Assessment of the patellofemoral cartilage: Correlation of knee pain score with magnetic resonance cartilage grading and magnetization transfer ratio asymmetry of glycosaminoglycan chemical exchange saturation transfer

Young Han Lee, Jaemoon Yang, Ha Kyu Jeong, Jin Suck Suh

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTRasym) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. Materials and methods This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTRasym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3 years; age range; 25–79 years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTRasym at 1.0 ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. Results The results of the phantom study revealed excellent correlation between the MTRasym values and the concentration of GAGs (r = 0.961; p = 0.003). The cartilage grades on the MR images showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.460; p = 0.031 and r = −0.543; p = 0.009, respectively). The VAS pain scores showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.435; p = 0.043 and r = −0.671; p = 0.001, respectively). Conclusion The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTRasym values of the gagCEST images, exhibited greater correlation with the pain scores than the morphological changes visualized on conventional MR images; these results provide evidence supporting the theory regarding the association of patellofemoral osteoarthritis with knee pain scores.

Original languageEnglish
Pages (from-to)61-68
Number of pages8
JournalMagnetic Resonance Imaging
Volume35
DOIs
Publication statusPublished - 2017 Jan 1

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Cartilage
Magnetic resonance
Glycosaminoglycans
Magnetization
Knee
Magnetic Resonance Spectroscopy
Thigh
Pain
Imaging techniques
Pain Measurement
Knee Osteoarthritis
Electronic Health Records
Research Ethics Committees
Electronic medical equipment
Hyaluronic acid
Articular Cartilage
Hyaluronic Acid
Knee Joint
Visual Analog Scale
Osteoarthritis

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Biomedical Engineering
  • Radiology Nuclear Medicine and imaging

Cite this

@article{9848c7a176784f91afad2bac4dc8b131,
title = "Assessment of the patellofemoral cartilage: Correlation of knee pain score with magnetic resonance cartilage grading and magnetization transfer ratio asymmetry of glycosaminoglycan chemical exchange saturation transfer",
abstract = "Purpose Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTRasym) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. Materials and methods This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTRasym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3 years; age range; 25–79 years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTRasym at 1.0 ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. Results The results of the phantom study revealed excellent correlation between the MTRasym values and the concentration of GAGs (r = 0.961; p = 0.003). The cartilage grades on the MR images showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.460; p = 0.031 and r = −0.543; p = 0.009, respectively). The VAS pain scores showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.435; p = 0.043 and r = −0.671; p = 0.001, respectively). Conclusion The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTRasym values of the gagCEST images, exhibited greater correlation with the pain scores than the morphological changes visualized on conventional MR images; these results provide evidence supporting the theory regarding the association of patellofemoral osteoarthritis with knee pain scores.",
author = "Lee, {Young Han} and Jaemoon Yang and Jeong, {Ha Kyu} and Suh, {Jin Suck}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.mri.2016.08.014",
language = "English",
volume = "35",
pages = "61--68",
journal = "Magnetic Resonance Imaging",
issn = "0730-725X",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Assessment of the patellofemoral cartilage

T2 - Correlation of knee pain score with magnetic resonance cartilage grading and magnetization transfer ratio asymmetry of glycosaminoglycan chemical exchange saturation transfer

AU - Lee, Young Han

AU - Yang, Jaemoon

AU - Jeong, Ha Kyu

AU - Suh, Jin Suck

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Purpose Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTRasym) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. Materials and methods This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTRasym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3 years; age range; 25–79 years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTRasym at 1.0 ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. Results The results of the phantom study revealed excellent correlation between the MTRasym values and the concentration of GAGs (r = 0.961; p = 0.003). The cartilage grades on the MR images showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.460; p = 0.031 and r = −0.543; p = 0.009, respectively). The VAS pain scores showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.435; p = 0.043 and r = −0.671; p = 0.001, respectively). Conclusion The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTRasym values of the gagCEST images, exhibited greater correlation with the pain scores than the morphological changes visualized on conventional MR images; these results provide evidence supporting the theory regarding the association of patellofemoral osteoarthritis with knee pain scores.

AB - Purpose Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTRasym) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. Materials and methods This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTRasym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3 years; age range; 25–79 years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTRasym at 1.0 ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. Results The results of the phantom study revealed excellent correlation between the MTRasym values and the concentration of GAGs (r = 0.961; p = 0.003). The cartilage grades on the MR images showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.460; p = 0.031 and r = −0.543; p = 0.009, respectively). The VAS pain scores showed significant negative correlation with the MTRasym values in the patellar facet and femoral trochlea (r = −0.435; p = 0.043 and r = −0.671; p = 0.001, respectively). Conclusion The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTRasym values of the gagCEST images, exhibited greater correlation with the pain scores than the morphological changes visualized on conventional MR images; these results provide evidence supporting the theory regarding the association of patellofemoral osteoarthritis with knee pain scores.

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