J Knee Surg 2021; 34(03): 251-257
DOI: 10.1055/s-0039-1695000
Original Article

Evaluation of Knee Cartilage Diurnal, Activity, and BMI-Related Variations Using Quantitative T2 Mapping MRI and Fitbit Activity Tracking

1   Department of Radiology, University of Southern California, Los Angeles, California
,
Ian A. Jones
2   Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California
,
J. Alex McIntyre
4   School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia
,
Robert Burt
3   Keck School of Medicine, University of Southern California, Los Angeles, California
,
Darryl Hwang
1   Department of Radiology, University of Southern California, Los Angeles, California
,
Steven Cen
1   Department of Radiology, University of Southern California, Los Angeles, California
,
Aaron J. Schein
1   Department of Radiology, University of Southern California, Los Angeles, California
,
C. Thomas Vangsness Jr.
2   Department of Orthopaedic Surgery, University of Southern California, Los Angeles, California
› Author Affiliations
Funding None.

Abstract

The aim of this study is to evaluate diurnal variation in knee cartilage 3 Tesla magnetic resonance imaging (MRI) T2 mapping relaxation times, as well as activity- and body mass index (BMI)-dependent variability, using quantitative analysis of T2 values from segmented regions of the weight-bearing articular surfaces of the medial and lateral femoral condyles and tibial plateaus. Ten healthy volunteers' daily activity (steps) were tracked with Fitbit pedometers. Sagittal MRI T2 maps were obtained in the morning and afternoon on days 2 and 3. Mean T2 values were analyzed for variation related to the number of steps taken (activity), time of day (diurnal variation), and BMI using mixed effect model. Significant (albeit small) differences in the medial femoral and medial tibial cartilage regions were identified between morning and afternoon scans (diurnal variation). Daily activity did not result in significant changes and increasing BMI only demonstrated a slight increase in T2 values for the lateral tibial plateau. These findings suggest that it may be necessary to control diurnal variation when using quantitative MRI T2 mapping to assess articular cartilage longitudinally in healthy participants. Further investigation is needed to confirm these findings and determine if they also apply to symptomatic patients.



Publication History

Received: 14 February 2019

Accepted: 03 July 2019

Article published online:
21 August 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Buckwalter JA, Mankin HJ. Articular cartilage: tissue design and chondrocyte-matrix interactions. Instr Course Lect 1998; 47: 477-486
  • 2 Thomas RJ, Hourd PC, Williams DJ. Application of process quality engineering techniques to improve the understanding of the in vitro processing of stem cells for therapeutic use. J Biotechnol 2008; 136 (3-4): 148-155
  • 3 Tran-Khanh N, Chevrier A, Lascau-Coman V, Hoemann CD, Buschmann MD. Young adult chondrocytes proliferate rapidly and produce a cartilaginous tissue at the gel-media interface in agarose cultures. Connect Tissue Res 2010; 51 (03) 216-223
  • 4 Månsson O, Sernert N, Rostgard-Christensen L, Kartus J. Long-term clinical and radiographic results after delayed anterior cruciate ligament reconstruction in adolescents. Am J Sports Med 2015; 43 (01) 138-145
  • 5 Paradowski PT, Kęska R, Witoński D. Does concomitant meniscectomy affect medium-term outcome of anterior cruciate ligament reconstruction? A preliminary report. Arch Med Sci 2014; 10 (05) 992-998
  • 6 Dijkgraaf LC, de Bont LG, Boering G, Liem RS. Normal cartilage structure, biochemistry, and metabolism: a review of the literature. J Oral Maxillofac Surg 1995; 53 (08) 924-929
  • 7 Blumenkrantz G, Majumdar S. Quantitative magnetic resonance imaging of articular cartilage in osteoarthritis. Eur Cell Mater 2007; 13: 76-86
  • 8 Roughley PJ, Lee ER. Cartilage proteoglycans: structure and potential functions. Microsc Res Tech 1994; 28 (05) 385-397
  • 9 Altman RD, Fries JF, Bloch DA. et al. Radiographic assessment of progression in osteoarthritis. Arthritis Rheum 1987; 30 (11) 1214-1225
  • 10 Apprich S, Welsch GH, Mamisch TC. et al. Detection of degenerative cartilage disease: comparison of high-resolution morphological MR and quantitative T2 mapping at 3.0 Tesla. Osteoarthritis Cartilage 2010; 18 (09) 1211-1217
  • 11 Apprich S, Mamisch TC, Welsch GH. et al. Quantitative T2 mapping of the patella at 3.0T is sensitive to early cartilage degeneration, but also to loading of the knee. Eur J Radiol 2012; 81 (04) e438-e443
  • 12 Wu Y, Yang R, Jia S, Li Z, Zhou Z, Lou T. Computer-aided diagnosis of early knee osteoarthritis based on MRI T2 mapping. Biomed Mater Eng 2014; 24 (06) 3379-3388
  • 13 Stehling C, Liebl H, Krug R. et al. Patellar cartilage: T2 values and morphologic abnormalities at 3.0-T MR imaging in relation to physical activity in asymptomatic subjects from the osteoarthritis initiative. Radiology 2010; 254 (02) 509-520
  • 14 Theologis AA, Schairer WW, Carballido-Gamio J, Majumdar S, Li X, Ma CB. Longitudinal analysis of T1ρ and T2 quantitative MRI of knee cartilage laminar organization following microfracture surgery. Knee 2012; 19 (05) 652-657
  • 15 Mlynárik V, Degrassi A, Toffanin R, Vittur F, Cova M, Pozzi-Mucelli RS. Investigation of laminar appearance of articular cartilage by means of magnetic resonance microscopy. Magn Reson Imaging 1996; 14 (04) 435-442
  • 16 Wang L, Regatte RR. Investigation of regional influence of magic-angle effect on t2 in human articular cartilage with osteoarthritis at 3 T. Acad Radiol 2015; 22 (01) 87-92
  • 17 Mosher TJ, Dardzinski BJ. Cartilage MRI T2 relaxation time mapping: overview and applications. Semin Musculoskelet Radiol 2004; 8 (04) 355-368
  • 18 Liess C, Lüsse S, Karger N, Heller M, Glüer CC. Detection of changes in cartilage water content using MRI T2-mapping in vivo. Osteoarthritis Cartilage 2002; 10 (12) 907-913
  • 19 Li X, Wyatt C, Rivoire J. et al. Simultaneous acquisition of T1ρ and T2 quantification in knee cartilage: repeatability and diurnal variation. J Magn Reson Imaging 2014; 39 (05) 1287-1293
  • 20 Mosher TJ, Liu Y, Torok CM. Functional cartilage MRI T2 mapping: evaluating the effect of age and training on knee cartilage response to running. Osteoarthritis Cartilage 2010; 18 (03) 358-364
  • 21 Mosher TJ, Smith HE, Collins C. et al. Change in knee cartilage T2 at MR imaging after running: a feasibility study. Radiology 2005; 234 (01) 245-249
  • 22 Subburaj K, Kumar D, Souza RB. et al. The acute effect of running on knee articular cartilage and meniscus magnetic resonance relaxation times in young healthy adults. Am J Sports Med 2012; 40 (09) 2134-2141
  • 23 Smith HE, Mosher TJ, Dardzinski BJ. et al. Spatial variation in cartilage T2 of the knee. J Magn Reson Imaging 2001; 14 (01) 50-55
  • 24 Shiomi T, Nishii T, Nakata K. et al. Three-dimensional topographical variation of femoral cartilage T2 in healthy volunteer knees. Skeletal Radiol 2013; 42 (03) 363-370
  • 25 Mosher TJ, Collins CM, Smith HE. et al. Effect of gender on in vivo cartilage magnetic resonance imaging T2 mapping. J Magn Reson Imaging 2004; 19 (03) 323-328
  • 26 Nag D, Liney GP, Gillespie P, Sherman KP. Quantification of T(2) relaxation changes in articular cartilage with in situ mechanical loading of the knee. J Magn Reson Imaging 2004; 19 (03) 317-322
  • 27 Nishii T, Kuroda K, Matsuoka Y, Sahara T, Yoshikawa H. Change in knee cartilage T2 in response to mechanical loading. J Magn Reson Imaging 2008; 28 (01) 175-180
  • 28 Coleman JL, Widmyer MR, Leddy HA. et al. Diurnal variations in articular cartilage thickness and strain in the human knee. J Biomech 2013; 46 (03) 541-547
  • 29 Waterton JC, Solloway S, Foster JE. et al. Diurnal variation in the femoral articular cartilage of the knee in young adult humans. Magn Reson Med 2000; 43 (01) 126-132
  • 30 Sitoci KH, Hudelmaier M, Eckstein F. Nocturnal changes in knee cartilage thickness in young healthy adults. Cells Tissues Organs 2012; 196 (02) 189-194
  • 31 Dontje ML, de Groot M, Lengton RR, van der Schans CP, Krijnen WP. Measuring steps with the Fitbit activity tracker: an inter-device reliability study. J Med Eng Technol 2015; 39 (05) 286-290
  • 32 Tully MA, McBride C, Heron L, Hunter RF. The validation of Fibit Zip™ physical activity monitor as a measure of free-living physical activity. BMC Res Notes 2014; 7: 952
  • 33 Jackson BD, Wluka AE, Teichtahl AJ, Morris ME, Cicuttini FM. Reviewing knee osteoarthritis--a biomechanical perspective. J Sci Med Sport 2004; 7 (03) 347-357
  • 34 Serebrakian AT, Poulos T, Liebl H. et al. Weight loss over 48 months is associated with reduced progression of cartilage T2 relaxation time values: data from the osteoarthritis initiative. J Magn Reson Imaging 2015; 41 (05) 1272-1280
  • 35 Baum T, Joseph GB, Nardo L. et al. Correlation of magnetic resonance imaging-based knee cartilage T2 measurements and focal knee lesions with body mass index: thirty-six-month followup data from a longitudinal, observational multicenter study. Arthritis Care Res (Hoboken) 2013; 65 (01) 23-33