Quantitative subchondral bone perfusion imaging in knee osteoarthritis using dynamic contrast enhanced MRI

Area of Science:

• Orthopedics
• Radiology
• Biomedical Engineering

Background:

• Subchondral bone changes, including increased turnover and vascularity, are linked to knee osteoarthritis (OA) progression and pain.
• Quantitative dynamic contrast-enhanced MRI (DCE-MRI) offers a method to assess bone perfusion.

Purpose of the Study:

• To evaluate bone perfusion in knee OA using quantitative DCE-MRI.
• To compare perfusion parameters between affected and unaffected knee compartments.
• To assess perfusion differences in subchondral bone marrow lesions (BMLs) compared to surrounding bone.

Main Methods:

• Twenty-three patients with unicompartmental knee OA underwent 3 Tesla DCE-MRI and T2-weighted MRI.
• Quantitative analysis of Ktrans and Kep (perfusion parameters) was performed.
• DCE-MRI parameters were compared between epimetaphyseal and subchondral bone, and within BMLs versus normal subchondral bone.

Main Results:

• Significantly higher Ktrans and Kep values were observed in the most affected knee compartments compared to the least affected ones, in both epimetaphyseal and subchondral bone.
• Subchondral bone marrow lesions (BMLs) were present in all patients.
• Ktrans and Kep values were significantly higher within subchondral BMLs compared to surrounding subchondral bone without BMLs (p < 0.001).

Conclusions:

• Unicompartmental knee OA exhibits increased perfusion parameters in epimetaphyseal bone, subchondral bone, and BMLs.
• Bone marrow lesions (BMLs) appear to be a major contributor to the elevated bone perfusion observed in knee OA.