Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Gong, Jingshan; Pedoia, Valentina; Facchetti, Luca; Link, Thomas M.; Benjamin, C.; Li, Xiaojuan

doi:10.21037/qims.2016.12.11

Cited by 30 publications

(20 citation statements)

References 53 publications

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“…1). Details about the segmentation technique have been previously published 28 . Knee cartilage mean T1r and T2 relaxation times for each compartment were calculated using algorithms that have been extensively described 29 .…”

Section: Magnetic Resonance Imaging Of the Knee And Quantification Ofmentioning

confidence: 99%

Infrapatellar fat pad abnormalities are associated with a higher inflammatory synovial fluid cytokine profile in young adults following ACL tear

Heilmeier

Mamoto

Amano

et al. 2020

Osteoarthritis and Cartilage

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Objective: To evaluate the degree of knee fat pad abnormalities after acute anterior cruciate ligament (ACL) tear via magnetic resonance fat pad scoring and to assess cross-sectionally its association with synovial fluid biomarkers and with early cartilage damage as quantified via T1r and T2 relaxation time measurements. Design: 26 patients with acute ACL tears underwent 3T MR scanning of the injured knee prior to ACL reconstruction. The presence and degree of abnormalities of the infrapatellar (IPFP) and the suprapatellar (SPFP) fat pads were scored on MR images along with grading of effusion-synovitis and synovial proliferations. Knee cartilage composition was assessed by 3T MR T1r and T2 mapping in six knee compartments. We quantified concentrations of 20 biomarkers in synovial fluid aspirated at the time of ACL reconstruction. Spearman rank partial correlations with adjustments for age and gender were employed to evaluate correlations of MR, particularly cartilage composition and fat pad abnormalities, and biomarker data. Results: The degree of IPFP abnormality correlated positively with the synovial levels of the inflammatory cytokine markers IFN-g (r partial ¼ 0.64, 95% CI (0.26e0.85)), IL-10 (r partial ¼ 0.47, 95% CI (0.04e0.75)), IL-6 (r partial ¼ 0.56, 95% CI (0.16e0.81)), IL-8 (r partial ¼ 0.49, 95% CI (0.06e0.76)), TNF-a (r partial ¼ 0.55, 95% CI (0.14e0.80)) and of the chondrodestructive markers MMP-1 and-3 (MMP-1: r partial ¼ 0.57, 95% CI (0.17 e0.81); MMP-3: r partial ¼ 0.60, 95% CI (0.21e0.83)). IPFP abnormalities were significantly associated with higher T1r and T2 values in the trochlear cartilage (T1r: r partial ¼ 0.55, 95% CI (0.15e0.80); T2: r partial ¼ 0.58, 95% CI (0.18e0.81)) and with higher T2 values in the medial femoral, medial tibial as well as in patellar cartilage (0.45 r partial 0.59). Correlations between SPFP abnormalities and synovial markers were not significant except for IL-6 (r partial ¼ 0.57, 95% CI (0.17e0.81)). Conclusions: This exploratory study suggests that acute ACL rupture can be associated with damage to knee tissues such as the inferior fat pad of the knee. Such fat pad injury could be partially responsible for the apparent post-injury pro-inflammatory response noted in ACL-injured individuals. However, future longitudinal studies are needed to link ACL-rupture associated fat pad injury with important patient outcomes such as the development of posttraumatic osteoarthritis.

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Section: Magnetic Resonance Imaging Of the Knee And Quantification Ofmentioning

confidence: 99%

Infrapatellar fat pad abnormalities are associated with a higher inflammatory synovial fluid cytokine profile in young adults following ACL tear

Heilmeier

Mamoto

Amano

et al. 2020

Osteoarthritis and Cartilage

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“…Magnetic resonance (MR) imaging–based compositional quantitative data (relaxometry) and morphologic quantitative data have become central imaging metrics for studying long-range outcomes in OA (3). MR imaging–based quantification of articular cartilage volume and thickness has been widely investigated (4,5).…”

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confidence: 99%

Use of 2D U-Net Convolutional Neural Networks for Automated Cartilage and Meniscus Segmentation of Knee MR Imaging Data to Determine Relaxometry and Morphometry

2018

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Purpose To analyze how automatic segmentation translates in accuracy and precision to morphology and relaxometry compared with manual segmentation and increases the speed and accuracy of the work flow that uses quantitative magnetic resonance (MR) imaging to study knee degenerative diseases such as osteoarthritis (OA). Materials and Methods This retrospective study involved the analysis of 638 MR imaging volumes from two data cohorts acquired at 3.0 T: (a) spoiled gradient-recalled acquisition in the steady state T1ρ-weighted images and (b) three-dimensional (3D) double-echo steady-state (DESS) images. A deep learning model based on the U-Net convolutional network architecture was developed to perform automatic segmentation. Cartilage and meniscus compartments were manually segmented by skilled technicians and radiologists for comparison. Performance of the automatic segmentation was evaluated on Dice coefficient overlap with the manual segmentation, as well as by the automatic segmentations’ ability to quantify, in a longitudinally repeatable way, re-laxometry and morphology. Results The models produced strong Dice coefficients, particularly for 3D-DESS images, ranging between 0.770 and 0.878 in the cartilage compartments to 0.809 and 0.753 for the lateral meniscus and medial meniscus, respectively. The models averaged 5 seconds to generate the automatic segmentations. Average correlations between manual and automatic quantification of T1ρ and T2 values were 0.8233 and 0.8603, respectively, and 0.9349 and 0.9384 for volume and thickness, respectively. Longitudinal precision of the automatic method was comparable with that of the manual one. Conclusion U-Net demonstrates efficacy and precision in quickly generating accurate segmentations that can be used to extract relaxation times and morphologic characterization and values that can be used in the monitoring and diagnosis of OA.

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“…BML lesions were additionally evaluated in relation to ACLR with conflicting findings. Gong et al 12 enrolled 54 patients with acute anterior cruciate ligament (ACL) tear and graded BML lesions with the Whole-Organ Magnetic Resonance Imaging Score. They noted BML lesions in 42 injured knees (77.8%) and found that while BML patterns in these patients resolved rapidly over time after ACLR, it was an independent predictor for faster cartilage degeneration during the 2-year follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies, however, failed to demonstrate a clinical outcome correlation with the presence of BML after ACI, 19 matrix-assisted autologous chondrocyte transplantation, 5,9 or ACLR. 4,12,16 To date, the association between preoperative tibial subchondral BML patterns and outcomes after isolated MAT is unknown. However, unlike that for cartilage restoration (predominantly ACI procedures), there is no standardized or widely agreed-on means by which to evaluate MRI scans for subchondral BML patterns in the case of noncartilage restoration surgery-in this study, MAT.…”

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confidence: 99%

Preoperative Tibial Subchondral Bone Marrow Lesion Patterns and Associations With Outcomes After Isolated Meniscus Allograft Transplantation

et al. 2018

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Nearly two-thirds of patients who undergo isolated MAT have subchondral BML on preoperative MRI. Our findings suggest that increasing BML size (Welsch et al) is correlated with worse postoperative pain measures (KOOS pain, WOMAC pain) and worse activity ratings (Marx Activity Rating Scale). Additionally, increasing disruption or depression of the normal contour of the cortical surface, with or without lesion contiguity with the subjacent articular surface (Costa-Paz et al), is correlated with greater postoperative satisfaction.

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Bone marrow edema-like lesions (BMELs) are associated with higher T1ρ and T2 values of cartilage in anterior cruciate ligament (ACL)-reconstructed knees: a longitudinal study

Cited by 30 publications

References 53 publications

Infrapatellar fat pad abnormalities are associated with a higher inflammatory synovial fluid cytokine profile in young adults following ACL tear

Infrapatellar fat pad abnormalities are associated with a higher inflammatory synovial fluid cytokine profile in young adults following ACL tear

Use of 2D U-Net Convolutional Neural Networks for Automated Cartilage and Meniscus Segmentation of Knee MR Imaging Data to Determine Relaxometry and Morphometry

Preoperative Tibial Subchondral Bone Marrow Lesion Patterns and Associations With Outcomes After Isolated Meniscus Allograft Transplantation

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