MRI T2 and T1ρ relaxation in patients at risk for knee osteoarthritis: a systematic review and meta-analysis

HF Atkinson, TB Birmingham, RF Moyer… - BMC musculoskeletal …, 2019 - Springer
BMC musculoskeletal disorders, 2019Springer
Background Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly
being proposed as imaging biomarkers potentially capable of detecting biochemical
changes in articular cartilage before structural changes are evident. We aimed to: 1)
summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in
participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ
relaxation between participants at-risk for knee OA and healthy controls. Methods We …
Background
Magnetic resonance imaging (MRI) T2 and T1ρ relaxation are increasingly being proposed as imaging biomarkers potentially capable of detecting biochemical changes in articular cartilage before structural changes are evident. We aimed to: 1) summarize MRI methods of published studies investigating T2 and T1ρ relaxation time in participants at risk for but without radiographic knee OA; and 2) compare T2 and T1ρ relaxation between participants at-risk for knee OA and healthy controls.
Methods
We conducted a systematic review of studies reporting T2 and T1ρ relaxation data that included both participants at risk for knee OA and healthy controls. Participant characteristics, MRI methodology, and T1ρ and T2 relaxation data were extracted. Standardized mean differences (SMDs) were calculated within each study. Pooled effect sizes were then calculated for six commonly segmented knee compartments.
Results
55 articles met eligibility criteria. There was considerable variability between scanners, coils, software, scanning protocols, pulse sequences, and post-processing. Moderate risk of bias due to lack of blinding was common. Pooled effect sizes indicated participants at risk for knee OA had lengthened T2 relaxation time in all compartments (SMDs from 0.33 to 0.74; p < 0.01) and lengthened T1ρ relaxation time in the femoral compartments (SMD from 0.35 to 0.40; p < 0.001).
Conclusions
T2 and T1ρ relaxation distinguish participants at risk for knee OA from healthy controls. Greater standardization of MRI methods is both warranted and required for progress towards biomarker validation.
Springer
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