Cartilage Quality Assessment by Using Glycosaminoglycan Chemical Exchange Saturation Transfer and 23Na MR Imaging at 7 T

Published Online:https://doi.org/10.1148/radiol.11101841

The strong correlation between 23Na imaging and glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging after cartilage repair surgery suggests that gagCEST MR imaging in vivo might be sensitive to cartilage glycosaminoglycan content.

Purpose

To compare a glycosaminoglycan chemical exchange saturation transfer (gagCEST) imaging method, which enables sampling of the water signal as a function of the presaturation offset (z-spectrum) at 13 points in clinically feasible imaging times, with sodium 23 (23Na) magnetic resonance (MR) imaging in patients after cartilage repair surgery (matrix-associated autologous chondrocyte transplantation and microfracture therapy).

Materials and Methods

One female patient (67.3 years), and 11 male patients (median age, 28.8 years; interquartile range [IQR], 24.6–32.3 years) were examined with a 7-T whole-body system, with approval of the local ethics committee after written informed consent was obtained. A modified three-dimensional gradient-echo sequence and a 28-channel knee coil were used for gagCEST imaging. 23Na imaging was performed with a circularly polarized knee coil by using a modified gradient-echo sequence. Statistical analysis of differences and Spearman correlation were applied.

Results

The median of asymmetries in gagCEST z-spectra summed over all offsets from 0 to 1.3 ppm was 7.99% (IQR, 6.33%–8.79%) in native cartilage and 5.13% (IQR, 2.64%–6.34%) in repair tissue. A strong correlation (r = 0.701; 95% confidence interval: 0.21, 0.91) was found between ratios of signal intensity from native cartilage to signal intensity from repair tissue obtained with gagCEST or 23Na imaging. The median of dimensionless ratios between native cartilage and repair tissue was 1.28 (IQR, 1.20–1.58) for gagCEST and 1.26 (IQR, 1.21–1.48) for 23Na MR imaging.

Conclusion

The high correlation between the introduced gagCEST method and 23Na imaging implies that gagCEST is a potentially useful biomarker for glycosaminoglycans.

© RSNA, 2011

Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101841/-/DC1

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Article History

Received September 21, 2010; revision requested November 23; final revision received December 23; accepted January 11, 2011; final version accepted February 3.
Published online: July 2011
Published in print: July 2011