Roland Krug

High-resolution Imaging Techniques for the Assessment of Osteoporosis

The importance of assessing the bones microarchitectural make-up in addition to its mineral density in the context of osteoporosis has been emphasized in several publications. The high spatial resolution required to resolve the bones microstructure in a clinically feasible scan time is challenging. At present, the best suited modalities meeting these requirements in vivo are high-resolution peripheral quantitative imaging (HR-pQCT) and magnetic resonance imaging (MRI). Whereas HR-pQCT is limited to peripheral skeleton regions like the wrist and ankle, MRI can also image other sites like the proximal femur but usually with lower spatial resolution. In addition, multidetector computed tomography has been used for high-resolution imaging of trabecular bone structure; however, the radiation dose is a limiting factor. This article provides an overview of the different modalities, technical requirements, and recent developments in this emerging field. Details regarding imaging protocols as well as image postprocessing methods for bone structure quantification are discussed.

In Vivo Determination of Bone Structure in Postmenopausal Women: A Comparison of HR-pQCT and High-Field MR Imaging†

Bone structural measures obtained by two noninvasive imaging tools—3T MRI and HR‐pQCT—were compared. Significant but moderate correlations and 2‐ to 4‐fold discrepancies in parameter values were detected, suggesting that differences in acquisition and analysis must be considered when interpreting data from these imaging modalities.

Patellar Cartilage: T2 Values and Morphologic Abnormalities at 3.0-T MR Imaging in Relation to Physical Activity in Asymptomatic Subjects from the Osteoarthritis Initiative

PURPOSE To study the interrelationship between patella cartilage T2 relaxation time, other knee abnormalities, and physical activity levels in asymptomatic subjects from the Osteoarthritis Initiative (OAI) incidence cohort. MATERIALS AND METHODS The study had institutional review board approval and was HIPAA compliant. One hundred twenty subjects from the OAI without knee pain (age, 45-55 years) and with risk factors for knee osteoarthritis (OA) were studied by using knee radiographs, 3.0-T knee magnetic resonance (MR) images (including intermediate-weighted fast spin-echo and T2 mapping sequences), and the Physical Activity Scale for the Elderly. MR images of the right knee were assessed by two musculoskeletal radiologists for the presence and grade of abnormalities. Segmentation of the patella cartilage was performed, and T2 maps were generated. Statistical significance was determined by using analysis of variance, chi(2) analysis, correlation coefficient tests, the Cohen kappa, and a multiple linear regression model. RESULTS Cartilage lesions were found in 95 (79.0%) of 120 knees, and meniscal lesions were found in 54 (45%) of 120 knees. A significant correlation between patella cartilage T2 values and the severity and grade of cartilage (P = .0025) and meniscus (P = .0067) lesions was demonstrated. Subjects with high activity levels had significantly higher prevalence and grade of abnormalities and higher T2 values (48.7 msec +/-4.35 vs 45.8 msec +/-3.93; P < .001) than did subjects with low activity levels. CONCLUSION Middle-aged asymptomatic individuals with risk factors for knee OA had a high prevalence of cartilage and meniscus knee lesions. Physically active individuals had more knee abnormalities and higher patellar T2 values. Additional studies will be needed to determine causality.

Isotropic 3D fast spin-echo imaging versus standard 2D imaging at 3.0 T of the knee—image quality and diagnostic performance

The objective of this study was to compare a newly developed fat-saturated intermediate-weighted (IM-w) 3D fast spin-echo (FSE) sequence with standard 2D IM-w FSE sequences regarding image quality and diagnostic performance in assessing abnormal findings of the knee. MR imaging was performed at 3.0 T in 50 patients. Images were assessed independently by three radiologists. Image quality was rated significantly higher (p < 0.05) for the 2D versus the 3D FSE sequences. Sensitivity for cartilage lesions was slightly higher for the 3D sequence, but specificity was lower. Low contrast objects were better visualized with 2D sequences, while high contrast objects were better shown with the 3D sequence. Confidence scores were higher for 2D than for 3D sequences, but differences were not significant. In conclusion, isotropic 3D FSE IM-w imaging may enhance standard knee MRI by increased visualization of high contrast lesions; however, 3D FSE image quality was lower.

Imaging of the musculoskeletal system in vivo using ultra-high field magnetic resonance at 7 T.

Recently, great progress has been made in particularly in the imaging of cartilage and bone structure. Increased interest has focused on high-field (3 Tesla) imaging and more recently on ultra-high field (UHF) magnetic resonance imaging (MRI) at 7 T for in vivo imaging. Because the signal-to-noise ratio (SNR) scales linearly with field strength, a substantial increase in SNR is expected compared with lower field strengths. This gain in SNR can be used to increase spatial resolution or reduce imaging time.The goal of this review was to highlight recent developments and challenges in in vivo musculoskeletal (MSK) imaging using UHF-MRI at 7 T. One focus of this review is on the emerging methodology of quantitative MRI for the assessment of trabecular bone structure at the tibia, wrist, and knee. In particular for this application, susceptibility effects between the bone and bone marrow transitions that scale with field strength have to be considered. Another important MSK application is the characterization of knee cartilage morphology. The higher SNR provided by UHF-MRI is a potential advantage for visualizing, segmenting, and analyzing cartilage.Standard clinical MSK imaging relies heavily on T1, T2, and proton density weighted fast spin echo sequences. However, fast spin echo imaging has proven to be very challenging at higher fields because of very high specific absorption rates, using multiple pulses in a short time frame; thus the imaging protocols have to be adapted and gradient echo sequences may be more beneficial. Imaging of more central body parts such as the spine at 7 T is still in its infancy and dedicated coils have to be developed.

In vivo bone and cartilage MRI using fully-balanced steady-state free-precession at 7 tesla

The purpose of this work was to investigated the feasibility of fully‐balanced steady‐state free‐precession (bSSFP) pulse sequence for trabecular bone and knee cartilage imaging in vivo using ultra‐high‐field (UHF) MRI at 7T in comparison with pulse sequences previously used at 3T. We showed that bSSFP and spin‐echo imaging is possible at higher field strengths within 3.2 W/kg specific absorption rate (SAR) constraints. All pulse sequences were numerically optimized based on measured tissue relaxation parameters from six healthy volunteers (T1 = 820 ± 128 ms, T2 = 43.5 ± 3 ms for bone marrow and T1 = 1745 ± 104 ms and T2 = 30 ± 4 ms for cartilage). From simulations of the Bloch equation, a signal‐to‐noise ratio (SNR) increase of more than 1.9 was predicted. Cartilage SNR of bSSFP was 2.4 times higher at 7T (51.3 ± 4.3) compared with 3T (21.3 ± 3.3). Bone SNR increased from 11.8 ± 2.0 to 13.2 ± 2.5 at the higher field strength. We concluded that there is SNR benefit and great potential for bone and cartilage imaging at higher field strength. Magn Reson Med, 2007.

Bone marrow fat quantification in the presence of trabecular bone: initial comparison between water-fat imaging and single-voxel MRS.

The purpose of the present study was to test the relative performance of chemical shift‐based water‐fat imaging in measuring bone marrow fat fraction in the presence of trabecular bone, having as reference standard the single‐voxel magnetic resonance spectroscopy (MRS).

7T Human Spine Imaging Arrays With Adjustable Inductive Decoupling

Ultrahigh-field human spine RF transceiver coil arrays face daunting technical challenges in achieving large imaging coverage with sufficient B1 penetration and sensitivity, and in attaining robust decoupling among coil elements. In this paper, human spine coil arrays for ultrahigh field were built and studied. Transceiver arrays with loop-shaped microstrip transmission line were designed, fabricated, and tested for 7-tesla (7T) MRI. With the proposed adjustable inductive decoupling technique, the isolation between adjacent coil elements is easily addressed. Preliminary results of human spine images acquired using the transceiver arrays demonstrate the feasibility of the design for ultrahigh-field MR applications and its robust performance for parallel imaging.

Feasibility and reproducibility of relaxometry, morphometric, and geometrical measurements of the hip joint with magnetic resonance imaging at 3T.

To test the feasibility of in vivo magnetic resonance T1ρ relaxation time measurements of hip cartilage, and quantify the reproducibility of hip cartilage thickness, volume, T2, T1ρ, and size of femoral head measurements.

In vivo ultra-high-field magnetic resonance imaging of trabecular bone microarchitecture at 7 T

To investigate the feasibility of 7T magnetic resonance imaging (MRI) to visualize and quantify trabecular bone structure in vivo by comparison with 3T MRI and in vivo three‐dimensional (3D) high‐resolution peripheral quantitative computed tomography (HR‐pQCT).