Diffusion-Weighted Imaging and Diffusion Tensor Imaging

Assessment of the integrity of the articular cartilage is considered key for the early diagnosis of osteoarthritis (OA). Diffusion-weighted imaging and diffusion tensor imaging have potential as biomarkers for cartilage composition and structure. The value of diffusion to detect compositional and structural changes in the cartilage matrix has been shown in ex vivo experiments for several years. However, it was not until recently that the first clinical studies have been performed. These clinical studies demonstrated the potential of diffusion to detect cartilage damage after injury, to early diagnose OA, and to measure cartilage remodeling after cartilage repair surgery. In this review, we provide a comprehensive overview of the literature on diffusion measurements on cartilage from ex vivo validation to its most recent clinical applications.