title: Cartilage quality in rheumatoid arthritis: comparison of T2* mapping, native T1 mapping, dGEMRIC, ΔR1 and value of pre-contrast imaging.
abstract: OBJECTIVE
  To prospectively evaluate four non-invasive markers of cartilage quality--T2* mapping, native T1 mapping, dGEMRIC and ΔR1--in healthy volunteers and rheumatoid arthritis (RA) patients.
  
  
  METHODS
  Cartilage of metacarpophalangeal (MCP) joints II were imaged in 28 consecutive subjects: 12 healthy volunteers [9 women, mean (SD) age 52.67 (9.75) years, range 30-66] and 16 RA patients with MCP II involvement [12 women, mean (SD) age 58.06 (12.88) years, range 35-76]. Sagittal T2* mapping was performed with a multi-echo gradient-echo on a 3 T MRI scanner. For T1 mapping the dual flip angle method was applied prior to native T1 mapping and 40 min after gadolinium application (delayed gadolinium-enhanced MRI of cartilage, dGEMRIC, T1(Gd)). The difference in the longitudinal relaxation rate induced by gadolinium (ΔR1) was calculated. The area under the receiver operating characteristic curve (AROC) was used to test for differentiation of RA patients from healthy volunteers.
  
  
  RESULTS
  dGEMRIC (AUC 0.81) and ΔR1 (AUC 0.75) significantly differentiated RA patients from controls. T2* mapping (AUC 0.66) and native T1 mapping (AUC 0.66) were not significantly different in RA patients compared to controls.
  
  
  CONCLUSIONS
  The data support the use of dGEMRIC for the assessment of MCP joint cartilage quality in RA. T2* and native T1 mapping are of low diagnostic value. Pre-contrast T1 mapping for the calculation of ΔR1 does not increase the diagnostic value of dGEMRIC.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, D-40225, Düsseldorf, Germany. Christian.buchbender@med.uni-duesseldorf.de
authors.forename: Christian
authors.initials: C
authors.lastname: Buchbender
authors.forename: Axel
authors.initials: A
authors.lastname: Scherer
authors.forename: Patric
authors.initials: P
authors.lastname: Kröpil
authors.forename: Birthe
authors.initials: B
authors.lastname: Körbl
authors.forename: Michael
authors.initials: M
authors.lastname: Quentin
authors.forename: Dorothea Ch
authors.initials: DCh
authors.lastname: Reichelt
authors.forename: Rotem S
authors.initials: RS
authors.lastname: Lanzman
authors.forename: Christian
authors.initials: C
authors.lastname: Mathys
authors.forename: Dirk
authors.initials: D
authors.lastname: Blondin
authors.forename: Bernd
authors.initials: B
authors.lastname: Bittersohl
authors.forename: Christoph
authors.initials: C
authors.lastname: Zilkens
authors.forename: Matthias
authors.initials: M
authors.lastname: Hofer
authors.forename: Hans-Jörg
authors.initials: HJ
authors.lastname: Wittsack
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Benedikt
authors.initials: B
authors.lastname: Ostendorf
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001172:Arthritis, Rheumatoid / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000473:pathology*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA