Sodium MRI for Assessment of Early OA.

描述（由申请人提供）：骨关节炎（OA）影响超过5000万美国人，并对美国经济和医疗保健系统产生重大影响。目前，没有治愈这种使人衰弱的疾病的方法，有效的治疗充其量是集中在症状缓解上。传统的MR技术已经显示出识别更微妙的形态学改变的希望，如软骨体积或表面纤维化所确定的。然而，即使是这些传统技术中更具创新性的技术，在预测膝关节OA进展方面也不一致。因此，对可靠、客观、非侵入性和定量成像标记物的需求很高，这些标记物可以在早期阶段识别风险人群。本提案的长期目标是开发、实施和表征用于超高场系统（7 T）上的体内膝关节应用的新型流体抑制-3D-23 Na-UTE技术。软骨的高分辨率、23 Na-（聚集蛋白聚糖）和1H-（形态学、胶原）成像，沿着改进的成像脉冲序列、图像重建和超高场系统（7 T）上的可视化方法将显著影响OA病理学的客观评估。具体而言，该提案将建立一种强大的非侵入性成像生物标志物，该生物标志物在临床上可用于对OA疾病严重程度进行分期，预测进展风险，并可能作为未来OA疾病修饰治疗的成像生物标志物。我们将以纵向方式获取年龄和性别匹配的OA受试者的高分辨率钠和质子MRI，以确定基线组合风险特征是否可以预测24个月期间严重膝关节OA进展的风险人群。最后，我们确定了骨关节炎受试者基线时联合钠和质子MRI（1H-形态学、T2标测和临床评分）结果在预测24个月内膝关节骨关节炎进展中的作用。一旦开发完成，并在人体膝关节中得到确认，那么钠方法将被转换到临床相关的3 T平台上。我们相信，这些研究不仅将深刻影响OA的早期诊断，而且可能在早期阶段识别风险人群。我们计划通过化学，放射学和流变学之间的跨学科合作来实现这些目标，以确定临床上可用于预测疾病进展风险的风险特征。

DESCRIPTION (provided by applicant): Osteoarthritis (OA) affects over 50 million Americans and has a substantial impact on the US economy and the health care system. Currently, there is no cure for this debilitating disease and the effective treatment is, at best, focused on symptomatic relief. The conventional MR techniques have shown promise for the identification of more subtle morphologic alterations as determined by cartilage volume, or surface fibrillation. However, they even the more innovative of these conventional techniques have not been consistent in predicting the knee OA progression. Therefore, there is a high demand for reliable, objective, non-invasive and quantitative imaging markers that identifies the risk population at early stage. The long-term goal of this proposal is to develop, implement, and characterize novel fluid suppressed-3D-23Na-UTE- techniques for in- vivo knee applications on an ultra high field system (7T). High-resolution, 23Na-(aggrecan) and 1H-(morphology, collagen) imaging of cartilage, along with improved imaging pulse sequences, image reconstructions, and visualization methods on an ultra-high field system (7T) will significantly impact the objective assessment of OA pathology. Specifically, this proposal will establish a powerful non-invasive imaging biomarker that is clinically useful for staging OA disease severity, predicting risk for progression and possibly serving as a future imaging biomarker for disease modifying therapies for OA. We will acquire high resolution sodium and proton MRI of age-and gender matched OA subjects in a longitudinal fashion to determine whether baseline combined risk profile can predict risk population for severe knee OA progression over 24 months period. Finally we determine the role of combined sodium and proton-MRI (1H-morphology, T2 mapping, and clinical scorings) findings at baseline in OA subjects in the prediction of knee OA progression over 24 months period. Once developed, validated in human knee joint then the sodium methodology will be translated on to a clinically relevant 3T platform. We believe that these studies will profoundly affect not only to diagnose OA in its earliest stages but also possibly identifies the risk population at early stage. We plan to address these goals via an interdisciplinary collaboration between Chemistry, Radiology, and Rheumatology to identify a risk profile that will be clinically useful to predict those at risk for disease progression.