Angéline Nemeth1, Lucy Di Marco2, Denis Grenier1, Michaël Sdika1, Olivier Beuf1, and Jean-Baptiste Pialat3
1CREATIS, Université de Lyon ; CNRS UMR5220 ; Inserm U1044 ; INSA-Lyon ; Université Claude Bernard Lyon 1, Lyon, France, 2Radiologie et Imagerie médicale diagnostique et thérapeutique, Hôpital François Mitterrand, Dijon, France, 3Radiologie Pavillon B, Hôpital Edouard Herriot, Hospices Civils de Lyon, INSERM U1033 and Université Lyon 1, Lyon, France
Synopsis
To detect early changes in cartilage, quantification methods were developed
with Magnetic Resonance Imaging.
T1rho sequence is a valuable tool to quantitatively access the proteoglycans
content, complementary to T2 mapping
technique that is correlated with the collagen content. The thin
cartilage thickness and deep location of the hip joint require a strong
compromise between SNR, pixel size and acquisition time. The aim of this study is to test the
repeatability and reproducibility of in vivo (magnetic resonance) T1rho and T2 relaxation times measures in the hip joint cartilage of thirty healthy asymptomatic volunteers. Introduction
Qualitative
degradation of the collagen matrix and the proteoglycans content of the
cartilage is precursory of morphologic cartilage loss. To detect early changes,
quantification methods were developed. T1rho sequence is a valuable tool to
quantitatively access the proteoglycans content, complementary to T2 maps
measures that are correlated with the collagen content
1,2. Studies
on specimens and in vivo assessment of several articulations including the knee
were reported
3, but very few studies focus on hip cartilage. Yet,
the hip is the second most common large joint affected by osteoarthritis
leading to joint arthroplasty. Hip imaging is challenging because of technical
limitations caused by the deepness and thinness of the hip cartilage. However,
interesting data was found on the knee cartilage, and improvement of the
performance of 3T-MR magnets encourages further research on the field of
quantitative assessment of hip cartilage.
Purpose
To test the
repeatability and reproducibility of in vivo magnetic resonance T1rho and T2 relaxation
time measurements in the hip joint cartilage.
Subjects
and Methods
The right hip joint of nineteen healthy asymptotic volunteers (nine
women and ten men) was explored. Exams were performed at 3T (GE MR750 3T
Discovery) using a 32 channels abdominal coil. Subjects were aged 31.1 ± 7.4 years with a BMI of 22.25
± 2.4 kg/m². Subjects were placed in supine position with feet
positioned in adduction. Subjects first underwent a 3D water excitation spoiled
gradient-echo (SPGR) acquisition, then a 3D T1rho weighted sequence and a 3D multiple
TE for T2 mapping (Table 1, Figure 1). T1rho and multiple TE sequences were repeated 30
min after the beginning of the exam and the entire exam was repeated for all
subjects 14 ± 7 days later.
The cartilage was automatically segmented into
8 regions (Figure 2.B), and 3 regions were preferentially studied (R3:
posterior region, R4: superior region, R5: antero-superior). The automatic
segmentation was implemented on GNU Octave (version 3.6.2). A circular Hough transform
was used to find a sphere encompassing the femoral head. The cartilage was then
segmented by thresholding voxels within this sphere. The cartilage subregions
were delimited by dividing the cartilage into 8 uniform angular sectors (see
Figure 2). Femoral and acetabular cartilages were segmented as a single unit on
SPGR images and full cartilage thickness was estimated. For T1rho-maps (as for T2-maps),
a mono-exponential fit was performed [$$$S(TSL)=S_{0}*exp(-TSL/T1_{rho})$$$]. A
determination coefficient R² was calculated to evaluate the fit quality. Only
pixels with R² > 0.8 were kept. A mask resulting from segmentation on SPGR
was transformed in T1rho- or T2-space using fsl-flirt
4 and merged
with respective maps (Figure 3). Repeatability of T1rho- and T2-values was
assessed comparing the two acquisitions performed with 30min delay and reproducibility
comparing two acquisitions with 14 ± 7 days delay. A paired t-test was
performed on mean value and the coefficient of variation CV was calculated for
region R3, R4, R5 using [$$$CV=(\frac{\sqrt{\sum_j^m SD^{2}_{j}/m}}{\sum_j^m
\overline{x_{j}}/m}*100)$$$] with m the number of subjects, $$$
\overline{x}_{j}$$$ and $$$SD_j$$$ the mean and standard deviation of repeated
measurements
5.
Results
Subjects
had a mean cartilage thickness of 2.90 ± 0.51 mm, for the region
R3, 3.13 ± 0.75 mm for R4 and 3.64 ± 0.73 mm for R5. Due to subject motion during the one hour
acquisition time, only data from 14 subjects were exploitable. Results of T1rho
and T2 are summarized in Table 2. Mean SNR of T1rho weighted images was 15 ± 4.3 for the shorter TSL. Only 40 ± 15% pixels respected the criterion R²>0.80 in segmented
cartilage (mean region size equal to 1 cm3) and contribute to the
calculation of T1rho values.
Discussion
The thin
cartilage thickness and deep location of the hip joint require a strong
compromise between SNR, pixel size and acquisition time. Mean T1-rho values in
this study were higher than in the literature
5, 6 but coherent.This could
be due to mono-exponential fit that could provide overestimated values at low
SNR
7. According to the paired t-test, values measured repeatedly
within the same exam or at 14 days interval were not significantly different (except
for R3). Carballido-Gamio and al. 6
have established on 5 subjects the reproducibility of T1rho measurement with CV
of 2.03%. In this work, CV ranged between 5.63% and 9.75% for T1rho measurements
(5.09% and 10.44% for T2). Re-positioning the patient had no effect on T1rho
and T2 values. Eleven more subjects will be included in this study for final
results.
Acknowledgements
This work was performed within the framework of
the LABEX PRIMES (ANR-11-LABX-0063) of Université de Lyon, within the program
"Investissements d'Avenir" (ANR-11-IDEX-0007) operated by the French
National Research Agency (ANR).References
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