Target audience

The target audience are residents in radiology with a particular interest in musculoskeletal radiology and researchers with little experience but interest in cartilage imaging (experimental and clinical research studies using MR imaging).

Overview

This talk on “Clinical Articular Cartilage Imaging with Emerging MR Methods” will focus on clinical, morphological imaging techniques, particularly cartilage MR imaging with different pulse sequences. Differences, challenges and difficulties will be discussed for different joints. It will be discussed for which joints standard MR imaging is sufficient in most cases, but for which joints other techniques mainly MR arthrography and CT arthrography are of advantage. Cases will be discussed in which standard native MR imaging is not sufficient in order to decide on treatment strategies. Different pulse sequences include standard 2D sequences with different weightings as well as new 3D techniques – including those called “cartilage” sequences. Advantages and disadvantages will be discussed. In order to interpret the MR images appropriately, sensitivities and specificities need to be kept in mind when reading those MRIs. Therefore, it will be pointed out, whether interpretation should be careful and whether additional imaging is needed. Statements will be underlined with clinical examples. In addition, quantitative MR imaging techniques for assessment of cartilage matrix degeneration will be discussed. Beyond others, these include for example dGEMRIC, T1rho relaxation time measurements, T2 and T2* relaxation time measurements. The focus will be on T2 relaxation time measurements. Potential clinical applications of these techniques and their use in clinical research studies and their limitations will be addressed. This allows the audience to implement these techniques thoughtfully in their own daily practice. Not only cartilage evaluation in the context of cartilage defects and osteoarthritis, but also postoperative cartilage evaluation after cartilage repair surgery or after osteochondral repair will be explained. Again, appropriate evaluation of morphological sequences as well as interpretation of quantitative cartilage MR images will be debated. By attending this lecture, the audience should be able to take home ideas on how to reasonably improve pre- and postoperative cartilage imaging in clinical practice at their own institutions.

Learning objectives

The audience should be able to apply appropriate imaging techniques for morphological cartilage imaging of different human joints in clinical practice. They should be able to use appropriate MR pulse sequences. In that context, the radiologists should be able to explain the advantages and disadvantages of different MR pulse sequences with respect to cartilage imaging. In order to do so, the audience should be able to remember sensitivities and specificities of the different techniques. In addition, knowing different advanced quantitative cartilage MR imaging techniques for assessment of cartilage matrix degeneration and their histologic correlation in osteoarthritis may allow the audience to reasonably implement those new quantitative techniques in experimental and clinical research studies as well as to interpret the results of these quantitative values thoughtfully. Last, the audience should be able to interpret postoperative findings after cartilage repair surgery – be it osteochondral transplantation (OATS), bone marrow stimulation techniques such as microfracturing or matrix-associated autologous chondrocyte implantation (MACI) by using emerging morphological and quantitative cartilage MR imaging methods.

Acknowledgements

No acknowledgement found.