Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment

Akshay S. Chaudhari, Kathryn J. Stevens, Bragi Sveinsson, Jeff Wood, Christopher F. Beaulieu, Edwin H.G. Oei, Jarrett K. Rosenberg, Feliks Kogan, Marcus T. Alley, Garry E. Gold, Brian A. Hargreaves

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)e183-e194
JournalJournal of Magnetic Resonance Imaging
Volume49
Issue number7
DOIs
StatePublished - Jun 1 2019

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Knee Joint
Protons
Knee
Fats
Confidence Intervals
Reading
Prospective Studies

Keywords

  • DESS
  • abbreviated protocol
  • fast imaging
  • knee MRI
  • quantitative imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment. / Chaudhari, Akshay S.; Stevens, Kathryn J.; Sveinsson, Bragi; Wood, Jeff; Beaulieu, Christopher F.; Oei, Edwin H.G.; Rosenberg, Jarrett K.; Kogan, Feliks; Alley, Marcus T.; Gold, Garry E.; Hargreaves, Brian A.

In: Journal of Magnetic Resonance Imaging, Vol. 49, No. 7, 01.06.2019, p. e183-e194.

Research output: Contribution to journalArticle

Chaudhari, AS, Stevens, KJ, Sveinsson, B, Wood, J, Beaulieu, CF, Oei, EHG, Rosenberg, JK, Kogan, F, Alley, MT, Gold, GE & Hargreaves, BA 2019, 'Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment', Journal of Magnetic Resonance Imaging, vol. 49, no. 7, pp. e183-e194. https://doi.org/10.1002/jmri.26582
Chaudhari, Akshay S. ; Stevens, Kathryn J. ; Sveinsson, Bragi ; Wood, Jeff ; Beaulieu, Christopher F. ; Oei, Edwin H.G. ; Rosenberg, Jarrett K. ; Kogan, Feliks ; Alley, Marcus T. ; Gold, Garry E. ; Hargreaves, Brian A. / Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment. In: Journal of Magnetic Resonance Imaging. 2019 ; Vol. 49, No. 7. pp. e183-e194.
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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.",
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T1 - Combined 5-minute double-echo in steady-state with separated echoes and 2-minute proton-density-weighted 2D FSE sequence for comprehensive whole-joint knee MRI assessment

AU - Chaudhari, Akshay S.

AU - Stevens, Kathryn J.

AU - Sveinsson, Bragi

AU - Wood, Jeff

AU - Beaulieu, Christopher F.

AU - Oei, Edwin H.G.

AU - Rosenberg, Jarrett K.

AU - Kogan, Feliks

AU - Alley, Marcus T.

AU - Gold, Garry E.

AU - Hargreaves, Brian A.

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N2 - 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.

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