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Quantitative OCT and MRI biomarkers for the differentiation of cartilage degeneration

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Abstract

Objective

To evaluate the usefulness of quantitative parameters obtained by optical coherence tomography (OCT) and magnetic resonance imaging (MRI) in the comprehensive assessment of human articular cartilage degeneration.

Materials and methods

Human osteochondral samples of variable degeneration (n = 45) were obtained from total knee replacements and assessed by MRI sequences measuring T1, T1ρ, T2 and T2* relaxivity and by OCT-based quantification of irregularity (OII, optical irregularity index), homogeneity (OHI, optical homogeneity index]) and attenuation (OAI, optical attenuation index]). Samples were also assessed macroscopically (Outerbridge classification) and histologically (Mankin classification) as grade-0 (Mankin scores 0–4)/grade-I (scores 5–8)/grade-II (scores 9–10)/grade-III (score 11–14). After data normalisation, differences between Mankin grades and correlations between imaging parameters were assessed using ANOVA and Tukey’s post-hoc test and Spearman’s correlation coefficients, respectively. Sensitivities and specificities in the detection of Mankin grade-0 were calculated.

Results

Significant degeneration-related increases were found for T2 and OII and decreases for OAI, while T1, T1ρ, T2* or OHI did not reveal significant changes in relation to degeneration. A number of significant correlations between imaging parameters and histological (sub)scores were found, in particular for T2 and OII. Sensitivities and specificities in the detection of Mankin grade-0 were highest for OHI/T1 and OII/T1ρ, respectively.

Conclusion

Quantitative OCT and MRI techniques seem to complement each other in the comprehensive assessment of cartilage degeneration. Sufficiently large structural and compositional changes in the extracellular matrix may thus be parameterized and quantified, while the detection of early degeneration remains challenging.

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Acknowledgements

This research project was supported by the START Program of the Faculty of Medicine, RWTH Aachen, Germany, granted to SN (AZ 09/14). HJ is a member of D-Board; this project has received funding from the European Union’s Seventh Framework Programme for research, technological development and demonstration under grant No. 305815. The authors would also like to thank Ms. Sophie Lecouturier for performing the histological workup as well as Simon Oehrl and Björn Sondern for helping with the MRI measurements.

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Authors and Affiliations

  1. Department of Orthopaedics, Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany

    Sven Nebelung, Markus Tingart & Holger Jahr

  2. Institute of Anatomy and Cell Biology, RWTH, Aachen, Germany

    Sven Nebelung & Thomas Pufe

  3. Fraunhofer Institute for Production Technology, Aachen, Germany

    Nicolai Brill

  4. Department of Diagnostic and Interventional Radiology, Aachen University Hospital, Aachen, Germany

    Christiane Kuhl & Daniel Truhn

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  1. Sven Nebelung
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Correspondence to Sven Nebelung.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this study, local Institutional Review Board approval (Ethical Committee – RWTH Aachen, Germany, AZ-EK 157/13) was obtained. Likewise, informed consent was obtained from all individual participants included in the study.

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Nebelung, S., Brill, N., Tingart, M. et al. Quantitative OCT and MRI biomarkers for the differentiation of cartilage degeneration. Skeletal Radiol 45, 505–516 (2016). https://doi.org/10.1007/s00256-016-2334-6

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  • DOI: https://doi.org/10.1007/s00256-016-2334-6

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