Non-invasive T1ρ mapping of the human cartilage response to loading and unloading.

Abstract

To define the physiological response to sequential loading and unloading in histologically intact human articular cartilage using serial T1ρ mapping, as T1ρ is considered to indicate the tissue's macromolecular content. 18 macroscopically intact cartilage-bone samples were obtained from the central lateral femoral condyles of 18 patients undergoing total knee replacement. Serial T1ρ mapping was performed on a clinical 3.0-T MRI system using a modified prostate coil. Spin-lock multiple gradient-echo sequences prior to, during and after standardized indentation loading (displacement controlled, strain 20%) were used to obtain seven serial T1ρ maps: unloaded (δ0), quasi-statically loaded (indentation1-indentation3) and under subsequent relaxation (relaxation1-relaxation3). After manual segmentation, zonal and regional regions-of-interest were defined. ROI-specific relative changes were calculated and statistically assessed using paired t-tests. Histological (Mankin classification) and biomechanical (unconfined compression) evaluations served as references. All samples were histologically and biomechanically grossly intact (Mankin sum: 1.8±1.2; Young's Modulus: 0.7±0.4MPa). Upon loading, T1ρ consistently increased throughout the entire sample thickness, primarily subpistonally (indentation1 [M±SD]: 9.5±7.8% [sub-pistonal area, SPA] vs 4.2±5.8% [peri-pistonal area, PPA]; P<0.001). T1ρ further increased with ongoing loading (indentation3: 14.1±8.1 [SPA] vs 7.7±5.9% [PPA]; P<0.001). Even upon unloading (i.e., relaxation), T1ρ persistently increased in time. Serial T1ρ-mapping reveals distinct and complex zonal and regional changes in articular cartilage as a function of loading and unloading. Thereby, longitudinal adaptive processes in hyaline cartilage become evident, which may be used for the tissue's non-invasive functional characterization by T1ρ.