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Review
. 2018 Apr 10;6(4):2325967118765448.
doi: 10.1177/2325967118765448. eCollection 2018 Apr.

Relationship Between Quantitative MRI Biomarkers and Patient-Reported Outcome Measures After Cartilage Repair Surgery: A Systematic Review

Drew A Lansdown  1 , Kevin Wang  2 , Eric Cotter  2 , Annabelle Davey  2 , Brian J Cole  2
Affiliations
Review

Relationship Between Quantitative MRI Biomarkers and Patient-Reported Outcome Measures After Cartilage Repair Surgery: A Systematic Review

Drew A Lansdown et al. Orthop J Sports Med. .

Abstract

Background: Treatment of articular cartilage injuries remains a clinical challenge, and the optimal tools to monitor and predict clinical outcomes are unclear. Quantitative magnetic resonance imaging (qMRI) allows for a noninvasive biochemical evaluation of cartilage and may offer advantages in monitoring outcomes after cartilage repair surgery.

Hypothesis: qMRI sequences will correlate with early pain and functional measures.

Study design: Systematic review; Level of evidence, 3.

Methods: A PubMed search was performed with the following search terms: knee AND (cartilage repair OR cartilage restoration OR cartilage surgery) AND (delayed gadolinium-enhanced MRI OR t1-rho OR T2 mapping OR dgemric OR sodium imaging OR quantitative imaging). Studies were included if correlation data were included on quantitative imaging results and patient outcome scores.

Results: Fourteen articles were included in the analysis. Eight studies showed a significant relationship between quantitative cartilage imaging and patient outcome scores, while 6 showed no relationship. T2 mapping was examined in 11 studies, delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in 4 studies, sodium imaging in 2 studies, glycosaminoglycan chemical exchange saturation transfer (gagCEST) in 1 study, and diffusion-weighted imaging in 1 study. Five studies on T2 mapping showed a correlation between T2 relaxation times and clinical outcome scores. Two dGEMRIC studies found a correlation between T1 relaxation times and clinical outcome scores.

Conclusion: Multiple studies on T2 mapping, dGEMRIC, and diffusion-weighted imaging showed significant correlations with patient-reported outcome measures after cartilage repair surgery, although other studies showed no significant relationship. qMRI sequences may offer a noninvasive method to monitor cartilage repair tissue in a clinically meaningful way, but further refinements in imaging protocols and clinical interpretation are necessary to improve utility.

Keywords: T2 mapping; cartilage repair surgery; dGEMRIC; quantitative magnetic resonance imaging.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: B.J.C. receives research support from Aesculap/B. Braun, Arthrex, Medipost, and the National Institutes of Health (NIAMS and NICDH); receives royalties from Arthrex, DJ Orthopaedics, Elsevier, Saunders-Mosby Elsevier, and SLACK Inc; is a paid consultant for Arthrex and Regentis; has stock/stock options in Carticept and Regentis; and receives fellowship educational support from Athletico, Ossur, Smith & Nephew, and Tornier. D.A.L. has received fellowship educational/research support from Arthrex and Smith & Nephew.

Figures

Figure 1.
Figure 1.
Flowchart demonstrating the systematic review process. MRI, magnetic resonance imaging.
See this image and copyright information in PMC

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