title: Comparison of a Fast 5-Minute Shoulder MRI Protocol With a Standard Shoulder MRI Protocol: A Multiinstitutional Multireader Study.
abstract: OBJECTIVE
  The purpose of this study was to compare the diagnostic performance of a 5-minute shoulder MRI protocol consisting of multiplanar 2D fast spin-echo (FSE) sequences with parallel imaging to that of a standard shoulder MRI protocol.
  
  
  METHODS
  A retrospective review of 151 3-T MRI examinations of shoulders of 147 patients (mean age, 46.95 years) and 50 1.5-T MRI examinations of shoulders of 50 patients (mean age, 53.74 years) with four fast and five standard sequences from two academic centers between January 2014 and April 2015 was performed by three musculoskeletal radiologists. Interchangeability of fast and standard MRI was tested by comparing interprotocol (fast vs standard) interreader agreement with standard MRI interreader agreement. Interreader agreement was also compared using kappa statistics. The frequency of major findings was compared using an adjusted McNemar test. Sensitivity and specificity of MRI were measured for 51 patients who underwent surgery.
  
  
  RESULTS
  Interprotocol reader agreement was essentially equal to reader agreement on standard MRI (mean difference ≤ 1%; 95% CI, -3.8% to 3.9%; 61-96% across structures). Interprotocol kappa values (0.373-0.645) were similar to standard MRI kappa values (0.320-0.726). Frequencies of major findings on fast and standard MRI were similar (0.7-19.6% across structures; p ≥ 0.08). Sensitivities of fast MRI for tendon and labral tears (33-92%) were equivalent or higher than those of standard MRI with similar specificities (77-98%).
  
  
  CONCLUSIONS
  Fast 5-minute shoulder MRI with multiplanar 2D FSE sequences using parallel imaging is interchangeable, with similar interreader agreement and accuracy, with standard shoulder MRI for evaluating shoulder injuries.
authors.affiliation: 1 Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, A21, Cleveland, OH 44195.
authors.forename: Naveen
authors.initials: N
authors.lastname: Subhas
authors.affiliation: 2 School of Medicine, Case Western Reserve University, Cleveland, OH.
authors.forename: Alex
authors.initials: A
authors.lastname: Benedick
authors.affiliation: 3 Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Obuchowski
authors.affiliation: 1 Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, A21, Cleveland, OH 44195.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Polster
authors.affiliation: 4 Department of Radiology, NYU Langone Medical Center-Hospital for Joint Diseases, New York, NY.
authors.forename: Luis S
authors.initials: LS
authors.lastname: Beltran
authors.affiliation: 1 Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, A21, Cleveland, OH 44195.
authors.forename: Jean
authors.initials: J
authors.lastname: Schils
authors.affiliation: 4 Department of Radiology, NYU Langone Medical Center-Hospital for Joint Diseases, New York, NY.
authors.forename: Gina A
authors.initials: GA
authors.lastname: Ciavarra
authors.affiliation: 4 Department of Radiology, NYU Langone Medical Center-Hospital for Joint Diseases, New York, NY.
authors.forename: Soterios
authors.initials: S
authors.lastname: Gyftopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D016247:Information Storage and Retrieval / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009518:New York; D015588:Observer Variation; D009820:Ohio; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D000070599:Shoulder Injuries / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: MRI; agreement; interchangeability; parallel imaging; shoulder; technique