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Synthetic MRI is not yet ready for morphologic and functional assessment of patellar cartilage at 1.5 Tesla - 25/02/21

Doi : 10.1016/j.diii.2020.09.002 
C. Vogrig a, , J.-S. Louis b, F. Avila a, R. Gillet a, G. Hossu b, A. Blum-Moyse a, P.A. Gondim Teixeira a
a Guilloz Imaging Department, Central Hospital, Regional University Hospital Center of Nancy (CHRU-Nancy), 54000 Nancy, France 
b Centre d’Investigation Clinique et d’Innovation Technologique, Université de Lorraine, Inserm, IADI, 54000 Nancy, France 

Corresponding author.

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Highlights

Synthetic MRI acquisitions help decrease examination time compared to conventional MRI sequences.
Synthetic MRI yields more motion artifacts and less spatial resolution compared to conventional MRI.
Synthetic MRI shows lower diagnostic performance for early patellar cartilage chondropathy compared to conventional MRI.
Mean patellar cartilage T2 values are systematically overestimated on synthetic MRI.

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Abstract

Purpose

The purpose of this study was to compare morphologic assessment and relaxometry of patellar hyaline cartilage between conventional sequences (fast spin-echo [FSE] T2-weighted fat-saturated and T2-mapping) and synthetic T2 short-TI inversion recovery (STIR) and T2 maps at 1.5T magnetic resonance imaging (MRI).

Method

The MRI examinations of the knee obtained at 1.5T in 49 consecutive patients were retrospectively studied. There were 21 men and 28 women with a mean age of 45±17.7 (SD) years (range: 18–88 years). Conventional and synthetic acquisitions were performed, including T2-weighted fat-saturated and T2-mapping sequences. Two radiologists independently compared patellar cartilage T2-relaxation time on conventional T2-mapping and synthetic T2-mapping images. A third radiologist evaluated the patellar cartilage morphology on conventional and synthetic T2-weighted images. The presence of artifacts was also assessed. Interobserver agreement for quantitative variables was assessed using intraclass correlation coefficient (ICC).

Results

In vitro, conventional and synthetic T2 maps yielded similar mean T2 values 58.5±2.3 (SD) ms and 58.8±2.6 (SD) ms, respectively (P=0.414) and 6% lower than the expected experimental values (P=0.038). Synthetic images allowed for a 15% reduction in examination time compared to conventional images. On conventional sequences, patellar chondropathy was identified in 35 patients (35/49; 71%) with a mean chondropathy grade of 4.8±4.8 (SD). On synthetic images, 28 patients (28/49; 57%) were diagnosed with patellar chondropathy, with a significant 14% difference (P=0.009) and lower chondropathy scores (3.7±4.9 [SD]) compared to conventional images. Motion artifacts were more frequently observed on synthetic images (18%) than on conventional ones (6%). The interobserver agreement was excellent for both conventional and synthetic T2 maps (ICC>0.83). Mean cartilage T2 values were significantly greater on synthetic images (36.2±3.8 [SD] ms; range: 29-46ms) relative to conventional T2 maps (31.8±4.1 [SD] ms; range: 26-49ms) (P<0.0001).

Conclusion

Despite a decrease in examination duration, synthetic images convey lower diagnostic performance for chondropathy, greater prevalence of motion artifacts, and an overestimation of T2 values compared to conventional MRI sequences.

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Keywords : Magnetic resonance imaging (MRI), Knee joint, T2 relaxation time, Cartilage diseases, Observer variation

Abbreviations : FSE, ICC, MRI, PD, ROI, SD, STIR, TE, TR, WORMS


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© 2020  Société française de radiologie. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 102 - N° 3

P. 181-187 - marzo 2021 Ritorno al numero
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