BackgroundWe used multimodal compositional magnetic resonance imaging (MRI) techniques, combined with clinical outcomes, to differentiate the alternations of composition in repair cartilage with allogeneic human adipose-derived mesenchymal progenitor cells (haMPCs) in knee osteoarthritis (KOA) patients.MethodsEighteen patients participated a phase I/IIa clinical trial. All patients were divided randomly into three groups with intra-articular injections of haMPCs: the low-dose (1.0 × 107 cells), mid-dose (2.0 × 107), and high-dose (5.0 × 107) groups with six patients each. Compositional MRI examinations and clinical evaluations were performed at different time points.ResultsSignificant differences were observed in quantitative T1rho, T2, T2star, R2star, and ADC measurements in patients of three dose groups, suggesting a possible compositional changes of cartilage with the treatment of allogeneic haMPCs. Also significant reduction in WOMAC and SF-36 scores showed the symptoms might be alleviated to some extent with this new treatment. As regards sensibilities of multi-parametric mappings to detect compositional or structural changes of cartilage, T1rho mapping was most sensitive to differentiate difference between three dose groups.ConclusionsThese results showed that multi-compositional MRI sequences might be an effective tool to evaluate the promotion of the repair of cartilage with allogeneic haMPCs by providing information of compositional alterations of cartilage.Trial registrationClinicaltrials, NCT02641860. Registered 3 December 2015.

Background: We used textural analysis matrix to examine the spatial distribution of pixel values and detect the compositional variation of repair cartilage with treatment of allogeneic human adipose-derived mesenchymal progenitor cells (haMPCs). Methods: Eighteen patients were divided randomly into three groups with intra-articular injections of haMPCs: the low-dose (1.0×107 cells), mid-dose (2.0×107), and high-dose (5.0×107) group with six patients each. 3D texture analyses based on gray level run-length matrix (GLRLM) of the segmented ROIs on MRI relaxation time maps including T1rho, T2, T2* and R2*. Five GLRLM parameters were analyzed, including run length non-uniformity (RLNonUni), grey level non-uniformity (GLevNonU), long run emphasis (LngREmph), short run emphasis (ShrtREmp) and fraction of image in runs (Fraction). We used the difference before and after treatment (D values) as the object to avoid errors caused by individual differences. Two-tailed Pearson linear correlation analysis was used to investigate correlations between texture parameters and the WOMAC scores. Results: The heterogeneity of spatial distribution of MRI relaxation time mapping pixels from three groups was decreased to varying degrees at 48 weeks after intra-articular injection of haMPCs. Spatial distribution of cartilage relaxation time maps pixels were uneven and layered, especially in T2 maps. Compared with base time, there were significant differences among three dose groups in GLRLM features for T1rho map including RLNonUni, GLevNonU, LngREmph, for T2 map including LngREmph, GLevNonU, ShrtREmp, for T2* map including RLNonUni, GLevNonU, and for R2* map including RLNonUni, GLevNonU. WOMAC pain scores were associated with RLNonUni of T1rho map, GLevNonU of T2 map, LngREmph of T2* map, LngREmph of R2* map and Fraction of T1rho map, whereas no significant correlations in other measurements.Conclusions: MRI texture analysis of cartilage may allow detection of the compositional variation of repair cartilage with treatment of allogeneic haMPCs. This has potential applications in understanding mechanism of stem cells repairing cartilage and assessing response to treatment.Trial registration: Clinicaltrials, NCT02641860. Registered 3 December 2015.https://www.clinicaltrials.gov/ct2/show/NCT02641860

We used 3D texture analysis of MRI relaxation times, combined with clinical outcomes, to evaluate the potential of repair cartilage with allogeneic human adipose-derived mesenchymal progenitor cells in patients with KOA. Significant differences were observed in texture RLM parameters of T1rho and T2 maps in patients. We also found correlations between WOMAC pain scores and texture parameters, suggesting the spatial heterogeneity of relaxation time maps maybe associated with clinical scores. As conclusion, texture analysis has potential applications in understanding mechanism of stem cells repairing cartilage and assessing response to treatment.