Native MR imaging of synovitis with diffusion-weighted MRI

• Applicant: Professor Dr. Henning Neubauer
• Subject Area: Nuclear Medicine, Radiotherapy, Radiobiology
• Term: from 2015 to 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 259187956

Aim of this project is to develop and to implement diffusion-weighted MR imaging (DWI) as a novel approach to imaging of synovitis without the need of intravenous contrast agent. Synovial inflammation plays a key role in the pathogenesis of arthritis and subsequent arthritic joint destruction. MRI has become the mainstay of musculoskeletal imaging and is the preferred imaging modality for early diagnosis of rheumatologic disease. To date, MR imaging of synovitis is a domain of T1-weighted sequences enhanced with intravenously administered gadolinium-based contrast agents. Placing a peripheral venous line for i.v. contrast application, however, transforms MRI into an invasive examination, which is particularly true for paediatric patients. Additionally, native imaging of synovitis would favourably address and avoid a number of other concerns, such as risk of allergic reactions to intravenous contrast, necessary pre-scan blood analysis to ascertain unimpaired renal function and cost of contrast agent. DWI derives imaging contrast from the varying degree of restriction that diffusivity of water molecules is subject to within biological tissues without the need of externally applied contrast material. Initial experience in patients with juvenile idiopathic arthritis of the knee joint demonstrates that visualisation of inflamed synovia based on altered diffusivity is feasible. The project focuses on development and clinical implication of novel techniques for diffusion-weighted MR imaging with optimized contrast, higher spatial resolution and shorter image acquisition so as to improve the so far limited image quality and to facilitate synovial imaging of small joints. The diagnostic value of these new sequences will prospectively undergo evaluation in comparison to the present gold standard of contrast-enhanced T1-weighted MR imaging. Quantitative analysis of synovial diffusivity, as measured with the apparent diffusion coefficient (ADC), will be investigated as a possible novel marker of inflammatory activity.

• DFG Programme: Research Grants
• Participating Persons: Professor Dr. Thorsten Bley; Professor Dr. Herbert Köstler; Professorin Dr. Martina Prelog