Extract
Currently, the most prevalent cartilage magnetic resonance imaging techniques are still two-dimensional fast-spin-echo and spoiled gradient-recalled sequencing. Two-dimensional fast-spin-echo imaging techniques have been made available as standards, and they provide reasonable contrast. More complex three-dimensional fast-spin-echo imaging techniques as well as three-dimensional steady-state free precession (3D-SSFP) are now available that can dramatically improve spatial resolution. Hardware parameters to improve the spatial resolution and reducibility include more powerful magnets at 3.0 and 7.0 Tesla, parallel imaging techniques, and coil design. In addition, modern cartilage-imaging techniques will have to provide increased offline viewing capabilities and a decrease in the need for manual segmentation. Magnetic resonance imaging of cartilage alone does not provide good correlation with clinical symptoms (i.e., pain) or disease progression. Hence, modern techniques will need to provide multiparametric assessment of joints to better monitor disease progression and severity of osteoarthritis. This may involve the evaluation of nontraditional parameters, such as the appearance of subchondral bone or fibrovascular ingrowth.
Currently, the most prevalent cartilage magnetic resonance imaging techniques are still two-dimensional fast-spin-echo and spoiled gradient-recalled sequencing. Two-dimensional fast-spin-echo imaging techniques have been made available as standards, and they provide reasonable contrast. More complex three-dimensional fast-spin-echo imaging techniques as well as three-dimensional steady-state free precession (3D-SSFP) are now available that can dramatically improve spatial resolution. Hardware parameters to improve the spatial resolution and reducibility include more powerful magnets at 3.0 and 7.0 Tesla, parallel imaging techniques, and coil design. In addition, modern cartilage-imaging techniques will have to provide increased offline viewing capabilities and a decrease in the need for manual segmentation. Magnetic resonance imaging of cartilage alone does not provide good correlation with clinical symptoms (i.e., pain) or disease progression. Hence, modern techniques will need to provide multiparametric assessment of joints to better monitor disease progression and severity of osteoarthritis. This may involve the evaluation of nontraditional parameters, such as the appearance of subchondral bone or fibrovascular ingrowth.
Overall, better diagnostic imaging and imaging tools are necessary in order to provide the transition to image-guided surgery without the need for lengthy registration processes and manual segmentation of images. Statistical correlation with atlases and interactive tools that allow for heads-up display image overlays and the integration of multiple modalities such as ultrasonography, computed tomography, magnetic resonance imaging, or fluoroscopy may be the methods that will achieve the goal of better description of the true biology. A better understanding of the true biology may then improve our ability to track disease progression and postsurgical outcomes from an imaging perspective. 