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Development of a technique for MRI gold-standard direct volumetric measurement of complex joint effusion, and validation at the hip

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Abstract

Objective

Accurate joint fluid quantification on MRI cannot simply rely on measuring the maximum fluid depth or using an ellipsoid approximation as this does not fully characterize the complex shape of a fluid-filled joint. As per the Outcome Measurement in Rheumatology (OMERACT) filter, we sought to evaluate the feasibility, reliability, and validity of a semi-automated supervised technique to quantify hip effusion volume.

Materials and methods

Ninety-three hip osteoarthritis patients were imaged with coronal short TI inversion recovery (STIR) and sagittal intermediate weighted fat-suppressed (IWFS) sequences at two time points (Fig. 1). Volumetric quantitative measurement (VQM) of joint fluid and measurement of the largest femoral neck fluid thickness (FTM) was performed using the custom MATLAB software. Self-reported Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and clinical measures of pain, stiffness, and function were recorded.

Results

Inter-observer reliability was significantly higher for VQM than FTM (ICC = 0.96 vs. 0.85, p < 0.05). VQM and FTM correlated moderately (r = 0.76, p < 0.0001). There was significantly more articular fluid in symptomatic than asymptomatic hips at baseline (mean = 9.8 vs. 5.9 mL). Volumetric quantitative measurement generally displayed more frequent and stronger correlations to clinical parameters than FTM. Volumetric quantitative measurement required 3.9 min/hip vs. < 1 min/hip for femoral neck fluid thickness.

Conclusion

Volumetric quantitative measurement of joint effusion can serve as an MRI gold-standard, could apply to other joints and collections, and is highly suited to future automation.

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Acknowledgments

We would like to acknowledge Dr. Abhilash Hareendranathan’s assistance in this manuscript.

Funding

The work was funded by the Alberta Health Services Chair in Diagnostic Imaging (currently held by Dr. Jaremko).

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Authors and Affiliations

  1. Department of Radiology, University of Alberta Hospital & Stollery Children’s Hospital, 2J2.00 WC Mackenzie Health Sciences Centre, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada

    Vanessa Quinn-Laurin, Bashiar Thejeel, Kieran J. D. Steer, Robert G. W. Lambert & Jacob L. Jaremko

  2. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada

    Geoffrey P. Bostick

  3. Central Alberta Medical Imaging Services, Red Deer, Canada

    Ramin Mandegaran

  4. Medical Imaging Consultants, Edmonton, Canada

    Robert G. W. Lambert & Jacob L. Jaremko

Authors
  1. Vanessa Quinn-Laurin
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  2. Geoffrey P. Bostick
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Correspondence to Jacob L. Jaremko.

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Conflict of interest

Dr. Ramin Mandegaran is a medical advisor for ThinkSono. Dr. Robert GW Lambert provides consultation for CareArthritis, Image Analysis Group, and Parexel. All other authors declare that they have no conflict of interest.

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Quinn-Laurin, V., Bostick, G.P., Thejeel, B. et al. Development of a technique for MRI gold-standard direct volumetric measurement of complex joint effusion, and validation at the hip. Skeletal Radiol 50, 781–787 (2021). https://doi.org/10.1007/s00256-020-03630-6

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  • DOI: https://doi.org/10.1007/s00256-020-03630-6

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