Protocol issues for delayed Gd(DTPA)2--enhanced MRI (dGEMRIC) for clinical evaluation of articular cartilage

TLDR

Delayed gadolinium‑enhanced MRI (dGEMRIC) uses cartilage T1 values after Gd(DTPA)2 penetration to assess glycosaminoglycan content, a method validated by biochemical and histologic studies. The study identifies key protocol factors—exercise immediately after contrast, double‑dose contrast, a 30–90 min hip window or 2–3 hr knee window, and reduced penetration in some subchondral bone hypointensities—that yield reproducible ROIs within 15 % and demonstrate clinical feasibility. Published in Magn Reson Med 45:36–41 (2001) © Wiley‑Liss, Inc.

Abstract

Biochemical and histologic data have validated the technique of delayed gadolinium-enhanced MRI, in which the T1 values of cartilage after penetration of Gd(DTPA)2–allow assessment of the glycosaminoglycan (GAG) component of articular cartilage. This work describes the factors that have been found to be important for the practical implementation of the technique: 1) Exercise immediately after intravenous contrast administration was necessary for effective penetration of the contrast into the articular cartilage; 2) double-dose contrast was better than single-dose; 3) after contrast administration, a time window of 30–90 min for the hip, and 2–3 hr for all compartments of the knee proved to be appropriate for assessing articular cartilage; and 4) in some cases of hypointensities in the subchondral patellar bone, decreased penetration of the contrast agent into cartilage from bone was found. With the protocol described, ROIs on T1 images were reproducible within 15% on two separate imaging sessions, and initial clinical studies demonstrated the possible applications of the technique. Magn Reson Med 45:36–41, 2001. © 2001 Wiley-Liss, Inc.