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Comparison of a fast 5-min knee MRI protocol with a standard knee MRI protocol: a multi-institutional multi-reader study

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Abstract

Purpose

To compare diagnostic performance of a 5-min knee MRI protocol to that of a standard knee MRI.

Materials and methods

One hundred 3 T (100 patients, mean 38.8 years) and 50 1.5 T (46 patients, mean 46.4 years) MRIs, consisting of 5 fast, 2D multi-planar fast-spin-echo (FSE) sequences and five standard multiplanar FSE sequences, from two academic centers (1/2015–1/2016), were retrospectively reviewed by four musculoskeletal radiologists. Agreement between fast and standard (interprotocol agreement) and between standard (intraprotocol agreement) readings for meniscal, ligamentous, chondral, and bone pathology was compared for interchangeability. Frequency of major findings, sensitivity, and specificity was also tested for each protocol.

Results

Interprotocol agreement using fast MRI was similar to intraprotocol agreement with standard MRI (83.0–99.5%), with no excess disagreement (≤ 1.2; 95% CI, −4.2 to 3.8%), across all structures. Frequency of major findings (1.1–22.4% across structures) on fast and standard MRI was not significantly different (p ≥ 0.215), except more ACL tears on fast MRI (p = 0.021) and more cartilage defects on standard MRI (p < 0.001). Sensitivities (59–100%) and specificities (73–99%) of fast and standard MRI were not significantly different for meniscal and ligament tears (95% CI for difference, −0.08–0.08). For cartilage defects, fast MRI was slightly less sensitive (95% CI for difference, −0.125 to −0.01) but slightly more specific (95% CI for difference, 0.01–0.5) than standard MRI.

Conclusion

A fast 5-min MRI protocol is interchangeable with and has similar accuracy to a standard knee MRI for evaluating internal derangement of the knee.

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Authors and Affiliations

  1. Department of Radiology, Musculoskeletal Division, NYU Langone Medical Center, New York, NY, USA

    Erin FitzGerald Alaia, Luis S. Beltran, Elisabeth Garwood, Christopher J. Burke & Soterios Gyftopoulos

  2. School of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Alex Benedick

  3. Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA

    Nancy A. Obuchowski

  4. Department of Radiology, Musculoskeletal Division, Cleveland Clinic, Cleveland, OH, USA

    Joshua M. Polster, Jean Schils & Naveen Subhas

  5. Texas Scottish Rite Hospital for Children, Dallas, TX, USA

    I-Yuan Joseph Chang

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  1. Erin FitzGerald Alaia
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  2. Alex Benedick
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Corresponding author

Correspondence to Naveen Subhas.

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Conflict of interest

N.O: Siemens AG Research Consultant, Elucid Bioimaging Inc. (unrelated, no conflict for this research study), SG: Federal Grant, Agency for Healthcare Research and Quality (unrelated, no conflict for this research study), NS: Research Grant, Siemens AG (unrelated, no conflict for this research study). The remainder of the authors have no conflict of interest to disclose.

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Alaia, E.F., Benedick, A., Obuchowski, N.A. et al. Comparison of a fast 5-min knee MRI protocol with a standard knee MRI protocol: a multi-institutional multi-reader study. Skeletal Radiol 47, 107–116 (2018). https://doi.org/10.1007/s00256-017-2780-9

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  • DOI: https://doi.org/10.1007/s00256-017-2780-9

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