Sodium MRI of the Hip

髋关节钠 MRI

• 批准号: 8897271
• 负责人: Guillaume MADELIN
• 金额: $ 8.48万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2017-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8897271
• 关键词: Affect; American; Arthritis; Biochemical; Biochemical Markers; Cartilage; Chemicals; Chronic; Clinical; Coiled Bodies; Collagen Fiber; Complement; Concentration measurement; Cone; Data; Degenerative Disorder; Degenerative polyarthritis; Detection; Development; Diagnosis; Diagnostic Imaging; Diffusion; Diffusion Magnetic Resonance Imaging; Disadvantaged; Disease; Disease Progression; Early Diagnosis; Elderly; Etiology; Future; Gadolinium; Geometry; Glycosaminoglycans; Goals; Gold; Grant; Health; Heterogeneity; Hip Joint; Hip Osteoarthritis; Hip Pain; Hip region structure; Image; Imaging Techniques; Individual; Joints; Liquid substance; Magnetic Resonance Imaging; Maps; Measurement; Measures; Methods; Noise; Nuclear Magnetic Resonance; Pain management; Patients; Performance; Pharmaceutical Preparations; Physiologic pulse; Pilot Projects; Population; Prevalence; Protons; Publishing; Radial; Recovery; Relaxation; Replacement Arthroplasty; Research; Resolution; Risk; Scanning; Sensitivity and Specificity; Signal Transduction; Sodium; Sodium Channel; Speed; Synovial Fluid; Techniques; Time; Tissues; Water; articular cartilage; base; cartilage degradation; data acquisition; disability; follow-up; gadolinium oxide; healthy volunteer; high risk; imaging modality; improved; in vivo; magnetic field; novel; radiofrequency; reconstruction

DESCRIPTION (provided by applicant): Osteoarthritis (OA) is the most common form of arthritis in synovial joints and a leading cause of chronic disability, mainly in the elderly population. It currently affects 9% of the US population and is expected to affect 19% of Americans by 2030. OA is a degenerative disease of articular cartilage and is mainly characterized by a loss of glycosaminoglycans (GAG), change in size and organization of collagen fibers, and increased water content. There is no known cure for OA and present treatments focus mainly on pain management and ultimately, joint replacement. There are many obstacles to studying OA (heterogeneity in etiology, variability in progression of disease, long time periods required to see morphological joint changes), and consequently we currently lack the ability to predict the course of the disease. The limitation of identifying OA patients at riskfor progression and the lack of available non-invasive early biochemical markers have impeded the clinical development of potential disease modifying OA drugs (DMOAD). Specifically, hip osteoarthritis has a prevalence from 3 to 11% in Western population over 35 years old, and it is the main cause of hip pain in older adults. Quantitative sodium magnetic resonance imaging (MRI) is a non-invasive technique that is highly specific to the GAG content in cartilage that could be used to assess the degree of biochemical degradation of cartilage in OA. However, due to the low sodium concentration in vivo, its low sensitivity and fast relaxation, detecting the sodium signal in cartilage requires high fields (>3T), specific coils and specific 3D non-Cartesian sequences with ultrashort echo time. To the best of our knowledge, no study on sodium MRI of the hip was published to date. The recent acquisition of a dual-tuned body coil for imaging at 3T by our research team will allow us to acquire co-registered proton and sodium images of the hip within the same session. Quantitative sodium MRI could therefore provide a unique endogenous assessment of cartilage GAG content in clinically feasible scan times (20-25 min), and allow detection of OA in articular cartilage before morphological damage occurs and help assessing the effect of DMOAD treatments. The aims of this pilot study are: 1) to develop and optimize the acquisition and reconstruction of quantitative sodium MRI of the hip joint in vivo (to optimize the acquisition sequence parameters for minimizing the acquisition time, increasing the signal-to-noise ratio and spatial resolution, to measure relaxation times and B1 maps, and to optimize synovial fluid suppression) and, 2) to apply quantitative sodium MRI to subjects with and without hip OA (to assess repeatability, sensitivity, specificity of the method, with and without fluid suppression). This method could profoundly affect how we diagnose OA in the hip joint and may allow the identification of high risk individuals and also assess DMOAD treatment follow-ups. Successful completion of this pilot project would allow us to apply to a R01 grant for improving the speed of sodium data acquisition (using compressed sensing) and investigating the clinical value of quantitative sodium MRI for assessing different degrees of OA in comparison to other proton-based imaging techniques such as dGEMRIC, T1 mapping or diffusion imaging.

描述(申请人提供)：骨关节炎(OA)是滑膜关节中最常见的关节炎形式，也是慢性残疾的主要原因，主要发生在老年人群中。目前它影响了9%的美国人口，预计到2030年将影响19%的美国人。骨性关节炎是一种关节软骨退行性疾病，其主要特征是糖胺多聚糖(GAG)丢失，胶原纤维大小和组织结构改变，水分含量增加。目前还没有已知的治疗方法，目前的治疗主要集中在疼痛管理和最终的关节置换上。研究骨性关节炎有许多障碍(病因的异质性、疾病进展的可变性、需要很长的时间才能看到关节形态的变化)，因此，我们目前缺乏预测疾病进程的能力。识别有进展风险的骨性关节炎患者的局限性以及缺乏可用的非侵入性早期生化标记物，阻碍了潜在的疾病修饰骨性关节炎药物(DMOAD)的临床开发。具体地说，在35岁以上的西方人口中，髋关节骨性关节炎的患病率从3%到11%，是老年人髋关节疼痛的主要原因。定量钠磁共振成像(MRI)是一种非侵入性技术，对软骨中的GAG含量具有高度的特异性，可用于评估OA软骨的生化降解程度。但由于体内钠浓度低、灵敏度低、松弛快，检测 软骨中的钠信号需要高场(&gt；3T)、特定的线圈和特定的3D非笛卡尔 回波时间超短的序列。据我们所知，到目前为止还没有关于髋关节的钠核磁共振研究发表。我们的研究团队最近获得了一个用于3T成像的双调谐体线圈，这将使我们能够在同一时段内获得共同注册的髋部质子和钠图像。因此，定量钠磁共振成像可以在临床可行的扫描时间(20-25分钟)内提供独特的软骨GAG含量的内源性评估，并可以在形态损伤发生之前检测关节软骨中的骨关节炎，并帮助评估DMOAD治疗的效果。这项先导性研究的目的是：1)建立和优化髋关节内定量钠磁共振成像的获取和重建(优化 为了最大限度地缩短采集时间、提高信噪比和空间分辨率、测量松弛时间和B1图、优化关节液抑制)，以及2)对患有和不患有髋关节骨性关节炎的受试者进行定量钠磁共振成像(以评估该方法的重复性、敏感性和特异性，以及是否有液体抑制)。这种方法可以深刻地影响我们诊断髋关节骨性关节炎的方式，可以识别高危个体，也可以评估DMOAD治疗的后续情况。这一试点项目的成功完成将使我们能够申请R01拨款，以提高钠数据采集的速度(使用压缩传感)，并与其他基于质子的成像技术(如dGEMRIC、T1映射或扩散成像)相比较，研究定量钠磁共振成像在评估不同程度的骨性关节炎方面的临床价值。