Qualitative and quantitative in vivo assessment of articular cartilage using magnetic resonance imaging.

The molecular organization and biochemical composition that give cartilage the viscoelasticity necessary for load distribution also convey unique magnetic resonance (MR) properties. In that context, MR imaging has the potential to detect cartilage degeneration and regeneration. Magnetization transfer (MT) imaging probes the exchange of magnetization between the bulk water pool and the water pool bound to macromolecules such as collagen and hence MT may be applied for evaluation of collagen integrity. In addition, Gd(DTPA)(2-)-induced T1 changes have been proposed as a surrogate marker of proteoglycan (PG) loss based on the principle that the paramagnetic agent Gd(DTPA)2- penetrates cartilage to an equilibrium concentration inversely proportional to the negative charge density (i.e. the PG concentration). Results obtained in vivo from MT and Gd(DTPA)(2-)-enhanced MRI acquisitions on the goat knee showed early signs of biochemical changes in response to a papain injection. A dose-dependent effect of papain was observed with both approaches over a wide range of PG depletion (i.e. T1 measurement) and collagen damage (i.e. MT measurement) as confirmed with post-mortem biochemistry and histology. Development of MRI protocols for non-invasive assessment of cartilage will facilitate diagnosis and monitoring of treatment efficacy in the clinic.