Characterization of bone perfusion by dynamic contrast‐enhanced magnetic resonance imaging and positron emission tomography in the Dunkin–Hartley guinea pig model of advanced osteoarthritis

Abstract

Purpose This study characterizes changes in subchondral bone circulation in OA and examines relationships to bone structure and cartilage degeneration in Dunkin-Hartley guinea pigs. Methods We have used dynamic contrast-enhanced MRI (DCE-MRI) and PET, with pharmacokinetic modeling, to characterize subchondral bone perfusion. Assessments are made of perfusion kinetics and vascular permeability by MRI, and blood volume and flow, and radionuclide incorporation into bone, by PET. These parameters are compared to cartilage lesion severity and bone histomorphometry. Assessments of intraosseous thrombi are made morphologically. Results Prolonged signal enhancement during the clearance phase of MRI correlated with OA severity and suggested venous stasis. Vascular permeability was not increased indicating that transvascular migration of contrast agent was not responsible for signal enhancement. Intraosseous thrombi were not observed. Decreased perfusion associated with severe OA was confirmed by PET and was associated with reduced radionuclide incorporation and osteoporosis. Discussion MRI and PET can be used to characterize kinetic parameters of circulation in OA and correlate them with subchondral bone metabolism of interest to the pathophysiology of OA. The significance of these observations may lie in alterations induced in the expression of cytokines by OA osteoblasts that are related to bone remodeling and cartilage breakdown.

[18F]‐Sodium Fluoride PET/MR Imaging for Bone–Cartilage Interactions in Hip Osteoarthritis: A Feasibility Study

“…While we did not see correlations between SUV and osteophytes, the increase in K pat in osteophytic regions in the femur could indicate increased blood flow toward these sites. This agreed with Dyke et al, who demonstrated that bone blood flow was related to bone formation. We did not see an association between cam deformities and PET static or dynamic parameters, which was unexpected.…”

Subchondral bone circulation in osteoarthritis of the human knee

“…Those observations have been extended with 18 F PET to show that decreased perfusion in subchondral bone was associated with both abnormal bone formation (decreased 18 F uptake) and increased severity of cartilage degeneration (Mankin scores) and confirmed a significant role for abnormal perfusion in the pathophysiology of OA. 6 Pharmacokinetic modeling suggests that perfusion in OA bone exhibits reduced arterial inflow (Ak ep ), redistribution (k ep ) and clearance (k el ). An increase in AUC 60 shows residual contrast remaining in the lateral tibial plateau that mimics early data using contrast venograms 8 .…”

“…These observations have been confirmed by a subsequent report detecting by DCE-MRI venous outflow obstruction and venous stasis in rat OA and by 18 F Fluoride Positron Emission Tomography ( 18 F PET). 6 It is the hypothesis of this study that alterations in blood flow kinetics in human subchondral bone are associated with OA and can be quantified by DCE-MRI. We present here for the first time the characterization of subchondral perfusion kinetics in OA of the human knee compared to perfusion kinetics in the same anatomical area of the normal knee.…”

International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment

“…However, the validity and sensitivity of these methods have only been thoroughly studied for general knee OA, and not specifically for PF OA. Promising quantitative MRI techniques enable assessment of cartilage composition, cartilage morphometry, morphological assessment of various tissues, patellar bone blood perfusion and the degree of bone remodeling [49,[52][53][54][55]. These techniques are still under development, and require further validation, correlation with clinical and semi-quantitative measures, and standardization.…”