Abstract
ObjectivesTo assess the discriminative power of a 5-min quantitative double-echo steady-state (qDESS) sequence for simultaneous T2 measurements of cartilage and meniscus, and structural knee osteoarthritis (OA) assessment, in a clinical OA population, using radiographic knee OA as reference standard.MethodsFifty-three subjects were included and divided over three groups based on radiographic and clinical knee OA: 20 subjects with no OA (Kellgren-Lawrence grade (KLG) 0), 18 with mild OA (KLG2), and 15 with moderate OA (KLG3). All patients underwent a 5-min qDESS scan. We measured T2 relaxation times in four cartilage and four meniscus regions of interest (ROIs) and performed structural OA evaluation with the MRI Osteoarthritis Knee Score (MOAKS) using qDESS with multiplanar reformatting. Between-group differences in T2 values and MOAKS were calculated using ANOVA. Correlations of the reference standard (i.e., radiographic knee OA) with T2 and MOAKS were assessed with correlation analyses for ordinal variables.ResultsIn cartilage, mean T2 values were 36.1 ± SD 4.3, 40.6 ± 5.9, and 47.1 ± 4.3 ms for no, mild, and moderate OA, respectively (p < 0.001). In menisci, mean T2 values were 15 ± 3.6, 17.5 ± 3.8, and 20.6 ± 4.7 ms for no, mild, and moderate OA, respectively (p < 0.001). Statistically significant correlations were found between radiographic OA and T2 and between radiographic OA and MOAKS in all ROIs (p < 0.05).ConclusionQuantitative T2 and structural assessment of cartilage and meniscus, using a single 5-min qDESS scan, can distinguish between different grades of radiographic OA, demonstrating the potential of qDESS as an efficient tool for OA imaging.Key Points• Quantitative T2values of cartilage and meniscus as well as structural assessment of the knee with a single 5-min quantitative double-echo steady-state (qDESS) scan can distinguish between different grades of knee osteoarthritis (OA).• Quantitative and structural qDESS-based measurements correlate significantly with the reference standard, radiographic degree of OA, for all cartilage and meniscus regions.• By providing quantitative measurements and diagnostic image quality in one rapid MRI scan, qDESS has great potential for application in large-scale clinical trials in knee OA.
Highlights
The growing population suffering from knee osteoarthritis (OA) and the lack of early biomarkers and therapeutics prompt the need for efficient imaging methods [1]
Quantitative T2 values of cartilage and meniscus as well as structural assessment of the knee with a single 5-min quantitative double-echo steady-state scan can distinguish between different grades of knee osteoarthritis (OA)
Out of the 196 potentially eligible patients, 53 subjects were included in this study: 20 subjects with no knee OA, 18 subjects with mild knee OA, and 15 subjects with moderate knee OA
Summary
The growing population suffering from knee osteoarthritis (OA) and the lack of early biomarkers and therapeutics prompt the need for efficient imaging methods [1]. QMRI techniques, such as T2 mapping, have the ability to non-invasively detect subtle changes in biochemical composition of tissues such as cartilage and menisci. Increased T2 relaxation times have been shown to be associated with cartilage and meniscus degeneration, potentially enabling early-stage detection of knee OA and similar conditions [5,6,7,8]. T2 mapping does not require a contrast injection or special MRI imaging hardware and numerous techniques for post-processing of T2 images are available [5, 7, 9, 10]
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