title: Evaluation of the Articular Cartilage of the Knee Joint Using an Isotropic Resolution 3D Fast Spin-Echo Sequence With Conventional and Radial Reformatted Images.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the use of radial reformatted images could improve the diagnostic performance of a 3D fast spin-echo (FSE) sequence for detecting surgically confirmed cartilage lesions within the knee joint.
  
  
  METHODS
  An MRI examination consisting of five 2D FSE sequences and a sagittal 3D FSE sequence was performed at 3 T on the knee joint of 150 patients who underwent subsequent knee arthroscopy, which included grading of the articular cartilage. Conventional axial, sagittal, and coronal reformatted images and radial reformatted images were created from the 3D FSE source data. Two musculoskeletal radiologists independently used the 2D FSE sequences, the 3D FSE sequence with conventional reformatted images only, and the 3D FSE sequence with both radial and conventional reformatted images at three separate sessions to grade each articular surface of the knee joint. McNemar tests were used to compare diagnostic performance for detecting cartilage lesions using arthroscopy as the reference standard.
  
  
  RESULTS
  The 3D FSE sequence with radial and conventional reformatted images had higher sensitivity (p < 0.001) and similar specificity (p = 0.73) to the 2D FSE sequences for detecting cartilage lesions and higher sensitivity (p < 0.001) and specificity (p = 0.002) than the 3D FSE sequence with conventional reformatted images for detecting cartilage lesions. The 3D FSE sequence with conventional reformatted images had similar sensitivity (p = 0.93) and lower specificity (p = 0.005) than did the 2D FSE sequences for detecting cartilage lesions.
  
  
  CONCLUSIONS
  A 3D FSE sequence had improved diagnostic performance compared with 2D FSE sequences for detecting cartilage lesions within the knee joint but only when using both radial and conventional reformatted images for cartilage evaluation.
authors.affiliation: 1 Department of Radiology, Penn State Milton S. Hershey Medical Center, 500 University Dr, Hershey, PA 17033.
authors.forename: Cristy N
authors.initials: CN
authors.lastname: Gustas
authors.affiliation: 2 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Donna G
authors.initials: DG
authors.lastname: Blankenbaker
authors.affiliation: 2 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.|3 Department of Biostatistics, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Alejandro Munoz Del
authors.initials: AM
authors.lastname: Rio
authors.affiliation: 4 Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Carl S
authors.initials: CS
authors.lastname: Winalski
authors.affiliation: 2 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI.
authors.forename: Richard
authors.initials: R
authors.lastname: Kijowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: 3 T; MRI; cartilage; diagnostic performance; morphology