Editorial comment: the future of compositional MRI for cartilage

Link, Thomas M.

doi:10.1007/s00330-018-5457-4

Cited by 10 publications

(14 citation statements)

References 11 publications

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“…Both studies used radiographs to assess OA which is obviously not the most sensitive method 15e17 . To assess early cartilage damage in humans an ethical and feasible method is needed 71 .…”

Section: Discussionmentioning

confidence: 99%

The protective effect of anterior cruciate ligament reconstruction on articular cartilage: a systematic review of animal studies

Deckers

Stephan

Wever

et al. 2019

Osteoarthritis and Cartilage

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s u m m a r yObjective: It is unclear if anterior cruciate ligament (ACL) reconstruction can prevent the onset of degenerative changes in the knee. Previous studies were inconclusive on this subject. The aim of this study was to systematically review all studies on the effect of ACL reconstruction on articular cartilage in animals. Design: Pubmed and Embase were searched to identify all original articles concerning the effect of ACL reconstruction on articular cartilage compared with both its positive (ACL transection) and negative (sham and/or non-operated) control in animals. Subsequently a Risk of bias and meta analysis was conducted based on five outcomes (gross macroscopic assessment, medical imaging, histological histochemical grading, histomophometrics and biomechanical characterization) related to articular cartilage. Results: From the 19 included studies, 29 independent comparisons could be identified which underwent ACL reconstruction with an average timing of data collection of 23 weeks (range 1e104 weeks). Due to limited data availability meta-analysis could only be conducted for gross macroscopic damage. ACL reconstruction caused significant gross macroscopic damage compared with intact controls (SMD 2.0 [0.88; 3.13]). These findings were supported by individual studies reporting on histomorphometrics, histology and imaging. No significant gross macroscopic damage was found when ACL reconstruction was compared with ACL transection (SMD À0.64 [À1.85; 0.57]). Conclusion: This systematic review with an average follow up of included studies of 23 weeks (range 1 e104 weeks) demonstrates that, in animals, ACL reconstruction does not protect articular cartilage from degenerative changes. The consistency of the direction of effect, provides some reassurance that the direction of effect in humans might be the same.

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Section: Discussionmentioning

confidence: 99%

The protective effect of anterior cruciate ligament reconstruction on articular cartilage: a systematic review of animal studies

Deckers

Stephan

Wever

et al. 2019

Osteoarthritis and Cartilage

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“…Nevertheless, MRI-based compositional cartilage biomarkers have not been used widely in clinical practice. Instead, they have been used mostly for cross-sectional and longitudinal research studies (12)(13)(14). A major issue preventing the transition to clinical application is a lack of standardization, which includes patient preparation, image acquisition, and image analysis, to reduce measurement variability and achieve comparable outcomes with different scanners.…”

mentioning

confidence: 99%

“…These shortcomings have limited the utility of the biomarkers to clinical research, such as longitudinal clinical trials. Thus, addressing them is crucial before these imaging approaches can be used as reliable and reproducible tools in clinical practice (12)(13)(14). These issues are mainly the results of specific scanner features, sequence protocols (including image noise, spatial resolution), and different technologies from multiple vendors (including data reconstruction, correction).…”

mentioning

confidence: 99%

The QIBA Profile for MRI-based Compositional Imaging of Knee Cartilage

Chalian¹,

Li²,

Guermazi³

et al. 2021

Radiology

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MRI-based cartilage compositional analysis shows biochemical and microstructural changes at early stages of osteoarthritis before changes become visible with structural MRI sequences and arthroscopy. This could help with early diagnosis, risk assessment, and treatment monitoring of osteoarthritis. Spin-lattice relaxation time constant in rotating frame (T1r) and T2 mapping are the MRI techniques best established for assessing cartilage composition. Only T2 mapping is currently commercially available, which is sensitive to water, collagen content, and orientation of collagen fibers, whereas T1r is more sensitive to proteoglycan content. Clinical application of cartilage compositional imaging is limited by high variability and suboptimal reproducibility of the biomarkers, which was the motivation for creating the Quantitative Imaging Biomarkers Alliance (QIBA) Profile for cartilage compositional imaging by the Musculoskeletal Biomarkers Committee of the QIBA. The profile aims at providing recommendations to improve reproducibility and to standardize cartilage compositional imaging. The QIBA Profile provides two complementary claims (summary statements of the technical performance of the quantitative imaging biomarkers that are being profiled) regarding the reproducibility of biomarkers. First, cartilage T1r and T2 values are measurable at 3.0-T MRI with a within-subject coefficient of variation of 4%-5%. Second, a measured increase or decrease in T1r and T2 of 14% or more indicates a minimum detectable change with 95% confidence. If only an increase in T1r and T2 values is expected (progressive cartilage degeneration), then an increase of 12% represents a minimum detectable change over time. The QIBA Profile provides recommendations for clinical researchers, clinicians, and industry scientists pertaining to image data acquisition, analysis, and interpretation and assessment procedures for T1r and T2 cartilage imaging and test-retest conformance. This special report aims to provide the rationale for the proposed claims, explain the content of the QIBA Profile, and highlight the future needs and developments for MRI-based cartilage compositional imaging for risk prediction, early diagnosis, and treatment monitoring of osteoarthritis.

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“…One limitation of this study is the small sample size of severe OA patients, which only enabled assessment of cartilage damage of ICRS grade III and IV. To develop a specific tool that can be used as a biomarker, early cartilage damage (ICRS grade I and II) should also be included 25 . Another limitation of this study is the manual coregistration of biochemistry locations with the gagCEST MRI and electromechanical measurements.…”

Section: Discussionmentioning

confidence: 99%

In vivo biochemical assessment of cartilage with gagCEST MRI: Correlation with cartilage properties

et al. 2020

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To assess articular cartilage in vivo, a noninvasive measurement is proposed to evaluate damage of the cartilage. It is hypothesized that glycosaminoglycan chemical exchange saturation transfer (gagCEST) can be applied as a noninvasive imaging technique as it would relate to electromechanical indentation and GAG content as measured with biochemical assays. This pilot study applies gagCEST MRI in total knee arthroplasty (TKA) patients to assess substantially damaged articular cartilage. The outcome was verified against electromechanical indentation and biochemical assays to assess the potential of gagCEST MRI. Five TKA patients were scanned on a 7.0 T MRI with a gagCEST sequence. Articular resurfacing cuts after TKA were obtained for electromechanical and biochemical analyses. The gagCEST MRI measurements on the medial condyle showed a moderate correlation with the GAG content, although sensitivity on the lateral condyle was lacking. Additionally, a strong negative correlation of gagCEST MRI with the electromechanical measurements was observed in the regression analysis. Correlation of gagCEST MRI with electromechanical measurements was shown, but the correlation of gagCEST MRI with GAG content was not convincing. In conclusion, gagCEST could be a useful tool to assess the GAG content in articular cartilage noninvasively, although the mismatch in heterogeneity requires further investigation.

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Editorial comment: the future of compositional MRI for cartilage

Abstract: This editorial comment refers to the article: "Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T" by Brinkhof et al, Eur Radiol 2018.

Cited by 10 publications

References 11 publications

The protective effect of anterior cruciate ligament reconstruction on articular cartilage: a systematic review of animal studies

The protective effect of anterior cruciate ligament reconstruction on articular cartilage: a systematic review of animal studies

The QIBA Profile for MRI-based Compositional Imaging of Knee Cartilage

In vivo biochemical assessment of cartilage with gagCEST MRI: Correlation with cartilage properties

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