Tracking Stem Cell Implants in Cartilage Defects of Minipigs by Using Ferumoxytol-enhanced MRI

Background Cartilage repair outcomes of matrix-associated stem cell implants (MASIs) in patients have been highly variable. Conventional MRI cannot help distinguish between grafts that will and grafts that will not repair the underlying cartilage defect until many months after the repair. Purpose To...

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Veröffentlicht in:Radiology 2019-07, Vol.292 (1), p.129-137
Hauptverfasser: Theruvath, Ashok J, Nejadnik, Hossein, Lenkov, Olga, Yerneni, Ketan, Li, Kai, Kuntz, Lara, Wolterman, Cody, Tuebel, Jutta, Burgkart, Rainer, Liang, Tie, Felt, Stephen, Daldrup-Link, Heike E
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container_end_page 137
container_issue 1
container_start_page 129
container_title Radiology
container_volume 292
creator Theruvath, Ashok J
Nejadnik, Hossein
Lenkov, Olga
Yerneni, Ketan
Li, Kai
Kuntz, Lara
Wolterman, Cody
Tuebel, Jutta
Burgkart, Rainer
Liang, Tie
Felt, Stephen
Daldrup-Link, Heike E
description Background Cartilage repair outcomes of matrix-associated stem cell implants (MASIs) in patients have been highly variable. Conventional MRI cannot help distinguish between grafts that will and grafts that will not repair the underlying cartilage defect until many months after the repair. Purpose To determine if ferumoxytol nanoparticle labeling could be used to depict successful or failed MASIs compared with conventional MRI in a large-animal model. Materials and Methods Between January 2016 and December 2017, 10 Göttingen minipigs ( = 5 male; = 5 female; mean age, 6 months ± 5.1; age range, 4-20 months) received implants of unlabeled ( = 12) or ferumoxytol-labeled ( = 20) viable and apoptotic MASIs in cartilage defects of the distal femur. All MASIs were serially imaged with MRI on a 3.0-T imaging unit at week 1 and weeks 2, 4, 8, 12, and 24, with calculation of T2 relaxation times. Cartilage regeneration outcomes were assessed by using the MR observation of cartilage repair tissue (MOCART) score (scale, 0-100), the Pineda score, and histopathologic quantification of collagen 2 production in the cartilage defect. Findings were compared by using the unpaired Wilcoxon rank sum test, a linear regression model, the Fisher exact test, and Pearson correlation. Results Ferumoxytol-labeled MASIs showed significant T2 shortening (22.2 msec ± 3.2 vs 27.9 msec ± 1.8; < .001) and no difference in cartilage repair outcomes compared with unlabeled control MASIs ( > .05). At week 2 after implantation, ferumoxytol-labeled apoptotic MASIs showed a loss of iron signal and higher T2 relaxation times compared with ferumoxytol-labeled viable MASIs (26.6 msec ± 4.9 vs 20.8 msec ± 5.3; = .001). Standard MRI showed incomplete cartilage defect repair of apoptotic MASIs at 24 weeks. Iron signal loss at 2 weeks correlated with incomplete cartilage repair, diagnosed at histopathologic examination at 12-24 weeks. Conclusion Ferumoxytol nanoparticle labeling can accelerate the diagnosis of successful and failed matrix-associated stem cell implants at MRI in a large-animal model. © RSNA, 2019 See also the editorial by Sneag and Potter in this issue.
doi_str_mv 10.1148/radiol.2019182176
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Conventional MRI cannot help distinguish between grafts that will and grafts that will not repair the underlying cartilage defect until many months after the repair. Purpose To determine if ferumoxytol nanoparticle labeling could be used to depict successful or failed MASIs compared with conventional MRI in a large-animal model. Materials and Methods Between January 2016 and December 2017, 10 Göttingen minipigs ( = 5 male; = 5 female; mean age, 6 months ± 5.1; age range, 4-20 months) received implants of unlabeled ( = 12) or ferumoxytol-labeled ( = 20) viable and apoptotic MASIs in cartilage defects of the distal femur. All MASIs were serially imaged with MRI on a 3.0-T imaging unit at week 1 and weeks 2, 4, 8, 12, and 24, with calculation of T2 relaxation times. Cartilage regeneration outcomes were assessed by using the MR observation of cartilage repair tissue (MOCART) score (scale, 0-100), the Pineda score, and histopathologic quantification of collagen 2 production in the cartilage defect. Findings were compared by using the unpaired Wilcoxon rank sum test, a linear regression model, the Fisher exact test, and Pearson correlation. Results Ferumoxytol-labeled MASIs showed significant T2 shortening (22.2 msec ± 3.2 vs 27.9 msec ± 1.8; &lt; .001) and no difference in cartilage repair outcomes compared with unlabeled control MASIs ( &gt; .05). At week 2 after implantation, ferumoxytol-labeled apoptotic MASIs showed a loss of iron signal and higher T2 relaxation times compared with ferumoxytol-labeled viable MASIs (26.6 msec ± 4.9 vs 20.8 msec ± 5.3; = .001). Standard MRI showed incomplete cartilage defect repair of apoptotic MASIs at 24 weeks. Iron signal loss at 2 weeks correlated with incomplete cartilage repair, diagnosed at histopathologic examination at 12-24 weeks. Conclusion Ferumoxytol nanoparticle labeling can accelerate the diagnosis of successful and failed matrix-associated stem cell implants at MRI in a large-animal model. © RSNA, 2019 See also the editorial by Sneag and Potter in this issue.</description><identifier>ISSN: 0033-8419</identifier><identifier>EISSN: 1527-1315</identifier><identifier>DOI: 10.1148/radiol.2019182176</identifier><identifier>PMID: 31063081</identifier><language>eng</language><publisher>United States: Radiological Society of North America</publisher><subject>Animals ; Cartilage Diseases - diagnostic imaging ; Cartilage Diseases - surgery ; Cartilage, Articular - diagnostic imaging ; Cartilage, Articular - surgery ; Contrast Media ; Disease Models, Animal ; Ferrosoferric Oxide ; Magnetic Resonance Imaging - methods ; Original Research ; Stem Cell Transplantation - methods ; Swine ; Treatment Outcome</subject><ispartof>Radiology, 2019-07, Vol.292 (1), p.129-137</ispartof><rights>2019 by the Radiological Society of North America, Inc. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-4bd76e741dbdea2f40007825da641f41b494f9426d88e01e6f31a07bb759fc413</citedby><cites>FETCH-LOGICAL-c399t-4bd76e741dbdea2f40007825da641f41b494f9426d88e01e6f31a07bb759fc413</cites><orcidid>0000-0003-1664-5439 ; 0000-0002-4929-819X ; 0000-0002-4942-7529 ; 0000-0003-2373-005X ; 0000-0002-9107-4229 ; 0000-0003-1249-0724 ; 0000-0003-0764-6800 ; 0000-0001-7030-717X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,4016,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31063081$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Theruvath, Ashok J</creatorcontrib><creatorcontrib>Nejadnik, Hossein</creatorcontrib><creatorcontrib>Lenkov, Olga</creatorcontrib><creatorcontrib>Yerneni, Ketan</creatorcontrib><creatorcontrib>Li, Kai</creatorcontrib><creatorcontrib>Kuntz, Lara</creatorcontrib><creatorcontrib>Wolterman, Cody</creatorcontrib><creatorcontrib>Tuebel, Jutta</creatorcontrib><creatorcontrib>Burgkart, Rainer</creatorcontrib><creatorcontrib>Liang, Tie</creatorcontrib><creatorcontrib>Felt, Stephen</creatorcontrib><creatorcontrib>Daldrup-Link, Heike E</creatorcontrib><title>Tracking Stem Cell Implants in Cartilage Defects of Minipigs by Using Ferumoxytol-enhanced MRI</title><title>Radiology</title><addtitle>Radiology</addtitle><description>Background Cartilage repair outcomes of matrix-associated stem cell implants (MASIs) in patients have been highly variable. Conventional MRI cannot help distinguish between grafts that will and grafts that will not repair the underlying cartilage defect until many months after the repair. Purpose To determine if ferumoxytol nanoparticle labeling could be used to depict successful or failed MASIs compared with conventional MRI in a large-animal model. Materials and Methods Between January 2016 and December 2017, 10 Göttingen minipigs ( = 5 male; = 5 female; mean age, 6 months ± 5.1; age range, 4-20 months) received implants of unlabeled ( = 12) or ferumoxytol-labeled ( = 20) viable and apoptotic MASIs in cartilage defects of the distal femur. All MASIs were serially imaged with MRI on a 3.0-T imaging unit at week 1 and weeks 2, 4, 8, 12, and 24, with calculation of T2 relaxation times. Cartilage regeneration outcomes were assessed by using the MR observation of cartilage repair tissue (MOCART) score (scale, 0-100), the Pineda score, and histopathologic quantification of collagen 2 production in the cartilage defect. Findings were compared by using the unpaired Wilcoxon rank sum test, a linear regression model, the Fisher exact test, and Pearson correlation. Results Ferumoxytol-labeled MASIs showed significant T2 shortening (22.2 msec ± 3.2 vs 27.9 msec ± 1.8; &lt; .001) and no difference in cartilage repair outcomes compared with unlabeled control MASIs ( &gt; .05). At week 2 after implantation, ferumoxytol-labeled apoptotic MASIs showed a loss of iron signal and higher T2 relaxation times compared with ferumoxytol-labeled viable MASIs (26.6 msec ± 4.9 vs 20.8 msec ± 5.3; = .001). Standard MRI showed incomplete cartilage defect repair of apoptotic MASIs at 24 weeks. Iron signal loss at 2 weeks correlated with incomplete cartilage repair, diagnosed at histopathologic examination at 12-24 weeks. 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Conventional MRI cannot help distinguish between grafts that will and grafts that will not repair the underlying cartilage defect until many months after the repair. Purpose To determine if ferumoxytol nanoparticle labeling could be used to depict successful or failed MASIs compared with conventional MRI in a large-animal model. Materials and Methods Between January 2016 and December 2017, 10 Göttingen minipigs ( = 5 male; = 5 female; mean age, 6 months ± 5.1; age range, 4-20 months) received implants of unlabeled ( = 12) or ferumoxytol-labeled ( = 20) viable and apoptotic MASIs in cartilage defects of the distal femur. All MASIs were serially imaged with MRI on a 3.0-T imaging unit at week 1 and weeks 2, 4, 8, 12, and 24, with calculation of T2 relaxation times. Cartilage regeneration outcomes were assessed by using the MR observation of cartilage repair tissue (MOCART) score (scale, 0-100), the Pineda score, and histopathologic quantification of collagen 2 production in the cartilage defect. Findings were compared by using the unpaired Wilcoxon rank sum test, a linear regression model, the Fisher exact test, and Pearson correlation. Results Ferumoxytol-labeled MASIs showed significant T2 shortening (22.2 msec ± 3.2 vs 27.9 msec ± 1.8; &lt; .001) and no difference in cartilage repair outcomes compared with unlabeled control MASIs ( &gt; .05). At week 2 after implantation, ferumoxytol-labeled apoptotic MASIs showed a loss of iron signal and higher T2 relaxation times compared with ferumoxytol-labeled viable MASIs (26.6 msec ± 4.9 vs 20.8 msec ± 5.3; = .001). Standard MRI showed incomplete cartilage defect repair of apoptotic MASIs at 24 weeks. Iron signal loss at 2 weeks correlated with incomplete cartilage repair, diagnosed at histopathologic examination at 12-24 weeks. Conclusion Ferumoxytol nanoparticle labeling can accelerate the diagnosis of successful and failed matrix-associated stem cell implants at MRI in a large-animal model. © RSNA, 2019 See also the editorial by Sneag and Potter in this issue.</abstract><cop>United States</cop><pub>Radiological Society of North America</pub><pmid>31063081</pmid><doi>10.1148/radiol.2019182176</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1664-5439</orcidid><orcidid>https://orcid.org/0000-0002-4929-819X</orcidid><orcidid>https://orcid.org/0000-0002-4942-7529</orcidid><orcidid>https://orcid.org/0000-0003-2373-005X</orcidid><orcidid>https://orcid.org/0000-0002-9107-4229</orcidid><orcidid>https://orcid.org/0000-0003-1249-0724</orcidid><orcidid>https://orcid.org/0000-0003-0764-6800</orcidid><orcidid>https://orcid.org/0000-0001-7030-717X</orcidid><oa>free_for_read</oa></addata></record>
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subjects Animals
Cartilage Diseases - diagnostic imaging
Cartilage Diseases - surgery
Cartilage, Articular - diagnostic imaging
Cartilage, Articular - surgery
Contrast Media
Disease Models, Animal
Ferrosoferric Oxide
Magnetic Resonance Imaging - methods
Original Research
Stem Cell Transplantation - methods
Swine
Treatment Outcome
title Tracking Stem Cell Implants in Cartilage Defects of Minipigs by Using Ferumoxytol-enhanced MRI
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