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In vivo transport of Gd-DTPA(2-) into human meniscus and cartilage assessed with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC)

Sigurdsson, Ulf LU ; Siversson, Carl LU ; Lammentausta, Eveliina; Svensson, Jonas LU ; Tiderius, Carl Johan LU and Dahlberg, Leif LU (2014) In BMC Musculoskeletal Disorders 15.
Abstract
Background: Impaired stability is a risk factor in knee osteoarthritis (OA), where the whole joint and not only the joint cartilage is affected. The meniscus provides joint stability and is involved in the early pathological progress of OA. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) has been used to identify pre-radiographic changes in the cartilage in OA, but has been used less commonly to examine the meniscus, and then using only a double dose of the contrast agent. The purpose of this study was to enable improved early OA diagnosis by investigate the temporal contrast agent distribution in the meniscus and femoral cartilage simultaneously, in healthy volunteers, using 3D dGEMRIC at two different doses of the contrast agent... (More)
Background: Impaired stability is a risk factor in knee osteoarthritis (OA), where the whole joint and not only the joint cartilage is affected. The meniscus provides joint stability and is involved in the early pathological progress of OA. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) has been used to identify pre-radiographic changes in the cartilage in OA, but has been used less commonly to examine the meniscus, and then using only a double dose of the contrast agent. The purpose of this study was to enable improved early OA diagnosis by investigate the temporal contrast agent distribution in the meniscus and femoral cartilage simultaneously, in healthy volunteers, using 3D dGEMRIC at two different doses of the contrast agent Gd-DTPA(2-). Methods: The right knee in 12 asymptomatic volunteers was examined using a 3D Look-Locker sequence on two occasions after an intravenous injection of a double or triple dose of Gd-DTPA(2-) (0.2 or 0.3 mmol/kg body weight). The relaxation time (T-1) and relaxation rate (R-1 = 1/T-1) were measured in the meniscus and femoral cartilage before, and 60, 90, 120 and 180 minutes after injection, and the change in relaxation rate (Delta R-1) was calculated. Paired t-test and Analysis of Variance (ANOVA) were used for statistical evaluation. Results: The triple dose yielded higher concentrations of Gd-DTPA(2-) in the meniscus and cartilage than the double dose, but provided no additional information. The observed patterns of Delta R-1 were similar for double and triple doses of the contrast agent. Delta R-1 was higher in the meniscus than in femoral cartilage in the corresponding compartments at all time points after injection. Delta R-1 increased until 90-180 minutes in both the cartilage and the meniscus (p < 0.05), and was lower in the medial than in the lateral meniscus at all time points (p < 0.05). A faster increase in Delta R-1 was observed in the vascularized peripheral region of the posterior medial meniscus, than in the avascular central part of the posterior medial meniscus during the first 60 minutes (p < 0.05). Conclusion: It is feasible to examine undamaged meniscus and cartilage simultaneously using dGEMRIC, preferably 90 minutes after the injection of a double dose of Gd-DTPA(2-) (0.2 mmol/kg body weight). (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
dGEMRIC, Glycosaminoglycans, Meniscus, Cartilage
in
BMC Musculoskeletal Disorders
volume
15
publisher
BioMed Central
external identifiers
  • wos:000339968100001
  • scopus:84903858219
ISSN
1471-2474
DOI
10.1186/1471-2474-15-226
language
English
LU publication?
yes
id
374a34a1-986c-4fda-a628-c7faa1fce8b5 (old id 4667851)
date added to LUP
2014-10-01 07:24:30
date last changed
2017-03-26 03:52:27
@article{374a34a1-986c-4fda-a628-c7faa1fce8b5,
  abstract     = {Background: Impaired stability is a risk factor in knee osteoarthritis (OA), where the whole joint and not only the joint cartilage is affected. The meniscus provides joint stability and is involved in the early pathological progress of OA. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) has been used to identify pre-radiographic changes in the cartilage in OA, but has been used less commonly to examine the meniscus, and then using only a double dose of the contrast agent. The purpose of this study was to enable improved early OA diagnosis by investigate the temporal contrast agent distribution in the meniscus and femoral cartilage simultaneously, in healthy volunteers, using 3D dGEMRIC at two different doses of the contrast agent Gd-DTPA(2-). Methods: The right knee in 12 asymptomatic volunteers was examined using a 3D Look-Locker sequence on two occasions after an intravenous injection of a double or triple dose of Gd-DTPA(2-) (0.2 or 0.3 mmol/kg body weight). The relaxation time (T-1) and relaxation rate (R-1 = 1/T-1) were measured in the meniscus and femoral cartilage before, and 60, 90, 120 and 180 minutes after injection, and the change in relaxation rate (Delta R-1) was calculated. Paired t-test and Analysis of Variance (ANOVA) were used for statistical evaluation. Results: The triple dose yielded higher concentrations of Gd-DTPA(2-) in the meniscus and cartilage than the double dose, but provided no additional information. The observed patterns of Delta R-1 were similar for double and triple doses of the contrast agent. Delta R-1 was higher in the meniscus than in femoral cartilage in the corresponding compartments at all time points after injection. Delta R-1 increased until 90-180 minutes in both the cartilage and the meniscus (p &lt; 0.05), and was lower in the medial than in the lateral meniscus at all time points (p &lt; 0.05). A faster increase in Delta R-1 was observed in the vascularized peripheral region of the posterior medial meniscus, than in the avascular central part of the posterior medial meniscus during the first 60 minutes (p &lt; 0.05). Conclusion: It is feasible to examine undamaged meniscus and cartilage simultaneously using dGEMRIC, preferably 90 minutes after the injection of a double dose of Gd-DTPA(2-) (0.2 mmol/kg body weight).},
  articleno    = {226},
  author       = {Sigurdsson, Ulf and Siversson, Carl and Lammentausta, Eveliina and Svensson, Jonas and Tiderius, Carl Johan and Dahlberg, Leif},
  issn         = {1471-2474},
  keyword      = {dGEMRIC,Glycosaminoglycans,Meniscus,Cartilage},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Musculoskeletal Disorders},
  title        = {In vivo transport of Gd-DTPA(2-) into human meniscus and cartilage assessed with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC)},
  url          = {http://dx.doi.org/10.1186/1471-2474-15-226},
  volume       = {15},
  year         = {2014},
}