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The aim of this study is to verify the ability of apparent diffusion coefficient (ADC) to detect differences in lesion microstructure between different JOCD stages, treatment groups, and healthy, unaffected contralateral knees. Pediatric patients with JOCD received quantitative diffusion MRI between January 2016 and September 2020 in this prospective research study. A disease stage (I\u2010IV) and stability of each JOCD lesion was evaluated. ADCs were calculated in progeny lesion, interface, parent bone, cartilage overlying lesion, control bone, and control cartilage regions. ADC differences were evaluated using linear mixed models with Bonferroni correction. Evaluated were 30 patients (mean age, 13 years; 21 males), with 40 JOCD\u2010affected and 12 healthy knees. Nine patients received surgical treatment after MRI. Negative Spearman rank correlations were found between ADCs and JOCD stage in the progeny lesion (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.572; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), interface (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.324; <jats:italic>p<\/jats:italic>\u2009=\u20090.041), and parent bone (<jats:italic>\u03c1<\/jats:italic>\u2009=\u2009\u22120.610; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), demonstrating the sensitivity of ADC to microstructural differences in lesions at different JOCD stages. We observed a significant increase in the interface ADCs (<jats:italic>p<\/jats:italic>\u2009=\u20090.007) between operative (mean [95%\u00a0CI]\u2009=\u20091.79 [1.56\u20132.01]\u2009\u00d7\u200910<jats:sup>\u22123<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s)\u00a0and nonoperative group (1.27 [0.98\u20131.57]\u2009\u00d7\u200910<jats:sup>\u22123<\/jats:sup>\u2009mm<jats:sup>2<\/jats:sup>\/s). Quantitative diffusion MRI detects microstructural differences in lesions at different stages of JOCD progression towards healing and reveals differences between patients assigned for operative versus nonoperative treatment.<\/jats:p>","DOI":"10.1002\/jor.25505","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T08:59:06Z","timestamp":1670576346000},"page":"1449-1463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of lesion and overlying articular cartilage in patients with juvenile osteochondritis dissecans of the knee using quantitative diffusion MRI"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8211-2828","authenticated-orcid":false,"given":"\u0160tefan","family":"Zb\u00fd\u0148","sequence":"first","affiliation":[{"name":"Department of Radiology, Center for Magnetic Resonance Research University of Minnesota Minneapolis Minnesota USA"},{"name":"Department of Radiology University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7670-8134","authenticated-orcid":false,"given":"Abdul Wahed","family":"Kajabi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Magnetic Resonance Research University of Minnesota Minneapolis Minnesota USA"},{"name":"Department of Radiology University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cyrus M.","family":"Nouraee","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Magnetic Resonance Research University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai D.","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Magnetic Resonance Research University of Minnesota Minneapolis Minnesota USA"},{"name":"Department of Radiology University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-7296","authenticated-orcid":false,"given":"Casey P.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Magnetic Resonance Research University of Minnesota Minneapolis Minnesota USA"},{"name":"Department of Veterinary Clinical Sciences University of Minnesota St. Paul Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc A.","family":"Tompkins","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery University of Minnesota Minneapolis Minnesota USA"},{"name":"TRIA Orthopedic Center Minneapolis Minnesota USA"},{"name":"Gillette Children's Specialty Healthcare St. Paul Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley J.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery University of Minnesota Minneapolis Minnesota USA"},{"name":"TRIA Orthopedic Center Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steen","family":"Moeller","sequence":"additional","affiliation":[{"name":"Department of Radiology, Center for Magnetic Resonance Research University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shelly","family":"Marette","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory 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