Observational Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2015; 6(8): 641-648
Published online Sep 18, 2015. doi: 10.5312/wjo.v6.i8.641
Standardized quantitative measurements of wrist cartilage in healthy humans using 3T magnetic resonance imaging
Jean-Vincent Zink, Philippe Souteyrand, Sandrine Guis, Christophe Chagnaud, Yann Le Fur, Daniela Militianu, Jean-Pierre Mattei, Michael Rozenbaum, Itzhak Rosner, Maxime Guye, Monique Bernard, David Bendahan
Jean-Vincent Zink, Philippe Souteyrand, Christophe Chagnaud, Department of Radiology, Conception Hospital, Aix-Marseille University, APHM, 13005 Marseille, France
Sandrine Guis, Jean-Pierre Mattei, Department of Rheumatology, Ste marguerite Hospital, Aix-Marseille University, APHM, 13009 Marseille, France
Yann Le Fur, Monique Bernard, David Bendahan, Faculté de Médecine de Marseille, Aix-Marseille Université - CRMBM-CNRS, 13005 Marseille, France
Daniela Militianu, Department of Medical Imaging, Rambam - Health Care Campus, Haifa 35254, Israel
Michael Rozenbaum, Itzhak Rosner, Department of Rheumatology, Bnai Zion Medical Center, Technion, Haifa 31048, Israel
Maxime Guye, Aix-Marseille Université - CEMEREM-CNRS, AP-HM Pôle Imagerie, 13005 Marseille, France
Author contributions: Zink JV, Souteyrand P, Guis S, Chagnaud C and Bendahan D designed the study and took part to the data acquisition; Statistical analyses were conducted by Zink JV, Fur YL, Mattei JP and Bendahan D; Fur YL, Militianu D, Rozenbaum M, Rosner I, Guye M and Bernard M made substantial contribution to analysis and interpretation of the data; Zink JV, Souteyrand P and Guis S drafted sections of the manuscript; all authors revised it critically for important intellectual content and approved the final version of the manuscript.
Supported by Aix-Marseille University and APHM (Assistance Publique Hôpitaux de Marseille), No. CNRS (UMR #7339).
Institutional review board statement: The study was reviewed and approved by Aix-Marseille Université - CRMBM-CNRS Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: None.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author at drgargpankaj@yahoo.com. No cosent was obtained but the presented data ara anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: David Bendahan, Director, Faculté de Médecine de Marseille, Aix-Marseille Université - CRMBM-CNRS, 27 boulevard Jean Moulin 13385, 13005 Marseille, France. david.bendahan@univ-amu.fr
Telephone: +33-491-324803 Fax: +33-491-256539
Received: February 5, 2015
Peer-review started: February 6, 2015
First decision: June 3, 2015
Revised: June 17, 2015
Accepted: July 29, 2015
Article in press: August 3, 2015
Published online: September 18, 2015
Abstract

AIM: To quantify the wrist cartilage cross-sectional area in humans from a 3D magnetic resonance imaging (MRI) dataset and to assess the corresponding reproducibility.

METHODS: The study was conducted in 14 healthy volunteers (6 females and 8 males) between 30 and 58 years old and devoid of articular pain. Subjects were asked to lie down in the supine position with the right hand positioned above the pelvic region on top of a home-built rigid platform attached to the scanner bed. The wrist was wrapped with a flexible surface coil. MRI investigations were performed at 3T (Verio-Siemens) using volume interpolated breath hold examination (VIBE) and dual echo steady state (DESS) MRI sequences. Cartilage cross sectional area (CSA) was measured on a slice of interest selected from a 3D dataset of the entire carpus and metacarpal-phalangeal areas on the basis of anatomical criteria using conventional image processing radiology software. Cartilage cross-sectional areas between opposite bones in the carpal region were manually selected and quantified using a thresholding method.

RESULTS: Cartilage CSA measurements performed on a selected predefined slice were 292.4 ± 39 mm2 using the VIBE sequence and slightly lower, 270.4 ± 50.6 mm2, with the DESS sequence. The inter (14.1%) and intra (2.4%) subject variability was similar for both MRI methods. The coefficients of variation computed for the repeated measurements were also comparable for the VIBE (2.4%) and the DESS (4.8%) sequences. The carpus length averaged over the group was 37.5 ± 2.8 mm with a 7.45% between-subjects coefficient of variation. Of note, wrist cartilage CSA measured with either the VIBE or the DESS sequences was linearly related to the carpal bone length. The variability between subjects was significantly reduced to 8.4% when the CSA was normalized with respect to the carpal bone length.

CONCLUSION: The ratio between wrist cartilage CSA and carpal bone length is a highly reproducible standardized measurement which normalizes the natural diversity between individuals.

Keywords: Cartilage, Magnetic resonance imaging, Wrist, Quantification

Core tip: Wrist cartilage cross-sectional area has been quantified in wrists of healthy subjects using 3T magnetic resonance imaging. Based on a semi-automatic segmentation method, the reproducibility of the measurements is high as compared to previous studies. A standardized quantitative index has been proposed. This standardized index can be used for future follow-up studies. The measurements performed in a small group of subjects should be further confirmed in a larger group.