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Five‐minute knee MRI for simultaneous morphometry and T 2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T
Author(s) -
Chaudhari Akshay S.,
Black Marianne S.,
Eijgenraam Susanne,
Wirth Wolfgang,
Maschek Susanne,
Sveinsson Bragi,
Eckstein Felix,
Oei Edwin H.G.,
Gold Garry E.,
Hargreaves Brian A.
Publication year - 2018
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25883
Subject(s) - reproducibility , relaxometry , repeatability , flip angle , osteoarthritis , nuclear medicine , meniscus , magnetic resonance imaging , medicine , cartilage , biomedical engineering , radiology , pathology , anatomy , spin echo , chemistry , mathematics , alternative medicine , geometry , incidence (geometry) , chromatography
Background Biomarkers for assessing osteoarthritis activity necessitate multiple MRI sequences with long acquisition times. Purpose To perform 5‐minute simultaneous morphometry (thickness/volume measurements) and T 2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS). Study Type Prospective. Subjects Fifteen healthy volunteers for morphometry and T 2 measurements, and 15 patients (five each Kellgren–Lawrence grades 0/2/3) for MOAKS assessment. Field Strength/Sequence A 5‐minute double‐echo steady‐state (DESS) sequence was evaluated for generating quantitative and semiquantitative osteoarthritis biomarkers at 3T. Assessment Flip angle simulations evaluated tissue signals and sensitivity of T 2 measurements. Morphometry and T 2 reproducibility was compared against morphometry‐optimized and relaxometry‐optimized sequences. Repeatability was assessed by scanning five volunteers twice. MOAKS reproducibility was compared to MOAKS derived from a clinical knee MRI protocol by two readers. Statistical Tests Coefficients of variation (CVs), concordance confidence intervals (CCI), and Wilcoxon signed‐rank tests compared morphometry and relaxometry measurements with their reference standards. DESS MOAKS positive percent agreement (PPA), negative percentage agreement (NPA), and interreader agreement was calculated using the clinical protocol as a reference. Biomarker variations between Kellgren–Lawrence groups were evaluated using Wilcoxon rank‐sum tests. Results Cartilage thickness ( P = 0.65), cartilage T 2 ( P = 0.69), and meniscus T 2 ( P = 0.06) did not significantly differ from their reference standard (with a 20° DESS flip angle). DESS slightly overestimated meniscus volume ( P < 0.001). Accuracy and repeatability CVs were <3.3%, except the meniscus T 2 accuracy (7.6%). DESS MOAKS had substantial interreader agreement and high PPA/NPA values of 87%/90%. Bone marrow lesions and menisci had slightly lower PPAs. Cartilage and meniscus T 2 , and MOAKS (cartilage surface area, osteophytes, cysts, and total score) was higher in Kellgren–Lawrence groups 2 and 3 than group 0 ( P < 0.05). Data Conclusion The 5‐minute DESS sequence permits MOAKS assessment for a majority of tissues, along with repeatable and reproducible simultaneous cartilage and meniscus T 2 relaxometry and morphometry measurements. Level of Evidence: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:1328–1341.