Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2024: imaging immediately after neoadjuvant therapy in soft tissue sarcoma, soft tissue tumor surveillance, and the role of interventional radiology.

Objectives: An update of the first European Society of Musculoskeletal Radiology (ESSR) consensus on soft tissue tumor imaging in 2015 became necessary due to technical advancements, further insights into specific entities, and the revised WHO classification (2020) and AJCC staging system (2017). The third part of the revised guidelines covers algorithms and techniques beyond initial imaging: (1) Imaging after neoadjuvant therapy in soft tissue sarcoma, (2) sarcoma surveillance, and (3) special aspects, including surveillance of non-malignant entities and the role of interventional radiology.

Materials And Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries.

Bone marrow edema-like signal after cartilage repair does not affect outcomes in a five-year follow-up.

Objectives: Bone marrow edema-like signal (BMELS) after cartilage repair is common, but its clinical significance remains uncertain. This study aimed to investigate the clinical and structural significance of BMELS following microfracturing (MFX) and matrix-induced autologous chondrocyte implantation (MACI).

Methods: In this multicenter study, MRI examinations were performed over a period of 5 years after cartilage repair surgery (MFX n = 17; MACI n = 28) in 45 patients.

Soft tissue tumor imaging in adults: whole-body staging in sarcoma, non-malignant entities requiring special algorithms, pitfalls and special imaging aspects. Guidelines 2024 from the European Society of Musculoskeletal Radiology (ESSR).

Objectives: The revised European Society of Musculoskeletal Radiology (ESSR) consensus guidelines on soft tissue tumor imaging represent an update of 2015 after technical advancements, further insights into specific entities, and revised World Health Organization (2020) and AJCC (2017) classifications. This second of three papers covers algorithms once histology is confirmed: (1) standardized whole-body staging, (2) special algorithms for non-malignant entities, and (3) multiplicity, genetic tumor syndromes, and pitfalls.

Materials And Methods: A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries.

Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where?

Objectives: Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary.

Ultrahigh-field MRI: where it really makes a difference.

Background: Currently, two major magnetic resonance (MR) vendors provide commercial 7‑T scanners that are approved by the Food and Drug Administration (FDA) for clinical application. There is growing interest in ultrahigh-field MRI because of the improved clinical results in terms of morphological detail, as well as functional and metabolic imaging capabilities.

Materials And Methods: The 7‑T systems benefit from a higher signal-to-noise ratio, which scales supralinearly with field strength, a supralinear increase in the blood oxygenation level dependent (BOLD) contrast for functional MRI and susceptibility weighted imaging (SWI), and the chemical shift increases linearly with field strength with consequently higher spectral resolution.

Unsupervised physiological noise correction of functional magnetic resonance imaging data using phase and magnitude information (PREPAIR).

Of the sources of noise affecting blood oxygen level-dependent functional magnetic resonance imaging (fMRI), respiration and cardiac fluctuations are responsible for the largest part of the variance, particularly at high and ultrahigh field. Existing approaches to removing physiological noise either use external recordings, which can be unwieldy and unreliable, or attempt to identify physiological noise from the magnitude fMRI data. Data-driven approaches are limited by sensitivity, temporal aliasing, and the need for user interaction.

Repeatability assessment of sodium (Na) MRI at 7.0 T in healthy human calf muscle and preliminary results on tissue sodium concentrations in subjects with Addison's disease.

Objectives: To determine the relaxation times of the sodium nucleus, and to investigate the repeatability of quantitative, in vivo TSC measurements using sodium magnetic resonance imaging (Na-MRI) in human skeletal muscle and explore the discriminatory value of the method by comparing TSCs between healthy subjects and patients with Addison's disease.

Materials And Methods: In this prospective study, ten healthy subjects and five patients with Addison's disease were involved. Na-MRI data sets were acquired using a density-adapted, three-dimensional radial projection reconstruction pulse sequence (DA-3DPR) with a modification for the relaxation times measurements.

MR Fingerprinting-A Radiogenomic Marker for Diffuse Gliomas.

(1) Background: Advanced MR imaging (MRI) of brain tumors is mainly based on qualitative contrast images. MR Fingerprinting (MRF) offers a novel approach. The purpose of this study was to use MRF-derived T1 and T2 relaxation maps to differentiate diffuse gliomas according to isocitrate dehydrogenase (IDH) mutation.

Differentiation of Cartilage Repair Techniques Using Texture Analysis from T Maps.

Objective: The aim of this study was to investigate texture features from T maps as a marker for distinguishing the maturation of repair tissue after 2 different cartilage repair procedures.

Design: Seventy-nine patients, after either microfracture (MFX) or matrix-associated chondrocyte transplantation (MACT), were examined on a 3-T magnetic resonance (MR) scanner with morphological and quantitative (T mapping) MR sequences 2 years after surgery. Twenty-one texture features from a gray-level co-occurrence matrix (GLCM) were extracted.

Soft Tissue Sarcoma Follow-up Imaging: Strategies to Distinguish Post-treatment Changes from Recurrence.

Soft tissue sarcomas encompass multiple entities with differing recurrence rates and follow-up intervals. The detection of recurrences and their differentiation from post-therapeutic changes is therefore complex, with a central role for the clinical radiologist. This article describes approved recommendations.

Reproducibility of an Automated Quantitative MRI Assessment of Low-Grade Knee Articular Cartilage Lesions.

Objective: The goal of this study was to assess the reproducibility of an automated knee cartilage segmentation of 21 cartilage regions with a model-based algorithm and to compare the results with manual segmentation.

Design: Thirteen patients with low-grade femoral cartilage defects were included in the study and were scanned twice on a 7-T magnetic resonance imaging (MRI) scanner 8 days apart. A 3-dimensional double-echo steady-state (3D-DESS) sequence was used to acquire MR images for automated cartilage segmentation, and T2-mapping was performed using a 3D triple-echo steady-state (3D-TESS) sequence.

Frontiers of Sodium MRI Revisited: From Cartilage to Brain Imaging.

Sodium magnetic resonance imaging ( Na-MRI) is a highly promising imaging modality that offers the possibility to noninvasively quantify sodium content in the tissue, one of the most relevant parameters for biochemical investigations. Despite its great potential, due to the intrinsically low signal-to-noise ratio (SNR) of sodium imaging generated by low in vivo sodium concentrations, low gyromagnetic ratio, and substantially shorter relaxation times than for proton ( H) imaging, Na-MRI is extremely challenging. In this article, we aim to provide a comprehensive overview of the literature that has been published in the last 10-15 years and which has demonstrated different technical designs for a range of Na-MRI methods applicable for disease diagnoses and treatment efficacy evaluations.

Chondral and Osteochondral Femoral Cartilage Lesions Treated with GelrinC: Significant Improvement of Radiological Outcome Over Time and Zonal Variation of the Repair Tissue Based on T Mapping at 24 Months.

Objective: To prospectively assess the efficacy of GelrinC in the treatment of chondral and osteochondral femoral cartilage lesions using morphological (Magnetic Resonance Observation of Cartilage Repair Tissue [MOCART]) and quantitative (T-mapping) magnetic resonance imaging (MRI).

Design: This study was designed as a prospective single-arm, open label, multicenter study. Morphological magnetic resonance imaging (MRI) for MOCART assessment and T mapping was performed 1 week and 6, 12, 18, and 24 months after GelrinC implantation.

Radiofrequency Chondroplasty May Not Have A Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans.

The effect of radiofrequency chondroplasty on cartilage tissue is not well studied. This prospective pilot study investigates the effect of radiofrequency chondroplasty on International Cartilage Repair Society (ICRS) grade II patellar cartilage defects using high-resolution magnetic resonance imaging (MRI) with T2 mapping. Six consecutive patients were treated for ICRS grade II patellar cartilage defects using radiofrequency chondroplasty.

Impact of concentration and dilution of three macrocyclic gadolinium-based contrast agents on MRI signal intensity at 1.5T and 3T and different pulse sequences: results of a phantom study in human plasma.

Background: Many factors influence the increase in signal intensity (SI) provided by magnetic resonance imaging (MRI) contrast media.

Purpose: To assess the impact of different gadolinium concentrations and dilutions of three macrocyclic gadolinium-based contrast agents (GBCA) on SI.

Material And Methods: This phantom study investigated gadobutrol, gadoteridol, and gadoterate in human plasma of a healthy donor pool at 37 °C.

Assessment of Low-Grade Focal Cartilage Lesions in the Knee With Sodium MRI at 7 T: Reproducibility and Short-Term, 6-Month Follow-up Data.

Objectives: Several articles have investigated potential of sodium (Na) magnetic resonance imaging (MRI) for the in vivo evaluation of cartilage health, but so far no study tested its feasibility for the evaluation of focal cartilage lesions of grade 1 or 2 as defined by the International Cartilage Repair Society. The aims of this study were to evaluate the ability of Na-MRI to differentiate between early focal lesions and normal-appearing cartilage, to evaluate within-subject reproducibility of Na-MRI, and to monitor longitudinal changes in participants with low-grade, focal chondral lesions.

Materials And Methods: Thirteen participants (mean age, 50.

Early diagnosis of degenerative changes in the articular/fibrocartilaginous disc of the temporomandibular joint in patients with temporomandibular disorders using delayed gadolinium-enhanced MRI at 3 Tesla - preliminary results.

Background: Delayed gadolinium enhanced MRI of cartilage (dGEMRIC) is a quantitative method for assessment of glycosaminoglycan content in connective tissues. We hypothesize that the early diagnosis of degenerative changes in the temporomandibular joint could be diagnosed using dGEMRIC technique.

Purpose: To test the compositional MRI technique, dGEMRIC, at 3 Tesla to diagnosis early the degenerative changes in the fibrocartilaginous disc of the temporomandibular joint (TMJ) in patients with temporomandibular disorders (TMD) and to compare the dGEMRIC index of patients to the healthy volunteers.

The MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score and Atlas.

Objective: Since the first introduction of the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score, significant progress has been made with regard to surgical treatment options for cartilage defects, as well as magnetic resonance imaging (MRI) of such defects. Thus, the aim of this study was to introduce the MOCART 2.0 knee score - an incremental update on the original MOCART score - that incorporates this progression.

Comparison of the Relaxivities of Macrocyclic Gadolinium-Based Contrast Agents in Human Plasma at 1.5, 3, and 7 T, and Blood at 3 T.

Purpose: The relaxivities of 3 macrocyclic gadolinium-based contrast agents (GBCAs) were determined in human plasma and blood under standardized and clinically relevant laboratory conditions.

Methods: The T1 relaxivity, r1, was determined in human plasma at 1.5, 3, and 7 T, and in human blood at 3 T at 37°C in phantoms containing 4 different concentrations of the macrocyclic GBCAs gadobutrol, gadoteridol, and gadoterate.

Magnetic Resonance Imaging of the Musculoskeletal System at 7T: Morphological Imaging and Beyond.

In 2017, a whole-body 7T magnetic resonance imaging (MRI) device was given regulatory approval for clinical use in both the EU and United States for neuro and musculoskeletal applications. As 7 Tesla allows for higher signal-to-noise , which results in higher resolution images than those obtained on lower-field-strength scanners, it has attracted considerable attention from the musculoskeletal field, as evidenced by the increasing number of publications in the last decade. Besides morphological imaging, the quantitative MR methods, such as T2, T2*, T1ρ mapping, sodium imaging, chemical-exchange saturation transfer, and spectroscopy, substantially benefit from ultrahigh field scanning.

T2 mapping with 3.0 T MRI of the temporomandibular joint disc of patients with disc dislocation.

Introduction: T2 mapping, as a quantitative biochemical MRI-technique that provides information on water and collagen fiber content and composition, was shown to be clinically feasible for the evaluation of healthy temporomandibular joints.

Objectives: The aim of our study was to compare the T2 values of whole discs in patients with and without disc dislocation, to evaluate the possible influence of morphological findings on T2 values and to assess the interrater agreement.

Methods: Sixty-six patients were included in the study.

The comparison of the performance of 3 T and 7 T T mapping for untreated low-grade cartilage lesions.

Objective: To investigate T mapping as a possible marker for low-grade human articular cartilage lesions during a one-year follow-up, possible changes during the follow-up and compare the reliability and sensitivity of these measurements on high-field (3 T) and ultra-high-field (7 T) MRI scanners.

Design: Twenty-one patients with femoral, tibial and patellar cartilage defect in the knee joint participated in the study. The MRI protocol consisted of morphological, as well as three-dimensional triple-echo steady-state (3D-TESS) T mapping sequences with similar parameters at 3T and 7T.