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Kaitlin G Sofko¹, Ibukunoluwa Elebute¹, Lumeng Cui², Marianne S Black³, Natasha M Bzowey¹, and Emily J McWalter^4
1Department of Mechanical Engineering, University of Saskatchewan, Saskatoon, SK, Canada, ²Siemens Healthcare Limited, Burnaby, BC, Canada, ³Department of Mechanical Engineering, University of Victoria, Victoria, BC, Canada, ⁴Department of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK, Canada

Keywords: Cartilage, Cartilage

T2 relaxation time mapping of articular cartilage is most often assessed in relaxed knees; however, it’s primary function is resisting and distributing forces. Further, most work has focused on regional analysis rather than local changes. The aim of this work was to assess the repeatability of T2 relaxation time in the loaded knees of five healthy participants using both regional and local (cluster-based) approaches. We show that regional and local assessments are sufficiently repeatable for in vivo studies.

Miaomiao Cheng¹, Hua Zhang¹, Jixian Li¹, Zhiyan Xie¹, Jiufa Cui¹, and Xuejun Liu^1
1The Affiliated Hospital of Qingdao University, Qing Dao, China

Keywords: Bone, Diffusion/other diffusion imaging techniques, diagnostic value

This study aimed to investigate the diagnostic value of IVIM-DWI and DCE-MRI in differentiating benign and malignant musculoskeletal tumors. IVIM parameters (FP, D, and DP) were statistically compared with ADC and DCE-MRI (Ktrans, Kep, Ve, and iAUC) within two groups. D, Ktrans and Kep have good diagnostic performance in identification of benign and malignant musculoskeletal tumors, DCE-MRI and IVIM have similar diagnostic efficacy, and combining these two methods can further improve the diagnostic performance. IVIM-DWI may be an alternative to DCE-MRI in patients with contrast contraindications.

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Brandon Clinton Jones^1,2, Felix Werner Wehrli¹, Nada Kamona^1,2, Brian-Tinh Duc Vu^1,2, Hyunyeol Lee^1,3, Hee Kwon Song¹, Mona al Mukaddam⁴, Peter J Snyder⁴, Trevor Chan¹, Walter RT Witschey¹, Matthew MacLean¹, Nicholas J Josselyn^1,5, Srikant Kamesh Iyer¹, and Chamith Sudesh Rajapakse^1
1Radiology, University of Pennsylvania, Philadelphia, PA, United States, ²Bioengineering, University of Pennsylvania, Philadelphia, PA, United States, ³School of Electronics, Kyungpook National University, Daegu, Korea, Republic of, ⁴Endocrinology, University of Pennsylvania, Philadelphia, PA, United States, ⁵Data Science, Worcester Polytechnic Institute, Worcester, MA, United States

Keywords: Bone, Aging, Osteoporosis, Porosity, ultrashort echo time

While ultrashort echo time (UTE) measures of pore water have shown promise in assessing cortical bone porosity, most are hindered by the need for complicated processing and reference samples. The suppression ratio (SR) is a marker of porosity which is simply calculated as the voxel-wise ratio of two UTE magnitude images, one without and with long-T₂ suppression. Automated cortical bone segmentation via deep learning showed elevated SR in postmenopausal women with osteoporosis (P=0.001) and was strongly associated with pore water density (R=0.93) and with pQCT BMD (R=-0.88). Results suggest that SR can detect elevated porosity in postmenopausal osteoporosis.

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Hector Lise de Moura¹, Richard Kijowski¹, Azadeh Sharafi², Marcelo Zibetti¹, and Ravinder Regatte^1
1Center for Biomedical Imaging, NYU Langone Health, New York City, NY, United States, ²Medical College of Wisconsin, Wauwatosa, WI, United States

Keywords: Tendon/Ligament, Osteoarthritis

This study was performed to investigate gender-related and age-related differences in ultra-short echo-time (UTE) T_1ρ parameters in the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and patellar tendon (PT).  A pointwise encoding time reduction with radial acquisition (PETRA) sequence was used to measure single-component and multi-component PETRA-T_1ρ parameters in the ACL, PCL, and PT at 3.0T in 18 healthy volunteers. There were significant correlations between age and single-component and multi-component PETRA-T_1p parameters in the ACL and PCL but not the PT. There were no significant differences in PETRA-T_1ρ parameters in the ACL, PCL, or PT between males and females.

Liu Suwei^1
1Second Hospital of Lanzhou University, Lanzhou, China

Keywords: Skeletal, Skeletal

Our study aimed to develop and validate one or more clinically relevant radiomic nomograms based on multisequence MRI radiomic features to predict the pre-treatment HRC status of patients with MM. We developed radiomic nomograms for 14 models at a single center using clinically obtained whole-spine MRI images of 159 patients with MM. This study revealed that radiomic features of pre-treatment MRI images are associated with HRC status in patients with MM. Among the proposed models, the nomograms of the FT2, FT2+1, and FT2+2+1 models were identified as outstanding at distinguishing patients with HRC from those with non-HRC status.

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Franklyn A Howe¹, Soraya Khoushesh², Anna Blundell², Christine Heron³, Vivienne Ejindu³, Abiola Harrison⁴, and Nidhi Sofat^2,5
1Molecular and Clinical Sciences, St George's, University of London, London, United Kingdom, ²Infection & Immunity, St George's, University of London, London, United Kingdom, ³Radiology, St George's University Hospital Foundation Trust, London, United Kingdom, ⁴Infection & Immunity, St George's University Hospital Foundation Trust, London, United Kingdom, ⁵Rheumatology, St George's University Hospital Foundation Trust, London, United Kingdom

Keywords: Osteoarthritis, Degenerative, Pain

We investigated how pain in knee osteoarthritis (OA) relates to physical damage, clinical parameters, pain sensitisation and serum levels of thrombosponin-4 (TSP4). Across all patients (mild and advanced OA), the number of osteophytes (nOst) and TSP4 levels are significant factors in determining pain levels, with BMI and HADS the strongest factors. Grouping the patients according to low and high TSP4 levels, suggests a TSP4 phenotype that relates to central sensitisation. For high TSP4, pain pressure thresholds are a significant factor in reported knee pain in addition to HADS, BMI and physical damage.

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Valentina Mazzoli¹, Marco Barbieri¹, Yael Vainberg¹, Michelle Li ¹, Matthew Middione¹, Daniel B Ennis¹, Feliks Kogan¹, and Garry E Gold^1
1Department of Radiology, Stanford University, Stanford, CA, United States

Keywords: Muscle, Diffusion/other diffusion imaging techniques

Assessment of microcirculation is extremely important in skeletal muscle aging reasearch. While IVIM can provide extremely valuable information on perfusion, this is usually dominated by flow in larger vessel, resulting in limited sensitivity to microcirculation. In this study we propose the use of flow and non-flow-compensated diffusion encoding waveforms for IVIM of skeletal muscle. Using this approach we show diffrences in IVIM parameters between younger and older adults, and show correlation between the difference in IVIM parameters and age

Jin Liu¹ and Ya-Jun Ma^1
1Department of Radiology, University of California San Diego, San Diego, CA, United States

Keywords: Bone, Skeletal

The bone collagen matrix makes a crucial contribution to the mechanical properties of bone including elasticity and tensile strength. Its changes can be accessed by the ultrashort echo time magnetization transfer (UTE-MT) technique. This study aims to investigate the feasibility of the UTE-MT ratio (UTE-MTR) in the assessment of lumbar osteoporosis (OP). Our results demonstrated that the UTE-MTR is highly correlated with bone mineral density and Fracture Risk Assessment Tool scores and has a high ability to distinguish people with different bone masses, which indicates that the UTE-MTR has great potential in the diagnosis of the patient with OP.

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Ashley A. Williams¹, Jessica L Asay², Daniella Asare¹, Arjun D. Desai², Gordhan B. Mahtani¹, Jade He¹, Adam L. C. Wadsworth¹, Sachi Bansal¹, Garry E. Gold², Brian Hargreaves², Akshay Chaudhari², and Constance R. Chu^1
1Orthopaedic Surgery, Stanford University, Stanford, CA, United States, ²Department of Radiology, Stanford University, Stanford, CA, United States

Keywords: Cartilage, Relaxometry, Repeatability, T2, qDESS

Intra- and inter-day repeatabilities of qDESS T2 in  knee cartilage, assessed by fully-automatic segmentation using a deep-learning, open-source framework for musculoskeletal MRI analysis (DOSMA) and also by manual segmentation of tread mark regions of known tibiofemoral contact areas, were assessed and compared in 10 uninjured participants. qDESS T2 RMSA-CVs were less than 6% for all ROIs examined and showed good to excellent ICCs for the majority of ROIs assessed. A preliminary sensitivity analysis found that both segmentation schemes detected significant T2 changes over time in lateral tibial cartilage while only DOSMA segmentation detected T2 change to medial tibial cartilage.

Cui Ren¹, Qing Li², Qiao Zhu¹, Sommer Stefan^3,4,5, and Huishu Yuan^1
1Peking University Third Hospital, Beijing, China, ²MR Collaborations, Siemens Healthineers Ltd, Shanghai, China, ³Siemens Healthineers International AG, Zurich, Switzerland, ⁴Swiss Center for Musculoskeletal Imaging (SCMI), Zurich, Switzerland, ⁵Advanced Clinical Imaging Technology (ACIT), Zurich, Switzerland

Keywords: Joints, Cartilage, sacroiliac joint

To assess the diagnostic performance of three-dimensional ultrashort echo time sequence (3D-UTE) in bone erosion detection of the sacroiliac joint (SIJ) in patients with ankylosing spondylitis (AS) and to test whether SIJ cartilage T2 * values might help in identification of patients with AS.

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Francesco Santini^1,2, Xeni Deligianni^1,2, Matteo Paoletti³, Sabrina Ravaglia³, Arianna Faggioli³, Ning Jin⁴, and Anna Pichiecchio^3,5
1Basel Muscle MRI, Department of Biomedical Engineering, University of Basel, Basel, Switzerland, ²Research Coordination Team, Department of Radiology, University Hospital Basel, Basel, Switzerland, ³Advanced Imaging and Radiomics Center, IRCCS Mondino Foundation, Pavia, Italy, ⁴Cardiovascular MR R&D, Siemens Medical Solutions USA, Inc., Cleveland, OH, United States, ⁵Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy

Keywords: Muscle, Rare disease, Dynamic MRI, Muscle Function

Accelerated three-dimensional. three-directional dynamic acquisition of muscle contraction during electrical muscle stimulation was applied on a cohort of 10 patients with metabolic diseases affecting the muscles and 14 healthy controls. Maximum strain and contraction rates were calculated on the three muscles of the triceps surae.

The strain and the buildup rate (rate to reach maximum strain) showed a clear trend for the differentiation of patients and volunteers, especially in the Soleus muscle.

In conclusion, dynamic muscle MRI during electrical stimulation is a promising marker for muscle health in muscular diseases.

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Benjamin Marty¹, Pierre-Yves Baudin¹, Aurélie Canal², Jean-Yves Hogrel², Melinda Gyenge³, Nuria Jebrouni³, Teresa Gerhalter⁴, Armin M Nagel⁴, Harmen Reyngoudt¹, and Guillaume Bassez^3
1NMR Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France, ²Neuromuscular Physiology and Evaluation Laboratory, Neuromuscular Investigation Center, Institute of Myology, Paris, France, ³Institute of Myology, Paris, France, ⁴Institute of Radiology, University Hospital Erlangen, FAU, Erlangen, Germany

Keywords: Muscle, Tissue Characterization

Myotonic dystrophy type 1 (DM1) is a neuromuscular disorder resulting in progressive muscle wasting and dysfunction. We aimed at determining the relationship between several ¹H and ²³Na MRI indices of disease severity and disease activity in the muscles of DM1 patients, and evaluating their response to a 12-month metformin treatment. We showed that these indices could differentiate DM1 patients from healthy controls. Variables related to disease severity correlated with functional tests and indices related to disease activity were increased and mutually correlated. Over the 12-months treatment interval, MRI variables were more sensitive than functional outcomes to detect disease progression.

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Kristian Stefanov¹, Flavia Sunzini¹, Salim Al-Wasity¹, Steven Harte², Richard Harris³, Daniel J. Clauw², Gordon Waiter⁴, Jonathan Cavanagh¹, and Neil Basu^1
1School of Infection & Immunity, University of Glasgow, Glasgow, United Kingdom, ²Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, United States, ³University of Michigan, Ann Arbor, MI, United States, ⁴Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United Kingdom

Keywords: Rheumatoid Arthritis, Brain Connectivity, Brain, fMRI (Resting State), Inflammation, Multimodal

Patients with the musculoskeletal disorder psoriatic arthritis improve their inflammation with current treatments but still experience pain. Previous neuroimaging findings have identified functional connectivity of the resting-state default mode network and we explored how such features associate with nociplastic pain using both agonistic and selective approaches. We observed increased connectivity between the default mode network and regions of the brain related to both increased pain intensity and decreased pain inhibition. The implications of such findings shift the focus onto targeting central pain pathways in people with psoriatic arthritis. 

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Clare Nimura¹, Darryl Sneag¹, Philip Colucci¹, Casey Urban², Tim Li³, Emily Pedrick¹, Joseph Feinberg⁴, Carlo Milani⁴, and Ek Tsoon Tan^1
1Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, United States, ²Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY, United States, ³Weill Cornell Medical College, New York, NY, United States, ⁴Department of Physiatry, Hospital for Special Surgery, New York, NY, United States

Keywords: Neurography, Nerves, Parsonage-Turner syndrome; electromyography

A retrospective analysis of 123 patients diagnosed with Parsonage-Turner Syndrome (PTS; neuralgic amyotrophy) found that magnetic resonance neurography (MRN)-based detection of hourglass-like constrictions (HGCs) in affected nerves was 91.2-92.0% sensitive to electromyography-confirmed PTS. Post-hoc inter-rater reliability analysis revealed an inter-reliability of 91.3-94.3% for detection of HGCs. This retrospective study confirmed that MRN detection of HGCs is sensitive and reliable for diagnosing PTS and may be used as an objective diagnostic tool for the syndrome.

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Susanne S. Rauh¹, Joep Suskens², Jithsa R. Monte³, Frank Smithuis³, Oliver J. Gurney-Champion³, Johannes L. Tol², Mario Maas³, Aart J. Nederveen³, Gustav J. Strijkers¹, and Melissa T. Hooijmans^3
1Department of Biomedical Engineering and Physics, Amsterdam Movement Sciences, Amsterdam UMC, location AMC, Amsterdam, Netherlands, ²Department of Orthopedic Surgery, Amsterdam UMC, location AMC, Amsterdam, Netherlands, ³Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, Netherlands

Keywords: Muscle, Diffusion Tensor Imaging

Diffusion tensor imaging (DTI) with correction for intravoxel incoherent motion (IVIM) is a potential biomarker to assess hamstring injury recovery and predict return-to-play time. However, the long acquisition times hinder the use in clinical practice. By accelerating in the b-value space and using multiband acceleration the scan time can be reduced to clinically acceptable levels. In this work we showed that those methods preserve the sensitivity to hamstring injuries and that high-b DTI in combination with multiband factor 2 can reduce the scan time to 3:40min.

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Kevin Koch¹, Andrew S Nencka¹, Mohammad Zarenia², and Rajeev Mannem^1
1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States, ²Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, United States

Keywords: Joints, Joints

We present the construction and analysis of dynamic carpal data elements derived from 4D-MRI of the moving wrist.    Across a clinically asymptomatic cohort of 31 subjects, dynamic data elements were constructed from capitate-normalized profiles of the scaphoid and lunate bones in a subject-specific radius-based coordinate system.   Along with computing stability estimates of these measures, they are utilized to perform preliminary logistic regression modeling of radiologically-identified asymptomatic abnormalities within the study cohort.   The results of this analysis suggests that the derived data elements have promising capabilities for characterizing carpal pathology and abnormalities.  

Nick Zafeiropoulos¹, Uros Klickovic¹, Luca Zampedri¹, Stephen Wastling¹, Jasper Morrow¹, Tarek Yousry¹, Michael Hanna¹, Linda Greensmith¹, Pietro Fratta¹, and John Thornton^1
1Queen Square Institute of Neurology, University College London, London, United Kingdom

Keywords: Muscle, Quantitative Imaging

Using optimised maximum-likelihood-estimation extended-phase-graph-model relaxometry in ALS patients, elevated muscle water T₂ (T_2m) were revealed for all calf muscles and most thigh muscles vs. controls, with evidence of sparing of particular muscles. Similar but les consistent increases were seen in the associated fat fraction (ff_a, relaxometry estimated). T_2m correlated significantly with both functional rating scores and myometry, most consistently at the calf level. Associated ff_a changes and correlations were less significant.

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Rupsa Bhattacharjee¹, Eric C. Hammond², Koren E. Roach¹, Emma Bahroos¹, Richard B. Souza^1,2, Sharmila Majumdar¹, and Valentina Pedoia^1
1Department of Radiology and Biomedical Imaging, University of California, San Francisco (UCSF), San Francisco, CA, United States, ²Department of Physical Therapy and Rehabilitation Science, University of California, San Francisco (UCSF), San Francisco, CA, United States

Keywords: Bone, PET/MR, SUV, T1rho, flexion strength, extension strength, patellofemoral OA, Cartilage-Bone-CrossTalk

In this exploratory study, we investigated standardized-uptake-values(SUV) from simultaneous bilateral PET-MRI, and individual joint loading in knees cross-sectionally in patients with isolated PFJOA. Additionally, to discover regions of colocalized changes in bone-cartilage interactions, we explored SUV interactions with cartilage biomarker T1rho relaxation values from high-resolution bilateral axial MAPSS. Strong negative correlations were between knee normalized isometric strength vs. maximum SUV in the lateral patella and medial trochlea, suggest higher degree of ongoing bone-remodelling combined with decreased knee flexion and extention strength. The existance of parallel higher trochlear bone remodelling and cartilage loss (disease progression) or vice-versa was also noted. 

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Alison R Roth¹, Ashley J Minks¹, Yongsheng Chen², Jun Li³, and Richard D Dortch^1
1Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, AZ, United States, ²Department of Neurology, Wayne State University School of Medicine, Detroit, MI, United States, ³Department of Neurology, Houston Methodist Hospital, Houston, TX, United States

Keywords: Muscle, CEST & MT

Magnetization transfer ratio (MTR) and volume of thigh muscles were investigated as imaging biomarkers in Charcot-Marie-Tooth type 1A (CMT1A) and hereditary neuropathy with liability to pressure palsy (HNPP) patients. MTR was significantly different between HNPP and healthy control subjects; muscle volume was significantly different between CMT1A patients and healthy control subjects and HNPP patients. MTR and volume were found to be repeatable and reliable.

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Rianne A van der Heijden¹, Robert Moskwa², Fang Liu³, John Wilson⁴, Bryan Heiderscheit⁴, Scott J Hetzel⁵, Zachary E Stewart³, Kenneth Lee¹, and Richard Kijowski^6
1Department of Radiology, University of Wisconsin-Madison, Madison, WI, United States, ²Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, United States, ³Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States, ⁴Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, United States, ⁵Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, United States, ⁶Department of Radiology, New York University Grossman School of Medicine, New York, NY, United States

Keywords: Tendon/Ligament, Quantitative Imaging, UTE

This study was performed to investigate the association between bi-component UTE-T2* parameter of the patellar tendon and clinical pain scores over time in a randomized control trial for patellar tendinopathy (PT).  The fraction of the fast-relaxing macromolecular bound water (F_F) of the proximal patellar tendon and VAS pain scores were assessed at 0, 16 and 52-weeks in 29 patients with PT randomized into three treatment groups. All treatment groups showed a significant improvement (p<0.05) in pain and a significant increase (p<0.05) in F_F over time, with a significant inverse correlation (p<0.05) between the increase in F_F and decreased pain.