Reproducibility of 3D delayed gadolinium enhanced MRI of cartilage (dGEMRIC) of the knee at 3.0 T in patients with early stage osteoarthritis
To assess the reproducibility of 3D delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 3 T in early stage knee osteoarthritis (OA) patients.
In 20 patients, 3D dGEMRIC at 3 T was acquired twice within 7 days. To correct for patient motion during acquisition, all images were rigidly registered in 3D. Eight anatomical cartilage ROIs were analysed on both images of each patient. Capability of dGEMRIC to yield T1 maps that reproducibly distinguish spatial differences in cartilage quality was assessed in two ROIs within a single slice in each patient. Reproducibility was assessed using ICCs and Bland-Altman plots.
ICCs ranged from 0.87 to 0.95, indicating good reproducibility. T1 maps revealed reproducible spatial differences in cartilage quality (ICC 0.79). Based on the Bland-Altman plots, we defined a threshold of 95 ms to determine if a change in dGEMRIC outcome in longitudinal research was statistically significant.
3D knee dGEMRIC at 3 T combined with 3D image registration is a highly reproducible measure of cartilage quality in early stage OA. Therefore, dGEMRIC may be a valuable tool in the non-invasive evaluation of cartilage quality changes in longitudinal research in patients with early stage OA and focal cartilage defects.
• Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) can assess osteoarthritis
• dGEMRIC yields highly reproducible T1 values in early stage osteoarthritic patients
• A threshold was established to determine significant changes in dGEMRIC outcomes
• dGEMRIC can be used to evaluate cartilage quality in longitudinal research
KeywordsQuantitative MR imaging Articular cartilage Knee osteoarthritis Reproducibility of results dGEMRIC
Abbreviations and acronyms
Anterior cruciate ligament tear
Delayed gadolinium-enhanced magnetic resonance imaging of cartilage
Intraclass correlation coefficient
Posterior non-weight-bearing cartilage of the femoral condyle
Regions of interest
Anterior weight-bearing cartilage of the femoral condyle
Posterior weight-bearing cartilage of the femoral condyle
Weight-bearing cartilage of the tibial plateau
Prof. G.P. Krestin is a consultant to GE and has a collaboration contract with them
- 9.Tiderius CJ, Olsson LE, Nyquist F, Dahlberg L (2005) Cartilage glycosaminoglycan loss in the acute phase after an anterior cruciate ligament injury: delayed gadolinium-enhanced magnetic resonance imaging of cartilage and synovial fluid analysis. Arthritis Rheum 52:120–127PubMedCrossRefGoogle Scholar
- 10.Trattnig S, Marlovits S, Gebetsroither S et al (2007) Three-dimensional delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) for in vivo evaluation of reparative cartilage after matrix-associated autologous chondrocyte transplantation at 3.0 T: Preliminary results. J Magn Reson Imaging 26:974–982PubMedCrossRefGoogle Scholar
- 11.Vasiliadis HS, Danielson B, Ljungberg M, McKeon B, Lindahl A, Peterson L (2010) Autologous chondrocyte implantation in cartilage lesions of the knee: long-term evaluation with magnetic resonance imaging and delayed gadolinium-enhanced magnetic resonance imaging technique. Am J Sports Med 38:943–949PubMedCrossRefGoogle Scholar
- 16.Siversson C, Tiderius CJ, Neuman P, Dahlberg L, Svensson J (2010) Repeatability of T1-quantification in dGEMRIC for three different acquisition techniques: two-dimensional inversion recovery, three-dimensional look locker, and three-dimensional variable flip angle. J Magn Reson Imaging 31:1203–1209PubMedCrossRefGoogle Scholar
- 26.Studler U, White LM, Andreisek G, Luu S, Cheng HL, Sussman MS (2010) Impact of motion on T1 mapping acquired with inversion recovery fast spin echo and rapid spoiled gradient recalled-echo pulse sequences for delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in volunteers. J Magn Reson Imaging 32:394–398PubMedCrossRefGoogle Scholar
- 27.Bron EE, van Tiel J, Smit H et al (2012) Image registration improves human knee cartilage T1 mapping with delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC). Eur Radiol. doi: 10.1007/s00330-012-2590-3
- 31.Rao CR (1946) Minimum variance and the estimation of several parameters. Cambridge Univ Press 43:280–283Google Scholar