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Cartilage quality in rheumatoid arthritis: comparison of T2* mapping, native T1 mapping, dGEMRIC, ΔR1 and value of pre-contrast imaging

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Abstract

Purpose

To prospectively evaluate four non-invasive markers of cartilage quality—T2* mapping, native T1 mapping, dGEMRIC and ΔR1—in healthy volunteers and rheumatoid arthritis (RA) patients.

Materials and methods

Cartilage of metacarpophalangeal (MCP) joints II were imaged in 28 consecutive subjects: 12 healthy volunteers [9 women, mean (SD) age 52.67 (9.75) years, range 30–66] and 16 RA patients with MCP II involvement [12 women, mean (SD) age 58.06 (12.88) years, range 35–76]. Sagittal T2* mapping was performed with a multi-echo gradient-echo on a 3 T MRI scanner. For T1 mapping the dual flip angle method was applied prior to native T1 mapping and 40 min after gadolinium application (delayed gadolinium-enhanced MRI of cartilage, dGEMRIC, T1Gd). The difference in the longitudinal relaxation rate induced by gadolinium (ΔR1) was calculated. The area under the receiver operating characteristic curve (AROC) was used to test for differentiation of RA patients from healthy volunteers.

Results

dGEMRIC (AUC 0.81) and ΔR1 (AUC 0.75) significantly differentiated RA patients from controls. T2* mapping (AUC 0.66) and native T1 mapping (AUC 0.66) were not significantly different in RA patients compared to controls.

Conclusions

The data support the use of dGEMRIC for the assessment of MCP joint cartilage quality in RA. T2* and native T1 mapping are of low diagnostic value. Pre-contrast T1 mapping for the calculation of ΔR1 does not increase the diagnostic value of dGEMRIC.

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Acknowledgements

We thankfully acknowledge the support of Mrs. E. Rädisch, Ms. L. Dor and Mr. Ch. Nowak in data acquisition and image post-processing. This study was supported by a grant of the Heinrich-Heine-University of Düsseldorf Research Committee.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, D-40225, Düsseldorf, Germany

    Christian Buchbender, Axel Scherer, Patric Kröpil, Michael Quentin, Dorothea Ch. Reichelt, Rotem S. Lanzman, Christian Mathys, Dirk Blondin, Hans-Jörg Wittsack, Gerald Antoch & Falk Miese

  2. Department of Endocrinology, Diabetology and Rheumatology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany

    Birthe Körbl, Matthias Schneider & Benedikt Ostendorf

  3. German Diabetes Centre, Heinrich-Heine-University, Leibniz Centre for Diabetes Research, Institute of Biometrics and Epidemiology, Düsseldorf, Germany

    Birthe Körbl

  4. Department of Orthopaedics, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany

    Bernd Bittersohl & Christoph Zilkens

  5. Medical Education Group, Medical School, Heinrich-Heine-University, Düsseldorf, Germany

    Matthias Hofer

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  1. Christian Buchbender
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Correspondence to Christian Buchbender.

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Buchbender, C., Scherer, A., Kröpil, P. et al. Cartilage quality in rheumatoid arthritis: comparison of T2* mapping, native T1 mapping, dGEMRIC, ΔR1 and value of pre-contrast imaging. Skeletal Radiol 41, 685–692 (2012). https://doi.org/10.1007/s00256-011-1276-2

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