Kompendium 2020 Forschung & Klinik

TOP-Studien
22
Quantitative Biochemical MRI
of Hyaline Cartilage
„Our study demonstrated that T2
mapping enables the quantification
of patellar cartilage defect progression
in untreated defects over time,
[indicating its potential as a]
predictive marker of patellar
cartilage degeneration.“
Sebastian Apprich
The department of Orthopedic and Trauma Surgery at the Medical
University of Vienna has conducted a successful interdisciplinary
collaboration with the onsite High Field MR Centre of Excellence
of Prof. Trattnig for years. A major goal is the implementation and
improvement of new imaging techniques to explore the natural
course of cartilage defects and its potential repair techniques.
As a result of this collaboration the article „Potential predictive value of
axial T2 mapping at 3 Tesla MRI in patients with untreated patellar cartilage
defects over a mean follow-up of four years“ was published in the Journal of
Osteoarthritis and Cartilage in 2020. Magnetic resonance imaging (MRI), with
its high spatial resolution and its capability for superior soft tissue contrast,
represents the gold standard for diagnosis of incipient osteoarthritis, the
follow up of its natural course, and the treatment options.
High resolution MRI and newly developed semi-quantitative scoring systems
allow for the morphological assessment of the whole joint in patients
with Osteoarthritis (OA) (e.g. MOAKS (MRI Osteoarthritis Knee Score) and
in patients after surgical cartilage repair (Whole joint MRI assessment of
surgical cartilage repair of the knee: cartilage repair osteoarthritis knee
score (CROAKS)). Additionally, new imaging techniques (T2/T2* Mapping,
dGEMRIC, Sodium Imaging, gagCEST Imaging, …) have evolved over the
recent year, which enable a deeper sight into the compositional structure
of hyaline cartilage itself.
Study:
Apprich SR, Schreiner MM,
Szomolanyi P, Welsch GH, Koller
UK, Weber M, Windhager R,
Trattnig S. Potential predictive
value of axial T2 mapping at
3 Tesla MRI in patients with
untreated patellar cartilage
defects over a mean follow-up
of four years. Osteoarthritis
Cartilage. Osteoarthritis Cartilage.
2020 Feb;28(2):215–222
Advantages of T2 Mapping
T2 mapping has proven the capability to gain information about water
content and structure of the collagen fiber network of hyaline cartilage
by assessment of quantitative T2 relaxation times. For several reasons, T2
mapping provides some major advantages over other techniques. On one
hand it is relatively independent from the available field strength of the MRI
scanners and can be performed using a 1.5 Tesla scanner and upwards, on
the other hand it does not require the administrations of a contrast agent
and is feasible within a reasonable scan time.
Within the aforementioned publication, we demonstrated the potential of
axial T2 mapping for quantification of untreated early-stage patellar cartilage
lesions over time and assessed its capability as a potential predictive
marker for future progression. Our study cohort consisted of thirty patients
(mean age, 36.7 ± 11.1 years; 16 males), with early-stage patellar cartilage