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3D CAIPIRINHA SPACE versus standard 2D TSE for routine knee MRI: a large-scale interchangeability study

  • Magnetic Resonance
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Abstract

Objective

To perform a large-scale interchangeability study comparing 3D controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) sampling perfection with application optimized contrast using different flip angle evolutions (SPACE) TSE with standard 2D TSE for knee MRI.

Methods

In this prospective study, 250 patients underwent 3 T knee MRI, including a multicontrast 3D CAIPIRINHA SPACE TSE (9:26 min) and a standard 2D TSE protocol (12:14 min). Thirty-three (13%) patients had previous anterior cruciate ligament and/or meniscus surgery. Two radiologists assessed MRIs for image quality and identified pathologies of menisci, ligaments, and cartilage by using a 4-point Likert scale according to the level of diagnostic confidence. Interchangeability of the protocols was tested under the same-reader scenario using a bootstrap percentile confidence interval. Interreader reliability and intermethod concordance were also evaluated.

Results

Despite higher image quality and diagnostic confidence for standard 2D TSE compared to 3D CAIPIRINHA SPACE TSE, the protocols were found interchangeable for diagnosing knee abnormalities, except for patellar (6.8% difference; 95% CI: 4.0, 9.6) and trochlear (3.6% difference; 95% CI: 0.8, 6.6) cartilage defects. The interreader reliability was substantial to almost perfect for 2D and 3D MRI (range κ, 0.785–1 and κ, 0.725–0.964, respectively). Intermethod concordance was almost perfect for all diagnoses (range κ, 0.817–0.986).

Conclusion

Multicontrast 3D CAIPIRINHA SPACE TSE and standard 2D TSE protocols perform interchangeably for diagnosing knee abnormalities, except for patellofemoral cartilage defects. Despite the radiologist’s preference for 2D TSE imaging, a pursuit towards time-saving 3D TSE knee MRI is justified for routine practice.

Key Points

• Multicontrast 3D CAIPIRINHA SPACE and standard 2D TSE protocols perform interchangeably for diagnosing knee abnormalities, except for patellofemoral cartilage defects.

• Radiologists are more confident in diagnosing knee abnormalities on 2D TSE than on 3D CAIPIRINHA SPACE TSE MRI.

• Despite the radiologist’s preference for 2D TSE, a pursuit towards accelerated 3D TSE knee MRI is justified for routine practice.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

ACL:

Anterior cruciate ligament

CAIPIRINHA:

Controlled aliasing in parallel imaging results in higher acceleration

CS:

Compressed sensing

DL:

Deep learning

MPR:

Multiplanar reformation

MRI:

Magnetic resonance imaging

PI:

Parallel imaging

SMS:

Simultaneous multislice

SPACE:

Sampling perfection with application optimized contrast using different flip angle evolutions

SPAIR:

Spectral attenuated inversion recovery

TSE:

Turbo spin echo

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Acknowledgements

We thank all radiographers operating the MRI scanner.

Funding

Céline Smekens is supported by the B-Q MINDED project (EU H2020 MSCA ETN #764513) and the University of Antwerp (Bijzonder Onderzoeksfonds/SEP #44883).

Author information

Authors and Affiliations

  1. Department of Radiology, Antwerp University Hospital (UZA), Drie Eikenstraat 655, B-2650, Edegem, Belgium

    Pieter Van Dyck, Thijs Vande Vyvere, Annemiek Snoeckx & Eline De Smet

  2. mVISION, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Antwerp, Belgium

    Pieter Van Dyck & Annemiek Snoeckx

  3. Imec-Vision Lab, Department of Physics, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Antwerp, Belgium

    Céline Smekens

  4. Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, University of Antwerp, Drie Eikenstraat 655, 2650, Edegem, Belgium

    Ella Roelant

  5. MOVANT, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Antwerp, Belgium

    Thijs Vande Vyvere

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  1. Pieter Van Dyck
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Correspondence to Pieter Van Dyck.

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The scientific guarantor of this publication is Pieter Van Dyck.

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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors (Ella Roelant) has significant statistical expertise.

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Van Dyck, P., Smekens, C., Roelant, E. et al. 3D CAIPIRINHA SPACE versus standard 2D TSE for routine knee MRI: a large-scale interchangeability study. Eur Radiol 32, 6456–6467 (2022). https://doi.org/10.1007/s00330-022-08715-5

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  • DOI: https://doi.org/10.1007/s00330-022-08715-5

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