Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology

Emma Einarsson; Jonas Svensson; Elin Folkesson; Iida Kestilä; Jon Tjörnstrand; Pernilla Peterson; Mikko A.J. Finnilä; H. Velocity Hughes; Aleksandra Turkiewicz; Simo Saarakkala; Martin Englund

doi:10.1016/j.ocarto.2020.100061

Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology

Emma Einarsson, Jonas Svensson, Elin Folkesson, Iida Kestilä, Jon Tjörnstrand, Pernilla Peterson, Mikko A.J. Finnilä, H. Velocity Hughes, Aleksandra Turkiewicz, Simo Saarakkala, Martin Englund

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Abstract

Background
Quantitative magnetic resonance imaging (MRI), e.g. relaxation parameter mapping, may be sensitive to structural and compositional tissue changes, and could potentially be used to non-invasively detect and monitor early meniscus degeneration related to knee osteoarthritis.
Objective
To investigate MR relaxation times as potential biomarkers for meniscus degeneration through comparisons with histopathology.
Methods
We measured MR relaxation parameters in the posterior horn of 40 menisci (medial and lateral) at a wide range of degenerative stages. T1, T2 and T2∗ were mapped using standard and ultrashort echo time sequences at 9.4 T and compared to gold standard histology using Pauli's histopathological scoring system, including assessment of surface integrity, collagen organization, cellularity and Safranin-O staining.
Results
All three relaxation times increased with total Pauli score (mean difference per score (95% CI) for T2∗: 0.62 (0.37, 0.86), T2: 0.83 (0.53, 1.1) and T1: 24.7 (16.5, 32.8) ms/score). Clear associations were seen with scores of surface integrity (mean difference per score for T2∗: 3.0 (1.8, 4.2), T2: 4.0 (2.5, 5.5) and T1: 116 (75.6, 156) ms/score) and collagen organization (mean difference between highest and lowest score for T2∗: 5.3 (1.6, 8.9), T2: 6.1 (1.7, 11) and T1: 204 (75.9, 332) ms). The results were less clear for the remaining histopathological measures.
Conclusions
MR relaxation times T1, T2 and T2∗ of ex vivo human menisci are associated with histologically verified degenerative processes, in particular related to surface integrity and collagen organization. If confirmed in vivo, MR relaxation times may thus be potential biomarkers for meniscus degeneration.

Original language	English
Article number	100061
Journal	Osteoarthritis and Cartilage Open
Volume	2
Issue number	2
DOIs	https://doi.org/10.1016/j.ocarto.2020.100061
Publication status	Published - 2020 Jun 1

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1 Doctoral Thesis (compilation)

Imaging of tissue degeneration in knee osteoarthritis using magnetic resonance and synchrotron radiation
Einarsson, E., 2022, Lund: Lund University, Faculty of Medicine. 59 p.
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Einarsson, E., Svensson, J., Folkesson, E., Kestilä, I., Tjörnstrand, J., Peterson, P., Finnilä, M. A. J., Hughes, H. V., Turkiewicz, A., Saarakkala, S., & Englund, M. (2020). Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology. Osteoarthritis and Cartilage Open, 2(2), [100061]. https://doi.org/10.1016/j.ocarto.2020.100061

@article{891ef2bb22af43f5924204ca072c66d6,

title = "Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology",

abstract = "BackgroundQuantitative magnetic resonance imaging (MRI), e.g. relaxation parameter mapping, may be sensitive to structural and compositional tissue changes, and could potentially be used to non-invasively detect and monitor early meniscus degeneration related to knee osteoarthritis.ObjectiveTo investigate MR relaxation times as potential biomarkers for meniscus degeneration through comparisons with histopathology.MethodsWe measured MR relaxation parameters in the posterior horn of 40 menisci (medial and lateral) at a wide range of degenerative stages. T1, T2 and T2∗ were mapped using standard and ultrashort echo time sequences at 9.4 T and compared to gold standard histology using Pauli's histopathological scoring system, including assessment of surface integrity, collagen organization, cellularity and Safranin-O staining.ResultsAll three relaxation times increased with total Pauli score (mean difference per score (95% CI) for T2∗: 0.62 (0.37, 0.86), T2: 0.83 (0.53, 1.1) and T1: 24.7 (16.5, 32.8) ms/score). Clear associations were seen with scores of surface integrity (mean difference per score for T2∗: 3.0 (1.8, 4.2), T2: 4.0 (2.5, 5.5) and T1: 116 (75.6, 156) ms/score) and collagen organization (mean difference between highest and lowest score for T2∗: 5.3 (1.6, 8.9), T2: 6.1 (1.7, 11) and T1: 204 (75.9, 332) ms). The results were less clear for the remaining histopathological measures.ConclusionsMR relaxation times T1, T2 and T2∗ of ex vivo human menisci are associated with histologically verified degenerative processes, in particular related to surface integrity and collagen organization. If confirmed in vivo, MR relaxation times may thus be potential biomarkers for meniscus degeneration.",

author = "Emma Einarsson and Jonas Svensson and Elin Folkesson and Iida Kestil{\"a} and Jon Tj{\"o}rnstrand and Pernilla Peterson and Finnil{\"a}, {Mikko A.J.} and Hughes, {H. Velocity} and Aleksandra Turkiewicz and Simo Saarakkala and Martin Englund",

year = "2020",

month = jun,

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doi = "10.1016/j.ocarto.2020.100061",

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journal = "Osteoarthritis and Cartilage Open",

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Einarsson, E , Svensson, J, Folkesson, E, Kestilä, I, Tjörnstrand, J , Peterson, P, Finnilä, MAJ, Hughes, HV, Turkiewicz, A, Saarakkala, S & Englund, M 2020, 'Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology', Osteoarthritis and Cartilage Open, vol. 2, no. 2, 100061. https://doi.org/10.1016/j.ocarto.2020.100061

TY - JOUR

T1 - Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology

AU - Einarsson, Emma

AU - Svensson, Jonas

AU - Folkesson, Elin

AU - Kestilä, Iida

AU - Tjörnstrand, Jon

AU - Peterson, Pernilla

AU - Finnilä, Mikko A.J.

AU - Hughes, H. Velocity

AU - Turkiewicz, Aleksandra

AU - Saarakkala, Simo

AU - Englund, Martin

PY - 2020/6/1

Y1 - 2020/6/1

N2 - BackgroundQuantitative magnetic resonance imaging (MRI), e.g. relaxation parameter mapping, may be sensitive to structural and compositional tissue changes, and could potentially be used to non-invasively detect and monitor early meniscus degeneration related to knee osteoarthritis.ObjectiveTo investigate MR relaxation times as potential biomarkers for meniscus degeneration through comparisons with histopathology.MethodsWe measured MR relaxation parameters in the posterior horn of 40 menisci (medial and lateral) at a wide range of degenerative stages. T1, T2 and T2∗ were mapped using standard and ultrashort echo time sequences at 9.4 T and compared to gold standard histology using Pauli's histopathological scoring system, including assessment of surface integrity, collagen organization, cellularity and Safranin-O staining.ResultsAll three relaxation times increased with total Pauli score (mean difference per score (95% CI) for T2∗: 0.62 (0.37, 0.86), T2: 0.83 (0.53, 1.1) and T1: 24.7 (16.5, 32.8) ms/score). Clear associations were seen with scores of surface integrity (mean difference per score for T2∗: 3.0 (1.8, 4.2), T2: 4.0 (2.5, 5.5) and T1: 116 (75.6, 156) ms/score) and collagen organization (mean difference between highest and lowest score for T2∗: 5.3 (1.6, 8.9), T2: 6.1 (1.7, 11) and T1: 204 (75.9, 332) ms). The results were less clear for the remaining histopathological measures.ConclusionsMR relaxation times T1, T2 and T2∗ of ex vivo human menisci are associated with histologically verified degenerative processes, in particular related to surface integrity and collagen organization. If confirmed in vivo, MR relaxation times may thus be potential biomarkers for meniscus degeneration.

AB - BackgroundQuantitative magnetic resonance imaging (MRI), e.g. relaxation parameter mapping, may be sensitive to structural and compositional tissue changes, and could potentially be used to non-invasively detect and monitor early meniscus degeneration related to knee osteoarthritis.ObjectiveTo investigate MR relaxation times as potential biomarkers for meniscus degeneration through comparisons with histopathology.MethodsWe measured MR relaxation parameters in the posterior horn of 40 menisci (medial and lateral) at a wide range of degenerative stages. T1, T2 and T2∗ were mapped using standard and ultrashort echo time sequences at 9.4 T and compared to gold standard histology using Pauli's histopathological scoring system, including assessment of surface integrity, collagen organization, cellularity and Safranin-O staining.ResultsAll three relaxation times increased with total Pauli score (mean difference per score (95% CI) for T2∗: 0.62 (0.37, 0.86), T2: 0.83 (0.53, 1.1) and T1: 24.7 (16.5, 32.8) ms/score). Clear associations were seen with scores of surface integrity (mean difference per score for T2∗: 3.0 (1.8, 4.2), T2: 4.0 (2.5, 5.5) and T1: 116 (75.6, 156) ms/score) and collagen organization (mean difference between highest and lowest score for T2∗: 5.3 (1.6, 8.9), T2: 6.1 (1.7, 11) and T1: 204 (75.9, 332) ms). The results were less clear for the remaining histopathological measures.ConclusionsMR relaxation times T1, T2 and T2∗ of ex vivo human menisci are associated with histologically verified degenerative processes, in particular related to surface integrity and collagen organization. If confirmed in vivo, MR relaxation times may thus be potential biomarkers for meniscus degeneration.

U2 - 10.1016/j.ocarto.2020.100061

DO - 10.1016/j.ocarto.2020.100061

M3 - Article

C2 - 33972933

VL - 2

JO - Osteoarthritis and Cartilage Open

JF - Osteoarthritis and Cartilage Open

SN - 2665-9131

IS - 2

M1 - 100061

ER -

Relating MR relaxation times of ex vivo meniscus to tissue degeneration through comparison with histopathology

Abstract

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Research output

Imaging of tissue degeneration in knee osteoarthritis using magnetic resonance and synchrotron radiation

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