Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) andT₂mapping at 3T MRI of the wrist: Feasibility and clinical application

Abstract

3 J. Magn. Reson. Imaging 2017;45:381-389.

Feasibility of gadoteric acid for delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) at the wrist and knee and comparison with Gd‐DTPA

“…Only the absolute postcontrast values were slightly higher for Gd‐DTPA. However, dGEMRIC values may show variations of about 5% in repeated bulk ROI measurements within the thick cartilage at the knee and some variation is expected in thinner cartilage, such as at the wrist . The dGEMRIC measures might also serve as reference values for further studies using gadoteric acid at the wrist.…”

“…A limitation of our study is that no correlation between arthroscopic and histologic findings could be provided to definitely confirm healthy cartilage. We assumed that the likelihood of normal cartilage without biopsy or arthroscopic/open surgical confirmation would be high in young individuals without physical problems at the wrist . However, patients in our knee cohort were older and symptomatic, so it is possible that age‐related changes or an overlap with early degenerative changes was present without any changes in the cartilage‐sensitive MR sequences.…”

“…We used a sequence protocol similar to that already implemented in the knee and wrist . Besides the study sequences for dGEMRIC, the routine imaging protocol included a cartilage‐sensitive, proton density‐weighted turbo spin‐echo sequence with fat saturation (PDfs) for morphological correlation and exclusion of cartilage defects.…”

“…In the knee cohort, dGEMRIC imaging was performed before (t = 0) and 90 minutes after intravenous administration of the contrast agent because this is the standard interval . In the wrist cohort, the 60 minutes timepoint was used, because this timepoint has been reported to be optimal for dGEMRIC of wrist cartilage . As previously recommended and used as standard in dGEMRIC studies, a 0.2 mmol/kg dose of Gd‐DTPA was administered.…”

“…and a resident (B.K.) with 12 and 4 years of experience in the field, respectively, in accordance with previous recommendations . The morphological sequences, including the cartilage‐sensitive PDfs sequence, were evaluated for the presence of normal cartilage, and areas with visible cartilage damage were excluded from further assessment.…”