# Time-efficient combined morphologic and quantitative joint MRI: an in situ study of standardized knee cartilage defects in human cadaveric specimens

## TL;DR

This study compares a new MRI technique called MIXTURE with traditional methods for assessing knee cartilage defects in human cadavers.

## Contribution

The study introduces MIXTURE sequences for time-efficient simultaneous morphologic and quantitative joint MRI.

## Key findings

- MIXTURE sequences provided comparable defect delineability and bone texture to reference sequences.
- Relaxation times increased significantly after defect creation in the central femur and combined regions.
- MIXTURE sequences allowed time-efficient morphologic and quantitative knee joint assessment.

## Abstract

Quantitative techniques such as T2 and T1ρ mapping allow evaluating the cartilage and meniscus. We evaluated multi-interleaved X-prepared turbo-spin echo with intuitive relaxometry (MIXTURE) sequences with turbo spin-echo (TSE) contrast and additional parameter maps versus reference TSE sequences in an in situ model of human cartilage defects.

Standardized cartilage defects of 8, 5, and 3 mm in diameter were created in the lateral femora of ten human cadaveric knee specimens (81 ± 10 years old; nine males, one female). MIXTURE sequences providing proton density-weighted fat-saturated images and T2 maps or T1-weighted images and T1ρ maps as well as the corresponding two- and three-dimensional TSE reference sequences were acquired before and after defect creation (3-T scanner; knee coil). Defect delineability, bone texture, and cartilage relaxation times were quantified. Appropriate parametric or non-parametric tests were used.

Overall, defect delineability and texture features were not significantly different between the MIXTURE and reference sequences (p ≤ 0.47). After defect creation, relaxation times significantly increased in the central femur (T2pre = 51 ± 4 ms [mean ± standard deviation] versus T2post = 56 ± 4 ms; p = 0.002) and all regions combined (T1ρpre = 40 ± 4 ms versus T1ρpost = 43 ± 4 ms; p = 0.004).

MIXTURE permitted time-efficient simultaneous morphologic and quantitative joint assessment based on clinical image contrasts. While providing T2 or T1ρ maps in clinically feasible scan time, morphologic image features, i.e., cartilage defects and bone texture, were comparable between MIXTURE and reference sequences.

Equally time-efficient and versatile, the MIXTURE sequence platform combines morphologic imaging using familiar contrasts, excellent image correspondence versus corresponding reference sequences and quantitative mapping information, thereby increasing the diagnostic value beyond mere morphology.

• Combined morphologic and quantitative MIXTURE sequences are based on three-dimensional TSE contrasts.

• MIXTURE sequences were studied in an in situ human cartilage defect model.

• Morphologic image features, i.e., defect delineabilty and bone texture, were investigated.

• Morphologic image features were similar between MIXTURE and reference sequences.

• MIXTURE allowed time-efficient simultaneous morphologic and quantitative knee joint assessment.

The online version contains supplementary material available at 10.1186/s41747-024-00462-0.