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Related Experiment Videos

dGEMRIC as a function of BMI.

C Tiderius1, M Hori, A Williams

  • 1Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, USA.

Osteoarthritis and Cartilage
|June 20, 2006
PubMed
Summary

Body Mass Index (BMI) affects contrast agent concentration in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Adjusting for this bias reveals no correlation in healthy knees but a negative correlation in osteoarthritis knees.

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Area of Science:

  • Biomedical Imaging
  • Radiology
  • Orthopedics

Background:

  • Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) assesses glycosaminoglycan (GAG) distribution.
  • Standard dGEMRIC protocols assume uniform plasma contrast agent levels post-injection, irrespective of body composition.
  • Adipose tissue has lower extracellular water, potentially altering contrast distribution and affecting dGEMRIC accuracy.

Purpose of the Study:

  • To investigate the relationship between Body Mass Index (BMI) and plasma levels of the contrast agent Gd-DTPA(2-).
  • To evaluate the impact of BMI-related contrast dosing bias on dGEMRIC measurements.
  • To determine the correlation between corrected dGEMRIC values and BMI in asymptomatic and osteoarthritis (OA) knees.

Main Methods:

  • Plasma Gd-DTPA(2-) concentrations were measured at serial time points after intravenous injection in individuals with varying BMIs (21.5–46.5).

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  • dGEMRIC imaging was performed on asymptomatic volunteers and patients with osteoarthritis.
  • Statistical analyses were conducted to assess correlations between BMI, plasma contrast levels, and dGEMRIC values, with adjustments for dosing bias.

    • Main Results:

    • Obese individuals exhibited higher plasma Gd-DTPA(2-) concentrations compared to leaner individuals, indicating a potential dosing bias.
    • A subject with BMI 45 had 1.4 times higher contrast concentration than a subject with BMI 20, leading to up to 20% bias in dGEMRIC.
    • After correcting for dosing bias, dGEMRIC showed no correlation with BMI in asymptomatic knees.
    • In OA knees, a negative correlation was observed between dGEMRIC and BMI in non-narrowed femoral compartments (R=0.57, P=0.004).

    Conclusions:

    • Body Mass Index (BMI) is a significant factor contributing to dosing bias in dGEMRIC.
    • A correction factor for BMI should be considered in dGEMRIC studies with a wide range of patient BMIs.
    • dGEMRIC is not correlated with BMI in healthy knees, but shows a negative correlation in osteoarthritis knees, suggesting altered cartilage composition in obesity within OA.