Feasibility of a UTE Stack-of-Spirals Sequence for Biexponential T_1ρ Mapping of Whole Knee Joint

This study aimed to develop and evaluate a novel magnetization-prepared, ultra-short echo time (UTE)-capable, stack-of-spirals sequence (STFL) to quantify monoexponential and biexponential T_1ρ maps of the whole knee joint, addressing limitations of existing MRI techniques in assessing bone-patellar tendon-bone (BPTB) donor site healing and graft remodeling after anterior cruciate ligament (ACL) reconstruction (ACLR). Experiments were performed with agar-gel model phantoms, seven healthy volunteers (four males, average age 31.4 years old), and five ACLR patients (three males, average age 28.2 years old). Compared with a conventional Cartesian turbo fast low angle shot (CTFL) sequence, the STFL sequence demonstrated an improved signal-to-noise ratio (SNR), increasing from 16.5 for CTFL to 21.7 for STFL. In ACLR patients, the STFL sequence accurately detected increased fractions of short T_1ρ components within the ACL graft, rising from 0.15 to 0.38, compared with 0.11 to 0.18 with CTFL. Furthermore, the STFL sequence revealed significant decreases in the fraction of short T_1ρ components in the patellar tendon of ACLR patients (from 0.6 to 0.47) compared with healthy controls, whereas no significant changes were observed with the CTFL sequence. These findings suggest that the STFL sequence holds promise for noninvasive assessment of BPTB donor site healing and graft maturation following ACLR.