Quantitative T2* assessment of knee joint cartilage after running a marathon

Hesper, Tobias; Miese, Falk; Hosalkar, Harish S.; Behringer, Michael; Zilkens, Christoph; Antoch, Gerald; Krauspe, Rüdiger; Bittersohl, Bernd

doi:10.1016/j.ejrad.2014.11.021

Cited by 29 publications

(31 citation statements)

References 30 publications

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“…This observation is likely explained by dose–response effects where longer lasting dynamic loading events facilitate gradual decreases in hydrostatic interstitial pressurization, which, in turn, may have affected the collagen–water interactions to a larger extent . In agreement with previous studies of in vivo cartilage deformation, ankle cartilage T2* changes appear greater than those observed after in vivo knee cartilage loading . This is most likely due to differences in extra‐cellular matrix organization, cartilage material properties and, thus, compressive stiffness moduli between cartilage plates of both joints …”

Section: Discussionsupporting

confidence: 87%

“…Despite its sensitivity to scanner imperfections and/or magnetic susceptibility, these features altogether render T2* a suitable candidate to accurately evaluate thin curved cartilage plates . To date, time‐dependent changes in T2* values upon in vivo loading events have been described in knee cartilage following a marathon run and in ankle cartilage at separate stages during a ultra‐marathon foot race . Interestingly, unexpected increases in T2* values were observed, which contradicted direction of change seen in similar experiments utilizing standard T2 mapping methods .…”

mentioning

confidence: 91%

“…To date, time‐dependent changes in T2* values upon in vivo loading events have been described in knee cartilage following a marathon run and in ankle cartilage at separate stages during a ultra‐marathon foot race . Interestingly, unexpected increases in T2* values were observed, which contradicted direction of change seen in similar experiments utilizing standard T2 mapping methods . Furthermore, effects of extreme loading events were appraised, which lack translational capacity to clinical settings.…”

mentioning

confidence: 96%

“…We hypothesized that T2* shows acceptable precision and segmentation consistency . Although we expected ankle cartilage to deform substantially, increases in T2* upon deformation were anticipated with relaxation times restored to baseline within 15 min after cessation of the exercise …”

mentioning

confidence: 97%

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In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

Ginckel

Witvrouw

2015

J. Orthop. Res.

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The objectives of this study were as follows: (i) to assess segmentation consistency and scan precision of T2 Ã mapping of human tibio-talar cartilage, and (ii) to monitor changes in T2 Ã relaxation times of ankle cartilage immediately following a clinically relevant in vivo exercise and during recovery. Using multi-echo gradient recalled echo sequences, averaged T2 Ã values were calculated for tibio-talar cartilage layers in 10 healthy volunteers. Segmentation consistency and scan precision were determined from two repeated segmentations and two repeated acquisitions with repositioning, respectively. Subsequently, acute in vivo cartilage loading responses were monitored by calculating averaged tibio-talar T2 Ã values at rest, immediately after (i.e., deformation) and at 15 min (i.e., recovery) following a 30-repetition knee bending exercise. Precision errors attained 4-6% with excellent segmentation consistency point estimates (i.e., intra-rater ICC of 0.95) and acceptable limits of confidence. At deformation, T2 Ã values were increased in both layers [þ16.1 (10.7)%, p ¼ 0.004 and þ17.3 (15.3)%, p ¼ 0.023, for the talus and tibia, respectively] whereas during recovery no significant changes could be established when comparing to baseline [talar cartilage: þ5.2 (8.2)%, p ¼ 0.26 and tibial cartilage: þ6.6 (10.4)%, p ¼ 0.23]. T2 Ã mapping is a viable method to monitor deformational behavior in thin cartilage layers such as ankle cartilage. Longitudinal changes in T2 Ã can be reliably appraised and require at least 4-6% differences to ascertain statistical significance. The ability to detect considerable change even after non-strenuous loading events, endorses T2 Ã mapping as an innovative method to evaluate the effects of therapeutic exercise on thin cartilage layers. ß

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Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 91%

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confidence: 96%

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confidence: 97%

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In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

Ginckel

Witvrouw

2015

J. Orthop. Res.

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“…Many of these studies found significant changes including bone marrow edema (BME), joint effusion and cartilage thickness and volume, but such changes seem to return to baseline after a rest period (1 h to 8 weeks) [13,20,23]. While the ankle and foot complex is one of the most common injured sites in response to long-distance running [24,25], there is no study systematically determining the effect of long-distance running on the ankle and foot.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of MR Images of the Ankle and Foot in Response to Long-Distance Running: A Systematic Review

Kim¹,

Fern²,

ez³

et al. 2017

Adv Tech Biol Med

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Background: It has remained controversial on whether excessive loadings imposed on the ankle and foot complex during long-distance running have a deleterious effect. The aim of this systematic review is to determine whether long-distance running causes any visible changes of the ankle and foot on magnetic resonance imaging (MRI).Methods: Scopus, Web of Science, Embase and Ovid Medline were searched using key terms in relation to MRI findings of the ankle and foot in response to long-distance running, published between 1990 and 2016. The final search was conducted on 19 September, 2016. Studies were identified using inclusion and exclusion criteria. Methodological quality was assessed using a modified Quality Index. Results:The database search initially produced 551 articles and it was screened based on inclusion and exclusion criteria, finally resulting in four articles. Edema was reported in the talus, tibia, calcaneus, navicular, cuboid and cuneiforms. A significant alteration in signal intensity and/or edema was appeared in the calcaneus at the Achilles insertion point, intraosseous and subcutaneous over long-distance running. The diameter of Achilles tendon was also significantly increased. However, when comparing between race finishers and non-finishers, the plantar aponeurosis and subcutaneous were only significantly different, reporting a high rate of edema in non-finishers. Additionally, one study adopted T2* mapping and found significant alteration in T2* values in tibiotalar cartilage, but the value was unexpectedly decreased in the middle of long-distance running. Conclusion:This is the first systematic review to determine the effect of long-distance running on the ankle and foot using MRI. It shows that long-distance running may cause subtle pathological and biochemical changes in the ankle and foot, including the talus, tibia, the distal and proximal group of tarsal bones, 5 th metatarsals, soft tissues and the Achilles tendons. However, there is no evidence that these changes have clinical relevance. Evaluation of MR

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Comparing the Effect of Mechanical Loading on Deep and Superficial Cartilage Using Quantitative UTE MRI

Wang,

Li,

et al. 2023

Magnetic Resonance Imaging

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BackgroundThe biomechanical properties of deep and superficial cartilage may be different, yet in vivo MRI validation is required.PurposeTo compare the effect of mechanical loading on deep and superficial cartilage in young healthy adults using ultrashort echo time (UTE)‐T2* mapping.Study TypeProspective, intervention.SubjectsThirty‐one healthy adults (54.8% females, median age = 23 years).Field Strength/Sequence3‐T, PD‐FS, and UTE sequences with four echo times (TEs = 0.1, 0.5, 2.8, and 4.0 msec; 0.6 mm isotropic spatial resolution) of the left knee, acquired before and after loading exercise.AssessmentQuantitative UTE‐T2* maps of the entire knee were generated using UTE images of four TEs. In deep and superficial cartilage of patella, medial and lateral femur, medial and lateral tibia cartilage (PC, MFC, LFC, MTC, and LTC), which were segmented manually, cartilage thickness and T2* values before and after loading were measured, extracted, taken averages of, and compared. Scan–rescan repeatability was evaluated. Body weight and body mass index (BMI) data were collected. Physical activity levels were evaluated using International Physical Activity Questionnaire.Statistical TestsPaired sample t‐tests, paired Wilcoxon Mann–Whitney tests, Pearson and Spearman correlation analyses, Kruskal–Wallis tests with post‐hoc Bonferroni correction. A P‐value <0.05 was considered statistically significant.ResultsThe scan–rescan repeatability was good (RMSA‐CV < 10%). After exercise, deep cartilage exhibited no significant differences in cartilage thickness (PPC = 0.576, PMTC = 0.991, PMFC = 0.899, PLTC = 0.861, PLFC = 0.290) and T2* values (PPC = 0.914, PMTC = 0.780, PMFC = 0.754, PLTC = 0.327, PLFC = 0.811), which both significantly decreased in superficial PC, MFC, LFC, and MTC. The T2* values of superficial MTC and deep MFC were moderately correlated with higher body weight (ρ = 0.431) and lower BMI (ρ = −0.499), respectively.Data ConclusionDeep and superficial cartilage may respond differently to mechanical loading as assessed by UTE‐T2*.Evidence Level2Technical EfficacyStage 3

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Quantitative T2* assessment of knee joint cartilage after running a marathon

Cited by 29 publications

References 30 publications

In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

In vivo deformation of thin cartilage layers: Feasibility and applicability of T2* mapping

Evaluation of MR Images of the Ankle and Foot in Response to Long-Distance Running: A Systematic Review

Comparing the Effect of Mechanical Loading on Deep and Superficial Cartilage Using Quantitative UTE MRI

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