PET/MRI Imaging of Early Musculoskeletal Disease

Osteoarthritis (OA) is the leading cause of disability worldwide, yet treatment options and understanding of OA remain limited, in part due to limited ability to detect early disease and responses to therapies. Radiography, the gold-standard of diagnosis in many MSK disorders, is insensitive to soft tissues and can only detect late-stage joint changes. New PET and MRI imaging methods can not only detect the earliest changes in OA in multiple joint tissues, but also relationships between them.

As it becomes clear that assessment of multiple tissues and functional processes is necessary to study the complex pathogenesis of OA and other MSK disorders, multi-modal imaging becomes increasingly important. We are pioneer PET-MRI technologies  to uniquely evaluate early, whole-joint OA pathogenesis. Dynamic PET imaging offers to provide multiple functional markers of bone physiology, which has been challenging with other methods that are invasive (bone biopsies) or lack spatial specificity (serum markers). Simultaneously acquired quantitative MRI, can evaluate early tissue microstructure changes in adjacent cartilage and meniscus. Together, this work will allow us to sensitively and quantitatively track the earliest changes of OA to study the spatiotemporal progression of disease. This will provide new insights into OA pathogenesis, leading to new treatment targets, and ultimately therapies to arrest the onset and progression of OA.

Watkins L, Haddock B, Mackay J, Uhlrich S, Mazzoli V, Gold G, Kogan F. [18F]NaF PET-MRI Detects Increased Metabolic Bone Response to Loading Stress in Osteoarthritic Knees. Osteoarthritis and Cartilage 2022;30(11):1515-1525 [OAC Link]

MacKay J, Watkins L, Gold G, Kogan F. [¹⁸F]NaF PET-MRI provides direct in-vivo evidence of the association between osseous metabolic activity and adjacent synovitis in knee osteoarthritis: a cross-sectional study. Osteoarthritis and Cartilage.  2021; 29(8): 1155-1162 [OAC Link]

Watkins L, MacKay J, Haddock B, Mazzoli V, Uhlrich S, Gold G, Kogan F. Kinetic Modeling of [18F]Sodium Fluoride PET Uptake for Quantitative Assessment of Subchondral Bone Perfusion and Mineralization in Knee Osteoarthritis. Osteoarthritis and Cartilage. 2021; 29:849-858 [OAC Link]

Haddock B, Fan A, Uhlrich S, Jorgenson N, Suetta C, Gold G, Kogan F. Assessment of acute bone loading in humans using [18F]-NaF PET/MRI. European Journal of Nuclear Medicine and Molecular Imaging 2019; 46(12):2452-2463 [ENJMMI Link][PMC Link]

Haddock B, Fan A, Jorgenson N, Suetta C, Gold G, Kogan F. Kinetic [¹⁸F]-fluoride of the knee in normal volunteers. Clinical Nuclear Medicine. 2019. 44(5):377-385

Yoder JS, Kogan F, Gold GE. Applications of PET–Computed Tomography–Magnetic Resonance in the Management of Benign Musculoskeletal Disorders. PET Clinics. 2019; 14(1): 1-15.

Kogan F, Fan A, Monu U, Iagaru A, Hargreaves B, Gold G. Quantitative Imaging of Bone-Cartilage Interactions in ACL-Injured Patients with PET-MRI. Osteoarthritis and Cartilage. 2018; 26(6): 790-796.

Kogan F, Broski S, Yoon D, Gold G. Applications of PET-MRI in Musculoskeletal Disease. Journal of Magnetic Resonance Imaging. 2018; 48(1): 27-47.

Kogan F, Fan A, McWalter E, Oei E, Quon A, Gold G. PET/MR Imaging of Metabolic Activity in Osteoarthritis: A Feasibility Study. Journal of Magnetic Resonance Imaging. 2017;45(6):1736-1745. (ISMRM Young Investigator Award Finalist (Cum Laude Award), Lodwick Award – Best paper of 2016 in the fields of musculoskeletal radiology, medicine, or biology - Musculoskeletal Division of the Department of Radiology at the Massachusetts General Hospital)

Kogan F, Fan AP, Gold GE. Potential of PET-MRI for imaging of non-oncologic musculoskeletal disease. Quantitative Imaging in Medicine and Surgery. 2016;6(6):756-771.