title: Assessment of cartilage-dedicated sequences at ultra-high-field MRI: comparison of imaging performance and diagnostic confidence between 3.0 and 7.0 T with respect to osteoarthritis-induced changes at the knee joint.
abstract: OBJECTIVE
  The objectives of the study were to optimize three cartilage-dedicated sequences for in vivo knee imaging at 7.0 T ultra-high-field (UHF) magnetic resonance imaging (MRI) and to compare imaging performance and diagnostic confidence concerning osteoarthritis (OA)-induced changes at 7.0 and 3.0 T MRI.
  
  
  METHODS
  Optimized MRI sequences for cartilage imaging at 3.0 T were tailored for 7.0 T: an intermediate-weighted fast spin-echo (IM-w FSE), a fast imaging employing steady-state acquisition (FIESTA) and a T1-weighted 3D high-spatial-resolution volumetric fat-suppressed spoiled gradient-echo (SPGR) sequence. Three healthy subjects and seven patients with mild OA were examined. Signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), diagnostic confidence in assessing cartilage abnormalities, and image quality were determined. Abnormalities were assessed with the whole organ magnetic resonance imaging score (WORMS). Focal cartilage lesions and bone marrow edema pattern (BMEP) were also quantified.
  
  
  RESULTS
  At 7.0 T, SNR was increased (p < 0.05) for all sequences. For the IM-w FSE sequence, limitations with the specific absorption rate (SAR) required modifications of the scan parameters yielding an incomplete coverage of the knee joint, extensive artifacts, and a less effective fat saturation. CNR and image quality were increased (p < 0.05) for SPGR and FIESTA and decreased for IM-w FSE. Diagnostic confidence for cartilage lesions was highest (p < 0.05) for FIESTA at 7.0 T. Evaluation of BMEP was decreased (p < 0.05) at 7.0 T due to limited performance of IM-w FSE.
  
  
  CONCLUSIONS
  Gradient echo-based pulse sequences like SPGR and FIESTA are well suited for imaging at UHF which may improve early detection of cartilage lesions. However, UHF IM-w FSE sequences are less feasible for clinical use.
authors.affiliation: Musculoskeletal and Quantitative Imaging Group, Department of Radiology, University of California, San Francisco, CA 94107-0946, USA. Robert.Stahl@radiology.ucsf.edu
authors.forename: Robert
authors.initials: R
authors.lastname: Stahl
authors.forename: Roland
authors.initials: R
authors.lastname: Krug
authors.forename: Douglas A C
authors.initials: DA
authors.lastname: Kelley
authors.forename: Jin
authors.initials: J
authors.lastname: Zuo
authors.forename: C Benjamin
authors.initials: CB
authors.lastname: Ma
authors.forename: Sharmila
authors.initials: S
authors.lastname: Majumdar
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Link
mesh_terms: D000328:Adult; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D020370:Osteoarthritis, Knee; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity