Assessment of normal patellar cartilage volume and thickness using MRI: an analysis of currently available pulse sequences

Sittek, H.; Eckstein, F.; Gavazzeni, Antonia; Milz, Stefan; Kiefer, Berthold; Schulte, Erik; Reiser, Maximilian

doi:10.1007/s002560050032

Cited by 96 publications

(69 citation statements)

References 21 publications

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“…Recent advances in MRI technology have led to significant improvements in spatial resolution and contrast, enabling researchers to evaluate anatomic damage of all these joint structures in the axial, coronal, and sagittal planes (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Recently, we and other investigators have developed a system for quantifying cartilage volume using MRI acquisitions combined with sophisticated software (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41); however, to date, few studies have used MRI technology to evaluate cartilage volume changes over time (42)(43)(44)(45)(46).…”

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confidence: 99%

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

Raynauld¹,

Martel‐Pelletier²,

Berthiaume³

et al. 2004

Arthritis & Rheumatism

239

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Objective. To evaluate the change in osteoarthritic (OA) knee cartilage volume over a two-year period with the use of magnetic resonance imaging (MRI) and to correlate the MRI changes with radiologic changes.Methods. Thirty-two patients with symptomatic knee OA underwent MRI of the knee at baseline and at 6, 12, 18, and 24 months. Loss of cartilage volumes were computed and contrasted with changes in clinical variables for OA and with standardized semiflexed knee radiographs at baseline at 1 and 2 years.Results. Progression of cartilage loss at all followup points was statistically significant (P < 0.0001), with a mean ؎ SD of 3.8 ؎ 5.1% for global cartilage loss and 4.3 ؎ 6.5% for medial compartment cartilage loss at 6 months, 3.6 ؎ 5.1% and 4.2 ؎ 7.5% at 12 months, and 6.1 ؎ 7.2% and 7.6 ؎ 8.6% at 24 months. Discriminant function analysis identified 2 groups of patients, those who progressed slowly (<2% of global cartilage loss; n ‫؍‬ 21) and those who progressed rapidly (>15% of global cartilage loss; n ‫؍‬ 11) over the 2 years of study. At baseline, there was a greater proportion of women (P ‫؍‬ 0.001), a lower range of motion (P ‫؍‬ 0.01), a greater circumference and higher level of pain (P ‫؍‬ 0.05) and stiffness in the study knee, and a higher body mass index in the fast progressor group compared with the slow progressor group. No statistical correlation between loss of cartilage volume and radiographic changes was seen.Conclusion. Quantitative MRI can measure the progression of knee OA precisely and can help to identify patients with rapidly progressing disease. These findings indicate that MRI could be helpful in assessing the effects of treatment with structure-modifying agents in OA.In people over the age of 60 years, osteoarthritis (OA) is a common cause of disability. Assessment of cartilage damage is important for monitoring disease progression and evaluating therapeutic response in OA. For many years, clinical studies of drug interventions in symptomatic knee OA have focused specifically on clinical parameters, such as pain and joint function, without assessing the effect of treatment on structural changes caused by the disease or the role of treatment in preventing cartilage degradation. Serial radiographs of affected joints appear to be a logical means of documenting the progression of OA over time (1), provided that a validated, reliable, and easily reproducible technique is used (2-5).

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confidence: 99%

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

Raynauld¹,

Martel‐Pelletier²,

Berthiaume³

et al. 2004

Arthritis & Rheumatism

239

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“…MR imaging can delineate the cartilage with highresolution and high contrast to surrounding tissue, provided that fat-suppressed gradient-echo sequences are employed [30,34,37]. In the knee, which displays cartilage thickness values of 5 mm and more, it has been shown that the cartilage volume can be determined with a high degree of accuracy [9,11,12,27,30,33].…”

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confidence: 99%

“…Specific 3D digital image analysis techniques have also permitted to compute the cartilage thickness and its variation throughout knee joint cartilage plates [5,38,39]. These analyses have been validated in comparison with anatomical sectioning [9,37], CT arthrography [I 1,121, A-mode ultrasound [S], and stereophotogrammetry [5]. The precision (reproducibility) of these measurements has also been examined under clinical in vivo imaging conditions, revealing coefficients of variation between 1% and 4% for estimates of cartilage volume and mean thickness [ 10,13,2 1,24, 30,39,43].…”

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confidence: 99%

Quantitative cartilage imaging of the human hind foot: Precision and inter‐subject variability

Al-Ali

Graichen

Faber

et al. 2002

Journal Orthopaedic Research

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Alterations of ankle cartilage are observed in degenerative and inflammatory joint disease, but cartilage cannot be directly visualized by radiography. The purpose of this study was therefore to analyze the feasibility and precision of quantitative cartilage imaging in the human hind foot (talocrural, talotarsal, and intertarsal joints), and to report the inter-subject variability for cartilage volume, thickness and surface areas. The feet of 16 healthy volunteers were imaged using a 3D gradient-echo magnetic resonance imaging sequence with water-excitation. After interpolation to a resolution of 1 z 0.125 y 0.125 mm? the cartilage plates were segmented, and the cartilage volume, thickness, and surface areas determined. The precision (four repeated measurements) was examined in eight volunteers, the RMS average CV% being 2.1% to 10.9% in single joint surfaces, and < 3% for the cumulative values of all joints. The mean cartilage thickness ranged from 0.57 i 0.08 (navicular surface) to 0.89 5 0 . 1 9 mm (trochlear surface for tibia). In conclusion this study shows that it is feasibIe to quantify thin cartilage layers in the hind foot under in vivo imaging conditions, and that the precision errors are substantially smaller than the inter-subject variability in healthy subjects.

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“…In the patella specimen, less than 17% of the image points deviated more than 0.5 mm when comparing MRI and histological sections. Between 50% and 90% were within an interval of 0.5 mm [19]. In our study, a difference of 0.5 mm would have led to a possible difference of about 20% for the average cartilage thickness of 2.69 mm.…”

Section: Discussionmentioning

confidence: 41%

Measurement of cartilage thickness in the human knee-joint by magnetic resonance imaging using a three-dimensional gradient-echo sequence

Kladny¹,

Martus²,

Schiwy-Bochat

et al. 1999

International Orthopaedics

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We studied human specimens and compared data on cartilage thickness measurements with magnetic resonance imaging by using an image analysing system with corresponding histological sections in the middle of each sector. The findings are based on 768 measurements in 26 knee joints. Overall, there was very good magnetic resonance/anatomic correlation (r=0.88). The poorest correlation was in the sectors of the femur (r=0.69). The correlation seemed not to be dependent on the grade of osteoarthritic cartilage lesions. Despite good correlation rates, the mean magnetic resonance/anatomic difference (absolute values) was 0.41 mm (standard deviation (SD) 0.34 mm) or 18.08% (SD 18.9%). Imaging techniques need to be improved if the assessment of cartilage thickness by this means is to be of clinical relevance .Résumé Nous avons examiné des speciments humains et comparé les dates des mesures de l'épaisseur du cartilage avec le MRI utilisant un système "image analysing" avec les séctions histologiques correspondantes dans le centre de chaque secteur. Les résultats sont fondés sur 768 mesures de 26 articulations du genou. Tous ensemble, la correlation magnetique resonance/anatomique était tres bien (r=0.88). La correlation plus petite dans notre exanination était dans les secteurs du femur (r=0.69). La correlation était apparement independante du degré des lésions osteoarthritique du cartilage. En dépit des taux positifs de correlation, la difference moyenne magnetique resonance/anatomique (valeurs absolues) était 0.41 mm (écart-type (EC): 0.34 mm) ou 18.08% (EC 18.9%). Les techniques d`images ont besoin d`améloriation si les mesures de l'épaisseur du cartilage avec le MRI semble important pour les questions médicales. Il faut considérer les differences selon la localisation en évaluant l'épaisseur du cartilage avec le MRI. IntroductionIn the evaluation of cartilage lesions, arthroscopy is still the "gold standard". However, arthroscopy is invasive and is less informative about cartilage thickness. Ultrasonography has the potential to provide information on the cartilage layer but access to the knee joint is restricted. Techniques to assess cartilage thickness by arthrography and X-ray measurements have been described [4,8,12]; however, they mainly provide information on the joint space. These methods are of only minor value. By contrast, magnetic resonance imaging (MRI) provides a non-invasive image of the cartilage layer. It has been recommended that in cartilage imaging with MRI there should be high resolution, thin planar slices without gaps and with good discrimination of the cartilage relative to the surrounding tissue [9]. A sequence termed "fast imaging with steady state precession" (FISP) has proved to be very effective in the evaluation of knee disorders [7,24] and meets these criteria. The following study of human knee joints compares cartilage thickness measurements by MRI with corresponding histological sections. Materials and methodsWe removed 30 fully encapsulated human knee joints at autopsy. Gross de...

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Assessment of normal patellar cartilage volume and thickness using MRI: an analysis of currently available pulse sequences

Cited by 96 publications

References 21 publications

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

Quantitative magnetic resonance imaging evaluation of knee osteoarthritis progression over two years and correlation with clinical symptoms and radiologic changes

Quantitative cartilage imaging of the human hind foot: Precision and inter‐subject variability

Measurement of cartilage thickness in the human knee-joint by magnetic resonance imaging using a three-dimensional gradient-echo sequence

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