Akshay S Chaudhari1,2, Kathryn J Stevens1,3, Bragi Sveinsson1,4,5, Jeff P Wood1, Christopher F Beaulieu1,3, Edwin H G Oei6, Jarrett K Rosenberg1, Feliks Kogan1, Marcus T Alley1, Garry E Gold1,2,3, Brian A Hargreaves1,2,7. 1. Department of Radiology, Stanford University, Stanford, California, USA. 2. Department of Bioengineering, Stanford University, Stanford, California, USA. 3. Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA. 4. Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, Massachusetts, USA. 5. Department of Radiology, Harvard Medical School, Boston, Massachusetts, USA. 6. Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. 7. Department of Electrical Engineering, Stanford University, Stanford, California, USA.
Abstract
BACKGROUND: Clinical knee MRI protocols require upwards of 15 minutes of scan time. PURPOSE/HYPOTHESIS: To compare the imaging appearance of knee abnormalities depicted with a 5-minute 3D double-echo in steady-state (DESS) sequence with separate echo images, with that of a routine clinical knee MRI protocol. A secondary goal was to compare the imaging appearance of knee abnormalities depicted with 5-minute DESS paired with a 2-minute coronal proton-density fat-saturated (PDFS) sequence. STUDY TYPE: Prospective. SUBJECTS: Thirty-six consecutive patients (19 male) referred for a routine knee MRI. FIELD STRENGTH/SEQUENCES: DESS and PDFS at 3T. ASSESSMENT: Five musculoskeletal radiologists evaluated all images for the presence of internal knee derangement using DESS, DESS+PDFS, and the conventional imaging protocol, and their associated diagnostic confidence of the reading. STATISTICAL TESTS: Differences in positive and negative percent agreement (PPA and NPA, respectively) and 95% confidence intervals (CIs) for DESS and DESS+PDFS compared with the conventional protocol were calculated and tested using exact McNemar tests. The percentage of observations where DESS or DESS+PDFS had equivalent confidence ratings to DESS+Conv were tested with exact symmetry tests. Interreader agreement was calculated using Krippendorff's alpha. RESULTS: DESS had a PPA of 90% (88-92% CI) and NPA of 99% (99-99% CI). DESS+PDFS had increased PPA of 99% (95-99% CI) and NPA of 100% (99-100% CI) compared with DESS (both P < 0.001). DESS had equivalent diagnostic confidence to DESS+Conv in 94% of findings, whereas DESS+PDFS had equivalent diagnostic confidence in 99% of findings (both P < 0.001). All readers had moderate concordance for all three protocols (Krippendorff's alpha 47-48%). DATA CONCLUSION: Both 1) 5-minute 3D-DESS with separated echoes and 2) 5-minute 3D-DESS paired with a 2-minute coronal PDFS sequence depicted knee abnormalities similarly to a routine clinical knee MRI protocol, which may be a promising technique for abbreviated knee MRI. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
BACKGROUND: Clinical knee MRI protocols require upwards of 15 minutes of scan time. PURPOSE/HYPOTHESIS: To compare the imaging appearance of knee abnormalities depicted with a 5-minute 3D double-echo in steady-state (DESS) sequence with separate echo images, with that of a routine clinical knee MRI protocol. A secondary goal was to compare the imaging appearance of knee abnormalities depicted with 5-minute DESS paired with a 2-minute coronal proton-density fat-saturated (PDFS) sequence. STUDY TYPE: Prospective. SUBJECTS: Thirty-six consecutive patients (19 male) referred for a routine knee MRI. FIELD STRENGTH/SEQUENCES: DESS and PDFS at 3T. ASSESSMENT: Five musculoskeletal radiologists evaluated all images for the presence of internal knee derangement using DESS, DESS+PDFS, and the conventional imaging protocol, and their associated diagnostic confidence of the reading. STATISTICAL TESTS: Differences in positive and negative percent agreement (PPA and NPA, respectively) and 95% confidence intervals (CIs) for DESS and DESS+PDFS compared with the conventional protocol were calculated and tested using exact McNemar tests. The percentage of observations where DESS or DESS+PDFS had equivalent confidence ratings to DESS+Conv were tested with exact symmetry tests. Interreader agreement was calculated using Krippendorff's alpha. RESULTS:DESS had a PPA of 90% (88-92% CI) and NPA of 99% (99-99% CI). DESS+PDFS had increased PPA of 99% (95-99% CI) and NPA of 100% (99-100% CI) compared with DESS (both P < 0.001). DESS had equivalent diagnostic confidence to DESS+Conv in 94% of findings, whereas DESS+PDFS had equivalent diagnostic confidence in 99% of findings (both P < 0.001). All readers had moderate concordance for all three protocols (Krippendorff's alpha 47-48%). DATA CONCLUSION: Both 1) 5-minute 3D-DESS with separated echoes and 2) 5-minute 3D-DESS paired with a 2-minute coronal PDFS sequence depicted knee abnormalities similarly to a routine clinical knee MRI protocol, which may be a promising technique for abbreviated knee MRI. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
Authors: Martin Blaimer; Felix Breuer; Matthias Mueller; Robin M Heidemann; Mark A Griswold; Peter M Jakob Journal: Top Magn Reson Imaging Date: 2004-08
Authors: Richard Kijowski; Kirkland W Davis; Michael A Woods; Mary J Lindstrom; Arthur A De Smet; Garry E Gold; Reed F Busse Journal: Radiology Date: 2009-08 Impact factor: 11.105
Authors: Richard Kijowski; Donna G Blankenbaker; Jessica L Klaers; Kazuhiko Shinki; Arthur A De Smet; Walter F Block Journal: Radiology Date: 2009-02-12 Impact factor: 11.105
Authors: Akshay S Chaudhari; Zhongnan Fang; Feliks Kogan; Jeff Wood; Kathryn J Stevens; Eric K Gibbons; Jin Hyung Lee; Garry E Gold; Brian A Hargreaves Journal: Magn Reson Med Date: 2018-03-26 Impact factor: 4.668
Authors: Goetz H Welsch; Tallal C Mamisch; Stephan E Domayer; Ronald Dorotka; Florian Kutscha-Lissberg; Stefan Marlovits; Lawrence M White; Siegfried Trattnig Journal: Radiology Date: 2008-04 Impact factor: 11.105
Authors: Sandro Kohl; Simon Meier; Sufian S Ahmad; Harald Bonel; Aristomenis K Exadaktylos; Anna Krismer; Dimitrios Stergios Evangelopoulos Journal: J Orthop Surg Res Date: 2015-12-29 Impact factor: 2.359
Authors: Akshay S Chaudhari; Kathryn J Stevens; Jeff P Wood; Amit K Chakraborty; Eric K Gibbons; Zhongnan Fang; Arjun D Desai; Jin Hyung Lee; Garry E Gold; Brian A Hargreaves Journal: J Magn Reson Imaging Date: 2019-07-16 Impact factor: 4.813
Authors: Bragi Sveinsson; Akshay S Chaudhari; Bo Zhu; Neha Koonjoo; Martin Torriani; Garry E Gold; Matthew S Rosen Journal: Radiol Artif Intell Date: 2021-05-26
Authors: Jacob Thoenen; Kathryn J Stevens; Tom D Turmezei; Akshay Chaudhari; Lauren E Watkins; Emily J McWalter; Brian A Hargreaves; Garry E Gold; James W MacKay; Feliks Kogan Journal: Eur Radiol Date: 2021-05-15 Impact factor: 5.315
Authors: Akshay S Chaudhari; Christopher M Sandino; Elizabeth K Cole; David B Larson; Garry E Gold; Shreyas S Vasanawala; Matthew P Lungren; Brian A Hargreaves; Curtis P Langlotz Journal: J Magn Reson Imaging Date: 2020-08-24 Impact factor: 5.119
Authors: Susanne M Eijgenraam; Akshay S Chaudhari; Max Reijman; Sita M A Bierma-Zeinstra; Brian A Hargreaves; Jos Runhaar; Frank W J Heijboer; Garry E Gold; Edwin H G Oei Journal: Eur Radiol Date: 2019-12-16 Impact factor: 5.315
Authors: Oliver Said; Justus Schock; Nils Krämer; Johannes Thüring; Lea Hitpass; Philipp Schad; Christiane Kuhl; Daniel Abrar; Daniel Truhn; Sven Nebelung Journal: MAGMA Date: 2020-04-20 Impact factor: 2.310
Authors: Jacob Thoenen; James W MacKay; Halston J C Sandford; Garry E Gold; Feliks Kogan Journal: AJR Am J Roentgenol Date: 2021-07-21 Impact factor: 3.959