The Journal of Bone and Joint Surgery (American). 2009;91:44-49.
doi:10.2106/JBJS.H.01498
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Toward Imaging Biomarkers for Glycosaminoglycans

Martha L. Gray, PhD1

1 Harvard-MIT Division of Health Sciences and Technology, 77 Massachusetts Avenue, E25-519, Cambridge, MA 02123. E-mail address: mgray{at}mit.edu

Disclosure: In support of her research for or preparation of this work, the author received, in any one year, outside funding or grants in excess of $10,000 from the National Institutes of Health (NIH), Proctor and Gamble, Pfizer, and the National Science Foundation (NSF). In addition, the author or a member of her immediate family received, in any one year, payments or other benefits of less than $10,000 or a commitment or agreement to provide such benefits from commercial entities (American Academy of Orthopaedic Surgeons [AAOS] and Pfizer).

Advances in the diagnosis and treatment of cartilage degeneration will be accelerated with the availability of validated biomarkers that reveal the features relevant to the health of cartilage. Using the delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) technique for evaluating tissue glycosaminoglycan as a case study, I review the types of evidence needed to validate imaging (or other) biomarkers. In addition, I present discussions about face validity and technical validity and offer a review of emerging data that provide pathophysiologic validity. Examples of such data include evidence that glycosaminoglycan content is restored after an injury-induced loss and evidence suggesting that dGEMRIC can indicate when it is too late for protective (load-modifying) surgery. These and other data suggest that new imaging biomarkers may indeed be able to provide a state-of-cartilage proxy that can be of use in the diagnosis and staging of disease.


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