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Systematic protocol for assessment of the validity of BOLD MRI in a rabbit model of inflammatory arthritis at 1.5 tesla

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Abstract

Background

Blood-oxygen-level-dependent (BOLD) MRI has the potential to identify regions of early hypoxic and vascular joint changes in inflammatory arthritis. There is no standard protocol for analysis of BOLD MRI measurements in musculoskeletal disorders.

Objective

To optimize the following BOLD MRI reading parameters: (1) statistical threshold values (low, r > 0.01 versus high, r > 0.2); (2) summary measures of BOLD contrast (percentage of activated voxels [PT%] versus percentage signal difference between on-and-off signal intensities [diff_on_off]); and (3) direction of BOLD response (positive, negative and positive + negative).

Materials and methods

Using BOLD MRI protocols at 1.5 T, arthritic (n = 21) and contralateral (n = 21) knees of 21 juvenile rabbits were imaged at baseline and on days 1, 14 and 28 after a unilateral intra-articular injection of carrageenan. Nine non-injected rabbits served as external control knees (n = 18). By comparing arthritic to contralateral knees, receiver operating characteristic curves were used to determine diagnostic accuracy.

Results

Using diff_on_off and positive + negative responses, a threshold of r > 0.01 was more accurate than r > 0.2 (P = 0.03 at day 28). Comparison of summary measures yielded no statistically significant difference (P > 0.05). Although positive + negative (AUC = 0.86 at day 28) and negative responses (AUC = 0.90 at day 28) for PT% were the most diagnostically accurate, positive + negative responses for diff_on_off (AUC = 0.78 at day 28) also had acceptable accuracy.

Conclusions

The most clinically relevant reading parameters included a lower threshold of r > 0.01 and a positive + negative BOLD response. We propose that diff_on_off is a more clinically relevant summary measure of BOLD MRI, while PT% can be used as an ancillary measure.

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Acknowledgments

This study was supported by a Seed Grant provided by the Radiological Society of North America Foundation to Dr. Andrea S. Doria. Dr. Michael W. Chan received the 2011 Comprehensive Research Experience for Medical Students (CREMS), Faculty of Medicine, University of Toronto Summer Studentship Award for the conduct of the data analysis of this study.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Canada, M5G 1X8

    Michael W. Chan, George Nathanael, Antonella Kis, Afsaneh Amirabadi, Anguo Zhong, Tammy Rayner, Ruth Weiss, Garry Detzler, Harpal Gahunia & Andrea S. Doria

  2. Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada

    Roland Jong

  3. Department of Public Health, Family and Community Medicine, Toronto, Canada

    Rahim Moineddin

  4. Department of Medical Imaging, University of Toronto, Toronto, Canada

    Adrian Crawley & Andrea S. Doria

  5. Department of Medical Imaging, Toronto Western Hospital, Toronto, Canada

    Adrian Crawley

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  1. Michael W. Chan
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Correspondence to Andrea S. Doria.

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Chan, M.W., Nathanael, G., Kis, A. et al. Systematic protocol for assessment of the validity of BOLD MRI in a rabbit model of inflammatory arthritis at 1.5 tesla. Pediatr Radiol 44, 566–575 (2014). https://doi.org/10.1007/s00247-013-2844-5

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  • DOI: https://doi.org/10.1007/s00247-013-2844-5

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