This first in human study evaluated cartilage biochemistry and bone function in sixteen knee osteoarthritis patients using simultaneous Time-Of-Flight (TOF) PET/MR imaging. Bone turnover and blood flow was studied using 18F Sodium Fluoride (NaF) and quantitative voxel by voxel MR derived T1ρ relaxation times characterizing the biochemical cartilage degeneration. Increased degeneration of cartilage, was associated with increased turnover in the adjoining bone as well as in the non-adjoining compartments. These observations highlight the complex biomechanical and biochemical interactions in the whole knee joint, alluding to a “bone-cartilage connectome”, that potentially changes during the natural history of the disease.
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