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. 2023 Oct 3;18(10):e0291757.
doi: 10.1371/journal.pone.0291757. eCollection 2023.

MRI overestimates articular cartilage thickness and volume compared to synchrotron radiation phase-contrast imaging

Suranjan Bairagi  1 , Mohammad-Amin Abdollahifar  1 , Oghenevwogaga J Atake  1 , William Dust  2 , Sheldon Wiebe  3 , George Belev  4 , L Dean Chapman  1 , M Adam Webb  4 , Ning Zhu  4 , David M L Cooper  1 , B Frank Eames  1
Affiliations

MRI overestimates articular cartilage thickness and volume compared to synchrotron radiation phase-contrast imaging

Suranjan Bairagi et al. PLoS One. .

Abstract

Accurate evaluation of morphological changes in articular cartilage are necessary for early detection of osteoarthritis (OA). 3T magnetic resonance imaging (MRI) has highly sensitive contrast resolution and is widely used clinically to detect OA. However, synchrotron radiation phase-contrast imaging computed tomography (SR-PCI) can also provide contrast to tissue interfaces that do not have sufficient absorption differences, with the added benefit of very high spatial resolution. Here, MRI was compared with SR-PCI for quantitative evaluation of human articular cartilage. Medial tibial condyles were harvested from non-OA donors and from OA patients receiving knee replacement surgery. Both imaging methods revealed that average cartilage thickness and cartilage volume were significantly reduced in the OA group, compared to the non-OA group. When comparing modalities, the superior resolution of SR-PCI enabled more precise mapping of the cartilage surface relative to MRI. As a result, MRI showed significantly higher average cartilage thickness and cartilage volume, compared to SR-PCI. These data highlight the potential for high-resolution imaging of articular cartilage using SR-PCI as a solution for early OA diagnosis. Recognizing current limitations of using a synchrotron for clinical imaging, we discuss its nascent utility for preclinical models, particularly longitudinal studies of live animal models of OA.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Custom sample holder and SR-PCI field of view.
(A) A custom, non-metal, and waterproof sample holder was 3D-printed with an appropriate size for both samples and imaging machines and with a stable sample position with fine adjustment. (B) Set up for scanning PBS-submerged sample at the CLS beamline BMIT. (C) Top view with blue lines indicating X-ray detector field of view (55mm). (D) Side view with blue lines indicating how multiple X-ray beam heights (2mm) were compiled for each sample (2mm).
Fig 2
Fig 2. Gross images of representative samples, and virtual slices and segmentations from 3D reconstructions of the same sample from MRI and SR-PCI.
(A, B) Gross images of medial tibial plateaus demonstrate normal articular cartilage appearance of a non-OA sample (A), while cartilage fibrillation and exposed subchondral bone are observed in an OA sample (B). (C, D) Virtual slices of equivalent regions of the same sample, based upon known orientation of the datasets and visual cues from morphology of both the articular cartilage and adjacent subchondral bone, from 3D reconstructed MRI (C) and SR-PCI (D) datasets suggest that SR-PCI has higher resolution than MRI. (E, F) Cartilage and bone segmentations on the same virtual slices as in panels C and D from 3D reconstructed MRI (E) and SR-PCI (F) datasets. Scale bars: A,B = 1cm; C-F = 0.5cm.
Fig 3
Fig 3. Representative heat-mapped images showing cartilage thickness.
(A-D) After image segmentation of articular cartilage from medial tibial condyles, regional cartilage thickness distribution (blue = thickest, red = thinnest) in representative non-OA samples suggested that MRI estimated higher values, compared to PCI. (E-H) A similar trend was observed in representative OA samples, which also contained large areas without any detectable cartilage. Scale bars: A-H = 1cm.
Fig 4
Fig 4. Both MRI and SR-PCI demonstrated significant decreases in clinically-relevant articular cartilage parameters.
(A, B) Quantitative analyses of average cartilage thickness (μm) showed that OA samples were significantly thinner than non-OA samples from both MRI (A, **p = 0.009) and SR-PCI data (B, *p = 0.037). (C, D) Quantitative analyses of overall cartilage volume (ml) showed that OA samples had significantly less cartilage than non-OA samples from both MRI (C, ***p = 0.001) and SR-PCI data (D, *p = 0.039).
Fig 5
Fig 5. Comparisons of imaging modalities with only one experimental group were inconclusive.
(A, B) Quantitative analyses of average cartilage thickness (A) and overall cartilage volume (B) of the non-OA samples trended towards an increased measure in MRI, compared to SR-PCI, but the results were not statistically significant. (C, D) Quantitative analyses of average cartilage thickness (C) and overall cartilage volume (D) of the OA samples trended towards an increased measure in MRI, compared to SR-PCI, but the results were not statistically significant.
Fig 6
Fig 6. MRI significantly over-estimated clinically-relevant articular cartilage parameters, compared to SR-PCI.
(A) Bland-Altman analyses of average cartilage thickness suggested that MRI over-estimated measurements, compared to SR-PCI; this finding was verified as significant by a one-sample t-test of differences compared to 0 (p = 0.005). (B) Regression analysis confirmed that the difference between the measures from MRI and SR-PCI was independent of the scale of the measurement (p = 0.646; R^2 = 0.038). (C) Bland-Altman analyses of overall cartilage volume suggested that MRI over-estimated measurements, compared to SR-PCI; this finding was verified as significant by a one-sample t-test of differences compared to 0 (p = 0.033). (D) Regression analysis confirmed that the difference between the measures from MRI and SR-PCI was independent of the scale of the measurement (p = 0.489; R^2 = 0.083). For Bland-Altman plots (A,C), the x-axis is labelled at difference = 0, dotted black line represents the mean difference among samples, and dotted blue lines represent 95% confidence intervals from the mean difference.
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