Protocol issues for delayed Gd(DTPA)2--enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage

Burstein, Deborah; Velyvis, John H.; Scott, Katherine T.; Stock, K.; Kim, Young Jo; Jaramillo, Diego; Boutin, Robert D.; Gray, Martha L.

doi:10.1002/1522-2594(200101)45:1<36::aid-mrm1006>3.0.co;2-w

Cited by 486 publications

(136 citation statements)

References 15 publications

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“…For T1, a good correspondence with the results of other research groups is seen (6,9,13,14). In the previous studies the calculated T1 relaxation values ranged from 300 to 580 msec for normal cartilage at 1.5T.…”

Section: Discussionsupporting

confidence: 72%

“…As described by Burstein et al (9), three factors are important for the practical implementation of the technique: 1) immediate active joint exercise after contrast administration, 2) administration of double-dose contrast (2 mmol/kg), and 3) a time window of approximately 2 hours between contrast administration and imaging.…”

Section: Discussionmentioning

confidence: 99%

“…The number of signal averages was 4, giving a total acquisition time of 11 minutes 51 seconds per compartment. The image acquisition was followed by intravenous injection of 0.2 mmol/kg Gd-DTPA (Magnevist®; Shering, Berlin, Germany) followed by an immediate active joint exercise period and a rest period of 120 minutes corresponding to the dGEMRIC protocol described by Burstein et al (9). Postcontrast scanning of the medial and lateral femoro-tibial compartment was then performed with the same experimental setting used for the precontrast scanning.…”

Section: Patients and Imagingmentioning

confidence: 99%

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Combined T1‐T2 mapping of human femoro‐tibial cartilage with turbo‐mixed imaging at 1.5T

Breuseghem¹,

Palmieri

Peeters

et al. 2005

Magnetic Resonance Imaging

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Purpose:To evaluate the influence of Gd-DTPA on cartilage T2 mapping using turbo-mixed (tMIX) imaging, and to show the possible usefulness of the tMIX technique for simultaneously acquiring T1 and T2 information in cartilage. Materials and Methods:Twenty volunteers underwent MRI of the knee using the tMIX sequence before and after gadolinium administration. T1 and T2 maps were calculated. The mean T1 was determined on the pre-and postcontrast T1 maps. T2 relaxation values before and after gadolinium administration were statistically analyzed. Results:The obtained relaxation values are in correspondence with previously published data. The mean T1 before gadolinium administration was 449 msec Ϯ 34.2 msec (SD), and after gadolinium administration it was 357 msec Ϯ 55.8 msec (SD). The postcontrast T1 relaxation range was 221.5-572.8 msec. The mean T2 of the precontrast T2 maps was 34.2 msec Ϯ 3.1 msec (SD), and the mean T2 of the postcontrast T2 maps was 32.5 msec Ϯ 3.1 msec (SD). These are statistically significant different values. A correction for the postcontrast T2 values, using a back-calculation algorithm, yielded a 98% correlation with the precontrast T2 values. Conclusion:The absolute difference of pre-and postcontrast T2 is very small and is ruled out using the backcalculation algorithm. Combined T1-T2 tMIX cartilage mapping is a valuable alternative for separate T1 and T2 cartilage mapping. MAGNETIC RESONANCE IMAGING (MRI), by virtue of its multiplanar capacity and excellent soft-tissue contrast, is a unique scanning technique for articular cartilage. While the ability to depict the cartilaginous anatomy represents a major advance in the evaluation of chondral abnormalities, a further advantage would be the ability to image and quantify functionally relevant macromolecules within the cartilage itself that are affected by degeneration. Two MRI techniques that have demonstrated promise in this regard are quantitative T2 mapping and T1 mapping after Gd-DTPA administration, known as delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Current research suggests that these techniques are complementary, with T2 mapping providing information on structural integrity of the collagen matrix (1-4), and dGEMRIC identifying regions of proteoglycan loss (5-7). The major disadvantages in the application of both techniques are the total length of the scan time needed (approximately 18 minutes) and the geometric mismatch between the acquired images. This geometric mismatch is induced by the technique itself, since T2 mapping is performed before gadolinium administration and dGEMRIC is performed after gadolinium administration. Combining both techniques would resolve this issue, and should deal with the influence of administered gadolinium on T2 mapping. The purpose of our study was to evaluate combined T1-T2 mapping of human cartilage using the turbo-mixed (tMIX) technique (8) and to investigate the influence of administered gadolinium on obtained T2 cartilage maps with this technique. MATERIALS AND METHODS TechniqueThe...

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Patients and Imagingmentioning

confidence: 99%

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Combined T1‐T2 mapping of human femoro‐tibial cartilage with turbo‐mixed imaging at 1.5T

Breuseghem¹,

Palmieri

Peeters

et al. 2005

Magnetic Resonance Imaging

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“…Further, its utility in measuring FCD changes in an animal model of OA has been described. The major advantage of sodium MRI, especially of cartilage, is that it is highly specific to PG content and, since the sodium from surrounding structures in the joint is low (<50 mM), cartilage can be visualized with very high contrast without the requirement for any exogenous contrast agent such as that in dGEMRIC (155). It can be used to quantify early molecular changes in osteoarthritis.…”

Section: Subjectsmentioning

confidence: 99%

Sodium and T_1ρ MRI for molecular and diagnostic imaging of articular cartilage

et al. 2006

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In this article, both sodium magnetic resonance (MR) and T 1r relaxation mapping aimed at measuring molecular changes in cartilage for the diagnostic imaging of osteoarthritis are reviewed. First, an introduction to structure of cartilage, its degeneration in osteoarthritis (OA) and an outline of diagnostic imaging methods in quantifying molecular changes and early diagnostic aspects of cartilage degeneration are described. The sodium MRI section begins with a brief overview of the theory of sodium NMR of biological tissues and is followed by a section on multiple quantum filters that can be used to quantify both bi-exponential relaxation and residual quadrupolar interaction. Specifically, (i) the rationale behind the use of sodium MRI in quantifying proteoglycan (PG) changes, (ii) validation studies using biochemical assays, (iii) studies on human OA specimens, (iv) results on animal models and (v) clinical imaging protocols are reviewed. Results demonstrating the feasibility of quantifying PG in OA patients and comparison with that in healthy subjects are also presented. The section concludes with the discussion of advantages and potential issues with sodium MRI and the impact of new technological advancements (e.g. ultra-high field scanners and parallel imaging methods). In the theory section on T 1r , a brief description of (i) principles of measuring T 1r relaxation, (ii) pulse sequences for computing T 1r relaxation maps, (iii) issues regarding radio frequency power deposition, (iv) mechanisms that contribute to T 1r in biological tissues and (v) effects of exchange and dipolar interaction on T 1r dispersion are discussed. Correlation of T 1r relaxation rate with macromolecular content and biomechanical properties in cartilage specimens subjected to trypsin and cytokineinduced glycosaminoglycan depletion and validation against biochemical assay and histopathology are presented. Experimental T 1r data from osteoarthritic specimens, animal models, healthy human subjects and as well from osteoarthritic patients are provided. The current status of T 1r relaxation mapping of cartilage and future directions is also discussed. Copyright # 2006 John Wiley & Sons, Ltd. KEYWORDS: cartilage; arthritis; spin-lock; T1rho; sodium; MRI OSTEOARTHRITIS Osteoarthritis (OA) affects more than half of the population above the age of 65 (1,2) and has a significant negative impact on the quality of life of elderly individuals (3). The economic costs in the USA from OA have been estimated to be more than 1% of the gross domestic product (4). OA is now increasingly viewed as a metabolically active joint disorder of diverse etiologies. The biochemistry of the disease is characterized by the following changes in cartilage: reduced proteoglycan (PG) concentration, possible changes in the size of collagen fibril and aggregation of PG, increased water content and increased rate of synthesis and degradation of matrix macromolecules. The earliest changes in the cartilage due to OA result in a partial breakdown in the proteoglyc...

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“…Functional biochemical sequence techniques for cartilage imaging, such as dGEMRIC (delayed gadolinium enhanced MR imaging of cartilage) [47], can detect the change in cartilage matrix composition even before morphological changes are visible. The dGEMRIC technique shows a loss of glycosaminoglycans (GAG), which in turn is regarded as the initial event in arthrosis formation [48,49] (▶ Fig.…”

Section: Functional Biochemical Cartilage Imagingmentioning

confidence: 99%

Modern Cartilage Imaging of the Ankle

Weber

Wünnemann

Jungmann

et al. 2017

Fortschr Röntgenstr

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ABSTR AC TBackground Talar osteochondral lesions are an important risk factor for the development of talar osteoarthritis. Furthermore, osteochondral lesions might explain persistent ankle pain. Early diagnosis of accompanying chondral defects is important to establish the optimal therapy strategy and thereby delaying or preventing the onset of osteoarthritis. The purpose of this review is to explain modern cartilage imaging with emphasis of MR imaging as well as the discussion of more sophisticated imaging studies like CT-arthrography or functional MR imaging.Methods Pubmed literature search concerning: osteochondral lesions, cartilage damage, ankle joint, talus, 2 D MR imaging, 3 D MR imaging, cartilage MR imaging, CT-arthrography, cartilage repair, microfracture, OATS, MACT.Results and Conclusion Dedicated MR imaging protocols to delineate talar cartilage and the appearance of acute and chronic osteochondral lesions were discussed. Recent developments of MR imaging, such as isotropic 3 D imaging that has a higher signal-to noise ratio when compared to 2 D imaging, and specialized imaging methods such as CT-arthrography as well as functional MR imaging were introduced. Several classifications schemes and imaging findings of osteochondral lesions that influence the conservative or surgical therapy strategy were discussed. MRI enables after surgery the noninvasive assessment of the repair tissue and the success of implantation. Key points▪ Modern MRI allows for highly resolved visualization of the articular cartilage of the ankle joint and of subchondral pathologies. ▪ Recent advances in MRI include 3 D isotropic ankle joint imaging, which deliver higher signal-to-noise ratios of the cartilage and less partial volume artifacts when compared with standard 2 D sequences. ▪ In case of osteochondral lesions MRI is beneficial for assessing the stability of the osteochondral fragment and for this discontinuity of the cartilage layer is an important factor. ▪ CT-arthrography can be used in case of contraindications of MRI and in unclear MRI findings as further diagnostic approach. Citation Format

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Protocol issues for delayed Gd(DTPA)2--enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage

Cited by 486 publications

References 15 publications

Combined T1‐T2 mapping of human femoro‐tibial cartilage with turbo‐mixed imaging at 1.5T

Combined T1‐T2 mapping of human femoro‐tibial cartilage with turbo‐mixed imaging at 1.5T

Sodium and T_1ρ MRI for molecular and diagnostic imaging of articular cartilage

Modern Cartilage Imaging of the Ankle

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Protocol issues for delayed Gd(DTPA)2--enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage

Cited by 486 publications

References 15 publications

Combined T1‐T2 mapping of human femoro‐tibial cartilage with turbo‐mixed imaging at 1.5T

Combined T1‐T2 mapping of human femoro‐tibial cartilage with turbo‐mixed imaging at 1.5T

Sodium and T1ρ MRI for molecular and diagnostic imaging of articular cartilage

Modern Cartilage Imaging of the Ankle

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Sodium and T_1ρ MRI for molecular and diagnostic imaging of articular cartilage