Osteoarthritis (OA) is a common, worldwide disorder. Magnetic resonance (MR) imaging can directly and noninvasively evaluate articular cartilage and has emerged as an essential tool in the study of OA.
Evidence Acquisition:
A PubMed search was performed using the keywords quantitative MRI and cartilage. No limits were set on the range of years searched. Articles were reviewed for relevance with an emphasis on in vivo studies performed at 3 tesla.
Study Design:
Clinical review.
Level of Evidence:
Level 4.
Results:
T2, T2*, T1 (particularly when measured after exogenous contrast administration, such as with the delayed gadolinium-enhanced MR imaging of cartilage [dGEMRIC] technique), and T1ρ are among the most widely utilized quantitative MR imaging techniques to evaluate cartilage and have been implemented in various patient cohorts. Existing challenges include reproducibility of results, insufficient consensus regarding optimal sequences and parameters, and interpretation of values.
Conclusion:
Quantitative assessment of cartilage using MR imaging techniques likely represents the best opportunity to identify early cartilage degeneration and to follow patients after treatment. Despite existing challenges, ongoing work and unique approaches have shown exciting and promising results.
AkellaSVRegatteRRGougoutasAJ. Proteoglycan-induced changes in T1ρ-relaxation of articular cartilage at 4T. Magn Reson Med. 2001;46:419-423.
2.
AspdenRMHukinsDW. Collagen organization in articular cartilage, determined by X-ray diffraction, and its relationship to tissue function. Proc R Soc Lond B Biol Sci. 1981;212:299-304.
3.
BashirAGrayMLBursteinD. Gd-DTPA2- as a measure of cartilage degradation. Magn Reson Med. 1996;36:665-673.
4.
BerberatJENissiMJJurvelinJSNieminenMT. Assessment of interstitial water content of articular cartilage with T1 relaxation. Magn Reson Imaging. 2009;27:727-732.
5.
BittersohlBHosalkarHSSondernM. Spectrum of T2* values in knee joint cartilage at 3 T: a cross-sectional analysis in asymptomatic young adult volunteers. Skeletal Radiol. 2014;43:443-452.
6.
BorthakurAMellonENiyogiSWitscheyWKneelandJBReddyR. Sodium and T1ρ MRI for molecular and diagnostic imaging of articular cartilage. NMR Biomed. 2006;19:781-821.
BursteinDHunterDJ. “Why aren’t we there yet?” Re-examining standard paradigms in imaging of OA: summary of the 2nd annual workshop on imaging based measures of osteoarthritis. Osteoarthritis Cartilage. 2009;17:571-578.
9.
Carballido-GamioJLinkTMMajumdarS. New techniques for cartilage magnetic resonance imaging relaxation time analysis: texture analysis of flattened cartilage and localized intra- and inter-subject comparisons. Magn Reson Med. 2008;59:1472-1477.
10.
Carballido-GamioJStahlRBlumenkrantzGRomeroAMajumdarSLinkTM. Spatial analysis of magnetic resonance T1ρ and T2 relaxation times improves classification between subjects with and without osteoarthritis. Med Phys. 2009;36:4059-4067.
11.
ChangEYDuJChungCB. UTE imaging in the musculoskeletal system. J Magn Reson Imaging. 2015;41:870-883.
12.
ChenW. Errors in quantitative T1rho imaging and the correction methods. Quant Imaging Med Surg. 2015;5:583-591.
13.
CohenNPFosterRJMowVC. Composition and dynamics of articular cartilage: structure, function, and maintaining healthy state. J Orthop Sports Phys Ther. 1998;28:203-215.
14.
DomayerSEWelschGHStelzenederD. Microfracture in the ankle: clinical results and MRI with T2-mapping at 3.0 T after 1 to 8 years. Cartilage. 2011;2:73-80.
15.
DuvvuriUReddyRPatelSDKaufmanJHKneelandJBLeighJS. T1ρ-relaxation in articular cartilage: effects of enzymatic degradation. Magn Reson Med. 1997;38:863-867.
16.
FosterMAHaaseA. Relaxation measurements in imaging studies. eMagRes. 2007. doi:10.1002/9780470034590.emrstm0457.
17.
GillisAGrayMBursteinD. Relaxivity and diffusion of gadolinium agents in cartilage. Magn Reson Med. 2002;48:1068-1071.
18.
GoreJCAndersonAW. The physics of relaxation. eMagRes. 2013;2(1). doi:10.1002/9780470034590.emrstm1282.
19.
GrayMLBursteinDKimYJMaroudasA. 2007 Elizabeth Winston Lanier Award Winner. Magnetic resonance imaging of cartilage glycosaminoglycan: basic principles, imaging technique, and clinical applications. J Orthop Res. 2008;26:281-291.
20.
GuhaAWyattCKarampinosDCNardoLLinkTMMajumdarS. Spatial variations in magnetic resonance-based diffusion of articular cartilage in knee osteoarthritis. Magn Reson Imaging. 2015;33:1051-1058.
21.
HannilaIRainaSSTervonenOOjalaRNieminenMT. Topographical variation of T2 relaxation time in the young adult knee cartilage at 1.5 T. Osteoarthritis Cartilage. 2009;17:1570-1575.
22.
HoltzmanDJTheologisAACarballido-GamioJMajumdarSLiXBenjaminC. T1ρ and T2 quantitative magnetic resonance imaging analysis of cartilage regeneration following microfracture and mosaicplasty cartilage resurfacing procedures. J Magn Reson Imaging. 2010;32:914-923.
23.
HuangCGraffCGClarksonEWBilginAAltbachMI. T2 mapping from highly undersampled data by reconstruction of principal component coefficient maps using compressed sensing. Magn Reson Med. 2012;67:1355-1366.
24.
HunterDJSchofieldDCallanderE. The individual and socioeconomic impact of osteoarthritis. Nat Rev Rheumatol. 2014;10:437-441.
25.
JordanCDMcWalterEJMonuUD. Variability of CubeQuant T1ρ, quantitative DESS T2, and cones sodium MRI in knee cartilage. Osteoarthritis Cartilage. 2014;22:1559-1567.
26.
KijowskiRBlankenbakerDGMunoz Del RioABaerGSGrafBK. Evaluation of the articular cartilage of the knee joint: value of adding a T2 mapping sequence to a routine MR imaging protocol. Radiology. 2013;267:503-513.
27.
KimYJJaramilloDMillisMBGrayMLBursteinD. Assessment of early osteoarthritis in hip dysplasia with delayed gadolinium-enhanced magnetic resonance imaging of cartilage. J Bone Joint Surg Am. 2003;85-A:1987-1992.
28.
KotlarzHGunnarssonCLFangHRizzoJA. Insurer and out-of-pocket costs of osteoarthritis in the US: evidence from national survey data. Arthritis Rheum. 2009;60:3546-3553.
29.
LattanzioPJMarshallKWDamyanovichAZPeemoellerH. Macromolecule and water magnetization exchange modeling in articular cartilage. Magn Reson Med. 2000;44:840-851.
30.
LiessCLusseSKargerNHellerMGluerCC. Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthritis Cartilage. 2002;10:907-913.
31.
LiWGriswoldMYuX. Fast cardiac T1 mapping in mice using a model-based compressed sensing method. Magn Reson Med. 2012;68:1127-1134.
32.
LiXMaBCLinkTM. In vivo T1ρ and T2 mapping of articular cartilage in osteoarthritis of the knee using 3 T MRI. Osteoarthritis Cartilage. 2007;15:789-797.
33.
LiXPaiABlumenkrantzG. Spatial distribution and relationship of T1ρ and T2 relaxation times in knee cartilage with osteoarthritis. Magn Reson Med. 2009;61:1310-1318.
34.
LinPCIrrechukwuORoqueRHancockBFishbeinKWSpencerRG. Multivariate analysis of cartilage degradation using the support vector machine algorithm. Magn Reson Med. 2012;67:1815-1826.
35.
LinPCReiterDASpencerRG. Classification of degraded cartilage through multiparametric MRI analysis. J Magn Reson. 2009;201:61-71.
36.
LinPCReiterDASpencerRG. Sensitivity and specificity of univariate MRI analysis of experimentally degraded cartilage. Magn Reson Med. 2009;62:1311-1318.
37.
LiuFChaudharyRHurleySA. Rapid multicomponent T2 analysis of the articular cartilage of the human knee joint at 3.0T. J Magn Reson Imaging. 2014;39:1191-1197.
38.
LiuFChoiKWSamsonovA. Articular cartilage of the human knee joint: in vivo multicomponent T2 analysis at 3.0 T. Radiology. 2015;277:477-488.
39.
LukasVAFishbeinKWReiterDALinPCSchneiderESpencerRG. Sensitivity and specificity of univariate MRI analysis of experimentally degraded cartilage under clinical imaging conditions. J Magn Reson Imaging. 2015;42:136-144.
40.
MamischTCTrattnigSQuirbachSMarlovitsSWhiteLMWelschGH. Quantitative T2 mapping of knee cartilage: differentiation of healthy control cartilage and cartilage repair tissue in the knee with unloading—initial results. Radiology. 2010;254:818-826.
41.
MarkhardtBKChangEY. Hypointense signal lesions of the articular cartilage: a review of current concepts. Clin Imaging. 2014;38:785-791.
42.
MarkhardtBKKijowskiR. The clinical significance of dark cartilage lesions identified on MRI. AJR Am J Roentgenol. 2015;205:1251-1259.
43.
MatzatSJMcWalterEJKoganFChenWGoldGE. T2 relaxation time quantitation differs between pulse sequences in articular cartilage. J Magn Reson Imaging. 2015;42:105-113.
44.
MenezesNMGrayMLHartkeJRBursteinD. T2 and T1ρ MRI in articular cartilage systems. Magn Reson Med. 2004;51:503-509.
MosherTJDardzinskiBJ. Cartilage MRI T2 relaxation time mapping: overview and applications. Semin Musculoskelet Radiol. 2004;8:355-368.
47.
MosherTJSmithHDardzinskiBJSchmithorstVJSmithMB. MR imaging and T2 mapping of femoral cartilage: in vivo determination of the magic angle effect. AJR Am J Roentgenol. 2001;177:665-669.
48.
MosherTJZhangZReddyR. Knee articular cartilage damage in osteoarthritis: analysis of MR image biomarker reproducibility in ACRIN-PA 4001 multicenter trial. Radiology. 2011;258:832-842.
NewbouldRDMillerSRUpadhyayN. T1-weighted sodium MRI of the articulator cartilage in osteoarthritis: a cross sectional and longitudinal study. PLoS One. 2013;8:e73067.
51.
NieminenMTRieppoJSilvennoinenJ. Spatial assessment of articular cartilage proteoglycans with Gd-DTPA-enhanced T1 imaging. Magn Reson Med. 2002;48:640-648.
52.
PachowskyMLTrattnigSApprichSMauererAZbynSWelschGH. Impact of different coils on biochemical T2 and T2* relaxation time mapping of articular patella cartilage. Skeletal Radiol. 2013;42:1565-1572.
53.
PalazzoCNguyenCLefevre-ColauMMRannouFPoiraudeauS. Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med. 2016;59:134-138.
54.
PauliCBaeWCLeeM. Ultrashort-echo time MR imaging of the patella with bicomponent analysis: correlation with histopathologic and polarized light microscopic findings. Radiology. 2012;264:484-493.
55.
RegatteRRAkellaSVBorthakurAKneelandJBReddyR. Proteoglycan depletion-induced changes in transverse relaxation maps of cartilage: comparison of T2 and T1ρ. Acad Radiol. 2002;9:1388-1394.
56.
SchoolerJKumarDNardoL. Longitudinal evaluation of T1ρ and T2 spatial distribution in osteoarthritic and healthy medial knee cartilage. Osteoarthritis Cartilage. 2014;22:51-62.
57.
Sophia FoxAJBediARodeoSA. The basic science of articular cartilage: structure, composition, and function. Sports Health. 2009;1:461-468.
58.
SpencerRGPleshkoN. How do statistical differences in matrix-sensitive magnetic resonance outcomes translate into clinical assignment rules?J Am Acad Orthop Surg. 2013;21:438-439.
59.
TheologisAASchairerWWCarballido-GamioJMajumdarSLiXMaCB. Longitudinal analysis of T1ρ and T2 quantitative MRI of knee cartilage laminar organization following microfracture surgery. Knee. 2012;19:652-657.
60.
TideriusCJOlssonLELeanderPEkbergODahlbergL. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in early knee osteoarthritis. Magn Reson Med. 2003;49:488-492.
61.
TideriusCJOlssonLENyquistFDahlbergL. Cartilage glycosaminoglycan loss in the acute phase after an anterior cruciate ligament injury: delayed gadolinium-enhanced magnetic resonance imaging of cartilage and synovial fluid analysis. Arthritis Rheum. 2005;52:120-127.
62.
TideriusCJSvenssonJLeanderPOlaTDahlbergL. dGEMRIC (delayed gadolinium-enhanced MRI of cartilage) indicates adaptive capacity of human knee cartilage. Magn Reson Med. 2004;51:286-290.
63.
TrattnigSDomayerSWelschGWMosherTEcksteinF. MR imaging of cartilage and its repair in the knee—a review. Eur Radiol. 2009;19:1582-1594.
64.
TrattnigSBursteinDSzomolanyiPPinkerKWelschGHMamischTC. T1(Gd) gives comparable information as Delta T1 relaxation rate in dGEMRIC evaluation of cartilage repair tissue. Invest Radiol. 2009;44:598-602.
65.
TrattnigSMarlovitsSGebetsroitherS. Three-dimensional delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) for in vivo evaluation of reparative cartilage after matrix-associated autologous chondrocyte transplantation at 3.0T: preliminary results. J Magn Reson Imaging. 2007;26:974-982.
66.
van TielJKotekGReijmanM. Is T1ρ mapping an alternative to delayed gadolinium-enhanced MR imaging of cartilage in the assessment of sulphated glycosaminoglycan content in human osteoarthritic knees? An in vivo validation study. Radiology. 2016;279:523-531.
67.
van TielJReijmanMBosPK. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) shows no change in cartilage structural composition after viscosupplementation in patients with early-stage knee osteoarthritis. PLoS One. 2013;8:e79785.
68.
van ZijlPCYadavNN. Chemical exchange saturation transfer (CEST): what is in a name and what isn’t?Magn Reson Med. 2011;65:927-948.
69.
WatanabeAWadaYObataT. Delayed gadolinium-enhanced MR to determine glycosaminoglycan concentration in reparative cartilage after autologous chondrocyte implantation: preliminary results. Radiology. 2006;239:201-208.
70.
Watrin-PinzanoARuaudJPOlivierP. Effect of proteoglycan depletion on T2 mapping in rat patellar cartilage. Radiology. 2005;234:162-170.
71.
WelschGHJurasVSzomolanyiP. Magnetic resonance imaging of the knee at 3 and 7 tesla: a comparison using dedicated multi-channel coils and optimised 2D and 3D protocols. Eur Radiol. 2012;22:1852-1859.
72.
WilliamsAGillisAMcKenzieC. Glycosaminoglycan distribution in cartilage as determined by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC): potential clinical applications. AJR Am J Roentgenol. 2004;182:167-172.
73.
WilliamsASharmaLMcKenzieCAPrasadPVBursteinD. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis: findings at different radiographic stages of disease and relationship to malalignment. Arthritis Rheum. 2005;52:3528-3535.
XiaY. Magic-angle effect in magnetic resonance imaging of articular cartilage: a review. Invest Radiol. 2000;35:602-621.
76.
ZhongHMillerDJUrishKL. T2 map signal variation predicts symptomatic osteoarthritis progression: data from the Osteoarthritis Initiative. Skeletal Radiol. 2016;45:909-913.
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