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Double echo steady state magnetic resonance imaging of knee articular cartilage at 3 Tesla: a pilot study for the Osteoarthritis Initiative
  1. F Eckstein1,2,
  2. M Hudelmaier1,2,
  3. W Wirth2,
  4. B Kiefer3,
  5. R Jackson4,
  6. J Yu5,
  7. C B Eaton6,
  8. E Schneider7
  1. 1Institute of Anatomy and Musculoskeletal Research, Paracelsus Private Medical University (PMU), Salzburg, Austria
  2. 2Chondrometrics GmbH, Ainring, Germany
  3. 3MR Application Development, Siemens Medical Solutions, Erlangen, Germany
  4. 4The Ohio State University, Department of Endocrinology, Diabetes and Metabolism, Columbus, OH, USA
  5. 5The Ohio State University, Department of Radiology, Columbus, OH, USA
  6. 6Center for Primary Care and Prevention, Memorial Hospital of Rhode Island and Brown University Medical School, Pawtucket, RI, USA
  7. 7SciTrials, LLC, Westwood, MA, USA
  1. Correspondence to:
    Professor F Eckstein
    Institute of Anatomy and Musculoskeletal Research, PMU, Strubergasse 21, A5020 Salzburg, Austria; felix.eckstein{at}


Background: Quantitative magnetic resonance imaging (qMRI) may provide valuable measures of cartilage morphology in osteoarthritis (OA) but has been confined to sequences with relatively long acquisition times at 1.5 Tesla (T).

Objective: To test the accuracy and precision of knee cartilage qMRI with a fast double echo, steady state (DESS) sequence with water excitation (we) at 3 T.

Methods: As a pilot study for the Osteoarthritis Initiative, test-retest MR images were acquired in the knees of 19 participants with no OA to moderate degrees of clinical OA. Two double oblique coronal fast low angle shot (FLASHwe) sequences (1.5 mm slice thickness) were acquired at 3 T, and two sagittal DESSwe sequences (0.7 mm slice thickness). Double oblique coronal multiplanar reformats (MPR) were performed (1.5 mm slice thickness) from the sagittal DESSwe. Knee joint cartilage plates were quantified unpaired in random order with blinding to subject identification.

Results: In the femorotibial joint, precision errors (root mean square coefficient of variation in % for unpaired analysis) for cartilage volume and thickness were 3.0–6.4% with coronal FLASHwe, 2.4–6.2% with coronal MPR DESSwe, and 2.3–8.2% with sagittal DESSwe. Correlation coefficients between DESSwe and FLASHwe ranged from r = 0.88 to 1.0. In the femoropatellar joint, precision errors (sagittal DESSwe) were 3.4–8.5%.

Conclusions: DESSwe permits accurate and precise analysis of cartilage morphology in the femorotibial joint at 3 T. Further studies are needed to examine the accuracy of DESSwe in the femoropatellar joint and its ability to characterise sensitivity to longitudinal changes in cartilage morphology.

  • AC, area of the cartilage surface
  • cLF, central lateral femur
  • cMF, central medial femur
  • cor, coronal
  • CV, coefficient of variation
  • dAB, denuded area of bone
  • DESS, double echo steady state
  • FLASH, fast low angle shot
  • LT, lateral tibiae
  • MPR, multiplanar reformats
  • MT, medial tibiae
  • NIAMS, National Institute of Arthritis and Musculoskeletal and Skin Diseases
  • qMRI, quantitative magnetic resonance imaging
  • OA, osteoarthritis
  • OAI, Osteoarthritis Initiative
  • P, patella
  • pLF, posterior lateral femur
  • pMF, posterior medial femur
  • RMS, root mean square
  • ROI, regions of interest
  • sag, sagittal
  • SPGR, spoiled gradient recalled echo
  • tAB, total area of subchondral bone
  • TrF, femoral trochlea
  • VC, cartilage volume
  • we, water excitation
  • cartilage
  • magnetic resonance imaging
  • osteoarthritis
  • biomarkers

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  • Published Online First 26 August 2005

  • Competing interest: None of the authors has a competing interest with regard to publication of the study, because no organisation may gain or lose financially from the results of conclusions published here. Felix Eckstein works as a consultant for Pfizer Inc, GlaxoSmithKline, and Virtualscopics Inc, and is CEO of Chondrometrics GmbH, a company providing MR image analysis services. Martin Hudelmaier and Wolfgang Wirth have a part time appointment with Chondrometrics GmbH.

  • Ethics approval: The study protocol, amendments, and informed consent documentation were reviewed and approved by the local institutional review boards.