Detection of early cartilage damage: feasibility and potential of gagCEST imaging at 7T

Sander Brinkhof (Corresponding author), Razmara Nizak, Vitaliy Khlebnikov, Jeanine J. Prompers, Dennis W.J. Klomp, Daniel B.F. Saris

Research output: Contribution to journalArticleAcademicpeer-review

37 Citations (Scopus)
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Objectives: The purpose was to implement a fast 3D glycosaminoglycan Chemical Exchange Saturation Transfer (gagCEST) sequence at 7 T, test stability and reproducibility in cartilage in the knee in healthy volunteers, and evaluate clinical applicability in cartilage repair patients. Methods: Experiments were carried out on a 7-T scanner using a volume transmit coil and a 32-channel receiver wrap-around knee coil. The 3D gagCEST measurement had an acquisition time of 7 min. Signal stability and reproducibility of the GAG effect were assessed in eight healthy volunteers. Clinical applicability of the method was demonstrated in five patients before cartilage repair surgery. Results: Coefficient of variation of the gagCEST signal was 1.9%. The reproducibility of the GAG effect measurements was good in the medial condyle (ICC = 0.87) and excellent in the lateral condyle (ICC = 0.97). GAG effect measurements in healthy cartilage ranged from 2.6%-12.4% compared with 1.3%-5.1% in damaged cartilage. Difference in GAG measurement between healthy cartilage and damaged cartilage was significant (p < 0.05). Conclusions: A fast 3D gagCEST sequence was applied at 7 T for use in cartilage in the knee, acquired within a clinically feasible scan time of 7 min. We demonstrated that the method has high stability, reproducibility and clinical applicability. Key Points: • gagCEST measurements are stable and reproducible • A non-invasive GAG measurement with gagCEST can be acquired in 7 min • gagCEST is able to discriminate between healthy and damaged cartilage.

Original languageEnglish
Pages (from-to)2874-2881
Number of pages8
JournalEuropean Radiology
Issue number7
Publication statusPublished - 1 Jul 2018


  • Cartilage
  • Glycosaminoglycans
  • Knee
  • Magnetic resonance imaging
  • Osteoarthritis
  • Reproducibility of Results
  • Cartilage, Articular/pathology
  • Humans
  • Magnetic Resonance Imaging/methods
  • Male
  • Healthy Volunteers
  • Knee Joint/pathology
  • Feasibility Studies
  • Young Adult
  • Adult
  • Female
  • Glycosaminoglycans/metabolism
  • Imaging, Three-Dimensional
  • Cartilage Diseases/pathology


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