Diagnostic Performance of Three-dimensional MRI for Depicting Cartilage Defects in the Knee: A Meta-Analysis

Abstract

Purpose To determine the diagnostic performance of three-dimensional (3D) MRI for the depiction and characterization of cartilage defects within the knee joint by using arthroscopy and/or open surgery as the standard of reference. Materials and Methods A systematic literature search was performed to extract diagnostic studies published between January 1985 and October 2017. Two independent investigators assessed the methodologic quality of each study by using Quality Assessment of Diagnostic Accuracy Studies 2. Bivariate random-effects model was used to compare the diagnostic odds ratio (DOR) of 3D and two-dimensional (2D) MRI for helping to detect knee cartilage defects and to assess the effect of relevant covariates on diagnostic performance of 3D MRI. Meta-regression analysis was performed to assess DOR of 3D MRI during the last 3 decades. Results Twenty-seven studies (composed of 1710 MRI examinations) were included. Of those, 16 (59%) studies compared the diagnostic performance of 3D and 2D MRI. The diagnostic performance of 3D MRI statistically significantly improved over the last 3 decades (P = .003). Three-dimensional MRI obtained by using 3.0-T field strength had higher DOR relative to 1.5-T or lower field strength (relative DOR, 4.05; P = .01). Three-dimensional multiplanar reformation was associated with higher specificity (P = .001) compared with conventional axial, sagittal, and coronal 2D MRI planes. Three-dimensional fast-spin-echo sequences provided higher sensitivity and specificity (P < .05) than did 2D MRI. Conclusion Three-dimensional MRI currently provides comparable diagnostic performance to two-dimensional MRI, with improvement in diagnostic performance achieved by using 3.0-T field strength, three-dimensional fast-spin-echo sequences, and multiplanar reformation. © RSNA, 2018 Online supplemental material is available for this article.

Cruciate ligament injuries of the knee: A meta‐analysis of the diagnostic performance of 3D MRI

“…6 This is in contrast with prior meta-analyses on diagnostic performance of 3D MRI for internal derangement of other structures of the knee. 46,47 It was previously reported that MPR could improve the specificity of 3D MRI for detection of cartilage defects and meniscal injuries. Also, FSE sequences were shown to have higher sensitivity for detecting lateral meniscal injuries of the knee.…”

“…[7][8][9] 3D sequences also provide thin, continuous sections through the knee joint, which reduces the effects of partial volume averaging. 10 Although prior studies have shown that 3D sequences could provide comparable accuracy to 2D sequences in detecting cartilage defects of the knee, 11 the available data in the current literature regarding the diagnostic performance of 3D sequences for detecting cruciate ligament injuries are conflicting and contradictory. [12][13][14][15][16] While some studies have found that 3D sequences are not as accurate as 2D sequences for detecting cruciate ligament injuries, 12,15 others have suggested that 3D sequences could replace 2D sequences in clinical practice.…”

Preoperative MRI of Articular Cartilage in the Knee: A Practical Approach

“…13 Thus far, however, systematic review and meta-analysis of 3D MRI studies show no improvement over 2D techniques, with pooled sensitivity and specificity of 75% and 93%, respectively, for knee cartilage defects. 14…”

“…Chondral defects are sharply marginated and well shouldered, as opposed to chronic degenerative cartilage loss that has smoother, more ill-defined margins (►Figs. [13][14][15].…”

Artificial Intelligence in Musculoskeletal Imaging: Review of Current Literature, Challenges, and Trends

“…MRI provides morphological data sets as well as compositional techniques, in particular T2 mapping, allowing the assessment of tissue structure, both of which can now be achieved at high resolution in 3D. [34][35][36][37] Currently, the analysis of MRI examinations is mainly based on semiquantitative assessments of morphological sequences. These semiquantitative scoring systems are extremely time consuming, and therefore costly, which also limits their use in clinical practice.…”