Thomas M. Link. Editor. Cartilage Imaging. Significance, Techniques, and New Developments

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1 Cartilage Imaging

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3 Thomas M. Link Editor Cartilage Imaging Significance, Techniques, and New Developments

4 Editor Thomas M. Link Department of Radiology and Biomedical Imaging University of California at San Francisco San Francisco, CA USA ISBN e-isbn DOI / Springer New York Dordrecht Heidelberg London Library of Congress Control Number: Springer Science+Business Media, LLC 2011 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 Preface One of the first systematic histological evaluations of the role of joint cartilage was published in 1843 by Ecker and was entitled Ueber Abnuetzung und Zerstoerung des Gelenkknorpels [1]. In 1942, Bennett et al. stated that degeneration of articular cartilage is the origin of osteoarthritis and that the degeneration is an inherent senescence of the cartilaginous tissue [2]. For many years, cartilage loss and degeneration were considered as inevitable, eventually leading to decrease in joint function, osteoarthritis, and immobility, with limited therapeutic options. Cartilage degeneration has been identified as a major threat to our aging society with substantial implications for health care and as a major socio-economic burden. Hence today, there is tremendous activity in developing strategies and treatments to prevent cartilage Abnuetzung (loss). These include injury prevention programs, cartilage repair, as well as oral and local treatments. While these therapies are clearly in their infancy, their development requires sensitive and reliable cartilage imaging and quantification techniques; these are indispensible to monitor the effects of new therapies and prevention strategies. Thus cartilage imaging gains a major and central role in the management of degenerative joint disease. The goal of this book was not simply to summarize currently available imaging techniques to assess cartilage, but also to provide clinical perspectives and an outlook on future developments. Major experts in this growing field contributed to this book, which is geared to radiologists, orthopedic surgeons, rheumatologists, and clinical and basic researchers. We believe that cartilage imaging and noninvasive quantification will be essential tools in preserving joint function and tackling the ever-increasing challenge of osteoarthritis in our society. I would finally like to acknowledge our developmental editor Michael Griffin s hard work and support during the preparation of this book. Thomas M. Link, MD References 1. Ecker A. Ueber Abnuetzung und Zerstoerung der Gelenkknorpel. Arch Physiol Heilk. 1843;2: Bennett G, Waine H, Bauer W. Changes in the knee joint at various ages. New York: Commonwealth Fund; v

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7 Contents 1 Anatomy and Histology of Cartilage... Andrew Horvai 1 2 Clinical Aspects: A Rheumatologist s Perspective... David J. Hunter 11 3 Clinical Aspects: An Orthopedic Surgeon s Perspective... Sunny Cheung and C. Benjamin Ma 19 4 Conventional Radiography as an Indirect Measure for Cartilage Pathology... Daichi Hayashi, Jeffrey Duryea, Frank W. Roemer, and Ali Guermazi 27 5 Value of CT Arthrography in the Assessment of Cartilage Pathology... Patrick Omoumi, Bruno C. Vande Berg, and Frédéric E. Lecouvet 37 6 MRI of Cartilage: Standard Techniques... Thomas M. Link 49 7 MRI of Cartilage: Pathological Findings... Thomas M. Link 67 8 Scoring Systems to Semiquantitatively Grade Cartilage Pathology with MRI... Christoph Stehling 93 9 Atlas: Cartilage Abnormalities and Scores Hans Liebl and Thomas M. Link 10 Cartilage Segmentation Julio Carballido-Gamio and Thomas M. Link 11 Quantitative MR Imaging of Cartilage Morphology in Osteoarthritis Felix Eckstein, Martin Hudelmaier, and Wolfgang Wirth 12 MR T2 Relaxation Time Measurements for Cartilage and Menisci Thomas Baum, Thomas M. Link, and Bernard J. Dardzinski 13 MR T1r Relaxation Time Quantification in Cartilage Xiaojuan Li vii

8 viii Contents 14 Cartilage Matrix Assessment Using dgemric Martha L. Gray and Deborah Burstein 15 Imaging of Cartilage Repair Goetz H. Welsch, Stephan Domayer, Vladimir Juras, Tallal C. Mamisch, and Siegfried Trattnig 16 Cartilage as a Biomarker Thomas M. Link 17 Frontiers in Molecular Imaging of Cartilage: Future Developments Ravinder Reddy, Arijitt Borthakur, Walter R.T. Witschey, and J. Bruce Kneeland 18 Future Perspective and Significance of Cartilage Imaging and Quantification Thomas M. Link and Sharmila Majumdar Index

9 Contributors Thomas Baum, MD Department of Radiology and Biomedical Imaging, Musculoskeletal and Quantitative Imaging Research Group, University of California, and Department of Radiology, Technische Universität München, Ismaninger Str. 22, Munich, Germany Arijitt Borthakur, PhD Department of Radiology, Center for Magnetic Resonance and Optical Imaging, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Deborah Burstein, PhD Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA Julio Carballido-Gamio, PhD Grupo Tecnológico Santa Fe, S.A. de C.V., Mexico City, Mexico and Department of Radiology and Biomedical Imaging, University of California at San Francisco, Sunny Cheung, MD Division of Orthopedic Sports Surgery, Mission Bay Orthopedic Institute, University of California, Bernard J. Dardzinski, PhD Exploratory and Translational Sciences Imaging, University of Pennsylvania, Merck & Co., Inc., Children s Hospital of Pennsylvania, West Point, PA, USA Stephan Domayer, MD Department of Orthopaedics, Medical University of Vienna, Vienna, Austria Jeffrey Duryea, PhD Department of Radiology, Brigham and Women s Hospital, Boston, MA, USA Felix Eckstein, MD Institute of Anatomy & Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria and Chondrometrics GmbH, Ainring, Germany ix

10 x Martha L. Gray, PhD Department of Electrical Engineering and Computer Science, MIT, Harvard-MIT Division of Health Sciences and Technology (HST), New England Baptist (NEB) Bone and Joint Center, BIDMC, Cambridge, MA, USA Ali Guermazi, MD Department of Radiology, Boston University, Quantitative Imaging Center (QIC), Boston, MA, USA Daichi Hayashi, MBBS, BSc Department of Radiology, Boston University School of Medicine, Boston, MA, USA Andrew Horvai, MD, PhD Department of Pathology, University of California, Martin Hudelmaier, MD Paracelsus Medical University, Institute of Anatomy and Musculoskeletal Research, Salzburg, Austria David J. Hunter, MBBS, PhD, FRACP Division of Research, New England Baptist Hospital, Boston, MA, USA and Rheumatology Department, Royal North Shore Hospital, University of Sydney, Australia Vladimir Juras, PhD Department of Radiology, MR Center, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria J. Bruce Kneeland, MD Department of Radiology, Center for Magnetic Resonance and Optical Imaging, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Frédéric E. Lecouvet, MD, PhD Department of Radiology and Medical Imaging, Cliniques Universitaires Saint-Luc UC Louvain, Brussels, Belgium Xiaojuan Li, PhD Department of Radiology and Biomedical Imaging, University of California, Hans Liebl Medical School, Technical University of Munich, Munich, Germany Thomas M. Link, MD Department of Radiology and Biomedical Imaging, University of California at San Francisco, C. Benjamin Ma, PhD Sports Medicine and Shoulder Service, Department of Orthopedic Surgery, University of California, San Francisco, Sharmila Majumdar, PhD Department of Radiology and Biomedical Imaging, University of California at San Francisco, Contributors

11 xi Contributors Tallal C. Mamisch, MD Department of Orthopaedic Surgery, University of Bern, Bern, Switzerland and Department of Radiology, MR Center, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria Patrick Omoumi, MD Department of Radiology and Medical Imaging, Saint-Luc University Hospital UC Louvain, Brussels, Belgium Ravinder Reddy, PhD Department of Radiology, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Frank W. Roemer, MD Department of Radiology, Klinikum Augsburg, Augsburg, Germany; Department of Radiology, Boston University, Quantitative Imaging Center (QIC), Boston, MA, USA Christoph Stehling, MD Department of Clinical Radiology, University of Muenster, Muenster, Germany Siegfried Trattnig, MD Department of Radiology, MR Center, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria Bruno C. Vande Berg, MD, PhD Department of Radiology and Medical Imaging, Saint-Luc University Hospital UC Louvain, Brussels, Belgium Goetz H. Welsch, MD Department of Radiology, MR Center, General Hospital of Vienna, Medical University of Vienna, Vienna, Austria and Department of Trauma Surgery, University of Erlangen-Nuremberg, Erlangen, Germany Wolfgang Wirth, PhD Institute of Anatomy and Musculoskeletal Research, Paracelsus Medical University, Salzburg, Austria Walter R.T. Witschey, PhD Department of Radiology, Center for Magnetic Resonance and Optical Imaging, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

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