Magnetic resonance chondro‐crassometry (MR CCM): A method for accurate determination of articular cartilace thickness?

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

doi:10.1002/mrm.1910350112

Cited by 54 publications

(40 citation statements)

References 42 publications

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“…Eckstein et al found no significant difference between areas of thin and thick cartilage in six human patellae [5]. In our study, we have very good correlation in the patellar cartilage.…”

Section: Discussionsupporting

confidence: 69%

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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“…Eckstein et al found no significant difference between areas of thin and thick cartilage in six human patellae [5]. In our study, we have very good correlation in the patellar cartilage.…”

Section: Discussionsupporting

confidence: 69%

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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“…In contrast to radiographic joint space width (JSW), for which sufficient accuracy was confirmed only in the medial FT compartment (119), the degree of accuracy of MRI-based measurements is similar for all knee surfaces (Table 1). Applying changes in gradient direction, it has been shown that no relevant geometric distortion is involved in quantitative measures of cartilage morphology (120,121). Cohen et al (94) observed the accuracy error for the AC in healthy knees to be slightly larger [root mean square (RMS) residual error ¼ 0.22 mm] than for tAB (0.14 mm), with cartilage thickness displaying an error of $0.3 mm.…”

Section: Technical Accuracy and Precision Of Measurementsmentioning

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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“…In orthopaedics and musculoskeletal radiology detection of cartilage thickness is of importance in both clinical practice and in research on biomechanics of joint structures [1,2,3]. In clinical practise cartilage thickness estimates can be used to stage joint disease in a primary diagnosis and in evaluation of pharmacological or surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

“…A lot of effort has been put into detection of cartilage in the knee joint [1,2,5,6,7,8,9]. In the knee cartilage thickness ranges typically from 2 to 5 mm.…”

Section: Introductionmentioning

confidence: 99%

“…Comparison of MR based methods for cartilage thickness measurements with estimates from anatomical sections show that roughly 10-50 % of the measurements have an inaccuracy of more than 0.5 mm [1,5]. These inaccuracies may be acceptable for measurements in the knee but are unacceptable when cartilage thickness is in the sub millimeter range like in most part of the wrist and in the ankle [10].…”

Section: Introductionmentioning

confidence: 99%

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Cartilage Thickness Measurement in the Sub-millimeter Range

Streekstra

Brascamp

Leij

et al. 2004

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2004

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Abstract. We present a method to measure cartilage thickness from CT images in the sub millimeter range. Current methods based on zero crossings of second derivatives across the cartilage layers are known to be biased in the sub millimeter range due to the finite width of the point spread function (PSF) of the imaging system. We developed a method for accurate thickness measurements of such small layers by taking into account the effect of the PSF. To this end the orientation of the cartilage layers is estimated using gradient vector information in the cartilage region. Subsequently, a model of the attenuation profile across the cartilage layer is convolved with a measured PSF to obtain an intensity profile that is fitted to the image data. Results of thickness estimates from simulated image data reveal that our method is unbiased in contrast to the method based on second derivative zero crossings. We illustrate the usefulness of our method by comparing measurement on CT arthrography images with results obtained from high resolution anatomical sections that served as a reference. We conclude that incorporation of the PSF in the measurement method allows for accurate cartilage thickness estimates even in the sub millimeter range.

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Magnetic resonance chondro‐crassometry (MR CCM): A method for accurate determination of articular cartilace thickness?

Cited by 54 publications

References 42 publications

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

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

Quantitative MRI of cartilage and bone: degenerative changes in osteoarthritis

Cartilage Thickness Measurement in the Sub-millimeter Range

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