dGEMRIC (delayed gadolinium‐enhanced MRI of cartilage) indicates adaptive capacity of human knee cartilage

Tiderius, Carl Johan; Svensson, Jonas; Leander, Peter; Thorsson, Ola; Dahlberg, Leif

doi:10.1002/mrm.10714

Cited by 147 publications

(136 citation statements)

References 48 publications

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“…These include correspondence of the dGEMRIC index to cartilage 'softening' as seen by arthroscopy (199), correlation of the dGEMRIC index with the level of physical activity (200), improved differentiation of disease relative to radiography in individuals with hip dysplasia (201), discriminatory power of dGEMRIC in radiographically similar compartments of the knee (202), sensitivity of medial/lateral dGEMRIC to malalignment in the knee (202), lower dGEMRIC values in individuals with ACL injury (203) and sensitivity to changes in knee cartilage following posterior cruciate ligament (PCL) injury (204).…”

Section: Cross-sectional and Longitudinal Observations In Oamentioning

confidence: 99%

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

2006

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Magnetic resonance imaging (MRI) and quantitative image analysis technology has recently started to generate a great wealth of quantitative information on articular cartilage and bone physiology, pathophysiology and degenerative changes in osteoarthritis. This paper reviews semiquantitative scoring of changes of articular tissues (e.g. WORMS ¼ whole-organ MRI scoring or KOSS ¼ knee osteoarthritis scoring system), quantification of cartilage morphology (e.g. volume and thickness), quantitative measurements of cartilage composition (e.g. T 2 , T 1rho , T 1Gd ¼ dGEMRIC index) and quantitative measurement of bone structure (e.g. app. BV/TV, app. TbTh, app. Tb.N, app. Tb.Sp) in osteoarthritis. For each of these fields we describe the hardware and MRI sequences available, the image analysis systems and techniques used to derive semiquantitative and quantitative parameters, the technical accuracy and precision of the measurements reported to date and current results from cross-sectional and longitudinal studies in osteoarthritis. Moreover, the paper summarizes studies that have compared MRI-based measurements with radiography and discusses future perspectives of quantitative MRI in osteoarthritis. In summary, the above methodologies show great promise for elucidating the pathophysiology of various tissues and identifying risk factors of osteoarthritis, for developing structure modifying drugs (DMOADs) and for combating osteoarthritis with new and better therapy. Copyright # 2006 John Wiley & Sons, Ltd.KEYWORDS: osteoarthritis; joint; cartilage; bone; magnetic resonance imaging; knee; image analysis; disease-modifying drugs RATIONALE FOR QUANTITATIVE MRI OF CARTILAGE AND BONE IN OSTEOARTHRITISThe health and integrity of diarthrodial (synovial) joints are prerequisites for pain-free movement and have a major impact on the quality of life. However, the population of individuals above the age of 65 years is rapidly growing and 70% of the women and 60% of the men aged 65 years or older suffer from degenerative joint disease [¼ osteoarthritis (OA)] (1-7). OA has been defined by the American College of Rheumatology (ACR) as a 'heterogeneous group of conditions that leads to joint symptoms and signs which are associated with defective integrity of articular cartilage, in addition to related changes in the underlying bone at the joint margins'. It remains an open question whether the initial changes take place in cartilage or bone or other articular tissues and, more importantly, what the causal relationship between these changes is (5-19). Also, within each NMR IN BIOMEDICINE NMR Biomed. 2006; 19: 822-854 Published online in Wiley InterScience (www.interscience.wiley.com). DOI:10.1002/nbm.1063 narrowing; JSW, joint space width; K, knee; KLG, Kellgren Lawrence grade; KOSS, knee osteoarthritis scoring system; LF, lateral femoral condyle; LT, lateral tibia; MRI, magnetic resonance imaging; MF, medial femoral condyle; MT, medial tibia; OA, osteoarthritis; OAI, Osteoarthritis Initiative; P, patella; PGs, proteoglycans;...

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Section: Cross-sectional and Longitudinal Observations In Oamentioning

confidence: 99%

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

2006

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“…Many studies have shown that mechanical loading of articular cartilage affects the metabolism of chondrocytes and its biochemical composition [1,32,37]. Both animal and human studies have shown that the GAG content is higher in cartilage that is habitually loaded [19,33] or has a higher level of activity [39], whereas immobilization results in a reversible decrease in cartilage PG content [18,30].…”

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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“…In addition, the MRI studies were performed at a field strength of 9.4 T, which is substantially larger than the typical clinical field strengths of 1.5 or 3 T. We note that successful FCD measurements have nonetheless been carried out at these lower field strengths. 3,31,32 Finally, while the present results provide strong evidence of the utility of MRI in monitoring the development of FCD in injectable hydrogel constructs, the effectiveness of this approach remains to be established in in vivo studies. 33 We note that the present investigation was targeted to the specific hypothesis that noninvasive MRI measurements of FCD would correlate with biochemically determined GAG in developing neocartilage.…”

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confidence: 67%

Noninvasive Assessment of Glycosaminoglycan Production in Injectable Tissue-Engineered Cartilage Constructs Using Magnetic Resonance Imaging

Ramaswamy

Uluer²,

Leen³

et al. 2008

Tissue Engineering Part C: Methods

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The glycosaminoglycan (GAG) content of engineered cartilage is a determinant of biochemical and mechanical quality. The ability to measure the degree to which GAG content is maintained or increases in an implant is therefore of importance in cartilage repair procedures. The gadolinium exclusion magnetic resonance imaging (MRI) method for estimating matrix fixed charge density (FCD) is ideally suited to this. One promising approach to cartilage repair is use of seeded injectable hydrogels. Accordingly, we assess the reliability of measuring GAG content in such a system ex vivo using MRI. Samples of the photopolymerizable hydrogel, poly(ethylene oxide) diacrylate, were seeded with bovine chondrocytes (*2.4 million cells/sample). The FCD of the constructs was determined using MRI after 9, 16, 29, 36, 43, and 50 days of incubation. Values were correlated with the results of biochemical determination of GAG from the same samples. FCD and GAG were found to be statistically significantly correlated (R 2 = 0.91, p < 0.01). We conclude that MRI-derived FCD measurements of FCD in injectable hydrogels reflect tissue GAG content and that this methodology therefore has potential for in vivo monitoring of such constructs.

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dGEMRIC (delayed gadolinium‐enhanced MRI of cartilage) indicates adaptive capacity of human knee cartilage

Cited by 147 publications

References 48 publications

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

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

Noninvasive Assessment of Glycosaminoglycan Production in Injectable Tissue-Engineered Cartilage Constructs Using Magnetic Resonance Imaging

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