Multimodal approach in the use of clinical scoring, morphological MRI and biochemical T2-mapping and diffusion-weighted imaging in their ability to assess differences between cartilage repair tissue after microfracture therapy and matrix-associated autologous chondrocyte transplantation: a pilot study

Welsch, Goetz H.; Trattnig, Siegfried; Domayer, Stephan; Marlovits, Stefan; White, Lawrence M.; Mamisch, Tallal C.

doi:10.1016/j.joca.2009.03.018

Cited by 98 publications

(118 citation statements)

References 45 publications

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“…In contrast to previous work using signal ratios between nondiffusion and DW-SSFP-Echo scans as diffusion estimate (12)(13)(14), quantitative DWI in the very-rapid-pulsing regime was demonstrated for the evaluation of cartilage function and repair in Fig. 9.…”

Section: In Vitro and In Vivo Experimentsmentioning

confidence: 69%

“…This regime has recently shown great promise for characterization of cartilage function and repair (12)(13)(14), but quantification was hampered, since application of the common Wu-Buxton model (and thus the KBE ansatz) failed to deliver an accurate description of diffusion effects in this limit (15). We will show that the mismatch between theory and measurement can be resolved with an appropriate model and quantitative SSFP-Echo DWI is evaluated and optimized from simulations, in vitro and in vivo measurements.…”

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confidence: 99%

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Fast diffusion‐weighted steady state free precession imaging of in vivo knee cartilage

Bieri

Ganter

Welsch

et al. 2011

Magnetic Resonance in Med

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Quantification of molecular diffusion with steady state free precession (SSFP) is complicated by the fact that diffusion effects accumulate over several repetition times (TR) leading to complex signal dependencies on transverse and longitudinal magnetization paths. This issue is commonly addressed by setting TR > T 2 , yielding strong attenuation of all higher modes, except of the shortest ones. As a result, signal attenuation from diffusion becomes T 2 independent but signal-to-noise ratio (SNR) and sequence efficiency are remarkably poor. In this work, we present a new approach for fast in vivo steady state free precession diffusion-weighted imaging of cartilage with TR << T 2 offering a considerable increase in signal-to-noise ratio and sequence efficiency. At a first glance, prominent coupling between magnetization paths seems to complicate quantification issues in this limit, however, it is observed that diffusion effects become rather T 2 (DD 1/10 DT 2 ) but not T 1 independent (DD~1/2 DT 1 ) for low flip angles a~10 2 15°. As a result, fast high-resolution (0. The dynamic displacement of water on cellular dimensions provides a unique insight into tissue structure, microstructure, and organization. As a result, diffusionweighted imaging (DWI) has become a highly sensitive and specific tool for the detection of pathological changes in tissue. While echo planar imaging (1) is the current gold standard for DWI of the brain (2), its rather poor achievable spatial resolution and coverage for tissues with short transverse relaxation times (T 2 ) has pushed the development of several other DWI techniques, some of them using the diffusion sensitivity of steady state free precession (SSFP) to a single, unbalanced gradient (see Fig. 1a; Refs. 3-7). Due to short repetition times (TR < T 2 ), as commonly used with SSFP, the steady state signal is composed of many different transverse and longitudinal paths or modes including stimulated echoes. As a result, especially the ''echo'' in nonbalanced SSFP (i.e., the refocused signal immediately preceding the radiofrequency pulse) is very sensitive to diffusion and represents a unique alternative to traditional echo planar imaging-based DWI. The FID (i.e., the signal immediately following the radiofrequency pulse) is generally not used, since its sensitivity to diffusion in tissues is quite low.Several models have been developed for the description of diffusion effects in SSFP (4,8-10), most of them being based on the seminal work of Kaiser, Bartholdi, and Ernst (KBE) (8). In MRI, besides semiempirical approaches, such as the one presented by Le Bihan (4), the extension of the KBE ansatz to pulsed gradient SSFP by Wu and Buxton (9,10) is generally well accepted and several research groups have reported DWI with SSFPEcho (for complete review, see Ref. 7). Quantification of diffusion, however, is complicated by contributions of many different echoes leading to complicated dependencies on relaxation times (T 1,2 ) and sequence parameters (TR, flip angle). Nevertheless, quantifi...

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Section: In Vitro and In Vivo Experimentsmentioning

confidence: 69%

mentioning

confidence: 99%

Fast diffusion‐weighted steady state free precession imaging of in vivo knee cartilage

Bieri

Ganter

Welsch

et al. 2011

Magnetic Resonance in Med

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“…Semiquantitative evaluation for cartilage repair-A first application of DWI has been to study cartilage repair using a diffusion-weighted SSFP sequence (116)(117)(118)(119). In these first studies, a semi quantitative evaluation of the images was performed to avoid the complex calculation of the diffusion coefficient.…”

Section: Diffusion-weighted Imagingmentioning

confidence: 99%

Techniques and applications of in vivo diffusion imaging of articular cartilage

Raya

2015

Magnetic Resonance Imaging

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Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity (MD) and to the collagen architecture through the fractional anisotropy (FA). However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (~40 ms at 3 T) and the high resolution needed (0.5-0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications.

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“…However, it is sensitive to motion artifacts, and it is demanding to get absolute quantitative measurements. It has been utilized for evaluation of patients after matrix-associated autologous chondrocyte transplantation to show distinction between healthy cartilage and cartilage repair tissue, but it has had limited use in other clinical settings to evaluate cartilage [39,75].…”

Section: àmentioning

confidence: 99%

Anterior Delayed Gadolinium-enhanced MRI of Cartilage Values Predict Joint Failure After Periacetabular Osteotomy

Kim

Jessel

Zurakowski

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Abstract: Using T2-mapping and DWI, additional information could be gained compared to clinical scoring or morphological MRI. In combination clinical, MR-morphological and MR-biochemical parameters can be seen as a promising multimodal tool in the follow-up of cartilage repair.

Cited by 98 publications

References 45 publications

Fast diffusion‐weighted steady state free precession imaging of in vivo knee cartilage

Fast diffusion‐weighted steady state free precession imaging of in vivo knee cartilage

Techniques and applications of in vivo diffusion imaging of articular cartilage

Anterior Delayed Gadolinium-enhanced MRI of Cartilage Values Predict Joint Failure After Periacetabular Osteotomy

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