Joint Embolization: Feasibility of Targeted Treatment and Response Assessment in the Shoulder, Hip and Knee Using Dynamic Contrast-Enhanced MRI

Motivation: Embolization, a new treatment for chronic joint pain, may be more clinically effective when treatment is targeted using pre-procedural dynamic contrast-enhanced (DCE)-MRI. Goal(s): Assess presence of synovitis and identify culprit arterial vessels using pre-procedural DCE-MRI. Approach: Representative patients with mild-moderate osteoarthritis of the shoulder, hip and knee underwent fat-suppressed DCE-MRI using CDT-VIBE. Imaging was performed with high temporal (6-7 sec/frame) and spatial (0.6 mm isotropic interpolated) resolution with 3-minute acquisition and 5cc/sec contrast injection. Results: DCE-MRI readily identifies regions of synovitis and its contributory arterial vessels. By exploiting contrast kinetics whole-joint synovial volumes can be semi-automatically calculated. Impact: MRI-targeted joint embolization therapy has the potential to result in improved pain and functional outcomes with reduced side effects. Rapid calculation of whole-joint synovial volumes may enable their use as a biomarker of arthritis severity and embolization treatment response.