In vivo biochemical assessment of cartilage with gagCEST MRI: Correlation with cartilage properties

Sander Brinkhof*, Razmara Nizak, Sotcheadt Sim, Vitaliy Khlebnikov, Eric Quenneville, Martin Garon, Dennis W.J. Klomp, Daniel Saris

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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To assess articular cartilage in vivo, a noninvasive measurement is proposed to evaluate damage of the cartilage. It is hypothesized that glycosaminoglycan chemical exchange saturation transfer (gagCEST) can be applied as a noninvasive imaging technique as it would relate to electromechanical indentation and GAG content as measured with biochemical assays. This pilot study applies gagCEST MRI in total knee arthroplasty (TKA) patients to assess substantially damaged articular cartilage. The outcome was verified against electromechanical indentation and biochemical assays to assess the potential of gagCEST MRI. Five TKA patients were scanned on a 7.0 T MRI with a gagCEST sequence. Articular resurfacing cuts after TKA were obtained for electromechanical and biochemical analyses. The gagCEST MRI measurements on the medial condyle showed a moderate correlation with the GAG content, although sensitivity on the lateral condyle was lacking. Additionally, a strong negative correlation of gagCEST MRI with the electromechanical measurements was observed in the regression analysis. Correlation of gagCEST MRI with electromechanical measurements was shown, but the correlation of gagCEST MRI with GAG content was not convincing. In conclusion, gagCEST could be a useful tool to assess the GAG content in articular cartilage noninvasively, although the mismatch in heterogeneity requires further investigation.

Original languageEnglish
Article numbere4463
JournalNMR in biomedicine
Issue number3
Publication statusPublished - 1 Mar 2021


  • 7 T
  • cartilage
  • gagCEST
  • osteoarthritis


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