Preliminary study on the assessment of early cartilage degeneration by quantitative ultrashort echo time magnetic resonance imaging in vivo

Background: To investigate the feasibility of quantitative ultrashort echo time magnetic resonance imaging (UTE-MRI) techniques for assessing early cartilage degeneration in vivo. Methods: A total of 46 patients with knee pain due to osteoarthritis (OA) as the main complaint were recruited into the study. We performed MRI examinations with different quantitative UTE-MRI techniques, including UTE-based magnetization transfer (MT), UTE-adiabaticTlp, and UTE-T2* mapping on a 3.0T clinical magnetic resonance (MR) scanner (MR750; GE Healthcare, Milwaukee, WI, USA). Three regions of interest (ROIs) were manually drawn on the medial and lateral femoral condyles and the corresponding medial and lateral tibial plateaus, respectively. A total of 561 ROIs (12 ROIs for each knee) were finally included and divided into 3 groups according to the MRI Osteoarthritis Knee Score (MOAKS): normal (MOAKS 0, n=175), mild degeneration (MOAKS 1, n=283), and moderate degeneration (MOAKS 2, n=103). One-way analysis of variance (ANOVA) and Tamhane's T2 test were used to compare the differences of quantitative UTE;-biomarkers among different groups. The analysis of Spearman's correlation was used to assess the correlation between the UTE-biomarkers and MOAKS grading. The diagnostic efficacy of different quantitative UTE-MRI techniques for detecting mild cartilage degeneration was evaluated using the receiver operating characteristic (ROC) curve. Results: The UTE-MT ratio (UTE-MTR) and the UTE-adiabatic T1 rho values had a moderate correlation with the MOAKS grading (r=-0.523, P<0.001; r=0.531, P<0.001, respectively), while the UTE-T2* was weakly correlated with the MOAKS grading (r=-0.396, P<0.001). For the normal group (MOAKS 0) and the mild group (MOAKS 1), the UTE-MTR values were 21.09%+/- 3.03% and 17.30%+/- 3.22%, respectively. The UTE adiabatic T1 rho values were 30.43 +/- 6.26 ms and 35.05 +/- 8.78 ms for the normal group (MOAKS 0) and the mild group (MOAKS 1), respectively. With respect to the LIFE- T2* values, the normal group (MOAKS 0) values were 21.49 +/- 3.96 ms and the mild group (MOAKS 1) values were 19.86 +/- 3.08 ms. All the differences between the 2 groups of the 3 UTE MRI values were significant. The AUCs of the UTE MTR, UTE-adiabatic T1 rho , and UTE-T2* mapping were 0.794, 0.732, and 0.651, respectively. Conclusions: The quantitative UTE-MRI techniques (UTE-MT, UTE-adiabatic T1 rho , and UTE-T2* mapping) show great promise for assessing the early degeneration of articular cartilage in vivo, and the UTE- MT and UTE-adiabatic Tip values show better diagnostic efficacy than UTE-T2* mapping.