Sodium MRI for Assessment of Early OA.

描述(申请人提供)：骨性关节炎(OA)影响着5000多万美国人，并对美国经济和医疗保健系统产生重大影响。目前，这种令人衰弱的疾病还没有治愈方法，有效的治疗充其量只能集中在缓解症状上。传统的MR技术在识别由软骨体积或表面纤颤决定的更细微的形态变化方面表现出了希望。然而，即使是这些传统技术中更具创新性的技术，在预测膝骨性关节炎进展方面也并不一致。因此，对早期识别危险人群的可靠、客观、非侵入性和定量的影像标志物的需求很高。这项建议的长期目标是开发、实施和表征用于超高场系统(7T)在体内膝关节应用的新型液体抑制-3D-23Na-UT技术。软骨的高分辨率、23Na和1H(形态、胶原)成像，以及改进的成像脉冲序列、图像重建和超高场系统(7T)上的可视化方法，将对OA病理的客观评估产生重大影响。具体地说，这项提议将建立一个强大的非侵入性成像生物标记物，该标记物在临床上可用于OA疾病严重程度的分期，预测进展的风险，并可能作为未来OA疾病修饰疗法的成像生物标记物。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磁共振成像，以确定基线联合风险描述是否可以预测24个月期间严重膝骨性关节炎进展的危险人群。最后，我们确定了联合使用钠和质子磁共振成像(1H-形态、T2图和临床评分)在预测24个月内膝关节骨关节炎进展中的作用。一旦开发出来，并在人类膝关节中得到验证，钠的方法学将被转化到临床相关的3T平台上。我们相信，这些研究不仅将深刻地影响到OA的早期诊断，而且可能会对早期识别危险人群产生深远的影响。我们计划通过化学、放射学和风湿病学之间的跨学科合作来解决这些目标，以确定将在临床上有用的风险概况，以预测那些有疾病进展风险的人。

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.