Intraoperative validation of quantitative T2 mapping in patients with articular cartilage lesions of the knee

Soellner, S.T.; Goldmann, A; Muelheims, D.; Welsch, Goetz H.; Pachowsky, Milena

doi:10.1016/j.joca.2017.07.021

Cited by 46 publications

(36 citation statements)

References 38 publications

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“…The increase in T2 mapping values in areas of damaged cartilage is in accordance with the findings of Lee et al, who reported that T2 mapping values were higher in patients with radiographically diagnosed primary glenoid OA than in those without OA 14 . Furthermore, our findings are in line with those of T2 mapping studies of OA in other joints that reported increased T2 mapping values in damaged cartilage 17 , 27 , 28 . In our study population, the highest overall T2 mapping value in normal cartilage in healthy patients (27.3 ms) and in normal-appearing cartilage in the patients with proven cartilage damage (26.0 ms) were lower than the lowest overall T2 value in the patients with cartilage damage (40.8 ms), indicating complete separation of the data in these study groups.…”

Section: Discussionsupporting

confidence: 92%

3-T T2 mapping magnetic resonance imaging for biochemical assessment of normal and damaged glenoid cartilage: a prospective arthroscopy-controlled study

Wuennemann

Kintzelé

Braun

et al. 2020

Sci Rep

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This study evaluated the ability of T2 mapping to assess the glenoid cartilage using arthroscopy as the gold standard. Eighteen consecutive patients (mean age: 52.4 ± 14.72 years, including 12 men) with shoulder pain underwent T2 mapping at 3-T with subsequent shoulder arthroscopy. With correlation to cartilage-sensitive morphologic sequences regions-of-interest were placed in the corresponding T2 maps both in normal-appearing cartilage and focal cartilage lesions using a quadrant-wise approach. Inter-reader and intra-reader correlation coefficients (ICCs) between two independent radiologists as well as cutoff values with their sensitivities/specificities for the detection of cartilage damage were calculated. The mean T2 value for healthy cartilage was 23.0 ± 3 ms with significantly higher values in the superior quadrants compared to the inferior quadrants (p < 0.0001). In 5 patients with focal cartilage damage significantly higher T2 values of 44.7 ± 3.7 ms (P < 0.01) were observed. The maximum T2 value in normal cartilage (27.3 ms) was lower than the minimum value in damaged cartilage (40.8 ms) resulting in perfect sensitivities/specificities of 100% (95% confidence-interval 47.8-100.0) for all cutoff values between 27.3-40.8 ms. ICCs ranged between 0.63 and 0.99. In conclusion, T2 mapping can evaluate biochemical cartilage integrity and discriminates arthroscopyproven healthy and damaged glenoid cartilage with high diagnostic performance. Osteoarthritis (OA) is a degenerative condition affecting the articulating facet joints. It is the most commonly encountered orthopaedic disorder and a leading cause of morbidity in elderly patients 1-3. Although OA predominantly affects the weight-bearing joints, glenoid OA is a well-known cause of shoulder disability with an increasing incidence and prevalence and ultimately leads to endoprosthetic joint replacement 4, 5. Cartilage defects are an important risk factor for development of OA 6, 7. Therefore, timely diagnosis of early and potentially reversible disruption of the chondral architecture is desirable to delay the onset and progression of OA. Magnetic resonance imaging (MRI) is the non-invasive gold standard for morphological evaluation of the articular cartilage 8. However, early degenerative changes in the cartilage, such as loss of glycosaminoglycans

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Section: Discussionsupporting

confidence: 92%

3-T T2 mapping magnetic resonance imaging for biochemical assessment of normal and damaged glenoid cartilage: a prospective arthroscopy-controlled study

Wuennemann

Kintzelé

Braun

et al. 2020

Sci Rep

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“…This demonstrated the superior sensitivity of T2 mapping compared to morphological MRI in the detection of mild to moderate cartilage lesions ( Table 2). Soellner et al confirmed that quantitative MRI is more sensitive to detecting early cartilage degeneration [42].…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, quantitative MRI was used to monitor the effect of radiofrequency chondroplasty on grade II patellar cartilage defects. Quantitative MRI with T2 mapping was utilized because it has been shown to be an accurate and reliable method to monitor the condition of early (grade I/II) articular cartilage defects in order to avoid second-look arthroscopy [40,42]. Furthermore, Baum et al showed that T2 relaxation times are a suitable, non-invasive tool to assess early cartilage degeneration in the knee joint [23].…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Chondroplasty May Not Have a Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans

Koller

Springer

Rentenberger

et al. 2020

JCM

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The effect of radiofrequency chondroplasty on cartilage tissue is not well studied. This prospective pilot study investigates the effect of radiofrequency chondroplasty on International Cartilage Repair Society (ICRS) grade II patellar cartilage defects using high-resolution magnetic resonance imaging (MRI) with T2 mapping. Six consecutive patients were treated for ICRS grade II patellar cartilage defects using radiofrequency chondroplasty. Before surgery and at defined follow-ups (2 weeks, 4 and 12 months) a high-resolution morphological 3 Tesla MRI with quantitative T2 mapping was performed. At baseline MRI, global T2 values of cartilage defects were increased (46.8 ms ± 9.7) compared to healthy cartilage (35.2 ms ± 4.5) in the same knee which served as reference. Two weeks after treatment, global T2 values (39.2 ms ± 7.7) of the defect areas decreased. However, global T2 values of the defect areas increased beyond the preoperative levels at 4 months (47.4 ms ± 3.1) and 12 months (51.5 ms ± 5.9), respectively. Zonal T2 mapping revealed that the predominant changes in T2 values occurred at the superficial cartilage layer. T2 mapping appears to be an ideal method to monitor cartilage degeneration after chondroplasty. Based on the small sample size of this pilot study, radiofrequency chondroplasty may cause cartilage damage and may not have a long-lasting effect in the treatment of grade II patellar cartilage defects. In five out of six patients, postoperative cartilage damage was observed on quantitative MRI. This study was therefore terminated before completion. We recommend only addressing the pathology which indicated arthroscopy and leaving concomitant cartilage lesions untreated.

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“…T2 relaxation time of cartilage is associated with collagen and tissue hydration 6,7 while T1r is sensitive to alterations in proteoglycan content 8 . Soellner et al 9 performed a validation of T2 relaxation time mapping of knee cartilage with intraoperative scoring in six compartments: patella, trochlea, central medial and central lateral femoral condyle, medial and lateral tibia plateau. They reported an increase of T2 with increasing grade of cartilage damage and established a T2 threshold value of 47.6 ms to differentiate between normal and degraded cartilage (Fig.…”

Section: Cross-sectional Studiesmentioning

confidence: 99%

Osteoarthritis year in review 2018: imaging

Nieminen

Casula

Nevalainen

et al. 2019

Osteoarthritis and Cartilage

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Purpose: To provide a narrative review of the most relevant original research published in 2017/2018 on osteoarthritis imaging. Methods: The PubMed database was used to recover all relevant articles pertaining to osteoarthritis and medical imaging published between 1 April 2017 and 31 March 2018. Review articles, case studies and in vitro or animal studies were excluded. The original publications were subjectively sorted based on relevance, novelty and impact. Results and conclusions: The publication search yielded 1,155 references. In the assessed publications, the most common imaging modalities were radiography (N ¼ 708) and magnetic resonance imaging (MRI) (355), followed by computed tomography (CT) (220), ultrasound (85) and nuclear medicine (17). An overview of the most important publications to the osteoarthritis (OA) research community is presented in this narrative review. Imaging studies play an increasingly important role in OA research, and have helped us to understand better the pathophysiology of OA. Radiography and MRI continue to be the most applied imaging modalities, while quantitative MRI methods and texture analysis are becoming more popular. The value of ultrasound in OA research has been demonstrated. Several multi-modality predictive models have been developed. Deep learning has potential for more automatic and standardized analyses in future OA imaging research.

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Intraoperative validation of quantitative T2 mapping in patients with articular cartilage lesions of the knee

Abstract: T2 mapping might provide a diagnostic tool for the detection of early knee-joint cartilage damage and for the non-invasive differentiation between ICRS grades by MRI in clinical practice.

Cited by 46 publications

References 38 publications

3-T T2 mapping magnetic resonance imaging for biochemical assessment of normal and damaged glenoid cartilage: a prospective arthroscopy-controlled study

3-T T2 mapping magnetic resonance imaging for biochemical assessment of normal and damaged glenoid cartilage: a prospective arthroscopy-controlled study

Radiofrequency Chondroplasty May Not Have a Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans

Osteoarthritis year in review 2018: imaging

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