Sensitivity to change of cartilage morphometry using coronal FLASH, sagittal DESS, and coronal MPR DESS protocols – comparative data from the osteoarthritis initiative (OAI)

Abstract

Objective The Osteoarthritis Initiative (OAI) is targeted at identifying sensitive biomarkers and risk factors of symptomatic knee OA onset and progression. Quantitative cartilage imaging in the OAI relies on validated FLASH sequences that suffer from relatively long acquisition times, and on a near-isotropic double echo steady state (DESS) sequence. We therefore directly compared the sensitivity to cartilage thickness changes and the correlation of these protocols longitudinally. Methods Baseline and 12 month followup data of 80 knees were acquired using 1.5mm coronal FLASH and 0.7mm sagittal DESS sequences. In these and in 1.5mm coronal multiplanar reconstructions (MPR) of the DESS the medial femorotibial cartilage was segmented with blinding to acquisition order. In the weight-bearing femoral condyle, a 60% (distance trochlear notch to posterior femur) and 75% region of interest (ROI) were studied. Results The standardized response mean (SRM=mean change /standard deviation of change) in central medial femorotibial (cMFTC) cartilage thickness was −0.34 for coronal FLASH, −0.37 for coronal MPR DESS, −0.36 for sagittal DESS with the 60% ROI, and −0.38 for the 75% ROI. Using every 2nd 0.7mm sagittal slice (DESS) yielded similar SRMs in cMFTC for the 60% and 75% ROI from odd (−0.35/−0.36) and even slice numbers (−0.36/−0.39), respectively. Baseline cartilage thickness displayed high correlations (r≥0.94) between the three protocols; the correlations of longitudinal changes were ≥0.79 (Pearson) and ≥0.45 (Spearman). Conclusions Cartilage morphometry with FLASH and DESS display similar longitudinal sensitivity to change. Analysis of every second slice of the 0.7mm DESS provides adequate sensitivity to change.

Mapping tibiofemoral gonarthrosis: an MRI analysis of non-traumatic knee cartilage defects

“…9,25,[29][30][31][32] In the present study, joint cartilage was examined using the 3D-DESS sequence on a 3-T MRI scanner, which various studies have shown to be very well suited for this purpose and, therefore, has served as a standard of reference in cartilage imaging in many major preceeding studies. [9][10][11] In addition to visualizing the actual cartilage thickness plus adequate contrasting of the cartilage-bone border, this sequence has the advantage of enabling multiplanar 3D reconstruction, thus allowing detailed evaluation of joint cartilage lesions. 10,11,33 Based on the current development of various cartilage-specific sequences for improving sensitivity, the status of 3-T MRI as an accurate diagnostic tool, especially for grade III and IV cartilage defects, can be confirmed.…”

“…[9][10][11] In addition to visualizing the actual cartilage thickness plus adequate contrasting of the cartilage-bone border, this sequence has the advantage of enabling multiplanar 3D reconstruction, thus allowing detailed evaluation of joint cartilage lesions. 10,11,33 Based on the current development of various cartilage-specific sequences for improving sensitivity, the status of 3-T MRI as an accurate diagnostic tool, especially for grade III and IV cartilage defects, can be confirmed. 25,30,[34][35][36] von Engelhardt et al 30 reported a uniform (medial, lateral) distribution of grade I/II defects in 3-T MRI examinations.…”

“…4,8 The use of three-dimensional double-echo steady-state (3D-DESS) sequences combined with the standard sequences on a 3-T MRI scanner has provided good diagnostic results and therefore has served as a standard of reference in cartilage imaging in many major preceding studies. [9][10][11] Various classifications of cartilaginous changes of the knee have been applied in the current literature.…”

Diz Eklemi: Kikirdak

“…FLASH tekniğinin kıkırdak defektinin saptanmasındaki tanısal performansı 2D SE ve 3D GRE teknikleri ile benzer olup diz kıkır-dağının morfolojik değerlendirmesinde kabul edilen görüntüleme tekniklerindendir [41]. Ancak bu tekniğin osteoartrit çalışmalarında zamanla oluşan kıkırdak incelmesi ve hacim kaybının değerlendirilmesinde kullanışsız olduğu gösterilmiştir [42]. Yağ baskılama ile veya su uyarılması ile birlikte kullanılabilir.…”

Efficient imaging of midbrain nuclei using inverse double‐echo steady‐state acquisition a)

“…The iDESS sequence originates from the double-echo steady-state (DESS) technique, [20][21][22][23][24][25][26][27] with the main difference in the order of echo acquisition. Figure 1(a) plots the schematic sequence diagram including the readout gradient waveforms of the DESS sequence.…”