{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:09:54Z","timestamp":1781669394944,"version":"3.54.5"},"reference-count":40,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["5\/4-5\/4\/Ortho\/08\/NCD1"],"award-info":[{"award-number":["5\/4-5\/4\/Ortho\/08\/NCD1"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objectives: It is difficult to capture the severity of synovial inflammation on imaging. Herein we hypothesize that diffusion tensor imaging (DTI) derived metrics may delineate the aggregation of the inflammatory cells and expression of inflammatory cytokines and dynamic contrast-enhanced (DCE) imaging may provide information regarding vascularity in the inflamed synovium. Patients and methods: Patients with knee arthritis (&gt;3-months duration) underwent conventional (T2-weighted fast spin echo and spin echo T1-weighted images) as well as DTI and DCE MRI and thereafter arthroscopic guided synovial biopsy. DCE and DTI metrics were extracted from the masks of the segments of the inflamed synovium which enhanced on post-contrast T1-weighted MRI. These metrics were correlated with immunohistochemistry (IHC) parameters of inflammation on synovium. Statistical analysis: Pearson\u2019s correlation was performed to study the relationship between DTI- and DCE-derived metrics, IHC parameters, and post-contrast signal intensity. Linear regression model was used to predict the values of IHC parameters using various DTI and DCE derived metrics as predictors. Results: There were 80 patients (52 male) with mean age 39.78 years and mean disease duration 19.82 months. Nineteen patients had tuberculosis and the rest had chronic undifferentiated monoarthritis (n = 31), undifferentiated spondyloarthropathy (n = 14), rheumatoid arthritis (n = 6), osteoarthritis (n = 4), reactive arthritis (n = 3), ankylosing spondylitis (n = 2), and juvenile idiopathic arthritis (n = 1). Fractional anisotropy (FA), a metric of DTI, had significant correlation with number of immune cells (r = 0.87, p &lt; 0.01) infiltrating into the synovium and cytokines (IL-1\u03b2, r = 0.55, p &lt; 0.01; TNF-\u03b1, r = 0.42, p &lt; 0.01) in all patients and also in each group of patients and adhesion molecule expressed on these cells in all patients (CD54, r = 0.51, p &lt; 0.01). DCE parameters significantly correlated with CD34 (blood flow, r = 0.78, p &lt; 0.01; blood volume, r = 0.76, p &lt; 0.01) in each group of patients, a marker of neo-angiogenesis. FA was the best predictor of infiltrating inflammatory cells, adhesion molecule and proinflammatory cytokines. Amongst the DCE parameters, blood volume, was best predictor of CD34. Conclusion: DTI and DCE metrics capture cellular and molecular markers of synovial inflammation in patients with chronic inflammatory arthritis.<\/jats:p>","DOI":"10.3390\/diagnostics12123041","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T04:10:02Z","timestamp":1670213402000},"page":"3041","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Diffusion Tensor and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Correlate with Molecular Markers of Inflammation in the Synovium"],"prefix":"10.3390","volume":"12","author":[{"given":"Deepak","family":"Tripathi","sequence":"first","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Awasthi","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4508-1233","authenticated-orcid":false,"given":"Vikas","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinita","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Pathology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram Kishore Singh","family":"Rathore","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Statistics, Indian Institute of Technology, Kanpur 208016, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kusum","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, PB, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra Mani","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, UP, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.berh.2004.08.002","article-title":"The different stages of synovitis: Acute vs chronic, early vs. late and non-erosive vs erosive","volume":"19","author":"Tarner","year":"2005","journal-title":"Best Pr. 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