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Ananya Goyal¹, Marco Barbieri¹, Valentina Mazzoli¹, and Feliks Kogan^1
1Radiology, Stanford University, Stanford, CA, United States

Keywords: Tendon/Ligament, Quantitative Imaging, T2*, Bi-exponential, UTE, CONES

Tendon laxity can cause pain and increased injury risk. Quantitative MRI using Ultrashort echo time (UTE) sequences can quantify both short and long T2* water components in tendons. This study evaluates the sensitivity of UTE-T2* mapping with a bi-exponential fit model to tendon laxity, in the Achilles tendon under tension and relaxation. T2*long values seemed to increase as tendon load increased, while T2*short values were the opposite. These changes may be caused by water movement due to loading and changes in fiber orientation due to tendon slackening.

Ni Yabo¹, Wang zhijun¹, and Tian Zhaorong^2
1Ningxia Medical University General Hospital Radiology department, Yinchuan, China, ²Ningxia Medical University General Hospital Radiology department, Yinchuan, China, Yinchuan, China

Keywords: Tendon/Ligament, Quantitative Imaging

In this study,to investigate the diagnostic value of quantitative parameters of synthetic magnetic resonance image in the grade of rotator cuff injury , we found that the T2 values had high diagnostic efficacy in grading the degree of rotator cuff injury, especially the T2 values of the lateral subregion and the middle subregion had high diagnostic efficacy in differentiating complete tears from partial tears, tendinopathy and normal tendons.

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Yinan Zheng¹, John A. Beasley², Vanessa Crain², Shannon L. Taylor³, Michael D. Pridmore², Maria E. Garza^2,4, Sheau-Chiann Chen⁵, Aaron W. Aday⁶, Joshua A. Beckman⁶, Paula M.C. Donahue^7,8, Manus J. Donahue^4,9, and Rachelle L. Crescenzi^2,3
1Vanderbilt University School of Medicine, Nashville, TN, United States, ²Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, ³Biomedical Engineering, Vanderbilt University, Nashville, TN, United States, ⁴Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States, ⁵Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United States, ⁶Vanderbilt Translational and Clinical Cardiovascular Research Center, Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville, TN, United States, ⁷Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, United States, ⁸Dayani Center for Health and Wellness, Vanderbilt University Medical Center, Nashville, TN, United States, ⁹Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, United States

Keywords: MSK, Screening, Translational Studies

Lipedema is an underdiagnosed connective tissue disorder characterized by disproportionate subcutaneous adipose tissue (SAT) accumulation in the lower extremities. Lipedema is frequently misdiagnosed as obesity and objective diagnostic tools are lacking for lipedema. Patients with lipedema (n=22) and BMI-matched controls (n=7) underwent lower extremity MRI and ultrasound evaluations of SAT as potential diagnostic modalities.  MRI and ultrasound measurement of SAT thickness yielded good concordance between modalities (Pearson’s r=0.95, reproducibility coefficient=3.3 mm), and demonstrated similar moderate effect sizes (Cohen’s d>0.5) for discriminating lipedema from controls. MRI and ultrasound are promising screening modalities for lipedema.

Qiang Zhao¹, Jiajia Xu¹, Yu Xin Yang², Yuqing Zhao¹, Qizheng Wang¹, Yongming Dai³, and Huishu Yuan^1
1Peking University Third Hospital, Beijing, China, ²United Imaging Research Institute of Intelligent Imaging, Beijing, China, ³Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Joints, Joints, Machine Learning/Artificial Intelligence

A deep learning-based compressed sensing (ACS) technology was recently introduced for an integrative MR acceleration solution. This study assessed the effectiveness of using ACS to evaluate ankle injuries. The ACS acceleration technique allows faster imaging than conventional acceleration methods, providing adequate image quality and diagnosis performance.

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Michael Pridmore^1,2, Emily Shardelow³, Shannon L. Taylor^1,2,4, Adam Behroozian⁵, Manus J. Donahue^6,7, Alex Sullivan³, Joshua A. Beckman⁸, and Rachelle Crescenzi^1,2,4
1Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN, United States, ²Radiology & Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, ³Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, United States, ⁴Biomedical Engineering, Vanderbilt University, Nashville, TN, United States, ⁵Cardiovascular Medicine, Scripps Memorial Hospital La Jolla, San Diego, CA, United States, ⁶Neurology, Vanderbilt University Medical Center, Nashville, TN, United States, ⁷Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States, ⁸Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States

Keywords: MSK, Atherosclerosis, Multi-Nuclear, Peripheral Disease

Peripheral artery disease (PAD) is an atherosclerotic occlusive disease that reduces lower-limb perfusion, causes ambulatory dysfunction, and leg pain. Sodium imaging (²³Na-MRI) may reveal areas of increased tissue sodium deposition related to the mechanisms of PAD dysfunction. We found that patients with PAD showed increased tissue sodium content in skin, subcutaneous adipose tissue (SAT), and inter-muscular adipose tissue (IMAT) compared to controls. Participants with PAD had lower SAT volume and fat content, arguing against a positive relationship between fat as the mediator of increased tissue sodium. ²³Na-MRI may inform PAD mechanisms and is being investigated in response to PAD therapies.

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Jingyu Jiang¹, Weiyin Vivian Liu², Wen Chen³, Ling Sang³, Huizheng Wang³, Xingyao Yu¹, and Lin Xu^3
1Biomedical Engineering College, Hubei University of Medicine, Shiyan Hubei, China, ²GE Healthcare,, Beijing, China, ³Taihe Hospital, Hubei University of Medicine,, Shiyan Hubei, China

Keywords: Tendon/Ligament, Aging, synthetic

Magnetic resonance imaging is the gold standard for evaluation of rotator cuff injury in non-invasive examination. And 90% occur in supraspinatus tendons. In this study, synthetic MRI (SyMRI) generated both structural and functional images to qualitatively and quantitatively evaluate supraspinatus tendon injury using zero-echo magnetic resonance imaging (ZTE-MRI) as structural reference images. Despite superior quality and inter-reader agreement on critical shoulder angle measurements of ZTE-MRI to SyMRI-generated T1WI, SyMRI showed excellent intra-modality agreement of acromion index and CSA to ZTE-MRI and also provided quantitative information for better identifying injured sites at the early stage of rotator cuff injury.

Huan Da Wei¹, Yuan Zhao Feng¹, Dou Wei Qiang², Wen Qing Qing², Liu Shao Wei¹, Lu Chao¹, Zhang Chao¹, Xia Tian Wei¹, and Shen Ji Rong^1
1Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Nanjing, China, ²MR Research China, GE Healthcare, Beijing, China

Keywords: Joints, DSC & DCE Perfusion

Osteonecrosis of femoral head (ONFH) occurs due to a defect in the blood supply to the femoral head. In this study, Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) was applied to ONFH patients in different stages to explore the perfusion changes in the progression of the severity of ONFH. It was found that perfusion in the   necrotic area was persistently reduced, while in the repair reaction areas, perfusion was progressively enhanced. DCE-MRI can sensitively detect the perfusion changes of ONFH and potentially could predict ONFH development.

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James R Peters¹, Sibaji Gaj¹, Nancy Obuchowski¹, Carl Winalski¹, Naveen Subhas¹, Valentina Pedoia², Sharmila Majumdar², Hollis Potter³, Matthew F Koff³, Kimberly K Amrami⁴, Cale Jacobs⁵, and Xiaojuan Li^1
1Cleveland Clinic, Cleveland, OH, United States, ²University of California, San Francisco, San Francisco, CA, United States, ³Hospital for Special Surgery, New York, NY, United States, ⁴Mayo Clinic, Rochester, MN, United States, ⁵University of Kentucky, Lexington, KY, United States

Keywords: Osteoarthritis, Joints

Acute knee joint injury often leads to the development of post-traumatic osteoarthritis (PTOA); however, the factors which may indicate PTOA progression are not well understood. Bone shape changes have been suggested as potential predictors for OA development. This study investigates longitudinal changes in patella bone shape in subjects who underwent ACL reconstruction. Subject’s patellae were segmented using machine learning methods and a statistical shape model was used to quantify patella bone shape. Data analysis showed longitudinal changes in patella shape between contralateral and ipsilateral sides, between subjects with allografts and autografts, and associations with age, sex, and BMI.

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Carly Lockard^1,2, Bruce Damon^1,2, and Hacene Serrai ^1,2
1Stephens Family Clinical Research Institute, Carle Clinical Imaging Research Program, Carle Health, Urbana, IL, United States, ²Carle Illinois Advanced Imaging Center, Urbana, IL, United States

Keywords: MSK, High-Field MRI, zero echo time; ultrashort echo time; UTE; ZTE

Ultrashort echo-time MRI allow signal acquisition from tissues with ultrashort (<1 ms) T2*. We evaluated repeatability, SNR, acquisition time, and potential for T2* mapping using a modified PETRA sequence at 7T. Signal values were repeatable, and subtraction imaging was both feasible and consistent with those previously reported.  T2* mapping had lower repeatability and may require improved modeling of TE-dependent k-space filling strategy effects. Short- and long-TE PETRA imaging was feasible at 7T in a phantom and ex vivo specimen. These initial results will serve as guidance for further optimization/potential applications.

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Yanping Xue¹, Li Wang¹, Hua Gu¹, Jiyang Zhang¹, Chen Zhang², Xiuqin Jia¹, and Qi Yang^1
1Radiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, ²MR Scientific Marketing, Siemens Healthineers, Beijing, China

Keywords: MSK, Joints

MRI has been widely used in the early detection of osteoarthritis (OA), especially in knee, as an important technique. However, the long acquisition time of MRI is a barrier in improving the quality of imaging and the comfort of patients, especially for pediatric and disabled people.  Many imaging acceleration factors have been implied in order to improve the condition.  This study focuses on the clinical application of simultaneous multi-slice (SMS) imaging, a newly developed acceleration technique using multi-band RF pulses, which can simultaneously excite, acquire, and reconstruct multiple slices and readout with two-dimensional images.

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Dominik Vilimek¹, Radana Kahankova¹, Radek Martinek¹, Martin Kryl¹, Veronika Janacova², Milos Golian^3,4, Jaroslav Uchytil³, Pavla Hanzlikova^5,6, Pavol Szomolanyi^2,7, Siegfried Trattnig^2,8,9,10, and Vladimir Juras^2
1Department of Cybernetics and Biomedical Engineering, VSB Technical University of Ostrava, Ostrava, Czech Republic, ²Department of Biomedical Imaging and Image-guided Therapy, High Field MR Centre, Medical University of Vienna, Vienna, Austria, ³Department of Human Movement Studies, Human Motion Diagnostic Center, University of Ostrava, Ostrava, Czech Republic, ⁴Department of Radiology, Vitkovice Hospital, Ostrava, Czech Republic, ⁵Department of Imaging Methods, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic, ⁶Department of Radiology, University Hospital Ostrava, Ostrava, Czech Republic, ⁷Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia, ⁸CD Laboratory fo MR Imaging Biomarkers (BIOMAK), Vienna, Austria, ⁹Austrian Cluster for Tissue Regeneration, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna, Austria, ¹⁰Institute for Clinical Molecular MRI in the Musculoskeletal System, Karl Landsteiner Society, Vienna, Austria

Keywords: Tendon/Ligament, Machine Learning/Artificial Intelligence

Changes in the Achilles tendon composition are associated with an increased risk of tendinopathy which is common in middle-aged overweight patients and is one of the most common sports injuries. However, measuring and quantifying such properties is a challenging task. The purpose of this paper is to introduce an end-to-end pipeline for segmenting Achilles tendon using deep convolutional neural networks and automatic segmentation into three segments. Our model shows promising results outperforming state-of-the-art approaches (Dice 90.6% and Jaccard 84.0%). This is one of the key steps for short and long T2* value analysis from 1.5T data.

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Saeed Jerban^1,2,3, Amir Masoud Afsahi ¹, Sophia Dwek¹, Jiyo Athertya¹, Bhavsimran Malhi¹, Dina Moazamian¹, Yajun Ma^1,2, Sam Sedaghat¹, Hyungseok Jang^1,2, Gina Woods⁴, Christine B Chung^1,2, Jiang Du^1,2, and Eric Y Chang^1,2
1Department of Radiology, University of California, San Diego, La Jolla, CA, USA, San Diego, CA, United States, ²Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, La Jolla, CA, USA, San Diego, CA, United States, ³Department of Orthopedic Surgery, University of California, San Diego, La Jolla, CA, USA, San Diego, CA, United States, ⁴Department of Medicine, University of California, San Diego, La Jolla, CA, USA, San Diego, CA, United States

Keywords: Tendon/Ligament, Tendon/Ligament

Tendon and bone comprise a special interacting unit. Bone loss in osteoporosis (OPo) may associate with a reduction in tendon quality that needs to be investigated. We investigated the tendon quality differences between OPo patients, osteopenia (OPe) patients, and healthy volunteers with normal bone (Normal) using the Frac-LongT2 index, a  rapid measure performed by dual-echo ultrashort echo time (UTE) MRI. The estimated Frac-LongT2 in the anterior and posterior tibialis tendon (ATT and PTT) were significantly higher in the OPo group compared with the Normal group. This study highlights the potential of this rapid UTE-based technique for in vivo tendon assessment.

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Jill M Slade¹, Nkhensani Mogale², Daniel Schanz¹, Viktor Ilyasov¹, Justin Scott³, Albert van Schoor², and Tamara R Bush^3
1Radiology, Michigan State University, East Lansing, MI, United States, ²University of Pretoria, Pretoria, South Africa, ³Mechanical Engineering, Michigan State Univerisity, East Lansing, MI, United States

Keywords: MSK, Muscle

MRI is well suited to quantify soft tissue but challenges remain in using MRI to address soft tissue in a seated position and for studying how tissue responds to loading. IDEAL and T1 weighted images were used to quantify apparent fat fraction and soft tissue thicknesses of the buttocks in a side lying position with the tissue unloaded and loaded. Tissue compression during loading predominantly reflected changes in the muscle and tendon. Intramuscular fat was not related to the change in muscle/tendon. These methods may be useful to study soft tissue in populations at risk for pressure ulcer development.

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Noel Naughton¹, Amir Ostadi Moghaddam¹, Mariana Kersh^1,2,3, Samni Koyejo⁴, Shreyan Majumdar¹, Amy Wagoner Johnson^1,2,3,5, and Bruce Damon^1,6
1Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States, ²Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, United States, ³Biomedical and Translational Sciences, Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, United States, ⁴Computer Science Department, Stanford University, Palo Alto, CA, United States, ⁵Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, United States, ⁶Carle Clinical Imaging Research Program, Stephens Family Clinical Research Institute, Carle Health, Urbana, IL, United States

Keywords: Tendon/Ligament, Diffusion Tensor Imaging

To guide development and optimization of dMRI protocols, here we present a numerical simulation framework for analyzing how changes in collagen microstructure influence the measured diffusion tensor. We experimentally characterize a porcine digital flexor tendon using second harmonic generation (SHG) microscopy to identify characteristic geometric parameters and use these parameter ranges to perform a sensitivity analysis of what microstructural features most influence diffusion tensor imaging (DTI) metrics. We conclude by exploring how geometric changes in collagen crimping due to tissue strain influence DTI metrics.

Ni Yabo¹, Tian Zhaorong¹, and Wang zhijun^1
1Ningxia Medical University General Hospital Radiology department, Yinchuan, China

Keywords: Multimodal, Tendon/Ligament

In this work,we found that the image quality of shoulder synthetic MRI sequence is not comparable to that of conventional image quality, and the scanning time is long, but once scanning can generate multiple sets of quantitative images, T2 mapping of synthetic sequence can provide a new quantitative method for the diagnosis and differential diagnosis of supraspinatus tendon related diseases.

Limei Han^1,2, Jie Yang¹, Zhiqiang Ming¹, Hao Feng¹, Yantao Huang¹, Hengping Wu¹, Chao Yuan¹, Huan Guo¹, Meining Chen³, and Jianquan Zhong^1
1Department of Radiology, Zigong First People's Hospital, Zigong, China, ²North Sichuan Medical College, Nanchong, China, ³MR Scientific Marketing, SIEMENS Healthineers Ltd., Shanghai, China

Keywords: Screening, Degenerative, lumbar disc herniation, annular tear, bone marrow fat

Recently T1 mapping, T2* mapping and bone marrow fat fraction (BMFF) has been separately applied to spine. But it hasn't studied the value of those mappings together with intervertebral discs (IVD) degeneration. In this study, we obtained three values (T1, T2* and BMFF value) by simultaneous multi-relaxation-time imaging technique, called TXI. We found that T1 values in abnormal (herniation or annular tear) disc were significantly lower than those in the normal. This study demonstrates that T1 mapping can be helpful in detecting IVD with herniation or annular tear.

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Ashley A. Williams¹, Gordhan B. Mahtani¹, Jade R He¹, Adam L. C. Wadsworth¹, and Constance R. Chu^1
1Orthopaedic Surgery, Stanford University, Stanford, CA, United States

Keywords: Cartilage, Relaxometry, Repeatability, UTE-T2*

This work examines the combined acquisition and segmentation repeatability of Cones UTE-T2* measures in tread mark cartilage regions and in small 2-D cartilage and meniscus ROIs in the knees of uninjured participants. Both intra- and inter-day repeatability assessments showed excellent average CVs of less than 10%  in all tread mark ROIs and in all but 2 small 2-D ROIs segmented from only a single slice. ICC estimates were good to excellent (0.79–0.98) in all tread mark ROIs and ranged from moderate to excellent (0.54-0.98) in small 2-D ROIs corresponding to absolute precision errors of less than 1ms in most cases.

Zheng Sun¹, Shan Huang², Xiance Zhao², Weibo Chen², Queenie Chan³, Yajing Zhang⁴, Johannes M. Peeters⁵, and Yuehua Li^1
1Shanghai Sixth People's Hospital, Shanghai, China, ²Philips Healthcare, Shanghai, China, ³Philips Healthcare, Hong Kong, China, ⁴Philips Health Technology, Suzhou, China, ⁵Philips Healthcare, Best, Netherlands

Keywords: Skeletal, Bone

The integration of compressed-SENSE and artificial intelligence allows to acquire high-resolution images within relatively short scan times The purpose of this study is to compare the image quality of the musculoskeletal images reconstructed with Compressed -SENSE (CS), CS with integrated artificial intelligence (CS-AI) and CS-AI combined with superresolution(CS-AI-HR) . We found that the image quality was significantly improved by using CS-AI-HR compared to CS. This study provides supportive information for the application of CS-AI-HR in routine clinical practice.