODS: Eleven ACT implants were studied 2 to 24 months postoperatively by dGEMRIC. T1 values from three regions of interest were obtained to examine GAG content (1) in the implant, (2) in native cartilage adjacent to the implant, and (3) in native cartilage further removed from the implant (as "control"). RESULTS: One implant failed and therefore was not included. Four of the implants were studied between 2 and 6 months postoperatively and showed low T1 (GAG), less than 80% of the control native cartilage. Five of the six implants studied between 12 and 24 months postoperativley showed T1 (GAG) comparable to (>80%) of control. One 18-month graft showed low T1 comparable to the surrounding native cartilage, with normal GAG seen in cartilage far from the graft site. The GAG index (T1 values of the graft normalized to control) from the group of implants 6 months or less was 59% +/- 5% of control, whereas those at 12 to 24 months were 91% +/- 18% of control. The two groups were statistically different with a P value of 0.005. CONCLUSIONS: The GAG level in grafts that were implanted for less than 12 months appeared to be lower than that in the remote cartilage. At 12 months or greater, the grafts in this study had GAG levels that were comparable to both the adjacent and remote cartilage. This preliminary study of ACT implants has shown that it is feasible to apply the dGEMRIC technique in patients with ACT as a way to obtain information related to the composition of grafts. These results provide motivation and the pilot data with which to design further clinical studies.     

Reproducibility of dGEMRIC in assessment of hip joint cartilage: A prospective study

Purpose

To investigate the reproducibility of dGEMRIC in the assessment of cartilage health of the adult asymptomatic hip joint.

Materials and Methods

Fifteen asymptomatic volunteers (mean age, 26.3 years ± 3.0) were preliminarily studied. Any volunteer that was incidentally diagnosed with damaged cartilage on MRI (n = 5) was excluded. Ten patients that had no evidence of prior cartilage damage (mean age, 26.2 years ± 3.4) were evaluated further in this study. The reproducibility of dGEMRIC was assessed with two T1_Gd exams performed 4 weeks apart in these volunteers. The protocol involved an initial standard MRI to confirm healthy cartilage, which was then followed by dGEMRIC. The second scan included only the repeat dGEMRIC. Region of interest (ROI) analyses for T1_Gd‐measurement was performed in seven radial reformats. Statistical analysis included the student's t‐test and intra‐class correlation (ICC) measurement to assess reproducibility.

Results

Overall 70 ROIs were studied. Mean cartilage T1_Gd values at various loci ranged from 560.9 ms to 684.4 ms at the first set of readings and 551.5 ms to 662.2 ms in the second one. The mean difference per region of interest between the two T1_Gd‐measurements ranged from 21.4 ms (3.7%) to 45.0 ms (6.8%), which was not found to be statistically significant (P = 0.153). There was a high reproducibility detected (ICC range, 0.667–0.915). Intra‐ and Inter‐observer analyses proved a high agreement for T1_Gd assessment (0.973 and 0.932).

Conclusion

We found dGEMRIC to be a reliable tool in the assessment of cartilage health status in adult hip joints. J. Magn. Reson. Imaging 2009;30:224–228. © 2009 Wiley‐Liss, Inc.     

Delayed gadolinium‐enhanced MRI of cartilage in the ankle at 3 T: Feasibility and preliminary results after matrix‐associated autologous chondrocyte implantation

Purpose:

To demonstrate the feasibility of delayed gadolinium‐enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the ankle at 3 T and to obtain preliminary data on matrix associated autologous chondrocyte (MACI) repair tissue.

Materials and Methods:

A 3D dual flip angle sequence was used with an eight‐channel multipurpose coil at 3 T to obtain T1 maps both pre‐ and postintravenous contrast agent (Magnevist, 0.2 mM/kg). Postcontrast T1 over time was evaluated in three volunteers; a modified dGEMRIC protocol was then used to assess 10 cases after MACI in the ankle.

Results:

Forty‐five minutes were found sufficient for maximum T1 decrease. MACI cases had a precontrast mean T1 of 1050 ± 148.4 msec in reference cartilage (RC) and 1080 ± 165.6 msec in repair tissue (RT). Postcontrast T1 decreased to 590 ± 134.0 msec in RC and 554 ± 133.0 msec in RT. There was no significant difference between the delta relaxation rates in RT (9.44 × 10^?4 s^?1) and RC (8.04 × 10^?4 s^?1, P = 0.487). The mean relative delta relaxation rate was 1.34 ± 0.83.

Conclusion:

It is feasible to assess the thin cartilage layers of the ankle with dGEMRIC at 3 T; MACI can yield RT with properties similar to articular cartilage. J. Magn. Reson. Imaging 2010;31:732–739. © 2010 Wiley‐Liss, Inc.

     

Value of precontrast T1 for dGEMRIC of native articular cartilage

Purpose

To evaluate if the difference between pre‐ and post‐Gd‐DTPA^2‐ relaxation rate (ΔR₁) provides better differentiation of osteoarthritic patients (OA) from healthy subjects (HS) with dGEMRIC, as compared to post‐Gd‐DTPA^2‐ spin‐lattice relaxation time (T_1Gd).

Materials and Methods

Seventeen OA and 14 HS underwent pre‐ and 90 minutes postcontrast (Gd‐DTPA^2‐) magnetic resonance imaging (MRI) of the knee, using inversion recovery fast spin‐echo and/or Lock–Locker sequences for T₁ mapping. Effect sizes for T_1pre, T_1Gd, and ΔR₁ were calculated, and receiver operating characteristic (ROC) curve and regression analysis were also performed to assess the effectiveness of each parameter in the separation of OA and HS.

Results

T_1Gd and ΔR₁ were almost identical in terms of areas under ROC curves (0.903 and 0.914, respectively), and effect sizes (1.34 and 1.31, respectively). These were significantly higher than T_1pre. In addition, a high inverse correlation was observed between ΔR₁ vs. T_1Gd (R = 0.96).

Conclusion

Either T_1Gd or ΔR₁ could be used as an index in the evaluation of native cartilage. However, considering the practical logistical cost involved in terms of time and effort to acquire precontrast T₁ measurements, our data further support the continued use of T_1Gd as the dGEMRIC index in the evaluation of native cartilage. J. Magn. Reson. Imaging 2009;29:494–497. © 2009 Wiley‐Liss, Inc.     

Three-dimensional delayed gadolinium-enhanced magnetic resonance imaging of hip joint cartilage at 3T: A prospective controlled study

Purpose

To assess acetabular and femoral hip joint cartilage with three-dimensional (3D) delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) in patients with degeneration of hip joint cartilage and asymptomatic controls with morphologically normal appearing cartilage.

Methods and materials

A total of 40 symptomatic patients (18 males, 22 females; mean age: 32.8 ± 10.2 years, range: 18–57 years) with different hip joint deformities including femoroacetabular impingement (n = 35), residual hip dysplasia (n = 3) and coxa magna due to Legg–Calve–Perthes disease in childhood (n = 2) underwent high-resolution 3D dGEMRIC for the evaluation of acetabular and femoral hip joint cartilage. Thirty-one asymptomatic healthy volunteers (12 males, 19 females; mean age: 24.5 ± 1.8 years, range: 21–29 years) without underlying hip deformities were included as control. MRI was performed at 3 T using a body matrix phased array coil. Region of interest (ROI) analyses for T1_Gd assessment was performed in seven regions in the hip joint, including anterior to superior and posterior regions.

Results

T1_Gd mapping demonstrated the typical pattern of acetabular cartilage consistent with a higher glycosaminoglycan (GAG) content in the main weight-bearing area. T1_Gd values were significantly higher in the control group than in the patient group whereas significant differences in T1_Gd values corresponding to the amount of cartilage damage were noted both in the patient group and in the control group.

Conclusions

Our study demonstrates the potential of high-resolution 3D dGEMRIC at 3 T for separate acetabular and femoral hip joint cartilage assessment in various forms of hip joint deformities.     

Image registration improves human knee cartilage T1 mapping with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC)

Objectives

To evaluate the effect of automated registration in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) of the knee on the occurrence of movement artefacts on the T1 map and the reproducibility of region-of-interest (ROI)-based measurements.

Methods

Eleven patients with early-stage knee osteoarthritis and ten healthy controls underwent dGEMRIC twice at 3?T. Controls underwent unenhanced imaging. ROIs were manually drawn on the femoral and tibial cartilage. T1 calculation was performed with and without registration of the T1-weighted images. Automated three-dimensional rigid registration was performed on the femur and tibia cartilage separately. Registration quality was evaluated using the square root Cramér–Rao lower bound (CRLB_σ). Additionally, the reproducibility of dGEMRIC was assessed by comparing automated registration with manual slice-matching.

Results

Automated registration of the T1-weighted images improved the T1 maps as the 90% percentile of the CRLB_σ was significantly (P?<?0.05) reduced with a median reduction of 55.8 ms (patients) and 112.9 ms (controls). Manual matching and automated registration of the re-imaged T1 map gave comparable intraclass correlation coefficients of respectively 0.89/0.90 (patients) and 0.85/0.85 (controls).

Conclusions

Registration in dGEMRIC reduces movement artefacts on T1 maps and provides a good alternative to manual slice-matching in longitudinal studies.

Key Points

? Quantitative MRI is increasingly used for biomedical assessment of knee articular cartilage ? Image registration leads to more accurate quantification of cartilage quality and damage ? Movement artefacts in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) are reduced ? Automated image registration successfully aligns baseline and follow-up dGEMRIC examinations ? Reproducibility of dGEMRIC with registration is similar to that using manual slice-matching     

Comparison study of intraarticular and intravenous gadolinium-enhanced magnetic resonance imaging of cartilage in a canine model

Background: Magnetic resonance (MR) imaging and measurement of glycosaminoglycan (GAG) have potential for characterization of hyaline articular cartilage. Recently, some reports have demonstrated the potential of direct administration of contrast media for MR imaging of cartilage.

Purpose: To prove the feasibility of intraarticular gadolinium-enhanced MR imaging of cartilage (iGEMRIC) and T1 relaxation mapping of the articular cartilage in vivo with intraarticular injection of Gd-DTPA^2-.

Material and Methods: Five healthy beagle dogs underwent MR imaging and T1 relaxation mapping of the knee joints of both hind legs. The delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) and iGEMRIC techniques were interchanged with MR imaging. For dGEMRIC, a double routine dose of Gd-DTPA^2- (0.2 mM/kg) was administered intravenously. For iGEMRIC, 2.5 and 1.25 mmol/l saline-diluted Gd-DTPA^2- solutions were separately injected into the right and left knee joints, respectively, prior to MR imaging. Color-coded T1 maps of 20 femoral condyles were obtained from the dGEMRIC and iGEMRIC images. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and glycosaminoglycan (GAG) delineation of articular cartilage were compared between the dGEMRIC and iGEMRIC techniques.

Results: The mean SNR was higher with dGEMRIC than with iGEMRIC, but the difference was not statistically significant (P = 0.174). The mean (±SD) CNR was higher with iGEMRIC (-11.6±3.4) than with dGEMRIC (-16.7±4.0; P = 0.000), although the absolute value of the CNR was higher with dGEMRIC. The layering and gradient distribution of GAG were more clearly visualized on the iGEMRIC images. The mean scores of GAG delineation with dGEMRIC and iGEMRIC were 0.7±0.6 and 2.2±1.7, respectively. The iGEMRIC method better visualized GAG distribution (P = 0.001).

Conclusion: Although the SNR did not differ significantly between the iGEMRIC and dGEMRIC techniques, the color-coded T1 map produced with iGEMRIC allowed better cartilage evaluation. Thus, iGEMRIC exhibits the useful features of both MR arthrography and dGEMRIC, and provides a color-coded T1 map that is useful for diagnosing early articular cartilage damage.     

Repeatability of T1‐quantification in dGEMRIC for three different acquisition techniques: Two‐dimensional inversion recovery,three‐dimensional look locker,and three‐dimensional variable flip angle

Purpose:

To evaluate the repeatability of the dGEMRIC (delayed gadolinium enhanced MRI of cartilage) method in osteoarthritis‐prone knee joints for three different T1 quantification techniques: two‐dimensional inversion recovery (2D‐IR), three‐dimensional Look‐Locker (3D‐LL), and three‐dimensional variable flip angle (3D‐VFA).

Materials and Methods:

Nine subjects were examined twice, with a 2‐week interval, using all three measurement techniques. Four regions of interest were defined in the central medial and lateral femoral cartilage. The repeatability was evaluated for each measurement technique. For the 3D techniques, the variation between different slices was also evaluated.

Results:

Repeatability expressed by root‐mean‐square coefficient of variation (CV_RMS) showed similar results for 2D‐IR and 3D‐LL (5.4–8.4%). For 3D‐VFA CV_RMS was higher (9.3–15.2%). Intraclass correlation coefficient showed both 2D‐IR and 3D‐LL reliability to be moderate, while 3D‐VFA reliability was low. Inter‐slice CV_RMS and ICC was of the same magnitude as the repeatability. No clear differences could be interpreted between the condyles.

Conclusion:

Both 2D‐IR and 3D‐LL perform well in generating repeatable dGEMRIC results, while 3D‐VFA results are somewhat inferior. Furthermore, repeatability results in this study are similar to previously published results for healthy subjects. Finally, the positioning of the analyzed images is crucial to generate reliable repeatability results. J. Magn. Reson. Imaging 2010;31:1203–1209. © 2010 Wiley‐Liss, Inc.     

Local flip angle correction for improved volume T1‐quantification in three‐dimensional dGEMRIC using the look‐locker technique

Purpose

To present an evaluation method for three‐dimensional Look‐Locker (3D‐LL) based T1 quantification, calculating correct T1 values independent of local flip angle (FA) variations. The method was evaluated both in phantoms and in vivo in a delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) study with 33 subjects.

Materials and Methods

T1 was measured with 3D‐LL, using both local FA correction and a precalculated FA slice profile, and compared with standard constant FA correction, for all slices in phantoms and in both femur condyles in vivo. T1 measured using two‐dimensional Inversion Recovery (2D‐IR) was used as gold standard.

Results

Due to the FA being slice dependent, the standard constant FA correction results in erroneous T1 (systematic error = 109.1 ms in vivo), especially in the outer slices. With local FA correction, the calculated T1 is excellent for all slices in phantoms (<5% deviation from 2D‐IR). In vivo the performance is lower (systematic error = ?57.5 ms), probably due to imperfect inversion. With precalculated FA correction the performance is very good also in vivo (systematic error = 13.3 ms).

Conclusion

With the precalculated FA correction method, the 3D‐LL sequence is robust enough for in vivo dGEMRIC, even outside the centermost slices. J. Magn. Reson. Imaging 2009;30:834–841. © 2009 Wiley‐Liss, Inc.

     

High‐risk nodules detected in the hepatobiliary phase of Gd‐EOB‐DTPA‐enhanced mr imaging in cirrhosis or chronic hepatitis: Incidence and predictive factors for hypervascular transformation,preliminary results

Purpose:

To evaluate the incidence and predictive factors of hypervascular transformation during follow‐up of “high‐risk nodules” detected in the hepatobiliary phase of initial Gd‐EOB‐DTPA‐enhanced MRI in chronic liver disease patients.

Materials and Methods:

A total of 109 patients with chronic liver disease who underwent Gd‐EOB‐DTPA‐enhanced MRI several times were investigated. Of these, 43 patients had 76 high‐risk nodules with both hypointensity in the hepatobiliary phase and hypovascularity in the arterial phase of initial MRI. These nodules were observed until hypervascularity was detected. MRI and clinical findings were compared to assess the incidence and potential predictive factors for hypervascular transformation between the group showing hypervascular transformation and the group not showing hypervascularization.

Results:

The median observation period was 242.5 ± 203.2 days (range, 47–802 days). Overall, 24 of 76 high‐risk nodules (31.6%) showed hypervascular transformation during follow‐up (median observation period, 186.0 ± 190.3 days). The growth rate of the nodules (P < 0.001), the presence of fat within nodules (P = 0.037), and hyperintensity on T1‐weighted images (P = 0.018) were significantly correlated with hypervascularization.

Conclusion:

Subsets of high‐risk nodules tended to show hypervascular transformation during follow‐up, with an increased growth rate, the presence of fat, and hyperintensity on T1‐weighted images as predictive factors. J. Magn. Reson. Imaging 2013;37:1377–1383. © 2013 Wiley Periodicals, Inc.     

A synthetic cartilage extracellular matrix model: hyaluronan and collagen hydrogel relaxivity, impact of macromolecular concentration on dGEMRIC

Objective  

To develop and characterize the MR properties of a synthetic model for cartilage extra-cellular matrix using hydrogels and to determine the concentration dependence of spin–lattice (T1) and spin-spin (T2) relaxation times of hydrogels and their glycosaminoglycan and collagen components in the presence and absence of gadopentetate dimeglumine (Gd-DTPA) for use in dGEMRIC.     

Effect of in ovo immobilization on development of chick hind‐limb articular cartilage: An evaluation using micro‐MRI measurement of delayed gadolinium uptake

To examine the effect of immobilization on the development of articular cartilage, we assessed glycosaminoglycan (GAG) content in the chick articular surface by delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC). Chick embryos were paralyzed by decamethonium bromide (DMB) from day 10 to either day 13 or day 16. The GAG content of the chick knee was compared with that of nonparalyzed chick embryos. Histologic analysis was unable to quantify GAG content; however, dGEMRIC demonstrated that GAG content was higher in the femoral condyles of the nonparalyzed embryos on day 13, and on day 16 the GAG content was lower in both the femoral condyles and the tibial plateaus of the nonparalyzed embryos. These results suggest that paralysis delays embryonic hind‐limb development. Osteoblastic activity at the cartilage canal, as demonstrated by staining for alkaline phosphatase (ALP), was present only in the nonparalyzed chick embryos on day 16. The GAG content of the cartilage decreased when the cartilage canals began to form on day 16. The effect of immobilization on hind‐limb development was indicated by the differences in the GAG content of the cartilage anlage measured by dGEMRIC in the developing knee joint of paralyzed and nonparalyzed embryonic chicks. Magn Reson Med, 2006. © 2006 Wiley‐Liss, Inc.     

dGEMRIC and subsequent T1 mapping of the hip at 1.5 Tesla: normative data on zonal and radial distribution in asymptomatic volunteers

Purpose:

To characterize the zonal distribution of three‐dimensional (3D) T1 mapping in the hip joint of asymptomatic adult volunteers.

Materials and Methods:

This study included 10 volunteers (3 males and 7 females with a mean age of 26.5 years; range, 24–31 years). MRI protocol included standard sequences for hip imaging and a dual‐flip‐angle 3D gradient‐echo (GRE) sequence with volumetric interpolated breathhold examination (VIBE) postcontrast administration. Seven radial cuts were created clockwise around the femoral neck by using multi‐planar reconstruction.

Results:

Analysis of the radial distribution revealed an increase of T1‐values toward the superior regions. T1‐values differed between the peripheral and central portions. The standard deviation (SD) ranged from 76.2 ms to 124.1 ms in the peripheral zone, and from 69.1 ms to 112.9 ms in the central zone. In both zones, SD was low in the superior regions compared with the anterior and posterior regions of the joint. Based on the high intra‐ (0.95) and interobserver (0.87) agreement, normative data from this study will prepare the foundation for further studies of dGEMRIC and T1 in the hip.

Conclusion:

We noted a radial T1 mapping pattern with higher values in the superior zone that was not statistically significant and a notable trend in zonal distribution between peripheral and central zones. These findings are critical while outlining future studies for detailed objective evaluation of zonal cartilage lesions due to varying pathologies. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Motion correction improves image quality of dGEMRIC in finger joints

Purpose

To assess motion artifacts in dGEMRIC of finger joints and to evaluate the effectiveness of motion correction.

Materials and methods

In 40 subjects (26 patients with finger arthritis and 14 healthy volunteers) dGEMRIC of metacarpophalangeal joint II was performed. Imaging used a dual flip angle approach (TE 3.72 ms, TR 15 ms, flip angles 5° and 26°). Two sets of T1 maps were calculated for dGEMRIC analysis from the imaging data for each subject: one with and one without motion correction. To compare image quality, visual grading analysis and precision of dGEMRIC measurement of both dGEMRIC maps for each case were evaluated.

Results

Motion artifacts were present in 82% (33/40) of uncorrected dGEMRIC maps. Motion artifacts were graded as severe or as rendering evaluation impossible in 43% (17/40) of uncorrected dGEMRIC maps. Motion corrected maps showed significantly less motion artifacts (P < 0.001) and were graded as evaluable in 97% (39/40) of cases. Precision was significantly higher in motion corrected images (coefficient of variation (CV = .176 ± .077), compared to uncorrected images (CV .445 ± .347) (P < .001). Motion corrected dGERMIC was different in volunteers and patients (P = .044), whereas uncorrected dGEMRIC was not (P = .234).

Conclusion

Motion correction improves image quality, dGEMRIC measurement precision and diagnostic performance in dGEMRIC of finger joints.     

Using the dGEMRIC technique to evaluate cartilage health in the presence of surgical hardware at 3T: comparison of inversion recovery and saturation recovery approaches

Objective

To evaluate the effect of metal artifact reduction techniques on dGEMRIC T₁ calculation with surgical hardware present.

Materials and methods

We examined the effect of stainless-steel and titanium hardware on dGEMRIC T₁ maps. We tested two strategies to reduce metal artifact in dGEMRIC: (1) saturation recovery (SR) instead of inversion recovery (IR) and (2) applying the metal artifact reduction sequence (MARS), in a gadolinium-doped agarose gel phantom and in vivo with titanium hardware. T₁ maps were obtained using custom curve-fitting software and phantom ROIs were defined to compare conditions (metal, MARS, IR, SR).

Results

A large area of artifact appeared in phantom IR images with metal when TI?≤?700 ms. IR maps with metal had additional artifact both in vivo and in the phantom (shifted null points, increased mean T₁ (+151 % IR ROI_artifact) and decreased mean inversion efficiency (f; 0.45 ROI_artifact, versus 2 for perfect inversion)) compared to the SR maps (ROI_artifact: +13 % T₁ SR, 0.95 versus 1 for perfect excitation), however, SR produced noisier T₁ maps than IR (phantom SNR: 118 SR, 212 IR). MARS subtly reduced the extent of artifact in the phantom (IR and SR).

Conclusions

dGEMRIC measurement in the presence of surgical hardware at 3T is possible with appropriately applied strategies. Measurements may work best in the presence of titanium and are severely limited with stainless steel. For regions near hardware where IR produces large artifacts making dGEMRIC analysis impossible, SR-MARS may allow dGEMRIC measurements. The position and size of the IR artifact is variable, and must be assessed for each implant/imaging set-up.