Radiology: FSE-Cube efficacious in 3T MR knee imaging
Fast spin-echo sequence (FSE)-Cube has similar diagnostic performance as a routine MR imaging protocol for detecting cartilage lesions, cruciate ligament tears, collateral ligament tears, meniscal tears and bone marrow edema lesions within the knee joint at 3T, according to a prospective study in this month’s issue of Radiology.
The authors said that 3D FSE sequences produce images with intermediate-weighted contrast, which is the most commonly used tissue contrast in musculoskeletal MRI.
Richard Kijowski, MD, from the department of radiology at the University of Wisconsin, Clinical Science Center in Madison, and colleagues sought to determine whether a 3D isotropic resolution FSE-Cube has similar diagnostic performance as a routine MRI protocol for evaluating the cartilage, ligaments, menisci and osseous structures of the knee joint in symptomatic patients at 3T.
According to the researchers, this HIPAA-compliant, institutional review board–review approved study was performed with a waiver of informed consent. FSE-Cube was added to the routine 3T MRI protocol performed in 100 symptomatic patients (54 male patients with a median age of 32 years and 46 female patients with a median age of 33 years) who subsequently underwent arthroscopic knee surgery. Two musculoskeletal radiologists independently reviewed all MRI studies twice.
During the first review, the authors said that routine MRI protocol was used to detect cartilage lesions, ligament tears, meniscal tears and bone marrow edema lesions. During the second review, FSE-Cube with multiplanar reformations was used to detect these joint abnormalities. With arthroscopic results as the reference standard, the sensitivity and specificity of FSE-Cube and the routine MRI protocol in the detection of cartilage lesions, anterior cruciate ligament tears, and meniscal tears were calculated. They used permutation tests to compare sensitivity and specificity values.
The investigators found that FSE-Cube had significantly higher sensitivity (p = .039) but significantly lower specificity (p = .003) than the routine MRI protocol for detecting cartilage lesions. There were no significant differences (p = .183–.999) in sensitivity and specificity between FSE-Cube and the routine MRI protocol in the detection of anterior cruciate ligament tears, medial meniscal tears or lateral meniscal tears.
Kijowski and colleagues found that FSE-Cube depicted 96.2 percent of medial collateral ligament tears, 100 percent of lateral collateral ligament tears and 85.3 percent of bone marrow edema lesions identified on images obtained with the routine MRI protocol.
The authors also noted that the difference between readers in the number of false-positive interpretations was similar for both FSE-Cube and the routine MRI protocol, and this resulted in similar interobserver agreements for determining the presence or absence of medial meniscus tears.
The authors said that 3D FSE sequences produce images with intermediate-weighted contrast, which is the most commonly used tissue contrast in musculoskeletal MRI.
Richard Kijowski, MD, from the department of radiology at the University of Wisconsin, Clinical Science Center in Madison, and colleagues sought to determine whether a 3D isotropic resolution FSE-Cube has similar diagnostic performance as a routine MRI protocol for evaluating the cartilage, ligaments, menisci and osseous structures of the knee joint in symptomatic patients at 3T.
According to the researchers, this HIPAA-compliant, institutional review board–review approved study was performed with a waiver of informed consent. FSE-Cube was added to the routine 3T MRI protocol performed in 100 symptomatic patients (54 male patients with a median age of 32 years and 46 female patients with a median age of 33 years) who subsequently underwent arthroscopic knee surgery. Two musculoskeletal radiologists independently reviewed all MRI studies twice.
During the first review, the authors said that routine MRI protocol was used to detect cartilage lesions, ligament tears, meniscal tears and bone marrow edema lesions. During the second review, FSE-Cube with multiplanar reformations was used to detect these joint abnormalities. With arthroscopic results as the reference standard, the sensitivity and specificity of FSE-Cube and the routine MRI protocol in the detection of cartilage lesions, anterior cruciate ligament tears, and meniscal tears were calculated. They used permutation tests to compare sensitivity and specificity values.
The investigators found that FSE-Cube had significantly higher sensitivity (p = .039) but significantly lower specificity (p = .003) than the routine MRI protocol for detecting cartilage lesions. There were no significant differences (p = .183–.999) in sensitivity and specificity between FSE-Cube and the routine MRI protocol in the detection of anterior cruciate ligament tears, medial meniscal tears or lateral meniscal tears.
Kijowski and colleagues found that FSE-Cube depicted 96.2 percent of medial collateral ligament tears, 100 percent of lateral collateral ligament tears and 85.3 percent of bone marrow edema lesions identified on images obtained with the routine MRI protocol.
The authors also noted that the difference between readers in the number of false-positive interpretations was similar for both FSE-Cube and the routine MRI protocol, and this resulted in similar interobserver agreements for determining the presence or absence of medial meniscus tears.