Imaging strategies for quantitative, whole-joint assessment of structure and function related to knee osteoarthritis
Abstract/Contents
- Abstract
- Osteoarthritis (OA) is a degenerative disease of the joints, but treatment options have remained limited largely due to an inability to detect and monitor OA in its earliest stages. Medical imaging is a valuable tool to non-invasively evaluate changes in bone, soft tissues like cartilage, and the synovium in OA onset and progression. However, there is a need for improved methods that can not only detect structural and compositional changes in these tissues, but also changes in joint function early in the course of disease. This work develops and progresses the application of medical imaging tools to assess whole joint health in early OA. First, I focus on a magnetic resonance imaging (MRI) technique called gagCEST which aims to image glycosaminoglycan depletion, thought to be the earliest degenerative cartilage changes in OA, with high specificity. However, technical challenges have limited its translational potential at clinical field strengths like 3 Tesla. Here, I make improvements to the gagCEST technique to enable rapid, 3D imaging of the whole knee with improved dynamic range and good repeatability and apply it to study cartilage in a healthy cohort and a cohort with mild to moderate OA. While MRI is a valuable tool to probe structural changes in soft tissues and bone, imaging of bone function remains a challenge with MRI. Combining MRI with [18F]sodium fluoride positron emission tomography (PET) imaging allows for simultaneous assessment of structure and function. I advance the application of PET-MR imaging in OA by comparing quantitative measures of bone vascularization and mineralization in healthy and OA knees and examining spatial relationships between altered bone metabolism and degenerative changes in bone, cartilage, and the synovium. I further applied hybrid PET-MR imaging to study knee joint function by quantifying the short-term response of bone and cartilage to exercise. Results suggest that this technique has strong potential to detect early joint dysfunction after loading. Overall, this work represents a shift toward whole-joint imaging to assess spatial relationships between structure and function of multiple joint tissues.
Description
| Type of resource | text |
|---|---|
| Form | electronic resource; remote; computer; online resource |
| Extent | 1 online resource. |
| Place | California |
| Place | [Stanford, California] |
| Publisher | [Stanford University] |
| Copyright date | 2021; ©2021 |
| Publication date | 2021; 2021 |
| Issuance | monographic |
| Language | English |
Creators/Contributors
| Author | Watkins, Lauren Elizabeth |
|---|---|
| Degree supervisor | Kogan, Feliks |
| Degree supervisor | Levenston, Marc Elliot |
| Thesis advisor | Kogan, Feliks |
| Thesis advisor | Levenston, Marc Elliot |
| Thesis advisor | Gold, Garry E |
| Degree committee member | Gold, Garry E |
| Associated with | Stanford University, Department of Bioengineering |
Subjects
| Genre | Theses |
|---|---|
| Genre | Text |
Bibliographic information
| Statement of responsibility | Lauren Elizabeth Watkins. |
|---|---|
| Note | Submitted to the Department of Bioengineering. |
| Thesis | Thesis Ph.D. Stanford University 2021. |
| Location | https://purl.stanford.edu/md321dx9874 |
Access conditions
- Copyright
- © 2021 by Lauren Elizabeth Watkins
- License
- This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).
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