Systematic review and meta-analysis of the reliability and discriminative validity of cartilage compositional MRI in knee osteoarthritis

Abstract

Objective: To assess reliability and discriminative validity of cartilage compositional magnetic resonance imaging (MRI) in knee osteoarthritis (OA). Design: The study was carried out per PRISMA recommendations. We searched MEDLINE and EMBASE (1974 e present) for eligible studies. We performed qualitative synthesis of reliability data. Where data from at least two discrimination studies were available, we estimated pooled standardized mean difference (SMD) between subjects with and without OA. Discrimination analyses compared controls and subjects with mild OA (KellgreneLawrence (KL) grade 1e2), severe OA (KL grade 3e4) and OA not otherwise specified (NOS) where not possible to stratify. We assessed quality of the evidence using Quality Appraisal of Diagnostic Reliability (QAREL) and Quality Assessment of Diagnostic Accuracy (QUADAS-2) tools. Results: Fifty-eight studies were included in the reliability analysis and 26 studies were included in the discrimination analysis, with data from a total of 2,007 knees. Intra-observer, inter-observer and testeretest reliability of compositional techniques were excellent with most intraclass correlation coefficients >0.8 and coefficients of variation <10%. T1rho and T2 relaxometry were significant discriminators between subjects with mild OA and controls, and between subjects with OA (NOS) and controls (P < 0.001). T1rho showed best discrimination for mild OA (SMD [95% CI] ¼ 0.73 [0.40 to 1.06], P < 0.001) and OA (NOS) (0.60 [0.41 to 0.80], P < 0.001). Quality of evidence was moderate for both parts of the review. Conclusions: Cartilage compositional MRI techniques are reliable and, in the case of T1rho and T2 relaxometry, can discriminate between subjects with OA and controls.

Rapid compositional mapping of knee cartilage with compressed sensing MRI

“…It is known that T 2 is sensitive to water, collagen content, and tissue anisotropy . In MacKay et al, it is shown that T 2 is usually higher in knee OA patients, compared to healthy subjects, with significant differences between subjects (standardized mean difference of 0.49). The acceleration of T 2 mapping using CS was among the first applications for knee cartilage, where radial acquisition and PCA sparsity were used to demonstrate the possibility of reducing the acquisition time by 8 times, requiring 2 minutes and 17 seconds, with little loss compared to the gold standard …”

“…For osteoarthritis (OA), a recent meta‐analysis validated the reliability (compiling 58 studies) and discriminative ability (compiling 26 studies) of cartilage compositional MRI mapping in the knee, where T 2 and T 1ρ relaxometry demonstrated discrimination validity in mild OA. This can help us to detect the early stages of OA …”

“…For human knee cartilage, quantitative relaxation mapping is able to reveal biochemical changes in cartilage composition before morphological changes occur. 4,5 For osteoarthritis (OA), a recent meta-analysis validated the reliability (compiling 58 studies) and discriminative ability (compiling 26 studies) of cartilage compositional MRI mapping in the knee, 6,7 where T 2 and T 1ρ relaxometry demonstrated discrimination validity in mild OA. This can help us to detect the early stages of OA.…”

High-Impact Exercise Increased Femoral Neck Bone Density With No Adverse Effects on Imaging Markers of Knee Osteoarthritis in Postmenopausal Women

“…1). (26) Semiquantitative scoring Sagittal proton density fat saturated sequences (TR = automatic [approximately 4000 ms], TE = 30 ms, ETL/echoes = 8, slice thickness = 3 mm with no gap, FOV = 16 cm, matrix = 384 × 288, acquisition time = 4 min 58 s) were acquired of each knee during the same scanning session as the T2 maps. (24) Specifically, four regions of condylar cartilage were defined for the medial and lateral tibial and femoral condyles, using bony landmarks and lateral borders of the bones.…”

Biexponential T1ρ relaxation mapping of human knee menisci

“…[12][13][14][15][16] T 1ρ is sensitive to the slow-motional interactions between local macromolecular environments and bulk water 17 and as a result to proteoglycan content in the tissue, 18 while T 2 is found to be sensitive to the collagen fibril orientation and anisotropy. 19,20 Furthermore, a recent meta-analysis 21 study validated the reliability (compiling 58 studies) and discriminative ability (compiling 26 studies) of T 1ρ and T 2 compositional mapping of knee cartilage, especially in mild knee OA as a motivation. T 1ρ showed better discrimination for mild OA and OA compared to T 2 .…”