Quantitative MRI Techniques to Monitor Changes in Osteonecrosis of the Femoral Head Following Core Decompression: A Preliminary Study

Motivation: T1- and T2-weighted MRI fails to detect post-treatment healing of osteonecrosis of the femoral head (ONFH), limiting further treatment. Goal(s): To determine whether quantitative T2, fat fraction (FF), and diffusion (D) mappings can detect changes in ONFH lesions following core decompression treatment. Approach: Patients with ONFH were imaged at 3T MRI before (n=10) and 6 months after (n=7) core decompression. Pre-operatively, T2, FF, and D values from affected vs. surrounding unaffected regions of the hips were compared, and their changes in affected areas were evaluated post-operatively. Results: T2, FF, and D are sensitive in detecting ONFH and subsequent compositional changes following core decompression. Impact: Quantitative MRI techniques are sensitive in detecting compositional changes in ONFH lesions following core decompression treatment. These methods may help identify patients who can benefit from a second intervention and help improve patient management and optimize therapeutic approaches for ONFH.