title: Delayed gadolinium enhanced MRI of cartilage (dGEMRIC) can be effectively applied for longitudinal cohort evaluation of articular cartilage regeneration.
abstract: OBJECTIVE
  Delayed gadolinium enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) facilitates non-invasive evaluation of the glycosaminoglycan content in articular cartilage. The primary aim of this study was to show that the dGEMRIC technique is able to monitor cartilage repair following regenerative cartilage treatment.
  
  
  METHODS
  Thirty-one patients with a focal cartilage lesion underwent a dGEMRIC scan prior to cartilage repair surgery and at 3 and 12 months follow-up. At similar time points clinical improvement was monitored using the Knee injury and Osteoarthritis Outcome Score (KOOS) and Lysholm questionnaires. Per MRI scan several regions-of-interest (ROIs) were defined for different locations in the joint. The dGEMRIC index (T1gd) was calculated for each ROI. Repeated-measures analysis of variance (RMANOVA) analysis was used to evaluate improvement in clinical scores and MRI T1gd over time. Also regression analysis was performed to show the influence of local repair on cartilage quality at distant locations in the knee.
  
  
  RESULTS
  Clinical scores and the dGEMRIC T1gd per ROI showed a statistically significant improvement (P < 0.01), from baseline, at 12 months follow-up. Also, improvement from baseline in T1gd of the ROI defining the treated cartilage defect showed a direct relationship (P < 0.007) to the improvement of the T1gd of ROI at other locations in the joint.
  
  
  CONCLUSIONS
  The dGEMRIC MRI protocol is a useful method to evaluate cartilage repair. In addition, local cartilage repair influenced the cartilage quality at other location in the joint. These findings validate the use of dGEMRIC for non-invasive evaluation of the effects of cartilage regeneration.
authors.affiliation: Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: J E J
authors.initials: JE
authors.lastname: Bekkers
authors.forename: L W
authors.initials: LW
authors.lastname: Bartels
authors.forename: R J
authors.initials: RJ
authors.lastname: Benink
authors.forename: A I
authors.initials: AI
authors.lastname: Tsuchida
authors.forename: K L
authors.initials: KL
authors.lastname: Vincken
authors.forename: W J A
authors.initials: WJ
authors.lastname: Dhert
authors.forename: L B
authors.initials: LB
authors.lastname: Creemers
authors.forename: D B F
authors.initials: DB
authors.lastname: Saris
mesh_terms: D000328:Adult; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000293:injuries / Q000502:physiology* / Q000601:surgery; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012038:Regeneration / Q000502:physiology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D006025:Glycosaminoglycans; D019786:Gadolinium DTPA