Imaging biomarker with T1ρ and T2 mappings in osteoarthritis - in vivo human articular cartilage study

Introduction: Osteoarthritis (OA) of the knee is a common and disabling disease worldwide. Its prevalence is increasing in view of the aging population. Changes in collagen content, its orientation and GAG content in the articular cartilage with age are the major features in knee osteoarthritis. These changes in collagen and GAG contents show no manifestation in plain radiography and conventional magnetic resonance imaging (MRI). Nevertheless, early diagnosis of the knee osteoarthritis is of paramount importance clinically in view of the evolution of putative interventions in its early stage. The aim of this project is to identify the relationships between the two imaging biomarkers (i.e. T1ρ and T2 mappings) and the GAG concentration in living human symptomatic cartilage.

Methodology: 28 patients with clinical diagnosis of knee osteoarthritis were enrolled. 7 males and 16 females were recruited and their mean age was 68.1 (ranges from 53 to 84). Conventional PD sequence, T1ρ and T2 mappings were performed for each subject within 1 week before total knee arthroplasty. Articular cartilage from the lateral tibial plateau was harvested and the GAG content in cartilage was determined by using dimethylmethylene blue method. T1ρ mean and T2 values were calculated and correlate with GAG concentration statistically.

Results: The mean value T1ρ was 40.3±13.5ms, ranging from 15.3 to 69.3ms and the mean value T2 was 31.0±10.5ms, ranging from 16.1 to 46.9ms. The mean value of GAG content was 80.1±33.3mg, ranging from 24.9 to 166.0mg while the mean value of GAG concentration was 267.4±165.9mg/cm(3), ranging from 91.3 to 760.5mg/cm(3). T2 values were inversely correlated with GAG concentration with R(2)=0.375, p=0.001 while T1ρ values were also inversely correlated with GAG concentration with R(2)=0.200, p=0.025.

Conclusion: This in vivo study confirmed that T1ρ and T2 values correlate with the GAG concentration in living human knee cartilages which corroborate with the previous works. The later (T2 values) is found more reliable in our study and less controversial in literatures. We postulate that T2 values can serve as a non-invasive imaging biomarker in the progress of knee osteoarthritis in terms of both disease diagnosis and treatment response monitoring.