Quantifying knee cartilage development trajectories in children aged 6-12 years via diffusion tensor imaging

Area of Science:

• Biomedical Imaging
• Pediatric Orthopedics
• Radiology

Background:

• Pediatric knee cartilage development involves complex microstructural changes.
• Establishing normative data for these changes is crucial for identifying developmental abnormalities.
• Sex-specific differences in cartilage development may exist and require characterization.

Purpose of the Study:

• To establish normative diffusion tensor imaging (DTI) biomarkers for pediatric knee cartilage development.
• To quantify microstructural changes in children aged 6-12 years.
• To identify sex-specific differences in knee cartilage development using DTI.

Main Methods:

• Eighty-four healthy children (43 boys, 41 girls) aged 6-12 years underwent 3.0T MRI of the knee with DTI sequences.
• Regions of interest included growth plate, patellar, medial, and lateral condylar cartilage.
• Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured; bone age assessed via radiography.

Main Results:

• FA values significantly increased with age and bone age, correlating stronger with bone age (boys: r=0.843; girls: r=0.789).
• Girls exhibited higher FA values than boys, particularly in growth plate cartilage.
• ADC values in the growth plate decreased with bone age (girls: r=-0.702; boys: r=-0.511), with a steeper decline in girls.

Conclusions:

• DTI biomarkers (FA/ADC) effectively reflect pediatric knee cartilage maturation.
• These biomarkers correlate best with bone age, outperforming chronological age.
• DTI enhances quantitative monitoring of cartilage development and pathology in children.