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Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T
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 T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis...
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| Published in: | Journal of magnetic resonance imaging 2018-05, Vol.47 (5), p.1328-1341 |
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| container_end_page | 1341 |
| container_issue | 5 |
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| container_title | Journal of magnetic resonance imaging |
| container_volume | 47 |
| creator | 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. |
| description | 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 T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS).
Study Type
Prospective.
Subjects
Fifteen healthy volunteers for morphometry and T2 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 T2 measurements. Morphometry and T2 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 T2 (P = 0.69), and meniscus T2 (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 |
| doi_str_mv | 10.1002/jmri.25883 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_wiley</sourceid><recordid>TN_cdi_proquest_miscellaneous_1958541165</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2024886067</sourcerecordid><originalsourceid>FETCH-LOGICAL-p1393-470c2a3efd498a9055a59d130e5789fcc4f5f055c00629cc5aecb53d4fd701593</originalsourceid><addsrcrecordid>eNpdUUtuFDEQbSEiERI2nMASGzYdyna7u71EEQlBQUhoWFuOu3riwZ-J7YbMjiNwIS7DSfDMZMWqqp7fqyrXa5rXFC4oAHu38cleMDGO_FlzSgVjbS365zUHwVs6wvCieZnzBgCk7MRp8-fK_sC_v357G5aC5HtAJJ-_3pA5JpKtX1zRAeOSiY9pex89lrQjOkxkxUhCpx-foDgTo1OxTq_x8O4x2GyqcF8cuqG3D4sOxRZd6lCS9GSji2trtCM6Z8y5igpZsg1rMsXlzu03Q3MfiQ0kF9TTrgK56uuMQvjqvDmZtcv46imeNd-uPqwuP7a3X65vLt_ftlvKJW-7AQzTHOepk6OWIIQWcqIcUAyjnI3pZjFX1AD0TBojNJo7wadungagQvKz5u2x7zbFhwVzUb5-Dp07HkdRKUbRUdqLSn3zH3UTlxTqdooB68axh36oLHpk_bQOd2qbrNdppyiovY1qb6M62Kg-VTcOGf8HFG2Z8A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2024886067</pqid></control><display><type>article</type><title>Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T</title><source>Wiley</source><creator>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.</creator><creatorcontrib>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.</creatorcontrib><description>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 T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS).
Study Type
Prospective.
Subjects
Fifteen healthy volunteers for morphometry and T2 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 T2 measurements. Morphometry and T2 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 T2 (P = 0.69), and meniscus T2 (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 T2 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 T2, 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 T2 relaxometry and morphometry measurements.
Level of Evidence: 2
Technical Efficacy: Stage 1
J. Magn. Reson. Imaging 2018;47:1328–1341.</description><identifier>ISSN: 1053-1807</identifier><identifier>EISSN: 1522-2586</identifier><identifier>DOI: 10.1002/jmri.25883</identifier><language>eng</language><publisher>Nashville: Wiley Subscription Services, Inc</publisher><subject>Agreements ; Arthritis ; Biocompatibility ; Biomarkers ; Biomedical materials ; Bone marrow ; Cartilage ; Cartilage diseases ; Coefficient of variation ; Confidence intervals ; Cysts ; DESS ; Field strength ; Knee ; Lesions ; Magnetic resonance imaging ; Mathematical analysis ; Meniscus ; MOAKS ; Morphometry ; Osteoarthritis ; Osteophytes ; Rank tests ; Reproducibility ; Sensitivity analysis ; Statistical analysis ; Statistical tests</subject><ispartof>Journal of magnetic resonance imaging, 2018-05, Vol.47 (5), p.1328-1341</ispartof><rights>2017 International Society for Magnetic Resonance in Medicine</rights><rights>2018 International Society for Magnetic Resonance in Medicine</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-3667-6796</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Chaudhari, Akshay S.</creatorcontrib><creatorcontrib>Black, Marianne S.</creatorcontrib><creatorcontrib>Eijgenraam, Susanne</creatorcontrib><creatorcontrib>Wirth, Wolfgang</creatorcontrib><creatorcontrib>Maschek, Susanne</creatorcontrib><creatorcontrib>Sveinsson, Bragi</creatorcontrib><creatorcontrib>Eckstein, Felix</creatorcontrib><creatorcontrib>Oei, Edwin H.G.</creatorcontrib><creatorcontrib>Gold, Garry E.</creatorcontrib><creatorcontrib>Hargreaves, Brian A.</creatorcontrib><title>Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T</title><title>Journal of magnetic resonance imaging</title><description>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 T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS).
Study Type
Prospective.
Subjects
Fifteen healthy volunteers for morphometry and T2 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 T2 measurements. Morphometry and T2 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 T2 (P = 0.69), and meniscus T2 (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 T2 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 T2, 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 T2 relaxometry and morphometry measurements.
Level of Evidence: 2
Technical Efficacy: Stage 1
J. Magn. Reson. Imaging 2018;47:1328–1341.</description><subject>Agreements</subject><subject>Arthritis</subject><subject>Biocompatibility</subject><subject>Biomarkers</subject><subject>Biomedical materials</subject><subject>Bone marrow</subject><subject>Cartilage</subject><subject>Cartilage diseases</subject><subject>Coefficient of variation</subject><subject>Confidence intervals</subject><subject>Cysts</subject><subject>DESS</subject><subject>Field strength</subject><subject>Knee</subject><subject>Lesions</subject><subject>Magnetic resonance imaging</subject><subject>Mathematical analysis</subject><subject>Meniscus</subject><subject>MOAKS</subject><subject>Morphometry</subject><subject>Osteoarthritis</subject><subject>Osteophytes</subject><subject>Rank tests</subject><subject>Reproducibility</subject><subject>Sensitivity analysis</subject><subject>Statistical analysis</subject><subject>Statistical tests</subject><issn>1053-1807</issn><issn>1522-2586</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpdUUtuFDEQbSEiERI2nMASGzYdyna7u71EEQlBQUhoWFuOu3riwZ-J7YbMjiNwIS7DSfDMZMWqqp7fqyrXa5rXFC4oAHu38cleMDGO_FlzSgVjbS365zUHwVs6wvCieZnzBgCk7MRp8-fK_sC_v357G5aC5HtAJJ-_3pA5JpKtX1zRAeOSiY9pex89lrQjOkxkxUhCpx-foDgTo1OxTq_x8O4x2GyqcF8cuqG3D4sOxRZd6lCS9GSji2trtCM6Z8y5igpZsg1rMsXlzu03Q3MfiQ0kF9TTrgK56uuMQvjqvDmZtcv46imeNd-uPqwuP7a3X65vLt_ftlvKJW-7AQzTHOepk6OWIIQWcqIcUAyjnI3pZjFX1AD0TBojNJo7wadungagQvKz5u2x7zbFhwVzUb5-Dp07HkdRKUbRUdqLSn3zH3UTlxTqdooB68axh36oLHpk_bQOd2qbrNdppyiovY1qb6M62Kg-VTcOGf8HFG2Z8A</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Chaudhari, Akshay S.</creator><creator>Black, Marianne S.</creator><creator>Eijgenraam, Susanne</creator><creator>Wirth, Wolfgang</creator><creator>Maschek, Susanne</creator><creator>Sveinsson, Bragi</creator><creator>Eckstein, Felix</creator><creator>Oei, Edwin H.G.</creator><creator>Gold, Garry E.</creator><creator>Hargreaves, Brian A.</creator><general>Wiley Subscription Services, Inc</general><scope>7QO</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3667-6796</orcidid></search><sort><creationdate>201805</creationdate><title>Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p1393-470c2a3efd498a9055a59d130e5789fcc4f5f055c00629cc5aecb53d4fd701593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Agreements</topic><topic>Arthritis</topic><topic>Biocompatibility</topic><topic>Biomarkers</topic><topic>Biomedical materials</topic><topic>Bone marrow</topic><topic>Cartilage</topic><topic>Cartilage diseases</topic><topic>Coefficient of variation</topic><topic>Confidence intervals</topic><topic>Cysts</topic><topic>DESS</topic><topic>Field strength</topic><topic>Knee</topic><topic>Lesions</topic><topic>Magnetic resonance imaging</topic><topic>Mathematical analysis</topic><topic>Meniscus</topic><topic>MOAKS</topic><topic>Morphometry</topic><topic>Osteoarthritis</topic><topic>Osteophytes</topic><topic>Rank tests</topic><topic>Reproducibility</topic><topic>Sensitivity analysis</topic><topic>Statistical analysis</topic><topic>Statistical tests</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chaudhari, Akshay S.</creatorcontrib><creatorcontrib>Black, Marianne S.</creatorcontrib><creatorcontrib>Eijgenraam, Susanne</creatorcontrib><creatorcontrib>Wirth, Wolfgang</creatorcontrib><creatorcontrib>Maschek, Susanne</creatorcontrib><creatorcontrib>Sveinsson, Bragi</creatorcontrib><creatorcontrib>Eckstein, Felix</creatorcontrib><creatorcontrib>Oei, Edwin H.G.</creatorcontrib><creatorcontrib>Gold, Garry E.</creatorcontrib><creatorcontrib>Hargreaves, Brian A.</creatorcontrib><collection>Biotechnology Research Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of magnetic resonance imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chaudhari, Akshay S.</au><au>Black, Marianne S.</au><au>Eijgenraam, Susanne</au><au>Wirth, Wolfgang</au><au>Maschek, Susanne</au><au>Sveinsson, Bragi</au><au>Eckstein, Felix</au><au>Oei, Edwin H.G.</au><au>Gold, Garry E.</au><au>Hargreaves, Brian A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T</atitle><jtitle>Journal of magnetic resonance imaging</jtitle><date>2018-05</date><risdate>2018</risdate><volume>47</volume><issue>5</issue><spage>1328</spage><epage>1341</epage><pages>1328-1341</pages><issn>1053-1807</issn><eissn>1522-2586</eissn><abstract>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 T2 relaxometry of both cartilage and meniscus, and semiquantitative MRI Osteoarthritis Knee Scoring (MOAKS).
Study Type
Prospective.
Subjects
Fifteen healthy volunteers for morphometry and T2 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 T2 measurements. Morphometry and T2 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 T2 (P = 0.69), and meniscus T2 (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 T2 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 T2, 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 T2 relaxometry and morphometry measurements.
Level of Evidence: 2
Technical Efficacy: Stage 1
J. Magn. Reson. Imaging 2018;47:1328–1341.</abstract><cop>Nashville</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1002/jmri.25883</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-3667-6796</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of magnetic resonance imaging, 2018-05, Vol.47 (5), p.1328-1341 |
| issn | 1053-1807 1522-2586 |
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| subjects | Agreements Arthritis Biocompatibility Biomarkers Biomedical materials Bone marrow Cartilage Cartilage diseases Coefficient of variation Confidence intervals Cysts DESS Field strength Knee Lesions Magnetic resonance imaging Mathematical analysis Meniscus MOAKS Morphometry Osteoarthritis Osteophytes Rank tests Reproducibility Sensitivity analysis Statistical analysis Statistical tests |
| title | Five‐minute knee MRI for simultaneous morphometry and T2 relaxometry of cartilage and meniscus and for semiquantitative radiological assessment using double‐echo in steady‐state at 3T |
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