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Finite Element Analysis Applied to 3-T MR Imaging of Proximal Femur Microarchitecture: Lower Bone Strength in Patients with Fragility Fractures Compared with Control Subjects

Chang, Gregory; Honig, Stephen; Brown, Ryan; Deniz, Cem M; Egol, Kenneth A; Babb, James S; Regatte, Ravinder R; Rajapakse, Chamith S
Purpose To determine the feasibility of using finite element analysis applied to 3-T magnetic resonance (MR) images of proximal femur microarchitecture for detection of lower bone strength in subjects with fragility fractures compared with control subjects without fractures. Materials and Methods This prospective study was institutional review board approved and HIPAA compliant. Written informed consent was obtained. Postmenopausal women with (n = 22) and without (n = 22) fragility fractures were matched for age and body mass index. All subjects underwent standard dual-energy x-ray absorptiometry. Images of proximal femur microarchitecture were obtained by using a high-spatial-resolution three-dimensional fast low-angle shot sequence at 3 T. Finite element analysis was applied to compute elastic modulus as a measure of strength in the femoral head and neck, Ward triangle, greater trochanter, and intertrochanteric region. The Mann-Whitney test was used to compare bone mineral density T scores and elastic moduli between the groups. The relationship (R2) between elastic moduli and bone mineral density T scores was assessed. Results Patients with fractures showed lower elastic modulus than did control subjects in all proximal femur regions (femoral head, 8.51-8.73 GPa vs 9.32-9.67 GPa; P = .04; femoral neck, 3.11-3.72 GPa vs 4.39-4.82 GPa; P = .04; Ward triangle, 1.85-2.21 GPa vs 3.98-4.13 GPa; P = .04; intertrochanteric region, 1.62-2.18 GPa vs 3.86-4.47 GPa; P = .006-.007; greater trochanter, 0.65-1.21 GPa vs 1.96-2.62 GPa; P = .01-.02), but no differences in bone mineral density T scores. There were weak relationships between elastic moduli and bone mineral density T scores in patients with fractures (R2 = 0.25-0.31, P = .02-.04), but not in control subjects. Conclusion Finite element analysis applied to high-spatial-resolution 3-T MR images of proximal femur microarchitecture can allow detection of lower elastic modulus, a marker of bone strength, in subjects with fragility fractures compared with control subjects. MR assessment of proximal femur strength may provide information about bone quality that is not provided by dual-energy x-ray absorptiometry. (c) RSNA, 2014.
PMCID:4263634
PMID: 24689884
ISSN: 0033-8419
CID: 895822

Feasibility of three-dimensional MRI of proximal femur microarchitecture at 3 tesla using 26 receive elements without and with parallel imaging

Chang, Gregory; Deniz, Cem M; Honig, Stephen; Rajapakse, Chamith S; Egol, Kenneth; Regatte, Ravinder R; Brown, Ryan
PURPOSE: High-resolution imaging of deeper anatomy such as the hip is challenging due to low signal-to-noise ratio (SNR), necessitating long scan times. Multi-element coils can increase SNR and reduce scan time through parallel imaging (PI). We assessed the feasibility of using a 26-element receive coil setup to perform 3 Tesla (T) MRI of proximal femur microarchitecture without and with PI. MATERIALS AND METHODS: This study had institutional review board approval. We scanned 13 subjects on a 3T scanner using 26 receive-elements and a three-dimensional fast low-angle shot (FLASH) sequence without and with PI (acceleration factors [AF] 2, 3, 4). We assessed SNR, depiction of individual trabeculae, PI performance (1/g-factor), and image quality with PI (1 = nonvisualization to 5 = excellent). RESULTS: SNR maps demonstrate higher SNR for the 26-element setup compared with a 12-element setup for hip MRI. Without PI, individual proximal femur trabeculae were well-depicted, including microarchitectural deterioration in osteoporotic subjects. With PI, 1/g values for the 26-element/12-element receive-setup were 0.71/0.45, 0.56/0.25, and 0.44/0.08 at AF2, AF3, and AF4, respectively. Image quality was: AF1, excellent (4.8 +/- 0.4); AF2, good (4.2 +/- 1.0); AF3, average (3.3 +/- 1.0); AF4, nonvisualization (1.4 +/- 0.9). CONCLUSION: A 26-element receive-setup permits 3T MRI of proximal femur microarchitecture with good image quality up to PI AF2. J. Magn. Reson. Imaging 2014;40:229-238. (c) 2013 Wiley Periodicals, Inc.
PMCID:4004721
PMID: 24711013
ISSN: 1053-1807
CID: 1042112

Three-dimensional Saturation Transfer (31)P-MRI in Muscles of the Lower Leg at 3.0 T

Parasoglou, Prodromos; Xia, Ding; Chang, Gregory; Regatte, Ravinder R
The creatine kinase (CK) reaction plays a critical role in skeletal muscle function, and can be studied non-invasively using phosphorus ((31)P) saturation transfer (ST) techniques. However, due to the low MR sensitivity of the (31)P nucleus, most studies on clinically approved magnetic fields (
PMCID:4048915
PMID: 24910264
ISSN: 2045-2322
CID: 1042292

MRI of the hip at 7T: Feasibility of bone microarchitecture, high-resolution cartilage, and clinical imaging

Chang, Gregory; Deniz, Cem M; Honig, Stephen; Egol, Kenneth; Regatte, Ravinder R; Zhu, Yudong; Sodickson, Daniel K; Brown, Ryan
PURPOSE: To demonstrate the feasibility of performing bone microarchitecture, high-resolution cartilage, and clinical imaging of the hip at 7T. MATERIALS AND METHODS: This study had Institutional Review Board approval. Using an 8-channel coil constructed in-house, we imaged the hips of 15 subjects on a 7T magnetic resonance imaging (MRI) scanner. We applied: 1) a T1-weighted 3D fast low angle shot (3D FLASH) sequence (0.23 x 0.23 x 1-1.5 mm3 ) for bone microarchitecture imaging; 2) T1-weighted 3D FLASH (water excitation) and volumetric interpolated breath-hold examination (VIBE) sequences (0.23 x 0.23 x 1.5 mm3 ) with saturation or inversion recovery-based fat suppression for cartilage imaging; 3) 2D intermediate-weighted fast spin-echo (FSE) sequences without and with fat saturation (0.27 x 0.27 x 2 mm) for clinical imaging. RESULTS: Bone microarchitecture images allowed visualization of individual trabeculae within the proximal femur. Cartilage was well visualized and fat was well suppressed on FLASH and VIBE sequences. FSE sequences allowed visualization of cartilage, the labrum (including cartilage and labral pathology), joint capsule, and tendons. CONCLUSION: This is the first study to demonstrate the feasibility of performing a clinically comprehensive hip MRI protocol at 7T, including high-resolution imaging of bone microarchitecture and cartilage, as well as clinical imaging. J. Magn. Reson. Imaging 2013;. (c) 2013 Wiley Periodicals, Inc.
PMCID:3962810
PMID: 24115554
ISSN: 1053-1807
CID: 571382

Evaluation of Subchondral Bone Marrow Lipids of Acute Anterior Cruciate Ligament (ACL)-Injured Patients at 3 T

Wang, Ligong; Salibi, Nouha; Chang, Gregory; Bencardino, Jenny T; Babb, James S; Rokito, Andrew; Jazrawi, Laith; Sherman, Orrin; Regatte, Ravinder R
RATIONALE AND OBJECTIVES: The objectives of this study were to investigate the changes in compartment-specific subchondral bone marrow lipids of femoral-tibial bone in acute anterior cruciate ligament (ACL)-injured patients compared to that of healthy volunteers and patients with osteoarthritis (OA) (Kellgren-Lawrence [KL] grade 2-3). MATERIALS AND METHODS: A total of 55 subjects were recruited in the study and subdivided into three subgroups: 17 healthy controls (4 females, 13 males; mean age = 41 +/- 16, age range 24-78 years), 17 patients with acute ACL injury (3 females, 14 males; mean age = 30 +/- 11, age range 18-61 years), and 21 patients with KL2-3 OA (12 females, 9 males; mean age = 65 +/- 12, age range 44-89 years). Routine clinical proton density-weighted fast spin echo images in sagittal (without fat saturation), axial, and coronal (fat saturation) planes were acquired on a 3 T clinical scanner for cartilage morphology using Whole-Organ Magnetic Resonance Imaging Score grading. A voxel of 10 x 10 x 10 mm3 was positioned in the medial and lateral compartments of the tibia and femur for proton magnetic resonance spectroscopy measurements using the single voxel stimulated echo acquisition mode pulse sequence. All proton magnetic resonance data were processed with Java-based magnetic resonance user interface. Wilcoxon rank sum test and mixed model two-way analysis of variance were performed to determine significant differences between different compartments and examine the effect of ACL injury, OA grade and compartment, and their interactions. RESULTS: The index of unsaturation in lateral tibial compartment in ACL-injured patients was significantly higher (P < .05) than all compartments except lateral femoral in patients with KL2-3 OA. Significantly lower values (P < .05) were also identified in saturated lipids at 2.03 ppm in all compartments in ACL-injured patients than those of all compartments in patients with KL2-3 OA. CONCLUSIONS: The preliminary results suggest that the indices of unsaturation in the lateral tibial compartment and the peaks of saturated lipids at 1.3 and 2.03 ppm in medial tibial compartment may be clinically useful to characterize subchondral bone marrow among healthy controls, acute ACL-injured patients, and patients with OA.
PMCID:4037703
PMID: 24717549
ISSN: 1076-6332
CID: 895832

SODIUM IMAGING OF THE KNEE JOINT REPAIR

Chapter by: Madelin, Guillaume; Chang, Gregory; Regatte, Ravinder R
in: ADVANCED QUANTITATIVE IMAGING OF KNEE JOINT REPAIR by Regatte, RR [Eds]
SINGAPORE : WORLD SCIENTIFIC PUBL CO PTE LTD, 2014
pp. 273-303
ISBN:
CID: 2544682

DIFFUSION TENSOR IMAGING (DTI) OF KNEE JOINT REPAIR

Chapter by: Raya, Jose G; Chang, Gregory
in: ADVANCED QUANTITATIVE IMAGING OF KNEE JOINT REPAIR by Regatte, RR [Eds]
SINGAPORE : WORLD SCIENTIFIC PUBL CO PTE LTD, 2014
pp. 197-247
ISBN:
CID: 2544692

Design and Application of Combined 8-Channel Transmit and 10-Channel Receive Arrays and Radiofrequency Shimming for 7-T Shoulder Magnetic Resonance Imaging

Brown, Ryan; Deniz, Cem Murat; Zhang, Bei; Chang, Gregory; Sodickson, Daniel K; Wiggins, Graham C
OBJECTIVE: The objective of the study was to investigate the feasibility of 7-T shoulder magnetic resonance imaging by developing transmit and receive radiofrequency (RF) coil arrays and exploring RF shim methods. MATERIALS AND METHODS: A mechanically flexible 8-channel transmit array and an anatomically conformable 10-channel receive array were designed and implemented. The transmit performance of various RF shim methods was assessed through local flip angle measurements in the right and left shoulders of 6 subjects. The receive performance was assessed through signal-to-noise ratio measurements using the developed 7-T coil and a baseline commercial 3-T coil. RESULTS: The 7-T transmit array driven with phase-coherent RF shim weights provided adequate B1 efficiency and uniformity for turbo spin echo shoulder imaging. B1 twisting that is characteristic of high-field loop coils necessitates distinct RF shim weights in the right and left shoulders. The 7-T receive array provided a 2-fold signal-to-noise ratio improvement over the 3-T array in the deep articular shoulder cartilage. CONCLUSIONS: Shoulder imaging at 7-T is feasible with a custom transmit/receive array either in a single-channel transmit mode with a fixed RF shim or in a parallel transmit mode with a subject-specific RF shim.
PMCID:4036121
PMID: 24056112
ISSN: 0020-9996
CID: 571392

Impact of body habitus on radiologic interpretations [Editorial]

Rajapakse, Chamith S; Chang, Gregory
PMID: 24331258
ISSN: 1076-6332
CID: 746022

MAGNETIC RESONANCE IMAGING OF CARTILAGE REPAIR WITH A FOCUS ON SUBCHONDRAL BONE

Chapter by: Chang, Gregory; Madelin, Guillaume; Xia, Ding; Sherman, Orrin; Strauss, Eric; Jazrawi, Laith; Regatte, Ravinder R
in: ADVANCED QUANTITATIVE IMAGING OF KNEE JOINT REPAIR by Regatte, RR [Eds]
SINGAPORE : WORLD SCIENTIFIC PUBL CO PTE LTD, 2014
pp. 305-324
ISBN:
CID: 2165732