Skip to main content
Top
Published in: European Radiology 10/2019

Open Access 01-10-2019 | Osteoarthrosis | Musculoskeletal

T2 mapping of the meniscus is a biomarker for early osteoarthritis

Authors: Susanne M. Eijgenraam, Frans A. T. Bovendeert, Joost Verschueren, Jasper van Tiel, Yvonne M. Bastiaansen-Jenniskens, Marinus A. Wesdorp, Kazem Nasserinejad, Duncan E. Meuffels, Jamal Guenoun, Stefan Klein, Max Reijman, Edwin H. G. Oei

Published in: European Radiology | Issue 10/2019

Login to get access

Abstract

Purpose

To evaluate in vivo T2 mapping as quantitative, imaging-based biomarker for meniscal degeneration in humans, by studying the correlation between T2 relaxation time and degree of histological degeneration as reference standard.

Methods

In this prospective validation study, 13 menisci from seven patients with radiographic knee osteoarthritis (median age 67 years, three males) were included. Menisci were obtained during total knee replacement surgery. All patients underwent pre-operative magnetic resonance imaging using a 3-T MR scanner which included a T2 mapping pulse sequence with multiple echoes. Histological analysis of the collected menisci was performed using the Pauli score, involving surface integrity, cellularity, matrix organization, and staining intensity. Mean T2 relaxation times were calculated in meniscal regions of interest corresponding with the areas scored histologically, using a multi-slice multi-echo postprocessing algorithm. Correlation between T2 mapping and histology was assessed using a generalized least squares model fit by maximum likelihood.

Results

The mean T2 relaxation time was 22.4 ± 2.7 ms (range 18.5–27). The median histological score was 10, IQR 7–11 (range 4–13). A strong correlation between T2 relaxation time and histological score was found (rs = 0.84, CI 95% 0.64–0.93).

Conclusion

In vivo T2 mapping of the human meniscus correlates strongly with histological degeneration, suggesting that T2 mapping enables the detection and quantification of early compositional changes of the meniscus in knee OA.

Key Points

• Prospective histology-based study showed that in vivo T 2 mapping of the human meniscus correlates strongly with histological degeneration.
• Meniscal T 2 mapping allows detection and quantifying of compositional changes, without need for contrast or special MRI hardware.
• Meniscal T 2 mapping provides a biomarker for early OA, potentially allowing early treatment strategies and prevention of OA progression.
Appendix
Available only for authorised users
Literature
1.
go back to reference MacFarlane LA, Yang H, Collins JE et al (2017) Associations among meniscal damage, meniscal symptoms and knee pain severity. Osteoarthritis Cartilage 25:850–857 MacFarlane LA, Yang H, Collins JE et al (2017) Associations among meniscal damage, meniscal symptoms and knee pain severity. Osteoarthritis Cartilage 25:850–857
2.
go back to reference McDermott I (2011) Meniscal tears, repairs and replacement: their relevance to osteoarthritis of the knee. Br J Sports Med 45:292–297CrossRefPubMed McDermott I (2011) Meniscal tears, repairs and replacement: their relevance to osteoarthritis of the knee. Br J Sports Med 45:292–297CrossRefPubMed
4.
go back to reference Ding C, Martel-Pelletier J, Pelletier JP et al (2007) Meniscal tear as an osteoarthritis risk factor in a largely non-osteoarthritic cohort: a cross-sectional study. J Rheumatol 34:776–784PubMed Ding C, Martel-Pelletier J, Pelletier JP et al (2007) Meniscal tear as an osteoarthritis risk factor in a largely non-osteoarthritic cohort: a cross-sectional study. J Rheumatol 34:776–784PubMed
5.
go back to reference Antony B, Driban JB, Price LL et al (2017) The relationship between meniscal pathology and osteoarthritis depends on the type of meniscal damage visible on magnetic resonance images: data from the Osteoarthritis Initiative. Osteoarthr Cartil 25:76–84CrossRef Antony B, Driban JB, Price LL et al (2017) The relationship between meniscal pathology and osteoarthritis depends on the type of meniscal damage visible on magnetic resonance images: data from the Osteoarthritis Initiative. Osteoarthr Cartil 25:76–84CrossRef
6.
go back to reference Baum T, Joseph GB, Karampinos DC, Jungmann PM, Link TM, Bauer JS (2013) Cartilage and meniscal T2 relaxation time as non-invasive biomarker for knee osteoarthritis and cartilage repair procedures. Osteoarthr Cartil 21:1474–1484CrossRef Baum T, Joseph GB, Karampinos DC, Jungmann PM, Link TM, Bauer JS (2013) Cartilage and meniscal T2 relaxation time as non-invasive biomarker for knee osteoarthritis and cartilage repair procedures. Osteoarthr Cartil 21:1474–1484CrossRef
7.
go back to reference Nebelung S, Tingart M, Pufe T, Kuhl C, Jahr H, Truhn D (2016) Ex vivo quantitative multiparametric MRI mapping of human meniscus degeneration. Skeletal Radiol 45:1649–1660CrossRefPubMed Nebelung S, Tingart M, Pufe T, Kuhl C, Jahr H, Truhn D (2016) Ex vivo quantitative multiparametric MRI mapping of human meniscus degeneration. Skeletal Radiol 45:1649–1660CrossRefPubMed
8.
go back to reference Guermazi A, Roemer FW, Burstein D, Hayashi D (2011) Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther 13:247CrossRefPubMedPubMedCentral Guermazi A, Roemer FW, Burstein D, Hayashi D (2011) Why radiography should no longer be considered a surrogate outcome measure for longitudinal assessment of cartilage in knee osteoarthritis. Arthritis Res Ther 13:247CrossRefPubMedPubMedCentral
9.
go back to reference Welsch GH, Scheffler K, Mamisch TC et al (2009) Rapid estimation of cartilage T2 based on double echo at steady state (DESS) with 3 Tesla. Magn Reson Med 62:544–549CrossRefPubMed Welsch GH, Scheffler K, Mamisch TC et al (2009) Rapid estimation of cartilage T2 based on double echo at steady state (DESS) with 3 Tesla. Magn Reson Med 62:544–549CrossRefPubMed
10.
go back to reference Hofmann FC, Neumann J, Heilmeier U et al (2018) Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skeletal Radiol 47:93–106CrossRefPubMed Hofmann FC, Neumann J, Heilmeier U et al (2018) Conservatively treated knee injury is associated with knee cartilage matrix degeneration measured with MRI-based T2 relaxation times: data from the osteoarthritis initiative. Skeletal Radiol 47:93–106CrossRefPubMed
11.
go back to reference Arno S, Bell CP, Xia D et al (2016) Relationship between meniscal integrity and risk factors for cartilage degeneration. Knee 23:686–691CrossRefPubMed Arno S, Bell CP, Xia D et al (2016) Relationship between meniscal integrity and risk factors for cartilage degeneration. Knee 23:686–691CrossRefPubMed
12.
go back to reference Wang A, Pedoia V, Su F et al (2016) MR T1ρ and T2 of meniscus after acute anterior cruciate ligament injuries. Osteoarthr Cartil 24:631–639CrossRef Wang A, Pedoia V, Su F et al (2016) MR T1ρ and T2 of meniscus after acute anterior cruciate ligament injuries. Osteoarthr Cartil 24:631–639CrossRef
13.
go back to reference Rauscher I, Stahl R, Cheng J et al (2008) Meniscal measurements of T1rho and T2 at MR imaging in healthy subjects and patients with osteoarthritis. Radiology 249:591–600CrossRefPubMedPubMedCentral Rauscher I, Stahl R, Cheng J et al (2008) Meniscal measurements of T1rho and T2 at MR imaging in healthy subjects and patients with osteoarthritis. Radiology 249:591–600CrossRefPubMedPubMedCentral
14.
go back to reference Son M, Goodman SB, Chen W, Hargreaves BA, Gold GE, Levenston ME (2013) Regional variation in T1ρ and T2 times in osteoarthritic human menisci: correlation with mechanical properties and matrix composition. Osteoarthr Cartil 21:796–805CrossRef Son M, Goodman SB, Chen W, Hargreaves BA, Gold GE, Levenston ME (2013) Regional variation in T1ρ and T2 times in osteoarthritic human menisci: correlation with mechanical properties and matrix composition. Osteoarthr Cartil 21:796–805CrossRef
15.
go back to reference Pauli C, Grogan SP, Patil S et al (2011) Macroscopic and histopathologic analysis of human knee menisci in aging and osteoarthritis. Osteoarthr Cartil 19:1132–1141CrossRef Pauli C, Grogan SP, Patil S et al (2011) Macroscopic and histopathologic analysis of human knee menisci in aging and osteoarthritis. Osteoarthr Cartil 19:1132–1141CrossRef
16.
go back to reference Junqueira LC, Bignolas G, Brentani RR (1979) Picrosirius staining plus polarization microscopy, a specific method for collagen detection in tissue sections. Histochem J 11:447–455CrossRefPubMed Junqueira LC, Bignolas G, Brentani RR (1979) Picrosirius staining plus polarization microscopy, a specific method for collagen detection in tissue sections. Histochem J 11:447–455CrossRefPubMed
17.
go back to reference Bron EE, van Tiel J, Smit H et al (2013) Image registration improves human knee cartilage T1 mapping with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Eur Radiol 23:246–252CrossRefPubMed Bron EE, van Tiel J, Smit H et al (2013) Image registration improves human knee cartilage T1 mapping with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Eur Radiol 23:246–252CrossRefPubMed
18.
go back to reference Wang L, Chang G, Bencardino J et al (2014) T1rho MRI of menisci in patients with osteoarthritis at 3 Tesla: a preliminary study. J Magn Reson Imaging 40:588–595CrossRefPubMed Wang L, Chang G, Bencardino J et al (2014) T1rho MRI of menisci in patients with osteoarthritis at 3 Tesla: a preliminary study. J Magn Reson Imaging 40:588–595CrossRefPubMed
19.
go back to reference Zarins ZA, Bolbos RI, Pialat JB et al (2010) Cartilage and meniscus assessment using T1rho and T2 measurements in healthy subjects and patients with osteoarthritis. Osteoarthr Cartil 18:1408–1416CrossRef Zarins ZA, Bolbos RI, Pialat JB et al (2010) Cartilage and meniscus assessment using T1rho and T2 measurements in healthy subjects and patients with osteoarthritis. Osteoarthr Cartil 18:1408–1416CrossRef
20.
21.
go back to reference van Tiel J, Kotek G, Reijman M et al (2016) Is T1ρ mapping an alternative to delayed gadolinium-enhanced MR imaging of cartilage in the assessment of sulphated glycosaminoglycan content in human osteoarthritic knees? An in vivo validation study. Radiology 279:523–531CrossRefPubMed van Tiel J, Kotek G, Reijman M et al (2016) Is T1ρ mapping an alternative to delayed gadolinium-enhanced MR imaging of cartilage in the assessment of sulphated glycosaminoglycan content in human osteoarthritic knees? An in vivo validation study. Radiology 279:523–531CrossRefPubMed
22.
go back to reference Tsai PH, Chou MC, Lee HS et al (2009) MR T2 values of the knee menisci in the healthy young population: zonal and sex differences. Osteoarthr Cartil 17:988–994CrossRef Tsai PH, Chou MC, Lee HS et al (2009) MR T2 values of the knee menisci in the healthy young population: zonal and sex differences. Osteoarthr Cartil 17:988–994CrossRef
23.
go back to reference McWalter EJ, Gold GE (2012) UTE T2* mapping detects sub-clinical meniscus degeneration. Osteoarthr Cartil 20:471–472CrossRef McWalter EJ, Gold GE (2012) UTE T2* mapping detects sub-clinical meniscus degeneration. Osteoarthr Cartil 20:471–472CrossRef
24.
go back to reference Ghadially FN, Lalonde JM, Wedge JH (1983) Ultrastructure of normal and torn menisci of the human knee joint. J Anat 136:773–791PubMedPubMedCentral Ghadially FN, Lalonde JM, Wedge JH (1983) Ultrastructure of normal and torn menisci of the human knee joint. J Anat 136:773–791PubMedPubMedCentral
25.
go back to reference Mosher TJ, Dardzinski BJ (2004) Cartilage MRI T2 relaxation time mapping: overview and applications. Semin Musculoskelet Radiol 8:355–368CrossRefPubMed Mosher TJ, Dardzinski BJ (2004) Cartilage MRI T2 relaxation time mapping: overview and applications. Semin Musculoskelet Radiol 8:355–368CrossRefPubMed
26.
go back to reference Sneag DB, Shah P, Koff MF, Lim WY, Rodeo SA, Potter HG (2015) Quantitative ultrashort echo time magnetic resonance imaging evaluation of postoperative menisci: a pilot study. HSS J 11:123–129CrossRefPubMed Sneag DB, Shah P, Koff MF, Lim WY, Rodeo SA, Potter HG (2015) Quantitative ultrashort echo time magnetic resonance imaging evaluation of postoperative menisci: a pilot study. HSS J 11:123–129CrossRefPubMed
27.
go back to reference Williams A, Qian Y, Golla S, Chu CR (2012) UTE-T2* mapping detects sub-clinical meniscus injury after anterior cruciate ligament tear. Osteoarthr Cartil 20:486–494CrossRef Williams A, Qian Y, Golla S, Chu CR (2012) UTE-T2* mapping detects sub-clinical meniscus injury after anterior cruciate ligament tear. Osteoarthr Cartil 20:486–494CrossRef
28.
go back to reference Matzat SJ, McWalter EJ, Kogan F, Chen W, Gold GE (2015) T2 relaxation time quantitation differs between pulse sequences in articular cartilage. J Magn Reson Imaging 42:105–113CrossRefPubMed Matzat SJ, McWalter EJ, Kogan F, Chen W, Gold GE (2015) T2 relaxation time quantitation differs between pulse sequences in articular cartilage. J Magn Reson Imaging 42:105–113CrossRefPubMed
29.
go back to reference Peterfy CG, Schneider E, Nevitt M (2008) The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee. Osteoarthr Cartil 16:1433–1441CrossRef Peterfy CG, Schneider E, Nevitt M (2008) The osteoarthritis initiative: report on the design rationale for the magnetic resonance imaging protocol for the knee. Osteoarthr Cartil 16:1433–1441CrossRef
30.
go back to reference Oei EH, van Tiel J, Robinson WH, Gold GE (2014) Quantitative radiologic imaging techniques for articular cartilage composition: toward early diagnosis and development of disease-modifying therapeutics for osteoarthritis. Arthritis Care Res (Hoboken) 66:1129–1141CrossRef Oei EH, van Tiel J, Robinson WH, Gold GE (2014) Quantitative radiologic imaging techniques for articular cartilage composition: toward early diagnosis and development of disease-modifying therapeutics for osteoarthritis. Arthritis Care Res (Hoboken) 66:1129–1141CrossRef
31.
go back to reference Li X, Cheng J, Lin K et al (2011) Quantitative MRI using T1rho and T2 in human osteoarthritic cartilage specimens: correlation with biochemical measurements and histology. Magn Reson Imaging 29:324–334CrossRefPubMed Li X, Cheng J, Lin K et al (2011) Quantitative MRI using T1rho and T2 in human osteoarthritic cartilage specimens: correlation with biochemical measurements and histology. Magn Reson Imaging 29:324–334CrossRefPubMed
Metadata
Title
T2 mapping of the meniscus is a biomarker for early osteoarthritis
Authors
Susanne M. Eijgenraam
Frans A. T. Bovendeert
Joost Verschueren
Jasper van Tiel
Yvonne M. Bastiaansen-Jenniskens
Marinus A. Wesdorp
Kazem Nasserinejad
Duncan E. Meuffels
Jamal Guenoun
Stefan Klein
Max Reijman
Edwin H. G. Oei
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-019-06091-1

Other articles of this Issue 10/2019

European Radiology 10/2019 Go to the issue