Multi-vendor multi-site quantitative MRI analysis of cartilage degeneration 10 Years after anterior cruciate ligament reconstruction: MOON-MRI protocol and preliminary results

D Xie; J Murray; R Lartey; S Gaj; J Kim; M Li; B L Eck; C S Winalski; F Altahawi; M H Jones; N A Obuchowski; L J Huston; K D Harkins; H T Friel; B M Damon; M V Knopp; C C Kaeding; K P Spindler; X Li

doi:10.1016/j.joca.2022.08.006

Multi-vendor multi-site quantitative MRI analysis of cartilage degeneration 10 Years after anterior cruciate ligament reconstruction: MOON-MRI protocol and preliminary results

Osteoarthritis Cartilage. 2022 Dec;30(12):1647-1657. doi: 10.1016/j.joca.2022.08.006. Epub 2022 Aug 30.

Authors

D Xie¹, J Murray², R Lartey³, S Gaj⁴, J Kim⁵, M Li⁶, B L Eck⁷, C S Winalski⁸, F Altahawi⁹, M H Jones¹⁰, N A Obuchowski¹¹, L J Huston¹², K D Harkins¹³, H T Friel¹⁴, B M Damon¹⁵, M V Knopp¹⁶, C C Kaeding¹⁷, K P Spindler¹⁸, X Li¹⁹

Affiliations

¹ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: xdx1024@csu.edu.cn.
² Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: murrayj8@ccf.org.
³ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: larteyr@ccf.org.
⁴ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: gajs@ccf.org.
⁵ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: kimj14@ccf.org.
⁶ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: lim3@ccf.org.
⁷ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: eckb@ccf.org.
⁸ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: winalsc@ccf.org.
⁹ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: altahaf@ccf.org.
¹⁰ Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: mhjones@bwh.harvard.edu.
¹¹ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: obuchon@ccf.org.
¹² Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: laura.huston@vanderbilt.edu.
¹³ Departments of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: kevin.harkins@vanderbilt.edu.
¹⁴ MR Clinical Science, Philips Healthcare, Highland Heights, OH, USA. Electronic address: harry.friel@philips.com.
¹⁵ Departments of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: Bruce.Damon@carle.com.
¹⁶ Wright Center of Innovation in Biomedical Imaging, Department of Radiology, The Ohio State University, Columbus, OH, USA. Electronic address: knopp.16@osu.edu.
¹⁷ Department of Orthopaedic Surgery, The Ohio State University, Columbus, OH, USA. Electronic address: christopher.kaeding@osumc.edu.
¹⁸ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA. Electronic address: spindlk@ccf.org.
¹⁹ Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Diagnostic Radiology, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: lix6@ccf.org.

Abstract

Objective: To describe the protocol of a multi-vendor, multi-site quantitative MRI study for knee post-traumatic osteoarthritis (PTOA), and to present preliminary results of cartilage degeneration using MR T_1ρ and T₂ imaging 10 years after anterior cruciate ligament reconstruction (ACLR).

Design: This study involves three sites and two MR platforms. The patients are from a nested cohort (termed as Onsite cohort) within the Multicenter Orthopaedic Outcomes Network (MOON) cohort 10 years after ACLR. Phantoms and controls were scanned for evaluating reproducibility. Cartilage was automatically segmented, and T_1ρ and T₂ were compared between operated, contralateral, and control knees.

Results: Sixty-eight ACL-reconstructed patients and 20 healthy controls were included. In phantoms, the intra-site coefficients of variation (CVs) of repeated scans ranged 1.8-2.1% for T_1ρ and 1.3-1.7% for T₂. The inter-site CVs ranged 1.6-2.1% for T_1ρ and 1.1-1.4% for T₂. In human subjects, the intra-site scan/rescan CVs ranged 2.2-3.5% for T_1ρ and 2.6-4.9% for T₂ for the six major compartments. In patients, operated knees showed significantly higher T_1ρ and T₂ values mainly in medial femoral condyle, medial tibia and trochlear cartilage compared with contralateral knees, and showed significantly higer T_1ρ and T₂ values in all six compartments compared to healthy control knees. The patient contralateral knees showed higher T_1ρ and T₂ values mainly in the lateral femoral condyle, lateral tibia, trochlear, and patellar cartilage compared to healthy control knees.

Conclusion: A platform and workflow with rigorous quality control has been established for a multi-vendor multi-site quantitative MRI study in evaluating PTOA 10 years after ACLR. Our preliminary report suggests significant cartilage matrix changes in both operated and contralateral knees compared with healthy control knees.

Keywords: ACL Reconstruction; Cartilage degeneration; MRI; T(1ρ); T(2).

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Anterior Cruciate Ligament Injuries* / diagnostic imaging
Anterior Cruciate Ligament Injuries* / surgery
Anterior Cruciate Ligament Reconstruction* / methods
Cartilage, Articular* / diagnostic imaging
Cartilage, Articular* / surgery
Humans
Knee Joint / diagnostic imaging
Knee Joint / surgery
Magnetic Resonance Imaging / methods
Multicenter Studies as Topic
Orthopedics*
Osteoarthritis* / surgery
Reproducibility of Results

Abstract

Publication types

MeSH terms

Grants and funding