Image registration improves human knee cartilage T1 mapping with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC)

Objectives: To evaluate the effect of automated registration in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) of the knee on the occurrence of movement artefacts on the T1 map and the reproducibility of region-of-interest (ROI)-based measurements. Methods: Eleven patients with early-stage knee osteoarthritis and ten healthy controls underwent dGEMRIC twice at 3 T. Controls underwent unenhanced imaging. ROIs were manually drawn on the femoral and tibial cartilage. T1 calculation was performed with and without registration of the T1-weighted images. Automated three-dimensional rigid registration was performed on the femur and tibia cartilage separately. Registration quality was evaluated using the square root Cramér-Rao lower bound (CRLB _σ). Additionally, the reproducibility of dGEMRIC was assessed by comparing automated registration with manual slice-matching. Results: Automated registration of the T1-weighted images improved the T1 maps as the 90% percentile of the CRLB_σ was significantly (P <0.05) reduced with a median reduction of 55.8ms (patients) and 112.9ms (controls). Manual matching and automated registration of the re-imaged T1 map gave comparable intraclass correlation coefficients of respectively 0.89/0.90 (patients) and 0.85/0.85 (controls). Conclusions: Registration in dGEMRIC reduces movement artefacts on T1 maps and provides a good alternative to manual slice-matching in longitudinal studies. Key Points: • Quantitative MRI is increasingly used for biomedical assessment of knee articular cartilage • Image registration leads to more accurate quantification of cartilage quality and damage • Movement artefacts in delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) are reduced • Automated image registration successfully aligns baseline and follow-up dGEMRIC examinations • Reproducibility of dGEMRIC with registration is similar to that using manual slice-matching