title: Fast comprehensive single-sequence four-dimensional pediatric knee MRI with T2shuffling.
abstract: To develop and clinically evaluate a pediatric knee magnetic resonance imaging (MRI) technique based on volumetric fast spin-echo (3DFSE) and compare its diagnostic performance, image quality, and imaging time to that of a conventional 2D protocol.
  
  
  
  A 3DFSE sequence was modified and combined with a compressed sensing-based reconstruction resolving multiple image contrasts, a technique termed T2Shuffling (T2Sh). With Institutional Review Board (IRB) approval, 28 consecutive children referred for 3T knee MRI prospectively underwent a standard clinical knee protocol followed by T2Sh. T2Sh performance was assessed by two readers blinded to diagnostic reports. Interpretive discrepancies were resolved by medical record chart review and consensus between the readers and an orthopedic surgeon. Image quality was evaluated by rating anatomic delineation, with 95% confidence interval. A Wilcoxon rank-sum test assessed the null hypothesis that T2Sh structure delineation compared to conventional 2D is unchanged. Intraclass correlation coefficients were calculated for interobserver agreement. Imaging time of the conventional protocol and T2Sh was compared.
  
  
  
  There was 81% and 87% concordance between T2Sh reports and diagnostic reports, respectively, for each reader. Upon consensus review, T2Sh had 93% sensitivity and 100% specificity compared to clinical reports for detection of clinically relevant findings. The 95% confidence interval of diagnostic or better rating was 95-100%, with 34-80% interobserver agreement. There was no significant difference in structure delineation between T2Sh and 2D, except for the retinaculum (P < 0.05), where 2D was preferred. Typical imaging time for T2Sh and the conventional exam was 7 and 13 minutes, respectively.
  
  
  
  A single-sequence pediatric knee exam is feasible with T2Sh, providing multiplanar, reformattable 4D images.
  
  
  
  2 J. MAGN. RESON. IMAGING 2017;45:1700-1711.
authors.affiliation: Department of Radiology, Stanford University, Stanford, California, USA.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Bao
authors.affiliation: Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Tamir
authors.affiliation: Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Young
authors.affiliation: Department of Radiology, Geisinger Health System, Danville, Pennsylvania, USA.
authors.forename: Umar
authors.initials: U
authors.lastname: Tariq
authors.affiliation: Diagnostic and Interventional Radiology, University Medical Center, Goettingen, Germany.|German Center for Cardiovascular Research (DZHK), Goettingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Uecker
authors.affiliation: Global Applied Science Laboratory, GE Healthcare, Menlo Park, California, USA.
authors.forename: Peng
authors.initials: P
authors.lastname: Lai
authors.affiliation: Global Applied Science Laboratory, GE Healthcare, Menlo Park, California, USA.
authors.forename: Weitian
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Lustig
authors.affiliation: Department of Radiology, Stanford University, Stanford, California, USA.
authors.forename: Shreyas S
authors.initials: SS
authors.lastname: Vasanawala
mesh_terms: D000293:Adolescent; D000465:Algorithms; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted
keywords: CUBE; SPACE; compressed sensing; knee MRI; pediatric; volumetric