"skipMainNavigation"
Search
Quick Search in Journals
Quick Search anywhere
Advanced Search
Radiology
Menu
Previous
Next
Original Research

Articular Cartilage: In Vivo Diffusion-Tensor Imaging

Published Online:Feb 1 2012https://doi.org/10.1148/radiol.11110821

Abstract

The receiver operating characteristic curve analysis of the data of this in vivo pilot study revealed that mean apparent diffusion coefficient and fractional anisotropy had both area under the curve and accuracy greater than 0.8, thus indicating potential for early diagnosis of osteoarthritis.

Purpose

To investigate technical feasibility, test-retest reproducibility, and the ability to differentiate healthy subjects from subjects with osteoarthritis (OA) with diffusion-tensor (DT) imaging parameters and T2 relaxation time.

Materials and Methods

This study was approved by the institutional review board and was HIPAA compliant. All subjects provided written informed consent. DT imaging parameters and T2 (resolution = 0.6 × 0.6 × 2 mm) of patellar cartilage were measured at 7.0 T in 16 healthy volunteers and 10 patients with OA with subtle inhomogeneous signal intensity but no signs of cartilage erosion at clinical magnetic resonance (MR) imaging. Ten volunteers were imaged twice to determine test-retest reproducibility. After cartilage segmentation, maps of mean apparent diffusion coefficient (ADC), fractional anisotropy (FA), and T2 relaxation time were calculated. Differences for ADC, FA, and T2 between the healthy and OA populations were assessed with nonparametric tests. The ability of each MR imaging parameter to help discriminate healthy subjects from subjects with OA was assessed by using receiver operating characteristic curve analysis.

Results

Test-retest reproducibility was better than 10% for mean ADC (8.1%), FA (9.7%), and T2 (5.9%). Mean ADC and FA differed significantly (P < .01) between the OA and healthy populations, but T2 did not. For ADC, the optimal threshold to differentiate both populations was 1.2 × 10−3 mm2/sec, achieving specificity of 1.0 (16 of 16) and sensitivity of 0.80 (eight of 10). For FA, the optimal threshold was 0.25, yielding specificity of 0.88 (14 of 16) and sensitivity of 0.80 (eight of 10). T2 showed poor differentiation between groups (optimal threshold = 22.9 msec, specificity = 0.69 [11 of 16], sensitivity = 0.60 [six of 10]).

Conclusion

In vivo DT imaging of patellar cartilage is feasible, has good test-retest reproducibility, and may be accurate in discriminating healthy subjects from subjects with OA. ADC and FA are two promising biomarkers for early OA.

© RSNA, 2011

References

  • 1 Centers for Disease Control and Prevention (CDC). National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions: United States, 2003. MMWR Morb Mortal Wkly Rep 2007;56(1):4–7.
    Medline Google Scholar
  • 2 Wieland HA, Michaelis M, Kirschbaum BJ, Rudolphi KA. Osteoarthritis: an untreatable disease? Nat Rev Drug Discov 2005;4(4):331–344.
    Medline Google Scholar
  • 3 Bashir A, Gray ML, Burstein D. Gd-DTPA2- as a measure of cartilage degradation. Magn Reson Med 1996;36(5):665–673.
    Medline Google Scholar
  • 4 Insko EK, Reddy R, Leigh JS. High resolution, short echo time sodium imaging of articular cartilage. J Magn Reson Imaging 1997;7(6):1056–1059.
    Medline Google Scholar
  • 5 Dardzinski BJ, Mosher TJ, Li S, Van Slyke MA, Smith MB. Spatial variation of T2 in human articular cartilage. Radiology 1997;205(2):546–550.
    Google Scholar
  • 6 de Visser SK, Bowden JC, Wentrup-Byrne E, et al.. Anisotropy of collagen fibre alignment in bovine cartilage: comparison of polarised light microscopy and spatially resolved diffusion-tensor measurements. Osteoarthritis Cartilage 2008;16(6):689–697.
    Medline Google Scholar
  • 7 Deng X, Farley M, Nieminen MT, Gray M, Burstein D. Diffusion tensor imaging of native and degenerated human articular cartilage. Magn Reson Imaging 2007;25(2):168–171.
    Medline Google Scholar
  • 8 Filidoro L, Dietrich O, Weber J, et al.. High-resolution diffusion tensor imaging of human patellar cartilage: feasibility and preliminary findings. Magn Reson Med 2005;53(5):993–998.
    Medline Google Scholar
  • 9 Meder R, de Visser SK, Bowden JC, Bostrom T, Pope JM. Diffusion tensor imaging of articular cartilage as a measure of tissue microstructure. Osteoarthritis Cartilage 2006;14(9):875–881.
    Medline Google Scholar
  • 10 Raya JG, Melkus G, Adam-Neumair S, et al.. Change of diffusion tensor imaging parameters in articular cartilage with progressive proteoglycan extraction. Invest Radiol 2011;46(6):401–409.
    Medline Google Scholar
  • 11 Attur M, Wang HY, Kraus VB, et al.. Radiographic severity of knee osteoarthritis is conditional on interleukin 1 receptor antagonist gene variations. Ann Rheum Dis 2010;69(5):856–861.
    Medline Google Scholar
  • 12 Altman R, Asch E, Bloch D, et al.. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986;29(8):1039–1049.
    Medline Google Scholar
  • 13 Skare S, Hedehus M, Moseley ME, Li TQ. Condition number as a measure of noise performance of diffusion tensor data acquisition schemes with MRI. J Magn Reson 2000;147(2):340–352.
    Medline Google Scholar
  • 14 Peterfy CG, Guermazi A, Zaim S, et al.. Whole-Organ Magnetic Resonance Imaging Score (WORMS) of the knee in osteoarthritis. Osteoarthritis Cartilage 2004;12(3):177–190.
    Medline Google Scholar
  • 15 Gudbjartsson H, Maier SE, Mulkern RV, Mórocz IA, Patz S, Jolesz FA. Line scan diffusion imaging. Magn Reson Med 1996;36(4):509–519.
    Medline Google Scholar
  • 16 Mendlik T, Faber SC, Weber J, et al.. T2 quantitation of human articular cartilage in a clinical setting at 1.5 T: implementation and testing of four multiecho pulse sequence designs for validity. Invest Radiol 2004;39(5):288–299.
    Medline Google Scholar
  • 17 Constantinides CD, Atalar E, McVeigh ER. Signal-to-noise measurements in magnitude images from NMR phased arrays. Magn Reson Med 1997;38(5):852–857.
    Medline Google Scholar
  • 18 Dietrich O, Raya JG, Reeder SB, Ingrisch M, Reiser MF, Schoenberg SO. Influence of multichannel combination, parallel imaging and other reconstruction techniques on MRI noise characteristics. Magn Reson Imaging 2008;26(6):754–762.
    Medline Google Scholar
  • 19 Raya JG, Dietrich O, Horng A, Weber J, Reiser MF, Glaser C. T2 measurement in articular cartilage: impact of the fitting method on accuracy and precision at low SNR. Magn Reson Med 2010;63(1):181–193.
    Medline Google Scholar
  • 20 König L, Groher M, Keil A. Semi-automatic segmentation of the patellar cartilage in MRI. Bildverarbeitung Med 2007;17:404–408.
    Google Scholar
  • 21 Eckstein F, Westhoff J, Sittek H, et al.. In vivo reproducibility of three-dimensional cartilage volume and thickness measurements with MR imaging. AJR Am J Roentgenol 1998;170(3):593–597.
    Medline Google Scholar
  • 22 Efron B. Better bootstrap confidence intervals. J Am Stat Assoc 1987;82(397):171–185.
    Google Scholar
  • 23 Dunn OJ. Multiple comparisons among means. J Am Stat Assoc 1961;56:52–64.
    Google Scholar
  • 24 Obuchowski NA. ROC analysis. AJR Am J Roentgenol 2005;184(2):364–372.
    Medline Google Scholar
  • 25 Maroudas A, Venn M. Chemical composition and swelling of normal and osteoarthrotic femoral head cartilage. II. Swelling. Ann Rheum Dis 1977;36(5):399–406.
    Medline Google Scholar
  • 26 Burstein D, Gray ML, Hartman AL, Gipe R, Foy BD. Diffusion of small solutes in cartilage as measured by nuclear magnetic resonance (NMR) spectroscopy and imaging. J Orthop Res 1993;11(4):465–478.
    Medline Google Scholar
  • 27 Xia Y, Farquhar T, Burton-Wurster N, Ray E, Jelinski LW. Diffusion and relaxation mapping of cartilage-bone plugs and excised disks using microscopic magnetic resonance imaging. Magn Reson Med 1994;31(3):273–282.
    Medline Google Scholar
  • 28 Xia Y, Farquhar T, Burton-Wurster N, Vernier-Singer M, Lust G, Jelinski LW. Self-diffusion monitors degraded cartilage. Arch Biochem Biophys 1995;323(2):323–328.
    Medline Google Scholar
  • 29 Berg A, Singer T, Moser E. High-resolution diffusivity imaging at 3.0 T for the detection of degenerative changes: a trypsin-based arthritis model. Invest Radiol 2003;38(7):460–466.
    Medline Google Scholar
  • 30 Knauss R, Schiller J, Fleischer G, Kärger J, Arnold K. Self-diffusion of water in cartilage and cartilage components as studied by pulsed field gradient NMR. Magn Reson Med 1999;41(2):285–292.
    Medline Google Scholar
  • 31 Raya JG, Melkus G, Dietrich O, et al.. Multiparametric characterization of healthy and diseased articular cartilage at 17.6T: comparison with histology [abstr]. In: Proceedings of the Seventeenth Meeting of the International Society for Magnetic Resonance in Medicine. Berkeley, Calif: International Society for Magnetic Resonance in Medicine, 2009; 4001.
    Google Scholar
  • 32 Glaser C, Putz R. Functional anatomy of articular cartilage under compressive loading: quantitative aspects of global, local and zonal reactions of the collagenous network with respect to the surface integrity. Osteoarthritis Cartilage 2002;10(2):83–99.
    Medline Google Scholar
  • 33 Broom ND. An enzymatically induced structural transformation in articular cartilage: its significance with respect to matrix breakdown. Arthritis Rheum 1988;31(2):210–218.
    Medline Google Scholar
  • 34 Welsch GH, Apprich S, Zbyn S, et al.. Biochemical (T2, T2* and magnetisation transfer ratio) MRI of knee cartilage: feasibility at ultra-high field (7T) compared with high field (3T) strength. Eur Radiol 2011;21(6):1136–1143.
    Medline Google Scholar
  • 35 Mosher TJ, Zhang Z, Reddy R, et al.. Knee articular cartilage damage in osteoarthritis: analysis of MR image biomarker reproducibility in ACRIN-PA 4001 multicenter trial. Radiology 2011;258(3):832–842.
    Google Scholar
  • 36 Glaser C, Horng A, Mendlik T, et al.. T2 relaxation time in patellar cartilage: global and regional reproducibility at 1.5 tesla and 3 tesla [in German]. Rofo 2007;179(2):146–152.
    Medline Google Scholar
  • 37 Glaser C, Mendlik T, Dinges J, et al.. Global and regional reproducibility of T2 relaxation time measurements in human patellar cartilage. Magn Reson Med 2006;56(3):527–534.
    Medline Google Scholar
  • 38 Raya JG, Horng A, Dietrich O, et al.. Voxel-based reproducibility of T2 relaxation time in patellar cartilage at 1.5 T with a new validated 3D rigid registration algorithm. MAGMA 2009;22(4):229–239.
    Medline Google Scholar
  • 39 Multanen J, Rauvala E, Lammentausta E, et al.. Reproducibility of imaging human knee cartilage by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5 Tesla. Osteoarthritis Cartilage 2009;17(5):559–564.
    Medline Google Scholar
  • 40 Heidemann RMPD, Porter DA, Anwander A, et al.. Diffusion imaging in humans at 7T using readout-segmented EPI and GRAPPA. Magn Reson Med 2010;64(1):9–14.
    Medline Google Scholar

Article History

Received April 21, 2011; revision requested June 13; revision received August 8; accepted August 19; final version accepted September 6.
Published online: Feb 2012
Published in print: Feb 2012