Non-invasive T1ρ mapping of the human cartilage response to loading and unloading

Nebelung, Sven; Sondern, Björn; Jahr, Holger; Tingart, Markus; Knobe, Matthias; Thüring, Johannes; Kuhl, Christiane K.; Truhn, Daniel

doi:10.1016/j.joca.2017.11.009

Cited by 20 publications

(25 citation statements)

References 59 publications

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“…Souza et al found significant decreases in T1r in the tibial cartilage only, while changes in femoral cartilage were discrepant 5,7 . Hamada et al reported decreases in T1r 13 , while our group found consistent increases 8,14 . Although these studies differed in design, loading protocol, tissue source and reference standard, cartilage functionality has been related to tissue degeneration.…”

Section: Introductionsupporting

confidence: 71%

“…Previous studies focusing on loading-induced changes in T1r reported inconsistent (and partially contradictory) results, i.e., increases 8,36 and decreases 7,13 . These discrepancies are most likely due to differences in species, study designs, loading and imaging protocols and segmentation techniques.…”

Section: Tissue Functionality In Degenerative Tissuementioning

confidence: 89%

“…However, the exact sensitivity and specificity of T1r remains to be clarified with some studies suggesting specificity for proteoglycans 28,30 , while others refuted any such specificity 11,12 . Nonetheless, it is commonly agreed that T1r is a surrogate parameter for the tissue's macromolecular constitution and functional properties 5,7,8,13,14 .…”

Section: Tissue Functionality In Intact Tissuementioning

confidence: 99%

“…Technically, our loading device allows standardized and reproducible loading in a more physiological configuration than previous devices 8,14,15,38,39 . Yet, this setup is not truly physiological as it allows only uni-axial compression along the mechanical leg axis.…”

Section: Limitationsmentioning

confidence: 99%

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Human articular cartilage mechanosensitivity is related to histological degeneration – a functional MRI study

Nebelung

Post

Knobe

et al. 2019

Osteoarthritis and Cartilage

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Objective: To investigate changes in response to sequential pressure-controlled loading and unloading in human articular cartilage of variable histological degeneration using serial T1r mapping. Method: We obtained 42 cartilage samples of variable degeneration from the medial femoral condyles of 42 patients undergoing total knee replacement. Samples were placed in a standardized artificial knee joint within an MRI-compatible whole knee-joint compressive loading device and imaged before (d 0), during (d ld1 , d ld2 , d ld3 , d ld4 , d ld5) and after (d rl1 , d rl2 , d rl3 , d rl4 , d rl5) pressure-controlled loading to 0.663 ± 0.021 kN (94% body weight) using serial T1r mapping (spin-lock multigradient echo sequence; 3.0T MRI system [Achieva, Philips]). Reference assessment included histology (Mankin scoring) and conventional biomechanics (Tangent stiffness). We dichotomized sample into intact (n ¼ 21) and degenerative (n ¼ 21) based on histology and analyzed data using Mann Whitney, Kruskal Wallis, oneway ANOVA tests and Spearman's correlation, respectively. Results: At d 0 , we found no significant differences between intact and degenerative samples, while the response-to-loading patterns were distinctly different. In intact samples, T1r increases were consistent and non-significant, while in degenerative samples, T1r increases were significantly higher (P ¼ 0.004, d0 vs dld1, d0 vs dld3), yet undulating and variable. With unloading, T1r increases subsided, yet were persistently elevated beyond d0. Conclusion: Cartilage mechanosensitivity is related to histological degeneration and assessable by serial T1r mapping. Unloaded, T1r characteristics are not significantly different in intact vs degenerative cartilage, while load bearing is organized in intact cartilage and disorganized in degenerative cartilage.

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Section: Introductionsupporting

confidence: 71%

Section: Tissue Functionality In Degenerative Tissuementioning

confidence: 89%

Section: Tissue Functionality In Intact Tissuementioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

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Human articular cartilage mechanosensitivity is related to histological degeneration – a functional MRI study

Nebelung

Post

Knobe

et al. 2019

Osteoarthritis and Cartilage

Self Cite

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“…7.0 T or 9.4 T) would have provided better signal-to-noise ratio, such scanners have not (yet) seen widespread clinical application and relaxation times are different from those at 3.0 T 54 . We deliberately chose sequence parameters similar to those in earlier studies [55][56][57][58][59] to render generalizability and transferability of the findings less related to actual sequence parameter settings.…”

Section: Discussionmentioning

confidence: 99%

Functional MRI Mapping of Human Meniscus Functionality and its Relation to Degeneration

Nebelung

Dötsch

Shah

et al. 2020

Sci Rep

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Meniscus pathology may promote early osteoarthritis. this study assessed human meniscus functionality (i.e. its response to loading) ex vivo based on quantitative T1, T1ρ, and T2 mapping as a function of histological degeneration and loading. Forty-five meniscus samples of variable degeneration were harvested from the lateral meniscus body region of 45 patients during total knee arthroplasties. Samples underwent serial mapping on a 3.0-T MRI scanner (Achieva, Philips) using a force-controlled and torque-inducing compressive loading device. Samples were measured at three loading positions, i.e. unloaded, loaded to 2 bar (compression force 37 N) and 4 bar (69 N). Histology (Pauli classification) and biomechanics (Elastic Modulus) served as references. Based on histology, samples were trichotomized as grossly intact (n = 14), mildly degenerative (n = 16), and moderate-to-severely degenerative (n = 15) and analyzed using appropriate parametric and non-parametric tests. For T1, we found loading-induced decreases in all samples, irrespective of degeneration. For T1ρ, zonal increases in intact (apex) and decreases in degenerative samples (base) were found, while for T2, changes were ambiguous. In conclusion, force-controlled loading and serial MR imaging reveal response-to-loading patterns in meniscus. Zonal T1ρ response-to-loading patterns are most promising in differentiating degeneration, while T1 and T2 aren't clearly related to degeneration.and may provide an imaging-based indication of functional tissue properties. Acute and chronic meniscus pathologies are frequent clinical entities 1. Due to its decisive role in load bearing, load transmission, load dissipation and in providing joint stability, congruity and lubrication 2 , meniscus integrity in form and function is of utmost importance to the knee joint's long-term health 3. Meniscus functionality, which is the tissue's ability to function properly, i.e. to disperse loads and reduce friction, is heavily dependent on its extracellular matrix properties. Collagen fibers, primarily type-I, define the tissue's tensile strength and shock-absorbing properties, while proteoglycans contribute to compressive strength by upholding swelling pressure 2,4,5. Lately, therapeutic efforts have been aimed at preserving and restoring the damaged meniscus secondary to trauma or degeneration 6,7. This is of particular relevance as meniscus and cartilage pathologies are closely interrelated. Consequently, meniscus damage and loss are key features of and risk factors for developing osteoarthritis (OA) 8. The discussion on whether meniscus pathologies are a cause or consequence of knee OA is ongoing 9,10. Yet common consensus prevails that morphological meniscus defects, i.e. surface breakdown and tissue tearing, are the consequence of degenerative changes of the extracellular matrix 11-13 , and contribute to the evolution of OA by altering load distribution and transmission to the adjacent articular cartilage. Hence, detecting such degenerative changes early is necessary in therapeu...

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Differentiation of human cartilage degeneration by functional MRI mapping—an ex vivo study

et al. 2019

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Non-invasive T1ρ mapping of the human cartilage response to loading and unloading

Cited by 20 publications

References 59 publications

Human articular cartilage mechanosensitivity is related to histological degeneration – a functional MRI study

Human articular cartilage mechanosensitivity is related to histological degeneration – a functional MRI study

Functional MRI Mapping of Human Meniscus Functionality and its Relation to Degeneration

Differentiation of human cartilage degeneration by functional MRI mapping—an ex vivo study

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