Osteoarthritis: Future
Stefan Zbyn1

1University of Minnesotta, Minneapolis, MN, United States

Synopsis

Compositional MRI techniques have gained increasing attention in Osteoarthritis (OA) research over the recent years, as they allow detection of early biochemical alteration in musculoskeletal tissues prior to appearance of the morphological changes. This presentation will provide an overview of basic technical principles, biochemical correlates, recent technical developments and in vivo applications of compositional MRI techniques for early detection, monitoring and prediction of OA progression in the knee joint.

Osteoarthritis (OA) is a complex disease process with multiple phenotypes affecting several different joint tissues. MRI can assess OA-related changes in soft and osseous tissues and therefore plays an important role in our understanding of OA pathogenesis, determining predisposing factors, and following its clinical progression. Among MR-based metrics, compositional MRI techniques have gained increasing attention over the recent years, as they allow evaluation of early biochemical changes in musculoskeletal tissues prior to detectable morphological changes using conventional clinical MRI sequences.

This presentation will focus on compositional MRI techniques, used to evaluate degenerative changes in cartilage and menisci [1], such as T2 and T1ρ relaxation time mapping [2-5], delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) [6, 7], glycosaminoglycan (GAG) specific chemical exchange saturation transfer (gagCEST) [8], diffusion tensor imaging (DTI) [9], and sodium imaging [10]. The review of basic technical principles, biochemical correlates, recent technical developments, advantages and challenges of compositional techniques will be followed by the findings from recent cross-sectional and longitudinal in vivo studies employing compositional MRI for the evaluation of OA patients.

Compositional MRI techniques play an increasingly important role in OA research, demonstrating their potential to complement morphological MRI and thus improve early detection, monitoring and prediction of disease progression. Further studies are needed to standardize data acquisition and postprocessing, and to evaluate the applicability and responsiveness of these techniques in large-scale studies before establishing the compositional MRI biomarkers as endpoints in OA clinical trials.

Acknowledgements

Grant support from the NIH (R01 AR070020, P41 EB015894, and S10 RR029672).

References

1. Chaudhari, A.S., et al., Five-minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double-echo in steady-state at 3T. J Magn Reson Imaging, 2018. 47(5): p. 1328-1341.

2. Kretzschmar, M., et al., Spatial distribution and temporal progression of T2 relaxation time values in knee cartilage prior to the onset of cartilage lesions - data from the Osteoarthritis Initiative (OAI). Osteoarthritis Cartilage, 2019.

3. Knox, J., et al., Longitudinal changes in MR T1rho/T2 signal of meniscus and its association with cartilage T1p/T2 in ACL-injured patients. Osteoarthritis Cartilage, 2018. 26(5): p. 689-696.

4. Pedoia, V., et al., MRI and biomechanics multidimensional data analysis reveals R2 -R1rho as an early predictor of cartilage lesion progression in knee osteoarthritis. J Magn Reson Imaging, 2018. 47(1): p. 78-90.

5. Juras, V., et al., The comparison of the performance of 3T and 7T T2 mapping for untreated low-grade cartilage lesions. Magn Reson Imaging, 2019. 55: p. 86-92.

6. Hirvasniemi, J., et al., Association between radiography-based subchondral bone structure and MRI-based cartilage composition in postmenopausal women with mild osteoarthritis. Osteoarthritis Cartilage, 2017. 25(12): p. 2039-2046.

7. Peterson, P., et al., Knee dGEMRIC at 7 T: comparison against 1.5 T and evaluation of T1-mapping methods. BMC Musculoskelet Disord, 2018. 19(1): p. 149.

8. Brinkhof, S., et al., Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T. Eur Radiol, 2018. 28(7): p. 2874-2881.

9. Duarte, A., et al., Diffusion tensor imaging of articular cartilage using a navigated radial imaging spin-echo diffusion (RAISED) sequence. Eur Radiol, 2018.

10. Madelin, G., et al., Longitudinal study of sodium MRI of articular cartilage in patients with knee osteoarthritis: initial experience with 16-month follow-up. Eur Radiol, 2018. 28(1): p. 133-142.

Proc. Intl. Soc. Mag. Reson. Med. 27 (2019)