Vienna University. Austria: A footballer is able to play football again or to recommence training
six months after an operation on a cruciate ligament rupture in case of
a normal healing process. This interruption is common in professional
football, but it is merely an empirical value, as Siegfried Trattnig
from the University Clinic for Radiology and Nuclear Medicine at the
MedUni Wien (Medical University of Vienna) has emphasised. In future,
however, it will be possible to evaluate precisely both the load-bearing
capacity of the "new" cruciate ligament and the risk of a renewed
rupture using a new imaging process methodologically developed for
clinical use at the MedUni Wien, with which the biomechanical properties
of the knee and the cruciate ligament can be measured.
In
this process, the so-called gagCEST technique is used, the basic
principle of which originates from New York University. The
methodological further development for application in clinics was then
conducted at the Centre of Excellence for High Field MR at the
University Clinic for Radiology and Nuclear Medicine at the MedUni Wien,
and has now been used for the first time on patients with an operative
replacement of the anterior cruciate ligament. It is possible to measure
important components of the cartilage, menisci and knee joint
ligaments; the glycosaminoglycans (GAG). They represent a general
biomarker for the biomechanical properties of knee joint structures.
In
case of a cruciate ligament operation following a rupture of the
anterior cruciate ligament, a tendon from the patient themselves –
usually a tendon from the thigh – is used as a replacement cruciate
ligament to replace the damaged one. "The human body reacts to this by
converting this tendon into a ligament again in a process lasting
several months", the MedUni Wien expert explains on the occasion of the
European radiologist congress, ECR, which takes place from the 4th to
8th March in the Austria Center Vienna.
The stability of the
ligament could not up to now be determined using the current standard
magnetic resonance, but this can be achieved using the new gagCEST
technology. Trattnig: "The more glycosaminoglycans we can measure in the
new ligament, the better its stability and load-bearing capacity. As a
result, we can measure precisely when, depending on the measured values
during the healing process, a higher load can be placed on the knee and
also whether the so-called ligamentization, i.e. the conversion of the
tendon to a ligament, is still in progress and there is therefore still a
risk of a renewed rupture of the cruciate ligament."
This new
technology has now been used for the first time using a 7-Tesla
ultra-high field magnetic resonance tomography at the MedUni Wien, but
it can also be applied during methodological further development using
the 3-Tesla devices normally in operation.
Five research clusters at the MedUni Wien
In
total, five research clusters are established at the MedUni Wien. Here
key areas are increasingly focussed on in terms of basic principle and
clinical research at the MedUni Wien. The research clusters encompass
medical imaging, cancer research/oncology, cardiovascular medicine,
medical neurosciences and immunology. The content of this work lies
within the subject area of the cluster for medical imaging.
ECR European Radiologist Congress at the Austria Center, Vienna (4th-8th March 2015). All info: www.myesr.org.