Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

Christoph A. Agten, Filippo Del Grande, Sandro F. Fucentese, Samuel Blatter, Christian W A Pfirrmann, Reto Sutter

Research output: Contribution to journalArticle

Abstract

Objectives: To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Methods: Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. Results: SEMAC reduced mean artefact size for STIR (11.8 cm2 vs. 37.7 cm2) and PD (16.8 cm2 vs. 18.9 cm2), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. Conclusions: STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons’ decisions towards surgery, while PD-SEMAC showed no clinical benefit. Key Points: • Slice-encoding for metal artefact correction (SEMAC) MRI reduces metal-induced artefact size. • STIR SEMAC detects more bone marrow oedema in painful unicompartmental knee arthroplasty. • STIR SEMAC can help the orthopaedic surgeon with decision making. • PD SEMAC suffers from blurring of images, potentially masking relevant meniscal lesions. • PD SEMAC does not improve cartilage lesion detection in the non-operated compartments.

Original languageEnglish (US)
Pages (from-to)2184-2193
Number of pages10
JournalEuropean Radiology
Volume25
Issue number7
DOIs
StatePublished - Jul 8 2015
Externally publishedYes

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Knee Replacement Arthroplasties
Artifacts
Metals
Protons
Therapeutics
Edema
Bone Marrow

Keywords

  • Artefacts
  • Decision making
  • Knee replacement arthroplasty
  • MRI
  • SEMAC

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Unicompartmental knee arthroplasty MRI : impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision. / Agten, Christoph A.; Del Grande, Filippo; Fucentese, Sandro F.; Blatter, Samuel; Pfirrmann, Christian W A; Sutter, Reto.

In: European Radiology, Vol. 25, No. 7, 08.07.2015, p. 2184-2193.

Research output: Contribution to journalArticle

Agten, Christoph A. ; Del Grande, Filippo ; Fucentese, Sandro F. ; Blatter, Samuel ; Pfirrmann, Christian W A ; Sutter, Reto. / Unicompartmental knee arthroplasty MRI : impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision. In: European Radiology. 2015 ; Vol. 25, No. 7. pp. 2184-2193.
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abstract = "Objectives: To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Methods: Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. Results: SEMAC reduced mean artefact size for STIR (11.8 cm2 vs. 37.7 cm2) and PD (16.8 cm2 vs. 18.9 cm2), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. Conclusions: STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons’ decisions towards surgery, while PD-SEMAC showed no clinical benefit. Key Points: • Slice-encoding for metal artefact correction (SEMAC) MRI reduces metal-induced artefact size. • STIR SEMAC detects more bone marrow oedema in painful unicompartmental knee arthroplasty. • STIR SEMAC can help the orthopaedic surgeon with decision making. • PD SEMAC suffers from blurring of images, potentially masking relevant meniscal lesions. • PD SEMAC does not improve cartilage lesion detection in the non-operated compartments.",
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T2 - impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

AU - Agten, Christoph A.

AU - Del Grande, Filippo

AU - Fucentese, Sandro F.

AU - Blatter, Samuel

AU - Pfirrmann, Christian W A

AU - Sutter, Reto

PY - 2015/7/8

Y1 - 2015/7/8

N2 - Objectives: To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Methods: Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. Results: SEMAC reduced mean artefact size for STIR (11.8 cm2 vs. 37.7 cm2) and PD (16.8 cm2 vs. 18.9 cm2), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. Conclusions: STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons’ decisions towards surgery, while PD-SEMAC showed no clinical benefit. Key Points: • Slice-encoding for metal artefact correction (SEMAC) MRI reduces metal-induced artefact size. • STIR SEMAC detects more bone marrow oedema in painful unicompartmental knee arthroplasty. • STIR SEMAC can help the orthopaedic surgeon with decision making. • PD SEMAC suffers from blurring of images, potentially masking relevant meniscal lesions. • PD SEMAC does not improve cartilage lesion detection in the non-operated compartments.

AB - Objectives: To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Methods: Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. Results: SEMAC reduced mean artefact size for STIR (11.8 cm2 vs. 37.7 cm2) and PD (16.8 cm2 vs. 18.9 cm2), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. Conclusions: STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons’ decisions towards surgery, while PD-SEMAC showed no clinical benefit. Key Points: • Slice-encoding for metal artefact correction (SEMAC) MRI reduces metal-induced artefact size. • STIR SEMAC detects more bone marrow oedema in painful unicompartmental knee arthroplasty. • STIR SEMAC can help the orthopaedic surgeon with decision making. • PD SEMAC suffers from blurring of images, potentially masking relevant meniscal lesions. • PD SEMAC does not improve cartilage lesion detection in the non-operated compartments.

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KW - Decision making

KW - Knee replacement arthroplasty

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KW - SEMAC

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