We demonstrate the clinical feasibility of high-resolution (HR) in-vivo mapping of proteoglycan water fraction (PgWF) in human knee cartilage by combining the mcDESPOT protocol for data acquisition and Bayesian Monte Carlo (BMC) analysis for data analysis. For all subjects, PgWF maps derived from low resolution datasets exhibited partial volume and magnetic susceptibility effects leading, respectively, to an overestimation and an underestimation of PgWF values in several cartilage regions. These issues were absent in HR PgWF maps. Further, BMC-mcDESPOT demonstrates high reproducibility and stability in the estimation of PgWF as compared to the conventional stochastic region contraction (SRC) algorithm.
Fig.1 shows examples of HR PgWF maps from the knee cartilage of the two young healthy subjects derived using BMC- (Fig.1a) or SRC- (Fig.1b) mcDESPOT. Visual inspection of the BMC results shows that the details of the voxel-by-voxel variation in PgWF is consistent between the two datasets, indicating the relative lack of sensitivity of BMC to experimental noise (Fig.1a). In addition, the mean and SD of the estimates of PgWF were essentially identical between the two datasets (Table1). In contrast, detailed comparison of the two successive images analyzed using SRC shows PgWF estimates clustered preferentially towards the upper search space limit, and substantial variation between these two independent acquisitions. Consistent with this, the mean and SD values of the estimates of PgWF (Table1) were both substantially higher than those calculated using BMC.
Fig. 2 shows examples of LR and HR BMC-mcDESPOT PgWF maps. As noted above, the HR images were acquired with a voxel volume that is ~5 times lower than in LR images. For each participant, LR and HR PgWF maps (Fig.2) and mean and SD values (Table2) were similar over all cartilage regions. Moreover, the older subject, with chronic knee pain exhibited lowed PgWF values compared to the young subjects (Fig.2 and Table2), consistent with the known effects of aging and injury on cartilage. The red arrows show regions with low PgWF values derived from the LR images. Corresponding zoomed regions from the LR SPGR images show that signal intensity in these regions was very low, indicating the presence of magnetic susceptibility effects. Indeed, this artifact was not visible in either the HR SPGR images, due to the relatively low magnetic field variation within a voxel, or LR and HR bSSFP images, in which T2* refocusing occurs at the time of signal acquisition. The yellow arrows indicate regions with PgWF very different between the LR and HR maps. Such differences are particularly prominent at the interfaces between bone and cartilage and are attributable to partial volume effects.
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