Can a single isotropic 3D fast spin echo sequence replace three-plane standard proton density fat-saturated knee MRI at 1.5 T?

Abstract

Cite this article as: Pass B, Robinson P, Hodgson R, Grainger AJ. Can a single isotropic 3D fast spin echo sequence replace three-plane standard proton density fat-saturated knee MRI at 1.5 T? Br J Radiol 2015; 88: 20150189. FULL PAPERCan a single isotropic 3D fast spin echo sequence replace three-plane standard proton density fat-saturated knee MRI at 1. Objective: To assess whether a single isotropic threedimensional (3D) fast spin echo (FSE) proton density fat-saturated (PD FS) sequence reconstructed in three planes could replace the three PD (FS) sequences in our standard protocol at 1.5 T (Siemens Avanto, Erlangen, Germany). Methods: A 3D FSE PD water excitation sequence was included in the protocol for 95 consecutive patients referred for routine knee MRI. This was used to produce offline reconstructions in axial, sagittal and coronal planes. Two radiologists independently assessed each case twice, once using the standard MRI protocol and once replacing the standard PD (FS) sequences with reconstructions from the 3D data set. Following scoring, the observer reviewed the 3D data set and performed multiplanar reformats to see if this altered confidence. The menisci, ligaments and cartilage were assessed, and statistical analysis was performed using the standard sequence as the reference standard. Conclusion:A 3D PD FSE sequence reconstructed in three planes gives reduced accuracy and decreased concordance among readers compared with conventional sequences when evaluating the menisci and cartilage with a 1.5-T MRI scanner. Advances in knowledge: Using the existing 1.5-T MR systems, a 3D FSE sequence should not replace twodimensional sequences.

Three-Dimensional Isotropic Fat-Suppressed Proton Density-Weighted MRI at 3 Tesla Using a T/R-Coil Can Replace Multiple Plane Two-Dimensional Sequences in Knee Imaging

“…For instance, a recent study by Pass et al observed reduced agreement between two independent observers for menisci and articular assessment using a 3 D fast spin echo proton density fat-saturated technique compared to the standard 2 D technique at 1.5 Tesla. However, the accuracy, sensitivity and specificity in the detection of knee pathologies were calculated using the standard 2 D protocol as the reference standard in that particular study [30]. Our study involved both quantitative and qualitative parameters to analyze the performance of both techniques and arthroscopic surgery was taken as the reference standard whenever available in a subgroup of 25 % of the patients.…”

Assessment of the usefulness of image reconstruction in the oblique and double-oblique sagittal planes for magnetic resonance imaging of the canine cranial cruciate ligament

“…The images obtained in 3D sequences have high tissue signal intensity, good signal-to-noise ratio (SNR), high image resolution, and fewer volume averaging artefacts. Unfortunately, the image acquisition time in 3D sequences is usually longer than in 2D sequences, which can potentially increase the risk of movement artefacts and cause the sequence to be repeated (35).…”

“…Particular interest in the possibility of image reconstruction can be observed in human medicine. Although it was mainly used in research with the application of high-field devices (16,21,30,34,35,39,47), its use has also been described with low-field systems in operation (31).…”

Are 3D FSE MRI sequences of the knee at 1.5 T effective in the detection of meniscal and ligament tears? How useful are they?

“…Although some authors question the real value of 3D FSE sequences for the diagnosis of meniscal and cartilaginous lesions in 1.5 T MRI scanners, those same authors acknowledge their value in providing better characterization of the injuries and improving diagnostic reliability as well as in reducing the total examination time ( 7 ) . Other researchers, also using 1.5 T scanners, obtained results similar to or even better, in some cases, than those obtained with 2D sequences for the detection of knee injuries ( 8 ) .…”

“…( 8 ) and Pass et al. ( 7 ) , both of whom also employed 1.5 T scanners, presented conflicting results regarding the substitution of volumetric sequences for the traditional 2D protocol in knee evaluations. However, both of those studies emphasized the clinical value of 3D sequences in allowing reformatting in any plane and representing a quicker option for patients in pain or who suffer from claustrophobia ( 2 ) .…”