Description
- Abstract:
- Anterior cruciate ligament (ACL) injuries are among the most common knee injuries, often resulting in long rehabilitation periods with an increased risk of reinjury and post-traumatic osteoarthritis (PTOA). Current clinical imaging primarily relies on qualitative interpretation of magnetic resonance imaging (MRI), which limits the ability to assess the healing tissue. The objective of this dissertation was to advance quantitative MRI (qMRI) as a noninvasive tool for assessing the structural and functional integrity of healing knee joints tissues following ACL surgery. By advancing qMRI toward precise mapping and image interpretation, this work establishes foundational steps toward the use of qMRI-derived metrics as predictive biomarkers that can inform clinical decision making and improve patient outcomes. To accomplish this objective, each chapter addressed a specific aim designed to overcome key barriers to clinical implementation needed for qMRI to function as a reliable clinical tool. Specific Aim 1 focused on establishing the predictive validity of qMRI-derived biomarkers for identifying patients at elevated risk of reinjury following ACL surgery. Demonstrating that imaging-derived metrics can predict clinically meaningful outcomes is a critical step in validating any biomarker intended for clinical application. Specific Aim 2 targeted a major technical barrier affecting qMRI measurements that compromise accurate ACL SI quantification. Metallic artifacts from surgical hardware can distort MRI signal characteristics, leading to inaccurate interpretation of tissue healing. While qMRI has been increasingly used to evaluate ACL graft integrity following surgery, its application to the menisci has been limited. Specific Aim 3 expanded the qMRI framework to include the menisci by translating and adapting previously developed biomarkers to characterize meniscal structural changes following ACL injury and surgery. Lastly, the development of clinically translatable qMRI tools requires consideration of MRI sequence selection and compatibility across imaging protocols. Therefore, Specific Aim 4 explored the potential for extending the qMRI framework to more clinically used sequences. Collectively, the research presented in this dissertation advances qMRI from a primarily research-based imaging technique toward a clinically meaningful tool capable of quantitatively evaluating multiple knee joint tissues following ACL surgery to support individualized rehabilitation strategies and improve long-term outcomes for patients recovering from ACL surgery.
- Notes:
- Thesis (Ph. D.)--Brown University, 2026
Citation
Barnes, Dominique Alexis,
"Advancement of a Quantitative MRI Pipeline to Assess Healing Progression of Soft Tissues in the Knee After ACL Surgery"
(2026).
Biomedical Engineering Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:urerv9uz/
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Biomedical Engineering Theses and Dissertations
Theses and Dissertations for the Biomedical Engineering department....