Detection of cartilage damage in femoroacetabular impingement with standardized dGEMRIC at 3 T

Lattanzi, Riccardo; Petchprapa, Catherine; Ascani, Daniele; Babb, James S.; Chu, Delin; Davidovitch, Roy I.; Youm, Thomas; Meislin, Robert J.; Recht, Michael P.

doi:10.1016/j.joca.2013.12.022

Cited by 44 publications

(51 citation statements)

References 44 publications

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“…They demonstrated that visual inspection of the standardized dGEMRIC maps was more accurate than an average z for the acetabular cartilage [70]. Others proposed to normalize regional T1 Gd values by dividing them by the average T1 Gd of the total (acetabular and femoral) cartilage, to draw attention to areas of abnormalities [25].…”

Section: Pearls and Pitfallsmentioning

confidence: 99%

Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

et al. 2015

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Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms "cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC", considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment.

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Section: Pearls and Pitfallsmentioning

confidence: 99%

Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

et al. 2015

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“…This can be measured using MRI [2][3][4]6]. Lattanzi et al [24] reported accuracy of 58%, sensitivity of 52%, and specificity of 67% in detecting cartilage damage in femoroacetabular impingement using dGEMRIC.…”

Section: Introductionmentioning

confidence: 99%

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Hingsammer

Miller

Millis

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Osteoarthritis may result from abnormal mechanics leading to biochemically mediated degradation of cartilage. In a dysplastic hip, the periacetabular osteotomy (PAO) is designed to normalize the mechanics and our initial analysis suggests that it may also alter the cartilage biochemical composition. Articular cartilage structure and biology vary with the depth from the articular surface including the concentration of glycosaminoglycans (GAG), which are the charge macromolecules that are rapidly turned over and are lost in early osteoarthritis. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) enables noninvasive measurement of cartilage GAG content. The dGEMRIC index represents an indirect measure of GAG concentration with lower values indicating less GAG content. GAG content can normally vary with mechanical loading; however, progressive loss of GAG is associated with osteoarthritis. By looking at the changes in amounts of GAG in response to a PAO at different depths of cartilage, we may gain further insights into the types of biologic events that are occurring in the joint after a PAO. Questions/purposes We (1) measured the GAG content in the superficial and deep zones for the entire joint before and after PAO; and (2) investigated if the changes in the superficial and deep zone GAG content after PAO varied with different locations within the joint. Methods This prospective study included 37 hips in 37 patients (mean age 26 ± 9 years) who were treated with periacetabular osteotomy for symptomatic acetabular dysplasia and had preoperative and 1-year follow up dGEMRIC scans. Twenty-eight of the 37 also had 2-year scans. Patients were eligible if they had symptomatic acetabular dysplasia with lateral center-edge angle \ 20°a nd no or minimal osteoarthritis. The change in dGEMRIC after surgery was assessed in the superficial and deep cartilage zones at five acetabular radial planes. Results The mean ± SD dGEMRIC index in the superficial zone fell from 480 ± 137 msec preoperatively to 409 ± 119 msec at Year 1 (95% confidence interval [CI], À87 to À54; p \0.001) and recovered to 451 ± 115 msec at Year 2 (95% CI, 34-65; p \ 0.001), suggesting that there is a transient event that causes the biologically sensitive superficial layer to lose GAG. In the deep acetabular cartilage zone, dGEMRIC index fell from 527 ± 148 msec preoperatively to 468 ± 143 msec at Year 1 (95% CI, À66 to À30; p\0.001) and recovered to 494 ± 125 msec at Year 2 (95% CI, 5-32; p = 0.008). When each acetabular radial plane was looked at separately, the change from before surgery to 1 year after was confined to zones around the superior part of the joint.

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“…Another disadvantage of the technique is the lack of specificity for the concentration of GAG molecules in the cartilage, although the examination time has been reduced considerably. Newer studies point to an advantage of the combination of T2 mapping and dGEMRIC, which combines high sensitivity and specificity [16,17].…”

Section: Functional Cartilage Imagingmentioning

confidence: 99%

Modern Radiological Imaging of Osteoarthritis of The Hip Joint With Consideration of Predisposing Conditions

Weber

Merle

Rehnitz

et al. 2016

Fortschr Röntgenstr

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Osteoarthritis is the most common disease of the hip joint in adults and has a high socioeconomic impact. This review article discusses the value of three imaging modalities in the diagnosis of osteoarthritis of the hip joint: projection radiography, computed tomography, and magnetic resonance imaging (MRI). Besides established imaging diagnostics of osteoarthritis, this review also outlines new MRI techniques that enable the biochemical analysis of hip joint cartilage and discusses predisposing deformities of the hip joint including femoroacetabular impingement (FAI) with labral pathologies, hip joint dysplasia, malrotation, and, finally, femoral head necrosis, for which early detection and an exact description of the extent and localization of the necrotic area are extremely important. Conventional X-rays remain indispensable for the diagnosis of osteoarthritis, while MRI is able to depict additional early symptoms and signs of activity of the disease. With the increasing number of joint-preserving interventions such as surgical hip luxation and hip joint arthroscopy for treating FAI, high-resolution imaging is gaining further importance for both pre- and postoperative diagnostics because it can accurately recognize early stages of joint damage. With high-resolution MR sequences and MR arthrography, the detailed depiction of the thin cartilaginous coating of the hip joint has become quite possible. Key points: ??Projection radiography is the method of choice for the diagnostic work-up of osteoarthritis of the hip joint. ??Using computed tomography, the amount of acetabular bone stock prior to total hip arthroplasty is assessed in selected patients. ??Magnetic resonance imaging can substantiate the indication of surgery in case of discrepancy between clinical symptoms and radiological findings of the hip joint. ??If distinct and left untreated, predisposing conditions (such as femoroacetabular impingement) may lead to early development of osteoarthritis of the hip joint. ??Functional cartilage imaging can verify changes in the biochemical composition of the cartilage before they become morphologically evident. Citation Format: ??Weber MA, Merle C, Rehnitz C et?al. Modern Radiological Imaging of Osteoarthritis of The Hip Joint With Consideration of Predisposing Conditions. Fortschr R?ntgenstr 2016; 188: 635???651

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Detection of cartilage damage in femoroacetabular impingement with standardized dGEMRIC at 3 T

Cited by 44 publications

References 44 publications

Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

Does Periacetabular Osteotomy Have Depth-related Effects on the Articular Cartilage of the Hip?

Modern Radiological Imaging of Osteoarthritis of The Hip Joint With Consideration of Predisposing Conditions

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